Maximal expiratory flow volume curve in quarry workers.
Maximal Expiratory Flow Volume (MEFV) curves were recorded with a computerized Spirometer (Med Spiror). Forced Vital Capacity (FVC), Forced Expiratory Volumes (FEV), mean and maximal flow rates were obtained in 25 quarry workers who were free from respiratory disorders and 20 healthy control subjects. All the functional values are lower in quarry workers than in the control subject, the largest reduction in quarry workers with a work duration of over 15 years, especially for FEF75. The effects are probably due to smoking rather than dust exposure.


Methylation of breast cancer susceptibility gene 1 (BRCA1) predicts recurrence in patients with curatively resected stage I non-small cell lung cancer.
Even after early detection and curative resection of early stage non-small cell lung cancer (NSCLC), a significant fraction of patients develop recurrent disease. Molecular biomarkers that can predict the risk of recurrence thus need to be identified to improve clinical outcomes. Using the methylation-specific polymerase chain reaction assay, promoter methylation of the breast cancer susceptibility gene 1 (BRCA1) was assessed in cancer tissues from 70 patients with curatively resected stage I NSCLC. The clinical relevance of BRCA1 methylation status was evaluated in terms of outcome of the disease. Methylation of the BRCA1 promoter was detected in 13 of 70 patients (18.6%). Multiple logistic regression analysis revealed that BRCA1 methylation was an independent risk factor for recurrence (P = .0197) and that patients with BRCA1 methylation demonstrated significantly poorer recurrence-free survival compared to those without (P = .0139). Cox's proportional hazard regression analysis revealed that BRCA1 methylation was an independent risk factor for recurrence-free survival (P = .0155). Methylated BRCA1 can be a potential biomarker that predicts the prognosis after curative resection of stage I NSCLC. Considering that BRCA1 plays a role in chemotherapy-induced apoptosis, it is plausible that identification of methylated BRCA1 could provide information that is clinically relevant to tailored adjuvant therapy.


R-phycoerythrin as a time-temperature integrator to verify the thermal processing adequacy of beef patties.
The objective of this study was to relate R-phycoerythrin (PE) fluorescence decay to the inactivation of Salmonella in beef patties cooked using adequate and inadequate thermal processes as defined by the U.S. Department of Agriculture (USDA) safe harbor requirements and lethality standards. Ground beef containing 4.8 or 19.1% fat was inoculated with an eight-strain cocktail of Salmonella and formed into 113-g patties. Capillary tubes containing PE in borate buffer at pH 9.0 were attached to a thermocouple and inserted horizontally into the patties. Patties (n = 43) were cooked on a grill maintained at 177 degrees C for 6 to 13 min and reached internal temperatures ranging from 57 to 77 degrees C. Patties were analyzed for Salmonella survivors and for fluorescence decay of PE. The thermal lethality of each process was calculated at a reference temperature of 65 degrees C. Twenty-four of the 43 high-fat patties met the USDA safe harbor regulations, with thermal lethalities of >66 s, whereas only 20 of these patties met the proposed 5-log10 lethality standard. Three of the 20 low-fat patties that met USDA regulations did not meet the proposed lethality standard. A normalized PE fluorescence value of about 0.3 (confidence interval = 99%) indicated that patties had been processed sufficiently to reduce Salmonella by 5 log10 cycles. PE has the potential for use as a marker to verify processing adequacy in food-processing plants and in other settings in which the use of the target pathogen is inappropriate.


Oligosaccharide processing at individual glycosylation sites on MOPC 104E immunoglobulin M. Differences in alpha 1,2-linked mannose processing.
Processing of the asparagine-linked oligosaccharides at the known glycosylation sites on the mu-chain of IgM secreted by MOPC 104E murine plasmacytoma cells was investigated. Oligosaccharides present on intracellular mu-chain precursors were of the high mannose type, remaining susceptible to endo-beta-N-acetylglucosaminidase H. However, only 26% of the radioactivity was released from [3H]mannose-labeled secreted IgM glycopeptides, consistent with the presence of high mannose-type and complex-type oligosaccharides on the mature mu-chain. [3H]Mannose-labeled cyanogen bromide glycopeptides derived from mu-chains of secreted IgM were isolated and analyzed to identify the glycopeptide containing the high mannose-type oligosaccharide from those containing complex-type structures. [3H]Mannose-labeled intracellular mu-chain cyanogen bromide glycopeptides corresponding to those from secreted IgM were isolated also, and the time courses of oligosaccharide processing at the individual glycosylation sites were determined. The major oligosaccharides on all intracellular mu-chain glycopeptides after 20 min of pulse labeling with [3H]mannose were identified as Man8GlcNAc2, Man9GlcNAc2, and Glc1Man9GlcNAc2. Processing of the oligosaccharide destined to become the high mannose-type structure on the mature protein was rapid. After 30 min of chase incubation the predominant structures of this oligosaccharide were Man5GlcNAc2 and Man6GlcNAc2 which were also identified on the high mannose-type oligosaccharide of the secreted mu-chain. In contrast, processing of oligosaccharides destined to become complex type was considerably slower. Even after 180 min of chase incubation, Man7GlcNAc2 and Man8GlcNAc2 were the predominant structures at some of these glycosylation sites. The isomeric structures of Man8GlcNAc2 obtained from all of the glycosylation sites were identical. Thus, the different rates of processing were not the result of a different sequence of alpha 1,2-mannose removal.


An LC-MS/MS Methodological Framework for Steroid Hormone Measurement from Human Serum.
Estrogens and androgens are important regulators of sexual development and physiological processes in men and women, acting on numerous organs throughout the body. Moreover, they can contribute to a variety of pathologies, including osteoporosis, cancer, and cardiovascular and neurologic diseases. Analysis of estrogens and androgens in biological samples has been commonly performed using immunoassays for many years. However, these assays are suboptimal, as there is cross-reactivity with similar analytes, and they have moderate specificity and sensitivity. Thus, there is a clinical need to develop highly sensitive and specific methods for the accurate measurement of estrogen and androgen concentrations. Herein, we describe the development of three liquid chromatography coupled tandem mass spectrometry-based methods that incorporate the use of a Triple Quadrupole Mass Spectrometer for quantitative measurement of endogenous concentrations of various steroid hormones in human serum samples: (1) the simultaneous measurement of testosterone, androstenedione, and cortisol, (2) dehydroepiandrosterone (DHEA), and (3) 17β-estradiol (E2). The use of derivatizing reagents, Girard's reagent P and dansyl chloride, allowed for significant gains in sensitivity in the analysis of DHEA and E2, respectively, relative to the underivatized analyte. These procedures proved efficient and adequately sensitive for steroid hormone analysis in extracted patient sera samples from older men and postmenopausal women, providing reliable data down to low nanogram/ml and sub-nanogram/ml levels. Moreover, utilizing the combination of highly specific mass transitions associated with these analytes and their respective internal deuterated standards provided a high degree of specificity to the identity of these hormones.


Thermodynamical and structural properties of binary mixtures of imidazolium chloride ionic liquids and alcohols from molecular simulation.
We have performed molecular dynamics simulations to determine the densities, excess energies of mixing, and structural properties of binary mixtures of the 1-alkyl-3-methylimidazolium chloride ionic liquids (ILs) [amim][Cl] and ethanol and 1-propanol in the temperature range from 298.15 to 363.15 K. As in our previous work [J. Chem. Phys. 128, 154509 (2008)], our simulation studies are based on a united atom model from Liu et al. [Phys. Chem. Chem. Phys. 8, 1096 (2006)] for the 1-ethyl- and 1-butyl-3-methylimidazolium cations [emim(+)] and [bmim(+)], which we have extended to the 1-hexyl-3-methylimidazolium [hmim(+)] cation and combined with parameters of Canongia Lopes et al. [J. Phys. Chem. B 108, 2038 (2004)] for the chloride anion [Cl(-)] and the force field by Khare et al. for the alcohols [J. Phys. Chem. B 108, 10071 (2004)]. With this, we provide both prediction for the densities of the mixtures that have mostly not been investigated experimentally yet and a molecular picture of the interactions between the alcohol molecules and the ions. The negative excess energies of all mixtures indicate an energetically favorable mixing of [amim][Cl] ILs and alcohols. To gain insight into the nonideality of the mixtures on the molecular level, we analyzed their local structures by radial and spatial distribution functions. These analyses show that the local ordering in these mixtures is determined by strong hydrogen-bond interactions between the chloride anion and the hydroxyls of the alcohols, enhanced interactions between the anion and the charged domain of the cation, and an increasing aggregation of the nonpolar alkyl tails of the alcohols and the cations with increasing cation size, which results in a segregation of polar and nonpolar domains.


MiR-101 promotes nasopharyngeal carcinoma cell apoptosis through inhibiting Ras/Raf/MEK/ERK signaling pathway.
Extra-cellular signal regulated kinase (ERK)/mitogen activated protein kinase (MAPK) signaling pathway is widely involved in cell proliferation and apoptosis. MAPK kinase 1 (MEK1) is the upstream protein kinase of ERK that can activate ERK/MAPK signaling pathway. microRNA-101 (MiR-101) down-regulation is found to be associated with nasopharyngeal carcinoma (NPC) pathogenesis. Bioinformatics analysis shows the complementary targeted relationship between miR-101 and the 3'-UTR of MEK1 mRNA. This study explores the role of miR-101 in regulating MEK1 expression, ERK/MAPK signaling pathway activation, and NPC pathogenesis. Dual luciferase assay confirmed the targeted relationship between miR-101 and MEK1. MiR-101 and MEK1 expressions were compared in inflammatory nasopharynx tissue and NPC tissue. MiR-101, MEK1, phosphorylated ERK 1/2 (p-ERK1/2), survivin expressions in NP69, CNE-1, HONE1, and C666-2 cell lines were detected. NPC cell line C666-1 was cultured in vitro and divided into four groups, including miR-NC, miR-101, si-NC and si-MEK1. Cell apoptosis was determined by flow cytometry. Cell proliferation was evaluated by EdU staining. MiR-101 targeted inhibited MEK1 expression. MiR-101 was significantly down-regulated, while MEK1 was significantly elevated in NPC tissue compared with inflammatory nasopharynx tissue. MiR-101 was markedly declined, whereas MEK1, p-ERK1/2, and survivin were apparently increased in CNE-1, HONE1, and C666-1 cells compared with NP69 cells. MiR-101 mimic and/or si-MEK1 transfection significantly reduced MEK1, p-ERK1/2, and survivin levels, attenuated cell proliferation, and enhanced cell apoptosis. Down-regulation of miR-101 was related to NPC pathogenesis. MiR-101 elevation suppressed NPC cell proliferation and promoted apoptosis through targeted inhibiting MEK1 expression to alleviate ERK/MAPK signaling pathway and survivin expression.


High efficiency inactivation of microalgae in ballast water by a new proposed dual-wave UV-photocatalysis system (UVA/UVC-TiO2).
A new synergistic method was developed to inactivate marine microalgae using combined longwave ultraviolet (UVA) and shortwave ultraviolet (UVC)-photocatalysis (UVA/UVC-TiO2) technology. Five kinds of representative marine microalgae in three phyla were used as inactivating targets to examine the inactivation effect. Compared with the photocatalytic systems using UVA or UVC alone as the light source, the algae inactivation ratio in the newly developed system increased by 0.31 log or 0.19 log, and the chlorophyll a removal rate increased by 17.5% or 9.7%, respectively. Total suspended solids (TSS) of the seawater did not cause remarkable impact on the inactivation process, and the increase of UV radiation intensity improved the treatment effect significantly. Further, UVA/UVC-TiO2 treatment causes irreversible damage to microalgae cell membrane. The content of lipid peroxidation product malondialdehyde (MDA) increased rapidly within a short period of time, and a large number of proteins leaked out. The results of this study indicated that UVA/UVC-TiO2 was an effective method to solve the challenge of efficient inactivation of plankton in ballast water containing a high density of suspended matter.


Effects on repetitive 24-hour ambulatory blood pressure in subjects with type II diabetes randomized to liraglutide or glimepiride treatment both in combination with metformin: a randomized open parallel-group study.
In this post hoc study, we aimed to investigate liraglutide treatment on repetitive 24-hour blood pressure (BP) in patients with type II diabetes. Sixty-two individuals with type II diabetes (45 males) were randomized to 1.8 mg liraglutide once daily or 4 mg glimepiride together with 1 g metformin twice daily. Ambulatory 24-hour systolic and diastolic blood pressure (sBP/dBP) was repetitively measured at baseline, 2 weeks, and 18 weeks. Outcomes were evaluated as treatment change from baseline, 2 weeks, and 18 weeks. Baseline clinical characteristics of liraglutide (n = 33) and glimepiride (n = 29) groups were well matched. No statistically significant difference in 24-hour sBP/dBP between three time periods and groups was observed. There was no treatment change for 24-hour sBP at week 2 or after week 18. There was a transient treatment change in 24-hour dBP in the liraglutide group at week 2 (3.2 ± 5.4 vs. -1.2 ± 4.5 mm Hg, P < .01). A treatment change in 24-hour heart rate at week 2 (4.9 ± 6.8 vs. 1.0 ± 6.0 bpm, P = .03) and at week 18 (5.9 ± 7.8 vs. 0.2 ± 6.3 bpm, P < .01) was observed in the liraglutide group. In conclusion, liraglutide treatment did not lower BP. However, a small diurnal variation in dBP without affecting BP variability or nocturnal BP dipping was observed.


Synchronization performance of complex oscillator networks.
Recently, synchronization of complex networks has attracted increasing attention from various research fields. However, most previous works focused on the stability of synchronization manifold. In this paper, we analyze the time-delay tolerance and converging speed of synchronization. Our theoretical analysis and extensive simulations show that the critical value of time delay for network synchronization is inversely proportional to the largest Laplacian eigenvalue, the converging speed without time delay is proportional to the second least Laplacian eigenvalue, and the time delay could increase the converging speed linearly for heterogeneous networks and significantly for homogeneous networks.


Insiders and incomers: how lay public health workers' knowledge might improve public health practice.
Since 2005, health trainers and other lay public health workers (LPHWs) have been increasingly active in the UK. Although elsewhere in the world LPHWs are expected to come from the communities within which they work and know that their knowledge is valued, neither is the case for LPHWs in the UK. This study sought to discover the lay knowledge of health trainers and other LPHWs, aiming to ascertain how this knowledge might more effectively be utilised within UK public health services. This paper describes a participatory and ethnographic case study research project undertaken on an anonymised urban estate in North East England. Findings were generated by a range of means including by participant observation and semi-structured interviews. Seven LPHWs took part, as did 32 other community members. This study found that the lay health knowledge of an individual UK LPHW is determined primarily by his or her position within, or in relation to, the community within which he or she works. Insider LPHWs possess an embodied knowledge and incomer LPHWs possess an experiential knowledge which, although different from one another, are essentially interpersonal in nature. Lay health knowledge can take different forms, and different LPHWs can provide different forms of lay health knowledge. Public health structures and services in the UK should make better use of all forms of LPHW knowledge, and should seek from LPHWs training on how to engage the most 'hard-to-reach' or 'difficult-to-engage' groups. Services recruiting LPHWs should decide whether they are seeking embodied insider LPHW knowledge, experiential incomer LPHW knowledge or a mixture of both.


Median and common peroneal neuropathy in coir workers of Alappuzha district, Kerala.
Coir work, in a large number of people involves mechanically rolling the coconut fibers into coir which is later subjected to various processes. The primary work is done as a cottage industry specially by women in the sitting posture for several hours. This study reports evidence of median and common peroneal neuropathy electrophysiologically in people who had been engaged in this job for several years. This study was initiated to establish the possible relationship between coir work and symptomatic neuropathies which was seen in that region with all investigations "for other causes not" contributing to the etiological diagnosis. One hundred and forty-two upper limbs and 142 lower limbs in patients engaged in long years of coir work but having no symptoms were evaluated electrophysiologically with informed consent and financial compensation, appropriate inclusion and exclusion criteria were followed as described in the text. There is electrophysiological evidence for median and common peroneal neuropathy in persons engaged in long years of coir work. Coir workers neuropathy appears to be a new occupational neuropathy which can be prevented by following simple preventive measures.


[Staphylococci in cheese made from raw milk. (author's transl)].
The presence of markedly varying numbers of coagulase-positive staphylococci per gram (less than 10(2) -- greater than 10(6)) of cheese made from raw milk is reported. In twenty cases, the strains isolated from the cheese were examined for their ability to produce toxins. Eight strains were found to produce toxin A, no toxin being isolated from cultures of the twelve other strains. In two cases, the studies were done because of food poisoning which had probably been caused by the cheese. The number of staphylococci was more than 10(6) in one case (cheese about four weeks old) and approximately 1.5 x 10(4) in another (matured cheese). Subsequent studies showed that rather large amount of enterotoxin A were present in the second cheese. The first cheese was not examined for the presence of toxin.


Characterization of an activated mutant of focal adhesion kinase: 'SuperFAK'.
Focal adhesion kinase (FAK) is a non-receptor tyrosine kinase that plays an important role in normal cellular processes such as adhesion, spreading, migration, proliferation and survival. In addition, FAK is overexpressed in a variety of cancer cells and tumours and may play a role in the development of human cancer. As a prelude to modelling the role of aberrant FAK signalling in the initiation of cancer, the goal of the present study was to engineer point mutations in FAK that would enhance enzymic activity. A number of substitutions that were reported as activating mutations in other tyrosine kinases were introduced into FAK. Glutamic acid substitutions for two lysine residues in the activation loop of FAK, based upon the K650E (Lys(650-->)Glu) mutant of fibroblast-growth-factor receptor 3, were made to create 'SuperFAK'. Two brain-specific exons were engineered into avian FAK to create FAK6.7. SuperFAK and, to a lesser extent, FAK6.7, exhibited increased catalytic activity in vitro compared with wild-type FAK. The expression of SuperFAK and FAK6.7 in fibroblasts led to hyperphosphorylation of FAK substrates. Although the catalytic activity of SuperFAK and FAK6.7 was largely independent of cell adhesion, tyrosine phosphorylation of downstream substrates was adhesion-dependent. Further, since SuperFAK exhibited the same ability as wild-type FAK to recruit Src family kinases, tyrosine phosphorylation of substrates was likely due to direct phosphorylation by FAK. In addition to enhanced biochemical signalling, SuperFAK also increased the motility of epithelial cells. SuperFAK and FAK6.7 may be valuable molecular tools to investigate the potential role of aberrant FAK signalling in human disease.


Regeneration of amputated limb-buds in early rat embryos.
Rat embryos, dissected from the uterus at 11 1/2 days' gestation, have been used to study the regenerative powers of the embryonic limb. One forelimb-bud of each embryo was amputated, via an incision in the membranes. Embryos were subsequently grown in roller-bottle cultures for 44 h, then examined histologically. Twenty-nine out of 32 healthy embryos had formed limb-bud regenerates, 14 of which were of normal size and shape. Eight of them had a normal apical ectodermal ridge. It is concluded that at this stage of development there is sufficient versatility in the embryonic cells for a limb rudiment to be replaced by adjacent mesenchyme and epidermal cells. The implications of this finding are discussed in connexion with previous studies on the regeneration of appendages in vertebrate embryos.


Classification of Human Emotional States Based on Valence-Arousal Scale using Electroencephalogram.
Recognition of human emotion states for affective computing based on Electroencephalogram (EEG) signal is an active yet challenging domain of research. In this study we propose an emotion recognition framework based on 2-dimensional valence-arousal model to classify High Arousal-Positive Valence (Happy) and Low Arousal-Negative Valence (Sad) emotions. In total 34 features from time, frequency, statistical and nonlinear domain are studied for their efficacy using Artificial Neural Network (ANN). The EEG signals from various electrodes in different scalp regions viz., frontal, parietal, temporal, occipital are studied for performance. It is found that ANN trained using features extracted from the frontal region has outperformed that of all other regions with an accuracy of 93.25%. The results indicate that the use of smaller set of electrodes for emotion recognition that can simplify the acquisition and processing of EEG data. The developed system can aid immensely to the physicians in their clinical practice involving emotional states, continuous monitoring, and development of wearable sensors for emotion recognition.


Metastatic primary pulmonary melanoma successfully treated with checkpoint inhibitors.
Our patient is a 69-year-old man who presented to the emergency department with left-sided hemiparesis that started 4 hours prior to presentation. Brain CT showed right basal ganglia and internal capsule haemorrhagic strokes. MRI revealed multiple brain lesions suspicious for metastases. Further workup revealed a 5 cm lung mass and a 1 cm pancreatic nodule. Biopsy of both pulmonary and pancreatic lesions was consistent with melanoma and was similar histologically. The patient underwent cyberknife stereotactic radiosurgery to the brain metastases followed by immunotherapy with pembrolizumab, and then by nivolumab and ipilimumab. The patient remains free of disease progression 2 years after treatment.


A case of rupture of the internal jugular vein caused by postoperative infection of functional neck dissection.
A 68-year old diabetic man with gingival cancer of the lower jaw underwent resection of the mandible and functional neck dissection. Swabs of a postoperative wound infection revealed methicillin-resistant Staphylococcus aureus (MRSA). The wound was irrigated, and antibiotics administered. The pathogens isolated were sensitive to the antibiotics used, but the infection failed to respond to treatment. Bleeding ensued on the 14th postoperative day (#14POD), when the wound was opened to reveal thrombosis and rupture of the right internal jugular vein. The patient's condition improved after ligation and surgical debridement of the right internal jugular vein. Our experience underlines the importance of early radiological investigation for possible thrombus formation in the internal jugular vein in cases of postoperative wound infection follows functional neck dissection with conservation of the internal jugular vein. It is also important to actively treat this condition surgically, including ligation of internal jugular vein for suppressing inflammation.


Phagocytic and oxidative burst activity of chicken thrombocytes to Salmonella, Escherichia coli and other bacteria.
The potential role of chicken thrombocytes in immune responses to Salmonella, Escherichia coli and other bacteria was investigated by in vitro assays of phagocytosis and respiratory burst activity. Thrombocytes were found to phagocytose bacteria, but were found to be less phagocytic than heterophils. Oxidative burst activity was generated upon challenge of thrombocytes with various Salmonella strains, E. coli, three other bacterial species, and zymosan A. These findings indicate that thrombocytes may play a role in innate immunity to bacteria in the chicken.


[Extraesophageal signs of gastroesophageal reflux disease: otorhinolaryngologist's view].
The data on association between various pathologies of the ENT organs and gastroesophageal reflux disease (GERD) is analysed in the article. The variety of extraesophageal signs of GERD in children and adults is given, what is advisable to inform physicians of different specialties about the possibilities of antireflux therapy. These options are expanded with the emergence of a unique new drug, Alfasoxx. Its bioadhesive formula is based on hyaluronic acid and chondroitin sulphate thereby protecting the esophageal mucosa. Alfasoxx acts on the surface of the esophageal mucosa without penetrating into the systemic bloodstream and it also has a low allergenic potential, which has been confirmed by numerous studies. With its healing and repairing effect on erosive lesions of the esophageal epithelium, Alfasoxx in combination with proton pump inhibitors is more effective in achieving regression of clinical manifestations of the disease and improving patients quality of life (according to SF-36 questionnaire) compared to proton pump inhibitors monotherapy.


The importance of the Doppler angle.
We examined 118 infrainguinal grafts (103 patients) to determine the effect changes in the angle of theta or Doppler angle had on the accuracy of velocity measurements made with a duplex scanner. Four separate measurements of peak velocity were made on each graft. Three measurements were made with the flow toward the probe at 60 degrees, 50 degrees, 120 degrees (60 degrees the other way). The probe was then turned 180 degrees so the flow was away from the probe and measurements were made at 60 degrees. When the primary cursor was aligned with the vessel wall (Technologist A), the mean velocity at 60 degrees was 69.4 cm/sec and 57.3 cm/sec at 50 degrees, a difference of 12 cm/sec. The same measurements done by Technologist B (primary cursor non aligned with the wall), showed a 10 cm/sec difference (60.7 and 50.5). We saw a consistent difference with even this small difference in the angle of theta throughout the study. The mean velocity obtained by Technologist A when the flow was toward the probe was 61.7. When the probe was turned 180 degrees (flow away from the probe), the mean velocity was 60.5. The same measurements by Technologist B were 51.8 and 50.5. This indicates that the direction of the flow of blood towards or away from the probe does not effect the velocity measurements. Using the vessel wall to line up the primary cursor provides a consistent and easily reproducible reference point to compare measurements made on different days but is less important for single measurements.


Hundred Languages of Deaf Children: Exploring the Reggio Emilia Approach in Deaf Education.
The study investigated the "hundred languages of Deaf children" (Malaguzzi, 1993) in two schools using the Reggio Emilia approach to early childhood education, which originated in Italy. One principle of this approach, "the hundred languages of children," supports young children in expressing their ideas and thoughts in different ways. The hundred languages include expression through written, spoken, and signed languages, among many other means, and children are empowered to express themselves using these multiple channels. The researchers employed ethnographic study methods: Multiple early childhood classrooms were observed, and focus groups were conducted with school leaders, teachers, and families. The study findings are valuable in that they provide a better understanding of why both schools chose the Reggio Emilia approach with Deaf children and how both schools used it. Both schools regarded Deaf children as capable learners and expected much of them.


Performance of QuantiFERON-TB Gold test compared to tuberculin skin test in detecting latent tuberculosis infection in HIV- positive individuals in Iran.
There is limited data about the performance of QuantiFERON-TB Gold (QFT-G) test in detecting latent tuberculosis infection (LTBI) in our region. We intended to determine the performance of QFT-G compared to conventional tuberculin skin test (TST) in detecting LTBI in HIV-positive individuals in Iran. This study was conducted in a HIV clinic in Tehran, Iran in April 2007. A total of 50 consecutive HIV-positive patients, not currently affected with active tuberculosis (TB), were recruited; 43 (86%) were male. The mean age was 38 ± 7.2 years (21-53). All had history of Bacillus Calmette Guerin (BCG) vaccination. A TST with purified protein derivative (PPD) and whole-blood interferon-gamma release assay (IGRA) in reaction to ESAT-6 and CFP-10 antigens was performed and measured by enzyme-linked immuno-sorbent assay (ELISA). The agreement between TST and QFT-G results were analyzed using Kappa test. A total of 36 (72%) patients had negative and 14 (28%) revealed positive TST. For QFT-G, 20 (40%) tested positive, 19 (38%) tested negative, and the results in 11 cases (22%) were indeterminate. A total of 14 (28%) patients had a CD4 count of <200. Of the 14, TST + group, 12 had QFT-G +, only one case TST+/QFT-G-, and QFT-G was indeterminate in one TST positive case. Of the 36 patients with negative TST tests, 8 (22%) had positive GFT-G and 10 (28%) yielded indeterminate results. There was no association between a positive TST and receiving highly active anti-retroviral therapy (HAART) or absolute CD4 counts. Similarly, the association between QFT-G results and receiving HAART or CD4 counts was not significant (P = 0.06). Although TST results were not significantly different in patients with CD4 < 200 vs. CD4 >200 (P = 0.295), association between QFT-G results and CD4 cutoff of 200 reached statistical significance (P = 0.027). Agreement Kappa coefficient between TST and QFT-G was 0.54 (Kappa = 0.54, 95% CI = 38.4-69.6,P < 0.001). Detecting LTBI in HIV-positive individuals showed moderate agreement between QFT-G and LTBI in our study. Interestingly, our findings revealed that nontuberculous mycobacteria and prior BCG vaccination have minimal influence on TST results in HIV patients in Iran.


Cardiovascular shunts and oxygen transport in lower vertebrates.
O2 transport in animals with normal or abnormal cardiovascular shunts is analyzed using a two-compartment model. This analysis reveals that the O2 affinity of blood is a key factor determining the arterial, venous, and tissue O2 partial pressure (PO2) levels. Depending on the value of "critical" PO2, factors that decrease O2 affinity (e.g., increased temperature and reduced pH) should increase tissue PO2 and favor increased tissue oxygenation. Species comparisons suggest that O2 affinity is closely linked to critical PO2. In contrast to the model for environmental hypoxia, hypoxia due to shunting a right-shifted O2 dissociation curve is, at sea level, always adaptive. When hypoxia due to shunting is combined with external hypoxia, a decreasing O2 affinity causes increased blood and tissue PO2 values up to a "breaking point," which varies with shunt fraction, inspired PO2, lung PCO2, and respiratory properties of the blood. External hypoxia would cause ectotherms with high preferred body temperatures (e.g., lizards) to have blood and tissue PO2 values beyond the breaking point. This led to the hypothesis, now confirmed in several species, that external hypoxia would result in a reduction of preferred body temperature.


Rapid and effective treatment of chronic osteomyelitis by conductive network-like MoS2/CNTs through multiple reflection and scattering enhanced synergistic therapy.
Staphylococcus aureus (S. aureus)-infected chronic osteomyelitis (COM) is one of the most devastating infectious diseases with a high recurrence rate, often leading to amputation and even death. It is incurable by all the current strategies involving the clinical use of radical debridement and systemic intravenous antibiotics. Here, we reported on a microwave (MW)-assisted therapy for COM by constructing a heterojunction formed by flake nanoflower-shaped molybdenum disulfide (MoS2) and tubular carbon nanotubes (CNTs). This composite could achieve a combination of MW thermal therapy (MTT) and MW dynamic therapy (MDT) to accurately and rapidly treat COM with deep tissue infection. In vitro and in vivo experiments showed that MoS2/CNTs were effective in non-invasively treating S. aureus-induced COM due to the heat and reactive oxygen species (ROS) produced under MW irradiation. The mechanism of heat and ROS generation was explained by MW network vector analysis, density of states (DOS), oxygen adsorption energy, differential charge and finite element (FEM) under MW irradiation. Since the Fermi layer was mainly contributed by the Mo-4d and C-2P orbitals, MoS2/CNTs could store a large amount of charge and easily release more electrons. In addition, charge accumulation and dissipation motion were strong on the surface of and inside MoS2/CNTs because of electromagnetic hot spots, resulting in the spilling out of a great deal of high-energy electrons. Due to the low oxygen adsorption energy of MoS2/CNTs-O2, these high-energy electrons combined further with the adsorbed oxygen to produce ROS.


Quantification of regional V/Q ratios in humans by use of PET. II. Procedure and normal values.
Regional measurements of tissue isotope concentration, made using positron emission tomography (PET), allow tracer models to be used in a quantitative manner to provide topographic distributions of many structural and functional parameters, each derived for the same well-defined lung element. In this paper we describe a technique to measure regional ventilation-perfusion ratios (V/Q), in absolute units, by use of PET and the continuous intravenous infusion of an inert gas isotope, 13N, and report on measurements made in 12 normal subjects (4 smokers). Data were obtained from a single lung section (slice thickness, 1.7 cm full width at half-maximum response to a line source) at the level of the right ventricle in the supine posture during quiet breathing. For the 12 subjects, volume-weighted mean values of V/Q, averaged over individual right and left lung fields, ranged from 0.50 to 1.29. Analysis of these means showed no difference between lungs: right, 0.80 +/- 0.23 SD; left, 0.76 +/- 0.20 SD. Topographically, a systematic fall of V/Q in the ventrodorsal direction was observed in eight of the subjects (mean ventrodorsal difference 0.39, range 0.19-0.90), whereas two showed a clear increase toward dependent lung regions (range 0.16-0.26). Seven of the subjects with a falling ventrodorsal V/Q gradient also exhibited discrete regions of low V/Q at the dorsal lung border. We conclude that, in normal subjects, ventilation and perfusion are generally well matched in the supine posture, but isolated mismatching often occurs in dependent lung regions.


LruA and LruB, novel lipoproteins of pathogenic Leptospira interrogans associated with equine recurrent uveitis.
Recurrent uveitis as a sequela to Leptospira infection is the most common infectious cause of blindness and impaired vision of horses worldwide. Leptospiral proteins expressed during prolonged survival in the eyes of horses with lesions of chronic uveitis were identified by screening a phage library of Leptospira interrogans DNA fragments with eye fluids from uveitic horses. Inserts of reactive phages encoded several known leptospiral proteins and two novel putative lipoproteins, LruA and LruB. LruA was intrinsically labeled during incubation of L. interrogans in medium containing [14C]palmitic acid, confirming that it is a lipoprotein. lruA and lruB were detected by Southern blotting in infectious Leptospira interrogans but not in nonpathogenic Leptospira biflexa. Fractionation data from cultured Leptospira indicate that LruA and LruB are localized in the inner membrane. Uveitic eye fluids contained significantly higher levels of immunoglobulin A (IgA) and IgG specific for each protein than did companion sera, indicating strong local antibody responses. Moreover, LruA- and LruB-specific antisera reacted with equine ocular components, suggesting an immunopathogenic role in leptospiral uveitis.


Minicolumnar organization within somatosensory cortical segregates: II. Emergent functional properties.
In this article we describe some functional properties of the model of a somatosensory cortical macrocolumn--the segregate--described in the preceding companion article. These functional properties emerged in the model network in the course of stimulus-driven self-organization of its afferent connections under control of short-range inhibitory and longer-range excitatory lateral interactions among its minicolumns. In general, self-organization leads the model network to develop complex, nonlinear functional properties, and makes its neurons sensitive to the shape and temporal features of peripheral stimuli. The properties acquired reproduce some of the known properties of somatosensory and visual cortical networks. In particular, it is shown that, even though the network is exposed only to stationary point stimuli during self-organization, neurons in the model still acquire the ability to discriminate the direction of a moving stimulus, as well as the orientation of a stationary bar stimulus. Different stimulus directions and orientations are represented by different neurons in the model network, and the maps of neurons having these preferences have many properties in common with real cortical maps. In addition, we demonstrate the model network's ability to discriminate among spatially complex stimuli, such as letters of the alphabet. The parallels between the emergent structural and functional properties of the model network and the properties of sensory neocortex suggest that the model captures some of the basic mechanisms by which sensory cortical modules develop and maintain their elegantly detailed and appreciable information-processing capabilities.


Cerebrospinal fluid analysis in eosinophilic meningoencephalitis.
Eosinophilic meningoencephalitis (EME) remains an important neurological disease and is widely distributed in Thailand. We analyzed the cytological specimens of 56 EME cases. Pertinent clinical data were analyzed retrospectively and correlated with the cerebrospinal fluid (CSF)analysis. Headache was the commonest symptom seen in all EME cases. History of raw or partially cooked Pila snail ingestion was elicited from most patients. There was a marked seasonal occurrence between July to January. Patients received specific treatment as supportive therapy, which included spinal taps, analgesics and corticosteroids, was adequate. No fatal cases were seen. The CSF specimens were sorted into two categories: fresh CSF and hematoxylin and eosin (H&E) stained centrifuged CSF sediment. There was a statistically significant difference between the number of eosinophils and lymphocytes of fresh CSF and the H&E stained centrifuged CSF sediment (p = 0.001 and 0.001 respectively). The CSF glucose and the number of eosinophils in both methods were significantly correlated (p = 0.000, p = 0.008 for fresh CSF and the H&E stained centrifuged CSF sediment respectively). Moreover, the number of eosinophils was statistically significant with the protein in the CSF (p = 0.013), and intracranial pressure (ICP) (p = 0.025). Higher yields of eosinophils, especially in the early course of the disease, can readily be detected in the H&E stained centrifuged CSF sediment, whereas fresh specimens were negative. Further tests may increase the sensitivity and specificity of EME diagnostic results.


Local cerebral metabolic rates of glucose in movement and language disorders from positron tomography.
Positron-computed tomography with [18F]fluorodeoxyglucose to measure glucose metabolism has shown changes in the brain distant to a focal area of infarction, demonstrating that what appears as a focal abnormality represents a more widespread functional process. Several approaches are presented to better understand quantitative metabolic data and focus on caudate and basal ganglia function. Area-to-area correlations in Parkinson's and Huntington's diseases showed decreases in the number of cortical relationships compared with control subjects, suggesting that the basal ganglia are involved with the ability of cortical regions to function together. In aphasia, caudate metabolism correlated with several language measures that suggested a role in some undefined basic process, seemingly related to Broca's area function. The studies presented suggest that the caudate may involve integrating the processing of language and cognition with the execution of the resulting response. Motor and cognitive function seem related to similar and overlapping brain systems. The disruption of such systems may result in loss of both cognitive and motor aspects of a function.


Polyhydramnios: ultrasonic detection of fetal and maternal conditions.
Estimation of amniotic fluid volume is an important part of routine obstetric sonography. A relationship between polyhydramnios and poor perinatal outcome has been reported. This study correlates the severity of polyhydramnios with perinatal morbidity and mortality. Among 67 cases of polyhydramnios detected in singleton pregnancies, 8 were associated with maternal conditions including noninsulin-dependent diabetes (5 cases), insulin-dependent diabetes (1 case) and gestational diabetes (2 cases). Forty-four were associated with fetal conditions, including fetal anomalies (31 cases), fetal chromosomal disorders (10 cases) and fetal functional disorders (3 cases). Fifteen of the 67 cases had no apparent underlying fetal or maternal cause. Perinatal death occurred in 19 cases (28%) and was associated with fetal anomalies (12 cases), chromosome disorders (6 cases) and a functional fetal abnormality (1 case). Severe polyhydramnios with amniotic pocket dimensions > or = 120 mm (91%) or with a need for amniocentesis (91%) were associated with fetal abnormalities in most cases. The rate of perinatal death was not increased, indicating that severe polyhydramnios does not always result in lethal abnormalities.


The most common types of uroliths larger than 1 mm are readily visible and accurately measured in an in vitro setting mimicking the canine abdomen using digital radiography.
Abdominal radiography is an important diagnostic to detect uroliths. Cystine and urate uroliths were historically characterized as nonmineral opaque on survey radiographs. However, recent research and clinical observations indicate that pure urate and cystine uroliths may be detected with digital radiography. The primary purpose of this prospective, in vitro, diagnostic accuracy study was to determine the sensitivity of digital radiography in detecting cystoliths of varying size and composition. Forty canine uroliths of pure composition (10 each of calcium oxalate, struvite, cystine, and urate), acquired from Minnesota Urolith Center and ranging from 1 to 10 mm, were placed in phantoms of three various sizes and radiographed. The radiographs, including three sets of each urolith separately, were evaluated by three blinded radiologists on two separate occasions. Evaluation included presence or absence of urolith, number of uroliths, and maximum diameter of the urolith(s). For all four types of uroliths and all readers, the specificity and PPV were 100% with an associated very high sensitivity (94.4%-98.9%) and NPV (94.8%-98.9%). Calcium oxalate uroliths were the most accurately measured and struvite were the least accurately measured when compared with the gross measurement. Smaller uroliths were more accurately measured than larger uroliths. Uroliths placed in smaller bladder phantoms were more accurately measured than in larger bladder phantoms. Though accurate measurement of uroliths is complicated by and dependent on numerous variables, our results reveal that urate and cystine uroliths are visualized on digital radiography making them a relevant differential diagnosis when seen clinically.


In situ prebiotics for weaning piglets: in vitro production and fermentation of potato galacto-rhamnogalacturonan.
Postweaning diarrhea (PWD) in pigs is a leading cause of economic loss in pork production worldwide. The current practice of using antibiotics and zinc to treat PWD is unsustainable due to the potential of antibiotic resistance and ecological disturbance, and novel methods are required. In this study, an in vitro model was used to test the possibility of producing prebiotic fiber in situ in the gastrointestinal (GI) tract of the piglet and the prebiotic activity of the resulting fiber in the terminal ileum. Soluble fiber was successfully produced from potato pulp, an industrial waste product, with the minimal enzyme dose in a simulated upper GI tract model extracting 26.9% of the initial dry matter. The fiber was rich in galactose and galacturonic acid and was fermented at 2.5, 5, or 10 g/liter in a glucose-free medium inoculated with the gut contents of piglet terminal ileum. Fermentations of 5 g/liter inulin or 5 g/liter of a purified potato fiber were used as controls. The fibers showed high fermentability, evident by a dose-dependent drop in pH and an increase in the organic acid content, with lactate in particular being increased. Deep sequencing showed a significant increase in the numbers of Lactobacillus and Veillonella organisms and an insignificant increase in the numbers of Clostridium organisms as well as a decrease in the numbers of Streptococcus organisms. Multivariate analysis showed clustering of the treatment groups, with the group treated with purified potato fiber being clearly separated from the other groups, as the microbiota composition was 60% Lactobacillus and almost free of Clostridium. For animal studies, a dosage corresponding to the 5-g/liter treatment is suggested.


Transcription of the apicoplast genome.
Many members of the Apicomplexa contain a remnant chloroplast, known as an apicoplast. The apicoplast encodes numerous genes, and loss of the organelle is lethal. Here, we present a summary of what is known about apicoplast transcription. Unlike plant chloroplasts, there is a single RNA polymerase, and initial transcription is polycistronic. RNA is then cleaved into tRNA, mRNA and rRNA molecules. Significant levels of antisense transcription have been reported, together with a single case of RNA editing. Polycistronic transcription is also observed in the related algae Chromera and Vitrella, which retain a photosynthetic chloroplast. Surprisingly, a polyU tail is added to Chromera and Vitrella transcripts which encode proteins involved in photosynthesis. No such tail is added to Plasmodium transcripts. Transcription in the Apicomplexa is remarkably similar to that seen in the chloroplast of the related peridinin dinoflagellate algae, reflecting the common evolutionary origins of the organelle.


Recording of Bipolar Multichannel ECGs by a Smartwatch: Modern ECG Diagnostic 100 Years after Einthoven.
Aims: Feasibility study of accurate three lead ECG recording (Einthoven I, II and III) using an Apple Watch Series 4. Methods: In 50 healthy subjects (18 male; age: 40 ± 12 years) without known cardiac disorders, a 12-lead ECG and three bipolar ECGs, corresponding to Einthoven leads I, II and III were recorded using an Apple Watch Series 4. Einthoven I was recorded with the watch on the left wrist and the right index finger on the crown, Einthoven II with the watch on the left lower abdomen and the right index finger on the crown, Einthoven III with the watch on the left lower abdomen and the left index finger on the crown. Four experienced cardiologists were independently asked to assign the watch ECGs to Einthoven leads from 12-lead ECG for each subject. Results: All watch ECGs showed an adequate signal quality with 134 ECGs of good (89%) and 16 of moderate signal quality (11%). Ninety-one percent of all watch ECGs were assigned correctly to corresponding leads from 12-lead ECG. Thirty-nine subjects (78%) were assigned correctly by all cardiologists. All assignment errors occurred in patients with similar morphologies and amplitudes in at least two of the three recorded leads. Erroneous assignment of all watch ECGs to leads from standard ECG occurred in no patient. Conclusion: Recording of Einthoven leads I-III by a smartwatch is accurate and highly comparable to standard ECG. This might contribute to an earlier detection of cardiac disorders, which are associated with repolarization abnormalities or arrhythmias.


Singers' phonation threshold pressure and ratings of self-perceived effort on vocal tasks.
This study was designed to determine if singers' self-ratings of vocal effort could predict phonation threshold pressure (PTP). It was hypothesized that effort ratings on the more complex task of singing "Happy Birthday" would best predict PTP. A multiple regression analysis was performed with PTP as the predicted variable and self-ratings on four phonatory tasks as the predictor variables. Participants were 48 undergraduate and graduate students majoring in vocal performance. They produced /pi/ syllable trains as softly as possible for the measurement of PTP. They then rated their self-perceived vocal effort while softly producing the following: (1) sustained "ah" (comfortable, midrange pitch); (2) "ah" glide (chest to head voice); (3) Staccato "ah" in head voice (not falsetto); and (4) Happy Birthday in head voice (not falsetto). No ratings of vocal effort predicted PTP. The lack of correlation between PTP and ratings of Happy Birthday remained when separately evaluating graduate versus undergraduate students or males versus females. Informal evaluation of repeated ratings over time suggested the potential for effective self-monitoring. Students' ratings of self-perceived vocal effort were poor predictors of PTP. This may be because of the use of "effortless" imagery during singing instruction or consistent positive feedback regarding vocal performance. It is possible that self-rating could become an effective tool to predict vocal health if task elicitation instructions were more precise, and the student and voice teacher worked collaboratively to improve self-evaluation.


Cyclic electron transport around photosystem I: genetic approaches.
The light reactions in photosynthesis convert light energy into chemical energy in the form of ATP and drive the production of NADPH from NADP+. The reactions involve two types of electron flow in the chloroplast. While linear electron transport generates both ATP and NADPH, photosystem I cyclic electron transport is exclusively involved in ATP synthesis. The physiological significance of photosystem I cyclic electron transport has been underestimated, and our knowledge of the machineries involved remains very limited. However, recent genetic approaches using Arabidopsis thaliana have clarified the essential functions of this electron flow in both photoprotection and photosynthesis. Based on several lines of evidence presented here, it is necessary to reconsider the fundamental mechanisms of chloroplast energetics.


Triptolide inhibits the proliferation of prostate cancer cells and down-regulates SUMO-specific protease 1 expression.
Recently, traditional Chinese medicine and medicinal herbs have attracted more attentions worldwide for its anti-tumor efficacy. Celastrol and Triptolide, two active components extracted from the Chinese herb Tripterygium wilfordii Hook F (known as Lei Gong Teng or Thunder of God Vine), have shown anti-tumor effects. Celastrol was identified as a natural 26 s proteasome inhibitor which promotes cell apoptosis and inhibits tumor growth. The effect and mechanism of Triptolide on prostate cancer (PCa) is not well studied. Here we demonstrated that Triptolide, more potent than Celastrol, inhibited cell growth and induced cell death in LNCaP and PC-3 cell lines. Triptolide also significantly inhibited the xenografted PC-3 tumor growth in nude mice. Moreover, Triptolide induced PCa cell apoptosis through caspases activation and PARP cleavage. Unbalance between SUMOylation and deSUMOylation was reported to play an important role in PCa progression. SUMO-specific protease 1 (SENP1) was thought to be a potential marker and therapeutical target of PCa. Importantly, we observed that Triptolide down-regulated SENP1 expression in both mRNA and protein levels in dose-dependent and time-dependent manners, resulting in an enhanced cellular SUMOylation in PCa cells. Meanwhile, Triptolide decreased AR and c-Jun expression at similar manners, and suppressed AR and c-Jun transcription activity. Furthermore, knockdown or ectopic SENP1, c-Jun and AR expression in PCa cells inhibited the Triptolide anti-PCa effects. Taken together, our data suggest that Triptolide is a natural compound with potential therapeutic value for PCa. Its anti-tumor activity may be attributed to mechanisms involving down-regulation of SENP1 that restores SUMOylation and deSUMOyaltion balance and negative regulation of AR and c-Jun expression that inhibits the AR and c-Jun mediated transcription in PCa.


Postmenopausal women and the health consequences of obesity.
The health consequences of obesity include increased risk of heart disease, hypertension, diabetes, sleep apnea, cancer, osteoarthritis, and mental health problems. Postmenopausal women have reached an age when the incidence of chronic health conditions becomes more prevalent. In addition to physical disease risks, a lifetime of ridicule and disrespect may seriously and adversely affect general and health-related quality of life. Thus, obese postmenopausal women stand at a crossroads between living the remainder of their lives in essentially good health or facing the likely onset of chronic diseases that might have been prevented. This article reviews the effects of obesity that have particular relevance for postmenopausal women.


Effects of Mesua ferrea leaf and fruit extracts on growth and morphology of Staphylococcus aureus.
Mesua ferrea is traditionally used for treating bleeding piles, fever, and renal diseases. It has been reported to have antimircobial activity. In the present study, antibacterial efficacy of leaf and fruit extracts on the growth and morphology of Staphylococcus aureus is evaluated. Both extracts display good antibacterial activity against S. aureus with a minimum inhibition concentration of 0.048 mg/mL. Both extracts are bacteriostatic at a minimum bacteriostatic concentration of 0.39 mg/mL. The bacteriostatic activity lasts for 24 h, and then cells start to grow as normal as shown in time-kill analysis. Scanning electron microscopy study indicated potential detrimental effect of the extracts of leaf and fruits of M. ferrea on the morphology of S. aureus. The treatment with the extracts caused extensive lysis of the cells, leakage of intracellular constituents, and aggregation of cytoplasmic contents forming an open meshwork of the matrix.


Treatment of carcinoma of the head and neck with combined irradiation and chemotherapy.
Radiation therapy was combined with simultaneous administration of bleomycin, cyclophosphamide and 5-fluorouracil for the treatment of 33 patients with carcinoma of the head and neck. This combination increased the toxicity to the normal tissue. Complete response was obtained in 46 per cent, partial response in 36 per cent and no response in 18 per cent. Patients with a complete response had a significantly longer survival than patients with a partial or no response. An increased cytotoxicity was noted after the combined treatment when compared with irradiation alone. However, no evidence of an increased therapeutic effect was obtained with the addition of simultaneous chemotherapy to irradiation.


Rapid eye movement sleep behavior disorder in Parkinson's disease: magnetic resonance imaging study.
Rapid eye movement sleep behavior disorder has poor prognostic implications for Parkinson's disease. The authors recruited 124 patients with early Parkinson's disease to compare clinical and neuroimaging findings based on the presence of this sleep disorder. The presence of rapid eye movement sleep behavior disorder was assessed with the Mayo Sleep Questionnaire. Magnetic resonance imaging sequences were obtained for voxel-based morphometry and diffusion tensor imaging. Patients with sleep disorder had more advanced disease, but groups had similar clinical characteristics and cognitive performance. Those with sleep disorder had areas of reduced cortical grey matter volume and white matter changes compared with those who did not have sleep disorder. However, differences were slight and were not significant when the analyses were adjusted for multiple comparisons. Rapid eye movement sleep behavior disorder was associated with subtle changes in white matter integrity and grey matter volume in patients with early Parkinson's disease.


Curcumin Based Drug Delivery Systems for Cancer Therapy.
Cancer accounts for the second major cause of death globally. Conventional cancer therapies lead to systemic toxicity that forbids their long term application. Besides, tumor resistance and recurrence have been observed in the majority of cases. Thus, the development of such therapy, which will pose minimum side effects, is the need of the hour. Curcumin or diferuloylmethane (CUR) is a natural polyphenol bioactive (obtained from Curcuma longa) which possesses anti-cancer and chemo-preventive activity. It acts by modulating various components of signaling cascades that are involved in cancer cell proliferation, invasion, and apoptosis process. It interacts with the adaptive and innate immune systems of our body and causes tumor regression. This may be the reason behind the attainment of in vivo anti-tumor activity at a very low concentration. Its ease of availability, safety profile, low cost, and multifaceted role in cancer prevention and treatment has made it a promising agent for chemoprevention of many cancers. Regardless of the phenomenal properties, its clinical utility is haltered due to its low aqueous solubility, poor bioavailability, rapid metabolism, and low cellular uptake. In the last few years, a variety of novel drug carriers have been fabricated to enhance the bioavailability and pharmacokinetic profile of CUR to attain better targeting of cancer. In this review, the recent developments in the arena of nanoformulations, like liposomes, polymeric NPs, solid lipid NPs (SNPs), polymeric micelles, nanoemulsions, microspheres, nanogels, etc. in anticancer therapy have been discussed along with a brief overview of the molecular targets for CUR in cancer therapy and role of CUR in cancer immunotherapy.


Managing Nausea and Vomiting in Patients With Cancer: What Works.
The approach to the treatment of nausea and vomiting in a cancer patient should begin with a complete assessment, including the frequency, duration, and intensity of the nausea/vomiting; associated activities; and whether anorexia or cachexia is present. It is important to determine whether the nausea and vomiting is related to treatment (chemotherapy, radiation) or is independent of cancer treatment. Nausea/vomiting unrelated to chemotherapy and/or radiation may have an etiology for which there is a specific and potentially successful intervention. Various national and international antiemetic guidelines have been developed for the prevention of chemotherapy- and radiotherapy-induced nausea and emesis. The antiemetics recommended in these guidelines (5-hydroxytryptamine type 3 receptor antagonists, neurokinin-1 receptor antagonists, dexamethasone) have significantly reduced emesis but not nausea. Recent randomized clinical trials have demonstrated that olanzapine may be an effective agent for the prevention and treatment of chemotherapy-induced nausea as well as emesis.


Effects of barley grain processing and dietary ruminally degradable protein on urea nitrogen recycling and nitrogen metabolism in growing lambs.
The objective of this study was to determine how interactions between dietary ruminally degradable protein (RDP) level and ruminally fermentable carbohydrate (RFC) alter urea N transfer to the gastrointestinal tract (GIT) and the utilization of this recycled urea N in rapidly growing lambs fed high-N diets. Four Suffolk ram lambs (34.8 +/- 0.5 kg of BW) were used in a 4 x 4 Latin square design with 21-d periods and a 2 x 2 factorial arrangement of dietary treatments. The dietary factors studied were 1) dry-rolled vs. pelleted barley as the principal source of RFC and 2) dietary levels of RDP of 60 vs. 70% (% of CP). All diets contained 28.8 g of N/kg of DM. Experimental diets were composed of 80% concentrate mixture and 20% barley silage (DM basis) and were fed twice daily at 0900 and 1700 as total mixed rations. Nitrogen balance was measured from d 15 to 20, and urea N kinetics were measured from d 15 to 19 using intrajugular infusions of [(15)N(15)N]-urea. Nitrogen intake (P = 0.001) and fecal (P = 0.002) and urinary (P = 0.03) N excretion increased as dietary RDP level increased, but the method of barley processing had no effect. Feeding dry-rolled compared with pelleted barley (P = 0.04) as well as feeding 60% RDP compared with 70% RDP (P = 0.04) resulted in a greater N digestibility. Whole-body N retention was unaffected (P >/= 0.74) by dietary treatment. Dietary treatment had no effect on endogenous production of urea N and its recycling to the GIT; however, across dietary treatments, endogenous production of urea N (45.8 to 50.9 g/d) exceeded N intake (42.3 to 47.9 g/d). Across dietary treatments, 30.6 to 38.5 g/d of urea N were recycled to the GIT, representing 0.67 to 0.74 of endogenous urea N production; however, 0.64 to 0.76 of urea N recycled to the GIT was returned to the ornithine cycle. In summary, although dietary treatment did not alter urea N kinetics, substantial amounts of hepatic urea N output were recycled to the GIT under the dietary conditions used in this study, and additional research is required to determine how this recycled urea N can be efficiently captured by bacteria within the GIT.


Psychotropic medications and their effects on sexual function: diagnosis, biology, and treatment approaches.
The recognition and treatment of sexual side effects caused by psychotropic agents have become topics of increasing clinical concern. Gaps in our understanding of the biology of sex and in our knowledge of the effect of Axis I disorders on sexual functioning have made both recognition of sexual side effects and a coherent treatment approach to these side effects difficult. The author reviews case reports, case series, and animal studies derived from a MEDLINE search for English language articles on the topics of the effects of psychiatric disorders on sexual functioning, the biology of sex, rates of sexual dysfunction associated with each medication class, and treatment approaches when these side effects occur. In evaluating sexual function in patients taking psychotropic medications, clinicians should first consider other potential causes of sexual dysfunction. In general, dopamine increases sexual behavior, serotonin inhibits it, while norepinephrine has conflicting effects. Sexual side effects have been described in association with all the major classes of psychotropic medications. Neuroleptics are often associated with sexual side effects. Priapism, seen with neuroleptics and trazodone, should be treated as a urological emergency. Anxiolytics cause mild, nonspecific sexual side effects as do the mood stabilizers. Among the antidepressants, the more powerful serotonergic medications--e.g., the serotonin selective reuptake inhibitors (SSRIs), clomipramine, and MAO inhibitors--may cause more sexual side effects than the tricyclics. Potential strategies to treat antidepressant-induced sexual side effects include lowering the dose, waiting, and switching to another agent. A number of specific antidotes, such as cyproheptadine and yohimbine, have been reported to reverse these side effects in a limited number of cases. Clinicians must be aware of and specifically ask about medication-induced sexual side effects. More effective treatments of these side effects must await much needed double-blind studies of various approaches, especially those to treat SSRI-induced sexual dysfunction.


Distilled Waste Plastic Oil as Fuel for a Diesel Engine: Fuel Production, Combustion Characteristics, and Exhaust Gas Emissions.
Waste plastic oil (WPO) derived from pyrolysis of plastic debris and municipal waste is one of the promising alternative fuels because of its similar carbon chain characteristics and physical properties to diesel fuel. WPO also contains naphtha which is gasoline-like and may not be well-suited to a diesel engine. Technically, naphtha should be eliminated from WPO by distillation, and the resulting product is called distilled waste plastic oil (WPOD). This work experimentally investigates the influences of these fuels burned in a diesel engine on combustion characteristics and exhaust gas emissions. Both WPO and WPOD fuels contribute to the larger amount of nitrogen oxides than diesel fuel. Carbon-based emissions increase when the engine operates with these pyrolysis fuels by retarding the ignition onset of their combustion occurrences. Meanwhile, their shorter-carbon-chain links provide a lower smoke index. However, brake thermal efficiency and brake specific fuel consumption are beneficial because of their high calorific value and cetane index.


Pathophysiology of ovarian steroid secretion in polycystic ovary syndrome.
The ovary in polycystic ovary syndrome (PCOS) produces markedly increased amounts of steroids in response to gonadotropin stimulation. Because FSH secretion is under tight long-loop negative-feedback control and LH is not, hyperandrogenism is the primary clinical manifestation of excess steroid production in PCOS. However, estrogen production by multiple, small follicles may inhibit FSH secretion sufficiently to prevent selection of a single, dominant follicle. Ovarian stimulation testing has suggested that ovarian hyperandrogenism is a result of dysregulation of the androgen producing enzyme P450c17. ACTH stimulation testing is consistent with dysregulation of adrenal P450c17 in about two-thirds of hyperandrogenic women. In most cases dysregulation appears to be due to an intrinsic abnormality of P450c17, or to an abnormality of autocrine/paracrine factors which regulate P450c17. Both LH and insulin hypersecretion are most often a result of the steroid secretory abnormalities. Once present they may amplify the underlying cause of dysregulation of P450c17.


MOON's Strategy for Obtaining Over Eighty Percent Follow-up at 10 Years Following ACL Reconstruction.
The Multicenter Orthopaedic Outcomes Network (MOON) study of anterior cruciate ligament (ACL) reconstruction has achieved >80% follow-up for study subjects who were enrolled from 2002 to 2005; patient-reported outcome measures (PROMs) were reported at 2, 6, and 10 years through a carefully designed protocol that included surgeon involvement to encourage subjects to complete and return questionnaires. The process included emails and telephone calls from the central coordinating center, from research coordinators at each local institution, and lastly, from the subjects' surgeons for those who were less inclined to complete the follow-up. In order to quantify the effect of site and surgeon involvement, the enrollment year of 2005 was monitored for the 10-year follow-up (n = 516 subjects). In contact efforts made by the coordinating center, 73.8% (381) of study subjects were reached by the central site coordinator, contact information was verified, and questionnaires were subsequently sent, completed, and returned. An additional 54 subjects (10.5% of the overall study population) returned the questionnaire after local study site involvement, indicating the importance of individual surgeon and local site involvement to improve follow-up rates in multicenter studies in orthopaedic surgery. Follow-up rates were higher when a specific individual (the surgeon or the research coordinator) was given the task of final follow-up.


Transcatheter aortic valve implantation using the left transcarotid approach in patients with previous ipsilateral carotid endarterectomy.
To assess the feasibility and safety of transcatheter aortic valve implantation (TAVI) through a left transcarotid approach in patients previously operated on for ipsilateral carotid endarterectomy (CEA). The healthcare impact of extracranial carotid artery disease is essential as stroke is the third-leading cause of death in industrialized nations and CEA is often present in the history of patients awaiting TAVI. The primary endpoint was to evaluate 30-day mortality and freedom from major TAVI-related complications in an observational analysis. From December 2011 to February 2014, we performed 9 TAVI. The mean age was 84.6 years. The procedure was performed without any technical complication or vascular injury in every patient. There was neither intraoperative mortality nor intraoperative major complications. One (11.1%) patient experienced spatial-temporal disorientation but cerebral computed tomography did not show any sign of stroke. Two (22.2%) patients needed the implantation of a pacemaker due to third-degree atrioventricular block appearance. Three (33.3%) patients were transfused with packed red blood cells and 1 (11.1%) patient developed a groin hematoma. Only 1 (11.1%) patient showed a residual paravalvular regurgitation ≥ 2. At 30-day follow-up there was neither mortality nor other TAVI-related complications and echocardiography parameters remained stable. TAVI through a left transcarotid approach in patients previously operated on for ipsilateral CEA is feasible and safe. The presence of a previous ipsilateral CEA represents no more a limitation to the utilization of this promising access route. At short-term follow-up, mortality and major complications rates are low.


Surgical management of coexisting coronary artery and valvular heart disease.
Combined coronary artery bypass (CAB) and valve surgery is one of the most challenging surgical procedures, but the operative results have improved over the years. From 1989 through 2004, combined CAB and valve operations were performed in 125 patients. Mean age was 63 years, and 86 patients were male. Forty-six patients were diagnosed with coronary artery disease during preoperative evaluation for valvular heart disease (VHD). All patients underwent CAB, and one or more underwent valve replacement or repair (mitral: 54, aortic: 61, tricuspid: 3, DVR: 7) simultaneously. Mean number of distal graft was 1.98 +/- 1.07, and LIMA was used in 68% of patients. Early mortality occurred in 6 patients (4.8%), and the causes were heart failure (4) and sepsis (2). Mean follow-up duration was 91.4 +/- 40.9 months (range: 47-245), and late mortality occurred in 4 patients. Kaplan Meier estimated survival rates at 1, 5, and 10 years were 94.4 %, 92.3%, and 89.9%, respectively. Combined coronary and valve operations can be performed safely with optimal surgical results. Although the surgical mortality of coexisting coronary and VHD is higher than either isolated coronary or valvular operations, it may not affect the long-term survival.


Diagnostically untypable hepatitis C virus variants: it is time to resolve the problem.
Pakistan is a low income country with more than 10 million hepatitis C virus (HCV) infections and the burden is on continuous raise. Accurate viral genotyping is very critical for proper treatment of the infected individuals as the sustained virological response of the standard antiviral interferon therapy is genotype dependent. We observed at our diagnostic center that 15.6% of HCV patient's samples were not genotype-able by using Ohno et al method. The genotyped samples showed that 3a (68.3%) is the major prevalent genotype in Pakistan followed by 2a (10.3%), 3b (2.6%), 1b (1.5%), 2b (1.2%) and 1a (0.5%). Presence of large number of untypable HCV variants in the current study highlights an important issue of health care setup in Pakistan. Untypable HCV cases create difficulties in treatment of these patients. The problem of routine diagnostics setup of Pakistan should be addressed on priority basis to facilitate the medical professionals in patient's treatment and to help in achieving the maximum sustained virological response.


Ribophorin I associates with a subset of membrane proteins after their integration at the sec61 translocon.
The biosynthesis of membrane proteins at the endoplasmic reticulum (ER) involves the integration of the polypeptide at the Sec61 translocon together with a number of maturation events, such as N-glycosylation and signal sequence cleavage, that can occur both during and after synthesis. To better understand the events occurring after the release of the nascent chain from the ER translocon, we investigated the ER components adjacent to the transmembrane-spanning domain of a well characterized fragment of the amyloid precursor protein. Using individual cysteine residues as site-specific cross-linking targets, we found that several ER components can be cross-linked to the fully integrated polypeptide. We identified strong adducts with both the ribophorin I subunit of the oligosaccharyltransferase complex and the 25-kDa subunit of the signal peptidase complex. Focusing on the association with ribophorin I, we found that adduct formation occurred exclusively after the exit of the nascent chain from the Sec61 translocon and was unaffected by the N-glycosylation status of the associated precursor. Only a subset of newly made membrane proteins associated with ribophorin I in vitro, and we could recapitulate a specific association between the amyloid precursor protein fragment and ribophorin I in vivo. Taken together, our data suggest a model where ribophorin I may function to retain potential substrates in close proximity to the catalytic subunit of the oligosaccharyltransferase and thereby stochastically improve the efficiency of the N-glycosylation reaction in vivo. Alternatively ribophorin I may be multifunctional and facilitate additional processes, for example, ER quality control.


[Interest of electroencephalogram in autism].
Autism spectrum disorders (ASD) have been associated with physiopathology in cerebral organization and function. Electroencephalography is a noninvasive technique that provides information about brain electrocortical activity. Electroencephalographic (EEG) studies using power spectra have documented differences associated with ASD, particularly in frontal areas that have been functionally linked to cognitive functions that are disrupted in individuals with ASD. Furthermore, EEG studies confirm coherence changes in individuals with ASD. Many studies have also reported high rates of interictal epileptiform EEG abnormalities in children with ASD with or without history of seizures. Several polysomnography studies have confirmed the presence of disrupted sleep architecture in children with ASD. Polysomnographic abnormalities include reduction of REM sleep, longer sleep latency, increased arousals, lower sleep efficiency, increased stage 1 sleep and decreased slow wave sleep as well as decreased density of spindle activity. The objective of this review is to present research data on the EEG findings in patients with ASD, with emphasis on their power EEG, coherence EEG, epileptiform EEG abnormalities and sleep disorders.


Measurement of des-gamma-carboxy prothrombin levels in cancer and non-cancer tissue in patients with hepatocellular carcinoma.
In a recent experiment, we discovered that liver tissue adjacent to HCC can also produce des-gamma-carboxy prothrombin (DCP). The goal of this study was to advance measurements of DCP levels in hepatocellular carcinoma (HCC) and non-cancer tissues using an electro-chemiluminescence immunoassay (ECLIA) and immunohistochemistry, and to assess their clinical significance. DCP levels in HCC tissues ranged from 0.7 to 209862.4 mAU/0.1 g tissue weight, with a median of 492.6 mAU/0.1 g. DCP levels in non-cancer tissues ranged from 0 to 2329.9 mAU/0.1 g tissue weight, with a median of 88.8 mAU/0.1 g. DCP levels in cell membranes were significantly higher than in the cytoplasm (p<0.001). DCP levels in HCC tissue were significantly higher than in non-cancer tissue (p<0.001). The logarithm of serum DCP levels correlated not only with that of DCP levels in HCC tissues (p=0.019), but also with that in non-cancer tissues (p=0.020), and the total DCP level of liver tissues (p=0.016). The logarithm of DCP levels in HCC tissues correlated with that of DCP levels in non-cancer tissues (p=0.011). DCP levels in HCC tissue with portal vein invasion were significantly greater than in HCC tissues without portal vein invasion (p=0.028). DCP levels in non-cancer tissues with intrahepatic metastatic lesions were significantly higher than in non-cancer tissues without intrahepatic metastatic lesions (p=0.023). Our results suggest that the origin of elevated serum DCP may lie not only in HCC tissue, but in non-cancer tissue. The existence of HCC may influence production of DCP in non-cancer tissue. Tissue DCP may be a prognostic factor, while increased DCP levels in non-cancer tissues may play an important role in hepatocarcinogenesis.


The effect of selective suture removal on astigmatism following penetrating keratoplasty.
We retrospectively evaluated selective removal of interrupted nylon sutures to reduce astigmatism following penetrating keratoplasty in 68 eyes with eight or 12 interrupted sutures and one running suture. Following removal of one to four interrupted sutures at one visit (N = 234 visits), corneal astigmatism had changed 2 to 3 diopters (range 0 to 12 D) by the next visit. The astigmatism decreased greater than or equal to 1 D in 54%, changed 0 to .87 D in 28%, and increased greater than or equal to 1 D in 18%. When a total of five or six sutures were removed during the 5 months following surgery, less than 3 D of residual astigmatism was present in 50 eyes (74%). The axis of astigmatism changed less than or equal to 40 degrees in 74% (n = 65). In a second group of 20 eyes with double running sutures, removal of the 10-0 running suture in all 20 eyes produced an average change of 1.8 D (range = 0 to 3.75 D), with an equal number of increases and decreases. Vector analysis showed the total induced change in astigmatism was approximately twice the absolute keratometric change.


Acetate-1-14C incorporation into polyunsaturated fatty acids of phospholipids of developing chick brain.
The incorporation of acetate-1-(14)C into the polyunsaturated fatty acids of glycerophosphatides of chick embryonic brain has been studied. After the injection of acetate-1-(14)C into the yolk sac, differences were found in the degree of labeling of the major fatty acids of the omega3 and omega6 series. Arachidonic acid (20:4omega6) showed a high degree of radioactivity while docosahexaenoic acid (22:6omega3) was poorly labeled, at a period of brain development when both fatty acids were being actively deposited. Evidence is presented to indicate that the low activity in docosahexaenoic acid is not explicable on the basis of either a low or high rate of turnover of this polyenoic acid. Similar results were obtained whether the rapid early or slower late stage of brain development was examined. It is suggested that the elongation of omega3 and omega6 series acids may be under the control of different regulatory mechanisms.


Irritable bowel syndrome, the microbiota and the gut-brain axis.
Irritable bowel syndrome is a common functional gastrointestinal disorder and it is now evident that irritable bowel syndrome is a multi-factorial complex of changes in microbiota and immunology. The bidirectional neurohumoral integrated communication between the microbiota and the autonomous nervous system is called the gut-brain-axis, which integrates brain and GI functions, such as gut motility, appetite and weight. The gut-brain-axis has a central function in the perpetuation of irritable bowel syndrome and the microbiota plays a critical role. The purpose of this article is to review recent research concerning the epidemiology of irritable bowel syndrome, influence of microbiota, probiota, gut-brain-axis, and possible treatment modalities on irritable bowel syndrome.


The safety of commonly used vitamins and minerals.
Dietary supplements are the most common type of complementary medicine in Australia, reportedly used by 47% of the population. Vitamins and minerals are particularly popular Like all medicines, supplements can cause potential harms such as adverse reactions, drug interactions, monetary cost, delay of more effective therapy, false hope, and increased medication burden Although most vitamins and minerals are available for open sale, many are subject to legal restrictions as scheduled medicines, depending on the dose Consumers are at risk of overdose when the same ingredient is present in multiple products Health professionals can assist consumers by discussing the potential benefits and harms of vitamins and minerals and assisting them to find authoritative information Adverse events with vitamins and minerals should be reported to the Therapeutic Goods Administration.


Pleural damage during capsulectomy and exchange of long-standing breast implants in Poland syndrome: a cautionary tale.
We present 3 patients undergoing revisional implant surgery more than 20 years after congenital breast asymmetry correction. All of them had Poland syndrome. In 2 patients, the parietal pleura was inadvertently damaged during capsulectomy, resulting in a pneumothorax in one patient and implant loss in the other. The loss followed a copious accumulation of fluid around the implant, possibly due to a (persistent) communication with the pleural cavity. In the first case the pneumothorax was successfully treated intraoperatively. The third patient suffered no complications during surgery. Predisposing factors for pleural damage during revisional implant surgery for congenital breast asymmetry are discussed, in addition to the merits of total capsulectomy during implant exchange. It is concluded that surgeons should aim to minimize the possibility of pleural damage during this surgery and should proceed with caution when performing total capsulectomy in at-risk patients.


[Nanogold - Biological effects and occupational exposure levels].
Nanogold has different properties and biological activity compared to metallic gold. It can be applied in many fields, such as medicine, laboratory diagnostics and electronics. Studies on laboratory animals show that nanogold can be absorbed by inhalation and ingestion. It can penetrate deep into the epidermis and dermis, but there is no evidence that it is absorbed through the skin. Gold nanoobjects accumulate mainly in the liver and spleen, but they can also reach other internal organs. Nanogold can cross the blood-brain and blood-placenta barriers. Toxicokinetics of nanogold depends on the particle size, shape and surface charge. In animals exposure to gold nanoparticles via inhalation induces slight changes in the lungs. Exposure to nanogold by the oral route does not cause adverse health effects in rodents. In animals after injection of gold nanoobjects changes in the liver and lungs were observed. Nanogold induced genotoxic effects in cells, but not in animals. No adverse effects on the fetus or reproduction were found. There are no carcinogenicity studies on gold nanoparticles. The mechanism of toxicity may be related to the interaction of gold nanoobjects with proteins and DNA, and it leads to the induction of oxidative stress and genetic material damage. The impact of nanostructures on human health has not yet been fully understood. The person, who works with nanomaterials should exercise extreme caution and apply existing recommendations on the evaluation of nanoobjects exposure. The risk assessment should be the basis for taking appropriate measures to limit potential exposure to nanometals, including nanogold. Med Pr 2017;68(4):545-556.


Mechanisms of cardioprotection by lysophospholipids.
The lysophospholipids sphingosine 1-phosphate (S1P) and lysophosphosphatidic acid (LPA) reduce mortality in hypoxic cardiac myocytes. S1P is also cardioprotective in both mouse and rat models of cardiac ischemia/reperfusion (I/R) injury. Although these results are consistent with prior work in other cell types, it is not known what signaling events are critical to cardioprotection, particularly with respect to ceramide and the preservation of mitochondrial function, which is essential for cardiac cell survival. Neither receptor regulation nor signaling has been studied during I/R in the heart with or without the application of S1P or LPA. The role of sphingosine kinase in I/R and in ischemic preconditioning (IPC) has not been defined, nor has the fate or function of S1P generated by this enzyme, particularly during preconditioning or I/R, been elucidated. Whether S1P infused systemically in animal models of myocardial infarction in which survival is an end-point will be hemodynamically tolerated has not been determined. If not, the substitution of agents such as the monosialoganglioside GM-1, which activates sphingosine kinase, or the development of alternative ligands for S1P receptors will be necessary.


Chronic neutrophilic leukemia--a case report.
Chronic neutrophilic leukemia is a rare hematological disorder with hepatosplenomegaly and sustained mature neutrophilic leucocytosis. Increased serum vitamin B12, increased serum urine acid levels and increased leukocyte alkaline phosphatase activity are the associated features in the absence of fever or any other underlying disorder to cause leukemoid reaction. We report one such rare case.


Investigation of the stiffness and yield behaviour of melt-intercalated poly(methyl methacrylate)/organoclay nanocomposites: characterisation and modelling.
The elastic modulus and yield stress behaviour of a melt intercalated Poly(methylmethacrylate)/ organoclay (PMMA/C30B and PMMA/C20A) were studied using uniaxial tensile tests at different temperatures and different strain rate. The stress-strain response was obtained for different loading rates and different test temperature. Both the stiffness and the yield stress were then clearly identified as function of strain rate and temperature. Our experimental results show that the yield stress and modulus of both PMMA/C20A and PMMA/C30B organoclay nanocomposites are very sensitive to clay concentration, strain rate and temperature. A micromechanically-based composite approach was used to predict the yield stress of both PMMA/C20A and PMMA/C30B organoclay nanocomposites. The results obtained from the model are in good agreement with our experimental results. As expected, the activation enthalpy of cooperative model increased slightly while the activation volume decreases slightly with the clay concentration.


Indian visceral leishmaniasis with extensive lymphadenopathy - An unusual presentation: A case report with literature review.
Visceral leishmaniasis (VL), also known as kala-azar, is a life-threatening systemic disease caused by the obligate intracellular protozoan, Leishmania, and transmitted to humans by the female phlebotomine sand fly (Phlebotomus argentipes). The disease is fatal, if left untreated. We report a case of a patient clinically suspected of disseminated tuberculosis, but fine needle aspiration cytology of cervical and axillary lymph nodes yielded a diagnosis of leishmaniasis. Diagnosis of VL was challenging as the disease closely mimicked tuberculosis in the setting of extensive lymphadenopathy including conglomerate of mesenteric lymph nodes, on and off fever, and granulomatous lymphadenitis on aspiration. Bone marrow examination was further performed. A detailed workup revealed patient to be severely immunocompromised and newly diagnosed human immunodeficiency virus (HIV) positive. Worldwide, India has the largest number of VL cases, accounting for 40%-50% of world's disease burden and the second largest HIV-infected population, accounting for approximately 10% of the global disease burden. HIV increases the risk of developing VL by 100-2320 times in endemic areas and concurrently VL promotes the clinical progression of HIV disease. Co-infection with HIV alters the body's immune response to leishmaniasis thus leading to unusual presentations. This case highlights the diagnostic problem in the aforesaid setting. Moreover, co-infection with HIV in VL can be a potential source of drug resistance. An early diagnosis and intensified treatment is the key to patient management.


The role of GPCRs in neurodegenerative diseases: avenues for therapeutic intervention.
Neurodegenerative diseases represent a large group of neurological disorders with heterogeneous clinical and pathological profiles. The majority of current therapeutic strategies provide temporary symptomatic relief but do not target the underlying disease pathobiology and thus do not affect disease progression. G protein-coupled receptors (GPCRs) are among the most successful targets for therapeutic development of central nervous system (CNS) disorders. Many current clinical therapeutic agents act by targeting this class of receptors and downstream signaling pathways. Here, we review evidence that perturbation of GPCR function contributes to the pathophysiology of various neurodegenerative diseases, including Alzheimer's disease, Frontotemporal dementia, Vascular dementia, Parkinson's disease, and Huntington's disease.


Association between Mild Cognitive Impairment and Gut Microbiota in Elderly Korean Patients.
Recent studies have confirmed that gut microbiota differs according to race or country in many diseases, including mild cognitive impairment (MCI) and Alzheimer's disease. However, no study has analyzed the characteristics of Korean MCI patients. This study was performed to observe the association between gut microbiota and MCI in the Korean elderly and to identify potential markers for Korean MCI patients. For this purpose, we collected fecal samples from Korean subjects who were divided into an MCI group (n = 40) and control group (n = 40) for 16S rRNA gene amplicon sequencing. Although no significant difference was observed in the overall microbial community profile, the relative abundance of several genera, including Bacteroides, Prevotella, and Akkermansia, showed significant differences between the two groups. In addition, the relative abundance of Prevotella was negatively correlated with that of Bacteroides (r = 0.733). This study may provide Korean-specific basic data for comparing the characteristics of the gut microbiota between Korean and non-Korean MCI patients.


Large hiatal hernia in infancy with right intrathoracic stomach along with left sided morgagni hernia.
Congenital diaphragmatic hernia is a very common intrathoracic fetal anomaly with Morgagni hernia typically seen on right side anteriorly and Bochdalek hernia on left side posteriorly, because of the protective effects of liver and heart on either side respectively. Hiatal hernias range from herniation of a small portion of stomach into thoracic cavity to herniation of entire stomach into the left thoracic cavity. Very rarely the herniated stomach has been reported in the right thoracic cavity. Early diagnosis and treatment of all diaphragmatic hernias is essential to reduce the associated morbidity and mortality. We present a very rare and interesting case of an 18 months old baby girl with reverse scenarios. She had a large hiatal hernia with right intrathoracic stomach along with a left sided Morgagni hernia in combination.


Local recurrence of breast cancer after MammoSite brachytherapy.
Women undergoing breast conservation therapy (BCT) for stage 1 breast cancer have adjuvant external beam radiotherapy (EBR). In addition, the use of brachytherapy radiation is being used. We present two local tumor recurrences for review. Our first patient underwent BCT, sentinel lymph node biopsy (SLNBx) and MammoSite brachytherapy for a T1N0M0 infiltrating ductal carcinoma (IDC) of the right breast. Pathology: 0.6 cm poorly differentiated ER, PR, and Her-2/ Neu negative IDC. At 18 months, she had palpable axillary lymph nodes. Fine needle aspiration and ultrasound-guided core biopsy of a nodule showed IDC. She underwent modified radical mastectomy (MRM) and EBR. Our second patient underwent BCT, SLNBx, and MammoSite brachytherapy for a T1N0M0 IDC of the left breast. Pathology: 0.8 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. At 18 months, a retroareolar mass was detected. Ultrasound guided core needle biopsy showed recurrent IDC. She chose a re-excision and EBR and not MRM. Pathology: 1.3 cm poorly differentiated, ER+, PR-, and Her-2/Neu negative tumor. Our 2 recurrences were >2 cm away from the lumpectomy site and therefor outside the 1 cm treatment plan of the MammoSite catheter. Both recurrences were biologically identical to the initial tumors and are felt to be local failures rather than new primaries.


Fracture risk in patients with chronic lung diseases treated with bronchodilator drugs and inhaled and oral corticosteroids.
Chronic lung diseases and drugs used to treat patients with chronic lung diseases may be associated with an increased fracture risk. The design was a case-control study of all patients with a fracture (n=124,655) in the year 2000 in Denmark as case subjects. For each case subject, three age- and gender-matched control subjects were randomly drawn from the general population (n=373,962). Chronic lung diseases such as COPD (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.13 to 1.25), emphysema (OR, 1.31; 95% CI, 1.16 to 1.48), and other chronic lung diseases (OR, 1.20; 95% CI, 1.00 to 1.44) were associated with a higher relative risk of any fracture than asthma (OR, 1.06; 95% CI, 1.01 to 1.12). Oral corticosteroids were associated with a dose-dependent increased risk of fractures. Inhaled short-acting beta-agonists were associated with an increase in fracture risk that was not dose dependent and was seen already at low doses. Oral beta-agonists were associated with an increase in fracture risk at low doses but not at higher doses. Other bronchodilators (inhaled long-acting beta-agonists, inhaled beta-agonists plus inhaled corticosteroids, inhaled beta-agonists plus antimuscarinic substances, inhaled antimuscarinic substances, inhaled cromoglycate and cromoglycate-like substances, oral theophylline, and oral leukotriene receptor antagonists), and inhaled corticosteroids were not associated with fracture risk. The increase in fracture risk seen with inhaled short-acting beta-agonists may be linked to the severity of the underlying lung disease rather than with the beta-agonists, per se, as other types of beta-agonists were not associated with fractures.


The development and evaluation of a hydrobromic acid-coated sampling tube for measuring occupational exposures to ethylene oxide.
A new sampling method has been developed for the measurement of ethylene oxide (EtO) exposures in the workplace. This sampling method uses a hydrobromic acid-coated charcoal tube to collect EtO as its 2-bromoethanol reaction product. Because 2-bromoethanol is less volatile and less reactive than EtO, improved sampling capacity and sample stability are observed with this method over the collection of EtO on untreated charcoal. Sample analysis is performed by gas chromatography with electron capture detection (GC/ECD) following desorption with dimethylformamide (DMF) and derivatization of the 2-bromoethanol reaction product with heptafluorobutyrylimidazole (HFBI). The direct analysis of 2-bromoethanol by GC/ECD was not reproducible and this effect was attributed to the presence of excess hydrobromic acid (HBr) in the sample. This matrix effect was eliminated by the formation of the heptafluorobutyrate ester, a water-insoluble derivative of 2-bromoethanol, which was extracted into iso-octane for analysis. This analytical scheme is very sensitive and was used to monitor test atmospheres of EtO at the 0.1 ppm level. An average recovery of 96% was obtained for short-term samples (15 minutes) collected from a 5-ppm test atmosphere at 23 degrees C and 80% relative humidity. Similar high recoveries were obtained for 4-hr samples collected at a sampling rate of 0.1 L/min from test atmospheres in the concentration range of 0.1 to 16 ppm EtO at high humidity (80%) and ambient temperature (22 degrees C to 25 degrees C). Samples collected under these same conditions and stored for a minimum of 2 weeks resulted in average recoveries that ranged from 84% to 101%. Average recoveries of 97% were obtained for 2-ppm air samples collected at low humidity with no storage; however, storage of these samples at 22 degrees C to 25 degrees C resulted in an approximate loss of 5% per week. A field comparison study of samples, that was obtained from a hospital sterilization facility, used the test method and the Qazi-Ketchum sample method and resulted in a correlation for paired samples of 0.99 over a concentration range of 0.3 to 7.0 ppm EtO. These results indicate that this sampling and analytical method is a convenient, accurate and reliable means of monitoring EtO exposures in the workplace.