[Surgical treatment of aortic valve disease: early results of a 360° minimally invasive approach].
Over the years, with the introduction of minimally invasive techniques and technologies aimed at reducing surgical trauma, aortic valve surgery has considerably developed and improved. Our approach includes: reduced incisions (upper "J" ministernomy or anterior right minithoracotomy), "ultra fast-track" anesthesia protocols, sutureless and rapid deployment valve prostheses and miniaturized circuits of extracorporeal circulation. The aim of this study was to evaluate the clinical outcomes associated with this multidisciplinary approach. Between October 2016 and November 2018, 429 patients underwent isolated aortic valve replacement at the Cardiac Surgery Unit of the "Ospedali Riuniti" of Ancona, Italy. Overall, 91 patients (21.2%) were operated according to our minimally invasive approach. A severe aortic valve stenosis was the indication for surgery in 90.1% of patients, aortic valve insufficiency in the remaining 18.7%. There were neither in-hospital deaths nor major or minor neurological events. Atrial fibrillation was the main postoperative complications (n=26, 28.6%). Four patients (4.4%) underwent permanent pacemaker implantation due to third-degree atrioventricular block, and a surgical bleeding revision was performed in 3.3%. No episodes of respiratory failure were reported. The median length of hospital stay was 6 days (5-8 days). Our initial experience with a 360° minimally invasive approach for the treatment of patients undergoing aortic valve replacement shows encouraging clinical outcomes; this approach may lead to an improved perception of surgery both by patients and their families. However, further clinical studies are needed to evaluate the long-term results.


Precrec: fast and accurate precision-recall and ROC curve calculations in R.
The precision-recall plot is more informative than the ROC plot when evaluating classifiers on imbalanced datasets, but fast and accurate curve calculation tools for precision-recall plots are currently not available. We have developed Precrec, an R library that aims to overcome this limitation of the plot. Our tool provides fast and accurate precision-recall calculations together with multiple functionalities that work efficiently under different conditions. Precrec is licensed under GPL-3 and freely available from CRAN (https://cran.r-project.org/package=precrec). It is implemented in R with C ++. firstname.lastname@example.com information: Supplementary data are available at Bioinformatics online.


Impaired endothelial alpha-2 adrenergic receptor-mediated vascular relaxation in the fructose-fed rat.
To investigate the vascular endothelial dysfunction in the insulin resistance syndrome, muscarinic and alpha2-adrenergic mediated relaxations were studied in the fructose-fed rat. Male Sprague-Dawley rats were fed either fructose-rich chow (FFR, n=14) or normal chow (CNT, n=13) for 8 weeks. Systolic blood pressure (SBP) was measured by the tail-cuff method. A 3 mm segment of mesenteric artery was cannulated and pressurized, pretreated with prazosin (10(-6) mol/l) and propranolol (3x10(-6) mol/l), then pre-contracted with serotonin (10(-6) mol/l). Endothelium-dependent relaxation was induced by addition of acetylcholine (ACh, 10(-9)-10(-4) mol/l) or a selective alpha2-agonist, B-HT 920 (10(-9)-10(-5) mol/l), with or without the nitric oxide (NO) synthase inhibitor, L-NAME (10(-4) mol/l). SBP was significantly elevated in FFR but not in CNT. Plasma triglyceride in FFT (241+/-115 mg/dl) was significantly (p<0.01) higher than in CNT (84+/-34 mg/dl). Insulin and insulin/glucose ratio were higher but not significantly. Plasma glucose was not different between the two groups. In the dose-response curves to ACh, maximum relaxation and ED50 were similar between FFR and CNT. Moreover, L-NAME shifted the dose-response curves similarly to the right in both groups. Dose-response curves to B-HT 920, however, showed less relaxation in FFR than in CNT (p<0.05). B-HT 920-induced relaxations were mostly abolished by L-NAME. It is concluded that endothelial alpha2-adrenergic relaxation, predominantly mediated by NO, is likely more sensitive to the development of insulin resistance than muscarinic receptor relaxation in this 8-weeks FFR model. This early impairment of endothelial alpha2-adrenergic relaxation may contribute to the development of hypertension and insulin resistance in the FFR.


Optimising a couples-focused intervention to increase couples' HIV testing and counselling using the person-based approach: a qualitative study in Kwa-Zulu Natal, South Africa.
This qualitative study explored how to optimise a couples-focused intervention to promote couples HIV testing and counselling (CHTC). Community setting in Kwa-Zulu Natal, South Africa. Qualitative interviews were conducted with 20 couples who had participated in a couples-focused intervention and five staff members delivering the intervention. Partners were interviewed individually by researchers of the same gender. A couples-focused intervention comprised of two group sessions and four couples counselling sessions was previously shown to significantly increase uptake to CHTC in Kwa-Zulu Natal, South Africa. However, more than half of couples participating in the intervention still chose not to test together during follow-up. The transcripts were analysed using the table of changes from the person-based approach. Proposed optimisations were discussed with a community group to ensure the intervention was as persuasive and acceptable as possible. Many couples found it challenging to discuss CHTC with their partner due to an implied lack of trust. Optimisations to the intervention were identified to increase readiness to discuss CHTC, including education about serodiscordance, discussions about CHTC by peer mentors and open discussion of personal barriers to CHTC during couples' counselling sessions. Additional training for staff in open questioning techniques could help them feel more comfortable to explore couples' perceived barriers to CHTC, rather than advising couples to test. A logic model was developed to show anticipated mechanisms through which the optimised intervention would increase uptake to CHTC, including increasing knowledge, increasing positive outcome beliefs and managing negative emotions. In-depth qualitative research informed optimisations to a couples-focused intervention for further evaluation in South Africa to encourage uptake to CHTC. Suggestions are made for optimal methods to gain open feedback on intervention experiences where participants may be reluctant to share negative views.


Penetrating paediatric thoracic injury.
Paediatric penetrating chest trauma is common in conflict, but rarely seen in peacetime. We describe the successful hospital management of a five year old female civilian casualty with life threatening penetrating thoracic trauma caused by a fragment from an explosive device.


Dissecting the transcriptional response to elicitors in Vitis vinifera cells.
The high effectiveness of cyclic oligosaccharides like cyclodextrins in the production of trans-resveratrol in Vitis vinifera cell cultures is enhanced in the presence of methyl jasmonate. In order to dissect the basis of the interactions among the elicitation responses triggered by these two compounds, a transcriptional analysis of grapevine cell cultures treated with cyclodextrins and methyl jasmonate separately or in combination was carried out. The results showed that the activation of genes encoding enzymes from phenylpropanoid and stilbene biosynthesis induced by cyclodextrins alone was partially enhanced in the presence of methyl jasmonate, which correlated with their effects on trans-resveratrol production. In addition, protein translation and cell cycle regulation were more highly repressed in cells treated with cyclodextrins than in those treated with methyl jasmonate, and this response was enhanced in the combined treatment. Ethylene signalling was activated by all treatments, while jasmonate signalling and salicylic acid conjugation were activated only in the presence of methyl jasmonate and cyclodextrins, respectively. Moreover, the combined treatment resulted in a crosstalk between the signalling cascades activated by cyclodextrins and methyl jasmonate, which, in turn, provoked the activation of additional regulatory pathways involving the up-regulation of MYB15, NAC and WRKY transcription factors, protein kinases and calcium signal transducers. All these results suggest that both elicitors cause an activation of the secondary metabolism in detriment of basic cell processes like the primary metabolism or cell division. Crosstalk between cyclodextrins and methyl jasmonate-induced signalling provokes an intensification of these responses resulting in a greater trans-resveratrol production.


Effects associated with the use of healthcare for eating disorders by women in the community: a longitudinal cohort study.
This study examined formal and informal healthcare use (HCU) in community women with disordered eating, and associations of HCU with mental health-related quality of life (MHRQoL), psychological distress, mental health literacy (MHL) and eating disorder (ED) symptoms over time. We hypothesised that HCU would lead to improvement in ED symptom severity, MHRQoL, MHL and psychological distress. Data were from years 2, 4 and 9 of a longitudinal cohort of 443 community women (mean age 30.6, SE 0.4 years) with a range of ED symptoms, randomly recruited from the Australian Capital Territory electoral role or via convenience sampling from tertiary education centres. Data were collected using posted/emailed self-report questionnaires; inclusion criteria were completion of the HCU questionnaire at time point of 2 years (baseline for this study). HCU was measured using a multiple-choice question on help seeking for an eating problem. To test the effect of HCU over time on MHRQoL (Short Form-12 score), psychological distress (Kessler Psychological Distress Scale score), ED symptom severity (Eating Disorder Examination Questionnaire score) and ED-MHL, linear or logistic mixed-effects regression analyses were used. 20% of participants sought ED-specific help at baseline; more than half of participants sought help that was not evidence based. HCU at baseline was significantly associated with improved MHRQoL and ED symptom severity and decreased psychological distress over time (Cohen's d all >0.3, ie, small). HCU was not significantly associated with MHL over time. The predictive ability of the fitted models ranged from 32.18% to 42.42% for psychological distress and MHL treatment, respectively. Formal and informal HCU were associated with small improvements in ED symptoms, MHRQoL and psychological distress but not with improved MHL. Informal services in ED management should be investigated further along with efforts to improve ED-MHL.


Injuries in Australian Army recruits. Part III: The accuracy of a pretraining orthopedic screen in predicting ultimate injury outcome.
Three hundred fifty male recruits were divided into two groups: Walk (N = 170) and Run (N = 180). A physical screen was performed before the commencement of recruit training consisting of a visual assessment of the feet looking for pes planus, pes cavus, and deformities of the toes. Each recruit was also asked if he had sustained any injury in the preceding 2 years. The visual findings and history of prior injury were noted and compared with actual injuries sustained during the 12-week training course. Fifty-three subjects in the Walk group and 54 in the Run group were identified as being at risk as a consequence of the screen. The sensitivity of the screen for predicting the subsequent injury was 34.4% in the Walk group and 31.8% in the Run group. The specificity was 72.6 and 77.4% in the Walk and Run groups, respectively. The predictive value of the test was 44.9% in the Walk group and 50.9% in the Run group. When reinjury was examined, the sensitivities fell to 9.4% (Walk) and 4.7% (Run) and the specificities to 57.5% (Walk) and 50.5% (Run). The screen correctly identified only 1 of 10 medical discharges in the Walk group and 2 of 16 in the Run group. The screening examination had poor sensitivity, specificity, and predictive value, and more than half of those thought to be at risk did not subsequently sustain an injury. Anecdotal beliefs that improvements in medical screening would reduce recruit wastage were not borne out. Abnormalities of the foot (pes planus, pes cavus, hallux valgus) were not significant factors in the development of injury during recruit training.


High prevalence of VIM-4 and NDM-1 metallo-β-lactamase among carbapenem-resistant Enterobacteriaceae.
The purpose of this study was to identify the mechanisms leading to carbapenem resistance among multidrug-resistant Enterobacteriaceae isolates recovered from hospitalized patients with nosocomial infections in Mubarak Al Kabeer Hospital, Kuwait. Fourteen carbapenem-resistant Enterobacteriaceae isolates were obtained from inpatients in different wards and intensive care units between April 2009 and February 2011. Antibiotic susceptibilities were determined using the E-test method. Genes encoding β-lactamases were characterized by specific PCR amplification, sequencing and conjugation assays. All isolates were identified as metallo-β-lactamase (MBL) producers using phenotypic and molecular methods. Eleven of the 14 isolates produced VIM-4 (six Klebsiella pneumoniae, three Escherichia coli, one Enterobacter cloacae and one Klebsiella oxytoca). Three K. pneumoniae isolates produced the MBL NDM-1 and co-produced the plasmid-encoded AmpC CMY-4. The VIM-4-producing isolates co-produced extended-spectrum β-lactamases including CTX-M-15 and some SHV derivatives. The VIM-4 gene was not transferable by conjugation studies of six selected strains. We demonstrated here the emergence of VIM-4- and NDM-1-producing isolates in the largest teaching hospital in Kuwait.


Gut microbiota and metabolic marker alteration following dietary isoflavone-photoperiod interaction.
The interaction between isoflavones and the gut microbiota has been highlighted as a potential regulator of obesity and diabetes. In this study, we examined the interaction between isoflavones and a shortened activity photoperiod on the gut microbiome. Male mice were exposed to a diet containing no isoflavones (NIF) or a regular diet (RD) containing the usual isoflavones level found in a standard vivarium chow. These groups were further divided into regular (12L:12D) or short active (16L:8D) photoperiod, which mimics seasonal changes observed at high latitudes. White adipose tissue and genes involved in lipid metabolism and adipogenesis processes were analysed. Bacterial genomic DNA was isolated from fecal boli, and 16S ribosomal RNA sequencing was performed. NIF diet increased body weight and adipocyte size when compared to mice on RD. The lack of isoflavones and photoperiod alteration also caused dysregulation of lipoprotein lipase (Lpl), glucose transporter type 4 (Glut-4) and peroxisome proliferator-activated receptor gamma (Pparg) genes. Using 16S ribosomal RNA sequencing, we found that mice fed the NIF diet had a greater proportion of Firmicutes than Bacteroidetes when compared to animals on the RD. These alterations were accompanied by changes in the endocrine profile, with lower thyroid-stimulating hormone levels in the NIF group compared to the RD. Interestingly, the NIF group displayed increased locomotion as compared to the RD group. Together, these data show an interaction between the gut bacterial communities, photoperiod length and isoflavone compounds, which may be essential for understanding and improving metabolic health.


Language maintenance and language shift: community languages in Australia, 1996.
"There is a continuing significant shift to English spoken in the home among Australia's established community language groups. There are also success stories in language maintenance. Factors influencing language use include the distribution of speakers, the age profile of the community, intermarriage patterns and cultural distance from Anglo-Australians. Australia-wide, the shift rates to English spoken at home range between three percent from Macedonian and 62 percent from Dutch in the first generation, and 15 percent from Macedonian and 95 percent from Dutch in the second generation."


Evaluation of the diagnostic value of serum bile acid in the detection and functional assessment of liver diseases.
The diagnostic usefulness of fasting total serum bile acids (SBA/F) in the detection of liver diseases and assessment of different aspects of hepatic function alteration was evaluated in 61 healthy subjects and 186 patients with liver disease. The value of SBA/F was compared with other routine tests. In 49 healthy subjects and 92 patients, serum bile acids were also measured after the im administration of Ceruletide as a cholecystokinetic agent (SBA/C). The diagnostic efficacy for the detection of disease states was better with aspartate-aminotransferase (EC 22.214.171.124) and alanine-aminotransferase (EC 184.108.40.206) than with SBA/F. When SBA/C was also determined the diagnostic efficacy was not substantially better than the SBA/F test. In the assessment of hepatocellular necrosis SBA/F showed a higher rate of misclassification errors compared to alanine-aminotransferase (mean error 45% vs 17%), whereas SBA/F gave similar results with direct bilirubin and pseudocholinesterase (EC 22.214.171.124) in the evaluation of cholestasis (mean error 40% vs 41%) and impaired biosynthesis (mean error 39% vs 40%), respectively. Serum bile acid determination did not show any significant diagnostic advantage with respect to the other routine liver tests.


Fractal structures in two-metal electrodeposition systems I: Pb and Zn.
Pattern formation in two-metal electrochemical deposition has been scarcely explored in the chemical literature. In this paper, we report new experiments on zinc-lead fractal co-deposition. Electrodeposits are grown in special cells at a fixed large value of the zinc ion concentration, while that of the lead ion is increased gradually. A very wide diversity of morphologies are obtained and classified. Most of the deposited domains are almost exclusively Pb or Zn. But certain regions originating at the base cathode, ranging from a short grass alley to dense, grown-up bushes or shrubs, manifest a combined Pb-Zn composition. Composition is determined using scanning electron microscopy/energy dispersive x ray measurements as well atomic absorption spectroscopy. Pb domains are characterized by shiny leaf-like and dense deposits as well as flowers with round, balloon-like corollas. The Zn zones display a greater variety of morphologies such as thick trunks and thin and fine branching, in addition to minute "cigar flower" structures. The various morphologies are analyzed and classified from the viewpoint of fractal nature, characterized by the box-count fractal dimension. Finally, macroscopic spatial alternation between two different characteristic morphologies is observed under certain conditions.


Indications for an active process underlying spontaneous and radiation-induced micronucleation in L929 cells.
To investigate the mechanism of micronucleus formation in irradiated L929 cells. Radiation-induced micronuclei (MN) of L929 cells isolated at 48 and 72 h after irradiation were processed for detection of DNA-laddering and higher-order chromatin fragments using conventional gel electrophoresis and pulse-field gel electrophoresis. Quantification of double-strand breaks in micronuclei and nuclei was performed with the TdT assay and quantified using image analysis. The number of binucleated cells containing micronuclei (cytochalasin B method) was counted after application of three unspecific endonuclease inhibitors (aurin, ATA, spermine), a topoisomerase II inhibitor (VM-26), administration of two PKC inhibitors (H-7, Gö6983) and after addition of N-acetylsphingosine (C2-ceramide). PKC activity was determined by measuring the incorporation of [gamma-32P]ATP into a suitable specific substrate. Proliferation was measured by detection of PCNA, RFP-A and BrdU (30-min pulse labelling) using both conventional immunofluorescence and laser scanning microscopy. (1) Higher chromatin fragments accumulated in MN with a size as they occur during early stages of apoptosis; (2) the frequency of MN was influenced by drugs known to play an important role in signalling and execution of apoptosis (endonucleases, topoisomerase II, protein kinases, ceramide); (3) MN are characterized by a reduced transcription ability (PCNA, RFP-A). A proportion of L929 MN may be formed by an active process comparable with the early stages of apoptosis; it may play a role in the re-organization of the damaged genome.


A comparison of modality-specific somatosensory changes during menstruation in dysmenorrheic and nondysmenorrheic women.
The objective was to evaluate somatosensory thresholds to a multimodality stimulation regimen applied both within and outside areas of referred menstrual pain in dysmenorrheic women, over four phases of confirmed ovulatory cycles, and to compare them with thresholds in nondysmenorrheic women during menstruation. Twenty dysmenorrheic women with menstrual pain scoring 5.45 +/- 0.39 cm (mean +/- standard error of mean) on a visual analog scale (10 cm) participated. Fifteen nondysmenorrheic women with a menstrual pain score of 0.4 +/- 0.2 cm participated as controls. Ovulation was confirmed by an enzyme-multiplied immunoassay technique. Menstrual pain was described with the McGill Pain Questionnaire. Areas within menstrual pain referral were two abdominal sites and the midline of the low back, and the arm and thigh were the control areas. The pressure pain threshold (PPT) and pinch pain threshold were determined by a hand-held electronic pressure algometer, the heat pain threshold (HPT) by a contact thermode, and the tactile threshold with von Frey hairs. In dysmenorrheic women the McGill Pain Questionnaire showed a larger sensory and affective component of pain than the evaluative and miscellaneous groups. The HPT and PPT were lower in the menstrual phase than in the ovulatory, luteal, and premenstrual phases, both within and outside areas of referred menstrual pain (p <0.01), with a more pronounced decrease at the referral pain areas. The pinch pain threshold was lower in the menstrual phase than in the ovulatory phase (p <0.02), and the tactile threshold did not differ significantly across the menstrual phases or within any site. Dysmenorrheic women had a lower HPT at the control sites and a lower PPT at the abdomen, back, and control sites, than in those of nondysmenorrheic women in the menstrual phase. The results show reduced somatosensory pain thresholds during menstruation to heat and pressure stimulation, both within and outside areas of referred menstrual pain in dysmenorrheic women. Dysmenorrheic women showed a lower HPT at the control sites and a lower PPT at all the sites than those for nondysmenorrheic women in the menstrual phase. The altered somatosensory thresholds may be dependent on a spinal mechanism of central hyperexcitability, induced by recurrent moderate to severe menstrual pain.


Clean intermittent catheterization in the management of the neurogenic bladder in children.
Clean intermittent catheterization has been successful in the management of urinary incontinence and upper tract changes associated with a neurogenic bladder. The results of clean intermittent catheterization controlling urinary incontinence, ureteral reflux, upper tract dilatation and urinary infection in 84 children with a neurogenic bladder were evaluated for up to 3 years of followup. Of the children 41 (49 per cent) were totally incontinent and 14 (17 per cent) were slightly damp. Preexisting ureteral reflux deteriorated in 25 per cent of the patients, ceased in 35 per cent and was unchanged in 40 per cent, while pre-existing upper tract dilatation improved in 12.5 per cent and was unchanged in 87.5 per cent. On clean intermittent catheterization and antibacterial medication 90 per cent of the children had sterile urine and 7.5 per cent had 10(5) or more colonies per ml. Complications occurred on 54 occasions but were minor in nature and were corrected easily. Half of the parents, schools and children found clean intermittent catheterization very acceptable or acceptable but a quarter of the parents and patients found it unacceptable or slightly unacceptable, or were undecided. Initial management of urinary complications associated with neurogenic bladder in children has changed to the clean intermittent catheterization program, with greatly improved results compared to Credé's expression of the bladder, an indwelling urethral catheter or urinary diversion. However, the clean intermittent catheterization regimen was not effective completely, not without complications and not accepted completely by parents, schools and children.


The interplay of stress and sleep impacts BDNF level.
Sleep plays a pivotal role in normal biological functions. Sleep loss results in higher stress vulnerability and is often found in mental disorders. There is evidence that brain-derived neurotrophic factor (BDNF) could be a central player in this relationship. Recently, we could demonstrate that subjects suffering from current symptoms of insomnia exhibited significantly decreased serum BDNF levels compared with sleep-healthy controls. In accordance with the paradigm indicating a link between sleep and BDNF, we aimed to investigate if the stress system influences the association between sleep and BDNF. Participants with current symptoms of insomnia plus a former diagnosis of Restless Legs Syndrome (RLS) and/or Periodic Limb Movement (PLM) and sleep healthy controls were included in the study. They completed questionnaires on sleep (ISI, Insomnia Severity Index) and stress (PSS, Perceived Stress Scale) and provided a blood sample for determination of serum BDNF. We found a significant interaction between stress and insomnia with an impact on serum BDNF levels. Moreover, insomnia severity groups and score on the PSS each revealed a significant main effect on serum BDNF levels. Insomnia severity was associated with increased stress experience affecting serum BDNF levels. Of note, the association between stress and BDNF was only observed in subjects without insomnia. Using a mediation model, sleep was revealed as a mediator of the association between stress experience and serum BDNF levels. This is the first study to show that the interplay between stress and sleep impacts BDNF levels, suggesting an important role of this relationship in the pathogenesis of stress-associated mental disorders. Hence, we suggest sleep as a key mediator at the connection between stress and BDNF. Whether sleep is maintained or disturbed might explain why some individuals are able to handle a certain stress load while others develop a mental disorder.


Investigations of chemical modifications of amino-terminated organic films on silicon substrates and controlled protein immobilization.
Fourier transform infrared spectroscopy by grazing-angle attenuated total reflection (FTIR-GATR), ellipsometry, atomic force microscopy (AFM), UV-visible spectroscopy, and fluorescence microscopy were employed to investigate chemical modifications of amino-terminated organic thin films on silicon substrates, protein immobilization, and the biological activity and hydrolytic stability of immobilized proteins. Amino-terminated organic films were prepared on silicon wafers by self-assembling 3-aminopropyltriethoxysilane (APTES) in anhydrous toluene. Surface amino groups were derivatized into three different linkers: N-hydroxysuccinimide (NHS) ester, hydrazide, and maleimide ester groups. UV-visible absorption measurements and fluorescence microscopy revealed that more than 40% of surface amino groups were chemically modified. Protein immobilization was carried out on modified APTES films containing these linkers via coupling with primary amines (-NH(2)) in intact monoclonal rabbit immunoglobulin G (IgG), the aldehyde (-CHO) of an oxidized carbohydrate residue in IgG, or the sulfhydryl (-SH) of fragmented half-IgG, respectively. FTIR spectra contain vibrational signatures of these functional groups present in modified APTES films and immobilized IgGs. Changes in the APTES film thickness after chemical modifications and protein immobilization were also observed by ellipsometric measurements. The biological activity and long-term hydrolytic stability of immobilized IgGs on modified APTES films were estimated by fluorescence measurements of an adsorbed antigen, fluorescein isothiocyanate (FITC)-labeled goat anti-rabbit IgG (FITC-Ab). Our results indicate that the FITC-Ab binding capacity of half-IgG immobilized via maleimide groups is greater than that of the oxidized IgG and the intact IgG immobilized via hydrazide and NHS ester groups, respectively. In addition, IgGs immobilized using all coupling chemistries were hydrolytically stable in phosphate-buffered saline (PBS).


Biofilm formation on clinically noninfected penile prostheses.
Biofilms are matrix enclosed bacterial populations that adhere to each other and/or to surfaces of implanted medical devices. Biofilm formation has consistently been demonstrated in association with infected penile prosthetic material. Clinically noninfected patients undergoing revision for mechanical malfunction have a surprisingly high rate of positive intraoperative cultures. After revision replacement prostheses have a higher rate of postoperative infection than first time implants. We characterized biofilm formation on penile prostheses in clinically noninfected patients undergoing revision surgery. Ten patients undergoing revision or removal of inflatable penile prosthetic devices due to mechanical malfunction were included. Specimens from the corporeal cylinders, scrotal pump and reservoir were analyzed. Bacterial biofilm coverage was detected and characterized using confocal scanning laser microscopy. Bacterial biofilm formation associated with multiple microorganisms was demonstrated on 8 of 10 prostheses. Biofilms consisted of gram-positive rods, cocci and fungal elements. The degree of biofilm formation on these prosthetic devices suggests that most patients have bacterial coverage on the implant. Host mechanisms to control infection may lead to a homeostatic balance that enables biofilms to exist on the surface of the prosthesis without generating clinical infection. A critical threshold of biofilm extent may exist beyond which clinical infection may occur. These results justify further evaluation of biofilms and penile prosthesis infections. Furthermore, the findings help to explain why strategies such as mini salvage procedures to eliminate subclinical biofilms may decrease the postoperative infection risk in patients undergoing repair or replacement of penile prostheses.


Intestinal obstruction secondary to left paraduodenal hernia.
An internal hernia-congenital or acquired-is a protrusion of bowel through an opening in the peritoneum or mesentery. Internal hernias are the etiology of <2% of intestinal obstructions, with paraduodenal hernias being the most common type of congenital internal hernia. We report a case of a left paraduodenal hernia (LPDH) combined with partial small bowel obstruction in a 69-year-old male with recurrent abdominal pain of 2 years duration and no previous abdominal surgeries. An abdominal computed tomography scan showed an agglomeration of small bowel loops in the left upper quadrant but failed to yield a clear diagnosis. Surgical intervention provided definitive diagnosis and treatment of the LPDH. We additionally review the literature regarding anatomy, pathogenesis, diagnosis and treatment of this uncommon hernia. Intestinal obstruction secondary to an internal hernia is a rare entity; however, delayed diagnosis and surgical intervention may result in significant morbidity and mortality.


E2F2/5/8 Serve as Potential Prognostic Biomarkers and Targets for Human Ovarian Cancer.
E2Fs are a family of pivotal transcription factors. Accumulative evidence indicates that aberrant expression or activation of E2Fs is a common phenomenon in malignances, and significant associations have been noted between E2Fs and tumorigenesis or progression in a wide range of cancers. However, the expression patterns and exact roles of each E2F contributing to tumorigenesis and progression of ovarian cancer (OC) have not yet been elucidated. In this study, we investigated the distinct expression and prognostic value of E2Fs in patients with OC by analyzing a series of databases, including ONCOMINE, GEPIA, cBioPortal, Metascape, and Kaplan-Meier plotter. The mRNA expression levels of E2F1/3/5/8 were found to be significantly upregulated in patients with OC and were obviously associated with tumor stage for OC. Aberrant expression of E2F2/5/7/8 was found to be associated with the clinical outcomes of patients with OC. These results suggest that E2F2/5/8 might serve as potential prognostic biomarkers and targets for OC. However, future studies are required to validate our findings and promote the clinical utility of E2Fs in OC.


Predictive Factors of Cerebral Aneurysm Rerupture After Clipping.
We aimed to estimate the risk of rerupture after first-time aneurysmal clipping surgery, explore the possible related factors, and assess long-term physical functionality. We hypothesized that the modified Rankin scale (mRS) could serve as an effective substitute for Hunter and Hess scale. This retrospective study included 171 patients with cerebral aneurysmal rupture who had completed aneurysmal clipping treatment and collected their demographic data and medical records. The outcome assessments include neuroimaging records, Hunter and Hess scale, and the mRS scale during hospitalization and follow-up after discharge. The mean length of follow-up was 4.28 years. After aneurysmal clipping treatment, 83 patients (48.5%) had subsequently ruptured aneurysms. The scores of the reruptured group on the Hunt and Hess scale and mRS were significantly higher than those of the non-reruptured group. Multiple Cox proportional-hazards regression also showed that postoperative mRS >2, smoking, and two or more aneurysms were potentially important risk factors leading to aneurysm rupture again [the corresponding hazard ratios (HRs) were 5.209, 2.109, and 2.775, respectively] in patients. In addition, the location of an aneurysm on the anterior cerebral artery (ACA) or the posterior communicating (Pcom) artery had a higher risk of rerupture (the corresponding HRs were 1.996 and 2.934, respectively). Nearly half of the collected participants experienced the rerupture episode, who had undergone the second-time clipping surgery. Smoking and multiple aneurysms are potential risk factors for aneurysmal rerupture. Most aneurysms are located along the ICA, but aneurysms located at the ACA or Pcom site are most likely to rerupture. As compared with the Hunter and Hess scale, the mRS scale does not have inferior predicting power in following patients' long-term functionalities.


When and how to start prevention of atherosclerosis? Lessons from the Cardiovascular Risk in the Young Finns Study and the Special Turku Coronary Risk Factor Intervention Project.
This review provides an up-to-date summary of findings from two ongoing population-based, prospective studies conducted in Finland: The Cardiovascular Risk in Young Finns Study, and the Special Turku Coronary Risk Factor Intervention Project (STRIP), which have contributed significantly to the scientific literature concerning the childhood origin of cardiovascular disease, and whether prevention efforts in adults can be expanded to young people. From the Young Finns Study, we summarize evidence demonstrating childhood risk factors to be associated with both risk factors and preclinical markers of atherosclerosis in adulthood, and from STRIP, we summarize evidence showing that supervised dietary counseling of a low saturated fat diet effectively decreases exposure to cardiovascular risk factors without affecting growth and development of healthy children and adolescents. The evidence available from these studies supports that the ability to prevent or delay the risk of premature atherosclerosis and its clinical sequelae later in life lies in maintaining a low lifetime risk by preventing the development of risk factors in early life.


Penetrating trauma to the head and neck from a nail gun: a unique mechanism of injury.
Published reports of nail gun injuries to the head and neck are rare. We describe the cases of three patients who sustained nail gun injuries to the head and who were managed at our institution. All patients were treated successfully and all recovered with minimal morbidity. Any physician who is called on to manage a nail gun injury to the head or neck should understand that most likely the patient will have sustained a surprisingly limited amount of tissue injury, owing to the relatively low velocity of the projectile compared with that delivered by firearms. Computed tomography and selective angiography can play a vital role in assessing the integrity of relevant vascular structures. Moreover, catheter angiography with embolization can be a most useful nonsurgical adjunct to control the extent of vascular injury.


The link between design and commissioning.
Establish a commissioning plan at project commencement and carry out periodic reviews against a check list for each key stage. Note the sequence of tasks: (a) Appointment to match the duties needed. (b) Formal briefing and recording stage. (c) Outline design to precede detail design. (d) Design in accordance with good practice. (e) Achieve 100% of design before tender. (f) Precisely specify contract requirements. (g) Interview contractors prior to tender. (h) Rigorous off and on site inspection. (j) Pre-commissioning before commissioning. (k) Phased availability of manuals/drawings prior to handover. (l) Adequate proving and training period before handover. (m) Phased withdrawal from site. The main thrust of this paper has been to call for a more rigorous approach on and off site. Without this the improvements in technology in building services which are presently emerging will not be reflected in the finished product. The causes of the problem are well known and the remedy is in all our hands.


Studying the Mechanics of Membrane Permeabilization through Mechanoelectricity.
In this research, real-time monitoring of lipid membrane disruption is made possible by exploiting the dynamic properties of model lipid bilayers formed at oil-water interfaces. This involves tracking an electrical signal generated through rhythmic membrane perturbation translated into the adsorption and penetration of charged species within the membrane. Importantly, this allows for the detection of membrane surface interactions that occur prior to pore formation that may be otherwise undetected. The requisite dynamic membranes for this approach are made possible through the droplet interface bilayer (DIB) technique. Membranes are formed at the interface of lipid monolayer-coated aqueous droplets submerged in oil. We present how cyclically alternating the membrane area leads to the generation of mechanoelectric current. This current is negligible without a transmembrane voltage until a composition mismatch between the membrane monolayers is produced, such as a one-sided accumulation of disruptive agents. The generated mechanoelectric current is then eliminated when an applied electric field compensates for this asymmetry, enabling measurement of the transmembrane potential offset. Tracking the compensating voltage with respect to time then reveals the gradual accumulation of disruptive agents prior to membrane permeabilization. The innovation of this work is emphasized in its ability to continuously track membrane surface activity, highlighting the initial interaction steps of membrane disruption. In this paper, we begin by validating our proposed approach against measurements taken for fixed composition membranes using standard electrophysiological techniques. Next, we investigate surfactant adsorption, including hexadecyltrimethylammonium bromide (CTAB, cationic) and sodium decyl sulfate (SDS, anionic), demonstrating the ability to track adsorption prior to disruption. Finally, we investigate the penetration of lipid membranes by melittin, confirming that the peptide insertion and disruption mechanics are, in part, modulated by membrane composition.


Exact quantification of time signals in Padé-based magnetic resonance spectroscopy.
This study reports on the fast Padé transform (FPT) for parametric signal processing of realistically synthesized free induction decay curves whose main spectral features are similar to those encoded clinically from a healthy human brain by means of magnetic resonance spectroscopy (MRS). Here, for the purpose of diagnostics, it is of paramount importance to be able to perform accurate and robust quantification of the investigated time signals. This amounts to solving the challenging harmonic inversion problem as a spectral decomposition of the given time signal by means of reconstruction of the unknown total number of resonances, their complex frequencies and amplitudes yielding the peak positions, widths, heights and phases. On theoretical grounds, the FPT solves exactly this mathematically ill-conditioned inverse problem for any noiseless synthesized time signal comprised of an arbitrarily large (finite or infinite) number of damped complex exponentials with stationary and non-stationary polynomial-type amplitudes leading to Lorentzian (non-degenerate) and non-Lorentzian (degenerate) spectra. Convergent validation for this fact is given via the proof-of-principle which is thoroughly demonstrated by the exact numerical solution of a typical quantification problem from MRS. The presently designed study is a paradigm shift for signal processing in MRS with particular relevance to clinical oncology, due to the unprecedented capability of the fast Padé transform to unequivocally resolve and quantify isolated, tightly overlapped and nearly coincident resonances.


Synthesis of La2O3/MWCNT nanocomposite as the sensing element for electrochemical determination of theophylline.
In this study, an electrochemical sensor was applied for the determination of theophylline, a bronchodilator drug, using differential pulse voltammetry (DPV). A glassy carbon electrode (GCE) surface was modified with the La2O3/MWCNT nanocomposite. The design is simplistic, efficient, greener and solvent-free microwave procedure for synthesizing La2O3/MWCNT nanocomposites. Fourier transform infrared (FT-IR) spectroscopy, field emission scanning electron microscopy (FESEM), energy dispersive X-ray spectroscopy (EDX), and X-ray diffraction (XRD) techniques are used to characterize the features of the La2O3/MWCNT nanocomposite morphology and structure. The use of the modified sensor remarkably enhanced the current density and displayed a linear response ranging between 0.1 and 400.0 μM, with a limit of detection of 0.01 μM (S/N = 3). Using optimized conditions, the modified sensor demonstrated very good stability, selectivity and improved accuracy. Acceptable outputs were achieved in the analysis of real specimens, indicating that it is possible to use the modified sensor for practical analyses.


Scope of the problem of functional digestive disorders.
Functional dyspepsia and the irritable bowel syndrome (IBS) are amongst the most widely recognised functional gastrointestinal disorders. Symptom based diagnostic criteria have been developed and refined for the syndromes (the Rome criteria) and these are now widely applied in clinical research. Both functional dyspepsia and IBS are remarkably prevalent in the general population, affecting approximately 20% and 10% of persons, respectively. The prevalence is stable from year to year because the onset of these disorders is balanced by their disappearance in the population. Clinically useful predictors of the course of these disorders have not been identified. Approximately one third of persons with functional dyspepsia concurrently have IBS. In most studies from Western countries, it has been shown that only a minority with functional dyspepsia and IBS present for medical care; the factors that explain consultation behaviour remain inadequately defined although fear of serious disease and psychological distress may be important. The majority of patients diagnosed as having functional dyspepsia or IBS continue to have symptoms long term with a significant impact on quality of life. The indirect costs of the functional gastrointestinal disorders greatly outweigh the direct costs but overall these conditions are responsible for a major proportion of health care consumption. Rational management of the functional gastrointestinal disorders will only follow a better understanding of the natural history of these conditions.


Tissue concentration of doxorubicin (adriamycin) in mouse pretreated with alpha-tocopherol or coenzyme Q10.
The tissue concentration of doxorubicin (adriamycin; ADM) and its major metabolite (aglycone I) was examined in mice pretreated with alpha-tocopherol (VE) or coenzyme Q10 (CoQ). In VE-pretreated group, the concentrations of aglycone I of the liver (1, 3 and 5 h after the administration), kidney (1 and 3h) and heart (3h) were significantly higher than those in the saline group. The clinical application of VE or CoQ concomitant with anti-tumor drugs especially ADM, requires caution.


Cells secreting anti-MAG antibody occur in cerebrospinal fluid and bone marrow in patients with polyneuropathy associated with M component.
Occurrence and distribution of cells secreting antibodies against myelin associated glycoprotein (MAG) were studied in 9 patients with polyneuropathy associated with the monoclonal (M) component in serum. Utilizing an immunospot assay, we found that 4 of 7 patients with polyneuropathy associated with an IgM M component had cells secreting anti-MAG IgM antibody in cerebrospinal fluid (CSF) numbering between 1 per 212 and 1 per 3333 mononuclear cells. All 7 patients had cells secreting anti-MAG IgM antibody in bone marrow (median value 1 per 2000 cells). In contrast, peripheral blood from only 2 of these patients contained low numbers of such cells. One patient with polyneuropathy associated with an IgA M component had cells secreting anti-MAG IgA antibody in CSF, and 1 with an IgG M component had cells secreting anti-MAG IgG antibody in CSF; both patients also had anti-MAG IgM antibodies detectable in CSF only by ELISA. These 2 patients may thus have concurrent intrathecal production of antibodies of 2 different isotypes which are directed against the same or different epitopes of MAG. The production of antibodies directed against a component of myelin occurring in the immediate vicinity of the peripheral nervous system might be involved in the pathogenesis of the polyneuropathy.


Feasibility study of home telerehabilitation for physically inactive veterans.
The aim of this study was to develop a system for and determine the feasibility of monitoring home exercise for physically inactive older adults using a Health Buddy (HB) text messaging device (Robert Bosch Healthcare; Palo Alto, California). Questions and messages related to exercise adherence are displayed on the HB screen and participants choose a response by pressing the corresponding button on the device. Responses are transmitted through a landline connection and high-risk responses are highlighted by the system for follow-up. We developed the questions and messages based on input from patient and clinician focus groups. We evaluated feasibility by administering the intervention to inpatient and outpatient adults aged 60 or older. We gave participants a choice of exercise monitoring by HB (n = 20) or telephone (n = 18). The results showed that home exercise monitoring by HB and telephone is safe, as evidenced by low adverse event rates. We saw a decline in exercise adherence rates to both the HB and telephone after 8 weeks, although adherence was better for HB than telephone. Taken together, the results demonstrate the feasibility of using text messaging to monitor home exercise adherence in physically inactive older adults.


In-situ etching observation of human teeth in acid agent by atomic force microscopy.
Atomic force microscopy was applied to the in-situ observation of the etching process of human teeth by acid agents. The change of surface morphology was observed consecutively before and during etching for the same area in the same specimen. The course of the etching process in enamel from dissolution of smear layer just after injection of acid agent, appearance of enamel prisms and progress of demineralization were quantitatively analysed for three fundamental acid agents of 2% phosphoric acid, 10% citric acid and 10% polyacrylic acid. Then the depth profile, etching amount, etching rate and thickness of smear layer were evaluated. Observation by scanning electron microscopy was also done and compared with the results by atomic force microscopy.


Prenatal DDT exposure and testicular cancer: a nested case-control study.
The authors examined maternal serum levels of DDT-related compounds in relation to son's risk of testicular cancer 30 years later. Fifteen of 9,744 live-born sons were diagnosed with germ cell testicular cancer and had maternal serum samples. Cases were matched to three controls on race and birth year. Maternal serum DDT-related compounds, measured in the early postpartum, were associated with her son's risk of testicular cancer. Despite low statistical power, we observed that mothers of cases had a significantly higher ratio of p,p'-DDT (1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane) to p,p'-DDE (1,1'-dichloro-2,2'-bis(p-chlorophenyl)ethylene) and lower o,p'-DDT (1,1,1-tricholoro-2-(p-chlororphenyl)-2-(o-chlorophenyl)ethane). These findings are consistent with earlier exposure to DDT and with slower p,p'-DDT elimination among mothers of cases. Whether these associations could be direct, or operate via other pathways is unknown. Further research on interindividual differences in DDT metabolism could provide clues to testicular cancer etiology.


An MD-PhD program in Brazil: students' concepts of science and of common sense.
In 1995, a pioneering MD-PhD program was initiated in Brazil for the training of medical scientists in experimental sciences at the Federal University of Rio de Janeiro. The program's aim was achieved with respect to publication of theses in the form of papers with international visibility and also in terms of fostering the scientific careers of the graduates. The expansion of this type of program is one of the strategies for improving the preparation of biomedical researchers in Brazil. A noteworthy absence of interest in carrying out clinical research limits the ability of young Brazilian physicians to solve biomedical problems. To understand the students' views of science, we used qualitative and quantitative triangulation methods, as well as participant observation to evaluate the students' concepts of science and common sense. Subjective aspects were clearly less evident in their concepts of science. There was a strong concern about "methodology", "truth" and "usefulness". "Intuition", "creativity" and "curiosity" were the least mentioned thematic categories. Students recognized the value of intuition when it appeared as an explicit option but they did not refer to it spontaneously. Common sense was associated with "consensus", "opinion" and ideas that "require scientific validation". Such observations indicate that MD-PhD students share with their senior academic colleagues the same reluctance to consider common sense as a valid adjunct for the solution of scientific problems. Overcoming this difficulty may be an important step toward stimulating the interest of physicians in pursuing experimental research.


Mosquito diapause.
Diapause, a dominant feature in the life history of many mosquito species, offers a mechanism for bridging unfavorable seasons in both temperate and tropical environments and serves to synchronize development within populations, thus directly affecting disease transmission cycles. The trait appears to have evolved independently numerous times within the Culicidae, as exemplified by the diverse developmental stages of diapause in closely related species. Its impact is pervasive, not only influencing the arrested stage, but also frequently altering physiological processes both before and after diapause. How the diapause response can be molded evolutionarily is critical for understanding potential range expansions of native and newly introduced species. The study of hormonal regulation of mosquito diapause has focused primarily on adult diapause, with little current information available on larval diapause or the intriguing maternal effects that regulate egg diapause. Recent quantitative trait locus, transcriptome, and RNA interference studies hold promise for interpreting the complex suite of genes that subserve the diapause phenotype.


Catecholamine responsiveness in human lymphocytes evaluated by intracellular free calcium measurements.
Intracellular free calcium concentration [f(Ca2+)i] and cyclic adenosine monophosphate (cAMP) in lymphocytes and basal plasma noradrenaline (NA) were measured in nine healthy male subjects (age 22-72 years). Lymphocytes were stimulated with isoproterenol and the plant lectin concanavalin A (Con A). Con A induced a dose dependent increase in f(Ca2+)i without increasing inositol lipid turnover. The mechanism by which Con A mobilized f(Ca2+)i is not clear, but we found that the level of prostaglandin E2, a metabolite from arachidonic acid, increased after stimulation with Con A, indicating the possibility of arachidonic acid released by phospholipase A2. Isoproterenol inhibited the Con A-induced calcium mobilization in a dose dependent manner in lymphocytes stimulated with both isoproterenol and Con A. This inhibitory effect of isoproterenol is most probably mediated via cAMP. Both isoproterenol induced increase in cAMP and inhibition of calcium mobilization were significantly correlated to basal plasma NA. Taken together our data indicate that the lymphocyte response to a specific stimulus may depend not only on the strength of this stimulus, but also on the level of sympathetic nerve activity.


Adaptation of Elecsys® anti-severe acute respiratory syndrome coronavirus-2 immunoassay to dried blood spots: proof of concept.
Aim: Several automated immunoassays have been validated on serum/plasma to evaluate the presence of significant levels of anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies, signs of a present or past infection, but the use of dried blood spots (DBS) would facilitate sampling, shipping and storage. Objective: The aim of this project was to give proof of concept of the possibility to use of the automatized Elecsys® anti-SARS-CoV-2 immunoassay with a volumetric DBS device. Results: Linearity and correlation were satisfactory between volumetric DBS and plasma. A cut-off value was suggested and should be validated with more samples. Conclusion: this study strongly support the possibility to work with volumetric DBS instead of serum/plasma to test for anti-SARS-CoV-2 antibodies.


An experimental study of bisphosphonate-induced jaws osteonecrosis in Sprague-Dawley rats.
Patients undergoing treatment with bisphosphonates may develop jaw lesions consisting mainly of bone necrosis. The present study describes a model of maxillary osteonecrosis in Sprague-Dawley rats, applying bisphosphonates and examines the changes occurring after tooth extraction. A total 200 animals were included in a randomized prospective study involving the following groups: group I (control, 20 rats without drug treatment), group II (60 animals administered dexamethasone 1 mg/kg/day for 7, 14 and 21 days, in subgroups of 20 animals each), group III (60 animals administered pamidronate daily at a dose of 3 mg/kg) and group IV (60 animals administered pamidronate and dexamethasone). In all groups, molar extraction was carried out on the right upper maxillary or mandibular side 8, 15 and 22 days after the start of dosing. The rats were killed 14 and 28 days after extraction in all groups. A total of 18 cases of osteonecrosis were recorded in the group administered pamidronate and dexamethasone. Osteonecrosis affected the upper maxilla in 10 cases and the mandible in eight cases, and was circumscribed to the extraction zone in all cases. Osteonecrosis was not seen in any of the other groups. The administration of pamidronate and dexamethasone in rats subjected to molar extraction increases the risk of osteonecrosis.


The Modulating Effects of Cardiac Resynchronization Therapy on Myocardial Metabolism in Heart Failure.
Heart failure (HF) is associated with changes in cardiac substrate utilization and energy metabolism, including a decline in high-energy phosphate content, mitochondrial dysfunction, and phosphotransfer enzyme deficiency. A shift toward glucose metabolism was noted in the end stage of HF in animals, although HF in humans may not be associated with a shift toward predominant glucose utilization. Deficiencies of micronutrients are well-established causes of cardiomyopathy. Correction of these deficits can improve heart function. The genes governing the energy metabolism were predominantly underexpressed in nonischemic cardiomyopathy and hypertrophic cardiomyopathy but were overexpressed in ischemic cardiomyopathy. Cardiac resynchronization therapy (CRT) has been proven to increase cardiac efficiency without increasing myocardial oxygen consumption. Altered myocardial metabolism is normalized by CRT to improve ventricular function.


Arthritis during interferon beta-1b treatment in multiple sclerosis.
Interferon beta (IFN-beta) is the most widely prescribed disease-modifying drug for multiple sclerosis (MS). Therapy with IFN-beta may be associated with a number of adverse reactions The development or exacerbation of other autoimmune diseases is a rare but reported side effect of IFN-beta therapy. In this case report, we present clinical and laboratory findings of two MS patients who developed arthritis during IFN-beta1b treatment, probably of autoimmune origin.


[Effect of GMDP encapsulated into liposomes on metastatic spread of Lewis lung carcinoma].
N-acetylglucosaminyl-N-acetylmuramyl-L-alanyl-D-isoglutamine (GMDP), a new liposome-encapsulated muramyl dipeptide analog, was studied for its effect on the Lewis lung carcinoma metastatic spreading as well as on the adenosine deaminase (ADA) and 5'-nucleotidase (5-N) activity in the alveolar and peritoneal mice macrophages. The drug administration was found to cause a sharp dose-dependent decrease in the lung metastases volume and number as compared to those in mice not treated with GMDP. The antimetastatic effect of GMDP is accompanied by an increase in the functional macrophage activity determined by ADA and 5-N level in these cells.


Update: influenza activity--United States and worldwide, May 19-September 28, 2013.
During May 19-September 28, 2013,* the United States experienced low levels of seasonal influenza activity overall. Influenza A (H1N1) pdm09 (pH1N1), influenza A (H3N2), and influenza B viruses were detected worldwide and were identified sporadically in the United States. In June, influenza A (H3N2) variant(†) viruses (H3N2)v were first detected in Indiana, and between June 18 and September 28, a total of 20 cases of influenza A variant viruses ([H3N2]v and influenza A (H1N1) variant [H1N1]v) were reported from five states. This report summarizes influenza activity in the United States and worldwide from May 19 through September 28, 2013.


TrAmplification of Human Dental Follicle Cells by piggyBac Transposon - Mediated Reversible Immortalization System.
Dental follicle cells (DFCs) are the precursor cells of periodontium. Under certain differentiation conditions, DFCs can be induced to differentiate into chondrogenic, osteogenic and adipogenic cells. However, DFCs has limited lifespan in vitro, so it's difficult to harvest enough cells for basic research and translational application. pMPH86 is a piggyBac transposon-mediated vector which contains SV40 T-Ag cassette that can be removed by flippase recognition target (FRT) recombinase. Here we demonstrated the pMPH86 can effectively amplify human DFCs through reversible immortalization. The immortalized DFCs (iDFCs) exhibit higher proliferate activity, which can be reversed to its original level before immortalization when deimmortalized by FLP recombinase. The iDFCs and deimmortalized DFCs (dDFCs) express most DFC markers and maintain multiple differentiation potential in vitro as they can be induced by BMP9 to differentiate into chondrogenic, osteogenic and adipogenic cells evidenced by gene expression and protein marker. We also proved telomerase activity of iDFCs are significantly increased and maintained at a high level, while the telomerase activity of primary DFCs was relatively low and decreased with every passage. After SV40 T-Ag was removed to deimmortalize the cells, telomerase activity was reduced to its original level before immortalization and decreased with passages just the same as primary DFCs. These results suggest that piggyBac immortalization system could be a potential strategy to amplify primary cells, which is critical for regenerative research and further clinical application.


Characterization and quantitation of extracellular collagen matrix in myocardium of pigs with spontaneously occurring hypertrophic cardiomyopathy.
The extracellular matrix between cardiocytes has been suggested to play an important role in maintaining the structure and function of the heart. The purpose of this study was to elucidate the morphological changes in the collagen of the extracellular matrix (ECM) in the hearts of pigs with hypertrophic cardiomyopathy. Sixty pigs diagnosed with hypertrophic cardiomyopathy from 605 purebred Landrace pigs ages 6 to 9 months were used in this study. Morphologically, these pigs with hypertrophic cardiomyopathy had increased heart weight and heart-to-body weight ratio, thickening of the left ventricular (LV) and right ventricular (RV) free walls and septum, disorientation of cardiocytes, myocardial fibrosis, and intramural coronary arteriosclerosis. Similar observations have been described in our preliminary report (Cardiovasc Pathol 3:261, 1994). In the present study, we have modified the silver impregnation technique to stain paraffin-embedded sections to demonstrate three types of ECM. There were endomysial struts, perimysial weaves, and epimysial coils in the myocardium. The light microscopic findings of the struts, weaves, and coils were also confirmed by scanning electromicroscopic examination. The numbers of these fine structures were increased significantly in the pigs with hypertrophic cardiomyopathy. In addition, the amounts of collagen in the LVs, RVs, and septum (Sep) in pigs with hypertrophic cardiomyopathy (LV = 19.37+/-0.79, RV = 23.72+/-0.72, Sep = 20.38+/-0.94 microg/mg, n = 60) were significantly higher (p < 0.01) than that in similar areas of normal pigs (LV = 14.56+/-1.11, RV = 18.90+/-1.02, Sep = 14.99+/-1.33 microg/mg, n = 30, respectively). Our findings of an overall increase of collagen content suggested that the accumulation of collagen matrix might be another factor responsible for the diastolic dysfunction of hypertrophic cardiomyopathy. These results might also infer that the increased collagen matrix could contribute to the stiffness of the cardiac chambers, thereby markedly affecting systolic and diastolic function of the heart. These observations provide further support that the pig may be an animal model for human cardiovascular disease.


Subnational variations in conceptions.
Conception statistics are derived from information collected at the registration of live births, still births, and legal abortions. This article looks at how conception rates vary across England and Wales using the 1991 ONS area classification of DHAs (Population Trends 79). A comparison is made between age-specific conception rates for different area classification groups in 1993, and changes between 1983 and 1993 are examined. Correlations between certain social and economic factors and conception rates are also analysed.


[The role of hyperhomocysteinemia in systemic lupus erythematosus and antiphospholipid syndrome].
To assess the role of hyperhomocysteinemia (HHC) in development of vascular complications in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). A total of 125 participants (24 males and 101 females aged 38 +/- 13 years) were divided into three groups: group 1--SLE patients (n=51); group 2--SLE+APS patients (n=49); group 3--primary APS patients (n=25). The patients had the disease for 14 +/- 11 years. Lupus anticoagulant (LA) and anticardiolipin antibodies (aCL) marked APS serologically. Homocystein (HC) was assayed by high performance liquid chromatography. HHC (HC > 15 mcg/l) was diagnosed in 82 of 125 (66%) patients: in 59% patients of group 1, 67%--of group 2 and 76%--of group 3. There was a relationship between HHC and digital necrosis (DN): 80% of DN patients had HHC while HHC was diagnosed in 57% patients free of DN (chi-square = 4.76, p = 0.03). Development of occlusions in APS was associated with HHC. Elevated levels of HC in blood was registered in 43 of 55 (78%) APS patients with thromboses vs. 9 of 19 (47%) patients with APS free of thromboses (p = 0.03). HHC occurred significantly more frequently in patients with arterial thromboses (in all 14 patients) than in patients with venous thromboses (in 16 of 23--69.6%, p = 0.03) and in the absence of thromboses (in 9 of 19, 47.4%, p = 0.04). HHC was associated with thromboses of cerebral, peripheral arteries (90 vs. 47% in patients without thrombosis, p = 0.005; 84 vs. 47%, p = 0.04, respectively), coronary vessels (79 vs. 47%, p = 0.04). In APS patients having arterial thromboses with duration of postthrombocytic period (PTP), estimated as time from thrombosis to entering the trial, less than 2 months, HC concentration was significantly higher (22.9 +/- 7.0 mcg/l) compared to patients with PTP more than 2 years (16.6 +/- 3.7 mcg/l (p = 0.04). More than 50% patients with SLE and APS, irrespective of APS variants, had an elevated HC level in the blood. Correlation between HHC and development of thromboses, primarily arterial, in APS gives grounds for the role of HHC in development of vascular complications in SLE and APS.


How to review scientific manuscripts and clinical case reports for Journal of Oral Implantology.
Peer review is a vital component of the publication process for the Journal of Oral Implantology (JOI), as with any scientific or professional journal. The ability to write constructive critical reviews, therefore, is a valued skill of benefit to authors, editors, and the journal. The purpose of this article is to discuss techniques for crafting useful reviews. A review should address both broad issues of wording and perception. A review should include specific issues of what to look for in each section of research papers and clinical case reports. While the article is written with JOI in mind, most guidelines expressed therein are applicable to reviewing for any journal.


Fabrication of titanium dioxide and tungstophosphate nanocomposite films and their photocatalytic degradation for methyl orange.
Photocatalytic multilayer films with different numbers of bilayers were prepared via an electrostatic layer-by-layer (LbL) self-assembly method. These LbL films were characterized by UV-vis spectroscopy, atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS). Our results indicate that TiO(2) and tungstophosphate (H(3)PW(12)O(40), abbreviated as PW(12)) are successfully incorporated into the thin films. The as-prepared (TiO(2)/PW(12))(n) films show good photocatalytic performance toward methyl orange (MO) solution at pH 2.0, which is attributed to the synergistic effect between TiO(2) and PW(12). The effect of experimental parameters including number of bilayers, initial concentration, and pH value of dye solution were also studied. The multilayer films can be easily recovered and reused several times with little change of degradation, indicating that they are stable under the ultraviolet (UV) irradiation. The detection of active species displays that active holes (h(+)) play a dominant role for MO photodegradation in the TiO(2)/PW(12) system. Taking advantage of immobilization of catalysts on glass slides, the problem of recovery is solved. It is expected that photocatalytic multilayer films have substantial applications in industry.


Comparison of the effects of adrenergic agonists and alpha-, beta 1-, beta 2-antagonists on the intraocular pressure and adenylate cyclase activity in the ciliary processes of the rabbit.
The hypotensive effect of different adrenergic agonists and antagonists were screened both in normo- and hypertensive rabbit eyes. The drugs were applicated topically and intraocular pressure (IOP) was monitored constantly with a manometric method. Subsequently the inhibitory effect of the antagonists on isoproterenol-stimulated adenylate cyclase activity in the ciliary processes was analyzed in vitro. In normotensive eyes agonist isoproterenol (beta) and antagonists labetalol (alpha beta), metoprolol (beta 1) and acebutolol (beta 1) decreased significantly IOP. In hypertensive eyes only isoproterenol and labetalol decrease IOP markedly. Timolol (beta) did not decrease IOP, although it inhibited adenylate cyclase activity as actively as labetalol. The other antagonists showed no inhibitory effect on in this respect. The results indicated that alpha-activity (labetalol, alpha beta) seems to potentiate the beta-activity (timolol, beta) in decreasing IOP. Whether this alpha-effect is a presynaptic effect (adrenergic denervation destroys it) is not yet clear. Similarly the beta 1-effect (metoprolol), without affecting adenylate cyclase activity, decreased IOP as well. This might be due to pre-synaptic release of endogenous transmitter(s) which in turn stimulate post-synaptic adenylate cyclase and induce the decreased IOP. Besides this, the possible role of blood vessels and CNS must also be kept in mind.


[Clinical aspects, surgical treatment and prognosis of lumbar intervertebral disk displacement in childhood].
This paper reports on 11 girls and 3 boys aged from 12 to 16 who, having suffered prolapses of lumbar discs, underwent surgery and were followed up between 18 and 87 months postoperatively. These 14 patients represent 0.25% of those who have undergone disc surgery in the authors' clinic over the last 11 years. Clinical peculiarities are pointed out and, in the light of the positive results (13 patients completely free of complaints) the prognosis is deemed to be very favourable; surgical treatment is therefore recommended of conservative therapy fails.


Photoperiodic control of dormancy in Sedum telephium and some other herbaceous perennial plants.
The environmental control of dormancy and flowering of the herbaceous perennial Sedum telephium was studied in controlled environments. Short photoperiods induced growth cessation and the formation of resting buds in both seedlings and mature plants, whereas long photoperiods resulted in immediate growth activation of dormant buds. No chilling was required for dormancy release, even in plants induced to dormancy and maintained at high temperature (21 degrees C) for more than 3 months. The critical photoperiod for dormancy release was about 15 h, a minimum of four long-day (LD) cycles (24 h) being required. The true photoperiodic nature of this response was ascertained by night interruption experiments. Flowering of S. telephium was found to have an obligatory LD requirement, with no requirement for vernalization. The critical photoperiod and minimum number of inductive cycles for floral induction were the same as for dormancy release. Dormancy release by long days was also obtained in preliminary experiments with three other herbaceous perennials. The eco-physiological significance of photoperiodic control of dormancy is discussed, and it is concluded that the mechanism ensures stability of winter dormancy, even under conditions of climatic warming.


Effect of kolaviron, a biflavanoid complex from Garcinia kola on some biochemical parameters in experimentally induced benign prostatic hyperplasic rats.
To determine the effect of kolaviron on some biochemical parameters in benign prostatic hyperplasia (BPH) rats. BPH was induced in rats using a mixture of dihydrotestosterone and estradiol valerate (10:1). The lethal dose of kolaviron was 3050mg/kg body weight. Body weights, relative heart weight (RHW), relative liver weight (RLW), serum levels of prostate specific antigen, prolactin, estradiol, testosterone, testosterone/estradiol ratio, aspartate transaminase (AST), alanine transaminase (ALT), urea, creatinine and prostatic levels of total proteins in the normal rats administered finasteride (standard drug) or kolaviron were not different (P>0.05) from normal control whereas most of these parameters were altered in the disease control except RHW, RLW, AST and ALT. Finasteride (5mg/70kg) or kolaviron (100 and 200mg/kg) ameliorated most of these parameters compared with disease control except RHW, RLW, prolactin, AST, ALT, urea and creatinine (for kolaviron at 100mg/kg). The normal rats administered finasteride or kolaviron had decreased prostate weights (P<0.05) compared with the normal control which results were corroborated by histological assay that also showed that treatment with kolaviron (200mg/kg) or finasteride reversed the histoarchitecture of the prostates of the BPH rats. Kolaviron could be useful in the management of BPH.


Correlations between auditory structures and hearing sensitivity in non-human primates.
Primates show distinctions in hearing sensitivity and auditory morphology that generally follow phylogenetic patterns. However, few previous studies have attempted to investigate how differences in primate hearing are directly related to differences in ear morphology. This research helps fill this void by exploring the form-to-function relationships of the auditory system in a phylogenetically broad sample of non-human primates. Numerous structures from the outer, middle, and inner ears were measured in taxa with known hearing capabilities. The structures investigated include the overall size and shape of the pinna, the areas of the tympanic membrane and stapedial footplate, the masses and lever arm lengths of the ossicles, the volumes of the middle ear cavities, and the length of the cochlea. The results demonstrate that a variety of auditory structures show significant correlations with certain aspects of hearing (particularly low-frequency sensitivity). Although the majority of these relationships agree with expectations from auditory theory, some traditional (and possibly outdated) ideas were not supported. For example, the common misconception that higher middle ear transformer ratios (e.g., impedance transformer ratio) result in increased hearing sensitivity was not supported. Although simple correlations between form and function do not necessarily imply causality, the relationships defined in this study not only increase our understanding of auditory patterns in extant taxa but also lay the foundation to begin investigating the hearing in fossil primates.


Molecular cloning and expression of chondroitin 4-sulfotransferase.
Chondroitin 4-sulfotransferase (C4ST) catalyzes the transfer of sulfate from 3'-phosphoadenosine 5'-phosphosulfate to position 4 of N-acetylgalactosamine residue of chondroitin. The enzyme has been previously purified to apparent homogeneity from the serum-free culture medium of rat chondrosarcoma cells (Yamauchi, A., Hirahara, Y., Usui, H., Takeda, Y., Hoshino, M., Fukuta, M., Kimura, J. H., and Habuchi, O. (1999) J. Biol. Chem. 274, 2456-2463). The purified enzyme also catalyzed the sulfation of partially desulfated dermatan sulfate. We have now cloned the cDNA of the mouse C4ST on the basis of the amino acid sequences of peptides obtained from the purified enzyme by protease digestion. This cDNA contains a single open reading frame that predicts a protein composed of 352 amino acid residues. The protein predicts a Type II transmembrane topology. The predicted sequence of the protein contains all of the known amino acid sequence and four potential sites for N-glycosylation, which corresponds to the observation that the purified C4ST is an N-linked glycoprotein. The amino acid sequence of mouse C4ST showed significant sequence homology to HNK-1 sulfotransferase. Comparison of the sequence of mouse C4ST with human HNK-1 sulfotransferase revealed approximately 29% identity and approximately 48% similarity at the amino acid level. When the cDNA was introduced in a eukaryotic expression vector and transfected in COS-7 cells, the sulfotransferase activity that catalyzes the transfer of sulfate to position 4 of GalNAc residue of both chondroitin and desulfated dermatan sulfate was overexpressed. Northern blot analysis showed that, among various mouse adult tissues, 5.7-kilobase message of C4ST was mainly expressed in the brain and kidney.


Longitudinal changes in ultrasonic measurements of body composition during growth in Suffolk ram lambs and evaluation of alternative adjustment strategies for ultrasonic scan data.
Four equations were used to compare alternative procedures to adjust ultrasonic estimates (y) of backfat thickness (BF) and LM area (LMA) for BW using data from a series of 7 scans on 24 Suffolk ram lambs born in 2007. Equations were linear, linear + quadratic, allometric (y = alphaBW(beta)), and allometric + BW (ABW; y = alphaBW(beta)e(gammaW)). Goodness of fit was very similar between equations over the range of the data. Resulting adjustment equations were tested using 3 serial scans on winter-born Suffolk (n = 150), Hampshire (n = 36), and Dorset (n = 43) rams and 52 fall-born Dorset rams tested at the Virginia Ram Test in 1999 through 2002. Partial correlations (accounting for the effect of year) between predicted and actual measures ranged from 0.78 to 0.87 for BF and 0.66 to 0.93 for LMA in winter-born rams and from 0.70 to 0.71 for BF and 0.72 to 0.78 for LMA in fall-born rams. No significant differences in predictive ability existed between equations for BF or LMA (P > 0.05), and there was no indication that the allometric equation was a better predictor than linear within the range of the data. Adjustment equations were also tested using serial scan data from 37 Suffolk ewe lambs born in the same contemporary group as the rams used to derive the prediction equations but fed for a substantially slower rate of BW gain. Correlations between predicted and actual values of BF and LMA indicated lambs were too young and small at the first scan (77 d, 32.4 kg) to reliably predict carcass measures at typical slaughter weights. For prediction using data from the 2 subsequent scans, at mean ages >96 d and mean BW >39 kg, correlations between predicted and actual values were 0.72 to 0.74 for BF and 0.54 to 0.76 for LMA. Little difference existed between equations for predicting BF. For LMA, the ABW form was a weaker predictor than the others, and the linear equation was slightly superior to allometric. Therefore, it appears the linear and allometric forms are both suitable for use in central ram test and performance-tested farm flocks.


Rate constants of hydroxyl radicals reaction with different dissociation species of fluoroquinolones and sulfonamides: Combined experimental and QSAR studies.
Hydroxyl radicals (·OH) initiated degradation is an important process governing fate of aquatic organic micropollutants (OMPs). However, rate constants for aqueous reaction of OMPs with ·OH (kOH) are available only for a limited number of OMPs, which complicates fate assessment of OMPs. Furthermore, molecular structures of many OMPs contain ionizable groups, and the OMPs may dissociate into different anionic/cationic species with different reactivity towards ·OH. Therefore, it is of importance to determine kOH of ionizable OMPs, and to develop quantitative structure-activity relationship (QSAR) models for predicting kOH of OMPs at different ionization forms. Herein kOH values of 9 fluoroquinolones (FQs) and 11 sulfonamides (SAs) at 3 dissociation forms (FQ±/FQ+/FQ-, SA0/SA+/SA-) were determined by competition kinetics experiments. A QSAR model using theoretical molecular structural descriptors was subsequently developed. The QSAR model successfully corroborated previous experimental results, exhibited good statistical performance, and is capable to predict kOH for FQs and SAs with different dissociation forms at environmentally relevant pH conditions. As organic ions have rarely been included in previous QSAR studies, the newly developed model that covers both neutral molecules and ions is of significance for future QSAR development as well as fate assessment of ionizable OMPs.


Perspectives in machine learning for wildlife conservation.
Inexpensive and accessible sensors are accelerating data acquisition in animal ecology. These technologies hold great potential for large-scale ecological understanding, but are limited by current processing approaches which inefficiently distill data into relevant information. We argue that animal ecologists can capitalize on large datasets generated by modern sensors by combining machine learning approaches with domain knowledge. Incorporating machine learning into ecological workflows could improve inputs for ecological models and lead to integrated hybrid modeling tools. This approach will require close interdisciplinary collaboration to ensure the quality of novel approaches and train a new generation of data scientists in ecology and conservation.


Ending the doctor-patient relationship in general practice: a proposed model.
The doctor-patient relationship in general practice is often viewed by practitioner and patient alike as a long-term 'personal' relationship. Little, however, is known about how such relationships are ended in general practice. This paper uses theoretical insights obtained from the sociology and social psychology of social relationships, together with the authors' own empirical work on the removal of patients from GPs' lists, to develop a theoretical model of ending the doctor-patient relationship in general practice. Ending the relationship involves 'breakdown' and 'termination'. 'Breakdown' in the relationship occurs when one party decides that the other has acted in such a way as to threaten that party's identity as a 'good' patient or doctor. 'Termination' may be patient initiated, doctor initiated or by mutual consent. It is proposed that further research is needed to delineate the rules and rituals governing entry into and maintenance of the doctor-patient relationship in general practice as well as those that govern its ending.


Insights into the proteomic profile and gene expression of Lutzomyia longipalpis-derived Lulo cell line.
Lutzomyia longipalpis-derived cell line (Lulo) has been suggested as a model for studies of interaction between sandflies and Leishmania. Here, we present data of proteomic and gene expression analyses of Lulo cell related to interactions with Leishmania (Viannia) braziliensis. Lulo cell protein extracts were analysed through a combination of two-dimensional gel electrophoresis and mass spectrometry and resulting spots were further investigated in silico to identify proteins using Mascot search and, afterwards, resulting sequences were applied for analysis with VectorBase. Sixty-four spots were identified showing similarities to other proteins registered in the databases and could be classified according to their biological function, such as ion-binding proteins (23%), proteases (14%), cytoskeletal proteins (11%) and interactive membrane proteins (9.5%). Effects of interaction with L. (V.) braziliensis with the expression of three genes (enolase, tubulin and vacuolar transport protein) were observed after an eight-hour timeframe and compared to culture without parasites, and demonstrated the impact of parasite interaction with the expression of the following genes: LLOJ000219 (1.69-fold), LLOJ000326 (1.43-fold) and LLOJ006663 (2.41-fold). This set of results adds relevant information regarding the usefulness of the Lulo cell line for studies with Leishmania parasites that indicate variations of protein expression.


Evolutionary psychology and evolutionary developmental psychology: understanding the evolution of human behavior and development.
This is an introduction to this special issue on evolutionary psychology (EP) and evolutionary developmental psychology (EDP). We suggest here that, contrary to some common assumptions, mainstream psychology continues to be essentially non Darwinian and that EP and EDP are new approaches that can potentially help us to change this situation. We then present the organization of the special issue (composed of six papers). We conclude that evolution is certainly not the final consideration in psychology, but emphasize its importance as the basis upon which all modern behaviors and development are built.


The impact of income redistribution on fertility in Canada.
This paper speculates on the role of income redistribution as a means of raising fertility in Canada. It is argued that if the relationship between income and fertility is non-linear at the household level, then changes in the income distribution in a society have important consequences for changes in aggregate fertility. In order to test this hypothesis, a simple fertility model is estimated using micro-data collected in the 1981 Canadian Census. The relationship between income and fertility is found to be nonlinear with properties that indicate that transfers of income from "rich" to "poor" households will likely further depress the overall level of fertility in Canada.


Dorsal root entry zone coagulation for treatment of deafferentation pain syndromes.
Deafferentation pain is a kind of chronic pain syndrome and hard to manipulate. To evaluate the effectiveness and safety of junctional dorsal root entry zone (DREZ) coagulation, 23 consecutive patients with intractable deafferentation pain syndrome were studied. Twenty-three patients underwent junctional DREZ coagulation (C5-T1 for upper extremities and L2-S1 for lower extremities) under general anesthesia. The pain severity was evaluated by the short McGill pain questionnaire (MPQ) and the visual analog scale (VAS), and the depression and anxiety of patients were assessed by Hamilton rating scale for depression (HRSD), Hamilton anxiety scale (HAMA), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). All the patients experienced significant pain reduction immediately after surgery. The scales of short MPQ and VAS at pre-operation, 6-month and 12-month follow-up were 31.5 +/- 3.4 and 8.8 +/- 1.5, 6.5 +/- 1.9 and 2.5 +/- 2.2, 7.1 +/- 2.1 and 2.9 +/- 1.9, respectively. The postoperative scores comparing to pre-operative scores showed a statistically significant difference (P < 0.01). The depression and anxiety state was also significantly relieved. At 12-month follow-up 6 patients had complete pain relief, 11 had excellent results with more than 75% pain relief, 17 had good results with more than 50% pain relief (73.9%). The main postoperative complications were transient slight hemiplegia (8), hypesthesia and paresthesia (15), a bearing down feeling of affected extremity (6), and deep sensory disability in the lower limbs (4) on the operated side. Because of the long time and prone position of the operation, 13 cases had a transient hyperalgesia in the upper chest. DREZ coagulation is a safe and effective procedure in the treatment of deafferentation pain syndromes.


Ketamine-xylazine-acepromazine compared with isoflurane for anesthesia during liver transplantation in rodents.
Orthotopic liver transplantation in mice and rats is used to study a wide range of scientific questions. Inhalant anesthesia is widely used in liver transplantation models in rodents, but drawbacks of inhalant anesthetics include issues of cost, safety, and ease of use. The goal here was to find an effective injection anesthesia protocol that would not directly influence metabolic or functional parameters after liver transplantation. We compared intraperitoneal injection of a ketamine-xylazine-acepromazine cocktail (KXA) with isoflurane during 50% liver transplantation in mice and rats. Anesthesia with KXA had rapid induction (5 +/- 3 min) and a long duration of surgical anesthesia (70 +/- 10 min). The 2 methods of anesthesia produced no significant differences in liver injury (histology, serum alanine aminotransferase and total bilirubin concentrations), inflammation (IL6, TNFalpha, myeloperoxidase activity), regeneration (incorporation of 5-bromo-2'-deoxyuridine, mitotic index, restitution of liver weight), or 7-d survival. In conclusion, a KXA regimen is a safe and effective injectable anesthetic for rodent liver transplantation and is a suitable substitute for currently used inhalant anesthesia. Injectable anesthetics offer advantages in terms of cost, personal safety, and ease of use and will be particularly beneficial to microsurgeons during their training period in liver transplantation.


The Multi-Parameter Wireless Sensing System (MPwise): Its Description and Application to Earthquake Risk Mitigation.
The Multi-Parameter Wireless Sensing (MPwise) system is an innovative instrumental design that allows different sensor types to be combined with relatively high-performance computing and communications components. These units, which incorporate off-the-shelf components, can undertake complex information integration and processing tasks at the individual unit or node level (when used in a network), allowing the establishment of networks that are linked by advanced, robust and rapid communications routing and network topologies. The system (and its predecessors) was originally designed for earthquake risk mitigation, including earthquake early warning (EEW), rapid response actions, structural health monitoring, and site-effect characterization. For EEW, MPwise units are capable of on-site, decentralized, independent analysis of the recorded ground motion and based on this, may issue an appropriate warning, either by the unit itself or transmitted throughout a network by dedicated alarming procedures. The multi-sensor capabilities of the system allow it to be instrumented with standard strong- and weak-motion sensors, broadband sensors, MEMS (namely accelerometers), cameras, temperature and humidity sensors, and GNSS receivers. In this work, the MPwise hardware, software and communications schema are described, as well as an overview of its possible applications. While focusing on earthquake risk mitigation actions, the aim in the future is to expand its capabilities towards a more multi-hazard and risk mitigation role. Overall, MPwise offers considerable flexibility and has great potential in contributing to natural hazard risk mitigation.


Geropsychiatric public sector nursing: placement challenges.
1. The nursing home eligible resident, who has experienced long periods of institutional living in state hospitals and many unsuccessful placements in nursing home facilities, presents a challenge in developing a viable community treatment plan. 2. Mental health consultations with nursing home staff are valuable resources for developing and implementing additional behavioral management interventions. 3. Collaborative efforts of public sector health care agencies have resulted in a cost effective approach to decreasing hospital admissions and recidivism and increasing community tenure of geropsychiatric residents.


Record statistics of financial time series and geometric random walks.
The study of record statistics of correlated series in physics, such as random walks, is gaining momentum, and several analytical results have been obtained in the past few years. In this work, we study the record statistics of correlated empirical data for which random walk models have relevance. We obtain results for the records statistics of select stock market data and the geometric random walk, primarily through simulations. We show that the distribution of the age of records is a power law with the exponent α lying in the range 1.5≤α≤1.8. Further, the longest record ages follow the Fréchet distribution of extreme value theory. The records statistics of geometric random walk series is in good agreement with that obtained from empirical stock data.


How the efficiency of rainbow trout (Oncorhynchus mykiss) ventricular muscle changes with cycle frequency.
Different species of animals require different cardiac performance and, in turn, their cardiac muscle exhibits different properties. A comparative approach can reveal a great deal about the mechanisms underlying myocardial contraction. Differences in myocardial Ca(2+) handling between fish and mammals suggest a greater energy cost of activation in fish. Further, while there is considerable evidence that heart rate (or cycle frequency) should have a profound effect on the efficiency of teleost cardiac muscle, this effect has been largely overlooked. We set out to determine how cycle frequency affects the power output and efficiency of rainbow trout (Oncorhynchus mykiss) ventricular muscle and to relate this to the heart's function in life. We measured power output and the rate of oxygen consumption ((O(2))) and then calculated efficiency over a physiologically realistic range of cycle frequencies. In contrast to mammalian cardiac muscle, in which (O(2)) increases with increasing heart rate, we found no significant change in (O(2)) in the teleost. However, power output increased by 25 % as cycle frequency was increased from 0.6 to 1.0 Hz, so net and total efficiency increased. A maximum total efficiency of 20 % was achieved at 0.8 Hz, whereas maximum power output occurred at 1.0 Hz. We propose that, since the heart operates continuously, high mechanical efficiency is a major adaptive advantage, particularly at lower heart rates corresponding to the more commonly used slower, sustainable swimming speeds. Efficiency was lower at the higher heart rates required during very fast swimming, which are used during escape or prey capture. If a fixed amount of Ca(2+) is released and then resequestered each time the muscle is activated, the activation cost should increase with frequency. We had anticipated that this would have a large effect on the total energy cost of contraction. However, since (O(2)) remains constant, less oxygen is consumed per cycle at high frequencies. We suggest that a constant (O(2)) would be observed if the amount of activator Ca(2+) were to decrease with frequency. This decrease in activation energy is consistent with the decrease in the systolic intracellular Ca(2+) ([Ca(2+)](i)) transient with increasing stimulation frequency seen in earlier studies.


Role of weight-bearing function on expression of myosin isoforms during regeneration of rat soleus muscles.
The expression of myosin isoforms was studied in regenerated rat soleus muscle during either normal or altered postural activity. Regeneration was induced following injury by venom from the Notechis scutatus scutatus snake. Immunohistochemical analysis showed that, in regenerating soleus muscle after 3 wk of hindlimb suspension, nearly all fibers reacted positively with the myosin heavy chain (MHC) antibody associated with fast-twitch muscle fibers (fast MHC). When 3 wk of recovery with normal weight-bearing activity followed hindlimb suspension, the regeneration soleus muscle exhibited a nearly homogeneous staining with the MHC antibody associated with the slow-twitch muscle fibers (slow MHC). These findings were in accordance with quantitative analysis of the electrophoretic separation of the native myosin isoforms. Immunohistochemical data showed that removal of weight bearing in the 21-day old regenerated soleus muscles resulted in an increase in fast MHC expression. Together, the results of the present study clearly demonstrate that the postural load is an important component in the induction of slow MHC in regenerating muscle and that the control of the expression of MHC in muscle comprising a homogeneous population of fibers deriving from satellite cells appears more homogeneous and more complete than in a nondegenerated one.


Psychosocial Stress, Glucocorticoid Signaling, and Prostate Cancer Health Disparities in African American Men.
Recent advances in our understanding of racial disparities in prostate cancer (PCa) incidence and mortality that disproportionately affect African American (AA) men have provided important insights into the psychosocial, socioeconomic, environmental, and molecular contributors. There is, however, limited mechanistic knowledge of how the interplay between these determinants influences prostate tumor aggressiveness in AA men and other men of African ancestry. Growing evidence indicates that chronic psychosocial stress in AA populations leads to sustained glucocorticoid signaling through the glucocorticoid receptor (GR), with negative physiological and pathological consequences. Compelling evidence indicates that treatment of castration-resistant prostate cancer (CRPC) with anti-androgen therapy activates GR signaling. This enhanced GR signaling bypasses androgen receptor (AR) signaling and transcriptionally activates both AR-target genes and GR-target genes, resulting in increased prostate tumor resistance to anti-androgen therapy, chemotherapy, and radiotherapy. Given its enhanced signaling in AA men, GR-together with specific genetic drivers-may promote CRPC progression and exacerbate tumor aggressiveness in this population, potentially contributing to PCa mortality disparities. Ongoing and future CRPC clinical trials that combine standard of care therapies with GR modulators should assess racial differences in therapy response and clinical outcomes in order to improve PCa health disparities that continue to exist for AA men.