Polymer-supported synthesis of pyridone-focused libraries as inhibitors of anaplastic lymphoma kinase.
The optimization of screening hits on a promising new target for therapy of certain cancers involving anaplastic lymphoma kinase (ALK) inspired the development of this efficient solid-phase chemistry. A series of novel pyridones have been recently discovered as inhibitors of ALK, which led to the design of focused libraries around the pyridone scaffold. A stepwise process involving iterative template modification based on both medicinal chemistry insights and computational ranking of virtual libraries was employed in the design. The unique solid-phase chemistry has addressed the need for rapid optimization of this "early lead" series. Herein the methodology and scope of the chemistry, as well as its application for library synthesis, are discussed.


Effects of electrokinetics and cationic surfactant cetyltrimethylammonium bromide [CTAB] on the hydrocarbon removal and retention from contaminated soils.
Hydrocarbon contaminated soil and groundwater is considered to be a leading cause for increased health risk and environmental contamination. Therefore, an efficient technique is needed to retard the movement or enhance the removal of the contaminant depending on the remediation objective. The goals of this study were to evaluate the impact of the addition of a cationic surfactant on the movement of hydrocarbons within a contaminated clay soil subjected to electrokinetic treatment. Water-flushing and surfactant-flushing experiments were conducted on one-dimensional soil columns. The model diesel fuel was composed of a mixture of benzene, toluene, ethylbenzene, xylenes [BTEX] and three selected polycyclic hydrocarbons [PAHs]. In the water-flushing experiments, the application of an electrokinetic treatment was found to enhance the removal of PAHs from the clay columns by about 20%. In contrast, the application of an electrokinetic treatment, when coupled with cationic surfactant-flushing, retarded the movement of BTEX and the three selected PAHs in the clay columns. Hydraulic columns with surfactant (CTAB) removed 17% more naphthalene and 11% more 2-methylnaphthalene compared to columns subjected to electrokinetic treatment with CTAB. The flux through the electrokinetic columns during water flushing as well as surfactant flushing was higher than the flux due to hydraulic gradient alone. As the solubility of hydrocarbons increased, they moved farther with electrokinetic treatment without CTAB. However, with CTAB the electrokinetic treatment tends to retard the movement. Use of a cationic surfactant coupled with electrokinetic treatment was found to retard the movement of contaminants.


Diagnosis and management of tumor lysis syndrome.
Tumor lysis syndrome (TLS) is an oncological emergency characterized by a classic tetrad of hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Risk assessment and prophylactic therapy is critical in preventing this oncological emergency. Treatment of established TLS involves aggressive hydration, electrolyte management, and the use of hypouricemic agents.


Spared feature-structure discrimination but diminished salience of environmental geometry in hippocampal-lesioned homing pigeons (Columba livia).
Homing pigeons (Columba livia) were trained to locate a goal in one corner of a rectangular arena by either its shape (geometry) or the left-right configuration of colored features located in each corner (feature structure). Control and hippocampal-lesioned pigeons learned at a similar rate, but the control birds made proportionally more geometric errors during acquisition. On conflict probe trials, the control birds preferred geometrically correct corners, whereas the hippocampal-lesioned birds displayed a greater preference for the correct corner defined by feature structure. On geometry-only probe trials, both groups demonstrated an ability to identify the goal location. Hippocampal lesions do not interfere with goal recognition by the feature structure of local cues but diminish the salience of arena shape.


Medical practice in the face of economic meltdown: peculiar challenges in Nigeria and other developing countries.
The impact of the global economic meltdown on every sector of economic activity has been enormous, especially in the developing countries. Medical practice in these nations has been particularly challenged and stretched under this milieu. This paper thus sets out to evaluate the phenomenon of economic meltdown with its effects on the developing countries, the challenges it poses to medical practice, with Nigeria as a case study, and makes suggestions to address this scenario. A review of the literature on economic meltdown with particular emphasis on the effect on medical practice, was done, with focus on the developing countries, and specifically Nigeria. Literature search was conducted using the Medline, Google search engine, the media, as well as national and localjournals. The definition and historical perspectives of global economic meltdown, as well as the geographical location of the developing countries, are set out. The peculiar economic challenges and those in the medical practice, with the concomitant glaring effects in the developing nations, with particular reference to the Nigerian situation, are outlined. Specific measures to adopt in addressing these challenges are suggested in this paper. The peculiar challenges of the global economic meltdown on medical practice in the developing world, and in Nigeria particularly, must be addressed wholisticaly involving every sector of the economy, with fundamental policy and structural changes put in place.


High-Quality Mixed-Organic-Cation Perovskites from a Phase-Pure Non-stoichiometric Intermediate (FAI)1- x -PbI2 for Solar Cells.
A high-quality mixed-organic-cation perovskite (MA)x (FA)1- x PbI3 is prepared from a phase-pure non-stoichiometric intermediate complex (FAI)1- x -PbI2 . The phase-pure (FAI)1- x -PbI2 probably facilitates homogenous nucleation and modulates the growth kinetics during the crystallization of (MA)x (FA)1- x PbI3 . This strategy can be expected to pave the way for the development of mixed-organic-cation perovskite solar cells.


Self-assembled supramolecular thermoreversible β-cyclodextrin/ethylene glycol injectable hydrogels with difunctional Pluronic®127 as controlled delivery depot of curcumin. Development, characterization and in vitro evaluation.
This study aimed to design a novel thermoreversible compact self-assembled host macromolecule based on β-cyclodextrin and low molecular weight ethylene glycol with a difunctional guest molecule i.e. poly (ethylene oxide)-poly (propylene oxide)-poly (ethylene oxide) tri-block co-polymer (Pluronic® 127) through host-guest inclusion complexation in aqueous media using cold method. The injectable thermoreversible self-assembled supramolecular hydrogel was developed to encapsulate hydrophobic curcumin as anti-malignant agent and for controlled delivery to systemic circulation after in vivo application through subcutaneous route. As reversible supramolecular assembly, the thermoresponsive gels showed a unique structure-related reversible gel to sol transition above and below LCST determined via tube titling method. The rheological measurements of the supramolecular hydrogels showed a viscoelastic structure. Optical transmittance of supramolecular assembly also confirmed the thermoreversible sol-gel transitions. The strong potential of supramolecular assembly as injectable controlled delivery was assessed using curcumin as model active pharmaceutical ingredient for in vitro release experiments. The release experiments conducted in various dissolution medias and at different temperature programs showed maximum curcumin release in phosphate buffer solution (7.4) at 35 °C. methyl thiazolyl tetrazolium assay was used to assess the safety and efficacy of self-assembled supramolecular injectable hydrogels. In vitro cytotoxicity study showed that blank supramolecular gels are non-toxic to the L929 cells. While curcumin released from supramolecular injectable hydrogels (Cur-β-CD/EG-PF127) has the ability to show pharmacological activity and kill the cancer cells. Furthermore the formation of channel type inclusion complex was studied through Fourier transformed infra-red spectroscopy, X-ray diffraction, thermogravimetric analysis, differential scanning calorimetric and scanning electron microscopic analysis.


Online monitoring of water toxicity by use of bioluminescent reporter bacterial biochips.
We describe a flow-through biosensor for online continuous water toxicity monitoring. At the heart of the device are disposable modular biochips incorporating agar-immobilized bioluminescent recombinant reporter bacteria, the responses of which are probed by single-photon avalanche diode detectors. To demonstrate the biosensor capabilities, we equipped it with biochips harboring both inducible and constitutive reporter strains and exposed it to a continuous water flow for up to 10 days. During these periods we challenged the biosensor with 2-h pulses of water spiked with model compounds representing different classes of potential water pollutants, as well as with a sample of industrial wastewater. The biosensor reporter panel detected all simulated contamination events within 0.5-2.5 h, and its response was indicative of the nature of the contaminating chemicals. We believe that a biosensor of the proposed design can be integrated into future water safety and security networks, as part of an early warning system against accidental or intentional water pollution by toxic chemicals.


Simultaneous Modulation of Interface Reinforcement, Crystallization, Anti-Reflection, and Carrier Transport in Sb Gradient-Doped SnO2 /Sb2 S3 Heterostructure for Efficient Photoelectrochemical Cell.
In this study, an effective quadruple optimization integrated synergistic strategy is designed to fabricate quality Sb gradient-doped SnO2 /Sb2 S3 heterostructure for an efficient photoelectrochemical (PEC) cell. The experimental results and theoretical calculations reveal that i) optical absorption matching is realized by combining the anti-reflection of SnO2 and high light absorption ability of Sb2 S3 in the visible region; ii) interface reinforcement is carried out by coordinating gradient-distributed Sb in SnO2 with S in S-rich precursor of Sb2 S3 for improving the Sb2 S3 crystallization process and matching crystalline lattice of Sb:SnO2 and Sb2 S3 ; iii) ultrahigh electron mobility is achieved by making Sb gradient-doped SnO2 ; iv) carrier separation and transport are accelerated by constructing type-II heterojunction with appropriate energy level alignment and forming a high-speed electron transport channel. All of above-mentioned optimization effects are integrated into a synergistic strategy for constructing the Sb:SnO2 /Sb2 S3 photoanode, achieving a photocurrent density of 2.30 mA cm-2 , hydrogen generation rate of 30.03 µmol cm-2 h-1 , and decent working stability. Notably, this method can also be used in other large-scale fabrication processes, such as drop-casting, spray-coating, blade-coating, printing, slot-die, etc. Moreover, this universal integrated strategy paves an avenue to fabricate efficient photoelectrodes with excellent photoelectrochemical performances.


Metabolism of C4 and linkage analysis in a kindred with hereditary incomplete C4 deficiency.
We studied a kindred in which C4 deficiency had been discovered. Unlike families with total absence of C4, in this kindred C4 deficiency was found to be incomplete, autosomal dominant, not caused by null alleles, and not associated with a high incidence of systemic lupus erythematosus. The deficient state was caused by hyposynthesis of C4, not by hypercatabolism. The locus for incomplete C4 deficiency was not closely linked to the major histocompatibility complex. The abnormal autosomal dominant allele is, apparently, rare, and how it causes decreased synthesis of C4 is unknown.


Emerging Cryptococcus gattii species complex infections in Guangxi, southern China.
The emergence and spread of cryptococcosis caused by the Cryptococcus gattii species complex has become a major public concern worldwide. C. deuterogattii (VGIIa) outbreaks in the Pacific Northwest region demonstrate the expansion of this fungal infection to temperate climate regions. However, infections due to the C. gattii species complex in China have rarely been reported. In this study, we studied eleven clinical strains of the C. gattii species complex isolated from Guangxi, southern China. The genetic identity and variability of these isolates were analyzed via multi-locus sequence typing (MLST), and the phylogenetic relationships among these isolates and global isolates were evaluated. The mating type, physiological features and antifungal susceptibilities of these isolates were also characterized. Among the eleven isolates, six belonged to C. deuterogattii, while five belonged to C. gattii sensu stricto. The C. deuterogattii strains from Guangxi, southern China were genetically variable and clustered with different clinical isolates from Brazil. All strains were MATα, and three C. deuterogattii isolates (GX0104, GX0105 and GX0147) were able to undergo sexual reproduction. Moreover, most strains had capsule and were capable of melanin production when compared to the outbreak strain from Canada. Most isolates were susceptible to antifungal drugs; yet one of eleven immunocompetent patients died of cryptococcal meningitis caused by C. deuterogattii (GX0147). Our study indicated that the highly pathogenic C. deuterogattii may be emerging in southern China, and effective nationwide surveillance of C. gattii species complex infection is necessary.


Scarf-Akin osteotomy correction for hallux valgus: short-term results from a district general hospital.
This study assessed the radiological measurements, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and patient satisfaction associated with performance of the scarf osteotomy, combined with an Akin osteotomy, for the treatment of hallux valgus in patients at a general hospital. Thirty-five patients were assessed before surgery, and at 6 months following performance of the scarf first metatarsal osteotomy plus Akin osteotomy. The mean first intermetatarsal and hallux abductus angles reduced from 14.1 degrees +/- 3.5 degrees to 10.0 degrees +/- 3.2 degrees and 32.1 degrees +/- 9.9 degrees to 16.4 degrees +/- 7.9 degrees , respectively, and these differences were statistically significant (P < .001). The mean first to second metatarsal sagittal plane length ratio was unchanged by the osteotomy (P > .05). The mean global AOFAS Hallux Metatarsophalangeal-Interphalangeal score increased from 58.8 +/- 11.6 to 86.4 +/- 11.6, and this difference was statistically significant (P < .0001). Of the 35 patients (36 operated feet), 20 (57.1%) were extremely satisfied, 10 (28.6%) were satisfied, and 5 (14.3%) were unsatisfied with the results of the surgery. Based on these results, we concluded that the improved radiographic angles and AOFAS scores observed in this study were comparable to previously reported results, and our findings indicated that, in the setting of a general hospital, the scarf osteotomy combined with the Akin osteotomy is a safe, versatile and useful procedure for the treatment of hallux valgus.


Mechanical CPR.
Mechanical devices for cardiopulmonary resuscitation have been in use for decades. Significant advances in the understanding of cardiac arrest physiology have led to improvements and new devices. Piston, load distribution band, active compression decompression and the impedance threshold device are discussed.


Developing a group practice comprehensive care education curriculum.
In fall 2002 the University of Illinois at Chicago College of Dentistry implemented a Group Practice Comprehensive Care Clinical Education Curriculum. The primary responsibility for patient care has shifted in this comprehensive care curriculum from the students to the faculty and staff. Students have a primary responsibility for learning. This competency-based education curriculum utilizes a variety of student evaluation methods including self-evaluation, OSCE, and portfolio to verify competence. Formative evaluation methods are utilized in daily assessment of student performance. On-time graduation rates have increased from 60-70 percent to 96 percent, and regional board first-time pass rates have been maintained at 90+ percent. Overall predoctoral clinical productivity in the first full year of the program has increased by over 300,000 dollars.


Electrosynthesis of Aromatic Poly(amide-amine) Films from Triphenylamine-Based Electroactive Compounds for Electrochromic Applications.
Two electropolymerizable monomers with a methoxytriphenylamine core linked via amide groups to two triphenylamine (TPA) or N-phenylcarbazole (NPC) terminal groups, namely 4,4'-bis(4-diphenylaminobenzamido)-4''-methoxytriphenylamine (MeOTPA-(TPA)₂) and 4,4'-bis(4-(carbazol-9-yl)benzamido)-4''-methoxytriphenylamine (MeOTPA-(NPC)₂), were synthesized and characterized by FTIR and ¹H NMR spectroscopy, mass spectrometry, and cyclic voltammetry. The electrochemical polymerization reactions of these MeOTPA-cored monomers over indium tin oxide (ITO) electrode allow the generation of electroactive poly(amide-amine) films. The electro-generated polymer films exhibited reversible redox processes and multi-colored electrochromic behaviors upon electro-oxidation, together with moderate coloration efficiency and cycling stability. The optical density changes (ΔOD) were observed in the range of 0.18⁻0.68 at specific absorption maxima, with the calculated coloration efficiencies of 42⁻123 cm²/C. Single-layer electrochromic devices using the electrodeposited polymer films as active layers were fabricated for the preliminary investigation of their electrochromic applications.


Large pi-aromatic molecules as potential sensitizers for highly efficient dye-sensitized solar cells.
Recently, dye-sensitized solar cells have attracted much attention relevant to global environmental issues. Thus far, ruthenium(II) bipyridyl complexes have proven to be the most efficient TiO(2) sensitizers in dye-sensitized solar cells. However, a gradual increment in the highest power conversion efficiency has been recognized in the past decade. More importantly, considering that ruthenium is a rare metal, novel dyes without metal or using inexpensive metal are desirable for highly efficient dye-sensitized solar cells. Large pi-aromatic molecules, such as porphyrins, phthalocyanines, and perylenes, are important classes of potential sensitizers for highly efficient dye-sensitized solar cells, owing to their photostability and high light-harvesting capabilities that can allow applications in thinner, low-cost dye-sensitized solar cells. Porphyrins possess an intense Soret band at 400 nm and moderate Q bands at 600 nm. Nevertheless, the poor light-harvesting properties relative to the ruthenium complexes have limited the cell performance of porphyrin-sensitized TiO(2) cells. Elongation of the pi conjugation and loss of symmetry in porphyrins cause broadening and a red shift of the absorption bands together with an increasing intensity of the Q bands relative to that of the Soret band. On the basis of the strategy, the cell performance of porphyrin-sensitized solar cells has been improved intensively by the enhanced light absorption. Actually, some push-pull-type porphyrins have disclosed a remarkably high power conversion efficiency (6-7%) that was close to that of the ruthenium complexes. Phthalocyanines exhibit strong absorption around 300 and 700 nm and redox features that are similar to porphyrins. Moreover, phthalocyanines are transparent over a large region of the visible spectrum, thereby enabling the possibility of using them as "photovoltaic windows". However, the cell performance was poor, owing to strong aggregation and lack of directionality in the excited state. Novel unsymmetrical zinc phthalocyanine sensitizers with "push" and "pull" groups have made it possible to reduce the aggregation on a TiO(2) surface, tune the level of the excited state, and strengthen the electronic coupling between the phthalocyanine core and the TiO(2) surface. As a result, the power conversion efficiency of up to 3.5% has been achieved. Perylenes are well-known as chemically, thermally, and photophysically stable dyes and have been used in various optical devices and applications. Nevertheless, the power conversion efficiency remained low compared to other organic dyes. The origin of such limited cell performance is the poor electron-donating abilities of the perylenes, which makes it difficult to inject electrons from the excited singlet state of the perylenes to the conduction band of the TiO(2) electrode efficiently. Strongly electron-donating perylene carboxylic acid derivatives with amine substituents at their perylene core have allowed us to increase the power conversion efficiency of up to approximately 7% in perylene-sensitized solar cells. The efficiency of large pi-aromatic molecule-sensitized solar cells could be improved significantly if the dyes with larger red and near-infrared absorption could be developed.


Insulin resistance, lipid and fatty acid concentrations in 867 healthy Europeans. European Group for the Study of Insulin Resistance (EGIR).
Insulin resistance, dyslipidaemia and abnormal nonesterified fatty acid (NEFA) metabolism are features of the 'metabolic syndrome', but the mechanisms of these relationships are uncertain. We studied associations between insulin resistance and lipoprotein concentrations by retrospective analysis of euglycaemic hyperinsulinaemic clamp data from 867 normoglycaemic subjects in 21 European centres. Data on NEFA concentrations were available in a subgroup of 541 subjects from 9 clinical centres. These subjects' characteristics do not vary significantly from those of the whole cohort. After adjustment for the effects of age, sex, obesity and intercentre variability, regression analysis showed relationships between triglycerides and markers of insulin sensitivity. There were significant correlations between triglycerides and fasting plasma glucose (P < 0.0001), fasting plasma insulin (P < 0.0001) and mean glucose infusion rate at steady state (M-value, P < 0.0001). Indices of insulin resistance were related to NEFA concentrations. Fasting NEFA were negatively correlated with the M-value (P < 0.0001). Non-esterified fatty acids at steady state were positively correlated with fasting markers of insulin resistance: fasting plasma glucose (P < 0.05), fasting plasma insulin (P < 0.005) and negatively correlated with the M-value (P < 0.0005). There were relationships between fasting concentrations of plasma lipids and of NEFAs. Non-esterified fatty acids at steady state correlated with fasting triglycerides (P < 0.0001), but not with any of the other plasma lipoprotein concentrations. The associations of fasting triglycerides with the M-value and with NEFAs at steady state were independent of each other. All these associations were independent of obesity and geographical location The results in this large cohort of healthy European subjects suggest that triglyceride concentrations depend upon both insulin's gluco-regulation (estimated by glucose uptake) and antilipolytic insulin action (measured by NEFA levels) during an euglycaemic clamp.


Prevalence of blaKPC and its occurrence with other beta-lactamases in Klebsiella pneumoniae.
Klebsiella pneumoniae (K. pneumoniae) is an important nosocomial pathogen, and the emergence of multidrug resistance in these organisms limits the treatment options for serious infections caused by them. K. pneumoniae carbapenemase (KPC) is one of the clinically significant Class A beta-lactamases. This study was aimed to detect the KPC and its coexistence with other beta-lactamases in K. pneumoniae. A total of 370 isolates, collected over a period of 1 year, were included in this study. The source of these isolates were urine (n = 170), exudative specimens (n = 132), respiratory secretions such as bronchial wash, endotracheal aspirate, and pleural fluid (n = 38), and blood (n = 30). For all the isolates, antibiotic susceptibility tests by disc diffusion, modified Hodge test, and KPC screening test were done. Polymerase chain reaction (PCR) was performed for the detection of KPC and the copresence of other beta-lactamases genes. Among the 370 isolates, 41 were resistant to the carbapenem by disc diffusion and minimum inhibitory concentration tests. Screen test using ertapenem and the boronic acid disk was positive in 14 isolates. Only one isolate harbored KPC gene by PCR, and it was co-produced with SHV-12 and CTX-M-15. PCR remains the gold standard for detection of KPC compared with any other phenotypic methods. Early detection of these genes helps in initiating proper antibiotic treatment.


GPs as medical educators--an Australian train-the-trainer program.
General practitioners undertake ongoing education in many areas. A train-the-trainer (TTT) approach may be an option for facilitation of continuing professional development (CPD) activities. With the aim of training GPs to facilitate peer CPD activities, Monash University's Department of General Practice undertook a national TTT program on men's sexual and reproductive health. Over a 3 year period, 40 'GP trainers' were trained to facilitate education sessions on the topics of androgen deficiency, erectile dysfunction, prostate cancer and male infertility for 568 GPs from 33 Australian divisions of general practice. Evaluation of this program showed that GP trainers were a valuable resource for conducting training programs for GPs, being experienced role models who could provide relevant and practical training to their colleagues. While resource intensive, the TTT model provided an effective means of improving GP knowledge and clinical practice on men's sexual and reproductive health.


Triangulation of microbial fingerprinting in anaerobic digestion reveals consistent fingerprinting profiles.
The anaerobic digestion microbiome has been puzzling us since the dawn of molecular methods for mixed microbial community analysis. Monitoring of the anaerobic digestion microbiome can either take place via a non-targeted holistic evaluation of the microbial community through fingerprinting or by targeted monitoring of selected taxa. Here, we compared four different microbial community fingerprinting methods, i.e., amplicon sequencing, metaproteomics, metabolomics and cytomics, in their ability to characterise the full-scale anaerobic digestion microbiome. Cytometric fingerprinting through cytomics reflects a, for anaerobic digestion, novel, single cell-based approach of direct microbial community fingerprinting by flow cytometry. Three different digester types, i.e., sludge digesters, digesters treating agro-industrial waste and dry anaerobic digesters, each reflected different operational parameters. The α-diversity analysis yielded inconsistent results, especially for richness, across the different methods. In contrast, β-diversity analysis resulted in comparable profiles, even when translated into phyla or functions, with clear separation of the three digester types. In-depth analysis of each method's features i.e., operational taxonomic units, metaproteins, metabolites, and cytometric traits, yielded certain similar features, yet, also some clear differences between the different methods, which was related to the complexity of the anaerobic digestion process. In conclusion, cytometric fingerprinting through flow cytometry is a reliable, fast method for holistic monitoring of the anaerobic digestion microbiome, and the complementary identification of key features through other methods could give rise to a direct interpretation of anaerobic digestion process performance.


[Effect of double-J stent indwelling time in treatment of ureteric calculi complicated with infection].
To evaluate the effect and double-J stent indwelling time in the treatment of acute upper urinary tract infection caused by ureteral calculi. A prospective non-randomized controlled study was carried out. From January 2011 to August 2015, a total of 142 patients treated in Department of Urology of Shanghai First People's Hospital for ureteral calculi with systematic inflammatory response syndrome were divided into double-J stent indwelling 7 days group (n=63) and double-J stent indwelling > 7 days group (n=79). The preoperative routine blood test, urinalysis, and urine culture, the urinalysis and urine culture immediately after double-J indwelling, and the routine blood test, urinalysis, and urine culture 7 days after indwelling were compared between the two groups. Postoperative complications after lithotripsy were analyzed. There were no statistically significant differences in preoperative blood white blood cell (WBC) count, urine WBC count, and positive bacterial culture between the two groups (all P>0.05). Seven days after double-J stent indwelling, significant improvement was seen in both the 7 d group and the >7 d group in blood WBC count, urine WBC count, and positive urine culture [(8.1±1.7) vs (14.8±3.1) ×10(9)/L, (356±44) vs (3 077±643)/μl, 1.6% vs 52.4%; (7.9±1.1) vs (15.1±3.8) ×10(9)/L, (363±52) vs (3 122±805)/μl, 3.8% vs 48.1%], and infection was managed effectively, while no statistically significant inter-group differences were observed. There was no significant difference in stone clearance rate between the two groups (96.8% vs 96.2%, P>0.05). There was no significant difference in the incidence of postoperative complications, especially infectious complications (all P>0.05). Indwelling double-J stents for 7 days could effectively manage the infection in patients with acute upper urinary tract infection secondary to ureteral calculi. These patients can be treated with lithotripsy safely. The time of double-J stent indwelling could be shortened.


Prevalence, severity and related factors of dental caries in school going children of vadodara city - an epidemiological study.
Among dental diseases, dental caries is an important dental public health problem in India which is irreversible in nature, and is predominantly a disease of childhood. Till date no study has been carried out in Vadodara. As baseline data of caries is required to improve oral health of children, the present study was undertaken to determine the pattern of dental caries in school children of Vadodara city in the mixed dentition period considering age, sex and dietary patterns. An epidemiological cross sectional descriptive study was carried out among 1600 school children aged 6-12 years in Vadodara city. A closed ended questionnaire according to World Health Organisation 1997 methodology was used to collect the data. The children were examined for the presence of dental caries using decayed missing filled teeth/decayed missing filled surfaces and Decayed Missing Filled Teeth/Decayed Missing Filled Surfaces index. Related factors which predispose caries such as age, sex and dietary patterns were recorded. The prevalence of dental caries was 69.12%. The mean dmft/dmfs and DMFT/DMFS were 3.00/4.79 and 0.45/0.56 respectively. The prevalence was higher in deciduous teeth than in permanent teeth. Positive association was found between dental caries and age, sex, frequency of sugar consumption in between meals. The study concludes that the prevalence and severity of dental caries in Vadodara city is high. So, in developing country like India, it is imperative to introduce primary prevention and increased restorative care for the purpose of both reducing the caries prevalence and maintaining those caries free children. How to cite this article: Joshi N, Sujan SG, Joshi K, Parekh H, Dave B. Prevalence, Severity and Related Factors of Dental Caries in School Going Children of Vadodara City - An Epidemiological Study. J Int Oral Health 2013; 5(4):40-48.


VACSATC (vaccine safety: attitudes, training and communication): why such a project?
The Vaccine safety: attitudes, training and communication (VACSATC) project was established in 2006 to study perceptions of immunisation and vaccine safety, to improve training of healthcare professionals on vaccine safety and to improve the availability of information on vaccine safety on the internet that adheres to good information practices. The three year project is funded by the European Commission's Directorate General for Health and Consumers and by the partners. The project complements the activities of the Vaccine Safety Net project and the Vaccine European New Integrated Collaboration Effort (VENICE) project.


Characterization of colchicine binding with normal and glycated albumin: In vitro and molecular docking analysis.
The transport of more than 90% of the drugs viz. anticoagulants, analgesics, and general anesthetics in the blood takes place by albumin. Hence, albumin is the prime protein needs to be investigated to find out the nature of drug binding. Serum albumin molecules are prone to glycation at elevated blood glucose levels as observed in diabetics. In this piece of work, glycation of bovine serum albumin (BSA) was carried out with glyceraldehyde and characterized by molecular docking and fluorometry techniques. Glycation of BSA showed 25% loss of free amino groups and decreased protein fluorescence (60%) with blue shift of 6 nm. The present study was also designed to evaluate the binding of colchicine (an anti-inflammatory drug) to native and glycated BSA and its ability to displace 8-analino-1-nephthalene sulfonic acid (ANS), from the BSA-ANS complex. Binding of ANS to BSA showed strong binding (Ka = 4.4 μM) with native conformation in comparison to glycated state (Ka = 8.4 μM). On the other hand, colchicine was able to quench the fluorescence of native BSA better than glycated BSA and also showed weaker affinity (Ka = 23 μM) for glycated albumin compared with native state (Ka = 16 μM). Molecular docking study showed that both glyceraldehyde and colchicine bind to common residues located near Sudlow's site I that explain the lower binding of colchicine in the glycated BSA. Based on our results, we believe that reduced drugs-binding affinity to glycated albumin may lead to drugs accumulation and precipitation in diabetic patients.


Cytologic identification of fungal arthritis in a Labrador Retriever with disseminated Talaromyces helicus infection.
An 8-year-old, neutered male Labrador Retriever presented with acute forelimb lameness. Clinical signs progressed over one week. On physical examination, right cubital joint effusion and bilateral axillary lymphadenomegaly were noted, and severe internal lymphadenomegaly was observed ultrasonographically. Granulomatous lymphadenitis with intralesional fungi was noted cytologically, and the dog was ultimately diagnosed with disseminated Talaromyces helicus infection via PCR of a pure isolate. Extensive medical therapy was pursued, and months later, an arthrocentesis was performed due to continued lameness and severe cubital joint effusion. The synovial fluid contained increased numbers of neutrophils, macrophages, and multinucleated giant cells. Frequent fungal hyphae were found both intracellularly and extracellularly. These basophilic organisms were 2-4 µm in width with internal eosinophilic granules, roughly parallel walls, and occasional to frequent septa. Round to oval yeast-like forms with thin, clear halos were also occasionally identified. Due to the severity of clinical signs, the right thoracic limb was amputated. Histologic examination of the cubital joint revealed marked granulomatous synovitis, fasciitis, panniculitis, and osteomyelitis, all with intralesional fungi. Talaromyces helicus is a very rare cause of disease, reported only in one other dog. Granulomatous lymphadenitis appears to be a feature of this disease, but this report is the first to describe a significant synovial component.


Intraoperative magnetic resonance imaging to update interactive navigation in neurosurgery: method and preliminary experience.
We report on the first successful intraoperative update of interactive image guidance based on an intraoperatively acquired magnetic resonance imaging (MRI) date set. To date, intraoperative imaging methods such as ultrasound, computerized tomography (CT), or MRI have not been successfully used to update interactive navigation. We developed a method of imaging patients intraoperatively with the surgical field exposed in an MRI scanner (Magnetom Open; Siemens Corp., Erlangen, Germany). In 12 patients, intraoperatively acquired 3D data sets were used for successful recalibration of neuronavigation, accounting for any anatomical changes caused by surgical manipulations. The MKM Microscope (Zeiss Corp., Oberkochen, Germany) was used as navigational system. With implantable fiducial markers, an accuracy of 0.84 +/- 0.4 mm for intraoperative reregistration was achieved. Residual tumor detected on MRI was consequently resected using navigation with the intraoperative data. No adverse effects were observed from intraoperative imaging or the use of navigation with intraoperative images, demonstrating the feasibility of recalibrating navigation with intraoperative MRI.


Rapid Reviews Methods Series: Involving patient and public partners, healthcare providers and policymakers as knowledge users.
Rapid reviews (RRs) are a helpful evidence synthesis tool to support urgent and emergent decision-making in healthcare. RRs involve abbreviating systematic review methods and are conducted in a condensed timeline to meet the decision-making needs of organisations or groups that commission them. Knowledge users (KUs) are those individuals, typically patient and public partners, healthcare providers, and policy-makers, who are likely to use evidence from research, including RRs, to make informed decisions about health policies, programmes or practices. However, research suggests that KU involvement in RRs is often limited or overlooked, and few RRs include patients as KUs. Existing RR methods guidance advocates involving KUs but lacks detailed steps on how and when to do so. This paper discusses the importance of involving KUs in RRs, including patient and public involvement to ensure RRs are fit for purpose and relevant for decision-making. Opportunities to involve KUs in planning, conduct and knowledge translation of RRs are outlined. Further, this paper describes various modes of engaging KUs during the review lifecycle; key considerations researchers should be mindful of when involving distinct KU groups; and an exemplar case study demonstrating substantive involvement of patient partners and the public in developing RRs. Although involving KUs requires time, resources and expertise, researchers should strive to balance 'rapid' with meaningful KU involvement in RRs. This paper is the first in a series led by the Cochrane Rapid Reviews Methods Group to further guide general RR methods.


Solvent-free, microwave-assisted N-arylation of indolines by using low palladium catalyst loadings.
Indoline-based compounds are abundant in nature, and the indoline skeleton is an often-encountered scaffold in a range of biologically active alkaloids, pharmaceutically active compounds, and functional molecules (e.g., sensitizers for solar cells). The wide range of uses warrants further interest in the structural modification of this class of compounds. A series of substituted N-aryl indolines is prepared by a solvent-free, palladium-catalyzed procedure. The procedure requires only low loadings of catalyst, uses microwave irradiation, and starts from commercially available substrates. The method proceeds in good yields and in short reaction times with aryl bromides, chlorides, and iodides, also on 2-substituted indolines. The combination of solvent-free methods with microwave heating will further increase in importance in the search for more environmentally acceptable synthesis methods.


Localization of the meningococcal receptors for human transferrin.
The interaction between gold-labelled human transferrin (Au-HTF) with live meningococci after growth in vivo or in different in vitro conditions was examined by electron microscopy to localize and quantify the numbers of HTF-binding sites on the cell surface. It was clearly demonstrated that HTF binds to the surface of live meningococci (of different serogroups and serotypes) after growth in either iron-sufficient or iron-restricted cultures, although the degree of labelling was always higher (2- to 35-fold) in the latter case. The commensal Neisseria polysaccharea behaved similarly. Ultrathin sections showed that Au-HTF was localized predominantly on the outer membrane of the cells and vesicles, with hardly any internalization. Au-HTF labelling on meningococci was significantly reduced after incubation with unlabelled HTF or with rabbit antiserum containing antibodies against transferrin-binding proteins (TBPs), demonstrating the specificity of the interaction. These sera also blocked binding between HTF and outer membrane proteins on Western immunoblots. Direct evidence of the expression of the TBPs (Western blots) and localization of the HTF receptor (electron microscopy) on in vivo-grown meningococci was obtained from organisms derived without laboratory culturing from the cerebrospinal fluid of a patient. There was considerable cell-to-cell variation in the amount of labelling present on cells of the same sample (in vitro- or in vivo-grown organisms) and between different strains. The degree of binding varied with time of incubation of the cells with Au-HTF. The gold particles frequently formed discrete circles on the cell surfaces of the in vitro-grown organisms; these circles appear to be associated with outer membrane vesicle formation. The results show that the TBPs, which form part of the active components of the HTF receptor(s), are expressed in vivo and are surface exposed and immunogenic and that antibodies against them can interfere with the HTF binding of the meningococcal cells, which may affect iron utilization. This study further supports the concept of regarding the TBPs as future vaccine candidates.


Patient satisfaction with care and behavioral compliance in end-stage renal disease patients treated with hemodialysis.
Compliance with the hemodialysis (HD) prescription is an important predictor of patient outcome. Although there is interest in the concept of patient satisfaction with medical care and caregivers, relatively few such data exist regarding HD patients. We examined whether associations exist between patient satisfaction with medical personnel and depressive affect and social support levels and behavioral compliance with prescribed HD treatment. Seventy-nine HD patients were interviewed, assessing depression, social support, and perception of satisfaction with dialysis staff. Medical and treatment data, Karnofsky functioning and severity of illness scores, and behavioral and laboratory compliance measures were determined. There was no association between patient satisfaction with care and level of depressive affect. A relationship was found between patient satisfaction with care with their nephrologist and attendance at dialysis sessions. Patients who had a poor perception of satisfaction with their nephrologist had poorer attendance at dialysis sessions. There was no relationship between behavioral compliance and patient perception of ancillary HD staff. In addition, patient perception of satisfaction with staff was related to perception of social support, protein catabolic rate, and serum albumin concentration, all of which have been linked to survival. We conclude that a nephrologist has a crucial role in patient compliance. These results suggest interventions that improve patient perception of physician support may improve patient adjustment and possibly survival.


Mechanism and stability of hyperproduction of the extended-spectrum beta-lactamase SHV-5 in Klebsiella pneumoniae.
Some isolates of SHV-5 beta-lactamase-producing Klebsiella pneumoniae K2 from a single-strain outbreak of cross-infection produced approximately five-fold more beta-lactamase than others. We investigated three possible genetic mechanisms of this hyperproduction: the presence of a more powerful promoter, an increase in plasmid copy number or an amplification of the gene on a plasmid. No differences between low and high beta-lactamase producers were detected in the promoter region of the SHV-5 beta-lactamase gene, which closely resembled that of SHV-2. SHV-5 beta-lactamase production was encoded on a low copy number plasmid, but DNA-DNA hybridization with an SHV-specific probe detected a higher gene dose in hyperproducers. The beta-lactamase hyperproduction was unstable on repeated subculture, with a reduction of about 75% after 100 generations. Hyperproducing mutants of a low-producing Klebsiella and its Escherichia coli K-12 transconjugants could be selected in vitro at a frequency of 10(-5) to 10(-6) and these variants had an increased SHV-5 beta-lactamase gene copy number on low copy number plasmids. We conclude that hyperproduction of the extended-spectrum beta-lactamase was caused by gene amplification that could be easily lost or gained in vitro. Since the change to hyperproduction occurred at a high frequency and hyperproducers showed increased resistance to many beta-lactams and beta-lactam/beta-lactamase inhibitor combinations, we suspect that these variants may readily be selected in patients during antibiotic therapy.


METTL3 promotes IL-1β-induced degeneration of endplate chondrocytes by driving m6A-dependent maturation of miR-126-5p.
METTL3 is an important regulatory molecule in the process of RNA biosynthesis. It mainly regulates mRNA translation, alternative splicing and microRNA maturation by mediating m6A-dependent methylation. Interleukin 1β (IL-1β) is an important inducer of cartilage degeneration that can induce an inflammatory cascade reaction in chondrocytes and inhibit the normal biological function of cells. However, it is unclear whether IL-1β is related to METTL3 expression or plays a regulatory role in endplate cartilage degeneration. In this study, we found that the expression level of METTL3 and methylation level of m6A in human endplate cartilage with different degrees of degeneration were significantly different, indicating that the methylation modification of m6A mediated by METTL3 was closely related to the degeneration of human endplate cartilage. Next, through a series of functional experiments, we found that miR-126-5p can play a significant role in IL-1β-induced degeneration of endplate chondrocytes. Moreover, we found that miR-126-5p can inhibit the PI3K/Akt signalling pathway by targeting PIK3R2 gene, leading to the disorder of cell vitality and functional metabolism. To further determine whether METTL3 could regulate miR-126-5p maturation, we first confirmed that METTL3 can bind the key protein underlying pri-miRNA processing, DGCR8. Additionally, when METTL3 expression was inhibited, the miR-126-5p maturation process was blocked. Therefore, we hypothesized that METTL3 can promote cleavage of pri-miR-126-5p and form mature miR-126-5p by combining with DGCR8.


Alternative pathway respiration and lipoxygenase activity in aged potato slice mitochondria.
Mitochondrial preparations isolated from aged white potato (Solanum tuberosum L.) slices exhibited classical cyanide-insensitive O(2) uptake which was inhibited by salicylhydroxamic acid and tetraethylthiuram disulfide (disulfiram). These mitochondria also possessed lipoxygenase activity, as determined by O(2) uptake in the presence of 4 millimolar linoleic acid. Purification of the mitochondrial preparation on a continuous Percoll gradient resulted in a large decrease in lipoxygenase activity whereas cyanide-insensitive (disulfiram sensitive) O(2) consumption was still observed. These data indicate that cyanide-insensitive O(2) consumption in mitochondrial preparations isolated from aged white potato slices is of mitochondrial origin and not due to lipoxygenase contamination.


Validation of the Chinese version of Brief Assessment of Cognition in Schizophrenia.
A test battery that measures cognitive function impairment in patients with schizophrenia, the Brief Assessment of Cognition in Schizophrenia (BACS), has been translated into various languages and validated. This study aimed to test the reliability and validity of the Chinese version of the BACS in a Chinese-speaking population. All participants in this study (66 patients with schizophrenia [mean age: 41.2 years, 57.6% male] and 66 age- and sex-matched healthy controls) were from Taiwan and assessed using the BACS and the University of California, San Diego (UCSD) Performance-Based Skills Assessment, Brief Version (UPSA-B). Thirty-eight of the 66 patients with schizophrenia received a reassessment using the BACS. The BACS had good test-retest reliability, and all BACS subtests had statistically insignificant practice effects. Principal components analysis demonstrated that a one-factor solution best fits our dataset (60.9% of the variance). In both patients and controls, the BACS composite scores were positively correlated with all BACS subscales (P<0.001) and UPSA-B scales (P<0.001). Furthermore, all BACS subtests (verbal memory, working memory, motor speed, verbal fluency, attention and processing speed, and executive function) significantly differentiated patients with schizophrenia from healthy controls (P<0.001), and the BACS composite score had the best discriminative validity (P<0.001). The Chinese version of the BACS exhibits satisfactory psychometric properties, including high test-retest reliability, high internal consistency, acceptable concurrent validity, and good discriminant validity. We suggest that the BACS is a reliable and practical tool for assessing cognitive function in patients with schizophrenia.


Superficial acral fibromyxoma: clinicopathological, immunohistochemical, and molecular study of 11 cases highlighting frequent Rb1 loss/deletions.
Superficial acral fibromyxoma (SAF) is an uncommon benign dermal mesenchymal lesion of adults with predilection for acral sites, in particular the nail region. To date, less than 300 cases have been reported. SAFs consistently express CD34, but other diagnostic markers or specific genetic alterations have not been established yet. We describe 11 SAFs occurring in 7 men and 4 women aged 37 to 86years (median, 48 years). Mean size was 6mm (range, 4-20mm). Affected sites were fingers (n=5), toes (n=3), heel (n=1), calf (n=1), and unspecified digit (n=1). None of 10 patients with available follow-up (2-60months; median, 24months) developed recurrence. Histology showed relatively hypocellular vaguely lobulated nodules composed of bland-looking spindled or stellate fibroblast-like cells arranged into storiform or loose fascicles within a variably myxoid, fibromyxoid, or collagenous vascularized stroma. Immunohistochemistry showed expression of CD34 (9/10) and focal weak reactivity for epithelial membrane antigen (2/11). None of the lesions expressed protein S100 (0/11), MUC4 (0/11), or STAT6 (0/11). Loss of Rb1 immunoexpression was observed in 9 (90%) of 10 cases. All 7 cases with successful RB1 fluorescence in situ hybridization testing showed RB1 gene deletions, which was variably associated with co-loss of the corresponding 13q12 signal (monosomy at the 13q region). To our knowledge, this is the first study investigating the expression status of the tumor suppressor Rb1 in SAF by immunohistochemistry and fluorescence in situ hybridization. Our results showed frequent Rb1 deficiency as a possible driver molecular event in SAF (seen in 90% of cases) indicating relationship of SAF to the RB1-deleted tumor family.


Presentation and outcomes of ectopia cordis.
Ectopia cordis, defined as complete or partial displacement of the heart outside the thoracic cavity, is rare. The cause and pathogenesis are unknown. The anatomy of the heart may be normal, but the presence of structural heart disease as well as noncardiac malformations is common. Patients present incidentally after birth or, more recently, the condition has been diagnosed by prenatal echocardiography. To review the presentation, diagnostic imaging, management and outcomes of infants with ectopia cordis at The Hospital for Sick Children, Toronto, Ontario. The medical records of the database of the Division of Cardiology, The Hospital for Sick Children, were searched; echocardiograms, and surgical and autopsy reports were further reviewed. Between 1978 and 1998, 10 patients with ectopia cordis presented to the authors' centre. Normal cardiac anatomy was noted in three, and mild to complex structural cardiac anomalies were noted in the remainder. Associated noncardiac malformations were found in six cases. Six were diagnosed by prenatal ultrasound between 19 and 37 weeks of gestation. Pregnancies were electively terminated or the infants died shortly after birth. Four other neonates with ectopia cordis were referred to the authors' centre. All of these infants subsequently died either at the time of surgery for cardiac and noncardiac anomalies or in the immediate postoperative period. Despite modern treatment options, the mortality remains high for patients with ectopia cordis, especially in the presence of structural heart disease or other malformations.


Exogenous nucleosides modulate expression and activity of transcription factors in Caco-2 cells.
Dietary nucleotides (NTs) have an important role in cellular and humoral immunity, intestinal growth, differentiation and recovery from tissue damage. Nucleosides (NSs) are the best-absorbed chemical form of NTs in the intestinal epithelium. The aim of this study was to evaluate the effects of NSs on the activity and expression of multiple transcription factors (TFs) in Caco-2 cells, as a possible molecular mechanism by which NSs modulate gene expression in human intestinal cells. The effects of NS-supplemented media on human Caco-2 cell proliferation, viability, protein and RNA concentration were determined, and the activity and expression profiles of multiple TFs were analyzed by using an array-based technology. Exogenous NSs did not affect Caco-2 cell proliferation or viability but increased the protein content in cytoplasm and nucleus and the nuclear protein/RNA ratio. The addition of NSs to the media increased the expression and activity of the TFs CCAAT displacement protein (CUX1), v-ets avian erythroblastosis virus E26 oncogene homolog 1 (ETS1) and SMAD family member 2. In contrast, NS addition decreased the expression and activity of the general upstream stimulatory factor 1 (USF1), glucocorticoid receptor (NR3C1), NFKB and tumor protein p53. In conclusion, our results suggest that exogenous NSs affect the expression and activity of several TFs involved in cell growth, differentiation, apoptosis, immune response and inflammation.


[Berolina iubilans: Berlin physicians as Halle doctoral candidates (III): Carl Ludwig Willdenow (1765-1812), Halle doctoral candidate of 1789].
Carl Ludwig Willdenow (1765-1812) who was trained as a pharmaceutical chemist and awarded the degree of Doctor of Medicine by the Faculty of Medicine of Halle University in 1789 belongs to the great botanists in an era in which the special subject represented by him finally disengages from the complex of medicine. The plant systematizer Willdenow worked on the traces of Linné, trying to note down the complex of species enlarged by him. Under his management the Botanic Garden in Berlin gained a world-wide renown. The Halle dissertation which was remarkable by its details was the intermediate station of Willdenow's professional career.


Comparing cohort incidence of schizophrenia with that of bipolar disorder and affective psychosis in individuals born in Stockholm County 1955-1967.
Perinatal factors are associated with increased risk for both schizophrenia and bipolar disorder. Improvements in obstetric and maternal healthcare and positive socioeconomic development in Sweden from the 1950s onwards could be expected to affect incidence estimates. However, commonly incidence rates are calculated during a specific year, i.e. time of diagnosis, which mirrors proximal precipitating risk factors. To examine whether incidence estimates are compatible with the hypothesis of an impact of perinatal exposures on the risk of the different disorders we here instead calculate incidence rates for consecutive birth cohorts born between 1955 and 1967. We hypothesized that schizophrenia incidence would be more affected compared to bipolar disorder and other affective psychoses since most perinatal risk factors are more pronounced in schizophrenia aetiology. Birth cohorts of individuals born in Sweden and resident in Stockholm (N = 2,16,322), were followed in The National Patient Register regarding incident inpatient episodes Incident cases/10,000 person-years and birth cohort were calculated. Linear regression was used to estimate change in incidence rate. We found stable birth cohort-based incidence estimates for bipolar disorder and other affective psychoses, but a continuous reduction in incidence estimates for schizophrenia as well as other non-affective psychoses in subsequent birth cohorts from 1955 to 1967. The consecutive birth cohort-based incidence estimates unveiled patterns that are compatible with the hypothesis of an impact of early life exposures decreasing over time, in the aetiology of schizophrenia, whereas this pattern is less apparent in affective psychoses..


Playing With Fire.
The authors present their concerns surrounding data presented in studies from 2018 and 2020 regarding very low dose bevacizumab for the treatment of retinopathy of prematurity. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:542-544.].


Current knowledge on E-vita abdominal endograft.
The field of endovascular abdominal aortic repair has changed remarkably compared to what it was prior to 1993, the year of the first commercial endograft deployment in the United States. Over the years of endovascular aneurysm repair experience, various companies have attempted to construct an ideal stent-graft for exclusion of an abdominal aortic aneurysm (AAA). However, it has become evident that not all abdominal aortic anatomies are amenable to endovascular treatment and that the rationale "one device fits all AAAs" can lead to disastrous results. Different endografts have dissimilar properties and characteristics. Type of graft material, configuration and type of stent structural support, modularity, type of transrenal fixation, are potentially influential factors of endograft behavior. The self-expanding E-vita abdominal stent-graft (JOTEC, Hechingen, Germany) is a relatively new infrarenal, modular stent-graft with suprarenal fixation designed for AAA reconstruction. The present paper analyzes the technical characteristics and properties of this device. We also analyze our experience with the endoprosthesis and review the current literature.


Nasopharyngeal metagenomic deep sequencing data, Lancaster, UK, 2014-2015.
Nasopharyngeal swabs were taken from volunteers attending a general medical practice and a general hospital in Lancaster, UK, and at Lancaster University, in the winter of 2014-2015. 51 swabs were selected based on high RNA yield and allocated to deep sequencing pools as follows: patients with chronic obstructive pulmonary disease; asthmatics; adults with no respiratory symptoms; adults with feverish respiratory symptoms; adults with respiratory symptoms and presence of antibodies against influenza C; paediatric patients with respiratory symptoms (2 pools); adults with influenza C infection (2 pools), giving a total of 9 pools. Illumina sequencing was performed, with data yields per pool in the range of 345.6 megabases to 14 gigabases after removal of reads aligning to the human genome. The data were deposited in the Sequence Read Archive at NCBI, and constitute a resource for study of the viral, bacterial and fungal metagenome of the human nasopharynx in healthy and diseased states and comparison with other metagenomic studies on the human respiratory tract.


C-peptide: much more than a byproduct of insulin biosynthesis.
During the past decade, numerous studies in both humans and animals have demonstrated that C-peptide, although not influencing blood sugar control, might play a role in preventing and potentially reversing some of the chronic complications of type 1 diabetes. The aim of this paper is to present an up-to-date review of C-peptide, focusing on its role in insulin biosynthesis and in the classification of diabetes mellitus, as well as its potential clinical applications. The relevant literature cited in the MEDLINE database shows that the measurement of C-peptide production combined with screening for the presence of islet-cell and other autoantibodies seems to exert an important role in the accurate differentiation between patients with type 1 and type 2 diabetes. Also, both experimental and clinical data provide evidence suggesting that combined replacement of insulin and C-peptide has potential therapeutic value in patients with type 1 diabetes. Further study in this area is warranted, but the findings that pancreas transplants promote the reversal of diabetic neuropathy and stabilization of diabetic retinopathy and that both pancreas and islet transplants lead to the reversal of diabetic nephropathy lend credence to the concept that combined replacement of insulin and C-peptide may more effectively mitigate the inexorable progression of diabetes-related complications.


Synthesis and antifungal activity of a novel series of alkyldimethylamine cyanoboranes and their derivatives.
A series of new amine cyanoborane derivatives were synthesized and exhibited antifungal activity. A long alkyl chain attached to the nitrogen of the amine cyanoboranes and carboxyboranes enhances antifungal activity. An enhanced activity was also obtained upon the halogenation of the amine cyanoboranes as well as in the presence of C=C double bond at the end of the N-alkyl group. The lead compounds were dimethylundecylamine cyanoborane (C11H23N(CH3)2BH2CN), 9, and its dibromo derivative dimethylundecylamine dibromocyanoborane (C11H23N(CH3)2BBr2CN), 11. The MIC values for the lead compounds against the most important human pathogenic fungi ranged from 16.25 to 32.5 micromol/L and from 10.05 to 79 micromol/L, respectively. Both compounds were found to be relatively safe in intravenous injections to mice, (MTD = 121.9 and 73.1 micromol/kg, respectively) and active against strains that are resistant to fluconazole (a conventional antifungal medicine). These data indicate their potential to become antifungal agents.


Fabrication and Manipulation of Ionotropic Hydrogels Crosslinked by Paramagnetic Ions.
This manuscript describes the fabrication and manipulation of millimeter-scale spheres fabricated from ionotropic hydrogels that are crosslinked with paramagnetic metal ions (e.g., Ho(3+)). These ionotropic hydrogels experience a force in a magnetic field gradient that correlates with the concentration of the paramagnetic cations crosslinking the polymer. In an externally applied magnetic field, the paramagnetic hydrogel spheres assemble into ordered arrays or confined geometrical structures in the regions of highest magnetic field. These spheres can be separated from heterogeneous mixtures of diamagnetic materials using a simple bar magnet. Two applications using these recoverable hydrogel spheres were demonstrated: i) When prepared with embedded indicator dyes bound to paper, the spheres were used as colorimetric sensors for pH. ii) When prepared with embedded activated carbon powder, they were used to remove organic materials from aqueous solutions.


Iron poisoning: a literature-based review of epidemiology, diagnosis, and management.
Although seen less frequently than acetaminophen or salicylate poisoning, acute iron poisoning remains a dangerous threat, particularly to pediatric patients. Multiple factors-including legal and manufacturing practices-have changed the landscape of iron poisoning over the decades. Despite these changes, diagnosis and management of iron poisoning have minimally evolved, and the current evidence for iron poisoning is yet based principally on case series, expert consensus, animal studies, and adult volunteer studies. This review article describes in detail the epidemiology of acute iron poisoning as it relates to the pediatric patient, as well as the historical and current array of literature on diagnosis and management.


Placental damage in pregnancies with systemic lupus erythematosus: A narrative review.
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease of unknown cause, which mainly affects women of childbearing age, especially between 15 and 55 years of age. During pregnancy, SLE is associated with a high risk of perinatal morbidity and mortality. Among the most frequent complications are spontaneous abortion, fetal death, prematurity, intrauterine Fetal growth restriction (FGR), and preeclampsia (PE). The pathophysiology underlying obstetric mortality and morbidity in SLE is still under investigation, but several studies in recent years have suggested that placental dysfunction may play a crucial role. Understanding this association will contribute to developing therapeutic options and improving patient management thus reducing the occurrence of adverse pregnancy outcomes in this group of women. In this review, we will focus on the relationship between SLE and placental insufficiency leading to adverse pregnancy outcomes.


Dissolution of composition B detonation residuals.
Composition B (Comp B) detonation residuals pose environmental concern to the U.S. Army because hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX), a constituent, has contaminated groundwater near training ranges. To mimic their dissolution on surface soils, we dripped water at 0.51 ml/h onto individual Comp B particles (0.1-2.0 mg) collected from the detonation of 81-mm mortars. Analyses of the effluent indicate thatthe RDX and 2,4,6-trinitrotoluene (TNT) in Comp B do not dissolve independently. Rather, the relatively slow dissolution of RDX controls dissolution of the particle as a whole by limiting the exposed area of TNT. Two dissolution models, a published steady-flow model and a drop-impingement model developed here, provide good agreementwith the data using RDX parameters for time scaling. They predict dissolution times of 6-600 rainfall days for 0.01-100 mg Comp B particles exposed to 0.55 cm/h rainfall rate. These models should bracket the flow regimes for dissolution of detonation residuals on soils, but they require additional data to validate them across the range of particle sizes and rainfall rates of interest.


Bisphenol A exposure enhances atherosclerosis in WHHL rabbits.
Bisphenol A (BPA) is an environmental endocrine disrupter. Excess exposure to BPA may increase susceptibility to many metabolic disorders, but it is unclear whether BPA exposure has any adverse effects on the development of atherosclerosis. To determine whether there are such effects, we investigated the response of Watanabe heritable hyperlipidemic (WHHL) rabbits to 400-µg/kg BPA per day, administered orally by gavage, over the course of 12 weeks and compared aortic and coronary atherosclerosis in these rabbits to the vehicle group using histological and morphometric methods. In addition, serum BPA, cytokines levels and plasma lipids as well as pathologic changes in liver, adipose and heart were analyzed. Moreover, we treated human umbilical cord vein endothelial cells (HUVECs) and rabbit aortic smooth muscle cells (SMCs) with different doses of BPA to investigate the underlying molecular mechanisms involved in BPA action(s). BPA treatment did not change the plasma lipids and body weights of the WHHL rabbits; however, the gross atherosclerotic lesion area in the aortic arch was increased by 57% compared to the vehicle group. Histological and immunohistochemical analyses revealed marked increases in advanced lesions (37%) accompanied by smooth muscle cells (60%) but no significant changes in the numbers of macrophages. With regard to coronary atherosclerosis, incidents of coronary stenosis increased by 11% and smooth muscle cells increased by 73% compared to the vehicle group. Furthermore, BPA-treated WHHL rabbits showed increased adipose accumulation and hepatic and myocardial injuries accompanied by up-regulation of endoplasmic reticulum (ER) stress and inflammatory and lipid metabolism markers in livers. Treatment with BPA also induced the expression of ER stress and inflammation related genes in cultured HUVECs. These results demonstrate for the first time that BPA exposure may increase susceptibility to atherosclerosis in WHHL rabbits.


Lung Ultrasound Findings of Patients with Dengue Infection: A Prospective Observational Study.
Lung ultrasound (LUS) is a more sensitive method of detecting pathological pulmonary changes than chest X-ray. Therefore, LUS for patients with dengue could be an important tool for the early detection of pleural effusions and pulmonary edema signifying capillary plasma leakage, which is the hallmark of severe dengue pathophysiology. We conducted a prospective observational study of pulmonary changes identifiable with LUS in dengue patients admitted to the Hospital for Tropical Diseases in Mahidol University, Bangkok, and the Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand. The LUS findings were described according to standard criteria, including the presence of A, B1, B2, and C patterns in eight chest regions and the presence of pleural effusions. From November 2017 to April 2018, 50 patients with dengue were included in the study. LUS was performed during the febrile phase for nine patients (18%) and during the critical-convalescence phase for 41 patients (82%). A total of 33 patients (66%) had at least one abnormality discovered using LUS. Abnormal LUS findings were observed more frequently during the critical-convalescence phase (N = 30/41; 73%) than during the febrile phase (N = 3/9; 33%) (P = 0.047). Abnormal aeration patterns were observed in 31 patients (62%). Only B patterns with only multiple B lines were observed in 21 patients (42%); of these patients, three had already exhibited B patterns during the febrile phase (N = 3). C patterns (N = 10; 24%), pleural effusion (N = 10; 24%), and subpleural abnormalities (N = 11; 27%) were observed only during the critical-convalescence phase. LUS can detect signs of capillary leakage, including interstitial edema and pleural effusions, early during the course of dengue.


Pheochromocytoma and extra-adrenal paraganglioma: updates.
Advances in genetics and gene expression profiling have led to new ways of thinking about the pathobiology of pheochromocytoma and extra-adrenal paraganglioma. These developments are concurrent with the publication and dissemination of the 2004 World Health Organization bluebook on pathology and genetics of endocrine tumors. To summarize new information required by pathologists for effective participation in patient management and research. Literature review and primary material from Tufts Medical Center. The World Health Organization reserves the term pheochromocytoma for tumors arising from chromaffin cells in the adrenal medulla. Closely related tumors in extra-adrenal sympathetic and parasympathetic paraganglia are classified as extra-adrenal paragangliomas. A pheochromocytoma is an intra-adrenal sympathetic paraganglioma. Although arbitrary, this nomenclature emphasizes important distinctive properties of intra-adrenal tumors, including an often adrenergic phenotype, relatively low rate of malignancy, and predilection to occur in particular hereditary syndromes. Malignancy is defined by presence of metastases not local invasion. Occult germline mutations characteristic of familial syndromes are now found in more than 20% of patients with apparently sporadic tumors, bringing the percentage of tumors with a known genetic basis close to 30%. In addition, tumor location and risk of malignancy vary with the underlying genetic defect. The "10 percent rule" for pheochromocytoma/paraganglioma--10% familial, 10% malignant, 10% extra-adrenal--is therefore no longer tenable. Current roles of pathology are limited to diagnosing primary or metastatic tumors and identifying features suggestive of malignant potential or hereditary disease. Future roles may involve more definitive assessment of malignancy, genotype-phenotype correlation, and identification of targets for therapy.


Rearing honey bees, Apis mellifera, in vitro 1: effects of sugar concentrations on survival and development.
A new method for rearing honey bees, Apis mellifera L. (Hymenoptera: Apidae), in vitro was developed and the effects of sugar concentrations on survival and development were studied. Seven different glucose (G) and fructose (F) compositions (0%G+0%F, 3%G+3%F, 6%G+6%F, 12%G+12%F, 0%G+12%F, 12%G+0%F, and 4%G+8%F) were tested. Larvae were able to grow to the post defecation stage without addition of sugars (Diet 1), but they were not able to metamorphose and pupate. Adults were reared from diets 2-7. The average larval survival, prepupal larval weights, adult weights, and ovariole numbers were affected significantly due to the sugar compositions in the diets. High sugar concentrations (12%G+12%F) increased the number of queens and intercastes.


Magnetic resonance microscopy determined velocity and hematocrit distributions in a Couette viscometer.
Magnetic resonance microscopy is used to non-invasively measure the radial velocity distribution in Couette flow of erythrocyte suspensions of varying aggregation behavior at a nominal shear rate of 2.20 s(-1) in a 1 mm gap. Suspensions of red blood cells in albumin-saline, plasma and 1.48% Dextran added plasma at average hematocrits near 0.40 are studied, providing a range of aggregation ability. The spatial distribution of the red blood cell volume fraction, hematocrit, is calculated from the velocity distribution. The hematocrit profiles provide direct measure of the thickness of the aggregation and shear rate dependent red blood cell depletion at the Couette surfaces. At the nominal shear rate studied hematocrit distributions for the red blood cells in plasma show a depletion zone near the inner Couette wall but not the outer wall. The red blood cells in plasma with Dextran show cell depletion regions of approximately 100 mum at both the inner and outer Couette surfaces, with greater depletion at the inner wall, but approach the normal blood hematocrit distribution with a doubling of shear rate due to decreased aggregation. The material response of the blood is spatially dependent with the shear rate and the hematocrit distribution non-uniform across the gap.


Micro-Raman Spectroscopy in Self-Catalyzed Indium Phosphide Nanostructures: Morphology and Substrate Effects.
We report the effect of morphology and substrate of self-catalyzed indium phosphide (InP) nanostructures on phonon vibration modes. Using liquid indium as a catalyst, we grew self-catalyzed InP nanocones and nanopillars on single crystal substrates of InP(111)B, Si(111), and Si(100) via metal-organic chemical vapor epitaxy. Due to crystal symmetry breaking in one-dimensional nanostructure, longitudinal-optical (LO) and transverse-optical (TO) phonon modes are clearly resolved with the strong anisotropic behavior. Broadening and downshift of LO phonon modes are found to be sensitive to the morphology (i.e., aspect ratio and surface-to-volume ratio) and crystal structure (i.e., Wurtzite and Zinc Blende) of the as-grown nanostructures. This work demonstrated that Raman spectroscopy provides statistical insights on the quality of as-grown nanostructures (i.e., growth orientation, crystal structures, and the presence of structural defects) without destroying samples.


Metal Oxides as Catalysts and Adsorbents in Ozone Oxidation of NO x.
NO x represents an important group of pollutants that are formed in fuel combustion. As these pollutants cause significant environmental problems, removal of NO x from exhaust gases is necessary. The present study investigated the influence of metal oxide powders on the removal of NO x by oxidation with ozone. The aim of the study was to compare the catalytic effect of TiO2, Al2O3, and Fe2O3 and to investigate the dependence of the effective rate constant on temperature. NO (400 ppm) and a variable concentration of ozone in a mixture of N2 and O2 was directed through the catalyst chamber and heated to 60-140 °C. The addition of metal oxides resulted in a significant increase in the efficiency of the oxidation of NO to N2O5. Fe2O3 had the largest effect with a maximum of an approximately 3-fold increase in the effective rate constant at 100 °C. At the same time Fe2O3 had the lowest NO x adsorption capacity. In the case of all metal oxides, oxidation of NO to N2O5 caused an abrupt increase in adsorption of NO x.


Theoretical analysis of maximum flow declination rate versus maximum area declination rate in phonation.
Maximum flow declination rate (MFDR) in the glottis is known to correlate strongly with vocal intensity in voicing. This declination, or negative slope on the glottal airflow waveform, is in part attributable to the maximum area declination rate (MADR) and in part to the overall inertia of the air column of the vocal tract (lungs to lips). The purpose of this theoretical study was to show the possible contributions of air inertance and MADR to MFDR. A simplified computational model of the kinematics of vocal fold movement was utilized to compute a glottal area function. The glottal flow was computed interactively with lumped vocal tract parameters in the form of resistance and inertive reactance. It was shown that MADR depends almost entirely on the ratio of vibrational amplitudes of the lower to upper margins of the vocal fold tissue. Adduction, vertical phase difference, and prephonatory convergence of the glottis have a lesser effect on MADR. A relatively simple rule was developed that relates MFDR to a vibrational amplitude ratio and vocal tract inertance. It was concluded that speakers and singers have multiple options for control of intensity, some of which involve more source-filter interaction than others.


PD-1 blockade in Hodgkin's lymphoma: learning new tricks from an old teacher.
Classical Hodgkin's Lymphoma (cHL) is characterized by genetic reliance on the PD-1 pathway. Rapid accumulation of data describing the role and efficacy of PD-1 and its blockade warrants a focused review. In this article, we will review the unique biologic features that predispose cHL to PD-1 inhibition, current data regarding the safety and efficacy of PD-1 inhibitors in the treatment of cHL, biomarkers of immune response, ongoing clinical trials with PD-1 inhibitors, as well as areas of uncertainty. Expert commentary: The biologic and genetic underpinnings of cHL make it unique among all malignancies in its exquisite sensitivity to PD-1 inhibition. High response rates to single agent PD-1 inhibitors in early phase clinical trials serve as further proof of concept. These data strongly support continued clinical investigation of the evolving role of PD-1 inhibition in classical Hodgkin's lymphoma, including the optimal sequence, setting, and combination to best exploit the immunologic properties of this disease.


Predictors for Recurrence of Chronic Subdural Hematoma.
This prospective study was designed to analyze the dependence of different factors on the recurrence rate of chronic subdural hematoma (cSDH) after surgical treatment. Seventy-three consecutive patients, who were surgically treated at our department due to cSDH between 2009 and 2012, were included. The following parameters were analyzed: patient age and gender, occurrence of trauma, time between trauma and admission, neurological symptoms, presence of minor diseases, intake of anticoagulation medication. We classified the results of diagnostic imaging and determined the space-consuming effect via the cerebral midline shift. In addition, we scrutinized intraoperative findings and the dependence of the position of subdural drainage on the recurrence rate of cSDH. In our patient group, cSDH recurrence was significantly associated with aphasia (p=0.008). Moreover an increased cSDH recurrence rate was observed in the patient group that had a separated manifestation of the cSDH in the preoperative diagnostic imaging (p=0.048) and received no drainage implant (p=0.016). Homogeneous isodense cSDH was associated with no apparent recurrence (p=0.037). Within the scope of this study, we detected aphasia and separated cSDH as predictors of cSDH recurrence. Homogeneous isodense cSDH seems to be a good prognostic sign regarding the risk of recurrence development. Furthermore, our data clearly emphasize the importance of surgically applied drainage implants to prevent a recurrence of cSDH.


Physical stimulations and their osteogenesis-inducing mechanisms.
Physical stimulations such as magnetic, electric and mechanical stimulation could enhance cell activity and promote bone formation in bone repair process via activating signal pathways, modulating ion channels, regulating bonerelated gene expressions, etc. In this paper, bioeffects of physical stimulations on cell activity, tissue growth and bone healing were systematically summarized, which especially focused on their osteogenesis-inducing mechanisms. Detailedly, magnetic stimulation could produce Hall effect which improved the permeability of cell membrane and promoted the migration of ions, especially accelerating the extracellular calcium ions to pass through cell membrane. Electric stimulation could induce inverse piezoelectric effect which generated electric signals, accordingly up-regulating intracellular calcium levels and growth factor synthesis. And mechanical stimulation could produce mechanical signals which were converted into corresponding biochemical signals, thus activating various signaling pathways on cell membrane and inducing a series of gene expressions. Besides, bioeffects of physical stimulations combined with bone scaffolds which fabricated using 3D printing technology on bone cells were discussed. The equipments of physical stimulation system were described. The opportunities and challenges of physical stimulations were also presented from the perspective of bone repair.


Loss of Sirtuin 1 Alters the Secretome of Breast Cancer Cells by Impairing Lysosomal Integrity.
The NAD+-dependent deacetylase Sirtuin 1 (SIRT1) is down-regulated in triple-negative breast cancer. To determine the mechanistic basis by which reduced SIRT1 expression influences processes related to certain aggressive cancers, we examined the consequences of depleting breast cancer cells of SIRT1. We discovered that reducing SIRT1 levels decreased the expression of one particular subunit of the vacuolar-type H+ ATPase (V-ATPase), which is responsible for proper lysosomal acidification and protein degradation. This impairment in lysosomal function caused a reduction in the number of multi-vesicular bodies (MVBs) targeted for lysosomal degradation and resulted in larger MVBs prior to their fusing with the plasma membrane to release their contents. Collectively, these findings help explain how reduced SIRT1 expression, by disrupting lysosomal function and generating a secretome comprising exosomes with unique cargo and soluble hydrolases that degrade the extracellular matrix, can promote processes that increase breast-cancer-cell survival and invasion.


Control of bacteriophage phi X 174 gene expression by the transcription termination factor rho in vitro.
The effect of rho factor on bacteriophage phi X 174 gene expression was studied in a cell-free, DNA-dependent, RNA-directed protein synthesizing system (transcription-translation coupled system) using S30 extracts of wild-type and rho-mutant Escherichia coli cells. It has been found that in the presence of a functionally active and endogenous or added rho factor, only a limited number of the viral genes (A, B, and D) are expressed effectively, whereas the expression of genes, F, G, and H, which encode capsid proteins, is strongly inhibited. Mutational or thermal inactivation of rho factor results in a considerable activation of capsid protein synthesis and, at the same time, in some depression of the synthesis of gene A, B, and D products. From the results of this study it is suggested that phage phi X 174 has two classes of gene, late and early, which are separated on the chromosome by a rho-dependent transcription terminator. We propose that the expression of these classes is regulated by a termination-antitermination mechanism.


Dual Tobacco use among Native American adults in southeastern North Carolina.
While patterns of smokeless tobacco (ST) use and cigarette smoking are well documented, the epidemiology of simultaneous use of both tobacco products is less well studied, particularly among Native American populations. This study examines correlates of dual tobacco use among Lumbee Indian adults in southeastern North Carolina. A telephone survey among 400 adult Lumbee Indians in Pembroke, North Carolina, collected information on demographics, current tobacco use, amounts of tobacco used, and tobacco related attitudes. Total of 241 (60.3%) individuals did not currently use tobacco, 104 (26%) currently smoked, 74 (18.5%) currently used ST, and 19 (4.8%) used both products. Thus, 19 of 104 (18.3%) current smokers and 19 of 74 (25.7%) current ST users reported dual tobacco use. Compared to exclusive users of either tobacco product, dual tobacco users were intermediate in age and frequency of church attendance, had lower levels of education, and were the highest proportion of subjects reporting no friends and few close relatives. There was no difference by gender or marital status by tobacco use categories. While exclusive cigarette smokers reported smoking more cigarettes per day than dual tobacco users, overall, dual tobacco users had higher estimated daily nicotine exposure levels. Logistic regression analysis showed that younger age and infrequent church attendance predicted exclusive cigarette smoking, while older age and less education predicted exclusive ST use. Dual tobacco use was predicted only by less education. Simultaneous use of ST and cigarettes is comparatively more common among Lumbee Indian adults than the general population and has an epidemiology distinct from either exclusive cigarette smoking or ST use. These data are the first to explore social support as well as tobacco-related attitudes among dual tobacco users in a Native American population. Recognition of these patterns of dual tobacco use would be important in any future tobacco intervention among Lumbee Indian adults.


A simple and effective prognostic staging system based on clinicopathologic features of intrahepatic cholangiocarcinoma.
Incidence and mortality of intrahepatic cholangiocarcinoma (ICC) are increasing. However, its prognostic predictive system associated with outcome after surgery remains poorly defined. In this study, we conducted retrospective survival analyses in a primary cohort of 370 patients who underwent partial hepatectomy for ICC (2005 and 2009). We found that seven variables were significantly independent predictors for overall survival (OS): serum prealbumin (hazard ratio [HR]: 1.447; p = 0.015), carbohydrate antigen 19-9 (HR: 1.438; p = 0.009), carcinoembryonic antigen (HR: 1.732; p = 0.002), tumor number (HR: 1.781; p < 0.001), vascular invasion (HR: 1.784; p < 0.001), regional lymphatic metastasis (HR: 2.003; p < 0.001) and local extrahepatic metastasis (HR: 1.506; p = 0.008). Using these independent predictors, we created a simple clinicopathologic prognostic staging system for predicting survival of ICC patients after resection. The validity of the prognostic staging system was prospectively assessed in 115 patients who underwent partial hepatectomy between January 2010 and December 2010 at the same institution. The prognostic power was quantified using likelihood ratio test and Akaike information criteria. Compared with the 6(th) and 7(th) AJCC staging systems, the new staging system in the primary cohort had a higher predictive accuracy for OS in terms of homogeneity and discriminatory ability. In the validation cohort, the homogeneity and discrimination of the new staging system were also superior to the two other staging systems. The new staging system based on clinicopathologic features may provide relatively higher accuracy in prognostic prediction for ICC patients after tumor resection.


Detection of colon cancer by monitoring the intracellular fluorescein fluorescence polarization changes in lymphocytes.
Structuredness of the cytoplasmic matrix (SCM)-responding lymphocytes from healthy donors can be differentiated from SCM-responding lymphocytes of patients with malignant disease on the basis of the change in the intracellular fluorescein fluorescence polarization (IFFP) induced by their exposure to various antigens. We have found that the overall sensitivity, specificity and positive and negative predictive values of the test were 92.0, 92.6, 96.3, and 84.7%, respectively. We demonstrated the capability of the test to distinguish between healthy people and colorectal cancer patients per stage of the disease. We also found a significant difference in IFFP values between Dukes' C patients and patients with metastatic disease, rendering the test potentially helpful in follow-up.


Recent progress on the interaction between insects and Bacillus thuringiensis crops.
Extensive use of chemical pesticides poses a great threat to the environment and food safety. The discovery of Bacillus thuringiensis (Bt) toxins with effective insecticidal activity against pests and the development of transgenic technology of plants opened a new era of pest control. Transgenic Bt crops, including maize, cotton and soya bean, have now been produced and commercialized to protect against about 30 major coleopteran and lepidopteran pests, greatly benefiting the environment and the economy. However, with the long-term cultivation of Bt crops, some target pests have gradually developed resistance. Numerous studies have indicated that mutations in genes for toxins activation, toxin-binding and insect immunization are important sources in Bt resistance. An in-depth exploration of the corresponding Bt-resistance mechanisms will aid in the design of new strategies to prevent and control pests. Future research will focus on Bt crops expressing new genes and multiple genes to control a broader range of pests as part of an integrated pest management programme. This article is part of the theme issue 'Biotic signalling sheds light on smart pest management'.


CD44 isoforms expression in intraductal and invasive pancreatic cancer and its correlation to p53 gene mutations.
The expression of the CD44 antigen and its isoforms is found in many normal and malignant tissues. Numerous studies indicate that the antigen affects the course of the disease, and its v6 isoform exerts a particularly negative effect on the prognosis. High CD44s (standard) and v6 isoform expression has been noted in pancreatic cancer. A similarly common genetic change in pancreatic cancer is the p53 gene mutation. The aim of the investigation was to study the expression of the CD44s and CD44v6 antigens in invasive and intraductal pancreatic cancer and its possible correlation to the p53 gene mutations. Immunohistochemical studies were carried out in 12 patients operated on for pancreatic cancer, in whom intraductal cancer had been detected in addition to infiltrating cancer. The results indicate that pancreatic cancer is characterized by a high, yet independent expression of CD44s and the p53 protein. CD44s expression shows no correlation with the degree of tumor differentiation, while v6 expression is higher in cancers with higher histological malignancy grades. Intraductal pancreatic cancers show a similarity to invasive cancers with respect to CD44s and v6 expression, what indicates that already at the stage of its intraductal growth pancreatic cancer manifests the presence of properties affecting its invasiveness and tendencies to metastasizing.


Evaluating hemoptysis hospitalizations among patients with bronchiectasis in the United States: a population-based cohort study.
The burden of hospitalizations and mortality for hemoptysis due to bronchiectasis is not well characterized. The primary outcome of our study was to evaluate in-hospital mortality in patients admitted with hemoptysis and bronchiectasis, as well as the rates of bronchial artery embolization, length of stay, and hospitalization costs. The authors queried the Nationwide Inpatient Sample (NIS) claims database for hospitalizations between 2016 and 2017 using the ICD-10-CM codes for hemoptysis and bronchiectasis in the United States. Multivariable regression was used to evaluate predictors of in-hospital mortality, embolization, length of stay, and hospital costs. There were 8240 hospitalizations (weighted) for hemoptysis in the United States from 2016 to 2017. The overall in-hospital mortality was 4.5%, but higher in males compared to females. Predictors of in-hospital mortality included undergoing three or more procedures, age, and congestive heart failure. Bronchial artery embolization (BAE) was utilized during 2.1% of hospitalizations and was more frequently used in those with nontuberculous mycobacteria and aspergillus infections, but not pseudomonal infections. The mean length of stay was 6 days and the median hospitalization cost per patient was USD $9,610. Having comorbidities and procedures was significantly associated with increased length of stay and costs. Hemoptysis is a frequent indication for hospitalization among the bronchiectasis population. In-hospital death occurred in approximately 4.5% of hospitalizations. The effectiveness of BAE in treating and preventing recurrent hemoptysis from bronchiectasis needs to be explored.


The BREASTrial Stage II: ADM Breast Reconstruction Outcomes from Definitive Reconstruction to 3 Months Postoperative.
The Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial is a prospective randomized trial comparing outcomes of tissue expander breast reconstruction using either AlloDerm or DermaMatrix. The trial was divided into 3 outcome stages; this study reports stage II outcomes, which are those from the time of definitive reconstruction to 3 months postoperative. A randomized trial was conducted to compare complication rates between AlloDerm and DermaMatrix groups. The impact of matrix type, age, obesity, radiation therapy, chemotherapy, and reconstruction type on complications was analyzed with regression models. Of the 128 patients (199 breasts) who were randomly assigned into the trial, 111 patients (173 breasts) were available for analysis in stage II. There was no difference in overall rates of complications (15.4% vs 18.3%, P = 0.8) or implant loss (2.2% vs 3.7%, P = 0.5) between the AlloDerm and DermaMatrix groups, respectively. Obesity was the only significant predictor of complications on regression analysis (odds ratio, 4.31, P = 0.007). Matrix type, age, radiation therapy, chemotherapy, or reconstruction type had no impact on the incidence/severity of complications. Acellular dermal matrix (ADM) will likely continue to have a role in breast reconstructive surgery; however, caution should be taken when using ADM because of relatively high complication rates, especially in obese patients. The particular ADM product should be selected based on individual surgeon preference, experience, and success rates. These data and forthcoming long-term outcomes from the Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial will enable surgeons to carefully weigh the risks and benefits of ADM use in breast reconstruction.


[Effects of soil factor on active components of Radix Ophiopogonis].
To study the effects of soil factors on the active components in Radix Ophiopogonis. The content of polysaccharide, flavonoids, saponins, water-soluble extract and inorganic elements in Radix Ophiopogonis gathered from 7 different places were compared, physical and chemical properties and inorganic elements of soil were analyzed. The path and grey connection analysis were applied for studying the effects on the active components of Radix Ophiopogonis. The concentrations of mineral elements in plant were mainly adjusted by active absorption. The active components in Radix Ophiopogonis was primarily effected by soil enzyme activity, the other important factors were potassium, pH, and organic matter. K, Fe, Mn, B, Ba, Zn of soil also had much influence on it then others inorganic elements.


[Antiemetic efficacy of granisetron in the treatment of pediatric cancer--(1). Clinical evaluation of granisetron at a dose of 40 micrograms/kg].
Seventeen children with various types of cancer were studied on the effectiveness of antiemetic drug, granisetron, by a crossover randomized trial; receiving granisetron (40 micrograms/kg; n = 53) or conventional antiemetics, during intensive chemotherapy. In the patients given granisetron nausea and vomiting were well controlled (83.0%), compared with 33.3% of conventional (non granisetron) group. The mean number of vomiting episodes for each 6h-period over 24h after chemotherapy was reduced markedly in the patients given granisetron, compared with conventional therapy. One patient developed paraesthesia of the hand after injection of granisetron as the adverse effect, which recovered to normal spontaneously after 3 hrs. Our data indicated that antiemetic effect of granisetron was superior to conventional antiemetic drugs, both in terms of clinical effectiveness and usefulness.