The role of depression and dissociation in the link between childhood sexual abuse and later parental practices.
Research has yielded contradictory results on the relationship between childhood sexual abuse and later parental functioning. This study was undertaken to specify the link between childhood sexual abuse and maternal parenting, while taking into account mothers' childhood physical and emotional traumas and current depressive and dissociative symptoms. Data were collected through self-report measures completed by 93 French-speaking Canadian mothers of children aged 6 to 11 years referred to Youth Protection Services. Parental behaviors examined included involvement with the child, use of positive reinforcement, lack of monitoring and supervision of the child, inconsistency in applying discipline, and use of corporal punishment. Mothers' perception of the quality of the relationship with her child was also assessed. In addition, history of abuse and neglect, depression and dissociation were respectively measured with the Childhood Trauma Questionnaire, the Diagnostic Interview Schedule Simplified, and the Dissociative Experiences Scale. The short-form of the Marlowe-Crowne Social Desirability Scale was used to control for respondent bias aimed at minimizing their problems. Mothers' current depressive symptoms were not found to predict any of the parental dimensions measured. Results from multiple hierarchical regressions pointed to dissociative symptoms as the key predictor of parental practices and attitudes. More specifically, dissociative symptoms predicted the use of positive reinforcement, lack of monitoring and supervision of the child, inconsistency in applying discipline, and use of corporal punishment. Dissociation also mediated the association between childhood maltreatment (physical and emotional abuse and neglect) and inconsistency in applying discipline. Implications for research and practice are discussed.


Long-term survival after transcatheter versus surgical aortic valve replacement for aortic stenosis: A meta-analysis of observational comparative studies with a propensity-score analysis.
To synthesize evidence regarding long-term survival after transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) for severe aortic stenosis (AS) from real-world clinical practice, we performed a meta-analysis of observational studies with a propensity-score analysis and ≥3-year follow-up. Databases including MEDLINE and EMBASE were searched through April 2017 using PubMed and OVID. Eligible studies were observational comparative studies with a propensity-score analysis of TAVI versus SAVR enrolling patients with severe AS and reporting ≥3-year all-cause mortality as an outcome. A hazard ratio (HR) with its 95% confidence interval (CI) of follow-up (including early) mortality for TAVI versus SAVR was extracted from each individual study. Our search identified 14 eligible studies enrolling a total of 4,197 patients. A pooled analysis of all the 14 studies demonstrated a statistically significant 54% increase in mortality with TAVI relative to SAVR (HR, 1.54; 95% CI, 1.31-1.81; P for effect < 0.00001; P for heterogeneity = 0.14; I2 = 30%). Several sensitivity analyses did not substantially change the statistically significant benefit for SAVR. There was no evidence of significant publication bias. On the basis of a meta-analysis of 14 observational comparative studies with a propensity-score analysis including a total of ≥4,000 patients, TAVI is associated with worse ≥3-year overall survival than SAVR.


Does inflammation have a role in migraine?
Migraine is a prevalent disorder, affecting 15.1% of the world's population. In most cases, the migraine attacks are sporadic; however, some individuals experience a gradual increase in attack frequency over time, and up to 2% of the general population develop chronic migraine. The mechanisms underlying this chronicity are unresolved but are hypothesized to involve a degree of inflammation. In this article, we review the relevant literature related to inflammation and migraine, from the initiation of attacks to chronification. We propose that the increase in migraine frequency leading to chronic migraine involves neurogenic neuroinflammation, possibly entailing increased expression of cytokines via activation of protein kinases in neurons and glial cells of the trigeminovascular system. We present evidence from preclinical research that supports this view and discuss the implications for migraine therapy.


Examination of use and barriers for five sun protection strategies in parents and their children.
Sun protection starting in childhood is an important means of skin cancer prevention. Factors associated with sunscreen use have been previously described. However, less is known about factors associated with children's utilization of non-sunscreen sun protection strategies. We sought to examine parent and child characteristics, parental use of sun protection, and barriers associated with children's use of five sun protection strategies: sunscreen, shirts with sleeves, wide-brimmed hats, sunglasses, and shade. A cross-sectional survey of parents of children entering kindergarten through grade 8. Survey participants were recruited at the 2016 Minnesota State Fair. A total of 409 parents were surveyed. The most common sun protection strategies parents reported for their child were wearing a shirt with sleeves (69.9%) and using sunscreen (61.9%), while protection via shade, wide-brimmed hats, and sunglasses were reported by less than one-quarter of parents. For each individual strategy, parents' own use of that strategy was strongly associated with that strategy in their children. Lack of child cooperation was associated with decreased use of sunscreen, shirts with sleeves, and wide-brimmed hats. Significant room for improvement exists in childhood sun protection. Parents should especially be encouraged to use shade, wide-brimmed hats, and sunglasses as methods of protection for their children. Advising parents to model seeking shade, applying sunscreen, and choosing appropriate clothing and hats may improve sun safety practices.


Characteristics of atmospheric volatile organic compounds (VOCs) at a mountainous forest site and two urban sites in the southeast of China.
Volatile organic compounds (VOCs) are important trace gases in the atmosphere, affecting air quality (e.g. ozone and secondary organic aerosol formation) and human health. To understand the emission, transport and chemistry of VOCs in the southeast of China (Fujian Province), a campaign was conducted in summer and winter of 2016 at three contrasting sites in close proximity. One measurement site (Mt. Wuyi) is a mountainous forest site (1139 m a.s.l.) located in a natural reserve, while the other two sites (Fuzhou, Xiamen) are coastal urban sites with high population and vehicle density. Comparison of VOCs at these three sites provides a valuable perspective on regional air pollution and transport. Many of the measured alkanes, alkenes and aromatics exhibited clear seasonal and diurnal patterns, driven by variations of hydroxyl (OH) radicals, which is the predominant oxidant of VOCs in the atmosphere. By examining tracer-tracer correlations for VOCs, variability-lifetime analysis and 36 h backward trajectories, strong emissions from vehicular exhaust, liquefied petroleum gas (LPG) and solvent usage were identified as key sources in Fuzhou and Xiamen, whereas at Mt. Wuyi the main emission sources were local emissions (e.g. biomass burning) in summer and long-range transport in winter. The results indicate that natural sites could be impacted strongly by surrounding urbanization. Isoprene and propylene in summer and propylene in winter contributed the most to ozone formation at the three sites. The data in this study provides a useful benchmark for future research on air quality monitoring and emission sources in the region.


Sleep and violence.
Most violence connected with sleep disorder is assumed to be related to sleep walking. It is less well known that other sleep disorders can also give rise to violence. The role of narcolepsy in car accidents is mentioned. Sleep drunkenness can lead to confusion resulting in violent behaviour especially on forced awakening. This condition is associated to sleep apnea. Primary or central sleep apnea is caused by disorders of the brain stem affecting the respiratory center. Secondary or upper airway sleep apnea can be caused by virtually any condition that results in cessation of the air flow due to occlusion of the upper airway. The author describes one patient who engaged in assaultive behaviour on forced awakening following earlier alcohol consumption. The pathomechanism of violent behaviour generated by a combination of sleep apnea and respiratory pathology is described. The differential diagnosis, prevention and treatment is outlined. The use of polysomnography in diagnosis and the potentially dangerous effects of drugs with respiratory depressing effects is highlighted.


[Markers of inflammatory process in stable and unstable coronary artery disease].
Clinical studies performed in last few years proved great role of inflammatory processes in development of atherosclerosis. Inflammatory markers indicating unstable atherosclerotic plaque were isolated. These biomarkers are used in diagnostics and identification of patients with unstable angina pectoris and miocardial infarct. Moreover usefulness of proinflammatory markers in indicating patients with high cardiovascular risk was confirmed. In result different markers of inflammation found their use in diagnostics of patients with stable and unstable coronary artery disease.


Life's Dominion: An Argument about Abortion, Euthanasia, and Individual Freedom, Ronald Dworkin.
As a teacher of biomedical ethics, I have constantly sought a method to motivate my students to engage in meaningful moral debate on the controversial issues of abortion and euthanasia, without risking a shouting match (as happened on one occasion). The moral views are so personalized and polarized that silence often displaces discourse. Ronald Dworkin's masterful Life's Dominion offers an innovative and insightful way through this impasse by identifying moral commitments shared by persons with different conclusions. His argument begins with "conservative" premises and winds up with "liberal" conclusions. It is a philosophical and constitutional analysis of the meaning of life and death that draws on substantive religious values. In so doing, Dworkin suggests an approach that could alter the adversarial and even violent nature of our cultural debate about the ending of life towards a more dialogic and tolerant, but not indifferent, mode....


Roles of endotoxin-related signaling molecules in the progression of acute necrotizing pancreatitis in mice.
To study the potential roles of lipopolysaccharide (LPS) signaling molecules, LPS-binding protein (LBP), CD14, and Toll-like receptor 4 (TLR4) in mice with acute necrotizing pancreatitis (ANP). The ANP model was made by 7 intraperitoneal injections of cerulein (50 mug/kg) at hourly intervals, challenged by LPS administration of a dose of 5 mg/kg intraperitoneally 5 hours after the first injection of cerulein. Fifty-nine Balb/C mice were divided into 4 groups: group A, ANP control group, n = 18, received physiological saline; group B, anti-LBP group, n = 18, received 200 mug anti-LBP antibody; group C, anti-CD14 group, n = 18, received 20 microg anti-CD14 antibody; group D, anti-TLR4 group, n = 5, received 20 mug anti-TLR4 antibody. All treatments were given at 15 minutes before LPS injection. Serum amylase and lactic dehydrogenase (LDH) were measured. Histologic alteration of the pancreas was evaluated. Expressions of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), and intercellular adhesion molecular (ICAM-1) mRNA were determined using reverse transcription polymerase chain reaction (RT-PCR). Myeloperoxidase (MPO) activity in pancreas was also analyzed. Nuclear factor-kappaB (NF-kappaB) p65 subunit was measured by immunohistochemistry and Western blotting. Pretreatment of animals with anti-CD14 antibody resulted in a significant decrease in serum amylase and LDH levels, reduction of the severity of pancreatic injury, down-regulation of TNF-alpha, IL-1beta, and ICAM-1 mRNA expression, decrease in pancreatic MPO activity, and decrease in NF-kappaB expression compared with ANP control mice. In contrast, mice pretreated with anti-LBP antibody or anti-TLR4 antibody resulted in increasing of serum amylase and LDH levels, aggravation of the severity of necrosis and inflammation in pancreas, up-regulation of TNF-alpha, IL-1beta, and ICAM-1 mRNA expression, increasing of pancreatic MPO activity, and up-regulation of NF-kappaB expression compared with ANP control mice. (1) LBP per se possesses a protective effect on ANP. It could facilitate clearance of endotoxin. (2) CD14 plays a crucial intermediate role in the progression of ANP. (3) TLR4, the essential transducer of LPS responses, may act independently of LPS. The antibody against TLR4 may mimic endotoxin and induce activation of downstream cytokines. For implication, recombinant LBP, anti-CD14 antibody, or silent TLR4 might alleviate the progression of ANP.


Plasma levels of antioxidant vitamins, selenium, total sulfhydryl groups and oxidative products in ischemic-stroke patients as compared to matched controls in Taiwan.
The possible involvement of oxidative damage and antioxidant protection has been suggested in the pathogenesis of stroke which is the second-leading cause of death in Taiwan. In this study we investigated the relationship between ischemic stroke and plasma status of antioxidants and oxidative products. Plasma levels of vitamin A, alpha-tocopherol, carotenoids, selenium (Se), total SH groups (T-SH), thiobarbituric acid-reactive substances (TBARS) and protein carbonyl, a marker of protein damage, were determined in ischemic-stroke patients (n = 36, blood sampled within 24 hrs after the clinical event) in comparison with 21 matched controls. The cholesterol-adjusted carotenoids and vitamin E were significantly lower (P < 0.05) in the plasma of ischemic-stroke patients than those of the controls. TBARS were higher (P < 0.05) in the patients than in the controls but Se, T-SH and protein carbonyls were not significantly different between the two groups. Separation of the patients into small-artery ischemic stroke (SAIS, n = 17) and large-artery ischemic stroke (LAIS, n = 19) groups revealed that both carotenoids/cholesterol and vitamin E/cholesterol ratios were significantly lower in both LAIS and SAIS groups than the controls (n = 21) while vitamin A/cholesterol was not different among the three groups. TBARS were only significantly higher in the LAIS group. The results demonstrated that, within 24 hrs after the clinical event, the acute-ischemic stroke patients had lowered levels of cholesterol-adjusted carotenoids and alpha-tocopherol but elevated levels of TBARS in the plasma as compared to the matched controls. It remains to be resolved as to whether enhanced lipid peroxidation is a cause or a result of lowered antioxidants in ischemic stroke.


The distance between the posterior communicating arteries and their relation to the endoscopic third ventriculostomy in adults: An anatomic study.
The diencephalic leaf of the Liliequist's membrane is a continuous structure that should be perforated in the endoscopic third ventriculostomy. Its lateral borders are penetrated by the third cranial nerve and the posterior communicating arteries. The most important complication of endoscopic third ventriculostomy is the vascular injury, such as the posterior communicating artery. The purpose of this study is to measure the distance between posterior communicating arteries located below the third ventricle floor and anterior of the mammillary bodies. In this observational prospective study 20 fresh brains from cadavers were utilized to measure the distance between the posterior communicating arteries in April 2008 at the Death Check Unit of our Institution. A digital photograph of the posterior communicating arteries was taken and the distance between the arteries was measured. The measurement was analyzed using descriptive statistics. In the descriptive analysis of the 20 specimens, the posterior communicating arteries distance was 9 to 18.9 mm, a mean of 12.5 mm, median of 12.2 mm, standard deviation of 2.3 mm. The detailed knowledge of vascular structures involved in the endoscopic third ventriculostomy as to the posterior communicating arteries distance provides a safe lateral vascular border when performing such procedure.


Single-step synthesis and structural study of mesoporous sulfated titania nanopowder by a controlled hydrolysis process.
An environmentally benign route for the single-step synthesis of mesoporous sulfated titania is described by a seeding method using titanium oxysulfate as the titania source. The hydrolysis was performed in the presence of NaOH and seed under constant-volume conditions around 98 degrees C. The XPS and DRIFT spectra show the existence of a bridged bidentate sulfate complex on the surface of titania. The elimination of sulfur on heat treatment showed a characteristic change in mesoporosity, specific surface area, and crystallinity of the material. The transformation of sulfated titania to anatase was incomplete at 900 degrees C, showing a delay in crystallization due to the presence of sulfur. Studies on the thermal stability of the sulfated titania showed that the material obtained can be used for various applications at temperatures below 300 degrees C. The ammonia-TPD and catalytic performance studies of the sulfated titania samples showed the presence of strong acid sites.


Structure of a putative molybdenum-cofactor biosynthesis protein C (MoaC) from Sulfolobus tokodaii (ST0472).
The crystal structure of a putative molybdenum-cofactor (Moco) biosynthesis protein C (MoaC) from Sulfolobus tokodaii (ST0472) was determined at 2.2 A resolution. The crystal belongs to the monoclinic space group C2, with unit-cell parameters a = 123.31, b = 78.58, c = 112.67 A, beta = 118.1 degrees . The structure was solved by molecular replacement using the structure of Escherichia coli MoaC as the probe model. The asymmetric unit is composed of a hexamer arranged as a trimer of dimers with noncrystallographic 32 symmetry. The structure of ST0472 is very similar to that of E. coli MoaC; however, in the ST0472 protein an additional loop formed by the insertion of seven residues participates in intermonomer interactions and the new structure also reveals the formation of an interdimer beta-sheet. These features may contribute to the stability of the oligomeric state.


sPAP/PAAT Ratio as a New Index of Pulmonary Vascular Load: A Study in Normal Subjects and Ssc Patients with and without PH.
In pulmonary hypertension (PH), the development of right ventricular (RV) dilatation and RV failure are signs of accelerated progression of the disease, resulting in an increased risk of cardiac death. Even the noninvasive assessment of systolic blood pressure in the pulmonary artery undertaken by echocardiography does not provide a measure of ventricle-pulmonary interaction. Some studies have shown the potential for echocardiography to indirectly evaluate pulmonary vascular resistance (PVR) and the acceleration time of pulmonary outflow (PAAT). We used systolic pulmonary artery pressure (sPAP) and pulmonary vascular resistance to develop an sPAP/PAAT ratio (strength/surface unit)/(time) for this study. From January 2017 to December 2018, 60 healthy subjects and 63 patients with systemic scleroderma (Ssc) (60 females, 3 males), 27 with PH and 36 without PH at two-dimensional echocardiographic/Doppler, were screened. In normal subjects, the mean sPAP/PAAT ratio was 0.26 ± 0.063, which indicated optimal pulmonary arterial ventricle coupling and biventricular function. The data derived from the analysis of the Ssc patients showed that those presenting pre-capillary PH at cardiac catheterization had an sPAP/PAAT ratio of 0.40 ± 0.05. There was a significant correlation between sPAP/PAAT with Walk Distance (WD) and PVR, but not with TAPSE. Interobserver variability was less than 5%. The sPAP/PAAT ratio is a new parameter that may indicate pulmonary vascular afterload and interaction, both in normal subjects and in patients with Ssc and PH.


Association of micronucleus frequency with neurodegenerative diseases.
Micronuclei (MNi) can originate either from chromosome breakage or chromosome malsegregation events and are therefore ideal biomarkers to investigate genomic instability. Studies in peripheral lymphocytes of patients with neurodegenerative diseases, mainly Alzheimer's disease (AD) and Parkinson's disease (PD), revealed an increased micronucleus (MN) frequency in both disorders but originating mainly from chromosome malsegregation events in AD and from chromosome breakage events in PD. Studies in other neurodegenerative diseases are largely missing, and some data in premature ageing disorders characterised by neurodegeneration and/or neurological complications, such as Ataxia telangiectasia, Werner's syndrome, Down's syndrome (DS) and Cockayne's syndrome, indicate that MNi increase with ageing in cultured cells. An increased frequency of aneuploidy characterises several tissues of AD patients, as well as of individuals at increased risk to develop AD, such as mothers of DS individuals and DS subjects themselves. The use of the buccal MN cytome assay in AD and DS subjects allowed finding significant changes in the MN frequency as well as other cellular modifications reflecting reduced regenerative capacity compared to age- and gender-matched controls. These changes in buccal cytome ratios may prove useful as potential future diagnostics to identify individuals of increased risk for these disorders.


Technetium-99m-HMPAO-labeled leukocytes and technetium-99m-labeled human polyclonal immunoglobulin G in diagnosis of focal purulent disease.
To evaluate the usefulness of 99mTc-HMPAO-labeled leukocytes and 99mTc-labeled polyclonal human immunoglobulin G (Technescan HIG) in the diagnosis of focal purulent disease, 31 comparative scintigraphies were done in 30 patients with known or strongly suspected focal infection. Focal purulent disease was the final diagnosis in 19 patients. Technetium-99m-labeled leukocytes showed 16 true-positive, no false-positive, 11 true-negative and 3 false-negative findings. The corresponding figures for 99mTc-labeled HIG were 11, 2, 9 and 8. The sensitivity and specificity of imaging with labeled leukocytes were 84% and 100%, respectively, and with labeled HIG, 58% and 82%, respectively. The overall accuracy of the leukocyte scan was significantly better than that of the HIG scan (90% versus 67%, p < 0.001). Thus, if focal infection is suspected, scintigraphy with 99mTc-labeled leukocytes is the preferable method. No cases exhibited a better imaging result with 99mTc-HIG scintigraphy than with 99mTc-labeled leukocytes.


A case study of strategic infarct dementia investigated with the cognitive assessment system.
Two subjects with brain lesions who were matched on demographic variables were tested on the Cognitive Assessment System (CAS). AK had been dependent on caregivers after a frontal aneurysm 6 years previously despite intact receptive and expressive language skills and motor functions. GM sustained multiple infarcts although he continued to function well on his own. Nonparametric analysis showed that AK's T scores on CAS subtests were lower than that of GM's based on a comparison with a heterogeneous group of brain-damaged patients (p < .003). The CAS's broad range of complexity of items within subtests, apparent sensitivity in differentiating rates of cognitive decline in dementia, and convergence with dementia rating scales suggests that it could be useful for assessment of strategic infarct dementia.


Meningococcal disease: how to prevent and how to manage.
Meningococcal disease is a significant problem in the paediatric population. The diagnosis of meningococcal disease can be problematic and progression of the disease can rapidly lead to a life-threatening illness. Despite the success of antibiotic treatment, mortality rates remain high. The development of protein-polysaccharide conjugate vaccines has significantly improved the success of vaccination in reducing the incidence of meningococcal disease. However, a comprehensive vaccine conferring protection against disease-associated serogroups remains elusive. The aim of this review is to highlight recent significant improvements in the prevention and management of meningococcal disease.


Ectomycorrhizal Fungal Communities of Red Pine (Pinus densiflora) Seedlings in Disturbed Sites and Undisturbed Old Forest Sites.
This study aimed to investigate differences in ectomycorrhizal (ECM) fungal communities between disturbed sites and undisturbed old forest sites. ECM root tips of Pinus densiflora were collected from 4 sites disturbed by human activities and 3 undisturbed old forest sites adjacent to the disturbed sites. Results in this study showed that the number of ECM root tips, species diversity, and number of species were significantly higher in the disturbed sites than in the undisturbed sites, suggesting that the ECM fungal community structure was affected by the degree of disturbance.


Altered dose response to beta-agonists in SERCA1a-expressing hearts ex vivo and in vivo.
In this study we evaluated the contractile characteristics of sarco(endo)plasmic reticulum Ca(2+)-ATPase (SERCA)1a-expressing hearts ex vivo and in vivo and in particular their response to beta-adrenergic stimulation. Analysis of isolated, work-performing hearts revealed that transgenic (TG) hearts develop much higher maximal rates of contraction and relaxation than wild-type (WT) hearts. Addition of isoproterenol only moderately increased the maximal rate of relaxation (+20%) but did not increase contractility or decrease relaxation time in TG hearts. Perfusion with varied buffer Ca(2+) concentrations indicated an altered dose response to Ca(2+). In vivo TG hearts displayed fairly higher maximal rates of contraction (+ 25%) but unchanged relaxation parameters and a blunted but significant response to dobutamine. Our study also shows that the phospholamban (PLB) level was decreased (-40%) and its phosphorylation status modified in TG hearts. This study clearly demonstrates that increases in SERCA protein level alter the beta-adrenergic response and affect the phosphorylation of PLB. Interestingly, the overall cardiac function in the live animal is only slightly enhanced, suggesting that (neuro)hormonal regulations may play an important role in controlling in vivo heart function.


Electromyographyc evaluation of movements of lower limb in double pulley system equipment: comparison between gastrocnemius (caput laterale) and gluteus maximus.
It was evaluated movements of lower limb in the double pulley system equipment on ten male volunteers during contraction of gastrocnemius (caput laterale) and gluteus maximus muscles in the following movements: 1) hip extension with extended knee and erect trunk, 2) hip extension with flexed knee and erect trunk, 3) hip extension with flexed knee and erect trunk, 3) hip extension with extended knee and inclined trunk, 5) hip abduction along the midline, 7) hip abduction with extension beyond the midline, 8) adduction with hip flexion beyond the midline, 8) adduction with hip flexion beyond the midline, and 9) adduction with hip extension beyond the midline. Myoelectric signals were taken up by Lec Tec surface electrodes connected to a 6-channel Lynx electromyographic signal amplifier coupled with a computer equipped with a model CAD 10/26 analogue digital conversion board and with a specific software for signal recording and analysis. We observed weak gastrocnemius muscle activity for all movements studied. In the case of gluteus maximus, the most important potentials were observed for movement 2, while for the remaining movements the actions were of reasonable intensity. Compared to gluteus, gastrocnemius was less required for all movements.


The gut microbiota in larvae of the housefly Musca domestica and their horizontal transfer through feeding.
House fly larvae provide a prolific and sustainable source of proteins used in poultry and fish feed. Wheat bran is a superior diet for house fly larvae and has been widely investigated to exploit its potential in the food and feed area. Using Illumina MiSeq 16S rDNA sequencing, this study investigated the gut microbiota of house fly larvae feeding on wheat bran and the bacterial community in the wheat bran. The bacterial communities in the house fly larvae were dominated by the phyla Proteobacteria and Firmicutes. Enterobacteriaceae and Providencia were the predominant bacteria at the family and genus levels, respectively. Some bacteria in the phyla Actinobacteria, Proteobacteria, Bacteroidetes and Firmicutes may be transferred from the gut of house flies to the wheat bran during feeding and may be involved in degrading and utilizing polysaccharides in the cell wall of wheat bran. The significance of the gut microbiota of house fly larvae, their transferring and roles in degradation of wheat bran is discussed. These findings regarding the gut microbiota of house fly larvae will provide opportunities for research on the impact of microbial communities on poultry and fish.


Recurrent administration of the nitric oxide donor, isosorbide dinitrate, induces a persistent cephalic cutaneous hypersensitivity: A model for migraine progression.
Background A subgroup of migraineurs experience an increase in attack frequency leading to chronic migraine. Methods We assessed in rats the roles of dose and repeat administration of systemic isosorbide dinitrate (ISDN), a nitric oxide donor, on the occurrence and development of cephalic/face and extracephalic/hindpaw mechanical allodynia as a surrogate of migraine pain, and the effect of acute systemic sumatriptan and olcegepant and chronic systemic propranolol on these behavioral changes. Results A single high (H-ISDN) but not low (L-ISDN) dose of ISDN induces a reversible cephalic and extracephalic mechanical allodynia. However, with repeat administration, L-ISDN produces reversible cephalic but never extracephalic allodynia, whereas H-ISDN induces cephalic and extracephalic allodynia that are both potentiated. H-ISDN-induced cephalic allodynia thus gains persistency. Sumatriptan and olcegepant block single H-ISDN-induced behavioral changes, but only olcegepant reduces these acute changes when potentiated by repeat administration. Neither sumatriptan nor olcegepant prevent chronic cephalic hypersensitivity. Conversely, propranolol blocks repeat H-ISDN-induced chronic, but not acute, behavioral changes. Conclusions Repeated ISDN administration appears to be a naturalistic rat model for migraine progression, suitable for screening acute and preventive migraine therapies. It suggests frequent and severe migraine attacks associated with allodynia may be a risk factor for disease progression.


Cellular normalization of viral DNA loads on whole blood improves the clinical management of cytomegalovirus or Epstein Barr virus infections in the setting of pre-emptive therapy.
Two quantitative duplex real-time PCR assays were developed for co-amplification of human albumin and cytomegalovirus (CMV) or Epstein Barr virus (EBV) genes after automated extraction on whole blood, and compared two units for expressing viral DNA loads (copies per ml of blood or per 10(6) peripheral blood leukocytes (PBLs)) on 1,138 positive samples. Both PCRs were characterized by high sensitivity, reproducibility, and linear range. Automated extraction by a MagNA Pure LC Instrument was shown to be more efficient when peripheral blood cell count was inferior to 5 x 10(9) PBLs/L. Albumin co-amplification allows the detection of PCR inhibitors and normalization of viral load according to the number of cells calculated in the sample. The two ways of expressing viral load results were highly correlated, but quantitative differences varied in relation to variations of blood cell count. As these two viruses are highly cell associated, viral loads can be underestimated in patients with leucopenia. In the setting of pre-emptive strategies during CMV infection, the units in which results are expressed can influence clinical management, as illustrated in this article.


Avoiding colonizer positions in the therapy room: some ideas about the challenges of dealing with the dialectic of misery and resources in families.
Some authors have argued that certain acts of family therapists-despite their best intentions-may represent a form of colonizing the family. When acting as a colonizer, a therapist is understood as becoming overly responsible for the family and focusing too strongly on change. In so doing, the therapist disrespects the family's pace, and neglects their own resources for change. This paper aims to highlight the need for therapists to be hypersensitive both to the resources of families entering therapy as well as to the impact of prevailing ideologies on their own positioning in the session. The kind of sensitivity advocated here is dialectical in the sense that every family is understood as having potentials promoting dynamism, happiness, and well-being as well as potentials contributing to stagnation, unhappiness, and misery. In this article, using illustrations from clinical practice, we present some ideas for resisting the tendency by the therapist to assume a colonizing position as a professional solver of problems for families. Our main aim here is to redirect the therapist toward connecting with the family's suffering, as well as with the resource repertoire it has developed for navigating and negotiating its way through life.


Complex pattern of alternative splicing in the normal uroporphyrinogen decarboxylase gene: implications for diagnosis of familial porphyria cutanea tarda.
We describe multiple alternative transcripts of uroporphyrinogen decarboxylase mRNA in normal individuals and patients with familial porphyria cutanea tarda. mRNA was reverse-transcribed, subjected to the polymerase chain reaction, and analyzed for nucleotide sequence. Seven different transcripts were characterized, and a cryptic splice acceptor site was identified in intron 1. In all mRNAs the exons abutted at previously defined exon boundaries. Characterization of the splice junctions in the genomic DNA showed that splice donor and acceptor sequences complied with the consensus sequences for these sites except for the splice acceptor sequences of exons 3 and 10. THese deviations were present in two normal individuals and one patient with familial porphyria cutanea tarda and were thus unable to explain the multiple aberrant uroporphyrinogen decarboxylase transcripts. We conclude that apparent deletions observed in transcripts derived from the uroporphyrinogen decarboxylase gene in patients with familial porphyria cutanea tarda should be interpreted with caution.


Public perceptions of animal experimentation across Europe.
The goal of this article is to map out public perceptions of animal experimentation in 28 European countries. Postulating cross-cultural differences, this study mixes country-level variables (from the Eurostat database) and individual-level variables (from Eurobarometer Science and Technology 2010). It is shown that experimentation on animals such as mice is generally accepted in European countries, but perceptions are divided on dogs and monkeys. Between 2005 and 2010, we observe globally a change of approval on dogs and monkeys, with a significant decrease in nine countries. Multilevel analysis results show differences at country level (related to a post-industrialism model) and at individual level (related to gender, age, education, proximity and perceptions of science and the environment). These results may have consequences for public perceptions of science and we call for more cross-cultural research on press coverage of animal research and on the level of public engagement of scientists doing animal research.


Pseudoalteromonas gelatinilytica sp. nov., isolated from surface seawater.
Three Gram-stain-negative, rod-shaped bacteria, designated strains NH153T, F-2-11 and M-1-78, were isolated from surface seawater of the South China Sea and the East China Sea. The three isolates were able to grow at 15-45 °C (optimum 28-37 °C), but no growth occurred at 4 or 50 °C. The pH range for growth was pH 5.5-9.5 (optimum pH 7.5-8.5). The isolates required sea salts for growth and growth occurred in the presence of 0-10 % (w/v) NaCl (optimum 3-5 %); no growth occurred in the presence of 12.0, 15.0 or 20.0 % (w/v) NaCl. They were positive for hydrolysis of gelatin and Tween 80. The sole respiratory quinone was ubiquinone-8 (Q-8). The major cellular fatty acids (>10 %) were C16 : 0, C18 : 1ω7c and summed feature 3 (C16 : 1ω7c and/or iso-C15 : 0 2-OH). The major polar lipid components were phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, one unidentified glycolipid, one unidentified phospholipid and one unidentified lipid. The genomic DNA G+C content of strain NH153T was 41.4 mol%. Based on 16S rRNA gene sequence analysis, the isolates were closely related to the type strain of Pseudoalteromonas shioyasakiensis (98.0-98.6 % sequence similarity). The 16S rRNA gene sequence similarities between the three isolates were 98.8-99.7 %. Phylogenetic analysis indicated that they formed a distinct lineage and clustered with P. shioyasakiensis and Pseudoalteromonas arabiensis. The level of DNA-DNA relatedness among the three isolates was 78.0-85.5 %. Strain NH153T exhibited average nucleotide identity values of 93.4 and 84.2 % with respect to P. shioyasakiensisJCM 18891T and P. arabiensisJCM 17292T, respectively. The genome-to-genome distance analysis revealed that strain NH153T shared 52.4 % DNA relatedness with P. shioyasakiensisJCM 18891T and 28.1 % with P. arabiensisJCM 17292T. On the basis of the phenotypic, genotypic and chemotaxonomic characterizations, as well as phylogenetic inference obtained in this study, strains NH153T, F-2-11 and M-1-78 represent a novel species within the genus Pseudoalteromonas, for which the name Pseudoalteromonasgelatinilytica sp. nov. is proposed. The type strain is NH153T (=CGMCC 1.15370T=DSM 100951T), and F-2-11 (=CGMCC 1.15364=DSM 100953) and M-1-78 (=CGMCC 1.15365=DSM 100952), are additional strains of the species.


Influence of aging and sex on specific IgE antibody production.
The influence of aging and sex on specific IgE production was evaluated in a non-allergic population aged from 18 to 99 years. Specific IgE against mite antigen and Japanese cedar pollen (JCP) were measured by fluorescence enzyme immunoassay. The incidence and titer of positive anti-mite and anti-JCP IgE antibodies decreased with age, particularly in the aged group. There were slight sex-related changes in IgE production. No significant correlation was noted between anti-mite and anti-JCP IgE antibody levels in the same individual subjects. These findings suggest that the production of specific IgE, as an immunoglobulin class, declines with aging.


Seven-year follow-up of LASIK for moderate to severe myopia.
To evaluate long-term refractive outcomes of LASIK for correcting moderate to severe myopia. A long-term (7-year) prospective follow-up study of visual and refractive outcomes in patients who underwent myopic LASIK surgery in 1998 and 1999. Fifty-nine patients (104 eyes) of the original cohort of 75 patients underwent detailed clinical assessment at 1 and 7 years postoperatively. The main outcome measures were predictability, efficacy, safety, and stability. Topography, corneal thickness, and postoperative complications were recorded at 7 years. All patients completed a questionnaire assessing their satisfaction with the procedure. At 7 years postoperatively, 89.4% of eyes were within 0.50 diopters (D) of attempted correction, and 90.4% were within 1.00 D. All eyes had 20/40 or better vision and 94.2% had 20/20 or better. Best spectacle-corrected visual acuity was unchanged or improved in 80.8% of eyes. Eyes did not regress in refraction between 1 and 7 years postoperatively. Complications were rare and patient satisfaction with the surgery was high. LASIK surgery has predictable and stable results in refractive and visual outcomes in correcting moderate to high myopia on long-term follow-up. Refractive stability is maintained over 7 years, with no evidence of progressive late-onset complications.


Regulation of intestinal cholesterol absorption.
The identification of defective structures in the ATP-binding cassette (ABC) transporters ABCG5 and ABCG8 in patients with sitosterolemia suggests that these two proteins are an apical sterol export pump promoting active efflux of cholesterol and plant sterols from enterocytes back into the intestinal lumen for excretion. The newly identified Niemann-Pick C1-like 1 (NPC1L1) protein is also expressed at the apical membrane of enterocytes and plays a crucial role in the ezetimibe-sensitive cholesterol absorption pathway. These findings indicate that cholesterol absorption is a multistep process that is regulated by multiple genes at the enterocyte level and that the efficiency of cholesterol absorption may be determined by the net effect between influx and efflux of intraluminal cholesterol molecules crossing the brush border membrane of the enterocyte. Combination therapy using cholesterol absorption (NPC1L1) inhibitor (ezetimibe) and 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibitors (statins) provides a powerful novel strategy for the prevention and treatment of hypercholesterolemia.


An unusual cause of hoarseness.
A 55-year-old man had a 3 month history of hoarseness and choking when he drinks liquids. Physical examination revealed evidence of left sided palsy of 9th, 10th, 11th and 12th cranial nerves. A brain MRI revealed a skull base lytic lesion. The authors diagnosed Collet-Sicard syndrome. The patient was found to have colon cancer. He received palliative skull radiotherapy and died few weeks later in hospice care.


Oxidative DNA strand scission induced by a trinuclear copper(II) complex.
A novel trinuclear copper(II) complex, Cu3-L (L = N,N,N',N',N' ',N' '-hexakis(2-pyridyl)-1,3,5-tris(aminomethyl)benzene), exhibited efficient oxidative strand scission of plasmid DNA. The solution behavior of the complex has been studied by potentiometric titration, UV spectroscopy, and cyclic voltammetry. The data showed that there are three redox-active copper ions in the complex with three types of bound water. The complex demonstrated a moderate binding ability for DNA. Cu3-L readily cleaves plasmid DNA in the presence of ascorbate to give nicked (form II) and then linear (form III) products, while the cleavage efficiency using H2O2 is less than by ascorbate, suggesting that the cleavage mode of the trinuclear complex is somewhat different from the traditional Fenton-like catalysis. Meanwhile, Cu3-L is far more efficient than its mononuclear analogue Cu-DPA (DPA = 2,2'-dipyridylamine) at the same [Cu2+] concentration, which suggests a possible synergy between the three or at least two Cu(II) centers in Cu3-L that contributes to its relatively high nucleolytic efficiency. Furthermore, the presence of standard radical scavengers does not have clear effect on the cleavage efficiency, suggesting the reactive intermediates leading to DNA cleavage are not freely diffusible radicals.


Teat tip reconstruction by supernumerary teat autotransplantation in cattle.
Evaluation of use of a supernumerary teat as a pedicle graft to repair experimental teat tip damage in cattle. Experimental study. Mature, non-gravid hybrid cows with > or =1 supernumerary teat. The main teat and adjacent supernumerary teat were examined for patency by ultrasound with a 8 MHz linear array transducer. The tip of the main teat was resected at the junction of cistern and canal. The supernumerary teat was partially resected semi-circumferentially at the cranial aspect of the base to maintain vascular supply and transplanted by end-to-end anastomosis. The pedicle of the supernumerary teat graft was amputated in stages starting at 14 days, again at 16 days and separated at 18 days. Reconstructed teat patency was evaluated at intervals by ultrasonography and confirmed at 50 days by histopathology. Repeated measures ANOVA was used to compare the measurements of luminal diameter between days; significance was set at P<.05. All reconstructed teats were patent. Decreased luminal diameters were detected at 25, 32, 39, and 46 days by ultrasonography. On histopathology, granulation and epithelial (mucosal) proliferation contributed to luminal reduction. In this experimental model of an acute damage to a teat tip, supernumerary teat grafting was successfully used to restore teat anatomy. Supernumerary teat pedicle grafting may be considered as a salvage technique for reconstruction of a damaged bovine teat in cows that have an adjacent patent supernumerary teat. Function of the reconstructed teat in a lactating cow remains unknown.


Autosomal dominant cortical tremor, myoclonus, and epilepsy (ADCME): Probable first family from India.
Autosomal dominant cortical tremor, myoclonus, and epilepsy (ADCME) is an extremely rare syndrome characterized by familial occurrence of postural and action-induced tremors of the hands but showing electrophysiologic findings of cortical reflex myoclonus. Patients also have cognitive decline and tonic-clonic seizures, often precipitated by sleep deprivation or photic stimulation. We describe probably the first family from India of this ill-defined syndrome.


A frequency based spatial filter to mitigate volume conduction in electroencephalogram signals.
Volume conduction is a major problem in spatial-temporal electroencephalogram (EEG) signals. We propose a frequency dependent subtraction approach to address the volume conduction problem in EEG signals. We validate the proposed approach using simulated data and discuss the application of the approach to the EEG data recorded from three sick infants. The frequency dependent subtraction mitigated the common signal better than the traditionally used re-referencing the EEG signals to the global average of EEG from all electrodes. Furthermore, the frequency-based approach also attenuated the other interfering signals such as noise from power line and mechanical ventilators used to support patients.


[Clinical, electrocardiographic and echocardiographic aspects in elderly hypertensive patients in Senegal].
Arterial hypertension (HTA) in the elderly is an independent risk factor for cardiovascular disease. Our study aims to describe the clinical, electrocardiographic and echocardiographic aspects of Arterial hypertension in elderly patients. We conducted a descriptive, cross-sectional study from January to September 2013. Hypertensive patients =60 years treated in Outpatient Cardiology Department at the Principal Hospital in Dakar were included in the study. Statistical data were analyzed using Epi Info 7 software and a p-value < 0.05 was taken as significant. A total of 208 patients were enrolled in the study. The average age was 69.9 years with a female predominance (sex ratio 0.85). Average blood pressure was 162/90 mm Hg. HTA was under control in 13% of cases. The ECG showed evidence of rhythm disturbance (17.78%), left atrial enlargement (45.19%), left ventricular hypertrophy (28.85%) and complete atrioventricular block in 2 cases. Holter ECG revealed non-sustained ventricular tachycardia (Lown class IVb) in 4 cases, paroxysmal atrial fibrillation in 6 cases and paroxysmal atrial flutter in 1 case. Echocardiography performed in 140 patients showed mainly concentric left ventricular hypertrophy in 25 patients, occuring more frequently in males (p=0,04) and dilated left atrium in 56,42% of cases, occuring more frequently in elderly patients (p= 0,01). Electrocardiographic and echocardiographic aspects in elderly hypertensive population are characterized by concentric left ventricular hypertrophy and by the frequency of arrhythmias sometimes revealed by long-term continuous external electrocardiographic recording.


Bone marrow transplantation for hematological diseases in Hokkaido--June 1985 to December 1991.
Bone marrow transplantation (BMT) was started in Hokkaido in 1985. In the present report we have reviewed the clinical outcome of patients treated with BMT for hematological diseases in Hokkaido. Fifty-eight allogeneic and 19 autologous transplants were registered by December 1991. The underlying diseases consisted of 47 leukemias, 14 lymphomas, 10 aplastic anemias and six myelodysplastic syndromes. Among the allogeneic BMT cases, 55 were human leucocyte antigen (HLA) identical and three were mismatched. Among the autologous BMT patients, two received their marrow purged with 4-hydroperoxycyclophosphamide and five, with monoclonal antibodies and complements. The conditioning regimens used for malignancies were chiefly cyclophosphamide (CY) plus total body irradiation, or busulfan plus CY. In many cases, cytokines were used for rapid recovery of decreased leukocytes. Engraftment was observed in 50 out of 52 evaluated allogeneic and 18 out of 19 autologous transplants. Ten allogeneic patients suffered from severe acute graft-versus-host diseases (GVHD), and extensive chronic GVHD appeared in 16 patients. Relapses were observed in four cases of allogeneic BMT and six of autologous BMT. The major complications were interstitial pneumonitis (IP) and severe infections. Long-term survival rates were almost 60% in both allogeneic and autologous transplants. Mild acute GVHD and limited chronic GVHD increased the survival rates. The results indicated that substantial problems such as GVHD, IP and relapses must be controlled in the near future for an improved outcome to be made possible.


Pathway for unfolding of ubiquitin in sodium dodecyl sulfate, studied by capillary electrophoresis.
This paper characterizes the complexes formed by a small protein, ubiquitin (UBI), and a negatively charged surfactant, sodium dodecyl sulfate (SDS), using capillary electrophoresis (CE), circular dichroism (CD), and amide hydrogen-deuterium exchange (HDX; as monitored by mass spectroscopy, MS). Capillary electrophoresis of complexes of UBI and SDS, at apparent equilibrium, at concentrations of SDS ranging from sub-micellar and sub-denaturing to micellar and denaturing, revealed multiple complexes of UBI and SDS of the general composition UBI-SDS(n). Examination of electrophoretic mobilities of complexes of UBI and SDS as a function of the concentration of SDS provided a new way to characterize the interaction of this protein with SDS and established key characteristics of this system: e.g., the reversibility of the formation of the complexes, their approximate chemical compositions, and the pathway of SDS binding to UBI. The work identified, in addition to SDS-saturated UBI, at least six groups of complexes of UBI with SDS, within which four groups were populated with complexes of distinct stoichiometries: UBI-SDS(approximately 11), UBI-SDS(approximately 25), UBI-SDS(approximately 33), and UBI-SDS(approximately 42). CD spectroscopy and amide HDX of the UBI-SDS(n) complexes suggested that many of the UBI-SDS(n) complexes (n > 11) have greater alpha-helical content than native UBI. Capillary electrophoresis provides a level of detail about interactions of proteins and SDS that has not previously been accessible, and CE is an analytical and biophysical method for studies of interactions of proteins and surfactants that is both convenient and practical. This study sheds light on the formation of the enigmatic protein-SDS complexes formed during SDS polyacrylamide gel electrophoresis and brings a new tool to the study of proteins and detergents.


H-bonds superstructures built by aquacomplexes and an azapurine derivative: a case of molecular recognition.
The crystal structures of six compounds involving the divalent cations of Mn, Zn and Cd, the anionic form of the heterocycle 4,6-dimethyl-1,2,3-triazolo[4,5-d]pyrimidin-5,7-dione (Hdmax) and bipyridyl based spacer ligands are reported. The most important feature of these structures is the presence, in all cases, of a topologically identical 1-D polymeric superstructure (tape), involving tetra- or hexaaqua complex cations and triazolopyrimidine anions, built through hydrogen bonds. Adding these results to others previously published, we may consider these tapes as robust supramolecular synthons where a defined/clear case of molecular recognition between these two moieties takes place.


Determination of the zygosity of ev21-K in late-feathering male White Leghorns using the polymerase chain reaction.
The dominant sex-linked late-feathering (LF) gene, K, is of commercial importance for sex determination at hatch. Knowledge of the zygosity of sequences associated with K would enable breeders to more efficiently select homozygous grandparent LF males on the maternal side of the standard feather-sex cross because all of their progeny would be LF, whereas only half of the progeny from heterozygous grandparent males would be LF. A specific, polymerase chain reaction (PCR) assay is described that distinguishes White Leghorn K/K males from K/k+ males and obviates the need to raise all LF grandparent males to sexual maturity. Because the Z chromosome of some LF broiler breeders have, in addition to the endogenous virus gene, ev21, the wild type allele, which is termed the unoccupied repeat b (URb), this approach may not be applicable to some broiler lines.


Severe asthma in children.
Most children with asthma have their disease easily controlled if low-dose inhaled corticosteroids (ICSs) are regularly and correctly administered. If a child presents with asthma which is apparently resistant to therapy with high-dose ICS and other controllers, then they have problematic severe asthma. However, in light of the UK National Review of Asthma Deaths, definitions of severe asthma based solely on the levels of prescribed treatment are too narrow. A detailed assessment of all such children should be performed. First, the diagnosis of asthma should be confirmed, then co-morbidities assessed. Next, a nurse-led assessment further characterizes the problem, conventionally categorizing the child as either having difficult asthma or severe therapy-resistant asthma. Here, we reassess in particular the interactions between, and management of, these two categories, highlighting that this dichotomous classification may need reconsideration. We use bronchoscopy and an intramuscular steroid injection to determine if the child has steroid-resistant asthma, using a novel, multidomain approach because the adult definition does not apply to around half the children we see. Finally, we highlight some mechanistic data which have emerged from this protocol such as the absence of T-helper 2 (TH2) cytokines even in eosinophilic severe asthma and the potential role of the innate epithelial cytokine IL-33, novel data on lineage negative innate lymphoid cells, which we can measure in induced sputum, and demonstrating that intraepithelial neutrophils are associated with better, not worse asthma outcomes. Severe paediatric asthma is very different from severe asthma in adults, and approaches must not be uncritically extrapolated from adult disease to children.


Little Hans: a centennial review and reconsideration.
Freud's "Analysis of a Phobia in a Five-year-old Boy" has stimulated interminable "reanalysis." The case of Little Hans, an unprecedented experimental child analytic treatment, is reexamined in the light of newer theory and newly derestricted documents. The understanding of the complex overdetermination of Hans's phobia was not possible in the heroic age of psychoanalysis. Current analytic thought, as well as distance de-idealization vis-à-vis the pioneering past, has potentiated a reformation of the case. The severe disturbance of his mother had an adverse impact on Little Hans and his family. Her abuse of Hans's infant sister has been overlooked by generations of analysts. Trauma, child abuse, parental strife, and the preoedipal mother-child relationship emerge as important issues that intensified Hans's pathogenic oedipal conflicts and trauma. With limited, yet remarkable help from his father and Freud, Little Hans nevertheless had the ego strength and resilience to resolve his phobia, resume progressive development, and forge a successful creative career.


A finite element analysis of the supportive effect of a new type of rotary support plate on lateral tibial plateau fractures.
Tibial plateau fractures (TPFs) are a challenging type of fracture in orthopedic traumatology. We previously designed a plate (Patent Number: CN201520195596.5) for posterolateral TPF combined with posterior lateral collapse.. In this study, finite element analysis was used to compare the biomechanical characteristics of two internal fixation methods for posterolateral TPF. We investigated the support effect of the new steel plate on lateral TPFs combined with posterior TPFs. Two models of complex TPF were established. Model A was fixed with the new type of plate, and model B was fixed without the plate. Three axial loads of 500, 1,000, and 1,500 N were applied using FEA on the two fracture models (A and B) to analyze the data. In model A, the maximum displacement at 500, 1,000, and 1,500 N was 0.085797, 0.17043, and 0.25465 mm, respectively; the maximum stress of the bone block was 11.285, 20.648, and 29.227 MPa, respectively; and the maximum strain of the bone block was 0.0012474, 0.007435, and 0.0035769 mm, respectively. The maximum displacement of the internal fixation was 0.096932, 0.18682, and 0.27655 mm, respectively; the maximum stress was 69.54, 112.1, and 155.71 MPa, respectively; and the maximum strain was 0.00066228, 0.0010676, and 0.0014829 mm, respectively. In model B, the maximum displacement of fractures at 500, 1,000, and 1,500 N was 0.15675, 0.29868, and 0.44017 mm, respectively; the maximum stress of the bone block was 6.5519, 12.575, and 18.842 MPa, respectively; and the maximum strain of the bone block was 0.0032554, 0.0074357, and 0.012146 mm, respectively. The maximum displacement of the screw was 0.14177, 0.27109, and 0.39849 mm, respectively; the maximum stress was 48.916, 92.251, and 135.27 MPa, respectively; and the maximum strain was 0.00046608, 0.00087893, and 0.0012887 mm, respectively. The fixation method using this type of plates and screws can replace other methods using two plates to fix complex TPF.


Human mesenchymal stem cells efficiently manage oxidative stress.
The transplantation of mesenchymal stem cells (MSCs) proves to be useful to treat pathologies in which tissue damage is linked to oxidative stress (OS). The aim of our work was to evaluate whether primary human MSCs (hMSCs) can manage OS. For this, in vitro we assessed the following parameters: (1) cell viability of hMSCs exposed to increasing concentrations of reactive oxygen species (ROS; source: hydrogen peroxide), reactive nitrogen species (RNS; source: S-nitroso-N-acetylpenicillamine), or both (ROS and RNS; source: 3-morpholinosydnonimine hydrochloride); (2) intracellular level of reactive species in hMSCs exposed to ROS and RNS; (3) basal gene expression and activity of superoxide dismutases, catalase, and glutathione peroxidase of hMSCs; (4) basal level of total glutathione (GSx) of hMSCs; and (5) cell viability of GSx-depleted hMSCs exposed to ROS and/or RNS. Results showed that hMSCs have a high resistance to OS-induced death, which correlates with low levels of intracellular reactive species, constitutive expression of enzymes required to manage OS, and high levels of GSx. When hMSCs were depleted of GSx they lose their capacity to manage OS. Thus, in vitro hMSCs were able to scavenge ROS and RNS and efficiently manage OS. If this potential is maintained in vivo, hMSCs could also contribute to tissue regeneration, limiting OS-induced tissue damage.


Weight reduction programmes at a rehabilitation centre and a health centre based on group counselling and individual support: short- and long-term follow-up study.
The objective of this study was to evaluate the effects of two weight reduction programmes on moderately and severely obese subjects over a period of five years. The subjects were randomly divided into a rehabilitation centre group (RC group) and a health centre group (HC group). Treatment in the RC group consisted of a three-week in-patient weight reduction programme at a rehabilitation centre and in the HC group of a ten-week out-patient weight reduction course at a health centre. Treatment in both groups continued for up to 24 months with an individual follow-up at 1-2-month intervals by a general practitioner (GP) at the health centre. The subjects were 42 women and 10 men. The mean weight of women at the onset of the study was 104 kg and the mean BMI 39.5 kg/m2 and the respective means of men 121 kg and 40.1 kg/m2. The mean age of both sexes was 40 years. In the RC group the mean weight loss at 6, 12 and 24 months was 11.5, 9.1 and 5.9 kg in women, and 19.0, 18.3 and 11.2 kg in men, respectively. In the HC group the respective values were 5.5, 4.8 and 3.2 kg in women and 12.2, 6.7 and 2.8 kg in men. At the five-year follow-up the mean weight change from baseline was -6.8 kg in the men and $0.3 kg in the women of the RC group. In the HC group the mean weight returned to baseline level in both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)


Ascites complicating ventriculoperitoneal shunts.
Ventriculoperitoneal shunts are currently a standard therapy for obstructive hydrocephalus. These shunts are associated with a variety of abdominal complications, one of which is the development of ascites. We report an 11-year-old girl with a ventriculoperitoneal shunt in whom a low-grade peritoneal infection presented with ascites. This case demonstrates the importance of diagnostic paracenteses, appropriate antibiotic therapy and the potential need to establish an alternative route for cerebrospinal fluid diversion in patients with ventriculoperitoneal shunts and ascites.


Inflammatory cell death induced by 5-aminolevulinic acid-photodynamic therapy initiates anticancer immunity.
Inflammatory cell death is a form of programmed cell death (PCD) that induces inflammatory mediators during the process. The production of inflammatory mediators during cell death is beneficial in standard cancer therapies as it can break the immune silence in cancers and induce anticancer immunity. Photodynamic therapy (PDT) is a cancer therapy with photosensitizer molecules and light sources to destroy cancer cells, which is currently used for treating different types of cancers in clinical settings. In this study, we investigated if PDT using 5-aminolevulinic (5-ALA-PDT) causes inflammatory cell death and, subsequently, increases the immunogenicity of cancer cells. Mouse breast cancer (4T1) and human colon cancer (DLD-1) cells were treated with 5-ALA for 4 hours and then irradiated with a light source. PCD induction was measured by western blot analysis and FACS. Morphological changes were determined by transmission electron microscopy (TEM). BALB/c mice were injected with cell-free media, supernatant of freeze/thaw cells or supernatant of PDT cells intramuscular every week for 4 weeks and then challenged with 4T1 cells at the right hind flank of BALB/c. Tumor growth was monitored for 12 days. We found that 5-ALA-PDT induces inflammatory cell death, but not apoptosis, in 4T1 cells and DLD-1 cells in vitro. Moreover, when mice were pretreated with 5-ALA-PDT culture supernatant, the growth of 4T1 tumors was significantly suppressed compared to those pretreated with freeze and thaw (F/T) 4T1 culture supernatant. These results indicate that 5-ALA-PDT induces inflammatory cell death which promotes anticancer immunity in vivo.


A Case of Perineal Hemangioma, External Genitalia Malformations, Lipomyelomeningocele, Vesicorenal Abnormalities, Imperforate Anus, and Skin Tag (PELVIS) Syndrome with Extensive Perineal Infantile Hemangioma.
PELVIS syndrome describes the constellation of perineal hemangioma, external genitalia malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus, and skin tag. A 2-month-old girl presented with infantile hemangioma on her perineum and genitalia with imperforate anus, rectovaginal fistula and perineal skin tag at birth. Under the impression of PELVIS syndrome, consequential spinal sonography was conducted and revealed an intrasacral meningocele without clinical neurologic deficit. The anorectal malformation was surgically corrected, she was taking oral propranolol for the cutaneous lesion, and she showed improvement and no complications.


Evidence for disturbed S-adenosylmethionine : S-adenosylhomocysteine ratio in patients with end-stage renal failure: a cause for disturbed methylation reactions?
Elevated homocysteine concentrations have been associated with premature arteriosclerosis and with impairment of key methylation reactions through accumulation of the homocysteine metabolite S-adenosylhomocysteine. In end-stage renal failure high homocysteine concentrations are commonly found but thus far the concentrations of related adenosylated metabolites in plasma have not been assessed. In this prospective study we determined plasma homocysteine and related metabolites in 25 patients on regular haemodialysis, and in 40 healthy volunteers. Blood samples from patients were drawn immediately before and in 10 patients additionally after the dialysis session. Folic acid and vitamin B12 in plasma were similar in patients (mean +/- SEM 25+/-2 nmol/l and 400+/-41 pmol/l respectively) and controls (24+/-3 and 324+/-23 respectively). In patients plasma homocysteine, S-adenosylmethionine and S-adenosylhomocysteine were markedly elevated (36.6+/-3.6 micromol/l, 381+/-32nmol/l and 1074+/-55 nmol/l respectively) compared to the control values (6.8+/-0.4 micromol/l, 60+/-3 nmol/l and 24.4+/-1.1 nmol/l respectively) whereas the molar ratio of plasma S-adenosylmethionine and S-adenosylhomocysteine was significantly decreased (0.36+/-0.02 and 2.7+/-0.2 in patients and controls respectively). Haemodialysis failed to normalize the abnormal levels of these metabolites. Since the ratio of S-adenosylmethionine : S-adenosylhomocysteine is closely linked to the activity of numerous enzymatic methylation reactions, these results suggest that methylation may be impaired in these patients.


Effectiveness of SARS-CoV-2 vaccination in patients with rheumatoid arthritis (RA) on DMARDs: as determined by antibody and T cell responses.
To assess antibody and T cell responses to SARS-CoV-2 vaccination in patients with rheumatoid arthritis (RA) on disease-modifying antirheumatic drugs (DMARDs). This prospective study recruited 100 patients with RA on a variety of DMARDs for antibody and T cell analysis, pre-vaccination and 4 weeks post-vaccination. Positive antibody response was defined as sera IgG binding to ≥1 antigen. Those that remained seronegative after first vaccination were retested 4 weeks after second vaccination; and if still seronegative after vaccination three. A T cell response was defined an ELISpot count of ≥7 interferon (IFN)γ-positive cells when exposed to spike antigens. Type I IFN activity was determined using the luminex multiplex assay IFN score. After vaccine one, in patients without prior SARS-CoV-2 exposure, 37/83 (45%) developed vaccine-specific antibody responses, 44/83 (53%) vaccine-specific T cell responses and 64/83 (77%) developed either antibody or T cell responses. Reduced seroconversion was seen with abatacept, rituximab (RTX) and those on concomitant methotrexate (MTX) compared to 100% for healthy controls (p<0.001). Better seroconversion occurred with anti-tumour necrosis factor (TNF) versus RTX (p=0.012) and with age ≤50 (p=0.012). Pre-vaccine SARS-CoV-2 exposure was associated with higher quantitative seroconversion (≥3 antibodies) (p<0.001). In the subgroup of non-seroconverters, a second vaccination produced seroconversion in 54% (19/35), and after a third in 20% (2/10). IFN score analysis showed no change post-vaccine. Patients with RA on DMARDs have reduced vaccine responses, particularly on certain DMARDs, with improvement on subsequent vaccinations but with approximately 10% still seronegative after three doses.


[Association study of Trp2 allele polymorphism with degenerative disc disease in a Chinese Han nationality].
To investigate the association between Trp2 allele polymorphism with degenerative disc disease (DDD) in a Chinese Han population. A total of 125 DDD patients (58 males and 67 females, 51.8 +/- 7.6 years old), and 125 controls matched in sex and age (63 males and 62 females, 45.3 +/- 8.3 years old) were recruited in the case-control study. Their peripheral blood samples were collected for DNA isolation. Based on NCBI genebank, the corresponding single nucleotide polymorphisms (snp)-SNP1 (rs7533552) and SNP2 (rs2077871) were identified. Hardy-Weinberg equilibrium was analyzed both in case and control groups. Then the case group was classified into different clinical phenotypes according to severity of degeneration, sole or multi-disc degeneration and different affected discs. Genotyping of all selected SNPs was performed by SNP stream technology. The association analysis between phenotypes and SNPs was conducted. Pairwise linkage disequilibrium was calculated in control population using Haploview 4.0 software. SNP1 (rs7533552), SNP2 (rs2077871) and corresponding SNP of Trp2 allele were gentyped and both polymorphisms distributed in line with Hardy-Weinberg equilibrium in case and control groups. Allelic frequency of SNP1A, SNP1G, SNP2C and SNP2T (42%, 47%, 88% and 90% respectively) of case group were not significantly different from those of control group (48%, 53%, 88% and 10% respectively, all P > 0.05). Genotypic frequencies of SNP1AA, SNP1AG, SNP1GG, SNP2CC, SNP2CT and SNP2TT in case group were not significantly different from those of control group (all P > 0.05). However there was an association with genotypic frequencies of SNP2 and severity of disc degeneration (chi(2) = 6.920, P = 0.031). Trp2 allele is one of risk factors for the development and severity of DDD in a Chinese Han population.


Making research ethics work for global health: towards a more agile and collaborative approach.
In this reflective essay, we seek to engage in a constructive dialogue with scholars across medicine, public health and anthropology on research ethics practices. Drawing on anthropological research and ethical dilemmas that our colleagues and we encountered as medical anthropologists, we reflect on presumed and institutionalised 'best' practices such as mandatory written informed consent, and problematise how they are implemented in interdisciplinary global health research projects. We demonstrate that mandatory, individualised, written, informed consent may be unsuitable in many contexts and also identify reasons why tensions between professionals in interdisciplinary teams may arise when decisions about ethics procedures are taken. We propose alternatives to written informed consent that acknowledge research governance requirements and contextual realities and leave more room for ethnographic approaches. Beyond informed consent, we also explore the situatedness of ethical practices when working in contexts where decision-making around health is clearly a shared concern. We use vignettes based on our own and colleagues' experiences to illustrate our arguments, using the collective 'we' instead of 'I' in our vignettes to protect our research participants, partners and interlocutors. We propose a decolonial, plural and vernacular approach to informed consent specifically, and research ethics more broadly. We contend that ethics procedures and frameworks need to become more agile, decolonial, pluralised and vernacularised to enable achieving congruence between communities' ideas of social justice and institutional ethics. We argue that global health research can benefit from anthropology's engagement with situated ethics and consent that is relational, negotiated and processual; and accountability that is not only bureaucratic but also constructive. In doing so, we hope to broaden ethical praxis so that the best outcomes that are also just, fair and equitable can be achieved for all stakeholders.


Fabrication and Highly Efficient Dye Removal Characterization of Beta-Cyclodextrin-Based Composite Polymer Fibers by Electrospinning.
Dye wastewater is one of the most important problems to be faced and solved in wastewater treatment. However, the treatment cannot be single and simple adsorption due to the complexity of dye species. In this work, we prepared novel composite fiber adsorbent materials consisting of ε-polycaprolactone (PCL) and beta-cyclodextrin-based polymer (PCD) by electrospinning. The morphological and spectral characterization demonstrated the successful preparation of a series of composite fibers with different mass ratios. The obtained fiber materials have demonstrated remarkable selective adsorption for MB and 4-aminoazobenzene solutions. The addition of a PCD component in composite fibers enhanced the mechanical strength of membranes and changed the adsorption uptake due to the cavity molecular structure via host⁻guest interaction. The dye removal efficiency could reach 24.1 mg/g towards 4-aminoazobenzene. Due to the admirable stability and selectivity adsorption process, the present prepared beta-cyclodextrin-based composite fibers have demonstrated potential large-scale applications in dye uptake and wastewater treatment.


Non-Linear Approach in Kinesiology Should Be Preferred to the Linear--A Case of Basketball.
In kinesiology, medicine, biology and psychology, in which research focus is on dynamical self-organized systems, complex connections exist between variables. Non-linear nature of complex systems has been discussed and explained by the example of non-linear anthropometric predictors of performance in basketball. Previous studies interpreted relations between anthropometric features and measures of effectiveness in basketball by (a) using linear correlation models, and by (b) including all basketball athletes in the same sample of participants regardless of their playing position. In this paper the significance and character of linear and non-linear relations between simple anthropometric predictors (AP) and performance criteria consisting of situation-related measures of effectiveness (SE) in basketball were determined and evaluated. The sample of participants consisted of top-level junior basketball players divided in three groups according to their playing time (8 minutes and more per game) and playing position: guards (N = 42), forwards (N = 26) and centers (N = 40). Linear (general model) and non-linear (general model) regression models were calculated simultaneously and separately for each group. The conclusion is viable: non-linear regressions are frequently superior to linear correlations when interpreting actual association logic among research variables.


Medial approach for popliteal artery injuries.
To evaluate the clinical application of the medial approach for repairing popliteal artery injuries. From 2002 to 2008, 11 cases of popliteal artery injuries had been repaired via the medial approach. Of these cases, 8 had limb fractures, 1 had knee dislocation, and 2 had visceral injuries. Ten popliteal arteries were anastomosed directly while one was repaired with a great saphenous vein graft. The operation time ranged from 3 to 4 hours (averaging 3.6 hours). All the injured limbs survived. At the follow up, 8 legs recovered the full function, 2 had minor contracture, and 1 serious Volkmann's contracture without amputation. The medial approach for repair of the popliteal artery is effective, applicable, and more advantageous to the management of multi-injures.


Computer-generated real-time digital holography: first time use in clinical medical imaging.
Assessment of the feasibility of creating real-time interactive 3D digital holograms in a standard catheterization laboratory. 3D medical images are typically displayed and interacted with on 2D screens limiting their usefulness. A digital computer-generated real-time holographic display of patient's 3D data could provide a spatially accurate image with all the depth cues and afford interaction within the image. We performed a feasibility study of creating real-time interactive 3D digital holograms with a purpose-built prototype using intraprocedural data from 3D rotational angiography and live 3D transesophageal echocardiography. The primary objective was to demonstrate that all the anatomical landmarks identified on standard imaging can be similarly identified using dynamic and static holographic images. The secondary objective was to demonstrate the usability of interactions with the image. Parameters were assessed by a rating scale. Eight patients were enrolled of whom five underwent transcatheter ASD closure using 3DTEE and three patients were evaluated by 3D rotational angiography. In all cases dynamic real-time and static 3D holograms were created in standard cath lab conditions. Four individual observers identified all anatomical landmarks on the holographic display independently from the 2D display. Interactions with the hologram including marking, cropping and rotation were performed. There were no adverse events. This study demonstrates, for the first time, the feasibility of generating high quality, clinically relevant, 3D real-time colour dynamic holograms in a standard clinical setting with real patient volumetric data. The impact of computer-generated holography needs to be evaluated in controlled clinical trials.


Who's in charge of children's environmental health at school?
Children spend many hours each week in and around school buildings. Their short- and long-term health outcomes and ability to learn are affected by numerous environmental factors related to the school buildings, the school grounds, the school transportation system, and the use of various products and materials in and around the school. Many school buildings are old, and they-and even newer buildings-can contain multiple environmental health hazards. While some districts self-report they have environmental health policies in place, no independent verification of these policies or their quality exists. Teachers and other staff, but not children who are more vulnerable to hazards than adults, are afforded some protections from hazards by Occupational Safety and Health Administration (OSHA) regulations, by their employment contracts, or through adult occupational health services. Major environmental problems include: indoor air quality, lighting, pests and pesticides, heavy metals and chemical management issues, renovation of occupied buildings, noise, and cleaning processes and products. No agency at the federal or state levels is charged with ensuring children's health and safety in and around school buildings. No systematic means exists for collecting data about exposures which occur in the school setting. Recommendations are made for dealing with issues of data collection, federal actions, state and local actions, and for building the capacity of the Environmental Protection Agency and the Centers for Disease Control and Prevention-designated and funded Pediatric Environmental Health Specialty Units (PEHSU) in responding to and evaluating risks to children's environmental health in schools.


Age-related striatal dopaminergic denervation and severity of a slip perturbation.
Striatal dopamine activity declines with normal aging. Age-related striatal dopaminergic denervation (SDD) has been implicated in standing balance and unperturbed gait. The goal of this study was to analyze the association between the degree of SDD and the magnitude of an unexpected slip perturbation induced during gait. Fifty healthy participants aged 20-86 years old underwent dopamine transporter positron emission tomography to classify SDD severity as mild, moderate, or severe. Participants also walked on a floor that was unexpectedly contaminated with a glycerol solution for gait testing. The magnitude of a slip was quantified using the peak slip velocity (PSV), measured at the slipping foot. Data were analyzed for both fast (greater than 1.2 m/s) and slow walkers as gait speed correlated with slip severity. All data analyses were age adjusted. Greater severity of dopaminergic denervation in the caudate nucleus was correlated with higher PSV (p < .01) but only in the fast speed walking group. The relationship between SDD in the putamen and slip severity was not statistically significant in fast and slow walkers. Age-related SDD may impact the ability to recover from large perturbations during walking in individuals who typically walk fast. This effect, prominent in the caudate nucleus, may implicate a role of cognitive frontostriatal pathways in the executive control of gait when balance is challenged by large perturbations. Finally, a cautious gait behavior present in slow walkers may explain the apparent lack of involvement of striatal dopaminergic pathways in postural responses to slips.


Entanglement percolation in quantum complex networks.
Quantum networks are essential to quantum information distributed applications, and communicating over them is a key challenge. Complex networks have rich and intriguing properties, which are as yet unexplored in the quantum setting. Here, we study the effect of entanglement percolation as a means to establish long-distance entanglement between arbitrary nodes of quantum complex networks. We develop a theory to analytically study random graphs with arbitrary degree distribution and give exact results for some models. Our findings are in good agreement with numerical simulations and show that the proposed quantum strategies enhance the percolation threshold substantially. Simulations also show a clear enhancement in small-world and other real-world networks.


Comparison of continuous-wave and pulsed Doppler S/D ratios of umbilical and uterine arteries.
Continuous-wave and pulsed Doppler ultrasound measurements of blood flow velocity waveforms of both uterine and umbilical arteries were performed on 85 patients to assess the correlation between these two measurements techniques. Peak systolic to end-diastolic (S/D) ratios measured by continuous-wave devices were not statistically different (P greater than .05) from those measured by a pulsed Doppler device. The S/D ratios of the umbilical artery measured by each device showed a strong correlation, whether measured by one observer (r = 0.93) or two observers (r = 0.89). Uterine artery ratios showed a weaker, although still significant, correlation (r = 0.57). Pulsed Doppler is not routinely necessary for the identification and measurement of umbilical and uterine artery S/D ratios.


The spatiotemporal relationships between chondroitin sulfate proteoglycans and terminations of calcitonin gene related peptide and parvalbumin immunoreactive afferents in the spinal cord of mouse embryos.
Chondroitin sulfate (CS) proteoglycans (PGs) are a family of complex molecules in the extracellular matrix and cell surface that regulate axon growth and guidance during development of the central nervous system. In this study, the expression of CSPGs was investigated in the mouse spinal cord at late embryonic and neonatal stages using CS-56 antibody. CS immunoreactivity was observed abundantly in ventral regions of spinal cord of embryonic day (E) 15 embryos. At E16 to E18, CS expression spread dorsally, but never reached the superficial layers of the dorsal horn. This pattern was maintained until postnatal day 4, the latest stage examined. Antibodies against calcitonin gene related peptide (CGRP) and parvalbumin (PV) were employed to label primary afferents from nociceptors and proprioceptors, respectively. CGRP-immunoreactive fibers terminated in the superficial regions of the dorsal horn where CSPGs were weakly expressed, whereas PV-immunoreactive fibers were found in CSPG-rich regions in the ventral horn. Therefore, we conclude that CS expression is spatiotemporally regulated in the spinal cord, which correlates to the termination of sensory afferents. This pattern suggests a role of CSPGs on patterning afferents in the spinal cord, probably through a differential response of axons to these growth inhibitory molecules.


Blood culture in the first 6 months of life for the diagnosis of vertically transmitted human immunodeficiency virus infection. The Women and Infants Transmission Study Group.
Serial blood cultures over the first 6 months of life in 310 infants with vertical exposure to human immunodeficiency virus (HIV) in the Women and Infants Transmission Study were analyzed to determine their value for early diagnosis of HIV infection. Cultures were done at 0-7 days and 1, 2, 4, and 6 months of age: 55 infants were infected. Blood culture sensitivity in infected children was 24% (7/29) during the first week of life and 85%, 91%, 82%, and 88%, respectively, at 1, 2, 4, and 6 months. The sensitivity, specificity, and positive and negative predictive values of a single culture between 1 and 6 months of age were, respectively, 86.9%, 99.6%, 97.9%, and 97.5%. Two negative cultures between 1 and 6 months of age defined an uninfected infant with a specificity of 99.2%-100.0%. Blood culture done between 1 and 6 months of age in children of HIV-positive mothers is a sensitive and specific test for HIV infection, with high positive and negative predictive values.


Coronal plane trunk asymmetry is associated with whole-body sagittal alignment in healthy young adolescents before pubertal peak growth.
To investigate coronal plane trunk asymmetry (TA) and its association with sagittal postural alignment in healthy subjects before pubertal peak growth. In this cross-sectional baseline study, 1190 healthy pre-peak growth velocity subjects were included. Coronal plane TA was evaluated using back surface topography. Whole-body sagittal alignment (previously validated and objectively classified as neutral, sway-back or leaning-forward) and sagittal spinopelvic profile (trunk lean, lumbar lordosis, thoracic kyphosis, sacral inclination and length of the posteriorly inclined thoracolumbar segment) were determined, as were height, proportion of trunk to body length, body mass index, generalized joint laxity, and handedness. Logistic regression analysis yielded overall sagittal posture class to be independently associated with coronal plane TA: having a leaning-forward posture associated with a nearly three times higher odds of coronal TA (p < 0.001) compared to neutrals. A sway-back was 2.2 times more likely to show TA (p = 0.016) than a neutral, yet only in boys. Significant associations with coronal TA were also found for trunk lean, thoracic kyphosis and body mass index. These correlations, however, were gender and posture class specific. The spinal region where asymmetry is seen, varies according to the whole-body sagittal alignment type: primary thoracic curves were the most frequent in leaning-forwards, whereas primary curves in the lumbar or declive thoracolumbar segment were the most common in sway-backs. In immature spines without known scoliosis, coronal plane TA is associated with whole-body sagittal alignment. It is more often seen in non-neutral than neutral sagittal posture types. Whether adolescent idiopathic scoliosis is related with postural characteristics before pubertal growth peak, should be addressed in future prospective studies.


DETERMINANTS OF THE INTENTION TO USE TELEMEDICINE: EVIDENCE FROM PRIMARY CARE PHYSICIANS.
While most studies have focused on analyzing the results of telemedicine use, it is crucial to consider the determinants of its use to fully understand the issue. This article aims to provide evidence on the determinants of telemedicine use in clinical practice. The survey targeted a total population of 398 medical professionals from a healthcare institution in Spain. The study sample was formed by the ninety-three primary care physicians who responded. Using an extended Technology Acceptance Model and microdata for the ninety-six physicians, binary logistic regression analysis was carried out. The analysis performed confirmed the model's goodness-of-fit, which allowed 48.1 percent of the dependent variable's variance to be explained. The outcomes revealed that the physicians at the healthcare institution placed greater importance on telemedicine's potential to reduce costs, and on its usefulness to the medical profession. The perception of medical information security and confidentiality and the patients' predisposition toward telemedicine were the second explanatory factors in order of importance. A third set of moderating effects would appear to corroborate the importance of the physicians' own opinions. These results have revealed the need for a dynamic approach to the design of telemedicine use, especially when it targets a variety of end-users. Hence, the importance of conducting studies before using telemedicine, and attempting to identify which of the above-mentioned predictors exert an influence and how.


Azo compounds in colon-specific drug delivery.
Azo compounds have the potential to act as drug carriers that facilitate the selective release of therapeutic agents to the colon, and also to effect the oral administration of those macromolecular drugs that require colon-specific drug delivery. With some further research-driven refinements, these materials may lead to more efficient treatments for local conditions, such as colonic cancer or inflammatory bowel disease. This article provides an overview of the azo-based systems developed to date, identifies the requirements for an ideal carrier, and highlights the directions for further developments in the field of azo group-facilitated colonic delivery.


Characteristic Scent from the Tahitian Liverwort, Cyathodium foetidissimum.
The volatile components of the Tahitian liverwort Cyathodium foetidissimum was analyzed using headspace solid phase micro-extraction (SPME) and GC-MS. Three volatile components, 4-methoxystyrene (24.4%), 3,4-dimethoxystyrene (28.7%), and skatole (15.9%) were identified as the major components from the fresh C. foetidissimum, along with several aliphatic aldehydes, n-octanal, n-nonanal, and n-decanal. However, (E)-2-nonenal recognized as aged malodor was not identified. In GC-O analysis, 2-aminoacetophenone was detected as one of the minor components with a strong aging note. In fact, C. foetidissimum showed the characteristic aging odor reminiscent the damp smell from old chest of drawers, or the civet like note with very strong feces and urine odor. The mixture consisted of 4-methoxystyrene, 3,4-dimethoxystyrene, and skatole in the detected ratio showed the sedative effect on CNV (contingent negative variation) measurement.


Tempol, a superoxide dismutase-mimetic drug, prevents chronic ischemic renal injury in two-kidney, one-clip hypertensive rats.
Tempol, a superoxide dismutase-mimetic drug, has been shown to attenuate radical-induced damage, exerting beneficial effects in the animal models of oxidative stress and hypertension. This study evaluated the effect of Tempol on renal structural and functional alterations in two-Kidney, one-Clip hypertensive rats. In this study, young male Wistar rats had the left kidney clipped (2K1C), and sham-operated animals (Sham) were used as controls. Animals received Tempol (1mmol/L in drinking water) or vehicle for 5 weeks. Systolic blood pressure was evaluated once a week. At the end of the experimental protocol, the animals were placed in metabolic cages to collect urine (24h) and then anesthetized with thiopental (70mg/kg i.p.) to collect blood by puncturing the descending aorta for biochemical analysis, and the clipped kidney for morphological and immunohistochemical analyses. The vasodilator effect of Tempol was evaluated in mesenteric arterial bed (MAB) isolated from adult Wistar rats. The chronic treatment with Tempol prevented the development of hypertension and the increased plasma levels of urea, creatinine, and 8-isoprostane in 2K1C animals. Tempol also improved both glomeruli number and kidney volume to normal levels in the 2K1C+Tempol group. In addition, the treatment prevented the increased collagen deposition and immunostaining for renin, caspase-3, and 8-isoprostane in the stenotic kidney of 2K1C animals. Moreover, Tempol induced a dose-dependent vasodilator response in MAB from Wistar rats. These results suggest that Tempol protects the stenotic kidney against chronic ischemic renal injury and prevents renal dysfunction in the 2K1C model, probably through its antioxidant, vasodilator and antihypertensive actions.


Localized Connectivity in Obsessive-Compulsive Disorder: An Investigation Combining Univariate and Multivariate Pattern Analyses.
Recent developments in psychoradiological researches have highlighted the disrupted organization of large-scale functional brain networks in obsessive-compulsive disorder (OCD). However, whether abnormal activation of localized brain areas would affect network dysfunction remains to be fully characterized. We applied both univariate analysis and multivariate pattern analysis (MVPA) approaches to investigate the abnormalities of regional homogeneity (ReHo), an index to measure the localized connectivity, in 88 medication-free patients with OCD and 88 healthy control subjects (HCS). Resting-state functional magnetic resonance imaging (RS-fMRI) data of all the participants were acquired in a 3.0-T scanner. First, we adopted a traditional univariate analysis to explore ReHo alterations between the patient group and the control group. Subsequently, we utilized a support vector machine (SVM) to examine whether ReHo could be further used to differentiate patients with OCD from HCS at the individual level. Relative to HCS, OCD patients showed lower ReHo in the bilateral cerebellum and higher ReHo in the bilateral superior frontal gyri (SFG), right inferior parietal gyrus (IPG), and precuneus [P < 0.05, family-wise error (FWE) correction]. ReHo value in the left SFG positively correlated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score (r = 0 0.241, P = 0.024) and obsessive subscale (r = 0.224, P = 0.036). The SVM classification regarding ReHo yielded an accuracy of 78.98% (sensitivity = 78.41%, specificity = 79.55%) with P < 0.001 after permutation testing. The most discriminative regions contributing to the SVM classification were mainly located in the frontal, temporal, and parietal regions as well as in the cerebellum while the right orbital frontal cortex was identified with the highest discriminative power. Our findings not only suggested that the localized activation disequilibrium between the prefrontal cortex (PFC) and the cerebellum appeared to be associated with the pathophysiology of OCD but also indicated the translational role of the localized connectivity as a potential discriminative pattern to detect OCD at the individual level.


Identification of leachables observed in the size exclusion chromatograms of a low concentration product stored in prefilled syringes.
Requisite leachables testing of pharmaceutical products is commonly conducted with pre-defined analytical methods on a subset of materials intended to be representative of the marketed product. Throughout product development, leachables may occasionally be detected in other methods not specifically intended for monitoring such impurities. We have identified two leachables, ethyl 4-ethoxybenzoate (E4E) and 2,6-di(t-butyl)-4-hydroxy-4-methyl-2,5-cyclohexadien-1-one (BHT-OH) in a low concentration product stored in prefilled syringes (PFS). The leachables were initially detected by size exclusion chromatography (SEC) as late-eluting impurity peaks. Syringe component extraction studies indicated that the impurities were related to the syringe stoppers. Positive identification of E4E was accomplished by reversed phase liquid chromatography- tandem mass spectrometry (RPLC-MS/MS). Positive identification of BHT-OH required RPLC-solid phase extraction-cryoflow NMR (RPLC-SPE-NMR), as initial RPLC-MS/MS investigations were unsuccessful in elucidating the structure. We focus specifically on the efforts required to identify the leachables, and the fortuitous mixed mode separation mechanism and low concentration nature of the product, which were the main factors contributing to the unlikely detection of the leachables by SEC. We note that our investigations were conducted independently of formal leachables and extractables (L&E) studies and we discuss challenges with designing and conducting such studies in a manner that captures the comprehensive L&E profile of a product.


Survival after ovarian granulosa and theca cell tumours.
Ninety-two cases of ovarian granulosa and theca cell tumours were recorded in the Tayside Gynaecological Tumour Registry during the 30 year period 1948-78. A high follow-up rate was achieved through this centralised registry and exhaustive annual recall. At 20 years after initial treatment patient actuarial survival was 92% for the theca cell tumours and 34% for granulosa cell tumours.


[Hemolytic-uremic syndrome with renal thrombotic microangiopathy].
Hemolytic-uremic syndrome (HUS) is characterized by intravascular hemolytic anemia with fragmented erythrocytes and thrombocytopenia, acute renal failure, and glomerular/arteriolar fibrin deposition. Most childhood HUS are postdiarrheal (enterocolitic) while adult HUS have various causes, such as shigellosis, pregnancy, malignant hypertension, AIDS, antineoplastic chemotherapy and organ transplantation. Disorders of endothelial hemostatic functions, induced in some cases by bacterial toxins, may have a role in the onset of microthromboses. HUS treatments are both supportive, including antihypertensive drugs and dialysis, and antithrombotic, including plasma infusions or plasma exchanges and antiplatelet agents.