Effect of Interactive Neurostimulation Therapy on Inflammatory Response in Patients With Chronic and Recurrent Mechanical Neck Pain.
The purpose of this study is to evaluate the effect of treatment with a novel noninvasive interactive neurostimulation device (InterX5000) on the production of inflammatory biomarkers in chronic and recurrent mechanical neck pain (NP) syndrome. This study represents pilot biological data from a randomized controlled clinical trial. Twenty-five NP patients and 14 asymptomatic subjects included for baseline comparison only completed the study. The patients received 6 InterX5000 or placebo treatments within 2 weeks, and pretreatment and post-treatment blood samples were collected for in vitro determination of biomarker production. Whole blood cell cultures were activated by lipopolysaccharide or by the combination of lipopolysaccharide and phytohemagglutinin for 24 to 48 hours. The levels of tumor necrosis factor α (TNFα) and its soluble type II receptor (sTNFR II), interleukin (IL) 1, IL-1 receptor antagonist (IL-1RA), IL-6, IL-10, and monocyte chemotactic protein (CCL2/MCP-1) were determined by specific immunoassays. Compared with asymptomatic subjects, baseline production levels of all proinflammatory mediators (TNFα, IL-1β, IL-6, and CCL2/MCP-1) were significantly augmented or trended higher (P = .000-.008) in patients with NP. Of the anti-inflammatory markers, only IL-1RA was significantly elevated (P = .004). The increase in IL-10 and tumor necrosis factor receptor II levels did not reach statistical significance. Neither InterX5000 nor placebo therapy had any significant effect on the production of the inflammatory mediators over the study period. This investigation determined that inflammatory cytokine pathways are activated in NP patients but found no evidence that a short course of InterX5000 treatment normalized the production of inflammatory biomarkers.


Meningococcal disease in international travel: vaccine strategies.
International travel and migration facilitate the rapid intercontinental spread of meningococcal disease. Serogroup A, and to a lesser extent serogroup C, have been responsible for pandemics in the past (mainly in Africa), but in recent years there was an international outbreak due to W135 related to the Hajj pilgrimage. The high carriage rates, persistence and transmissibility, in combination with the high case fatality rate of the Hajj-associated W135 outbreak clone, certainly raise considerable concern about the public health consequences of widespread dissemination of this organism and the potential for future epidemics. Indeed, the now evolving W135 epidemic in Africa mandates that the bivalent meningococcal vaccine should be replaced by the tetravalent meningococcal vaccine, covering A, C, Y and W135 serogroups. The currently available polysaccharide tetravalent meningococcal vaccine, albeit associated with high seroconversion and efficacy rates, has several shortcomings: it is not immunogenic in young children, duration of protective immunity is short, and it has minimal or no effect on nasopharyngeal carriage and therefore transmission of the organism. Immunogenicity of polysaccharide vaccines can be improved by chemical conjugation to a protein carrier, thereby eliciting a T-cell-dependent antibody response. In contrast to polysaccharide vaccines, conjugate vaccines are immunogenic in young infants, induce long-term protection, and reduce nasopharyngeal carriage. The tetravalent conjugate vaccine will be a leap forward in the control of meningococcal epidemics in affected countries. It will also boost the uptake of meningococcal vaccines in travelers, because the duration of protection is longer and it eliminates the problem of immune hyporesponsiveness of serogroup C with repeated dosing. The small risk of travel-associated disease for the general traveler and the unpredictable nature of epidemics make it difficult to provide evidence-based vaccine recommendations. The current recommendation is to vaccinate all Hajj pilgrims, travelers to areas with current outbreaks, travelers to the sub-Saharan meningitis belt, and high-risk individuals (i.e., those with immunodeficiencies).


Methacholine responsiveness using the raised volume forced expiration technique in infants.
Infant lung function can be assessed with the tidal volume "squeeze" technique or, over an extended volume range, with the newer raised volume forced expiration technique (RVFET). We assessed methacholine responsiveness in 11 infants, measuring both maximal expiratory flow at functional residual capacity (V.max,FRC)with the tidal volume technique, and forced expiratory volume/time (FEV(t)) with RVFET. We used a standard methodology for the former. FEV(t) was measured by inflating the infant's lungs to 20 cm H2O and forcing expiration using a jacket setup to transmit a pressure of 20 cm H2O to the airway. Lung function was measured at baseline and after methacholine inhalations, increasing from 0.1 g/L to 10 g/L in half log dosage increments (DI). The provocative concentrations (PC) of methacholine leading to a 40% fall in V.max,FRC and a 15 or 20% fall in FEV(t) were calculated. The mean provocative concentration of methacholine required to produce a 40% fall in V.max,FRC was less than that required to produce a 20% fall in FEV0.5 by 0.39 DI (95% CI, -0.60 to 1.38) and less than that required to produce a 20% fall in FEV0.75 by 0.42 DI (95%, CI, -0.54 to 1.39). Similarly, the provocative concentration of methacholine required to produce a 40% fall in V.max,FRC was less than that required to produce a 15% fall in FEV0.5 by 0.14 DI (95% CI, -0.99 to 1.28) or a 15% fall in FEV0.75 by 0.13 DI (95% CI, -0.80 to 1.08), but the differences were small and not significant. Despite these differences the agreement between the two methods was good, and bronchoconstriction was not attenuated by the forced inspiration delivered by the raised volume maneuver. We conclude that the raised volume forced expiration technique is able to detect methacholine-induced bronchoconstriction.


Hypoxia Induces Multidrug Resistance via Enhancement of Epidermal Growth Factor-Like Domain 7 Expression in Non-Small Lung Cancer Cells.
Chemotherapy is widely used in non-small cell lung cancer (NSCLC) treatment, yet multidrug resistance (MDR) is a major chemotherapeutic obstacle in both resectable and advanced NSCLC. Epidermal growth factor-like domain 7 (EGFL7), also known as vascular endothelial stain, is an endothelial cell-derived secreted factor that regulates vascular tube formulation. The aim of this study was to investigate the potential relationships between EGFL7 and MDR in NSCLC cells. We first obtained the CDDP-based MDR phenotype cell line A549/CDDP by repeated exposure to a proper concentration of CDDP (cisplatin) from original A549 cells. These A549/CDDP cells, which maintained relative high levels of EGFL7 and P-glycoprotein (P-gp), were resistant to other chemotherapy drugs, such as carboplatin (CBP), paclitaxel (TAX), and gemcitabine (GEM) (p < 0.05). We also found that hypoxia significantly reduced the chemosensitivity of NSCLC cells, and hypoxia-induced MDR was mediated by P-gp and EGFL7 (p < 0.05). EGFL7 was veryy relevant to NSCLC cell MDR, and downregulation of EGFL7 could significantly increase the chemosensitivity of NSCLC cells (p < 0.05). Thus, our findings first indicate that hypoxia induced NSCLC cell MDR at least partly by enhancing the expression of EGFL7 protein. EGFL7 might be a feasible target for reversing hypoxia-mediated MDR in NSCLC cells and a promising biomarker for predicting the development of MDR in NSCLC patients on chemotherapy.


The challenges with the validation of research antibodies.
This article further discusses the reproducibility crisis in biomedical science and how poor conduct of commercial antibodies contribute to this. In addition, the way quality data are presented on product sheets by antibody vendors is scrutinized. The article proposes that there is a distinction between testing data and validation data, and special attention is asked for consistency between batches and aliquots. Moreover, the article separates the specifics, such as formulation, antigen and price, from the specifics on performance. Finally, a two-tier approach is discussed, enabling scientists to anticipate how an antibody is likely to perform when repeated purchases are required.


Mechanism of action of magnesium on acetylcholine-evoked secretory responses in isolated rat pancreas.
This study investigates the effects of magnesium (Mg2+) on acetylcholine (ACh)-evoked secretory responses and calcium (Ca2+) mobilization in the isolated rat pancreas. ACh induced marked dose-dependent increases in total protein output and amylase release from superfused pancreatic segments in zero, normal (1 x 1 mM) and elevated (10 mM) extracellular Mg2+. Elevated Mg2+ attenuated the ACh-evoked secretory responses compared to zero and normal Mg2+. In the absence of extracellular Ca2+, but presence of 1 mM-EGTA (ethylene glycol bis(beta-aminoethylether)-N,N,N',N''-tetraacetic acid), ACh elicited a small transient release of protein from pancreatic segments compared to a larger and more sustained secretion in the absence of both Ca2+ and Mg2+. Incubation of pancreatic segments with 45Ca2+ resulted in time-dependent uptake with maximum influx of 45Ca2+ occurring after 20 min of incubation period. ACh stimulated markedly the 45Ca2+ uptake compared to control tissues. In elevated extracellular Mg2+ the ACh-induced 45Ca2+ influx was significantly (P less than 0.001) reduced compared to zero and normal Mg2+. ACh also evoked dose-dependent increases in cytosolic free Ca2+ concentrations ([Ca2+]i) in pancreatic acinar cells loaded with the fluorescent dye Fura-2 AM. In elevated Mg2+ the ACh-induced cytosolic [Ca2+]i was significantly (P less than 0.001) reduced compared to zero and normal Mg2+. These results indicate that Mg2+ can influence ACh-evoked secretory responses possibly by controlling both Ca2+ influx and release in pancreatic acinar cells.


SAR, pharmacokinetics, safety, and efficacy of glucokinase activating 2-(4-sulfonylphenyl)-N-thiazol-2-ylacetamides: discovery of PSN-GK1.
Allosteric activators of the glucose-sensing enzyme glucokinase (GK) are currently attracting much interest as potential antidiabetic therapies because they can achieve powerful blood glucose lowering through actions in multiple organs. Here, the optimization of a weakly active high-throughput screening hit to (2 R)-2-(4-cyclopropanesulfonylphenyl)- N-(5-fluorothiazol-2-yl)-3-(tetrahydropyran-4-yl)propionamide (PSN-GK1), a potent GK activator with an improved pharmacokinetic and safety profile, is described. Following oral administration, this compound elicited robust glucose lowering in rats.


Postprandial Effects of Breakfast Glycemic Index on Vascular Function among Young Healthy Adults: A Crossover Clinical Trial.
This study aimed to evaluate the postprandial effects of high and low glycemic index (GI) breakfasts on vascular function. It was a crossover trial that included 40 young healthy adults (50% women), aged 20-40 years, who were recruited at primary care settings. They consumed three experimental breakfasts in randomized order, each one separated by a 1-week washout period: (1) control conditions (only water); (2) low GI (LGI) breakfast (29.4 GI and 1489 KJ energy); and (3) high GI (HGI) breakfast (64.0 GI and 1318 KJ energy). Blood samples were collected at 60 and 120 min after each breakfast to determine glucose and insulin levels. Vascular parameters were measured at 15 min intervals. Augmentation index (AIx) was studied as a primary outcome. Secondary outcomes comprised glucose, insulin, heart rate (HR) and pulse pressures (PPs). We found a trend toward increased AIx, HR and PPs for the HGI versus the LGI breakfast. A significant interaction between the type of breakfast consumed and all measured parameters was identified (p < 0.05) except for central PP. Stratifying data by sex, this interaction remained significant for AIx and augmentation pressure only in males (p < 0.05). In conclusion, breakfast GI could affect postprandial vascular responses in young healthy adults.


Regulators of G-protein signaling accelerate GPCR signaling kinetics and govern sensitivity solely by accelerating GTPase activity.
G-protein heterotrimers, composed of a guanine nucleotide-binding G alpha subunit and an obligate G betagamma dimer, regulate signal transduction pathways by cycling between GDP- and GTP-bound states. Signal deactivation is achieved by G alpha-mediated GTP hydrolysis (GTPase activity) which is enhanced by the GTPase-accelerating protein (GAP) activity of "regulator of G-protein signaling" (RGS) proteins. In a cellular context, RGS proteins have also been shown to speed up the onset of signaling, and to accelerate deactivation without changing amplitude or sensitivity of the signal. This latter paradoxical activity has been variably attributed to GAP/enzymatic or non-GAP/scaffolding functions of these proteins. Here, we validated and exploited a G alpha switch-region point mutation, known to engender increased GTPase activity, to mimic in cis the GAP function of RGS proteins. While the transition-state, GDP x AlF(4)(-)-bound conformation of the G202A mutant was found to be nearly identical to wild-type, G alpha(i1)(G202A) x GDP assumed a divergent conformation more closely resembling the GDP x AlF(4)(-)-bound state. When placed within Saccharomyces cerevisiae G alpha subunit Gpa1, the fast-hydrolysis mutation restored appropriate dose-response behaviors to pheromone signaling in the absence of RGS-mediated GAP activity. A bioluminescence resonance energy transfer (BRET) readout of heterotrimer activation with high temporal resolution revealed that fast intrinsic GTPase activity could recapitulate in cis the kinetic sharpening (increased onset and deactivation rates) and blunting of sensitivity also engendered by RGS protein action in trans. Thus G alpha-directed GAP activity, the first biochemical function ascribed to RGS proteins, is sufficient to explain the activation kinetics and agonist sensitivity observed from G-protein-coupled receptor (GPCR) signaling in a cellular context.


Computational refocusing in phase-resolved confocal microscopy.
We demonstrate numerical refocusing in coherent confocal laser scanning microscopy based on synthetic optical holography. In this physics-based approach, computational propagation is implemented on the complex signal recovered in synthetic holography, consistent with wave physics and the parameters of the microscope. An experimental demonstration is shown to restore an in-focus image of a test object from data acquired at several focal plane off-sets. Numerical refocusing can provide focused views on samples with large height variation, with a potential application in confocal optical surface profiling.


[A review of the transformation of American higher medical education in the early 20th century].
This paper has a review of the transformation of American higher medical education in the early 20th century, which is signalized by the publication of Flexner report in 1910. At the same time, the author also has an analysis on the whole event. The experience of its success or failure is summarized in order to give references to the reform of Chinese higher medical education.


Spatiotemporal molecular dynamics of the developing human thalamus.
The thalamus plays a central coordinating role in the brain. Thalamic neurons are organized into spatially-distinct nuclei, but the molecular architecture of thalamic development is poorly understood, especially in humans. To begin to delineate the molecular trajectories of cell fate specification and organization in the developing human thalamus, we used single cell and multiplexed spatial transcriptomics. Here we show that molecularly-defined thalamic neurons differentiate in the second trimester of human development, and that these neurons organize into spatially and molecularly distinct nuclei. We identify major subtypes of glutamatergic neuron subtypes that are differentially enriched in anatomically distinct nuclei. In addition, we identify six subtypes of GABAergic neurons that are shared and distinct across thalamic nuclei. Single cell and spatial profiling of the developing thalamus in the first and second trimester yields molecular mechanisms of thalamic nuclei development.


Evaluation of graphene oxide, chitosan and their complex as antibacterial agents and anticancer apoptotic effect on HeLa cell line.
Cancer and bacterial infection are the most serious problems threatening people's lives worldwide. However, the overuse of antibiotics as antibacterial and anticancer treatments can cause side effects and lead to drug-resistant bacteria. Therefore, developing natural materials with excellent antibacterial and anticancer activity is of great importance. In this study, different concentrations of chitosan (CS), graphene oxide (GO), and graphene oxide-chitosan composite (GO-CS) were tested to inhibit the bacterial growth of gram-positive (Bacillus cereus MG257494.1) and gram-negative (Pseudomonas aeruginosa PAO1). Moreover, we used the most efficient natural antibacterial material as an anticancer treatment. The zeta potential is a vital factor for antibacterial and anticancer mechanism, at pH 3-7, the zeta potential of chitosan was positive while at pH 7-12 were negative, however, the zeta potential for GO was negative at all pH values, which (p < 0.05) increased in the GO-CS composite. Chitosan concentrations (0.2 and 1.5%) exhibited antibacterial activity against BC with inhibition zone diameters of 4 and 12 mm, respectively, and against PAO1 with 2 and 10 mm, respectively. Treating BC and PAO1 with GO:CS (1:2) and GO:CS (1:1) gave a larger (p < 0.05) inhibition zone diameter. The viability and proliferation of HeLa cells treated with chitosan were significantly decreased (p < 0.05) from 95.3% at 0% to 12.93%, 10.33%, and 5.93% at 0.2%, 0.4%, and 0.60% concentrations of chitosan, respectively. Furthermore, CS treatment increased the activity of the P53 protein, which serves as a tumor suppressor. This study suggests that chitosan is effective as an antibacterial and may be useful for cancer treatment.


Gingival epithelial cells support osteoclastogenesis by producing receptor activator of nuclear factor kappa B ligand via protein kinase A signaling.
Periodontal disease is dental plaque-induced inflammatory disease of the periodontal tissues that results in bone loss in the affected teeth. During bone resorption, receptor activator of nuclear factor kappa B ligand (RANKL) is an essential factor that regulates osteoclastogenesis. Recently, we found that gingival epithelial cells (GECs) in periodontal tissue produce RANKL, the expression of which is regulated by tumor necrosis factor-α and protein kinase A signaling. In this study, we asked whether RANKL-producing GECs induce bone marrow macrophages (BMMs) to form osteoclasts in a co-culture system. Ca9-22 GECs and osteoclast precursor BMMs were co-cultured with or without the protein kinase A signaling activator forskolin or inhibitor H89 to examine whether the RANKL-producing GECs could be induced to form osteoclasts, as determined using a pit formation assay. Osteoclasts formed spontaneously in co-cultures of Ca9-22 cells and BMMs, even in the absence of RANKL. The cells were cultured on bone slices for 14 d, at which time resorption pits were observed. Forskolin treatment significantly increased osteoclast numbers in these co-cultures, but forskolin alone did not induce osteoclast formation by BMMs. GECs producing RANKL are able to support osteoclastogenesis in an in vitro co-culture system using GECs and BMMs, in a process promoted by forskolin.


Integrating professionalism teaching into undergraduate medical education in the UK setting.
This paper examines how professionalism teaching might be integrated into undergraduate medical education in the United Kingdom setting. It advocates adopting an outcome-based approach to curriculum planning, using the Scottish Deans' Medical Curriculum Group's (SDMCG) outcomes as a starting point. In discussing the curricular content, potential learning methods and strategies, theoretical considerations are explored. Student selection, assessment and strategies for optimising the educational environment are also considered.


Studies of intestinal microflora. VI. Effect of x irradiation on the fecal microflora of the rat.
The effect of sublethal, midlethal, and lethal doses of total-body X irradiation on the fecal microbial population of the rat was studied. No changes were observed in animals receiving sublethal doses of X ray. Midlethal and lethal doses produced an increase in the numbers of fecal coliforms, staphylococci, streptococci, and fungi; these changes were transient in rats that survived, but were more marked and persisted during life in those that died. The possible role of these alterations in intestinal microflora in post-irradiation infection and in death is discussed.


Sperm structure and spermiogenesis in Coletinia sp. (Nicoletiidae, Zygentoma, Insecta) with a comparative analysis of sperm structure in Zygentoma.
The spermatozoon of Coletinia sp. has a bilayered acrosome, a short nucleus (4 microm) and a relatively short sperm tail with two mitochondrial derivatives. The chromatin is uniformly dense except for several electron-lucid channels or strands which permeate the nucleus and which originate in the spermatid as invaginations of the nuclear envelope. The invaginations occur mostly or exclusively along two meridians of the spermatid that are also characterized by the presence of a longitudinal rod of medium electron density. The two rods (designated as 'mid-spermatid rods') evidently are instrumental in the formation of the electron-lucid channels. The significance of this elaborate system of intranuclear channels is not understood. The sperm tail has a 9 + 9 + 2 axoneme with each of the nine microtubular doublets accompanied by an accessory microtubule; scant intertubular material can also be distinguished. Hence, the tail axoneme resembles that of many pterygote insects. Each of the two mitochondrial derivatives contains a crystalline inclusion that has periodically spaced layers going in different directions on either side of the midline. Two synapomorphic traits appear to be shared by Ateluridae and Nicoletiidae, namely the invaginations of the nuclear membrane along two meridians of the nucleus and the shape of the crystalline inclusions of the mitochondrial derivatives. Four species from the family Lepismatidae were also examined as to their sperm ultrastructure. Three of them, Allacrotelsa kraepelini, Ctenolepisma longicaudata and Ctenolepisma sp., were found to be very similar to the two previously examined lepismatids, Thermobia domestica and Lepisma saccharina. On the other hand, spermatozoa of Tricholepisma aurea were aggregated in small groups rather than pairwise joined as seen in the other lepismatids. Sperm characters are also used to reconstruct a phylogenetic hypothesis which suggests a close relationship between Ateluridae and Nicoletiidae.


Current status of quality evaluation of nursing care through director review and reflection from the Nursing Quality Control Centers.
The quality evaluation of nursing care is a key link in medical quality management. It is important and worth studying for the nursing supervisors to know the disadvantages during the process of quality evaluation of nursing care and then to improve the whole nursing quality. This study was to provide director insight on the current status of quality evaluation of nursing care from Nursing Quality Control Centers (NQCCs). This qualitative study used a sample of 12 directors from NQCCs who were recruited from 12 provinces in China to evaluate the current status of quality evaluation of nursing care. Data were collected by in-depth interviews. Content analysis method was used to analyze the data. Four themes emerged from the data: 1) lag of evaluation index; 2) limitations of evaluation content; 3) simplicity of evaluation method; 4) excessive emphasis on terminal quality. It is of great realistic significance to ameliorate nursing quality evaluation criteria, modify the evaluation content based on patient needs-oriented idea, adopt scientific evaluation method to evaluate nursing quality, and scientifically and reasonably draw horizontal comparisons of nursing quality between hospitals, as well as longitudinal comparisons of a hospital's nursing quality. These methods mentioned above can all enhance a hospital's core competitiveness and benefit more patients.


Multi-omics data provide insight into the adaptation of the glasshouse plant Rheum nobile to the alpine subnival zone.
Subnival glasshouse plants provide a text-book example of high-altitude adaptation with reproductive organs enclosed in specialized semi-translucent bracts, monocarpic reproduction and continuous survival under stress. Here, we present genomic, transcriptomic and metabolomic analyses for one such plant, the Noble rhubarb (Rheum nobile). Comparative genomic analyses show that an expanded number of genes and retained genes from two recent whole-genome duplication events are both relevant to subnival adaptation of this species. Most photosynthesis genes are downregulated within bracts compared to within leaves, and indeed bracts exhibit a sharp reduction in photosynthetic pigments, indicating that the bracts no longer perform photosynthesis. Contrastingly, genes related to flavonol synthesis are upregulated, providing enhanced defense against UV irradiation damage. Additionally, anatomically abnormal mesophyll combined with the downregulation of genes related to mesophyll differentiation in bracts illustrates the innovation and specification of the glass-like bracts. We further detect substantial accumulation of antifreeze proteins (e.g. AFPs, LEAs) and various metabolites (e.g. Proline, Protective sugars, procyanidins) in over-wintering roots. These findings provide new insights into subnival adaptation and the evolution of glasshouse alpine plants.


The ozone-iodine-chlorate clock reaction.
This work presents a new clock reaction based on ozone, iodine, and chlorate that differs from the known chlorate-iodine clock reaction because it does not require UV light. The induction period for this new clock reaction depends inversely on the initial concentrations of ozone, chlorate, and perchloric acid but is independent of the initial iodine concentration. The proposed mechanism considers the reaction of ozone and iodide to form HOI, which is a key species for producing non-linear autocatalytic behavior. The novelty of this system lies in the presence of ozone, whose participation has never been observed in complex systems such as clock or oscillating reactions. Thus, the autocatalysis demonstrated in this new clock reaction should open the possibility for a new family of oscillating reactions.


Importance of a 4-Alkyl Substituent for Activity in the Englerin Series.
The ring closing metathesis/transannular etherification approach to the englerin nucleus was adapted to provide two key intermediates for analogue synthesis: the 4-desmethyl Δ5,6 tricycle and the 4-oxo Δ5,6 tricycle. The former was elaborated to 4-desmethyl englerin A and the latter served as a common precursor for englerin A, 4-ethyl englerin A, and 4-isopropyl englerin A. 4-Desmethyl englerin A was less active than the natural product by an order of magnitude, but the 4-ethyl and 4-isopropyl analogues were comparable in activity to englerin A. These results are consistent with the premise that the 4-alkyl group enforces the binding conformation of the cinnamoyl ester substituent. Furthermore, they suggest that 4-alkyl englerin structures may prove to be useful tool compounds.


Beliefs and attitudes about endemic dental fluorosis among adolescents in rural Brazil.
OBJECTIVE: To understand beliefs and attitudes about fluorosis among young people living in a rural area. METHODOLOGICAL PROCEDURES: Qualitative study consisting of semi-structured interviews with 23 adolescents with dental fluorosis, 14 teachers and three health authorities in the city of São Francisco, Southeastern Brazil, in 2002. Content analysis and social representation theory were applied. ANALYSIS OF RESULTS: The organoleptic characteristics of carbonates that affect groundwater (salty flavor, whitish coloration, and turbidity) associated with negative aspects of household use of this water are considered a cause of mottled enamel. Even after contact with researchers who investigated this phenomenon and helped find a solution for this condition, the local population is still unwilling to accept fluoride as the cause of the problem and does not fully agree to use water from other sources because they are afraid of the quality of water. CONCLUSIONS: Misperceptions of the causes of dental fluorosis and water treatment costs compromise the implementation of uncontaminated surface water supplies. Health education strategies are required in parallel with solutions for securing water supply in drought-ravaged areas.


The "eardrum artifact" in ipsilateral reflex measurements.
A source of error in ipsilateral reflex measurements with impedance methods is explained. It is shown that the inherent non-linearity of the cavity represented by the ear canal and tympanic membrane gives rise to an artifact in the measurement of acoustic impedance which is synchronous with the stimulus. The magnitude of the artifact increases with the intensity of the stimulus, but is relatively insensitive to the frequency of the stimulus. A practical method for measuring the magnitude of the artifact is described.


Electromagnetic fields and anomalous transports in heavy-ion collisions-a pedagogical review.
The hot and dense matter generated in heavy-ion collisions may contain domains which are not invariant under P and CP transformations. Moreover, heavy-ion collisions can generate extremely strong magnetic fields as well as electric fields. The interplay between the electromagnetic field and triangle anomaly leads to a number of macroscopic quantum phenomena in these P- and CP-odd domains known as anomalous transports. The purpose of this article is to give a pedagogical review of various properties of the electromagnetic fields, the anomalous transport phenomena, and their experimental signatures in heavy-ion collisions.


Communication diary to aid care at the end of life.
This study describes how clinical staff at an acute hospital developed and introduced a diary tool that improved communication with the relatives (or carers) of patients receiving end-of-life care. The "Relatives'/carers' diary" was given to relatives of patients on the Liverpool Care Pathway. The diary enables relatives to be more meaningfully engaged in end-of-life care. It also enables nurses to monitor the quality of their care and respond quickly to any concerns.


A necrotizing pneumonia in lambs caused by pseudorabies virus (Aujesky's disease virus).
An outbreak of pseudorabies occurred in sheep housed with swine in the same building. Although the sheep and swine were not in physical contact, the lambs and ewes were exposed to air from the sows' section. Three dead lambs were submitted to the Iowa State University Veterinary Diagnostic Laboratory for necropsy. Grossly there were pulmonary congestion and multifocal pulmonary hemorrhages. Microscopic lesions were severe acute multifocal necrotizing bronchopneumonia with necrotizing vasculitis and intranuclear inclusion bodies within the neurons of the parabronchial ganglia. Bacterial cultures were negative for pathogenic agents; pseudorabies virus was isolated from ovine brain tissue. Viral antigen was demonstrated in the neurons of the parabronchial ganglia by immunoperoxidase staining. Electron microscopy revealed nucleocapsids in the parabronchial ganglionic neurons which contained basophilic intranuclear inclusion bodies. Viral DNA prepared from the ovine pseudorabies virus isolate was found by restriction endonuclease analysis to be related to the Indiana Funkhauser strain of pseudorabies virus.


Scheuermann's juvenile kyphosis. A histologic study.
The case histories and gross and microscopic findings of two adolescent patients with Scheuermann's kyphosis demonstrate that the anterior longitudinal ligament is bowstrung across the apex of the hyphosis. The microscopic findings include markedly irregular end plates and end plate disruption with protrusion of disk material into the vertebral body. The ring apophysis does not show avascular necrosis. The intervertebral disk is interpreted as normal both by routine histology and electron microscopy. It is postulated that Scheuermann's kyphosis may be secondary to vertebral osteoporosis occurring during the juvenile period rather than to an intrinsic abnormality in the intervertebral disk or ring apophysis.


TRPC6 channel-mediated neurite outgrowth in PC12 cells and hippocampal neurons involves activation of RAS/MEK/ERK, PI3K, and CAMKIV signaling.
The non-selective cationic transient receptor canonical 6 (TRPC6) channels are involved in synaptic plasticity changes ranging from dendritic growth, spine morphology changes and increase in excitatory synapses. We previously showed that the TRPC6 activator hyperforin, the active antidepressant component of St. John's wort, induces neuritic outgrowth and spine morphology changes in PC12 cells and hippocampal CA1 neurons. However, the signaling cascade that transmits the hyperforin-induced transient rise in intracellular calcium into neuritic outgrowth is not yet fully understood. Several signaling pathways are involved in calcium transient-mediated changes in synaptic plasticity, ranging from calmodulin-mediated Ras-induced signaling cascades comprising the mitogen-activated protein kinase, PI3K signal transduction pathways as well as Ca(2+) /calmodulin-dependent protein kinase II (CAMKII) and CAMKIV. We show that several mechanisms are involved in TRPC6-mediated synaptic plasticity changes in PC12 cells and primary hippocampal neurons. Influx of calcium via TRPC6 channels activates different pathways including Ras/mitogen-activated protein kinase/extracellular signal-regulated kinases, phosphatidylinositide 3-kinase/protein kinase B, and CAMKIV in both cell types, leading to cAMP-response element binding protein phosphorylation. These findings are interesting not only in terms of the downstream targets of TRPC6 channels but also because of their potential to facilitate further understanding of St. John's wort extract-mediated antidepressant activity. Alterations in synaptic plasticity are considered to play an important role in the pathogenesis of depression. Beside several other proteins, TRPC6 channels regulate synaptic plasticity. This study demonstrates that different pathways including Ras/MEK/ERK, PI3K/Akt, and CAMKIV are involved in the improvement of synaptic plasticity by the TRPC6 activator hyperforin, the antidepressant active constituent of St. John's wort extract.


Activated (Ia+) T-cells and their subsets in Graves' disease and Hashimoto's thyroiditis using dual laser flow microfluorocytometric analysis.
Lymphocytes from patients with Graves' disease and Hashimoto's thyroiditis were analysed directly by a dual laser-activated cell-sorter for the percentage of activated T-cells and their subsets using two-colour dye-labelling with monoclonal antibodies specific for antigens of Ia+ T-cells, as well as either their T-helper/inducer (TH/I) or T-suppressor/cytotoxic (TS/C) subsets. Compared to normal subjects, patients with hyperthyroid Graves' disease had a significantly (p less than 0.0001) higher percentage of activated (Ia+ Leu 4+) T-cells (7.8 +/- 1.9 versus 1.9 +/- 0.4), wherein their percentage of Ia+ Leu 3a+ (Ia+ TH/I) subset was significantly increased (p less than 0.001) and the percentage of Ia+ Leu 2a+ (Ia+ TS/C) subset decreased; patients with hypothyroid Hashimoto's thyroiditis also had a significant (p less than 0.001) increase in the percentage of Ia+ T-cells (4.3 +/- 0.6 versus 1.9 +/- 0.4), wherein their percentage of Ia+ TH/I was significantly reduced (p less than 0.001), while the percentage of the Ia+ TS/C subset was increased compared to normal. Following a return of thyroid status to euthyroidism, the percentage of Ia+ T-cells decreased in both Graves' and Hashimoto's thyroiditis patients, but remained significantly higher (p less than 0.001) than normal subjects, while the Ia+ TH/I and Ia+ TS/C subsets were no longer different. (1) the feasibility of enumerating Ia+ T-cells and their subsets in autoimmune thyroid diseases using two-coloured dyes and dual laser flow microfluorometric analytical techniques has been demonstrated. (2) Percentage increases in Ia+ T-cells have been demonstrated in both hyperthyroid Graves' and hypothyroid Hashimoto's which, following restoration to euthyroidism, decreased but still remained significantly higher than normal. (3) Patients with hyperthyroid Graves' and hypothyroid Hashimoto's disease were demonstrated to have the opposite phenotypic changes within activated T-cell subsets, thereby indicating that their pathogenic mechanisms are different.


Elasticity measurements show the existence of thin rigid cores inside mitotic chromosomes.
Chromosome condensation is one of the most critical steps during cell division. However, the structure of condensed mitotic chromosomes is poorly understood. In this paper we describe a new approach based on elasticity measurements for studying the structure of in vitro assembled mitotic chromosomes in Xenopus egg extract. The approach is based on a unique combination of measurements of both longitudinal deformability and bending rigidity of whole chromosomes. By using specially designed micropipettes, the chromosome force-extension curve was determined. Analysis of the curvature fluctuation spectrum allowed for the measurement of chromosome bending ridigity. The relationship between the values of these two parameters is very specific: the measured chromosome flexibility was found to be 2,000 times lower than the flexibility calculated from the experimentally determined Young modulus. This requires the chromosome structure to be formed of one or a few thin rigid elastic axes surrounded by a soft envelope. The properties of these axes are well-described by models developed for the elasticity of titin-like molecules. Additionally, the deformability of in vitro assembled chromosomes was found to be very similar to that of native somatic chromosomes, thus demonstrating the existence of an essentially identical structure.


CBD oil: Your patients are using it. Here's what you need to know.
Cannabinoid (CBD) oil is a trend in self-care management. In this digital age, patients have access to products from across the globe, and these products may not be regulated. Healthcare providers must be at the forefront of the latest trends in medicine and alternative therapies to better serve patients' needs. This article reviews various medical conditions for which CBD oil already is being used, its other medicinal uses, major adverse reactions, and what patients should know before they decide to consume CBD oil.


Optimized Conformal Total Body Irradiation methods with Helical TomoTherapy and Elekta VMAT: Implementation, Imaging, Planning and Dose Delivery for Pediatric Patients.
Optimized conformal total body irradiation (OC-TBI) is a highly conformal image guided method for irradiating the whole human body while sparing the selected organs at risk (OARs) (lungs, kidneys, lens). This study investigated the safety and feasibility of pediatric OC-TBI with the helical TomoTherapy (TomoTherapy) and volumetric modulated arc (VMAT) modalities and their implementation in routine clinical practice. This is the first study comparing the TomoTherapy and VMAT modalities in terms of treatment planning, dose delivery accuracy, and toxicity for OC-TBI in a single-center setting. The OC-TBI method with standardized dosimetric criteria was developed and implemented with TomoTherapy. The same OC-TBI approach was applied for VMAT. Standardized treatment steps, namely, positioning and immobilization, contouring, treatment planning strategy, plan evaluation, quality assurance, visualization and treatment delivery procedure were implemented for 157 patients treated with TomoTherapy and 52 patients treated with VMAT. Both modalities showed acceptable quality of the planned target volume dose coverage with simultaneous OARs sparing. The homogeneity of target irradiation was superior for TomoTherapy. Overall assessment of the OC-TBI dose delivery was performed for 30 patients treated with VMAT and 30 patients treated with TomoTherapy. The planned and delivered (sum of doses for all fractions) doses were compared for the two modalities in groups of patients with different heights. The near maximum dose values of the lungs and kidneys showed the most significant variation between the planned and delivered doses for both modalities. Differences in the patient size did not result in statistically significant differences for most of the investigated parameters in either the TomoTherapy or VMAT modality. TomoTherapy-based OC-TBI showed lower variations between planned and delivered doses, was less time-consuming and was easier to implement in routine practice than VMAT. We did not observe significant differences in acute and subacute toxicity between TomoTherapy and VMAT groups. The late toxicity from kidneys and lungs was not found during the 2.3 years follow up period. The study demonstrates that both modalities are feasible, safe and show acceptable toxicity. The standardized approaches allowed us to implement pediatric OC-TBI in routine clinical practice.


Lower initial dose desoxycorticosterone pivalate for treatment of canine primary hypoadrenocorticism.
To evaluate the efficacy of initial doses of desoxycorticosterone pivalate (DOCP) that are lower and less expensive than the presently recommended initial dose of 2.2 mg/kg for treating dogs with primary hypoadrenocorticism. A retrospective study was performed on 49 dogs with primary hypoadrenocorticism, including 36 with initial DOCP doses less than 2.2 mg/kg. Medical records were reviewed for clinical data. All study dogs were followed up with telephone calls to owners or veterinarians to determine the date of death or last follow-up. Data were analysed to investigate relationships between initial DOCP dose and survival and serum Na, K and their ratio. Regardless of their initial DOCP dose, none of the dogs developed uncontrolled hypoadrenocorticism or severe electrolyte abnormalities or clinical problems that would have made an increase in the DOCP dose necessary. Over time, most dogs had a decrease in their DOCP dose in mg/kg, because of weight gain during treatment. No statistically significant relationships were found between initial DOCP dose and survival or post-treatment serum Na, K or Na : K, with the exception of one statistically significant result that suggested lower efficacy for higher doses. Initial DOCP doses less than 2.2 mg/kg may be effective in controlling serum electrolyte concentrations in dogs with primary hypoadrenocorticism without adversely affecting survival. If confirmed by additional research, these findings would enable practitioners to reduce the cost of DOCP treatment by using lower initial doses, potentially saving the lives of dogs that would otherwise be euthanased because of treatment expense.


Changes in male reproductive function after high altitude mountaineering.
The male reproductive functions of the members of the Masherbrum (7821 m) Expedition in 1999 were examined via semen analyses and endocrine tests. Specimens were collected from three subjects who had stayed above 5100 m for 21 to 24 days and above 6700 m for 4 to 5 days before departure and 1 month, 3 months, and 2 yr after returning from the expedition. Semen analyses showed no change in the semen volume. Sperm counts decreased after 1 month and had not recovered after 3 months, but they had recovered after 2 yr in all subjects. An increase in abnormally shaped sperm was also observed after 1 month, but had nearly recovered to the preexpedition state after 3 months. Endocrine tests revealed slightly decreased testosterone in the blood after 1 month, which had decreased still further after 3 months. The tests were completely normal after 2 yr. We suggest that a high altitude sojourn may induce reversible spermatogenic and Leydig cell dysfunction.


Effect of laryngoplasty on respiratory noise reduction in horses with laryngeal hemiplegia.
Laryngoplasty is the technique of choice for treatment of laryngeal hemiplegia, with the aim of improving airway function and/or eliminating respiratory noise. However, there are no quantitative data in the literature describing the effect of laryngoplasty on upper airway noise or its relationship to upper airway mechanics in horses with laryngeal hemiplegia. To determine whether laryngoplasty reduces respiratory noise in exercising horses with laryngeal hemiplegia; and to establish whether the degree of upper airway obstruction can be predicted by upper airway noise, or the degree of arytenoid abduction correlated with airway obstruction and noise production. Six Standardbred horses with normal upper airways during maximal exercise were used. Respiratory sounds and inspiratory transupper airway pressure (Pui) were measured in all horses before and after induction of laryngeal hemiplegia and 30, 60 and 90 days after laryngoplasty. Inspiratory sound level (SL) and the sound intensity of the 3 inspiratory formants (F1, F2 and F3, respectively) were measured using a computer-based sound analysis programme. The degree of abduction was graded by endoscopic visualisation 1, 30, 60 and 90 days post operatively. Linear regression analysis was used to determine correlations between Pui, sound indices and grades of arytenoid abduction. In laryngeal hemiplegia-affected horses, Pui, inspiratory SL and the sound intensity of F1, F2 and F3 were significantly increased. At 30 days following laryngoplasty, the sound intensity of F1 and Pui returned to baseline values. The sound intensities of F2, F3 and SL were significantly improved from laryngeal hemiplegia values at 30 days post operatively, but did not return to baseline at any measurement period. Sound level, F2 and F3 were significantly correlated with Pui (P<0.05), but the correlations were weak (r2 = 0.26, 035 and 0.40, respectively). Grade of abduction and F2 were positively and significantly correlated (P<0.006, r2 = 0.76). Grade of arytenoid abduction and Pui were not correlated (P = 0.12). Laryngoplasty reduced inspiratory noise in laryngeal hemiplegia-affected horses by 30 days following surgery, but did not return it to baseline values. While upper airway noise and Pui were correlated, this relationship was insufficiently strong to predict Pui from noise in individual animals. The degree of arytenoid abduction was not correlated with Pui, but was positively correlated with noise production. Laryngoplasty reduces upper airway noise in horses with laryngeal hemiplegia, but is not as effective as bilateral ventriculocordectomy in this regard, although respiratory noise reduction occurs more rapidly than with bilateral ventriculocordectomy. Residual noise during exercise cannot be used as a predictor of improvement in upper airway function in individual horses following laryngoplasty. The degree of arytenoid abduction obtained following surgery does not affect upper airway flow mechanics. Interestingly, we found that the greater the arytenoid abduction, the louder the respiratory noise.


Insulin pathway related genes and risk of colorectal cancer: INSR promoter polymorphism shows a protective effect.
Western lifestyle leading to obesity and type 2 diabetes has been associated with increased risk of colorectal cancer (CRC). Diet and related factors may affect the risk by modifying plasma insulin levels. Thus, the inter-individual variation in insulin signaling may play a plausible role in the development of CRC. We hypothesized that functional polymorphisms in the insulin pathway genes INS, INSR, IGFBPI, insulin receptor substrate 1 (IRS1), and IRS2 may be associated with CRC. We studied the association of five single nucleotide polymorphisms (SNPs) with the risk of CRC using a hospital-based case-control design with 712 cases and 748 controls from the Czech Republic. The INSR A-603G promoter SNP, which is located within a known Sp1-binding site, was associated with the risk of CRC, with carriers of the G allele having a decreased risk (odds ratios (OR) 0.71, 95% confidence interval (CI) 0.54-0.93). Carrying the variant allele of the IRS1 Gly972Arg SNP further decreased the risk among the INSR-603G allele carriers (OR 0.28, 95% CI 0.11-0.70). SNPs in the INS, IGFBPI, and IRS2 genes did not affect the risk of CRC. In conclusion, genetic variation in the insulin signaling pathway genes may affect the risk of CRC.


Influence of the central metal ion in controlling the self-assembly and magnetic properties of 2D coordination polymers derived from [(NiL)2M](2+) nodes (M = Ni, Zn and Cd) (H2L = salen-type di-Schiff base) and dicyanamide spacers.
Three new 2D coordination polymers (CPs) (2)∞[(NiL)2Ni(μ1,5-N(CN)2)2]n (), (2)∞[(NiL)2Cd(μ1,5-N(CN)2)2]n () and (2)∞[(NiL)2Zn(μ1,5-N(CN)2)2]n () have been synthesized by reacting a [NiL] "metalloligand" (where H2L = N,N'-bis(salicylidene)-1,3-propanediamine) with three different metal(ii) (Ni, Cd and Zn) perchlorates and sodium dicyanamide, with identical molar ratios of the reactants. All three products have been characterized by IR and UV-Vis spectroscopies, elemental analyses, powder and single crystal X-ray diffraction and variable temperature magnetic measurements. The isomorphous compounds and consist of similar [(NiL)2M(μ1,5-N(CN)2)] (M = Ni for and Cd for ) angular trinuclear units in which two terminal "metalloligands" [NiL] coordinate to the central nickel(ii) (in ) or cadmium(ii) (in ) ion through phenoxido oxygen atoms. The μ1,5-bridging dicyanamido spacers connect the central Ni(ii) or Cd(ii) of one node to terminal Ni(ii) of two different nodes giving rise to 2D CPs. Compound also contains trinuclear units with the same formula as those of and : [(NiL)2M(μ1,5-N(CN)2)] (M = Zn in ). The main differences are that these units are linear in and the dicyanamide spacers link only the nickel atoms of neighbouring nodes. As in and , these trinuclear units are connected to four other units via four μ1,5-bridging dicyanamido ligands, giving rise to 2D CP with a similar topology: a uninodal 4-connected underlying net with the sql (Shubnikov tetragonal plane net) topology and (4(4)·6(2)) point symbol. The magnetic properties show the presence of moderate intra-trimer antiferromagnetic interactions in (J = -12.9 cm(-1)) and weak antiferromagnetic interactions between the terminal Ni(ii) ions in (J = -2.4 cm(-1)). In the Ni(ii) ions are well isolated by the central Zn(ii) ion and accordingly, only a very weak antiferromagnetic interaction through the single μ1,5-bridging dicyanamido ligands is observed (J = -0.44 cm(-1), D = -3.9 cm(-1)).


Completion of mouse embryogenesis requires both the maternal and paternal genomes.
Transplantation of pronuclei between one-cell-stage embryos was used to construct diploid mouse embryos with two female pronuclei ( biparental gynogenones ) or two male pronuclei ( biparental androgenones ). The ability of these embryos to develop to term was compared with control nuclear-transplant embryos in which the male or the female pronucleus was replaced with an isoparental pronucleus from another embryo. The results show that diploid biparental gynogenetic and androgenetic embryos do not complete normal embryogenesis, whereas control nuclear transplant embryos do. We conclude that the maternal and paternal contributions to the embryonic genome in mammals are not equivalent and that a diploid genome derived from only one of the two parental sexes is incapable of supporting complete embryogenesis.


Optical transmission modules for multi-channel superconducting quantum interference device readouts.
We developed an optical transmission module consisting of 16-channel analog-to-digital converter (ADC), digital-noise filter, and one-line serial transmitter, which transferred Superconducting Quantum Interference Device (SQUID) readout data to a computer by a single optical cable. A 16-channel ADC sent out SQUID readouts data with 32-bit serial data of 8-bit channel and 24-bit voltage data at a sample rate of 1.5 kSample/s. A digital-noise filter suppressed digital noises generated by digital clocks to obtain SQUID modulation as large as possible. One-line serial transmitter reformed 32-bit serial data to the modulated data that contained data and clock, and sent them through a single optical cable. When the optical transmission modules were applied to 152-channel SQUID magnetoencephalography system, this system maintained a field noise level of 3 fT/√Hz @ 100 Hz.


Influence of human acute wound fluid on the antibacterial efficacy of different antiseptic polyurethane foam dressings: An in vitro analysis.
Treating infected acute and/or chronic wounds still represents a major challenge in medical care. Various interactions of antiseptic dressings with wound environments regarding antimicrobial efficacy remain unclear. Therefore, this work aimed to investigate the influence of human acute wound fluid (AWF) on the antimicrobial performance of different antiseptic foam dressings in vitro against typical bacterial wound pathogens. Eight antiseptic polyurethane foam dressings containing either a silver formulation or a polyhexamethylene-biguanide (PHMB) were assessed regarding their antimicrobial potency against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa using a modified time-kill assay based on ISO EN 20743. The antiseptic efficacy was evaluated standardly as well as under the influence of human AWF after 2, 4, 6, and 24 hours. The specific chemical formulation and concentration of the antiseptic substance (ionic or nanocrystalline silver, silver sulfadiazine, PHMB 0.1%/0.5%) embedded within the dressings seemed to play a key role. For certain dressings (two nanocrystalline and one ionic silver dressing), the antimicrobial efficacy was significantly reduced under the influence of AWF compared to unchallenged test series. Unchallenged the efficacy of PHMB was comparable to silver against P. aeruginosa and even significantly superior against S. aureus and E. coli. Challenged with AWF the reduction rates for silver adjusted or even exceeded (P. aeruginosa) those of PHMB. Within a challenging wound environment, especially some silver formulations demonstrated a reduced bacterial reduction. Regarding the presented in vitro results, the biomolecular interactions of antiseptic wound dressings with wound fluid should be part of more extensive investigations, considering varying factors such as bacterial species and wound (micro)environment to develop targeted therapeutic regimes for the individual.


Efficacy and Safety of Nab-Paclitaxel as Second-line Chemotherapy for Locally Advanced and Metastatic Non-small Cell Lung Cancer.
To investigate the efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) for locally advanced or metastatic non-small cell lung cancer (NSCLC) as second-line chemotherapy. We retrospectively reviewed the treatment of 34 patients with advanced NSCLC whose first-line treatment had failed. These patients received nab-paclitaxel 260 mg/m2 on day 1 and day 8 of a 21-day cycle from July 2014 to February 2016. One cycle of treatment lasted 3 weeks and all patients completed more than two cycles. All patients were assessed for adverse events related to treatment. No patient achieved complete response (CR); 12 patients reached partial response (PR), 12 patients achieved stable disease (SD) and 10 patients progressive disease (PD). The overall response rate (ORR) was 35.3% and the disease control rate (DCR) 70.6 %. There was no significant difference in either ORR or DCR within the subgroups. The median progression-free survival (PFS) was 5.7 months (95% confidence interval (CI)=3.8-7.6) and the median overall survival (OS) was 9 months (95% CI=8.3-9.7). There was no statistical difference in OS (p=0.066), but subgroup analysis showed that patients with squamous carcinoma benefited more in PFS (the median PFS of squamous carcinoma vs. adenocarcinoma was 7.3 months vs. 5 months, p=0.001). Major adverse events included myelosuppression, gastrointestinal response, baldness, myalgia and neurotoxicity. Hypersensitivity reactions were not reported. Nab-paclitaxel is an effective chemotherapy for locally advanced and metastatic NSCLC as treatment and has a superior application prospect for squamous NSCLC. Toxicity is generally mild and manageable.


Oral Rehabilitation of a Severe Periodontally Involved Patient with Mucous Membrane Pemphigoid: A 15-Year Follow-Up Case Report.
Mucous membrane pemphigoid (MMP) refers to a group of chronic autoimmune subepithelial diseases distinguished by erosive lesions of the mucous membranes and skin. Its treatment consists of inhibition of the inflammatory reaction by means of corticosteroids and symptomatic medication. This is a report of a patient suffering from a combination of MMP and severe generalized chronic periodontitis. The patient has been treated with oral corticosteroids, initial phase therapy, extraction with immediate implant placement, and periodontal surgery where the prognosis was questionable. The case has been followed up for 15 years. Periodontal therapy with immediate implant placement was determined to be a viable modality to achieve a total rehabilitation of a case suffering from MMP combined with severe generalized chronic periodontitis.


Theoretical study on stabilities of multiple hydrogen bonded dimers.
A series of self-constituted multiple hydrogen bonded (MHB) complexes has been investigated systematically by density functional theory (PBE1PBE /6-31G**), the Morokuma energy decomposition method (HF/6-31G**) and MP2 (6-31G** and 6-311++G**) calculation. We have discovered that (i) for doubly hydrogen bonded (DHB) complexes, both the interaction energy and stability increase with the charge transfer energy; (ii) for quadruple hydrogen bonded (QHB) complexes, cooperativity is the most important factor determining stability of the complex: stronger cooperative energy correlates well with larger interaction energy and thus more stable complex and vice versa; (iii) correlation energy plays an important role in intermolecular interactions. The correlation energy, mainly consisting of dispersive energy, also exhibits cooperativity in MHB dimers: positive for M-aadd and generally negative for other complexes.


Volatile organic compound emissions from dry mill fuel ethanol production.
Ethanol fuel production is growing rapidly in the rural Midwest, and this growth presents potential environmental impacts. In 2002, the U.S. Environmental Protection Agency (EPA) and the Minnesota Pollution Control Agency (MPCA) entered into enforcement actions with 12 fuel ethanol plants in Minnesota. The enforcement actions uncovered underreported emissions and resulted in consent decrees that required pollution control equipment be installed. A key component of the consent decrees was a requirement to conduct emissions tests for volatile organic compounds (VOCs) with the goal of improving the characterization and control of emissions. The conventional VOC stack test method was thought to underquantify total VOC emissions from ethanol plants. A hybrid test method was also developed that involved quantification of individual VOC species. The resulting database of total and speciated VOC emissions from 10 fuel ethanol plants is relatively small, but it is the most extensive to date and has been used to develop and gauge compliance with permit limits and to estimate health risks in Minnesota. Emissions were highly variable among facilities and emissions units. In addition to the variability, the small number of samples and the presence of many values below detection limits complicate the analysis of the data. To account for these issues, a nested bootstrap procedure on the Kaplan-Meier method was used to calculate means and upper confidence limits. In general, the fermentation scrubbers and fluid bed coolers emitted the largest mass of VOC emissions. Across most facilities and emissions units ethanol was the pollutant emitted at the highest rate. Acetaldehyde, acetic acid, and ethyl acetate were also important emissions from some units. Emissions of total VOCs, ethanol, and some other species appeared to be a function of the beer feed rate, although the relationship was not reliable enough to develop a production rate-based emissions factor.


[Celiprolol in the treatment of chronic stable angina].
Celiprolol is a third generation beta blocking drug with intrinsic vasodilator effect. We evaluated the effect of this drug at a fixed dose of 400 mg daily in 20 patients with coronary artery disease and stable angina having 2 to 40 episodes of pain a week. All patients had positive exercise stress test with greater than 1 mm ST depression. Compared to the 1 month baseline placebo phase, patients after 3 months of treatment with celiprolol had less episodes of angina (2.4 vs 7.2 a week, p less than 0.001), higher angina threshold (667 vs 337 sec, p less than 0.025), higher ischemia threshold (614 vs 401 sec, p less than 0.001) and were able to perform more work (3937 vs 2403 kgm/min. p less than 0.01). 9 patients had no pain during exercise. A decrease in blood pressure, heart rate and double product was evident in the stress tests of the active phase. Adverse effects included headache (4 patients), sweating (1) and fatigue (1) not requiring modification of drug dose. No adverse effects were seen in 13 patients. Thus, celiprolol is effective to decrease angina during daily life and increase exercise tolerance in patients with chronic stable angina pectoris.


An easy access to gamma-lactone-fused cyclopentanoids.
The tricyclic alpha-keto hemiacetals 3a,b and 8a-d obtained from ruthenium-catalyzed oxidation of tetrahalonorbornyl derivatives possessing a pendant hydroxymethyl group were cleaved using Pb(OAc)(4) or alkaline H(2)O(2) to give gamma-lactone-fused cyclopentane derivatives 5a,b and 9a-d. The alpha-keto hemiacetal 3b has also been elaborated to spiroepoxide derivative 25. The stable hydrate 4 formed from ruthenium-catalyzed oxidation of acrolein adduct 10 furnished an intramolecular hemiacetal 11 upon cleavage with Pb(OAc)(4). The alpha-halo ester moiety in 5a was transformed smoothly in a highly regio- and stereoselective manner to alpha-hydroxy esters through a lactone-assisted intermediate to furnish 18.


Histopathological examination of ruptured carotid artery after irradiation.
We report 2 cases of carotid artery rupture after irradiation that was performed 1 year and 17 years before the ruptures. When irradiation-induced arterial rupture occurs, it usually does so within a few months following irradiation. However, the histopathological sections obtained in the present cases revealed carotid artery necrosis that was presumably induced by irradiation. Carotid artery rupture is sudden, massive hemorrhage that ranks among the most dreaded complications in the head and neck. However, several patients have been saved by hospital personnel who discovered the rupture in time to take appropriate measures such as cleaning of the wound and protection with myocutaneous or myofascial flaps. Therefore, it is important to be aware of the possibility of rupture or perforation of major vessels after irradiation, even when the radiation therapy was performed a long time ago.


Modulation of host cell receptors: a mechanism for the survival of malaria parasites.
Intra-erythrocytic stages of malaria parasites can alter the surface of their host cells and release toxins which induce the production of cytokines, which in turn can up- or down-regulate the expression of adhesion receptors on the surface of microvascular endothelial cells. New adhesion receptors on endothelial cells provide the parasite with increased chances of survival despite an increasing level of host immunity. In order to take advantage of these new opportunities for survival, the parasite itself needs to make best use of its considerable ability to vary its surface antigens and adherent molecules. The paper describes the various players in this survival game and articulates a working hypothesis to explain how it may all fit together.


Adhesive restorations with amalgam: guidelines for the clinician.
The adhesive amalgam restoration technique combines the good properties of amalgam with the principles of tooth structure preservation and marginal seal inherent to adhesive materials. In spite of lack of longitudinal data, results of early clinical and laboratory tests are encouraging. If the present research is substantiated by clinical confirmation of their results, bonded amalgam restorations will become routine. The purpose of this article is to present a brief literature review on adhesive amalgam restoration and to introduce guidelines for its use.


Comparing the Efficiency of a Newly Designed Spring With the T Loop for Buccal Canine Disimpaction: A Finite Element Study.
Disimpacting a buccally impacted canine precisely using frictionless mechanics is a challenge in orthodontics. Various mechanics can be used for aligning an impacted canine and a spring is one of the most versatile methods of accomplishing it. The present study describes a newly designed spring for canine disimpaction using the finite element method (FEM) model. In the present study, the efficiency of the newly designed spring was compared with the T loop. The FEM model of the maxilla was prepared. Harsha's Canine Disimpaction (HCD) spring and T loop with no pre-activation bends were utilized to disimpact the left maxillary canine using a 0.017 x 0.025 inch titanium molybdenum alloy wire. Efficiency of both springs in all dimensions (sagittal, vertical and transverse) was compared. Stress acting on the bone and teeth and number of activations needed for disimpaction were evaluated when the spring was activated by 3 mm. A movement/displacement of 0.8, 0.4 and 0.1 mm was seen in the sagittal (X), transverse (Y) and vertical (Z) planes, respectively, with the HCD spring, and 0.4, 0.1 and 0.1 mm seen in the X, Y and Z planes, respectively, with the T loop. A total of 12-13 and 80 activations were required as per the FEM simulation for disimpaction using the HCD spring and T loop, respectively. Stress concentration in the disto-cervical region was observed during disimpaction with both HCD spring and T loop. Within the constraints and limitations of the present study, it can be concluded that the HCD spring requires lesser activation and brings about greater control of canine disimpaction in all three dimensions when compared to the T loop.


Psychiatric disorders and obesity: A review of association studies.
Inconsistent evidence exists regarding the strength, direction, and moderators in the relationship between obesity and psychiatric disorders. This study aims to summarize the evidence on the association between psychiatric illness and obesity with particular attention to the strength and direction of association and also the possible moderators in each postulated link. Systematic electronic searches of MEDLINE through PubMed, ScienceDirect, PsycINFO, and Google Scholar were carried out from inception till October 2016. Generated abstracts were screened for eligibility to be included in the review. Study designs that evaluated the strength of relationship between obesity and psychiatric disorders were included in the study. Quality assessment of included studies was done using the Newcastle-Ottawa checklist tool. From a total of 2424 search results, 21 eligible articles were identified and reviewed. These included studies on obesity and depression (n = 15), obesity and anxiety (four) and one each on obesity and personality disorders, eating disorder (ED), attention deficit hyperactivity disorder, and alcohol use. Maximal evidence existed for the association between depression and obesity with longitudinal studies demonstrating a bidirectional link between the two conditions. The odds ratios (ORs) were similar for developing depression in obesity (OR: 1.21-5.8) and vice versa (OR: 1.18-3.76) with a stronger association observed in women. For anxiety disorders, evidence was mostly cross-sectional, and associations were of modest magnitude (OR: 1.27-1.40). Among other disorders, obesity, and EDs appear to have a close link (OR: 4.5). Alcohol use appears to be a risk factor for obesity and not vice versa but only among women (OR: 3.84). Obesity and depression have a significant and bidirectional association. Evidence is modest for anxiety disorders and inadequate for other psychiatric conditions. Gender appears to be an important mediator in these relationships.


Unique Microbial Diversity and Metabolic Pathway Features of Fermented Vegetables From Hainan, China.
Fermented vegetables are typically traditional foods made of fresh vegetables and their juices, which are fermented by beneficial microorganisms. Herein, we applied high-throughput sequencing and culture-dependent technology to describe the diversities of microbiota and identify core microbiota in fermented vegetables from different areas of Hainan Province, and abundant metabolic pathways in the fermented vegetables were simultaneously predicted. At the genus level, Lactobacillus bacteria were the most abundant. Lactobacillus plantarum was the most abundant species, followed by Lactobacillus fermentum, Lactobacillus pentosaceus, and Weissella cibaria. These species were present in each sample with average absolute content values greater than 1% and were thus defined as core microbiota. Analysis results based on the alpha and beta diversities of the microbial communities showed that the microbial profiles of the fermented vegetables differed significantly based on the regions and raw materials used, and the species of the vegetables had a greater effect on the microbial community structure than the region from where they were harvested. Regarding microbial functional metabolism, we observed an enrichment of metabolic pathways, including membrane transport, replication and repair and translation, which implied that the microbial metabolism in the fermented vegetables tended to be vigorous. In addition, Lactobacillus plantarum and Lactobacillus fermentum were calculated to be major metabolic pathway contributors. Finally, we constructed a network to better explain correlations among the core microbiota and metabolic pathways. This study facilitates an understanding of the differences in microbial profiles and fermentation pathways involved in the production of fermented vegetables, establishes a basis for optimally selecting microorganisms to manufacture high-quality fermented vegetable products, and lays the foundation for better utilizing tropical microbial resources.


Estradiol-17 beta and estradiol-17-glucosiduronate before and at delivery.
The maternal peripheral serum level of estradiol-17 beta (E2), which reaches a peak a few weeks before delivery, may play a role in initiating delivery. In this study, the steroidal activity regulated by both the production and conjugation was estimated by measuring estradiol-17-glucosiduronate (E2-17-G), E2, estriol-16-glucosiduronate (E3-16-G), and estriol (E3) before and at delivery. At delivery, levels of E2 and E2-17-G were higher in the maternal peripheral vein (MP) than in the umbilical vein (UV) and umbilical artery (UA), but those of E3 and E3-16-G were higher in UV and UA than in MP. These results suggested that the production and conjugation of E2 were mainly regulated on the maternal side, but those of E3 were regulated mainly in the feto-placental unit. The ratios of E2/E2-17-G in MP were or became high a few weeks before delivery but decreased remarkably as pregnancy progressed to delivery. The activity of E2 seems to be regulated at least in part by conjugation in late pregnancy and at delivery.


Performance comparison of the MOXY and PortaMon near-infrared spectroscopy muscle oximeters at rest and during exercise.
The purpose of the study was to compare muscle oxygenation as measured by two portable, wireless near-infrared spectroscopy (NIRS) devices under resting and dynamic conditions. A recently developed low-cost NIRS device (MOXY) was compared against an established PortaMon system that makes use of the spatially resolved spectroscopy algorithm. The influence of increasing external pressure on tissue oxygen saturation index (TSI) indicated that both devices are stable between 2 and 20 mmHg. However, above this pressure, MOXY reports declining TSI values. Analysis of adipose tissue thickness (ATT) and TSI shows a significant, nonlinear difference between devices at rest. The devices report similar TSI (%) values at a low ATT (<7 mm) (PortaMon minus MOXY difference is +1.1±2.8%) with the major subsequent change between the devices occurring between 7 and 10 mm; at ATT values >10 mm the difference remains constant (-14.7±2.8%). The most likely explanation for this difference is the small source-detector separation (2.5 cm) in the MOXY resulting in lower tissue penetration into muscle in subjects with higher ATT. Interday test-retest reliability of resting TSI was evaluated on five separate occasions, with the PortaMon reporting a lower coefficient of variation (1.8% to 2.5% versus 5.7% to 6.2%). In studies on male subjects with low ATT, decreases in the TSI were strongly correlated during isometric exercise, arterial occlusion, and incremental arm crank exercise. However, the MOXY reports a greater dynamic range, particularly during ischemia induced by isometric contraction or occlusion (Δ74.3% versus Δ43.7%; hyperemia MAX-occlusion MIN). This study shows that in this subject group both MOXY and PortaMon produce physiologically credible TSI measures during rest and exercise. However, the absolute values obtained during exercise are generally not comparable between devices unless corrected by physiological calibration following an arterial occlusion.


Gas adsorption on monolayer blue phosphorus: implications for environmental stability and gas sensors.
Monolayer blue phosphorus has recently been synthesized by molecular beam epitaxial growth on Au(111) substrate. It is intriguing to compare this new 2D phase of phosphorus with phosphorene as to both fundamental properties and application prospects. Here, first-principles calculations are carried out to explore the adsorption behaviors of environmental gas molecules on monolayer blue phosphorus, including O2, NO, SO2, NH3, H2O, NO2, CO2, H2S, CO, and N2, and address their effects on the electronic properties of the material. Our calculations show that O2 is prone to dissociate and tends to chemisorb on the blue phosphorus sheet, phenomena which has also been observed in phosphorene. The other gas molecules can stably physisorb on monolayer blue phosphorus, showing different interaction strengths with the monolayer. These molecules induce distinct modifications to the band gap, carrier effective mass, and work function, which also depends on the molecular coverage. The responses of the electronic properties are subject to the charge transfer as well as alignment of the frontier molecular orbital levels of the gaseous molecules and band edges of the parent sheet. These results suggest that monolayer blue phosphorus is a promising candidate for novel gas sensors.


Impact of Nested Vark (Visual, Auditory, Read, Kinesthetic) Strategies on Parental Attachment, Anxiety, Maternal and Fetal Outcome Among First Time Childbearing Couples: A Randomized Controlled Trial.
The transition to parenthood is not only a tremendous joy but also great stress to a mother (especially a primigravida) both physically and psychologically. The purpose of this research is to improve confidence in first-time childbearing couples, increase parental attachment, alleviate anxiety and promote the maternal and neonatal outcomes of delivery. In a randomized controlled trial design, simple randomization was utilized to enroll 300 first-time childbearing couples who have completed the 24th week of gestation (150 in control and experimental arms). Nested refers to fully contained antenatal exercises, kick chart monitoring, and the use of a preggy imitator. VARK strategies indicate visual (information exhibited through demonstration), auditory (preference for information that is heard or spoken through lectures), read (information displayed as words, text-based input and output), and kinesthetic (preference for gathering information through experience and practice, simulated real, through concrete personal experiences) strategies along with routine care were executed on the experimental group. Data was collected using Condon's Parental Attachment Scale and Perinatal Anxiety Scale during the pre-test at the 24th week and post-tests at the 32nd, 33-34, and 36-38 weeks of gestation respectively, after the intervention through the self-administration method. Maternal and fetal outcomes were identified through medical records within 24 to 48 hours after delivery. The pre-test parental attachment mean score was significantly increased in post-test (Mothers: 61.44±3.27 to 77.89±32.44, fathers: 51.44±1.93 to 58.89±24.86) the for experimental group after the intervention compared to the control group (Pre-test score mother: 61.41±2.98 to 66.43±31.55, father: 51.24±3.95 to 49.30± 23.55) at p <0.001. The pre-test anxiety mean score was significantly reduced after intervention (mother: 44.60±3.92 to 16.57± 8.18, father: 22.55±3.41 to 6.28±4.47) for the experimental group compared to the control group (mother=46.22±5.12 to 25.03± 13.89, father=22.62±3.39 to 17.92± 9.92) at p <0. 001. The study findings recommend VARK strategies to be advocated with existing hands-on childbirth preparation classes for childbearing couples.


The influence of language on the acoustic properties of phonetic features: a study of the feature [strident] in Ewe and English.
This study explored the extent to which the acoustic manifestation of a phonetic feature is influenced by the linguistic role that the feature plays in the sound inventory of the particular language. To this end, we investigated the acoustic property associated with the feature [strident] in the production of bilabial and labiodental fricatives in Ewe, and labiodental and alveolar fricatives in English, and explored whether the acoustic manifestation of the feature [strident] varied in the instantiation of [f] in Ewe and English. In Ewe, the feature [strident] plays a contrastive role distinguishing labiodental from bilabial fricatives, whereas in English the feature [strident] does not play a contrastive role. Results showed that a measure of turbulence noise was able to distinguish bilabial and labiodental fricatives in Ewe and labiodental and alveolar fricatives in English. Moreover, the range of values associated with defining the amplitude characteristics for [f] was similar in the two languages. Nevertheless, differences emerged in the acoustic fine structure of the noise amplitude for [f v] in the two languages, with the frequency distribution for the labiodental fricative in Ewe being skewed towards the high amplitude range relative to English. These results suggest that while the fundamental manifestation of the acoustic property is the same across languages, its instantiation may be influenced by the functional role that its associated feature plays in the language.


Factors influencing postoperative abdominal pain in DIEP flap breast reconstruction.
Identification of a subgroup of patients with severe postoperative pain is important for adequate pain management for enhanced, fast recovery after deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. The purpose of this study was to identify factors influencing postoperative abdominal pain in patients undergoing DIEP flap breast reconstruction. Consecutive patients who underwent unilateral breast reconstruction using DIEP free flaps from October 2018 to July 2020 were included in this study. Visual analog scale (VAS)-guided postoperative pain scores were documented every 3 hours until 48 hours postoperatively. Factors affecting patient-reported pain scores were analyzed using a linear mixed-effects model. Independent variables included patient characteristics, history of previous open abdominal surgery, and operative factors including the flap size, flap weight, use of a unipedicled or bipedicled flap, number of perforators, timing of reconstruction, and use of a catheter-based subcutaneous plane block in the abdomen. A catheter was placed above the rectus fascia during closure, and analgesics were continuously infused during the 48 hours using an ON-Q Pain Relief System (I-Flow Co., Lake Forest, CA, USA). Fifty-five patients were included in the analysis. In the linear mixed effect model using multiple clinical variables, the harvested flap weight was significantly associated with the degree of pain (β coefficient =0.157, P=0.008). The pain degrees significantly decreased according to postoperative days (β coefficient =-0.649, P<0.001). The flap type (unipedicle or bipedicle), number of perforators, timing of reconstruction, and history of previous abdominal surgery did not influence pain degrees. The use of subcutaneous plane block did not affect the degree of pain or dose of analgesics used. A larger flap weight is associated with an increased degree of pain in patients undergoing DIEP flap breast reconstructions. Vigorous pain management might be necessary when a large flap is elevated.


Selenium Polysaccharide SPMP-2a from Pleurotus geesteranus Alleviates H2O2-Induced Oxidative Damage in HaCaT Cells.
Selenium- (Se-) enriched polysaccharide SPMP-2a was extracted and purified from Pleurotus geesteranus. SPMP-2a is a white flocculent polysaccharide and soluble in water, with a molecular weight of 3.32 × 104 Da. Fourier transform infrared spectroscopy spectral analysis indicated that it belongs to an acid Se polysaccharide with α-D-glucopyranoside bond. The effects of Se polysaccharide SPMP-2a in P. geesteranus against hydrogen peroxide- (H2O2-) induced oxidative damage in human keratinocytes (HaCaT) cells were evaluated further. Reduced cell viability and elevated apoptotic rates in H2O2-treated HaCaT cells were proven by MTT and flow cytometry assays. Hoechst 33342 staining revealed chromatin condensations in the nuclei of HaCaT cells. However, with the addition of SPMP-2a, cell viability improved, nuclear condensation declined, and cell apoptotic rates dropped significantly. Ultrastructural observation consistently revealed that treatments with SPMP-2a reduced the number of swollen and vacuolar mitochondria in the H2O2-treated cells compared with the controls. Furthermore, SPMP-2a increased the superoxide dismutase (SOD) and catalase (CAT) activities and reduced reactive oxygen species (ROS) content. Western blot analysis showed that SPMP-2a treatment effectively increased B-cell lymphoma 2 (Bcl-2) protein expression. Therefore, SPMP-2a could improve cellular antioxidant enzyme activities, reduce ROS levels, and increase Bcl-2 protein expression levels, thereby reducing cell apoptosis and protecting HaCaT cells from H2O2-induced oxidative damage.


[Work loss and depression. Impact of fluoxetine].
The goal of our study was to explore the impact of various antidepressant drugs on the relative risk of work loss in depressed patients. 1,852 depressed patients (DSM III-R) were observed using a "cross-sectional" design. Patients were included into five groups: patients without antidepressant treatment, patients treated with one of the main antidepressant drugs in France (amineptine amitriptyline, clomipramine and fluoxetine). Primary variables were the depression intensity (Hamilton scores) and job status (work loss). The other parameters (clinical, demographic, economic, therapeutic) were used as potentially predicting variables. Data have been collected through a network of 295 physicians (GP, Psychiatrists). The main socio-demographic characteristics of treated and untreated depressive patients, either working or absent from work, were predominantly female and city dwellers. A significant difference was found between working patients and work loss in terms of professional characteristics, i.e. type of employment (p < 0.001), type of employer (p < 0.05), level of responsibility (p < 0.01) and type of remuneration (p < 0.01). We found a positive correlation between depression severity and the risk of work loss (R2 = 0.86, p < 0.001). This risk was significantly lower with fluoxetine compared to other treatments. Pooling these data with data from clinical trials led to a saving of 2.4 days (vs clomipramine) to 4.7 days (vs amitriptyline) (p < 0.05, respectively) of work loss per patient for a 8-week treatment period.


Light and electric field control of ferromagnetism in magnetic quantum structures.
A strong influence of illumination and electric bias on the Curie temperature and saturation value of the magnetization is demonstrated for semiconductor structures containing a modulation-doped p-type Cd(0.96)Mn(0.04)Te quantum well placed in various built-in electric fields. It is shown that both light beam and bias voltage generate an isothermal and reversible crossover between the paramagnetic and ferromagnetic phases, in the way that is predetermined by the structure design. The observed behavior is in quantitative agreement with the expectations for systems, in which ferromagnetic interactions are mediated by the weakly disordered two-dimensional hole liquid.


LHRH and analogues as potential therapy for benign prostatic hyperplasia and hormone-dependent cancers.
In adult male rats, daily s.c. injections of 0.008-125 microgram luteinizing hormone releasing hormone (LHRH) or its analogue (D-Ala, des-Gly-NH2)LHRH ethylamide, led to significant differences in inhibitory effects on testicular function and accessory sex organ weights. The analogue was at least 35 times more potent than LHRH in reducing testicular LH/hCG receptors and 350 times more effective in decreasing plasma testosterone concentrations. In a second study, adult male rats treated with 25-2500 microgram LHRH daily for a 3-week period showed 85%-90% decrease in plasma testosterone concentrations. Treatment with 25 or 250 microgram LHRH effected a maximal 25% and 40% decrease of the ventral prostate and seminal vesicles, respectively, without affecting the testicular weight, the latter being reduced by 15% with the higher dose of 2500 microgram. The LHRH analogue is proposed for the treatment of prostatic and breast cancers while native LHRH could be an effective therapy for benign prostatic hyperplasia.


Transnasal oesophagoscopy: the feasibility and potential impact on service provision of an office based procedure for upper gastrointestinal disorders in malaysia.
A Health Technology Assessment (HTA) was conducted in 2011 to evaluate whether transnasal oesophagoscopy (TNE) should be made available at otorhinolaryngology (ORL) clinics in the Ministry of Health facilities. The safety, efficacy or effectiveness and economic implication of using transnasal oesophagoscopy (TNE) were reviewed. This review provides a summary of the HTA and an updated literature review as well as how this technology might potentially affect services in the Ministry of Health.


A Case of Severe Carotid Stenosis in a Patient with Familial Hypercholesterolemia without Significant Coronary Artery Disease.
Familial hypercholesterolemia (FH) is an inherited metabolic disorder characterized by elevated low-density lipoprotein cholesterol levels in the blood. In its heterozygous form, it occurs in 1 in 500 individuals in the general population. It is an important contributor to the early onset of coronary artery disease (CAD), accounting for 5-10% of cases of cardiovascular events in people younger than 50 years. Atherogenesis triggered by hypercholesterolemia generally progresses faster in the coronary arteries, followed by the subsequent involvement of other arteries such as the carotids. Thus, symptoms of CAD commonly appear before the onset of significant carotid stenosis. Herein, we report the case of a patient with untreated FH who had severe carotid atherosclerosis at the age of 46 years but had no evidence of significant CAD.


Association mapping to discover significant marker-trait associations for resistance against fusarium wilt variant 2 in pigeonpea [Cajanus cajan (L.) Millspaugh] using SSR markers.
Pigeonpea production is severely constrained by wilt disease caused by Fusarium udum. In the current study, we discover the putative genomic regions that control resistance response to variant 2 of fusarium wilt using association mapping approach. The association panel comprised of 89 diverse pigeonpea genotypes including seven varieties, three landraces and 79 germplasm lines. The panel was screened rigorously for 3 consecutive years (2013-14, 2014-15 and 2015-2016) against variant 2 in a wilt-sick field. A total of 65 pigeonpea specific hypervariable SSR markers (HASSRs) were screened representing seven linkage groups and 29 scaffolds of the pigeonpea genome. A total of 181 alleles were detected, with average values of gene diversity and polymorphism information content (PIC) of 0.55 and 0.47, respectively. Further analysis using model based (STRUCTURE) and distance based (clustering) approaches separated the entire pigeonpea collection into two distinct subgroups (K = 2). The marker trait associations (MTAs) were established based on three-year wilt incidence data and SSR dataset using a unified mixed linear model. Consequently, six SSR markers were identified, which were significantly associated with wilt resistance and explained up to 6% phenotypic variance (PV) across the years. Among these SSRs, HASSR18 was found to be the most stable and significant, accounting for 5-6% PV across the years. To the best of our knowledge, this is the first report of identification of favourable alleles for resistance to variant 2 of Fusarium udum in pigeonpea using association mapping. The SSR markers identified here will greatly facilitate marker assisted resistance breeding against fusarium wilt in pigeonpea.


[Elof Förberg--one of the pioneers of modern odontology].
A short biography of Elof Förberg (1851-1923), dentist to H.M. the King. He was in many respects--professionally and culturally--the leading dentist in Sweden at the turn of the century. His many commissions, national and international, bear witness to Förberg's capability and distinction. Outside his professional sphere he took for example the initiative in creating the Swedish Linné Society and in restoring Linné's Botanical Gardens in Uppsala. He was an esteemed collector of art and books. His library included 15,000 volumes, among them a unique Linnaean collection and an excellent Strindberg collection.


Neo-Traditional Medicines: Ethnographic Contributions to Conceptual Definition.
Since the end of 1970, the World Health Organization has encouraged the development of public policies that expand the approach to care and the therapeutic possibilities offered by its member states beyond technoscientific health care. In Brazil, the institutionalization of this approach is related to the promotion of popular and traditional knowledge associated with the usage of medicinal plants. With this convergence as an argumentative horizon, in this ethnography we examine the institutionalization of pharmaceutical services that have become known in Brazilian public health policy as living pharmacies. This term has been mobilized throughout the history of phytotherapy in Brazil and refers to the possibility of instituting the use of medications that expand care approaches and problem resolution possibilities beyond the domain of the biomedical sciences, evoking alliances with so-called traditional and popular knowledge and practices. For this, we propose and discuss the concept of neo-traditional medicines as a comprehensive-interpretative category, verifying the approximation and distancing points assigned to it in contemporaneous anthropological literature. Beyond the domain of science over other fields of knowledge, we argue in favour of this category in order to present new arrangements and social dynamics that define Brazil's medication policies.


Perturbation training prior to ACL reconstruction improves gait asymmetries in non-copers.
We investigated whether preoperative perturbation training would help anterior cruciate ligament (ACL) deficient individuals who complain of knee instability ("non-copers") regain quadriceps strength and walk normally after ACL reconstruction. Nineteen non-copers with acute ACL injury were randomly assigned into a perturbation group (PERT) or a strengthening group (STR). The PERT group received specialized neuromuscular training and progressive quadriceps strength training, whereas the STR group received progressive quadriceps strength training only. We compared quadriceps strength indexes and knee excursions during the mid-stance phase of gait preoperatively to data collected 6 months after ACL reconstruction. Analyses of Variance with repeated measures (time/limb) were conducted to compare quadriceps strength index values over time (time x group) and differences in knee excursions in limbs between groups over time (limb x time x group). If significance was found, post hoc analyses were performed using paired and independent t-tests. Quadriceps strength indexes before intervention (Pert: 87.2%; Str: 75.8%) improved 6 months after ACL reconstruction in both groups (Pert: 97.1%; Str: 94.4%). Non-copers who received perturbation training preoperatively had no differences in knee excursions between their limbs 6 months after ACL reconstruction (p = 0.14), whereas those who received just strength training continued to have smaller knee excursions during the mid-stance phase of gait (p = 0.007). Non-copers strength and knee excursions were more symmetrical 6 months postoperatively in the group that received perturbation training and progressive quadriceps strength training than the group who received strength training alone.


Biosynthesis of Astrocytic Trehalose Regulates Neuronal Arborization in Hippocampal Neurons.
Trehalose is a nonreducing disaccharide that has recently attracted much attention because of its ability to inhibit protein aggregation, induce autophagy, and protect against dissections and strokes. In vertebrates, the biosynthesis of trehalose was long considered absent due to the lack of annotated genes involved in this process. In contrast, trehalase (TreH), which is an enzyme required for the cleavage of trehalose, is known to be conserved and expressed. Here, we show that trehalose is present as an endogenous metabolite in the rodent hippocampus. We found that primary astrocytes were able to synthesize trehalose and release it into the extracellular space. Notably, the TreH enzyme was observed only in the soma of neurons, which are the exclusive users of this substrate. A statistical analysis of the metabolome during different stages of maturation indicated that this metabolite is implicated in neuronal maturation. A morphological analysis of primary neurons confirmed that trehalose is required for neuronal arborization.


Demonstration of Shor's factoring algorithm for N [Formula: see text] 21 on IBM quantum processors.
We report a proof-of-concept demonstration of a quantum order-finding algorithm for factoring the integer 21. Our demonstration involves the use of a compiled version of the quantum phase estimation routine, and builds upon a previous demonstration. We go beyond this work by using a configuration of approximate Toffoli gates with residual phase shifts, which preserves the functional correctness and allows us to achieve a complete factoring of [Formula: see text]. We implemented the algorithm on IBM quantum processors using only five qubits and successfully verified the presence of entanglement between the control and work register qubits, which is a necessary condition for the algorithm's speedup in general. The techniques we employ may be useful in carrying out Shor's algorithm for larger integers, or other algorithms in systems with a limited number of noisy qubits.


Ethnic Disparities in Thrombotic and Bleeding Diatheses Revisited: A Systematic Review of Microsurgical Breast Reconstruction across the East and West.
Ethnicity has been shown to play a role in disparate coagulative responses between East Asian and Caucasian patients undergoing nonmicrovascular surgery. In this study, we sought to further investigate this hematologic phenomenon between the two ethnic groups within the field of microsurgical breast reconstruction. A systematic review examining the reported incidence of microvascular thrombosis and all-site bleeding among breast free flaps in East Asians and Westerners was performed. Statistical analysis was performed using the chi-square test. Ten East Asian studies with 581 flaps and 99 Western studies with 30,767 flaps were included. A statistically significant higher rate of thrombotic complications was found in Westerners compared with East Asians (4.2 vs. 2.2%, p = 0.02). Conversely, bleeding events were more common in East Asians compared with Westerners (2.6 vs. 1.2%, p = 0.002). There appears to be an ethnicity-based propensity for thrombosis in Westerners and, conversely, for bleeding in East Asians, as evident by the current systematic review of microvascular breast reconstruction data. It is therefore advisable to consider ethnicity in the comprehensive evaluation of patients undergoing microsurgical procedures.