Laparoscopic pelvic lymphnodes dissection for prostate and bladder cancer: indication, techniques and results.
Laparoscopic pelvic lymphadenectomy has been proposed for staging of prostate cancer and it might be used, in selected cases, also in bladder cancer. On a total of 31 laparoscopic lymphadenectomies (LPND), 18 for prostate cancer and 13 for bladder cancer, we found positive nodes in 8 cases (26.1%), 4 in prostate and 4 in bladder cancer group. We had no intraoperative complications and negligible postoperative complications (in 10% of cases shoulder-tip pain and in 24% subcutaneous emphysema); all these spontaneously disappeared after 24-36 hours. Patients with negative nodes underwent radical surgery except two prostate cancer patients who underwent radiotherapy, and patients with positive nodes underwent hormonal therapy (for prostate cancer) or chemoradiotherapy protocol (for bladder cancer). In conclusion, laparoscopic lymphadenectomy proved to be a feasible and safe method for staging urological malignancies, being less invasive, with shorter hospitalization and postoperative convalescence than open lymphadenectomy. It should be mainly indicated in high risk prostate cancer patients (elevated PSA and/or Gleason score). In bladder cancer patients, it could be proposed in bladder sparing investigational protocols, as the percentage of pelvic nodes metastases in T2/T3 bladder cancer is sufficiently high to justify an additional staging procedure.


Magnetic resonance- and ultrasound imaging-based elasticity imaging methods: a review.
Elasticity imaging methods aim at measuring the mechanical behavior of soft tissues by using medical imaging modalities, such as ultrasonography or magnetic resonance imaging. The initial motivation behind these techniques, and still the main one, is the need for new diagnostic tools based on the visualization of tissue stiffness. Recent developments have demonstrated the potential that elasticity imaging methods can offer in new fields other than direct medical diagnosis, such as the field of in vivo biomechanical characterization. After a short description of the general principles behind elasticity imaging, this review illustrates some of the most original clinical applications. The use of elastography for quantitative mechanical characterization is particularly emphasized, and original applications of these methods to several biomedical research fields are reviewed.


Drip bloodstain appearance on inclined apparel fabrics: Effect of prior-laundering, fibre content and fabric structure.
The interaction of blood and fabrics is currently a 'hot topic', since the understanding and interpretation of these stains is still in its infancy. A recent simplified perpendicular impact experimental programme considering bloodstains generated on fabrics laid the foundations for understanding more complex scenarios. Blood rarely impacts apparel fabrics perpendicular; therefore a systematic study was conducted to characterise the appearance of drip stains on inclined fabrics. The final drip stain appearance for 45° and 15° impact angles on torso apparel fabrics (100% cotton plain woven, 100% polyester plain woven, a blend of polyester and cotton plain woven and 100% cotton single jersey knit) that had been laundered for six, 26 and 52 cycles prior to testing was investigated. The relationship between drop parameters (height and volume), angle and the stain characteristics (parent stain area, axis 1 and 2 and number of satellite stains) for each fabric was examined using analysis of variance. The appearance of the drip stains on these fabrics was distorted, in comparison to drip stains on hard-smooth surface. Examining the parent stain allowed for classification of stains occurring at an angle, however the same could not be said for the satellite stains produced. All of the dried stains visible on the surface of the fabric were larger than just after the impacting event, indicating within fabric spreading of blood due to capillary force (wicking). The cotton-containing fabrics spread the blood within the fabrics in all directions along the stain's circumference, while spreading within the polyester plain woven fabric occurred in only the weft (width of the fabric) and warp (length) directions. Laundering affected the formation of bloodstain on the blend plain woven fabric at both impact angles, although not all characteristics were significantly affected for the three impact conditions considered. The bloodstain characteristics varied due to the fibre content and fabric structure for both impact angles investigated. It is therefore necessary to consider the age of the fabric (which is fabric specific), the fibre type (including blends) and the fabric structure, before interpreting bloodstain patterns. An understanding of this simplified inclined drip stain interaction has been investigated to generate a basis for more complex interactions, such as spatter bloodstains.


Hepatitis in clinical practice. 2. Non-A non-B and delta hepatitis.
Non-A non-B (NANB) hepatitis has at least two distinct causative agents. NANB hepatitis can lead to chronic liver disease, cirrhosis, and hepatocellular carcinoma. No definitive policy exists to exclude this disease as a cause of posttransfusion hepatitis. Delta agent is epidemiologically linked to hepatitis B virus (HBV) infection, either as a coinfection or as a superinfection in chronic hepatitis B surface antigen carriers. Recognition of hepatitis due to delta agent will probably increase as testing for this agent becomes more available and its presence becomes more generally well known throughout the medical profession.


A three-dimensional water quality modeling approach for exploring the eutrophication responses to load reduction scenarios in Lake Yilong (China).
Lake Yilong in Southwestern China has been under serious eutrophication threat during the past decades; however, the lake water remained clear until sudden sharp increase in Chlorophyll a (Chl a) and turbidity in 2009 without apparent change in external loading levels. To investigate the causes as well as examining the underlying mechanism, a three-dimensional hydrodynamic and water quality model was developed, simulating the flow circulation, pollutant fate and transport, and the interactions between nutrients, phytoplankton and macrophytes. The calibrated and validated model was used to conduct three sets of scenarios for understanding the water quality responses to various load reduction intensities and ecological restoration measures. The results showed that (a) even if the nutrient loads is reduced by as much as 77%, the Chl a concentration decreased only by 50%; and (b) aquatic vegetation has strong interaction with phytoplankton, therefore requiring combined watershed and in-lake management for lake restoration.


Eye and pit size are inversely correlated in crotalinae: Implications for selection pressure relaxation.
Mate, prey, and predator recognition often depend on the integration of information from multiple sensory modalities including visual, auditory, and/or olfactory inputs. In Crotalinae, the eyes sense visible light while the pit organs detect infrared (IR) radiation. Previous studies indicate that there is significant overlap between the eye and pit sensory fields and that both senses are involved in recognition processes. This study investigated the relationships between eye and pit sizes in this taxonomic group as a function of phylogeny and habitat. In view of the fact that pit orientation depends largely on snout shape, pit vipers were grouped as follows: 1) arboreal, 2) terrestrial with rounded snout, and 3) terrestrial with pointed snout. The pit orientations and habitant patterns were fully independent of the Crotalinae phylogenetic tree. The phylogenetic generalized least squares model showed that both eye and pit areas were not of significantly phylogenetic relatedness, implying alternatively a strong effect of adaptation on eye and pit sizes. Negative correlations between relative eye and pit areas in terrestrial (both pointed and rounded snouts) and arboreal species were statistically significant. Our results suggest that the eyes and pits function in a complementary fashion such that selection for IR-perception relaxes selection pressures on the visual system and selection for visual discrimination relaxes selection pressures acting on the IR-system.


Catalytic Carbo- and Aminoboration of Alkenyl Carbonyl Compounds via Five- and Six-Membered Palladacycles.
A palladium(II)-catalyzed alkene difunctionalization reaction has been developed, wherein B2pin2 is used to trap chelation-stabilized alkylpalladium(II) intermediates that are formed upon nucleopalladation. A range of carbon and nitrogen nucleophiles were found to be suitable coupling partners in this transformation, providing moderate to high yields. Both 3-butenoic and 4-pentenoic acid derivatives were reactive substrate classes, affording β,γ- and γ,δ-difunctionalized carboxylic acid derivatives. This work represents a new strategy to synthesize highly functionalized secondary boronates that complements existing methods.


[Doppler ultrasound technique compared to angiography, intraoperative pressure gradients and blood flow measurements in carotid surgery (author's transl)].
Doppler ultrasound technique was used in 32 patients to differentiate between non-signigicant stenosis, significant stenosis and occlusion of the internal carotid artery. The results were then compared to angiographic findings and peroperative pressure gradients and blood flow measurements. The Doppler examinations showed good agreement with the angiograms. Pathologic Doppler results were positively correlated to a high pressure gradient but were not correlated to the internal carotid blood flow. Pre- and postoperatively the Doppler ultrasound examinations increased the diagnostic security, improved the assessment of the hemodynamic significance of a stenosis and made in some cases an angiogram unnecessary.


A self-adhering mesh for inguinal hernia repair: preliminary results of a prospective, multicenter study.
Prosthetic reinforcement is the gold standard treatment for inguinal hernia and reduces the risk of recurrence. Yet up to one-third of patients complain of post-surgical pain due to irritation and inflammation caused by the mesh and the fixation materials. Of these patients, 3-4% will experience severe and disabling chronic pain. We performed a prospective multicenter clinical study of a self-adhering prosthesis, consisting of a lightweight polypropylene mesh (40 g/m²) coated on each side with synthetic glue, to evaluate early postoperative complications and patient outcomes. Between August 2008 and June 2010, 186 patients underwent hernia repair using the Lichtenstein technique and the self-adhering prosthesis. Primary endpoints were the frequency of disabling complications and quality of life (QoL) at 3-month follow-up. Pain, numbness, and groin discomfort were evaluated pre- and postoperatively (1 week, 1 and 3 months) using a visual analogue scale (VAS). Patients' pre- and postoperative QoL were measured using the SF12 questionnaire. Secondary endpoints were number of complications and recurrence rate, use of analgesic drugs, length of hospital stay, delay to return to normal activities, and patient satisfaction. The quality of the self-adhering mesh and its clinical utility were also evaluated by the participating surgeons. A total of 186 patients were enrolled and followed for at least 3 months after inguinal hernia repair. A total of 174 (95%) primary hernias and 12 (5%) recurrent hernias were treated. There were no intraoperative complications, no recurrences, and no repeat interventions performed during the study. The post-surgical complication rate was 4.5%. The mean delay to recover normal physical activity was 4 days. For the primary endpoint of pain, a VAS of zero was reported by 93/184 (50.5%) patients at 1 week, 130/171 (76.0%) patients at 1 month and 119/132 (90.2%) patients at 3 months' follow-up (P < 0.0001). The postoperative SF12 scores showed a significant improvement in patient QoL following surgery (P < 0.0001). Adhesix( ® ) self-adhering mesh for prosthetic reinforcement following inguinal hernia repair is atraumatic and associated with infrequent post-surgical complications or pain, a rapid recovery rate, and a high patient-reported QoL. A longer follow-up is underway to assess the frequency of post-surgical recurrence.


Estimation of cell volume and biomass of penicillium chrysogenum using image analysis.
A methodology for the estimation of biomass for the penicillin fermentation using image analysis is presented. Two regions of hyphae are defined to describe the growth of mycelia during fermentation: (1) the cytoplasmic region, and (2) the degenerated region including large vacuoles. The volume occupied by each of these regions in a fixed volume of sample is estimated from area measurements using image analysis. Areas are converted to volumes by treating the hyphae as solid cylinders with the hyphal diameter as the cylinder diameter. The volumes of the cytoplasmic and degenerated regions are converted into dry weight estimations using hyphal density values available from the literature. The image analysis technique is able to estimate biomass even in the presence of nondissolved solids of a concentration of up to 30 gL(-1). It is shown to estimate successfully concentrations of mycelia from 0.03 to 38 gL(-1). Although the technique has been developed for the penicillin fermentation, it should be applicable to other (nonpellected) fungal fermentations.


Application of assessing care of vulnerable elders-3 quality indicators to patients with advanced dementia and poor prognosis.
To use a formal decision-making strategy to reach clinically appropriate, internally consistent decisions on the application of quality indicators (QIs) to vulnerable elders (VEs) with advanced dementia (AD) or poor prognosis (PP). Using a conceptual model that classifies QIs principally by aim and burden of the care process, 12 clinical experts rated whether each Assessing Care of Vulnerable Elders-3 (ACOVE-3) QI should be applied in evaluating quality of care for older persons with AD or PP. QI exclusions were assessed for each of the 26 conditions and by whether these conditions were mainly medical (e.g., diabetes mellitus), geriatric (e.g., falls), or crosscutting processes of care (e.g., pain management). QI exclusions were also identified for older persons who decided against hospitalization or surgery. Of 392 ACOVE-3 QIs, 140 (36%) were excluded for patients with AD and 135 (34%) for patients with PP; 57% of QIs focusing on medical conditions were excluded from patients with AD and 53% from patients with PP, whereas only 20% of QIs for geriatric conditions were excluded from AD and 15% from PP. All QIs with care processes judged to carry a heavy burden were excluded; 86% of moderate-burden QIs were excluded from AD and 92% from PP. All QIs aimed at long-term goals were excluded; 83% of intermediate-term goal QIs were excluded from AD and 98% from PP. Individuals holding a preference to forgo hospitalization or surgery would be excluded from 7% of potentially applicable QIs. Measurement of quality of care for VEs with AD, PP, and less-aggressive care preferences should include only a subset of the ACOVE-3 QIs, largely those whose burden is light and whose goal is continuity or short-term improvement or prevention.


Evaluation of the ruminant serum chemistry profile.
In general, laboratory tests provide useful information about a patient and aid in making a diagnosis, determining a prognosis, formulating a treatment plan, and monitoring response. The serum chemistry profile, composed of a battery of tests, is readily available to clinicians through in-house testing or veterinary reference and diagnostic laboratories. A chemistry profile allows for evaluation of several body systems and assessment of metabolic, acid-base, or electrolyte disturbances. The first sections of this article introduce concepts important to all laboratory tests, such as sample collection and handling, reference intervals, and quality control. The remainder of the article discusses each of the analytes found on a typical clinical chemistry profile and the interpretation of abnormal results.


Altering pasting characteristics of sweet potato starches through amino acid additives.
This study assessed the effects of amino acid additives, aspartic acid, leucine, lysine, and methionine, on the pasting and thermal characteristics of white- and orange-fleshed Beauregard sweet potato starches. A rapid visco analyzer 3D was used to determine pasting properties. In comparing pasting characteristics, starch from orange-fleshed sweet potato was found to be easier to cook, had a lower potential for retrogradation, and was less stable during heating than the white-fleshed sweet potato starch. The RVA analysis showed that the charged amino acids, aspartic acid and lysine, altered pasting characteristics of the 2 starches more than the neutral amino acids, leucine and methionine. Aspartic acid had similar effects on both starches, making them less stable during cooking and lowering the potential for retrogradation. Lysine, when added to the orange-fleshed sweet potato starch, decreased the breakdown, allowing for more stability during cooking. This study showed that pasting properties of sweet potato starches can be altered by the addition of amino acids.


The effect of a chlorhexidine-containing gel on oral cleanliness and gingival health in young adults.
Students at a vocational school participated in a double-blind, cross-over study to test the effect of brushing with a 1% chlorhexidine-containing gel once a day. In the control period, a placebo gel was used. Each treatment period lasted for 4 weeks. This was subsequently followed by 4 weeks of ordinary toothbrushing. Any toothbrushing additional to the therapeutic brushing was performed with a standard commercial dentifrice without abrasives. In addition to the treatment groups, containing a total of 24 subjects, another group of 12 subjects received standardized oral hygiene instruction. Oral hygiene and gingival condition were assessed in all groups throughout the study. The chlorhexidine-containing gel seemed to have no effect on gingivitis and only a slight inhibitory effect on plaque formation. Furthermore, an increase in the degree and frequency of staining of the tooth surfaces related to the use of active gel were observed.


Carbonylation of myofibrillar proteins through the maillard pathway: effect of reducing sugars and reaction temperature.
Carbonylation is recognized as one of the most remarkable chemical modifications in oxidized proteins and is generally ascribed to the direct attack of free radicals to basic amino acid residues. The purpose of this work was to investigate the formation of specific carbonyls, α-aminoadipic and γ-glutamic semialdehydes (AAS and GGS, respectively), in myofibrillar proteins (MP) through a Maillard-type pathway in the presence of reducing sugars. The present study confirmed the concurrent formation of protein carbonyls and advanced glycation end-products (AGEs) during incubation (80 °C/48 h) of MP (4 mg/mL) in the presence of reducing sugars (0.5 M). Copper irons (10 μM) were found to promote the formation of protein carbonyls, and a specific inhibitor of the Maillard reaction (0.02 M pyridoxamine) blocked the carbonylation process which emphasize the occurrence of a Maillard-type pathway. The Maillard-mediated carbonylation occurred in a range of reducing sugars (0.02-0.5 M) and reaction temperatures (4-110 °C) compatible with food systems. Upcoming studies on this topic may contribute further to shed light on the complex interactions between protein oxidation and the Maillard reaction and the impact of the protein damage on food quality and human health.


Robotic Navigational Bronchoscopy Combined with Needle-Based Confocal Laser Endomicroscopy: Case Report of a Novel Approach to Diagnose Small Lung Nodules.
Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer-related death. Advancements in navigational bronchoscopy have shown encouraging results but the diagnostic yield of small lung nodules by bronchoscopic techniques is still below that of transthoracic needle aspiration. The development of robotic bronchoscopy has demonstrated a significantly improved navigational success but the diagnostic yield is regularly limited by near-miss of the target nodule. Needle-based confocal laser endomicroscopy is a novel imaging technique that allows for the real-time visualization of individual cells and structures with microscopic resolution at the tip of the needle. We present the first reported case of confocal laser endomicroscopy guided robotic bronchoscopy for the real-time diagnosis of a small, partially cystic lung nodule.


VSV-G Viral Envelope Glycoprotein Prepared from Pichia pastoris Enhances Transfection of DNA into Animal Cells.
Vesicular stomatitis virus G glycoprotein (VSV-G) has been widely used for pseudotyping retroviral, lentiviral, and artificial viral vectors. The objective of this study was to establish a potential approach for large-scale production of VSV-G. To this end, VSV-G was cloned with an N-terminal His-tag into Pichia pastoris expression vector pPIC3.5K. Three clones (Muts) containing the VSV-G expression cassette were identified by PCR. All clones proliferated normally in expansion medium, whereas the proliferation was reduced significantly under induction conditions. VSV-G protein was detected in cell lysates by western blot analysis, and the highest expression level was observed at 96 h post induction. VSV-G could also be obtained from the condition medium of yeast protoplasts. Furthermore, VSV-G could be incorporated into Ad293 cells and was able to induce cell fusion, leading to the transfer of cytoplasmic protein. Finally, VSV-G-mediated DNA transfection was assayed by flow cytometry and luciferase measurement. Incubation of VSV-G lysate with the pGL3-control DNA complex increased the luciferase activity in Ad293 and HeLa cells by about 3-fold. Likewise, incubation of VSV-G lysate with the pCMV-DsRed DNA complex improved the transfection efficiency into Ad293 by 10% and into HeLa cells by about 1-fold. In conclusion, these results demonstrate that VSV-G could be produced from P. pastoris with biofunctionalities, demonstrating that large-scale production of the viral glycoprotein is feasible.


Nanoparticle-Based Magnetic Resonance Imaging on Tumor-Associated Macrophages and Inflammation.
The inflammatory response, mediated by tissue-resident or newly recruited macrophages, is an underlying pathophysiological condition for many diseases, including diabetes, obesity, neurodegeneration, atherosclerosis, and cancer. Paradoxically, inflammation is a double-edged sword in oncology. Macrophages are, generally speaking, the major drivers of inflammatory insult. For many solid tumors, high density of cells expressing macrophage-associated markers have generally been found in association with a poor clinical outcome, characterized by inflamed microenvironment, a high level of dissemination and resistance to conventional chemotherapies. On another hand, radiation treatment also triggers an inflammatory response in tumors (often referred to as pseudoprogression), which can be associated with a positive treatment response. As such, non-invasive imaging of cancer inflammation and tumor-associated macrophages (TAMs) provides a revolutionary diagnostic tool and monitoring strategy for anti-inflammatory, immuno- and radiotherapies. Recently, quantitative T2-weighted magnetic resonance imaging (qT2wMRI), using injection of superparamagnetic iron oxide nanoparticles (SPIONs), has been reported for the assessment of TAMs non-invasively in animal models and in human trials. The SPIONs are magnetic resonance imaging (MRI) contrast agents that significantly decrease T2 MR relaxation times in inflamed tissues due to the macrophage-specific uptake and retention. It has been shown that macrophage-populated tumors and metastases will accumulate iron oxide nanoparticles and decrease T2-relaxation time that will result in a negative (dark) contrast in qT2wMRI. Non-invasive imaging of TAMs using SPION holds a great promise for staging the inflammatory microenvironment of primary and metastatic tumors as well monitoring the treatment response of cancer patients treated with radiation and immunotherapy.


Screening of highly informative and representative microsatellite markers for genotyping of major cultivated cotton varieties.
We screened and assessed published cotton simple sequence repeat (SSR) primers to establish a set of core SSR markers suitable for cotton major cultivars in China and analyzed genetic diversity based on the core marker set. Using a stepwise screening strategy, 12 leading cultivars for preliminary screening and 96 cultivars for rescreening were evaluated. A total of 184 polymorphic SSR markers were initially screened from 3299 candidates, and a core set of 52 SSR markers with wide genome coverage (2 markers per chromosome) was obtained. Among 96 major cultivars, 273 amplification genotypes were generated using the core marker set. Polymorphism information content values ranged from 0.28-0.83, with an average value of 0.56. The core SSR marker set detected on denaturing polyacrylamide gel electrophoresis indicated that the band genotype was either a single or double band on conventional cultivars, while most were double bands (65.4%). Among 56 hybrids, the average heterozygosis rate was 35.8%, ranging from 7.1-55.4%. Eighteen of 96 cultivars had distinct band genotypes. The genetic diversity analyzed using the of NTSYS-pc V2.10 software indicated that the Yangtze River valley cotton region had the highest polymorphic level, followed by Xinjiang and then the Yellow River valley. The genetic basis of conventional cultivars was narrower than that of hybrids. The core marker set can be used for fingerprint construction, variety identification, and purity tests of major cotton cultivars in China.


Effect of pore size on in vitro cartilage formation using chitosan-based hyaluronic acid hybrid polymer fibers.
In this study, we successfully developed three-dimensional scaffolds fabricated from the chitosan-based hyaluronic acid hybrid polymer fibers, which can control the porous structure. To determine the adequate pore size for enhancing the chondrogenesis of cultured cells, we compared the behaviors of rabbit chondrocytes in scaffolds comprising different pore sizes (100, 200, and 400 microm pore size). Regarding the cell proliferation, there was no significant difference among the three groups. On the other hand, glycosaminoglycan contents in the 400 microm group significantly increased during the culture period, compared with those in the other groups. The ratio of type II to type I collagen mRNA level was also significantly higher in the 400 microm group than in the other groups. These results indicate that our scaffold with 400 microm pore size significantly enhances the extracellular matrix synthesis by chondrocytes. Additionally, the current scaffolds showed high mechanical properties, compared with liquid and gel materials. The data derived from this study suggest great promise for the future of a novel fabricated material with relatively large pore size as a scaffold for cartilage regeneration. The biological and mechanical advantages presented here will make it possible to apply our scaffold to relatively wide cartilaginous lesions.


Craniometric and Aesthetic Outcomes in Craniosynostosis Surgery: A Systematic Review and Meta-Analysis.
To systematically review the published comparative aesthetic outcomes, and its determinants, for craniosynostoses surgically treated by minimally-invasive cranial procedures and open cranial vault remodeling (CVR). PRISMA-compliant systematic review. Not-applicable. Articles were included if they compared spring cranioplasty, strip minimally-invasive craniectomy or CVR for outcomes related to aesthetics or head shape. Forty-two studies were included, comprising 2402 patients. None. The craniometric and PROM used to determine surgical outcomes. Twenty-five studies (59%) evaluated sagittal craniosynostosis, with metopic (7;17%) and unicoronal (4;10%) the next most prevalent. Thirty-eight studies (90%) included CVR, 24 (57%) included strip craniectomy with helmeting, 9 (22%) included strip craniectomy without helmeting, 11 (26%) included spring cranioplasty, and 3 (7%) included vault distraction. A majority of studies only used 1 (43%) or 2 (14%) craniometric measures to compare techniques. In sagittal synostosis, 13 (59%) studies showed no difference in craniometric outcomes, 5 (23%) showed better results with CVR, 3 (14%) with strip craniectomy, and 1 (5%) with springs. In studies describing other synostoses, 10/14 (71%) were equivocal. Subjective outcome measures followed similar trends. Meta-analysis shows no significant difference in cranial index (CI) outcomes between CVR and less invasive procedures in patients with sagittal synostosis. There is no difference in CI outcomes between CVR and less invasive procedures. The majority of literature comparing craniometric and aesthetic outcomes between CVR and less invasive procedures shows equivocal results for sagittal synostosis. However, the heterogeneity of data for other craniosynostoses did not allow meta-analysis.


Integrating mitochondrial energetics, redox and ROS metabolic networks: a two-compartment model.
To understand the mechanisms involved in the control and regulation of mitochondrial reactive oxygen species (ROS) levels, a two-compartment computational mitochondrial energetic-redox (ME-R) model accounting for energetic, redox, and ROS metabolisms is presented. The ME-R model incorporates four main redox couples (NADH/NAD(+), NADPH/NADP(+), GSH/GSSG, Trx(SH)(2)/TrxSS). Scavenging systems-glutathione, thioredoxin, superoxide dismutase, catalase-are distributed in mitochondrial matrix and extra-matrix compartments, and transport between compartments of ROS species (superoxide: O(2)(⋅-), hydrogen peroxide: H(2)O(2)), and GSH is also taken into account. Model simulations are compared with experimental data obtained from isolated heart mitochondria. The ME-R model is able to simulate: i), the shape and order of magnitude of H(2)O(2) emission and dose-response kinetics observed after treatment with inhibitors of the GSH or Trx scavenging systems and ii), steady and transient behavior of ΔΨ(m) and NADH after single or repetitive pulses of substrate- or uncoupler-elicited energetic-redox transitions. The dynamics of the redox environment in both compartments is analyzed with the model following substrate addition. The ME-R model represents a useful computational tool for exploring ROS dynamics, the role of compartmentation in the modulation of the redox environment, and how redox regulation participates in the control of mitochondrial function.


A Study on the Correlation Between the Body Mass Index (BMI), the Body Fat Percentage, the Handgrip Strength and the Handgrip Endurance in Underweight, Normal Weight and Overweight Adolescents.
The handgrip strength and endurance have evolved as an important tool for the assessment of the nutritional status and as a marker of the muscle quality. In underweight as well as overweight individuals, there is the possibility of a change in the muscle quality. So, we undertook this study to find out the correlation between the BMI, the Body Fat percentage and the Hand grip strength and endurance. One hundered eighty students in three BMI ranges-underweight (BMI≤ 18.49), normal weight (BMI- 18.5- 24.99) and overweight (25-29.99) were included according to the WHO guidelines. The body fat percentage was measured by using a bioelectric impedance. The handgrip strength and the handgrip endurance were recorded by using an INCO handgrip dynamometer. The statistical correlation was done by using ANOVA. In males, the handgrip endurance was better in normal weight individuals, but among the females, the underweight females had a better handgrip endurance, but the difference was statistically insignificant (p>0.05). In both males and females, there was a statistically significant difference in the handgrip endurance, with the maximum grip endurance in the normal weight group and the minimum grip endurance in the overweight group (p< 0.05). The correlation between the BMI, the body fat percentage and the handgrip endurance was complex and different for males and females. The underweight and overweight groups had a lower grip strength and endurance than the normal weight group in males, but not in females. The correlation was weak and it suggested that on both sides of the normal BMI, the hand grip endurance tended to decrease in males as well as in females. The increase in the body fat percentage might decrease the handgrip endurance but not the handgrip strength.


Allosteric Fine-Tuning of the Binding Pocket Dynamics in the ITK SH2 Domain by a Distal Molecular Switch: An Atomistic Perspective.
Although the regulation of function of proteins by allosteric interactions has been identified in many subcellular processes, molecular switches are also known to induce long-range conformational changes in proteins. A less well understood molecular switch involving cis-trans isomerization of a peptidyl-prolyl bond could induce a conformational change directly to the backbone that is propagated to other parts of the protein. However, these switches are elusive and hard to identify because they are intrinsic to biomolecules that are inherently dynamic. Here, we explore the conformational dynamics and free energy landscape of the SH2 domain of interleukin-2-inducible T-cell or tyrosine kinase (ITK) to fully understand the conformational coupling between the distal cis-trans molecular switch and its binding pocket of the phosphotyrosine motif. We use multiple microsecond-long all-atom molecular dynamics simulations in explicit water for over a total of 60 μs. We show that cis-trans isomerization of the Asn286-Pro287 peptidyl-prolyl bond is directly coupled to the dynamics of the binding pocket of the phosphotyrosine motif, in agreement with previous NMR experiments. Unlike the cis state that is localized and less dynamic in a single free energy basin, the trans state samples two distinct conformations of the binding pocket-one that recognizes the phosphotyrosine motif and the other that is somewhat similar to that of the cis state. The results provide an atomic-level description of a less well understood allosteric regulation by a peptidyl-prolyl cis-trans molecular switch that could aid in the understanding of normal and aberrant subcellular processes and the identification of these elusive molecular switches in other proteins.


A Physician-led Care Redesign Blunts Predictors of Length of Stay after Total Hip and Knee Arthroplasty.
We questioned to what extent traditional predictors of care team burden (via increased length of stay [LOS] after total joint arthroplasty [TJA]) were able to be mitigated through alteration of the care pathway. The impact on LOS of traditional patient risk factors, as well as encounter variables, were analyzed for a consecutive set of patients undergoing surgery before and after a physician-initiated arthroplasty care pathway redesign. We analyzed the impact of these variables on LOS, discharge disposition, and 90-day readmission; separate analyses were performed pre- and post-redesign for LOS. Several patient factors (Risk Assessment and Prediction Tool, body mass index, age, insurance type, smoking) predicted longer LOS in the pre-redesign cohort; post-redesign, only ambulation on the day of surgery and anticoagulation type were predictive. The redesign also lessened the aggregate impact of the patient-specific risk factors, resulting in reduced variation in LOS. Physician leadership of care pathways can reduce the impact of factors that have portended longer LOS, thereby reducing variability in LOS and costs for disparate patient populations while driving improvements in value-based care indices. (Journal of Surgical Orthopaedic Advances 32(2):097-101, 2023).


A 5-year follow-up comparative analysis of the efficacy of various osseointegrated dental implant systems: a systematic review of randomized controlled clinical trials.
To test the null hypothesis that there is no difference in failure rates between various root-formed osseointegrated dental implant systems after 5 years of loading. A search was conducted for all randomized controlled clinical trials (RCTs) comparing different implant systems with a follow-up of 5 years. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, and EMBASE were searched. Several dental journals were also searched by hand. Written contacts were established with authors of the identified RCTs and with more than 55 oral implant manufacturers and personal contacts to identify unpublished RCTs. No language restriction was applied. The last electronic search was conducted on February 1, 2005. Screening of eligible studies, quality assessment, and data extraction were conducted in duplicate. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence intervals. Ten RCTs were identified. Four of these RCTs, reporting results from a total of 204 patients, were considered suitable for inclusion. Six different implant types were compared. On a per-patient rather than a per-implant basis, there were no statistically significant differences, with the exception of more marginal bone loss around early loaded Southern implants when compared to early loaded Steri-Oss implants (mean difference -0.35 mm; 95% CI -0.70 to -0.01). However, the difference disappeared in the meta-analysis. There were no clinical differences among implant systems. However, these findings are based on only 4 RCTs with few participants. More RCTs should be conducted with larger patient samples.


Microfabrication of axicons by glass blowing at a wafer-level.
This Letter reports on the generation of glass-based axicons realized at the wafer level by means of microfabrication. The technique is based on micro glass blowing allowing parallel fabrication of numerous components at a time. Blowing is achieved due to cavities containing a gas that expands when the wafer stack is introduced in a furnace. Such cavities, generated in a silicon wafer and sealed by a bonded glass wafer, act as pistons pushing locally the other side of the glass wafer where the micro-optical component profile emerges. After cavities' removal by polishing, it is shown that such a component produces nondiffracting Bessel beams.


Pd-Catalyzed double N-arylation of primary amines to synthesize phenoxazines and phenothiazines.
An efficient and versatile Pd-catalyzed tandem C-N bond formation between aryl halides and primary amines is developed. The transformation allows a one-pot synthesis of phenoxazine and phenothiazine derivatives with a broad range of substitution patterns from readily available precursors.


The Health and Social Impacts of Easy Access to Alcohol and Exposure to Alcohol Advertisements Among Women of Childbearing Age in Urban and Rural South Africa.
The purpose of this study was to analyze the impact of easy access to alcohol and exposure to alcohol advertisements on women's alcohol consumption, reproductive history, and health and social outcomes in an urban and rural site in South Africa. Trained fieldworkers conducted face-to-face interviews with 1,018 women of childbearing age in the Moot, Mamelodi, and Eesterus areas of the City of Tshwane (Gauteng province) and in the rural Cederberg, Bergrivier, and Swartland municipalities (Western Cape province), recruited through random sampling and stratified cluster random sampling, respectively. Multivariate logistic regression analyses were conducted, stratified according to the urban and rural sites and controlled for four demographic factors. In Tshwane, complications in the last pregnancy (odds ratio [OR] = 7.84, 95% CI [1.77, 34.80]), interpartner binge drinking (OR = 6.50, 95% CI [3.85, 10.94]), and community drinking (OR = 7.92, 95% CI [4.59, 13.65]) were positively associated with alcohol accessibility. Interpartner violence (OR = 4.16, 95% CI [1.99, 8.70]) and community drinking (OR = 3.39, 95% CI [2.07, 5.53]) were positively associated with exposure to alcohol advertisements. In Western Cape, community drinking (OR = 10.26, 95% CI [4.02, 26.20]) was positively associated with alcohol accessibility, whereas ability to pay for health care (OR = 0.48, 95% CI [0.24, 0.96]) was inversely associated. Hazardous drinking on the Alcohol Use Disorders Identification Test (AUDIT; OR = 2.26, 95% CI [1.03, 4.95]) and CAGE (OR = 4.51, 95% CI [1.30, 15.61]), interpartner violence (OR = 1.69, 95% CI [1.04, 2.76]), and community drinking (OR = 3.39, 95% CI [2.07, 5.53]) were positively associated with exposure to alcohol advertisements. Easy access to alcohol and exposure to alcohol advertisements are positively associated with adverse health and social outcomes. Although further studies are needed, these findings lend support to emphasizing upstream policy interventions to limit access to alcohol and advertisements.


[Use of plasmapheresis in therapy of systemic lupus erythematosus: a controlled study].
The effectivity of a combination of various plasma exchange regimens in combination with immunosuppressive medication consisting of corticosteroids and cyclophosphamide was tested in patients with severe systemic lupus erythematosus (SLE) the symptoms of which were found to be refractory to conventional immunosuppressive treatment administered orally. The patients were then submitted in a controlled manner to the following treatment modalities: 1. consecutive plasmapheresis (plasma exchanges every 2 to 3 days during a period of 2 to 3 weeks) with a continuation of immunosuppressive therapy administered orally; 2. chronic intermittent treatment (once per week) with parallel immunosuppression; 3. 2 plasmaphereses followed by an i.v. cyclophosphamide bolus. Only the third approach resulted in a stable and persistent clinical and serological improvement of disease activity.


The use of CrossMAb technology for the generation of bi- and multispecific antibodies.
The major challenge in the generation of bispecific IgG antibodies is enforcement of the correct heavy and light chain association. The correct association of generic light chains can be enabled using immunoglobulin domain crossover, known as CrossMAb technology, which can be combined with approaches enabling correct heavy chain association such as knobs-into-holes (KiH) technology or electrostatic steering. Since its development, this technology has proven to be very versatile, allowing the generation of various bispecific antibody formats, not only heterodimeric/asymmetric bivalent 1+1 CrossMAbs, but also tri- (2+1), tetravalent (2+2) bispecific and multispecific antibodies. Numerous CrossMAbs have been evaluated in preclinical studies, and, so far, 4 different tailor-made bispecific antibodies based on the CrossMAb technology have entered clinical studies. Here, we review the properties and activities of bispecific CrossMAbs and give an overview of the variety of CrossMAb-enabled antibody formats that differ from heterodimeric 1+1 bispecific IgG antibodies.


Measuring inequalities in health from survey data using self-assessed social class.
Asking participants to assess their social class may be an efficient approach to examining inequalities in heath from survey data. The present study investigated this possibility empirically by testing whether subjective class identification is related to overall health. I used pooled cross-sectional data from the 2012 and the 2014 General Social Survey, a nationally representative survey carried out among adults in the United States. The association between health and class was estimated separately by gender, race and age. The association follows a gradient pattern where health deteriorates with lower class position even after controlling for indicators typically used in research that examines class differences in health-educational attainment, family income and occupational prestige. The results largely hold when the data are stratified by gender, race and age. These findings demonstrate the empirical value of subjective class identification for assessing social inequalities in health from survey data.


Functional deficiency of splenic adherent cells in New Zealand black mice.
New Zealand Black (NZB) mice hyporespond after in vitro immunization to sheep erythrocytes but not after in vivo immunization. The difference between in vitro and in vivo immunization was found to involve a non-antigen-specific change in the spleen which occurs in vivo soon after priming. Adherent spleen cells from young NZB or control strain mice were compared in their ability to cooperate with nonadherent cells in the induction of a primary immune response to sheep erythrocytes in vitro. The results support the hypothesis that there is a functional deficiency of adherent cells in the spleens of unprimed NZB mice.


Invasive Listeria monocytogenes Gastroenteritis Leading to Stupor, Bacteremia, Fever, and Diarrhea: A Rare Life-Threatening Condition.
Listeria monocytogenes is a gram-positive, rod-shaped organism that can cause serious infections such as meningitis, invasive gastroenteritis, and endocarditis. Every year 1600 people in the United States are affected, with significant mortality of 260 people annually. Listeria gastroenteritis has the third highest mortality rate among all the food-borne infection. Invasive listeriosis most commonly affect pregnant women, those in extremes of ages, people with comorbid diseases, and people with weakened immune response. In this article, we present a rare case of invasive Listeria gastroenteritis in an 83-year-old female with multiple comorbid conditions and past medical history of type 2 diabetes mellitus and multiple risk factors who was brought to the hospital with altered mental status. She had history of fever, abdominal pain, and watery diarrhea up to 14 episodes in 24 hours for the last 7 days. Her stool culture grew Listeria monocytogenes sensitive to penicillin. She was started on penicillin for 2 weeks. She had subsequently complete resolution of fever, diarrhea, and abdominal pain. High index of suspicion is the key to ensure timely initiation of appropriate empirical treatment in the setting of invasive gastroenteritis, especially in people who have high risk factors for listeriosis. We recommend raising awareness in the health care profession about invasive listeriosis in the need of time. Intravenous ampicillin or penicillin G is the treatment of choice, with meropenem as an alternative.


Respiratory hazards in hard metal workers: a cross sectional study.
A cross sectional study was conducted on 513 employees at three hard metal plants: 425 exposed workers (351 men, 74 women) and 88 controls (69 men, 19 women). Cough and sputum were more frequent in workers engaged in "soft powder" and presintering workshops compared with controls (12.5% and 16.5% v 3.5%). Spirometric abnormalities were more frequent among women in sintering and finishing workshops compared with control women (56.8% v 23.8%) and abnormalities of carbon monoxide test were more frequent in exposed groups than in controls; this difference was more pronounced in women (31.4% v 5.6%) than in men (18.5% v 13%). No significant correlation was observed between duration of exposure and age adjusted lung function tests. Slight abnormalities of chest radiographs (0/1, 1/1 according to ILO classification) were more frequent in exposed men than controls (12.8% v 1.9%) and mostly in soft powder workers. In subjects with abnormal chest radiographs FVC, FEV1 and carbon monoxide indices (fractional uptake of CO or CO transfer index or both) were lower compared with those with normal chest radiographs. Although relatively mild, the clinical, radiological, and functional abnormalities uncovered call for a regular supervision of workers exposed to hard metal dust.


The effect of under-reporting of energy intake on dietary patterns and on the associations between dietary patterns and self-reported chronic disease in women aged 50-69 years.
The aim of this cross-sectional study was to investigate whether under-reporting of energy intake affects derived dietary patterns and the association between dietary patterns and self-reported chronic disease. Diets of 6204 women aged 50-69 years participating in the Norwegian Breast Cancer Screening Program were assessed using a 253-item FFQ. We identified dietary patterns using principal component analysis. According to the revised Goldberg cut-off method, women with a ratio of reported energy intake:estimated BMR<1·10 were classified as low energy reporters (n 1133, 18 %). We examined the associations between dietary patterns and self-reported chronic diseases by log-binomial regression, and the results are presented as prevalence ratios (PR) and CI. 'Prudent', 'Western' and 'Continental' dietary patterns were identified among all reporters and plausible reporters. The PR expressing the associations between the 'Western' and 'Prudent' dietary pattern scores and self-reported chronic diseases were consistently highest among plausible reporters except for joint/muscle/skeletal disorders. The largest difference in PR among plausible v. all reporters was found for the association between the 'Prudent' pattern and diabetes (PR for highest v. lowest tertile: PRall reporters 2·16; 95 % CI 1·50, 3·13; P trend<0·001; PRplausible reporters 2·86; 95 % CI 1·81, 4·51; P trend<0·001). In conclusion, our results suggest that under-reporting can result in systematic error that can affect the association between dietary pattern and disease. In studies of dietary patterns, investigators ought to consider reporting effect estimates both for all individuals and for plausible reporters.


Sorting nexin 10 induces giant vacuoles in mammalian cells.
Eukaryotic cells maintain a sophisticated network of intracellular membranous system to ensure the proper distribution and compartmentalization of cellular proteins critical for diverse functions such as cell division or cell-cell communication. Yet, little is known about the mechanism that regulates the homeostasis of this system. While analyzing the impact of sorting nexins on the trafficking of membrane type matrix metalloproteinases, we unexpectedly discovered that the expression of SNX10 induced the formation of giant vacuoles in mammalian cells. This vacuolizing activity is sensitive to mutations at the putative phosphoinositide 3-phosphate binding residue Arg(53). Domain-swap experiments with SNX3 demonstrate that the PX domain of SNX10 alone is insufficient to generate vacuoles and the downstream C-terminal domain is required for vacuolization. Brefeldin A, a chemical known to block the endoplasmic reticulum to Golgi transport, inhibited the vacuolization process. Together, these results suggest that SNX10 activity may be involved in the regulation of endosome homeostasis.


Distribution of radiolabelled lymph cells in lymph nodes and the migratory properties of blood lymphocytes in sheep.
The results found in this study supported the concept of lymphocyte populations with preferential migratory pathways. Preferential localization of lymphocytes in lymph nodes could not explain the non-random lymphocyte migration patterns observed in sheep. The migration of lymphocytes isolated from the blood was similar to that of lymphocytes in the efferent lymph of a subcutaneous lymph node, but was different from the migration of lymphocytes isolated from efferent intestinal lymph. The subcutaneous lymph node did not need to be selective for lymphocytes which entered from blood. However, there must be a selective entry of a population of lymphocytes with preference for migrating through mesenteric lymph nodes into efferent intestinal lymph in order to observe the differential lymphocyte migration patterns exhibited by the lymphocytes in the efferent intestinal lymph of sheep.


Surprisingly high stability of the Aβ oligomer eliminating all-d-enantiomeric peptide D3 in media simulating the route of orally administered drugs.
The aggregation of the amyloid β protein (Aβ) plays an important role in the pathology of Alzheimer's disease. Previously, we have developed the all-d-enantiomeric peptide D3, which is able to eliminate neurotoxic Aβ oligomers in vitro and improve cognition in a transgenic Alzheimer's disease mouse model in vivo even after oral administration. d-Peptides are expected to be more resistant against enzymatic proteolysis compared to their l-enantiomeric equivalents, and indeed, a pharmacokinetic study with tritiated D3 revealed the oral bioavailability to be about 58%. To further investigate the underlying properties, we examined the stability of D3 in comparison to its corresponding all-l-enantiomeric mirror image l-D3 in media simulating the gastrointestinal tract, blood and liver. Potential metabolization was followed by reversed-phase high-performance liquid chromatography. In simulated gastric fluid, D3 remained almost completely stable (89%) within 24h, while 70% of l-D3 was degraded within the same time period. Notably, in simulated intestinal fluid, D3 also remained stable (96%) for 24h, whereas l-D3 was completely metabolized within seconds. In human plasma and human liver microsomes, l-D3 was metabolized several hundred times faster than D3. The remarkably high stability may explain the high oral bioavailability seen in previous studies allowing oral administration of the drug candidate. Thus, all-d-enantiomeric peptides may represent a promising new compound class for drug development.


Risk Factors of Death in Bloodstream Infections Caused by AmpC β-Lactamase-Producing Enterobacterales in Patients with Neoplasia.
The infections caused by ESCPM Enterobacterales (Enterobacter spp., Serratia spp., Citrobacter spp., Providencia spp. and Morganella spp.) have limited therapeutic options. Patients with neoplastic diseases are particularly vulnerable to bloodstream infections (BSIs). To analyze determinant factors of death in patients with neoplasia complicated with BSI caused by ESCPM Enterobacterales. A cohort study of patients aged 18 years or older with neoplasia and BSI due to ESCPM group was conducted at the Cancer Hospital I of the National Cancer Institute, Brazil, from September 2012 to December 2017. The variables associated with death were analyzed using multivariate logistic regression. Of the 103 patients included in the cohort, 67.0% were male, the median age was 63 years and 67.0% had solid tumors. Of the 107 BSI episodes evaluated, 70.1% were hospital-acquired infections, 54.2% were secondary to extravascular focus of infection, gastrointestinal tract (19.6%), mainly. Enterobacter spp. (n: 49, 45.4%) was the most frequent agent isolated followed by Serratia spp. (n: 34, 31.5%), Morganella morganii (n: 16, 14.9%), Citrobacter freundii. (n: 7, 6.5%) and Providencia spp. (n: 2, 1.8%). Ten (9.3%) BSI episodes were caused by multidrug-resistant ESCPM Enterobacterales (MDR-ESCPM). The 7-day and 30-day mortality were 9.3% and 21.5%, respectively. The BSIs caused by MDR-ESCPM were independently associated with 7-day death (OR = 21.62 95% CI: 1.81-258.51 P = 0.01). Monotherapy with piperacillin-tazobactam tended to be associated with 7-day death (OR = 10.46 95% CI: 0.97-112.91 P = 0.05) and 30-day death (OR = 2.73 95% CI: 0.96-7.70 P = 0.05). BSIs due to ESCPM group have high mortality and when caused by MDR-ESCPM are independently associated with 7-day death. The possible association of piperacillin-tazobactam monotherapy for BSI-ESCPM with death needs to be better studied.


Neonatal screening: current trends and quality control in the United Kingdom.
Neonatal screening for phenylketonuria (PKU) and congenital hypothyroidism (CHT) is universal across the UK using heel prick blood collected at 6-14 days of age. Additional programmes for sickle cell disorders, cystic fibrosis, Duchenne muscular dystrophy and galactosaemia are provided in some areas. The number of inherited metabolic disorders (IMDs) has greatly increased since the introduction of PKU screening, and there have been major advances in treatment, e.g. organ transplantation, drug therapy. Recent developments in technology have expanded the possibilities for screening using the heel prick blood specimen, particularly the application of tandem mass spectrometry. There is a case for introducing tandem mass spectrometry, limited to clearly defined diseases where specificity is adequate and there are satisfactory diagnostic tests. Any change in newborn screening to a much broader group of disorders must be carefully introduced and monitored preferably as a pilot study. A key component of a laboratory screening service is quality control. There are well established UK programmes for PKU and CHT. Consideration of the needs for other disorders is now an important priority.


Induction of the aromatic hydrocarbon receptor by trans-4-acetylaminostilbene in rat liver. Comparison with other aromatic amines.
The effect of the aromatic amines 2-acetylaminofluorene (AAF), 2-acetylaminophenanthrene (AAP) and trans-4-acetylaminostilbene (AAS) on the rat hepatic aromatic hydrocarbon (Ah) receptor level was studied. 3-Methylcholanthrene (MC), as a known receptor ligand, was used as a control. The complete liver carcinogen AAF and MC did not alter significantly the hepatic receptor concentration. In contrast, the strong liver tumor initiator AAS doubled the hepatic Ah receptor level when a dose of 20 mumol/kg was administered for 5 days. AAP increased the amount of the receptor 1.5-fold.


Automatic Gleason grading of prostate cancer using quantitative phase imaging and machine learning.
We present an approach for automatic diagnosis of tissue biopsies. Our methodology consists of a quantitative phase imaging tissue scanner and machine learning algorithms to process these data. We illustrate the performance by automatic Gleason grading of prostate specimens. The imaging system operates on the principle of interferometry and, as a result, reports on the nanoscale architecture of the unlabeled specimen. We use these data to train a random forest classifier to learn textural behaviors of prostate samples and classify each pixel in the image into different classes. Automatic diagnosis results were computed from the segmented regions. By combining morphological features with quantitative information from the glands and stroma, logistic regression was used to discriminate regions with Gleason grade 3 versus grade 4 cancer in prostatectomy tissue. The overall accuracy of this classification derived from a receiver operating curve was 82%, which is in the range of human error when interobserver variability is considered. We anticipate that our approach will provide a clinically objective and quantitative metric for Gleason grading, allowing us to corroborate results across instruments and laboratories and feed the computer algorithms for improved accuracy.


Review: alcohol use and problems among immigrants from the former Soviet Union in Israel.
This paper attempts to deal with multiple issues, provide data, and cover the current state of alcohol use among immigrants from the Former Soviet Union (FSU) in Israel. A comprehensive review of all studies published in the professional literature (mainly in Hebrew), as well as in reports and theses in Hebrew, is presented. This is an attempt to correct the lack of information among English readers about alcohol use patterns and problems in the Russian immigrant community in Israel. This paper is the first summary of findings in the alcohol use domain-epidemiology, treatment, and homelessness in relation to FSU immigrants in Israel. The review identifies alcohol use among recent FSU immigrants as more prevalent than among the Jewish-Israeli-absorbing society, and shows that FSU immigrants are overrepresented in treatment, and that most of the homeless persons in Israel are FSU immigrants and alcoholics. The paper also describes findings from other FSU immigrant studies in related fields such as genetics, workplace issues, pregnancy, emergency rooms and driving. Recommendations for future activities include the need for special analysis and focus on the FSU immigrants in national studies, as well as further investigations about cultural effects on FSU immigrants' drinking habits.


Conformation of a polyelectrolyte complexed to a like-charged colloid.
We report results from a molecular dynamics simulation on the conformations of a long flexible polyelectrolyte complexed to a charged sphere, both negatively charged, in the presence of neutralizing counterions in the strong Coulomb coupling regime. The structure of this complex is very sensitive to the charge density of the polyelectrolyte. For a fully charged polyelectrolyte the polymer forms a dense two-dimensional "disk," whereas for a partially charged polyelectrolyte the monomers are spread over the colloidal surface. A mechanism involving the overcharging of the polyelectrolyte by counterions is proposed to explain the observed conformations.


The role performance of public health nurses as clinical instructors in Japan.
To investigate the factors associated with the role performance of public health nurses as clinical instructors in Japan. Newly graduated public health nurses in Japan have competencies that are below the minimum requirements of the Ministry of Health, Labour and Welfare because of their limited clinical experience in undergraduate clinical education. Public health nurses play crucial roles in the clinical practicum and their role performance as clinical instructors is a key to successful learning outcomes. This study targeted public health nurses in governmental public health centres and those who had gained experience as an undergraduate clinical instructor for nursing students. A self-administered questionnaire was distributed to a national sample of 1467 public health nurses. Data were collected from July 2011 to September 2011. In total, 722 of 1467 questionnaires were completed (nurse age 22-64 years). Of the participants, almost half (49%) strongly disagreed (3%) or disagreed (46%) that they had confidence in their role as a clinical instructor, and preparation programmes for clinical instructors had been attended by just 262 (36.3%). Years of experience as public health nurses, previous attendance of preparation programmes, viewing their role positively, professional identity and professional competency were significantly associated with performance. Logistic regression analysis revealed that nurses with higher role performance scores had higher self-confidence, greater interests in their role and higher professional identity. The self-confidence and interests of public health nurses in their role as clinical instructors as well as their professional identity were found to be significant predictors of their role performance as clinical instructors. The factors identified in our investigation can be used to predict effective clinical instructors and to develop preparation programmes to enhance their confidence and interests and potentially increase their role satisfaction.


Binaural hearing aids: are they dangerous for children?
We report a case in which a child suffered apparently permanent damage to residual hearing due to use of a powerful hearing aid. After review of the literature on damage to residual hearing by powerful hearing aids, we suggest that due caution should be observed in the prescription and monitoring of hearing aid usage for hearing-impaired children. Uncritical advocacy of powerful binaural aids is challenged as a potentially dangerous practice.


Physical Activity Dimensions Associated with Impaired Glucose Metabolism.
Physical activity (PA) is important in the prevention of Type 2 diabetes, yet little is known about the role of specific dimensions of PA, including sedentary time in subgroups at risk for impaired glucose metabolism (IGM). We applied a data-driven decision tool to identify dimensions of PA associated with IGM across age, sex, and body mass index (BMI) groups. This cross-sectional study included 1501 individuals (mean (SD) age, 65.6 (6.8) yr) at high risk for Type 2 diabetes from the ADDITION-PRO study. PA was measured by an individually calibrated combined accelerometer and heart rate monitor worn for 7 d. PA energy expenditure, time spent in different activity intensities, bout duration, and sedentary time were considered determinants of IGM together with age, sex, and BMI. Decision tree analysis was applied to identify subgroup-specific dimensions of PA associated with IGM. IGM was based on oral glucose tolerance test results and defined as a fasting plasma glucose level of ≥6.1 mmol·L and/or a 2-h plasma glucose level of ≥7.8 mmol·L. Among overweight (BMI ≥25 kg·m) men, accumulating less than 30 min·d of moderate-to-vigorous PA was associated with IGM, whereas among overweight women, sedentary time was associated with IGM. Among individuals older than 53 yr with normal weight (BMI <25 kg·m), time spent in light PA was associated with IGM. None of the dimensions of PA were associated with IGM among individuals ≤53 yr of age with normal weight. We identified subgroups in which different activity dimensions were associated with IGM. Methodology and results from this study may suggest a preliminary step toward the goal of tailoring and targeting PA interventions aimed at Type 2 diabetes prevention.


Reducible poly(amido ethylenimine)s designed for triggered intracellular gene delivery.
Poly(amido ethylenimine) polymers, a new type of peptidomimetic polymer, containing multiple disulfide bonds (SS-PAEIs) designed to degrade after delivery of plasmid DNA (pDNA) into the cell were synthesized and investigated as new carriers for triggered intracellular gene delivery. More specifically, three SS-PAEIs were synthesized from Michael addition reactions between cystamine bisacrylamide (CBA) and three different ethylene amine monomers, i.e., ethylenediamine (EDA), diethylenetriamine (DETA), or triethylenetetramine (TETA). Complete addition reactions were confirmed by (1)H NMR. The molecular weight, buffer capacity, and relative degree of branching for each SS-PAEI was determined by gel permeation chromatography (GPC), acid-base titration, and liquid chromatography-mass spectroscopy (LC-MS), respectively. Physicochemical characteristics of polymer/pDNA complexes (polyplexes) were analyzed by gel electrophoresis, particle size, and zeta-potential measurements. All three SS-PAEIs effectively complex pDNA to form nanoparticles with diameters less than 200 nm and positive surface charges of approximately 32 mV. The in vitro gene transfer properties of SS-PAEIs were evaluated using mouse embryonic fibroblast cell (NIH3T3), primary bovine aortic endothelial cell (BAEC), and rat aortic smooth muscle cell (A7R5) lines. Interestingly, polyplexes based on all three SS-PAEIs exhibited remarkably high levels of reporter gene expression with nearly 20x higher transfection efficiency than polyethylenimine 25k. The high transfection efficiency was maintained in the presence of 10% serum in the transfection medium. Furthermore, confocal microscopy experiments using labeled pDNA indicated that polyplexes of SS-PAEI displayed greater intracellular distribution of pDNA as compared to PEI, most likely due to environmentally triggered release. Therefore, SS-PAEIs are a new class of transfection agents that facilitate high gene expression while maintaining a low level of toxicity.


First detection of Aedes japonicus in Spain: an unexpected finding triggered by citizen science.
Aedes japonicus is an invasive vector mosquito from Southeast Asia which has been spreading across central Europe since the year 2000. Unlike the Asian Tiger mosquito (Aedes albopictus) present in Spain since 2004, there has been no record of Ae. japonicus in the country until now. Here, we report the first detection of Ae. japonicus in Spain, at its southernmost location in Europe. This finding was triggered by the citizen science platform Mosquito Alert. In June 2018, a citizen sent a report via the Mosquito Alert app from the municipality of Siero in the Asturias region (NW Spain) containing pictures of a female mosquito compatible with Ae. japonicus. Further information was requested from the participant, who subsequently provided several larvae and adults that could be classified as Ae. japonicus. In July, a field mission confirmed its presence at the original site and in several locations up to 9 km away, suggesting a long-time establishment. The strong media impact in Asturias derived from the discovery raised local participation in the Mosquito Alert project, resulting in further evidence from surrounding areas. Whilst in the laboratory Ae. japonicus is a competent vector for several mosquito-borne pathogens, to date only West Nile virus is a concern based on field evidence. Nonetheless, this virus has yet not been detected in Asturias so the vectorial risk is currently considered low. The opportunity and effectiveness of combining citizen-sourced data to traditional surveillance methods are discussed.


Collagen and heparan sulfate coatings differentially alter cell proliferation and attachment in vitro and in vivo.
Tissue engineering is an innovative field of research applied to treat intestinal diseases. Engineered smooth muscle requires dense smooth muscle tissue and robust vascularization to support contraction. The purpose of this study was to use heparan sulfate (HS) and collagen coatings to increase the attachment of smooth muscle cells (SMCs) to scaffolds and improve their survival after implantation. SMCs grown on biologically coated scaffolds were evaluated for maturity and cell numbers after 2, 4 and 6 weeks in vitro and both 2 and 6 weeks in vivo. Implants were also assessed for vascularization. Collagen-coated scaffolds increased attachment, growth and maturity of SMCs in culture. HS-coated implants increased angiogenesis after 2 weeks, contributing to an increase in SMC survival and growth compared to HS-coated scaffolds grown in vitro. The angiogenic effects of HS may be useful for engineering intestinal smooth muscle.


Hierarchical time-series analysis of dynamic bioprocess systems.
Monoclonal antibodies (mAbs) are leading types of 'blockbuster' biotherapeutics worldwide; they have been successfully used to treat various cancers and chronic inflammatory and autoimmune diseases. Biotherapeutics process development and manufacturing are complicated due to lack of understanding the factors that impact cell productivity and product quality attributes. Understanding complex interactions between cells, media, and process parameters on the molecular level is essential to bring biomanufacturing to the next level. This can be achieved by analyzing cell culture metabolic levels connected to vital process parameters like viable cell density (VCD). However, VCD and metabolic profiles are dynamic parameters and inherently correlated with time, leading to a significant correlation without actual causality. Many time-series methods deal with such issues. However, with metabolic profiling, the number of measured variables vastly exceeds the number of experiments, making most of existing methods ill-suited and hard to interpret. Here we propose an alternative workflow using hierarchical dimension reduction to visualize and interpret the relation between evolution of metabolic profiles and dynamic process parameters. The first step of proposed method is focused on finding predictive relation between metabolic profiles and process parameter at all time points using OPLS regression. For each time point, the p(corr) obtained from OPLS model is considered as a differential metabogram and is further assessed using principal components analysis (PCA). Compared to traditional batch modeling, applying proposed methodology on metabolic data from Chinese Hamster Ovary (CHO) antibody production characterized the dynamic relation between metabolic profiles and critical process parameters.


A Cost-Effective Microfluidic Device to Teach the Principles of Electrophoresis and Electroosmosis.
Electrophoresis is integral to analytical and biochemistry experiences in undergraduate education; however, fundamental principles of the method are often taught in upper-level laboratories through hands-on experiences. A laboratory activity is reported that teaches the concepts of electrophoretic mobility and electroosmotic flow. A single reuseable instrument, called a mini-E, costs 37 USD and consists of a DC power supply, a voltmeter, platinum electrodes, and a chip cast in polydimethylsiloxane. This activity uses common reagents costing only 0.02 USD per student. Experiments are devised that allow students to investigate the properties of electrophoretic flow and electroosmotic flow by separating the two commonly used food dyeing agents Brilliant Blue FCF and Allura Red AC in vinegar and in a solution of ammonium hydroxide. A dark-purple mixture of these dyes is separated into red and blue bands that are easily visualized. The migration order of the dyes differs when the separation is performed under conditions of reversed polarity and suppressed electroosmotic flow (vinegar) compared to conditions of normal polarity and active electroosmotic flow (ammonium hydroxide). When delivered to chemistry majors, students had a significant gain in their ability to apply the concepts of electroosmosis and electrophoresis to predict analyte migration. Although this activity targets upper-level chemistry content, it can also be adapted for other laboratory experiences.


Deprenyl and pergolide rescue spinal motor neurons from axotomy-induced neuronal death in the neonatal rat.
It has been reported that both the monoamine oxidase inhibitor, deprenyl and the dopamine receptor agonist, pergolide have neuroprotective actions. To investigate the effect of deprenyl and pergolide on axotomized motor neuron death, we examined the survival of spinal motor neurons after sciatic nerve transection in the neonatal rats. Newborn rats were anesthetized with hypothermia. Sciatic nerve was cut near the obturator tendon in the left thigh. Animals were then treated daily with deprenyl (10 mg kg(-1)), pergolide (5 mg kg(-1)), or PBS for 14 days with intraperitoneal injections in a blind fashion. After the treatment, the number of spinal motor neurons in the L 4-6 was counted. There was approximately a 50% loss of spinal motor neurons in PBS-treated group. By contrast, both deprenyl and pergolide prevents spinal motor neuron death after axotomy Co-administration of deprenyl and pergolide is more effective than either agent alone but not significant. These findings are consistent with the idea that deprenyl and pergolide are survival factors for developing spinal motor neurons.


Treatment of capecitabine-induced hand-foot syndrome using a topical retinoid: A case report.
Capecitabine is a chemotherapeutic drug used in patients with breast, colon and gastric cancer. Hand-foot syndrome (HFS) is a type of dermatitis that frequently occurs as a reaction to capecitabine. To date, no effective strategies have been found to prevent or reverse HFS. Furthermore, chemotherapy induces an elevation in the expression of heparin-binding epidermal growth factor-like growth factor (HB-EGF), and this activation represents a critical mechanism for the induction of chemotherapeutic resistance. Adapalene is a third-generation synthetic retinoid. Topical retinoids are important therapeutic anti-aging agents for managing photodamaged skin, and are known to increase HB-EGF levels, which is important for skin wound healing. Accordingly, the current report focused on the topical retinoids that increase HB-EGF expression in the skin, and we hypothesized that these topical retinoids induce local chemotherapeutic resistance in the skin of patients receiving chemotherapy and consequently, decrease the cutaneous side-effects of chemotherapy. This report presents a case of the successful treatment of refractory HFS induced by capecitabine using the topical application of adapalene. Topical adapalene was applied for 3 months and significantly reduced inflammation and pain following chemotherapy. Topical retinoids may have the potential to effectively treat capecitabine-induced HFS by increasing HB-EGF expression and decreasing cutaneous side-effects. Further studies are required to establish the therapeutic efficacy of topical retinoids on HFS.


Circumspection in using automated measures: Talker gender and addressee affect error rates for adult speech detection in the Language ENvironment Analysis (LENA) system.
Automatic speech processing devices have become popular for quantifying amounts of ambient language input to children in their home environments. We assessed error rates for language input estimates for the Language ENvironment Analysis (LENA) audio processing system, asking whether error rates differed as a function of adult talkers' gender and whether they were speaking to children or adults. Audio was sampled from within LENA recordings from 23 families with children aged 4-34 months. Human coders identified vocalizations by adults and children, counted intelligible words, and determined whether adults' speech was addressed to children or adults. LENA's classification accuracy was assessed by parceling audio into 100-ms frames and comparing, for each frame, human and LENA classifications. LENA correctly classified adult speech 67% of the time across families (average false negative rate: 33%). LENA's adult word count showed a mean +47% error relative to human counts. Classification and Adult Word Count error rates were significantly affected by talkers' gender and whether speech was addressed to a child or an adult. The largest systematic errors occurred when adult females addressed children. Results show LENA's classifications and Adult Word Count entailed random - and sometimes large - errors across recordings, as well as systematic errors as a function of talker gender and addressee. Due to systematic and sometimes high error in estimates of amount of adult language input, relying on this metric alone may lead to invalid clinical and/or research conclusions. Further validation studies and circumspect usage of LENA are warranted.


Familiarity-and-liking relationship under conditions of induced lateral orientation.
Right-handed subjects who oriented their bodies and their attention toward their right produced a significant relationship between their rated familiarity with and liking for several well-known individuals. Those induced to orient toward their left showed no such effect. It is argued that such orientation produces relatively greater activation of the contralateral hemisphere, and experiments and reviews are cited which show that the left hemisphere has been suggested as the site for both processing of familiar stimuli and positive affect. Even if familiarity does activate liking by some means by virtue of being predominantly processed in the same hemisphere, it is not known how this occurs nor how it is altered by lateralized attention.


The embalmed heart of Richard the Lionheart (1199 A.D.): a biological and anthropological analysis.
During the Middle Ages, the partition of the cadaver of the elite members was a current practice, with highly technical treatment given to symbolic organs such as the heart. Considered mostly from a theoretical point of view, this notion of dilaceratio corporis has never been biologically explored. To assess the exact kind of embalming reserved to the heart, we performed a full biomedical analysis of the mummified heart of the English King Richard I (1199 A.D.). Here we show among other aspects, that the organ has been embalmed using substances inspired by Biblical texts and practical necessities of desiccation. We found that the heart was deposed in linen, associated with myrtle, daisy, mint, frankincense, creosote, mercury and, possibly, lime. Furthermore, the goal of using such preservation materials was to allow long-term conservation of the tissues, and good-smelling similar to the one of the Christ (comparable to the odor of sanctity).


[Prognostication : prophecy or medical practice ?]
The issue of prognostication is seldom approached in medical education, even though it represents an important question for the patients. Clinical assessment alone is inaccurate and systematically over-optimistic, especially if the question is formulated in temporal terms (how long will the patient live ?). The inaccuracy augments if the doctor has known the patient for a long time. However, other ways of addressing the question exist, and several validated clinical tools are available to improve the accuracy of the prognosis. The patients' self-rating and the evaluation by the nursing staff should also be considered as valuable information.


Underused Weapon In the War on Addiction.
Buprenorphine could save thousands more lives than it does-if it weren't for legal barriers, a fear of disruptive patients, and insurance red tape. And it can be prescribed in the primary care physician's office.


Compact, Highly Efficient, and Fully Flexible Circularly Polarized Antenna Enabled by Silver Nanowires for Wireless Body-Area Networks.
A compact and flexible circularly polarized (CP) wearable antenna is introduced for wireless body-area network systems at the 2.4 GHz industrial, scientific, and medical (ISM) band, which is implemented by employing a low-loss composite of polydimethylsiloxane (PDMS) and silver nanowires (AgNWs). The circularly polarized radiation is enabled by placing a planar linearly polarized loop monopole above a finite anisotropic artificial ground plane. By truncating the anisotropic artificial ground plane to contain only 2 by 2 unit cells, an integrated antenna with a compact form factor of 0.41λ0 × 0.41λ0 × 0.045λ0 is obtained, all while possessing an improved angular coverage of CP radiation. A flexible prototype was fabricated and characterized, experimentally achieving S 11 <- 15 dB, an axial ratio of less than 3 dB, a gain of around 5.2 dBi, and a wide CP angular coverage in the targeted ISM band. Furthermore, this antenna is compared to a conventional CP patch antenna of the same physical size, which is also comprised of the same PDMS and AgNW composite. The results of this comparison reveal that the proposed antenna has much more stable performance under bending and human body loading, as well as a lower specific absorption rate. In all, the demonstrated wearable antenna offers a compact, flexible, and robust solution which makes it a strong candidate for future integration into body-area networks that require efficient off-body communications.


Mitochondrial myopathies-clinicopathological features and diagnostic modalities.
Mitochondrial myopathy is the term applied to a clinically and biochemically heterogeneous group of disorders which have multisystem involvement. The concept was introduced by Luft in 1962. These are due to genetic defects in the respiratory chain enzymes which are detected by histochemical, immunohistochemical stains, molecular biological studies and ultrastructural studies on muscle biopsy. Classification of the disorders can be genetic, based on defects of respiratory enzyme complexes or on the basis of the clinical syndromes. Due to the extremely variable clinical presentations of these disorders, a complete clinical and laboratory workup involving strict diagnostic criteria is essential.


Study of the association between histo-blood group antigens and norovirus infection in Chinese children.
Human caliciviruses (HuCVs) have been recognized as a major cause of sporadic viral diarrhea in children, among which norovirus genotype GII.4 is the most prevalent genotype. Stool and saliva samples were collected from 295 children with acute diarrhea and 150 asymptomatic children at a hospital in China. The HuCV detection rate was 10.85% (32/295) among the children with acute diarrhea, and all of these 32 children were either HBGA secretors (12/32) or partial secretors (20/32). HuCV was detected in two (1.33%) of the 150 samples obtained from the asymptomatic children. Of the norovirus-GII.3-positive children, 60% had blood type O, but only 17.29% of the symptomatic patients had blood type O, indicating that type O individuals could be at higher risk of GII.3 infection. However, due to the limited number of individuals in this study, further studies with a larger number of subjects should be conducted to verify this hypothesis.


A Rare Etiology of Unilateral Pseudo-Pulmonary Fibrosis in a Puerto Rican Child.
Congenital unilateral pulmonary hypoplasia of a pulmonary artery is considered a rare congenital anomaly in the pediatric and adult population. With an estimated prevalence of one in 200,000, it can range from partial to near-total lung underdevelopment. The diagnosis of lung and pulmonary artery hypoplasia is challenging in adults as they can easily be mistaken for more common diseases. Many survive into adulthood with minimal or no symptoms, which makes their identification challenging. We present the case of a 14-year-old female with a previous diagnosis of 3-methylglutaconic aciduria (3-MGA-uria) with a history of chronic wet cough andrecurrent respiratory tract infections (RTIs) that led to multiple hospitalizations throughout her childhood. After further evaluation, the patient was diagnosed with hypoplasia of the right-sided pulmonary artery system and its branches. This case report highlights the importance of early identification of congenital unilateral pulmonary hypoplasia of a pulmonary artery to prevent pulmonary complications like recurrent RTIs in pediatric patients with rare diseases.


Delirium in the emergency department: an independent predictor of death within 6 months.
Delirium's adverse effect on long-term mortality in older hospitalized patients is well documented, whereas its effect in older emergency department (ED) patients remains unclear. Similarly, the consequences of delirium on nursing home patients treated in the ED are also unknown. As a result, we seek to determine whether delirium in the ED is independently associated with 6-month mortality in older patients and whether this relationship is modified by nursing home status. Our prospective cohort study was conducted at a tertiary care, academic ED, using convenience sampling, and included English-speaking patients who were aged 65 years and older and were in the ED for less than 12 hours at enrollment. Patients were excluded if they refused consent, were previously enrolled, were unable to follow simple commands at baseline, were comatose, or had incomplete data. The Confusion Assessment Method for the Intensive Care Unit was used to determine delirium and was administered by trained research assistants. Cox proportional hazard regression was performed to determine whether delirium in the ED was independently associated with 6-month mortality after adjusting for age, comorbidity burden, severity of illness, dementia, functional dependence, and nursing home residence. To test whether the effect of delirium in the ED on 6-month mortality was modified by nursing home residence, an interaction term (delirium*nursing home) was incorporated into the multivariable model. Hazard ratios with their 95% confidence intervals were reported. Of the 628 patients enrolled, 108 (17.2%) were delirious in the ED and 58 (9.2%) were from the nursing home. For the entire cohort, the 6-month mortality rate was higher in the delirious group compared with the nondelirious group (37.0% versus 14.3%). Delirium was an independent predictor of increased 6-month mortality (hazard ratio=1.72; 95% confidence interval 1.04 to 2.86) after adjusting for age, comorbidity burden, severity of illness, dementia, functional dependence, and nursing home residence. The "delirium*nursing home" interaction was nonsignificant (P=.86), indicating that place of residence had no effect on the relationship between delirium in the ED and 6-month mortality. Delirium in older ED patients is an independent predictor of increased 6-month mortality, and this relationship appears to be present regardless of nursing home status.


Comparative effects of carvedilol vs bisoprolol for severe congestive heart failure.
Although carvedilol and bisoprolol are effective medicines for the treatment of patients with heart failure (HF), only a few reports have compared their effects. This study was designed to compare the effects of them in patients with severe HF. A total of 655 consecutive patients with HF, categorized as New York Heart Association Class 3 or 4, were retrospectively investigated. Of these patients, 217 were administered beta-blockers after admission and were divided into 2 groups (carvedilol, n=110; bisoprolol, n=107). No significant differences were observed in their characteristics between the 2 groups prior to the introduction of the beta-blockers. After 18 months of follow-up, there were no significant differences in the survival and cardiac event-free rates between the 2 groups. In contrast, there were several significant differences in patients with atrial fibrillation (AF) (carvedilol, n=40; bisoprolol, n=43). The percent changes in heart rate and brain natriuretic peptide level improved significantly in the bisoprolol group than in the carvedilol group. Furthermore, more patients in the bisoprolol group were defibrillated from AF to sinus rhythm than those in the carvedilol group (48% vs 16%; P=0.03). Our data suggest that the 2 beta-blockers are equally effective in the improvement of severe HF, but bisoprolol shows favorable effects in patients with AF.


Factors associated with safe sex among public school students in Minas Gerais, Brazil.
A cross-sectional study was conducted to evaluate factors associated with safe sex among sexually active public school students in Minas Gerais State, Brazil. The study focused on correlations between the variables gender, age, schooling, current grade, ethnicity, religion, importance attributed to religion, mothers' education, prior exposure to any sex education, promotion of juvenile protagonism, and participation by health professionals in school activities and consistent condom use with casual or stable partners and with use of other modern contraceptive methods. Bivariate and multivariate logistic regression analyses were used. Male gender and participation by health professionals in school activities were positively associated with all indicators of safe sex, and maternal schooling of more than eight years was positively associated with consistent condom use with casual and stable partners. Secondary (versus elementary) schooling and age (older) were inversely associated with consistent condom use with casual and stable partners, respectively. Ascribing greater importance to religion and Evangelical religion were negatively associated with use of modern contraceptives in the last sexual intercourse.


Malignant Ovarian Steroid Cell Tumor, Not Otherwise Specified, Causes Virilization in a 4-Year-Old Girl: A Case Report and Literature Review.
We report a case of a 4-year-old girl with an ovarian steroid cell tumor, not otherwise specified (SCT-NOS). She was admitted to the hospital with progressing virilization and Cushing's syndrome, which included abnormality of the perineum, hirsutism, hypertrichosis, flushing of face, hoarseness, and weight gain. Blood testing showed a significantly increased testosterone level and slightly increased cortisol level. Computed tomography scan revealed an 8.0 × 5.0 × 5.0 cm tumor of the right ovary. The patient underwent right salpingo-oophorectomy, and pathological examination showed malignant potential. Three courses of bleomycin, etoposide, and cisplatin were administered as postoperative chemotherapy. After tumor resection, her testosterone decreased to undetectable levels. However, during the course of the treatment, the patient suffered from adrenal insufficiency resulting in the need for hydrocortisone replacement therapy. Although SCT-NOS in childhood are typically benign, pathological findings should be carefully observed for potential malignancy. In cases of cortisol-producing SCT-NOS, serum levels should be monitored, and hydrocortisone replacement therapy should be considered before resection.


Robust Visual Responses and Normal Retinotopy in Primate Lateral Geniculate Nucleus following Long-term Lesions of Striate Cortex.
Lesions of striate cortex (V1) trigger massive retrograde degeneration of neurons in the LGN. In primates, these lesions also lead to scotomas, within which conscious vision is abolished. Mediation of residual visual capacity within these regions (blindsight) has been traditionally attributed to an indirect visual pathway to the extrastriate cortex, which involves the superior colliculus and pulvinar complex. However, recent studies have suggested that preservation of the LGN is critical for behavioral evidence of blindsight, raising the question of what type of visual information is channeled by remaining neurons in this structure. A possible contribution of LGN neurons to blindsight is predicated on two conditions: that the neurons that survive degeneration remain visually responsive, and that their receptive fields continue to represent the region of the visual field inside the scotoma. We tested these conditions in male and female marmoset monkeys (Callithrix jacchus) with partial V1 lesions at three developmental stages (early postnatal life, young adulthood, old age), followed by long recovery periods. In all cases, recordings from the degenerated LGN revealed neurons with well-formed receptive fields throughout the scotoma. The responses were consistent and robust, and followed the expected eye dominance and retinotopy observed in the normal LGN. The responses had short latencies and preceded those of neurons recorded in the extrastriate middle temporal area. These findings suggest that the pathway that links LGN neurons to the extrastriate cortex is physiologically viable and can support residual vision in animals with V1 lesions incurred at various ages.SIGNIFICANCE STATEMENT Patients with a lesion of the primary visual cortex (V1) can retain certain visually mediated behaviors, particularly if the lesion occurs early in life. This phenomenon ("blindsight") not only sheds light on the nature of consciousness, but also has implications for studies of brain circuitry, development, and plasticity. However, the pathways that mediate blindsight have been the subject of debate. Recent studies suggest that projections from the LGN might be critical, but this finding is puzzling given that the lesions causes severe cell death in the LGN. Here we demonstrate in monkeys that the surviving LGN neurons retain a remarkable level of visual function and could therefore be the source of the visual information that supports blindsight.


Diesel exhaust particles enhance lung injury related to bacterial endotoxin through expression of proinflammatory cytokines, chemokines, and intercellular adhesion molecule-1.
Epidemiologic studies demonstrate acute and serious adverse effects of particulate air pollution on respiratory health, especially in people who are susceptible to bacterial infection. However, the underlying mechanism remains to be elucidated. To provide experimental evidence for the epidemiologic data, we determined the effects of diesel exhaust particles (DEP), major participants in particulate pollutants, on lung injury related to bacterial endotoxin in mice. Intratracheal instillation of DEPs synergistically enhanced lung injury related to endotoxin from gram-negative bacteria, which was characterized by neutrophil sequestration, interstitial edema, and alveolar hemorrhage. In the presence of endotoxin, DEPs further activated the nuclear translocation of p65 subunit of nuclear factor-kappaB (NF-kappaB) in the lung and increased the lung expression of intercellular adhesion molecule-1, interleukin-1beta, macrophage chemoattractant protein-1, keratinocyte chemoattractant (KC), macrophage inflammatory protein-1alpha, and Toll-like receptors. DEPs given alone increased the lung expression of Toll-like receptor 4 and the nuclear localization of p50 subunit of NF-kappaB. The combined exposure to DEPs and endotoxin decreased nuclear localization of CCAAT/enhancer binding protein beta. These results provide the first experimental evidence that DEPs enhance neutrophilic lung inflammation related to bacterial endotoxin. The enhancement is mediated by the induction of proinflammatory molecules, likely through the expression of Toll-like receptors and the activation of p65-containing dimer(s) of NF-kappaB, such as p65/p50.


A clash of civilizations? Examining liberal-democratic values in Turkey and the European Union.
Turkey's proposed entry into the European Union (EU) has been undermined by Europeans' perceptions of Turkish-European cultural differences, particularly regarding the liberal-democratic values that the EU promotes (democracy, rule of law, and respect for and appreciation of minority/human rights). Yet, cross-national research on values has not focused on Turkey, the EU, and these liberal-democratic values, leaving assumptions of cultural differences and their explanations untested. Through analyses of World and European Values Survey data (1999-2002), this article asks whether people in Turkey have the same values regarding democracy, rule of law (versus religious and authoritarian rule), and minority/human rights as people in EU member and candidate states (as of 2000)? What factors explain these values? I find that people in Turkey support democracy to the same extent as people in EU member and candidate states, but people in Turkey are more supportive of religious and authoritarian rule and are less tolerant of minorities. Although the 'clash of civilizations' thesis expects liberal values to be ordered according to countries' religious traditions, with western Christian the most supportive and Islamic the least, only for tolerance of minorities values is this pattern found. Instead, economic development most consistently explains differences between Turkey and EU member and candidate states in support for these values. I conclude with calls for theoretical refinement, particularly of the clash of civilizations thesis, along with suggestions for future research to examine more Muslim and Orthodox countries; I discuss the debate over Turkey's EU entry.