Determinants of COVID-19 vaccine readiness and hesitancy among adults in sub-Saharan Africa.
There is very limited data on the extent and determinants of COVID-19 vaccine hesitancy among adults living in sub-Saharan Africa since the global roll-out of vaccines began in 2021. This multi-country survey sought to investigate COVID-19 vaccine hesitancy and other predictors of readiness to get vaccinated. We conducted surveys among adults residing in nine urban and rural areas in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania in late 2021. Log binomial regression models were used to identify prevalence and factors associated with vaccine hesitancy and beliefs around COVID-19 misinformation. We completed a total of 2,833 interviews. Among all respondents, 9% had never heard of a COVID-19 vaccine, 12% had been vaccinated, and 20% knew someone else who had been vaccinated. The prevalence of vaccine hesitancy varied by country (Ethiopia 29%, Burkina Faso 33%, Nigeria 34%, Ghana 42%, Tanzania 65%), but not by rural or urban context. People who did not think the vaccine was safe or effective, or who were unsure about it, were more likely to be vaccine hesitant. Those who reported they did not have a trusted source of information about the vaccine (aPR: 1.25, 95% CI: 1.18,1.31) and those who thought the vaccine would not be made available to them within the year were more likely to be vaccine hesitant. Women were more likely to be vaccine hesitant (aPR: 1.31, 95% CI: 1.19,1.43) and believe COVID-19 falsehoods (aPR: 1.05, 95% CI: 1.02,1.08). The most commonly believed falsehoods were that the vaccine was developed too fast and that there was not enough information about whether the vaccine was effective or not. Educational campaigns targeted at misinformation and tailored to suit each country are recommended to build trust in COVID-19 vaccines and reduce hesitancy.


To Be or Not to Be? Five Guidelines to Avoid Misassignments in Cross-Linking/Mass Spectrometry.
The number of publications in the field of chemical cross-linking/mass spectrometry (MS) for deriving protein 3D structures and for probing protein/protein interactions has largely increased during the last years. MS analysis of the large cross-linking data sets requires an automated data analysis by dedicated software tools, but applying scoring procedures with statistical methods does not eliminate the fundamental problems of a misassignment of cross-linked products. In fact, we have observed a significant rate of misassigned cross-links in a number of publications, mainly due to the presence of isobaric cross-linked species, an incomplete fragmentation of cross-linked products, and low-mass accuracy fragment ion data. These false assignments will eventually lead to wrong conclusions on the structural information derived from chemical cross-linking/MS experiments. In this contribution, we examine the most common sources for misassigning cross-linked products. We propose and discuss rational criteria and suggest five guidelines that might be followed for a reliable and unambiguous identification of cross-links, independent of the software used for data analysis. In the interest of the cross-linking/MS approach, it should be ensured that only high-quality data enter the structural biology literature. Clearly, there is an urgent need to define common standards for data analysis and reporting formats of cross-linked products.


Effects of pelleting, extrusion, or extrusion and pelleting on energy and nutrient digestibility in diets containing different levels of fiber and fed to growing pigs.
An experiment was conducted to determine effects of pelleting, extrusion, and extrusion and pelleting on energy and nutrient digestibility in diets containing low, medium, or high concentrations of fiber. Three diets were formulated: 1) the low-fiber diet contained corn and soybean meal; 2) the medium-fiber diet contained corn, soybean meal, and 25% distillers dried grains with solubles (DDGS); and 3) the high-fiber diet contained corn, soybean meal, 25% DDGS, and 20% soybean hulls. Each diet was divided into 4 batches after mixing. One batch was not further processed and was fed in a meal form, one batch was pelleted at 85°C, one batch was extruded at 115°C using a single-screw extruder, and one batch was extruded at 115°C and then pelleted at 85°C. Thus, 12 different diets were produced. Twenty-four growing pigs (26.5 ± 1.5 kg initial BW) had a T-cannula installed in the distal ileum and were allotted to the 12 diets in a split-plot design with 8 pigs allotted to the low-fiber diets, the medium-fiber diets, and the high-fiber diets, respectively. Diets were fed to the pigs during four 14-d periods. Within each type of diet, the 8 pigs were fed the diets produced using the 4 processing technologies. Therefore, there were 8 replicate pigs per diet. Pigs were adjusted to their diets for 14 d before the experiment was initiated. Each of the four 14-d periods consisted of 5 d for adaptation, 5 d of fecal collection according to the marker to marker approach, and ileal digesta were collected on d 13 and 14. Results indicated that pelleting, extrusion, or extrusion and pelleting improved ( < 0.05) the apparent ileal digestibility of starch and most indispensable AA. In most cases, there were no differences between the pelleted, the extruded, and the extruded and pelleted diets. The apparent total tract digestibility of GE was also improved ( < 0.05) by pelleting and by the combination of extrusion and pelleting. The ME of pelleted diets was greater ( < 0.05) than that of meal diets for the low- and medium-fiber diets, but this was not the case for high-fiber diets (interaction, < 0.05). Medium- and high-fiber diets that were extruded had greater ME ( < 0.05) than meal diets, but that was not the case for low-fiber diets. These data indicate that energy utilization may be improved by pelleting or extrusion or by a combination of the 2 technologies, but the response seems to be greater for extrusion in diets that are relatively high in fiber.


Determination of oxytetracycline residues in matrixes from a freshwater recirculating aquaculture system.
This paper describes related procedures to determine the amount of oxytetracycline (OTC) present in trout tissue (muscle with skin attached), biofilter sand, sediment, and tank water from a recirculating aquaculture system. OTC was extracted from the matrixes by different techniques, depending on complexity of the matrix and desired OTC detection level in that matrix. Listed in order of increasing complexity, OTC was extracted from tank water by dilution with acidic buffer containing ethylenediaminetetraacetic acid (EDTA); from biofilter sand by shaking with 0.1 N HCl; from sediment by homogenization and shaking with buffer/EDTA; and from ground trout by homogenization and shaking with buffer/EDTA (twice), with further cleanup and concentration of the extract on a polymeric solid-phase extraction cartridge. The 4 procedures all used the same reversed-phase gradient chromatography on a polymeric column with UV detection at 350 nm. The lower limit of detection (estimated) and upper limit of validation for each of these 4 matrixes were 0.04-4.0 microg/g (ppm; trout), 0.03-20 ppm (biofilter sand), 1-6000 ppm (sediment), and 0.003-10 ppm (water). Recoveries ranged from 82 to 108%, with relative standard deviation <20% over the applicable concentration ranges. These procedures were used to monitor OTC residues resulting from medicated feed administered to rainbow trout in a recirculating aquaculture system.


Transcutaneous electrosigmoidography. Study of the myoelectric activity of sigmoid colon by surface electrodes.
The purpose of this study was to determine the feasibilty of performing transcutaneous electrosigmoidography (TC-ESG). The study involved 19 healthy volunteers (11 men, 8 women; mean age 38.2 +/- 14.8 years). To validate the results of TC-ESG, the latter was performed simultaneously with intra-sigmoid ESG. TC-ESG was done also in five patients who underwent sigmoidectomy. The optimal position of the electrodes was determined after several trials. Two electrodes (Beckman) were applied, each 2-3 cm away from the middle of a line drawn from the umbilicus to the symphysis pubis. A third electrode was placed just above the symphysis pubis. A reference electrode was applied to one of the lower limbs. For intra-sigmoid IS-ESG, two silver-silver chloride electrodes were introduced from the anal orifice into the sigmoid colon and were attached to the mucosa by suction. Pacesetter potentials (PPs) were recorded as regular negative deflections. They had constant amplitude, frequency and velocity when recordings were obtained in the same subject. The PPs registered transcutaneously had the same amplitude, frequency and velocity as those recorded intrasigmoidally. Action potentials could be registered only intrasigmoidally and not transcutaneously. No electric waves could be recorded by TC-ESG in 5 patients who had undergone sigmoidectomy. In conclusion, TC-ESG is a simple, non-invasive and non-radiologic technique that can substitute intra-sigmoid ESG and potentially can be used in the diagnosis of various pathologic conditions of sigmoid colon.


Recurrent chylopericardium.
A 19-year-old male presented with recurrent episodes of pericardial effusion. On evaluation, he was diagnosed to have idiopathic chylous effusion. As there was persistent pericardial collection, chemical pericardiodesis was done. Following pericardiodesis, there was no recurrence of pericardial effusion. Chemical pericardiodesis may be an effective treatment option for recurrent, idiopathic chylopericardium.


Using the serratus anterior free flap for dynamic facial reanimation: Systematic review.
It was the purpose of this study to evaluate the role of the serratus anterior free flap (SAFF) with its long thoracic nerve (LTN) as composite flap for dynamic facial reanimation. A total of 10 studies, published between 2004 and 2021, met inclusion criteria. Clinical data of 48 patients were used for the systematic review and analysis. One to three slips were used, mainly as one-stage procedures (n = 39; 81.3%), to create different force vectors. Single or double innervated muscle transfers were utilized in 32 (66.7%) and 16 (33.3%) cases with additionally harvested skin paddles in 4 (8.3%) patients. The LTN was mostly anastomosed to the ipsilateral masseteric nerve (45.8%; n = 22) or to remaining facial nerve branches (37.5%; n = 18), while cross-facial-nerve-grafting was rarely used (16.7%; n = 8). The SAFF as composite flap with different force vectors proved to be a good candidate for immediate dynamic facial reanimation after any midface defects.


Torpedo maculopathy with multifocal central serous chorioretinopathy: A rare case report.
We present a very rare case of torpedo maculopathy (TM) with multifocal central serous chorioretinopathy. A 26-year-old male presented with painless loss of vision in the right eye of 2 months duration. Clinical examination showed a torpedo-shaped lesion temporal to fovea and subretinal fluid in foveal center. Fluorescein angiography showed multifocal leaks. Optical coherence tomography showed an optically clear space/neurosensory detachment at the site of lesion. Patient underwent focal laser to the leaks. TM is a rare congenital disorder detected accidentally during routine fundus examination. It is usually unilateral and does not affect vision.


Prevalence and predictors of 6-month exclusive breastfeeding among Canadian women: a national survey.
In spite of the evidence supporting the importance of breastfeeding during the first year of life, data on breastfeeding practices remain limited in Canada. The study aimed to examine the prevalence and predictors of 6-month exclusive breastfeeding among Canadian women. The analysis was based on the Maternity Experience Survey targeting women aged >or= 15 years who had singleton live births between February 2006 - May 2006 in the Canadian provinces and November 2005 - February 2006 in the territories. The main outcome was exclusive breastfeeding based on the World Health Organization definition. Socioeconomic, demographic, maternal, pregnancy and delivery related variables were considered for a multivariate logistic regression using stepwise modeling. Bootstrapping was performed to account for the complex sampling design. The sample size in this study was 5,615 weighted to represent 66,810 Canadian women. While ever breastfeeding was 90.3%, the 6-month exclusive breastfeeding rate was 13.8%. Based on the regression model, having higher years of education, residing in the Northern territories and Western provinces, living with a partner, having had previous pregnancies, having lower pre-pregnancy body mass index and giving birth at older age were associated with increased likelihood of 6-month exclusive breastfeeding. Moreover, smoking during pregnancy, Caesarean birth, infant's admission to the intensive care unit and maternal employment status before 6 months of infant's age were negatively associated with exclusive breastfeeding. Mothers choosing to deliver at home were more likely to remain exclusively breastfeeding for 6 months (Odds Ratio: 5.29, 95% Confidence Interval: 2.95-9.46). The 6-month exclusive breastfeeding rate is low in Canada. The study results constitute the basis for designing interventions that aim to bridge the gap between the current practices of breastfeeding and the World Health Organization recommendation.


Techno-economic assessment of hybrid extraction and distillation processes for furfural production from lignocellulosic biomass.
Lignocellulosic biomass is one of the most promising alternatives for replacing mineral resources to overcome global warming, which has become the most important environmental issue in recent years. Furfural was listed by the National Renewable Energy Laboratory as one of the top 30 potential chemicals arising from biomass. However, the current production of furfural is energy intensive and uses inefficient technology. Thus, a hybrid purification process that combines extraction and distillation to produce furfural from lignocellulosic biomass was considered and investigated in detail to improve the process efficiency. This effective hybrid process depends on the extracting solvent, which was selected based on a comprehensive procedure that ranged from solvent screening to complete process design. Various solvents were first evaluated in terms of their extraction ability. Then, the most promising solvents were selected to study the separation feasibility. Eventually, processes that used the three best solvents (toluene, benzene, and butyl chloride) were designed and optimized in detail using Aspen Plus. Sustainability analysis was performed to evaluate these processes in terms of their energy requirements, total annual costs (TAC), and carbon dioxide (CO2) emissions. The results showed that butyl chloride was the most suitable solvent for the hybrid furfural process because it could save 44.7% of the TAC while reducing the CO2 emissions by 45.5% compared to the toluene process. In comparison with the traditional purification process using distillation, this suggested hybrid extraction/distillation process can save up to 19.2% of the TAC and reduce 58.3% total annual CO2 emissions. Furthermore, a sensitivity analysis of the feed composition and its effect on the performance of the proposed hybrid system was conducted. Butyl chloride was found to be the most suitable solvent for the hybrid extraction/distillation process of furfural production. The proposed hybrid sequence was more favorable than the traditional distillation process when the methanol fraction of the feed stream was <3% and more benefit could be obtained when that fraction decreased.


[Exercise as a therapeutic strategy in epilepsy: a literature review].
Epilepsy is a common neurologic disease with emotional and physical consequences. Thirty percent of patients have drug-resistant epilepsy, therefore adjuvant non-pharmacological therapies, such as physical activity, have been proposed. This study reviews the literature about physical activity in people with epilepsy, to evaluate the benefits, potential side effects, impact on comorbidities, the risk classification of sports, and the barriers to their practice. Multiple animal and human models evaluate the benefits of exercise in epilepsy, explained by modulation on neurotransmitters, hormones, and neurotrophic factors. Furthermore, exercise demonstrates positive impact on comorbidities such as obesity, cardiovascular disease, depression, and osteoporosis. Despite being a practice that has been shown to be safe, people with epilepsy are less physically active due to barriers that limit their practice. Physical activity is beneficial and safe for people with epilepsy. Literature suggests better control of seizures, psychosocial benefits, and improvements on the comorbidities. There is a low risk of injury associated. Exercise should be promoted after a careful clinical evaluation, considering seizure control in the last year, potential triggering factors and the sport chosen.


Fatty acids inhibit anticancer effects of 5-fluorouracil in mouse cancer cell lines.
The present study investigated the effects of two major dietary fatty acid components, linoleic acid (LA) and elaidic acid (EA), on the antitumor effects of 5-fluorouracil (5-FU) in the LL2, CT26 and CMT93 mouse cancer cell lines. Concurrent treatment with LA and 5-FU elicited a decreased cell viability compared with treatment with 5-FU alone. In addition, increased inhibition of growth was observed following concurrent treatment with EA and 5-FU. Sequential treatment of LA followed by 5-FU abrogated the anticancer effects of 5-FU, and treatment with EA followed by 5-FU increased cancer cell growth in addition to abrogating the anticancer effects of 5-FU. The expression of the stem cell markers CD133 and nucleostemin (NS) increased in all three cell lines treated concurrently with 5-FU and either LA or EA when compared with cells treated with 5-FU alone. Aldehyde dehydrogenase activity in the cancer stem cells (CSCs), in response to concurrent treatment with 5-FU and either LA or EA, was increased compared with 5-FU treatment alone. 5-FU inhibited the growth of CT26 tumors, but co-treatment with either LA or EA abrogated this effect. NS-positive CSCs were more abundant in CT26 tumors treated with 5-FU and either LA or EA compared with those treated with 5-FU alone. The results of the present study suggested that, rather than altering the sensitivity of cancer cells to 5-FU, LA and EA may promote the survival of CSCs. The results indicated that dietary composition during chemotherapy is an important issue.


The role of prostacyclin during exercise in patients with chronic angina pectoris.
To determine changes in platelet activity, prostaglandin metabolism and catecholamine release along with changes in hemodynamics during exercise, we measured these parameters before and immediately after treadmill exercise. Measurements were made on peripheral arterial blood simultaneously with a direct aortic pressure recording in 30 patients with coronary artery disease (Group 1), in 20 patients without significant coronary disease (Group 2), and in 11 young healthy volunteers as controls. At the peak of the exercise regimen, the ST segment depression was found to be significantly lower in Group 1 than in Group 2, whereas the changes in the DPTI/TTI ratio in Group 2 and the controls decreased with the increase in the duration of exercise. The increased serum lactate level at the intermediate level of exercise (420 +/- 20 sec) was significantly lower in the controls than in the other 2 groups. Changes in beta thromboglobulin, platelet factor 4, and plasma norepinephrine were similarly increased in all 3 groups by exercise. At the termination of exercise, however, 6 keto-prostaglandin F1 alpha in Group 1 was insignificantly elevated, whereas it increased from 42.9 +/- 7 pg/ml to 55.7 +/- 7.1 (p less than 0.05) in Group 2 and from 38.2 +/- 5.7 pg/ml to 45.1 +/- 6.8 (p less than 0.01) in the controls. These results suggest that decreased prostacyclin production in the vessel wall might be an indicator of myocardial ischemia, and that the administration of prostacyclin may modulate the coronary vascular tone exaggerated by exercise.


[Ultrasonics and deep vein thrombosis. Ilio-caval level and the lower extremities].
All the important abdominal veins and limbs vein can be examined. The veins, in cross-section are rounded in repletion, (maximum normal vein caliber has reached when erect) almost flat in a state of vacuous-ness. The lumen normally echofree is limited by a wall thinner and less echogenic than the wall of adjacent artery. The parietal motions are rythmed by breathing. Venous blood flow can become echogenic, with weak echoes, as snow storm within the lumen. These phenomena are often visible in venous confluent and within the lumen below occlusion where there is sludge. In supine position deep abdominal veins, limbs veins until popliteal veins are easily seen. Below the popliteal fossa in prone position the veins are nearly empty and not visible beyond pathological circumstances. Objective studies demonstrated the inaccuracy of clinical diagnosis of deep venous thrombosis, echotomography (coupled with doppler) is among the non-invasive methods the most interesting, permitting to recognize venous occlusion complete or incomplete by clot but also compression by tumour or ganglion. The compression under the probe collapse the normal vein, but if there is clot inside, the compression become incomplete or impossible. The caliber of the vein is dilated also in supine position. The richest of venous clot in red cells in comparison with arterial thrombus make it more and earlier echogenic and more especially as the investigation is performed with high frequency probe. In the same way if the clot is floating its motions are put in evidence. Echotomography make usually difference between clot and neoplastic thrombus which is again more echogenic and also have special location. Echotomography permit to follow evolution ot venous thrombosis under treatment. The wall vein lesions after thrombosis are analysed showing thickening, destruction of the cups, dilatation of some veins while others are still obstructed.


Long-term social isolation in the adulthood results in CA1 shrinkage and cognitive impairment.
Social isolation in adulthood is a psychosocial stressor that can result in endocrinological and behavioral alterations in different species. In rodents, controversial results have been obtained in fear conditioning after social isolation at adulthood, while neural substrates underlying these differences are largely unknown. Neural cell adhesion molecule (NCAM) and its polysialylated form (PSA-NCAM) are prominent modulators of synaptic plasticity underlying memory processes in many tasks, including fear conditioning. In this study, we used adult female Octodon degus to investigate the effects of long-term social isolation on contextual and cued fear conditioning, and the possible modulation of the synaptic levels of NCAM and PSA-NCAM in the hippocampus. After 6½ months of social isolation, adult female degus showed a normal auditory-cued fear memory, but a deficit in contextual fear memory, a hippocampal dependent task. Subsequently, we observed reduced hippocampal synaptic levels of PSA-NCAM in isolated compared to grouped-housed female degus. No significant differences were found between experimental groups in hippocampal levels of the three main isoforms of NCAM (NCAM180, NCAM140 and NCAM120). Interestingly, social isolation reduced the volume of the hippocampal CA1 subfield, without affecting the volume of the CA3 subregion or the total hippocampus. Moreover, attenuated body weight gain and reduced number of granulocytes were detected in isolated animals. Our findings indicate for the first time, that long-term social isolation of adult female animals induces a specific shrinkage of CA1 and a decrease in synaptic levels of PSA-NCAM in the hippocampus. These effects may be related to the deficit in contextual fear memory observed in isolated female degus.


Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Antenatal Women With Pre-eclampsia: A Case-Control Study.
Background Pre-eclampsia (PE) is a disorder characterized by hypertension that may occur in a pregnant woman who was normotensive earlier. One of the major factors responsible consists of the inflammatory system being activated with cytokines and chemokines. The normal range of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) varies from 1 to 3 and 90 to 210, respectively. Therefore, this study was conducted to compare PE patients with normotensive pregnant women in relation to their NLR as well as PLR. Methodology From January 1, 2021, to December 31, 2022, a case-control study was conducted in the department of obstetrics and gynecology at a tertiary care center. Based on the inclusion and exclusion criteria, a total of 140 antenatal women were included and divided into a case group consisting of 70 women with PE and a control group involving 70 normotensive pregnant women. A blood sample for complete blood count testing was collected to determine NLR and PLR. Results The mean NLR in the case group and control group was 3.52 ± 1.05 and 3.22 ± 0.88, respectively, with statistically significant results. Additionally, the PLR in the case group was 98.08 ± 18.27, and in the control group, it was 85.25 ± 12.36, having a significant difference between both the groups along with a significant difference in the case group among the severe and non-severe PE. Conclusion In antenatal women, NLR and PLR increase with PE along with an increase in NLR and PLR. Additionally, with the availability of a complete blood count, detecting PE ability markers such as the NLR and PLR will be a significant advantage for managing PE to prevent adverse outcomes.


Safety and Efficacy of Endoscopic Therapy for Nonmalignant Duodenal Duplication Cysts: Case Report and Comprehensive Review of 28 Cases Reported in the Literature.
Analyze efficacy, safety of endoscopic therapy for duodenal duplication cysts (DDC) by comprehensively reviewing case reports.Tandem, independent, systematic, computerized, literature searches were performed via PubMed using medical subject headings or Keywords "cyst" and "duodenal" and "duplication"; or "cyst", and "endoscopy" or "endoscopic", and "therapy" or "decompression"; with reconciliation of generated references by two experts. Case report followed CARE guidelines.Literature review revealed 28 cases (mean = 1.3 ± 1.2 cases/report). Endoscopic therapy is increasingly reported recently (1984-1999: 3 cases, 2000-2015: 25 cases, P = 0.003, OR = 8.33, 95%-CI: 1.77-44.5). Fourteen (54%) of 26 patients were men (unknown-sex = 2). Mean age = 32.2 ± 18.3 years old. Procedure indications: acute pancreatitis-16, abdominal pain-8, jaundice-2, gastrointestinal (GI) obstruction-1, asymptomatic cyst-1. Mean maximal DDC dimension = 3.20 ± 1.53 cm (range, 1-6.5 cm). Endoscopic techniques included cyst puncture via needle knife papillotomy (NKP)/papillotome-18, snare resection of cyst-7, cystotome-2, and cyst needle aspiration/ligation-1. Endoscopic therapy was successful in all cases. Among 24 initially symptomatic patients, all remained asymptomatic post-therapy without relapses (mean follow-up = 36.5 ± 48.6 months, 3 others reported asymptomatic at follow-up of unknown duration; 1 initially asymptomatic patient remained asymptomatic 3 years post-therapy). Two complications occurred: mild intraprocedural duodenal bleeding related to NKP and treated locally endoscopically.A patient is reported who presented with vomiting, 15-kg-weight-loss, and profound dehydration for 1 month from extrinsic compression of duodenum by 14 × 6 cm DDC, underwent successful endosonographic cyst decompression with large fenestration of cyst and endoscopic aspiration of 1 L of fluid from cyst with rapid relief of symptoms. At endoscopy the DDC was intubated and visualized and random endoscopic mucosal biopsies were obtained to help exclude malignant or dysplastic DDC.Study limitations include retrospective literature review, potential reporting bias, limited patient number, variable follow-up.In conclusion, endoscopic therapy for DDC was efficacious in all 29 reported patients including current case, including patients presenting acutely with acute pancreatitis, or GI obstruction. Complications were rare and minor, suggesting that endoscopic therapy may be a useful alternative to surgery for nonmalignant DDC when performed by expert endoscopists.


Isolated systolic blood pressure elevation in the elderly: mechanisms, risk, and the need for further studies.
Isolated systolic hypertension (ISH) is generally defined as a systolic pressure of 160 mm Hg or more, with a diastolic pressure cutoff point below 95 mm Hg in some studies and 90 mm Hg in others. Its prevalence and incidence vary from 3 to 30% depending on the definition applied, methodology of measurement, as well as the population and the age and sex of the patient. Mechanisms that could lead to the development of isolated systolic hypertension are discussed, especially the role of atherosclerosis. The risks of systolic hypertension on mortality and morbidity in the elderly are considered. The need for further studies to quantify the risk and the effect of treatment is emphasized. The Syst-Eur trial enters patients above the age of 60 years with a diastolic pressure below 95 mm Hg and a systolic of 160 mm Hg or more. The study is a double-blind, placebo-controlled trial and the main purpose is to examine the influence of ISH on morbidity, mortality, and general well-being. Investigation of blood pressure variation over 24 h and its relationship to morbidity and use for planning treatment will be incorporated. Other centers are invited to join in the enlarging project.


Novel α-galactosidase A gene mutation in a Chinese Fabry disease family: A case report.
Fabry disease (FD) is a rare X-linked lysosomal storage disease caused by a deficiency of the enzyme α-galactosidase A. Herein, we analyzed a four-generation Chinese family. The proband is a 57-year-old woman who was diagnosed with left ventricular hypertrophy and atrial fibrillation 7 years ago. Echocardiography showed an end-diastolic diameter of the interventricular septum of 19.9 mm, left ventricular end-diastolic diameter of 63.1 mm, and moderate-to-severe mitral regurgitation. Cardiac magnetic resonance indicated an enlarged left heart and right atrium, decreased left ventricular systolic and diastolic function, a left ventricular ejection fraction of 20%, and thickening of the left ventricular septum. In March 2019, gene and enzyme activity tests confirmed the diagnosis of FD. Her son was diagnosed with FD after gene and enzyme activity assay, and was prescribed agalsidase-β for enzyme replacement therapy in July 2020. Two sisters of the proband were also diagnosed with FD by genetic testing. Both of them had a history of atrial fibrillation. A novel mutation was identified in a Chinese family with FD, in which the male patient had a low level of enzyme activity, early-onset, and severe organ involvement. Comprehensive analysis of clinical phenotype genetic testing and enzyme activity testing helped in the diagnosis and treatment of this FD family.


Optimization of cyclosporine therapy in renal transplantation by a pharmacokinetic strategy.
Although cyclosporine (CsA) displays high immunosuppressive efficacy due to potent selective inhibition of T cell, but not nonspecific, immune functions, the pleiotropic toxicities of the drug result in a low therapeutic index. Thus for a given individual there is at best only a narrow dosage range producing immunosuppression not beclouded by toxicity. Selection of the appropriate CsA dose to achieve this state is complicated by marked inter- and intraindividual variability in drug pharmacokinetics and pharmacodynamics (1). Even considering renal transplant recipients solely, pharmacokinetic variations in drug absorption, volume of distribution, and metabolism as estimated by clearance rates are so great that strategies based on median population values are not useful for a great proportion of patients. Thus it is necessary to devise a CsA strategy that tailors therapy to compensate for interindividual variations. Implementation of such a strategy not only standardizes drug therapy, but also reveals the clinical impact of interindividual differences in the profile of CsA metabolites and in pharmacodynamic effects of a given quantity of CsA, reflecting both the therapeutic actions on the immune system and toxic effects on target organs. Thus a dosing strategy that achieves uniform drug levels by compensating for pharmacokinetic variation is essential for the eventual dissection of a rational CsA regimen.


Toward a standardized evaluation of imputation methodology.
Developing new imputation methodology has become a very active field. Unfortunately, there is no consensus on how to perform simulation studies to evaluate the properties of imputation methods. In part, this may be due to different aims between fields and studies. For example, when evaluating imputation techniques aimed at prediction, different aims may be formulated than when statistical inference is of interest. The lack of consensus may also stem from different personal preferences or scientific backgrounds. All in all, the lack of common ground in evaluating imputation methodology may lead to suboptimal use in practice. In this paper, we propose a move toward a standardized evaluation of imputation methodology. To demonstrate the need for standardization, we highlight a set of possible pitfalls that bring forth a chain of potential problems in the objective assessment of the performance of imputation routines. Additionally, we suggest a course of action for simulating and evaluating missing data problems. Our suggested course of action is by no means meant to serve as a complete cookbook, but rather meant to incite critical thinking and a move to objective and fair evaluations of imputation methodology. We invite the readers of this paper to contribute to the suggested course of action.


Actinomycin D in childhood acute lymphocytic leukemia.
Eighteen evaluable children who relapsed with acute lymphocytic leukemia (ALL) were treated with intermittent, high-dose actinomycin D. Objective responses occurred in four of 11 children who had relapsed with chemotherapy which did not contain an anthracycline. The major toxic effects included thrombocytopenia and granulocytopenia. Minor toxic effects included nausea, vomiting, skin rash, and stomatitis. The onset of the maculopapular skin rash coincided with the platelet count nadir. These data suggested that actinomycin D is active in ALL.


[Expression of genes related to inflammatory response in myocardium of rats after burn injury].
To observe expression of genes related to inflammatory response in myocardium of rats after burn injury. After 40 percent total body surface area (TBSA) of rat was burned gene expression of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), induced nitric oxide synthase (iNOS) and cytoplastic phospholipids A(2) (cPLA(2)) in myocardium was detected with reverse transcription-polymerase chain reaction (RT-PCR) at different time after burn. Meanwhile, changes of contractile and diastolic ability of left ventricle were determined with physiological recorder. TNF-alpha and cPLA(2) mRNAs were increased dramatically at 1 hour after burn and maintained at high level up to 24 hours later (P<0.01), IL-1beta gene expression was up-regulated at 3 hours after burn (P<0.01) and declined to normal level 12 hours later, herein any significant increase of iNOS mRNA in myocardium in rats was not found except decrease in iNOS mRNA could be detected at 1 hour after burn. As expected, severe impairment of myocardium was occurred at 3 hours after burn, represented by declining in both contractile and diasotolic ability of lefe ventrical. Over expression of TNF-alpha, cPLA(2) and IL-1beta mRNA in myocardium in rats may be partial cause of local myocardial uncontrolled inflammatory response and then partially contributed to cardiac impairment after burn.


A neonatal rat model of increased right ventricular afterload by pulmonary artery banding.
To construct a neonatal rat model of increased right ventricular (RV) afterload for studying the pathophysiological remodeling of the right ventricle in patients with congenital heart disease with increased RV afterload. Surgery was performed within 6 hours after birth. Horizontal thoracotomy was performed by dissecting the intercostal muscles and splitting the sternum. The PA was then banded with 11-0 nylon thread. At postnatal day 7 (P7), constriction of PA was confirmed by echocardiography. The RV systolic and diastolic pressures were measured by cardiac catheterization. The RV end-systolic volume, end-diastolic volume, end-diastolic diameter, and free wall thickness were assessed by magnetic resonance imaging. The histological changes in sham-operated and PA-banding (PAB) hearts were evaluated by hematoxylin and eosin staining. Increased RV afterload was established by constriction of the PA in neonatal rats within 6 hours after birth. The survival rate was 75% at P7. Relative to the sham group, the peak pressure gradient across the PA constriction and RV systolic and diastolic pressures, end-systolic volume, end-diastolic volume, end-diastolic diameter, and free wall thickness were significantly increased in the PAB group at P7 (P < .01). Consistently, histological examination showed that the RV free wall was significantly hypertrophic in the PAB group. We successfully established a neonatal RV afterload increase model through PAB within 6 hours after birth, which can be used to study the pathophysiological changes in congenital heart diseases with increased RV afterload.


Cancers in Australia in 2010 attributable to and prevented by the use of combined oral contraceptives.
To estimate the proportion and number of cancers occurring in Australia in 2010 attributable to combined oral contraceptive pill (OCP) use. We estimated the population attributable fraction (PAF) for cancers causally associated with combined OCP use (breast, cervix), and the proportion of endometrial and ovarian cancers prevented (prevented fraction [PF]). We used standard formulae incorporating prevalence of combined OCP use in the Australian population, relative risks of cancer associated with this exposure and cancer incidence. An estimated 105 breast and 52 cervical cancers (0.7% and 6.4% of each cancer, respectively) in Australia in 2010 were attributable to current use of combined OCP. Past combined OCP use was estimated to have prevented 1,032 endometrial and 308 ovarian cancers in 2010, reducing the number of cancers that would otherwise have occurred by 31% and 19%, respectively. A small proportion of breast and cervical cancers is attributable to combined OCP use; OCP use is likely to have prevented larger numbers of endometrial and ovarian cancers. Women seeking contraceptive advice should be told of potential adverse effects, but should also be told that - along with reproductive health benefits - combined OCP use can reduce long-term risks of ovarian and endometrial cancers.


Interstitial cystitis: characterization and management of an enigmatic urologic syndrome.
The enigmatic urologic condition known as interstitial cystitis has an estimated prevalence of 0.01% to 0.50% of the female population. Its etiology is unknown but may involve microbiologic, immunologic, mucosal, neurogenic, and/or other, as yet undefined, agents. There is no gold standard for the diagnosis of interstitial cystitis; rather, it is a diagnosis of exclusion. It is impossible to provide a purely evidence-based treatment strategy, but review of available evidence suggests that conservative supportive therapy (including diet modification); oral treatment with pentosan polysulfate, amitriptyline, hydroxyzine, or cimetidine; and intravesical treatments with heparinoids, dimethyl sulfoxide, alkalized lidocaine, or bacille Calmette-Guérin may be effective in some patients.


Comparison of Stimulated Cycles with Low Dose r-FSH versus Hormone Replacement Cycles for Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer in Young Women with Polycystic Ovarian Syndrome: A Single-Center Retrospective Cohort Study from China.
The principal purpose of this study was to compare reproductive outcomes for stimulated cycles (STC) and hormone replacement cycles (HRC) for endometrial preparation before frozen-thawed embryo transfer (FET) in young women with polycystic ovary syndrome (PCOS). We conducted a retrospective study of 1434 FET cycles from January, 2017 to March, 2020 in our reproductive center, in which stimulated and hormone replacement cycles were used for endometrial preparation. Pregnancy outcomes of couples undergoing routine STC-FET or HRC-FET were analyzed by propensity score matching (PSM) and multivariable logistic regression analyses. Data on 1234 HRC protocols (86% of the total) and 200 STC protocols (14%) were collected. After PSM, 199 patients were included in both groups, respectively. There was no significant difference in positive pregnancy rate (52.7% vs 54.8%, p=0.763), clinical pregnancy rate (51.8% vs 52.8%, p=0.841), live birth rate (45.2% vs 43.7%, p=0.762), pregnancy loss rate (9.7% vs 16.2%, p=0.164) and ectopic pregnancy rate (1.5% vs 0.5%, p=0.615) between STC and HRC protocols. Subsequent multivariate logistic regression analysis also yielded similar results. STC for endometrial preparation had similar pregnancy outcomes compared with HRC protocols. Evidence is available which shows that for young women with PCOS in preparation for FET, HRC could be a reasonable choice for patients who are unwilling to accept injections. However, STC may reduce unnecessary anxiety and operational costs and offer more flexibility for patients. Eventually, we must embrace the concepts of individualization, securitization, and optimization in the clinic.


AGIA Tag System Based on a High Affinity Rabbit Monoclonal Antibody against Human Dopamine Receptor D1 for Protein Analysis.
Polypeptide tag technology is widely used for protein detection and affinity purification. It consists of two fundamental elements: a peptide sequence and a binder which specifically binds to the peptide tag. In many tag systems, antibodies have been used as binder due to their high affinity and specificity. Recently, we obtained clone Ra48, a high-affinity rabbit monoclonal antibody (mAb) against dopamine receptor D1 (DRD1). Here, we report a novel tag system composed of Ra48 antibody and its epitope sequence. Using a deletion assay, we identified EEAAGIARP in the C-terminal region of DRD1 as the minimal epitope of Ra48 mAb, and we named this sequence the "AGIA" tag, based on its central sequence. The tag sequence does not include the four amino acids, Ser, Thr, Tyr, or Lys, which are susceptible to post-translational modification. We demonstrated performance of this new tag system in biochemical and cell biology applications. SPR analysis demonstrated that the affinity of the Ra48 mAb to the AGIA tag was 4.90 × 10-9 M. AGIA tag showed remarkably high sensitivity and specificity in immunoblotting. A number of AGIA-fused proteins overexpressed in animal and plant cells were detected by anti-AGIA antibody in immunoblotting and immunostaining with low background, and were immunoprecipitated efficiently. Furthermore, a single amino acid substitution of the second Glu to Asp (AGIA/E2D) enabled competitive dissociation of AGIA/E2D-tagged protein by adding wild-type AGIA peptide. It enabled one-step purification of AGIA/E2D-tagged recombinant proteins by peptide competition under physiological conditions. The sensitivity and specificity of the AGIA system makes it suitable for use in multiple methods for protein analysis.


Taxotere-induced WNT16 Expression in Carcinoma-Associated Fibroblasts Might Associate with Progression and Chemoresistance of Breast Cancer.
The objective of this study is to investigate the relationship between WNT16 expression in carcinoma-associated fibroblasts and Taxotere treatments in breast cancer. WNT16 expression in primarily cultured carcinoma-associated fibroblasts was detected via Real-Time PCR and Western blot. A total of 106 breast cancer cases were prepared for immunohistochemistry. Multiple assays were performed to examine the function of breast cancer cells (MDA-MB-231) co-cultured with carcinoma-associated fibroblasts when WNT16 was inhibited. Enhanced WNT16 expression was verified in carcinoma-associated fibroblasts after Taxotere treatment (p<0.0001). MDA-MB-231 cells co-cultured with carcinoma-associated fibroblasts displayed decreasing invasion, proliferation abilities, and an increasing sensitivity to Taxotere treatment when WNT16 was inhibited. The WNT16 expression of carcinoma-associated fibroblasts in breast cancer was significantly associated with tumor size (p=0.0164), and chemotherapy treatment (p=0.0015). The results indicate that Taxotere-induced WNT16 expression in carcinoma-associated fibroblasts might contribute to the progression and chemoresistance of breast cancer.


Urogenital Chlamydia trachomatis in Gabon: an unrecognised epidemic.
Samples from 218 men with urethritis, 517 women with pelvic pain or pelvic pain and vaginal discharge, 218 women consulting for infertility, and 598 postpartal women were screened for Chlamydia trachomatis by culture and direct immunofluorescence. Chlamydiae were detected in 18% (39/218) of the men, 18% (45/252) of women with vaginal discharge, 14% (38/265) of those with pelvic pain, 10% (21/218) of infertile, and 10% (59/598) of postpartal women. A chlamydial prevalence of 18% (41) was observed in 229 postpartal women aged under 21, whereas only 5% (10) of 360 postpartal women over 21 had C trachomatis. In the other clinical groups, an age related decrease in prevalence was noted in women over 25. The direct immunofluorescence test correlated well with culture. The small difference in isolation between symptomatic and postpartal women indicates that women in this population do not seek medical attention for chlamydial infections and expose themselves to chlamydial salpingitis and infertility.


Portrait of a newborn.
To discover whether the American woman has a preconceived idea of her newborn's appearance, ten primigravidas were asked to draw their newborns-to-be and were interviewed about their expectations. Responses were analyzed for recurring themes and compared with a stereotypical baby described by Lorenz. The informants' general descriptions of their newborns-to-be were specific to the particular family. The newborns were closer in appearance to an older baby than to a newborn. The informants' newborns had two of the Lorenz's six stereotypical attributes.


How nurses perceive barriers to research implementation.
This article follows up a previous article on community nurses' perceived barriers to implementing research (Walsh 1997). Here the author examines the perceived barriers to research use among a sample of 63 hospital and 78 community nurses. The major barriers identified relate to the clinical setting and understanding research reports. The results have significant implications for managers of the service and educators who seek to promote research-based practice.


The Diversity-Segregation Conundrum.
There is a long literature extolling the virtues of diversity for both the civility and economic performance of nations and cities. On the most basic level, diversity helps nations and cities attract the wide range of creative talent that drives innovation and economic growth. Yet similarly, there is a large amount of literature on the sorting and segregation of different types of people into distinct communities. This in turn undermines the very mixing of people and groups required for economic prosperity to flourish. This essay looks at the conundrum between diversity and segregation. It argues that both are increasingly salient, interdependent, and interconnected features of large, advanced cities or metropolitan areas. This diversity-segregation conundrum is increasingly a core feature of our social and economic landscape. It reviews several recent studies that highlight this problem, as well as some of my own very recent empirical findings on the issue.


Long-term follow-up results of surgery for chronic pancreatitis.
Based on a mean follow-up period of 86 months, the long-term results of 87 drainage and resection operations performed for chronic pancreatitis between 1990-94 were evaluated. To evaluate the results, two questionnaires were filled out by the patients. The first was related to the pancreatitis and the long-term complications, the second was a Gastrointestinal Quality of Life Index questionnaire. Data of deceased patients were collected with the help of general practitioners. Based on the analysis of disease-related and quality of life questionnaire forms only 34% of the investigated patients could be classified as a group showing good results. There was a high incidence of long-term mortality (25%). Eighty-three percent of the deceased patients (18 patients) died after the seventh postoperative year. The most threatened group seems to be the alcoholic and insulin-dependent diabetic one. The combination of the two pathologies was the cause of death in a third of the cases. Insulin-dependent diabetes mellitus developed in 13 patients after an average of 3.9 years following surgery, mainly as a consequence of the irreversible and progressive nature of disease. The rate of disability was 51%. No significant difference could be demonstrated between the resected and the decompressed group according to either disability or late mortality rate. Based on these results, the authors wish to emphasize that in chronic pancreatitis the short-term follow-up results may be deceptive, and that the real outcome of the surgical treatment can only be expected five years following surgery.


Sodium MRI radiofrequency coils for body imaging.
The proliferation of high-field whole-body systems, advances in gradient performance and refinement of signal-to-noise ratio (SNR)-efficient short-TE sequences suitable for sodium imaging have led to a resurgence of interest in sodium imaging for body applications. With this renewed interest has come increased demand for SNR-efficient sodium coils. Efficient coils can significantly increase SNR in sodium imaging, allowing higher resolutions and/or shorter scan times. In this work, we focus on body imaging applications of sodium MRI, and review developments in MRI radiofrequency (RF) coil topologies for sodium imaging. We first provide a brief discussion of RF coil design considerations in sodium imaging. This is followed by an overview of common coil topologies, their advantages and disadvantages, and examples of each.


Effects of aging on mitochondrial hydrogen peroxide emission and calcium retention capacity in rat heart.
Aging is a risk factor for heart disease and heart failure, which result from a progressive impairment of cardiac functions, including stroke volume, cardiac output, blood flow, and oxygen consumption. Age-related cardiac dysfunction is associated with impaired cardiac structures, such as the loss of myocytes, structural remodeling, altered calcium (Ca2+) handling, and contractile dysfunction. However, the mechanism by which aging affects mitochondrial function in the heart is poorly understood. The purpose of this study was to determine the effects of aging on mitochondrial function in the rat heart. Male Fischer 344 rats were randomly assigned to very young sedentary (VYS, 1 month), young sedentary (YS, 4 months), middle-aged sedentary (MS, 10 months), and old sedentary (OS, 20 months) groups. mitochondrial complex protein levels and mitochondrial function (e.g., mitochondrial hydrogen peroxide (H2O2) emission and Ca2+ retention capacity) were analyzed in the left ventricle. Aging was associated with decreased levels of OXPHOS (oxidative phosphorylation) protein expression of complex I to IV in the function of the electron transport chain. Aging increased the mitochondrial H2O2 emitting potential in the heart. In contrast, mitochondrial Ca2+ retention capacity gradually decreased with age. These data demonstrate that aging impairs mitochondrial function in cardiac muscle, suggesting that mitochondrial dysfunction with aging may be a primary factor for aging-induced cardiac dysfunction in the heart.


Arteriosclerotic femoral artery aneurysms.
Arteriosclerotic aneurysms of the femoral artery are uncommon lesions that occur in elderly men. In 30 patients 36 aneurysms were repaired at the Toronto Western Hospital from January 1965 to June 1977. Half of the patients presented with ischemia and one quarter with an enlarging mass, and one quarter had no symptoms. Two thirds had other aneurysms and one third had suffered from cerebral or myocardial ischemia. The technique of repair changed from reconstructive aneurysmorrhaphy before 1970 to use of an interposition arterial prosthesis thereafter. Minimal groin dissection, internal control of blood flow in the deep femoral artery, and use of an appropriate arterial prosthesis provided excellent results. Surgical repair is recommended for most symptomatic ones when the patient's life expectancy is more than 2 years.


Breast cancer screening: Where have we been and where are we going? A personal perspective based on history, data and experience.
It is important to understand the history of breast cancer screening to better understand the continuing effort to reduce access to screening. Since the randomized, controlled trials have shown a statistically significant mortality reduction for women ages 40-74, the appropriate threshold for initiating screening is age 40 with no data to support the use of the age of 50 as a threshold for screening. All women are at risk for developing breast cancer and all women should have access to screening.


Characteristics of acute glomerulonephritis associated with human parvovirus B19 infection.
Acute glomerulonephritis (AGN) is a rare complication of human parvovirus B19 (HPB19) infection. The clinical and pathological features of AGN associated with HPB19 (HPBAGN) have not yet been fully elucidated. We analyzed 10 HPBAGN cases, focusing on their clinical and serological features. We also performed histopathological examinations of renal biopsy specimens obtained from three of the 10 patients on day 15, 19 and 23, respectively, after the onset of symptoms. The phenotype of the glomerular infiltrating leukocytes in HPBAGN was determined by immunohistochemical staining and compared with that of glomerular infiltrating leukocytes in poststreptococcal AGN (PSAGN) and lupus nephritis. The clinical course and laboratory data of the HPBAGN patients revealed female preponderance (male = 0, female = 10), erythema in 9 of the 10 patients, leukopenia in 3, positive antinuclear antibody titer in 4, hypocomplementemia with low levels of C3, C4, and CH50 in 9, and liver dysfunction in 7. Endocapillary hypercellularity of leukocytes was demonstrated in all three patients who underwent renal biopsy. In comparison with PSAGN and lupus nephritis with crescents there were less neutrophil in HPBAGN compared to marked macrophage infiltrates that were equally intense in both the control and the HPBAGN group. Our findings indicate that HPBAGN is characterized by female preponderance, erythema, leukopenia, positive antinuclear antibody titer, and hypocomplementemia, and that minor neutrophil infiltration may be related to mild clinical manifestations despite the marked fixation of glomerular leukocytes in HPBAGN.


Constitutively active TrkB confers an aggressive transformed phenotype to a neural crest-derived cell line.
Neuroblastoma arises from sympathoadrenal progenitors of the neural crest and expression of the neurotrophin receptor TrkB and its ligand, brain-derived neurotrophic factor (BDNF), is correlated with poor prognosis. Although activated TrkB signaling promotes a more aggressive phenotype in established neuroblastoma cell lines, whether TrkB signaling is sufficient to transform neural crest-derived cells has not been investigated. To address the role of TrkB signaling in malignant transformation, we removed two immunoglobulin-like domains from the extracellular domain of the full-length rat TrkB receptor to create a ΔIgTrkB that is constitutively active. In the pheochromocytoma-derived cell line PC12, ΔIgTrkB promotes differentiation by stimulating process outgrowth; however, in the rat neural crest-derived cell line NCM-1, ΔIgTrkB signaling produces a markedly transformed phenotype characterized by increased proliferation, anchorage-independent cell growth, anoikis resistance and matrix invasion. Furthermore, expression of ΔIgTrkB leads to the upregulation of many transcripts encoding cancer-associated genes including cyclind1, twist1 and hgf, as well as downregulation of tumor suppressors such as pten and rb1. In addition, ΔIgTrkB NCM-1 cells show a 21-fold increase in mRNA for MYCN, the most common genetic marker for a poor prognosis in neuroblastoma. When injected into NOD SCID mice, control GFP NCM-1 cells fail to grow whereas ΔIgTrkB NCM-1 cells form rapidly growing and invasive tumors necessitating euthanasia of all mice by 15 days post injection. In summary, these results indicate that activated TrkB signaling is sufficient to promote the formation of a highly malignant phenotype in neural crest-derived cells.


Congenital Thrombophilia and Intracardiac Thrombosis: Probably an Underdiagnosed Event.
To investigate the number of patients with congenital thrombophilia who presented an intracardiac thrombosis. Personal files were reevaluated together with a time-unlimited search of the literature. Twenty-five patients with intracardiac thrombosis and congenital thrombophilia have been gathered from the literature including the two personal cases. The distribution observed in thrombophilia patients is similar for left side or right side heart (9 vs 11 cases). The left ventricle and the right ventricle were involved in six or five instances, respectively. In one case, both ventricles were involved. On the contrary, the left atrium was involved in three cases whereas the right atrium was affected in six cases. In the remaining cases, more than one heart chamber was involved. In "normal" subjects, left side thromboses are predominant once catheter-associated thrombi are excluded. The reason of this discrepancy lies in the greater prothrombotic effect exercised by congenital thrombophilia on venous thrombosis compared to arterial thrombosis. The relative high prevalence of cardiac thrombosis seen in patients with antithrombin and protein C deficiencies indicated that a cardiac evaluation should be carried out in all patients with these two defects.


Multifrequency Analysis of Masseter Vestibular Evoked Myogenic Potentials in Young Adults.
The purpose of this study was to explore the dynamics of multifrequency tone bursts on the masseter vestibular evoked myogenic potential (mVEMP) parameters. Furthermore, it sought to determine the optimal frequency tuning of mVEMP responses. Twenty young adults with normal hearing sensitivity participated in the study. Bilateral tone burst evoked mVEMPs were obtained using the zygomatic montage at 250-, 500-, 750-, 1000-, 1500-, and 2000-Hz stimulation frequencies. Self-monitoring biofeedback was given during the procedure to confirm the tension of the masseter muscle between 49.9 and 150.6 rms. Furthermore, the electromyography (EMG) scaling was done to avoid any muscle-related irregularities. Tone burst evoked mVEMPs were found to be 100% present at the stimulation frequencies of 250, 500, 750, and 1000 Hz. There were no ear and gender effects seen for any of the frequencies. Significant shortening of the P1 and N1 latencies with increasing stimulation frequencies was observed. The peak-to-peak amplitude was the highest at 500 Hz and lowest at 2000 Hz tone bursts under both EMG scaled and unscaled conditions. The present revealed higher response rates and larger amplitudes study of mVEMP at lower frequencies, and, therefore, the frequency tuning was seen for the stimulation frequency at 500 Hz.


Quantitation of HIV-1 in whole blood of infected children.
To validate the technique of HIV-1 culture from whole blood for the quantitation of viral load in infected children. Forty-three HIV-1-infected children were followed in two paediatric centres. Quantitative HIV-1 cultures from unfractionated whole blood using an end-point dilution technique were compared with simultaneous quantitative cultures of peripheral blood mononuclear cells (PBMC) and plasma. Good sensitivity (93%) of the methods used was confirmed. A close correlation (r = 0.80) was observed between HIV-1 titres measured directly from whole blood and those expected from PBMC and plasma titres. The mean whole blood viral load was higher in patients with more severe signs of disease, but the difference did not reach statistical significance. The whole blood viral titres measured sequentially at monthly intervals remained within one dilution of each other in 16 of the 22 patients studied. In this study, the quantitation of HIV-1 in unfractionated blood allowed for a reliable and sensitive measurement of the whole blood viral load in infected children.


[The sleep-wake rhythm of the fetus].
Our work refers to a body of studies carried out by Sonargram observation, which allowed us to study fetal movements in real time. These fetuses were studied not only as parameters of correct neurobiological maturity but also from the psychological interest which looks for the beginning of thinking based on the question: When and how does the thought process begin in biological matter? The study comparing the movement of fetuses and new-born babies to psychoanalytical research (which have been described in other works) led us to formulate the following hypothesis: motor and sense experiences can only become "mental" after separation from the mother; it can only come about by birth which effectively forces a confrontation on biological grounds: it prepares the thinking process without yet having it. There is a debate between these positions and psychoanalytical schools of thought in which thinking could precede the birth of the human fetus; there might be a stage of sleep (REM) that corresponds to adult dreaming.


The influence of the work environment on cardiovascular health: a historical, conceptual, and methodological perspective.
The framework of psychosocial epidemiology is used to examine research developments that characterize the accumulation of knowledge regarding the role of the work environment in cardiovascular health and disease. The discussion of current programs of research focuses on the work of T. Theorell and R. Karasek (1996) and J. Siegrist (1996) as exemplars of European and American studies that have contributed the most to the understanding of occupational cardiovascular health. It is argued that researchers need to maintain and nurture relatively broad conceptual models of etiology because cardiovascular disease involves multiple biomedical risk factors and because specific aspects of the work environment are embedded in a large, complex matrix of other psychosocial influences. At the same time, investigators need to push ahead with focused research strategies to clarify the precise nature of the work environmental risk factors that emerge in the broad, somewhat imprecise epidemiologic study designs.


Molecular Insight into Long-Wavelength Fluorogenic Dye Design: Hydrogen Bond Induces Activation of a Dormant Acceptor.
The detection of chemical or biological analytes in response to molecular changes relies increasingly on fluorescence methods. Therefore, there is a substantial need for the development of improved fluorogenic dyes. In this study, we demonstrated how an intramolecular hydrogen bond activates a dormant acceptor through a charge induction between phenolic hydrogen and a heteroaryl nitrogen moiety. As a result, a new fluorochrome is produced, and the molecule exhibits a strong fluorescent emission. When the strength of the hydrogen bonding was increased by conformational locking, the obtained dye emitted at longer wavelengths and fluoresced under physiological conditions. The dye was implemented in a turn-ON system responsive to hydrogen peroxide. The molecular insight provided by this study should assist in the design of fluorescent dyes that are suitable for in vitro and in vivo applications.


[Ultrasound diagnosis of the meniscus].
As a supplement to clinical findings, sonographic examination of the meniscus is an easily available, noninvasive imaging technique that can be used to optimize preoperative diagnosis and check the indication for arthroscopy. Careful consideration of the technical requirements and systematic performance of the dynamic examination should lead to further improvement of the examination results and to growing clinical significance in the future.


Adult maltase acid deficiency myopathy: treatment with long-term home mechanical ventilation.
We report a study of an adult with a maltase acid deficiency myopathy. A restrictive respiratory syndrome due to respiratory muscle weakness is associated with paralysis of other muscular groups. In 1982 the patient presented with an alveolar hypoventilation, and mechanical ventilation was required after acute respiratory failure. The patient has received nocturnal mechanical ventilation by tracheostomy at home for 5 years. His clinical status gradually improved in parallel to amelioration of his respiratory condition. Functional respiratory tests improved: initial hypoxia-hypercapnia disappeared, vital capacity increased. The possible mechanisms underlying the improvement are discussed. Increase in pulmonary compliance is an argument to explain the functional improvement observed. Ventilatory response to carbon dioxide was abnormal whereas the ventilatory response to exercise and maxima minute ventilation test were normal. Results are consistent with a respiratory control impairment. The role of mechanical ventilation is difficult to assess in the improvement we observed.


17β-estradiol promotes cholesterol efflux from vascular smooth muscle cells through a liver X receptor α-dependent pathway.
Estrogen has pleiotropic effects on the cardiovascular diseases, yet the underlying mechanisms remain incompletely understood. Cholesterol efflux is a key mechanism through which to prevent foam cell formation and the development of atherosclerosis. Recent studies highlight the role of vascular smooth muscle cell (VSMC)-derived foam cells in atherogenesis. However, it remains unclear whether estrogen promotes cholesterol efflux from VSMCs and inhibits VSMC-derived foam cell formation. In the present study, we demonstrated that 17β-estradiol (E2) markedly enhanced cholesterol efflux to apolipoprotein (apo)A-1 and high-density lipoprotein (HDL) and attenuated oxidized low-density lipoprotein (ox-LDL) induced cholesteryl ester accumulation in VSMCs, which was associated with an increase in the expression of ATP-binding cassette transporters ABCA1 and ABCG1. The upregulation of ABCA1 and ABCG1 expression by E2 resulted from liver X receptor (LXR)α activation, which was confirmed by the prevention of the expression of ABCA1 and ABCG1 after inhibition of LXRα with a pharmacological inhibitor or small interfering RNA (siRNA). Furthermore, E2 increased LXRα, ABCA1 and ABCG1 expression in VSMCs via the estrogen receptor (ER), and the involvement of ERβ was confirmed by the use of selective ERα or ERβ antagonists (MPP and PHTPP) and agonists (PPT and DPN). These findings suggest that E2 promotes cholesterol efflux from VSMCs and reduces VSMC-derived foam cell formation via ERβ- and LXRα-dependent upregulation of ABCA1 and ABCG1 and provide novel insights into the anti-atherogenic properties of estrogen.


Age-Related Changes in Associations Between Reasons for Alcohol Use and High-Intensity Drinking Across Young Adulthood.
Analyses focus on whether self-reported reasons for drinking alcohol change in their associations with high-intensity drinking across the transition to adulthood. Self-report data on high-intensity drinking (10+ drinks) collected from the national Monitoring the Future study in 2005 to 2014 from those ages 18-26 were used (N = 2,664 [60% women] for all drinkers and 1,377 for heavy episodic [5+] drinkers; up to 6,541 person-waves). Time-varying effect modeling examined changes in the direction and magnitude of associations between eight reasons for drinking and high-intensity alcohol use across continuous age. Four reasons to drink showed quite stable associations with high-intensity drinking across age: drinking to get away from problems, to get high, to relax, and to sleep. Associations between two reasons and high-intensity drinking decreased with age: anger/frustration and to have a good time. The association between drinking because of boredom and high-intensity drinking increased with age. Drinking because it tastes good had a weak association with high-intensity drinking. Among heavy episodic drinkers, reasons for use also differentiated high-intensity drinking, with two exceptions: drinking to have a good time and to relax did not distinguish drinking 10+ drinks from drinking 5-9 drinks. Reasons for drinking are differentially associated with high-intensity drinking, compared with any other drinking and compared with lower intensity heavy drinking, across age during the transition to adulthood. Intervention programs seeking to mitigate alcohol-related harms should focus on reasons for use when they are the most developmentally salient.


Non-newtonian fluid flow through three-dimensional disordered porous media.
We investigate the flow of various non-newtonian fluids through three-dimensional disordered porous media by direct numerical simulation of momentum transport and continuity equations. Remarkably, our results for power-law (PL) fluids indicate that the flow, when quantified in terms of a properly modified permeability-like index and Reynolds number, can be successfully described by a single (universal) curve over a broad range of Reynolds conditions and power-law exponents. We also study the flow behavior of Bingham fluids described in terms of the Herschel-Bulkley model. In this case, our simulations reveal that the interplay of (i) the disordered geometry of the pore space, (ii) the fluid rheological properties, and (iii) the inertial effects on the flow is responsible for a substantial enhancement of the macroscopic hydraulic conductance of the system at intermediate Reynolds conditions.


Statistical energy minimization theory for systems of drop-carrier particles.
Drop-carrier particles (DCPs) are solid microparticles designed to capture uniform microscale drops of a target solution without using costly microfluidic equipment and techniques. DCPs are useful for automated and high-throughput biological assays and reactions, as well as single-cell analyses. Surface energy minimization provides a theoretical prediction for the volume distribution in pairwise droplet splitting, showing good agreement with macroscale experiments. We develop a probabilistic pairwise interaction model for a system of such DCPs exchanging fluid volume to minimize surface energy. This leads to a theory for the number of pairwise interactions of DCPs needed to reach a uniform volume distribution. Heterogeneous mixtures of DCPs with different sized particles require fewer interactions to reach a minimum energy distribution for the system. We optimize the DCP geometry for minimal required target solution and uniformity in droplet volume.


Enhanced radiative emission rate and quantum efficiency in coupled silicon nanocrystal-nanostructured gold emitters.
We report local-field-enhanced light emission from silicon nanocrystals close to a film of nanoporous gold. We resolve photoluminescence as the gold-Si nanocrystal separation distance is varied between 0 and 20 nm and observe a fourfold luminescence intensity enhancement concomitant with increases in the coupled silicon nanocrystal/nanoporous gold absorbance cross section and radiative decay rate. A detailed analysis of the luminescence data indicated a local-field-enhanced quantum efficiency of 58% for the Si nanocrystals coupled to the nanoporous gold layer.


Uncertainties of deformable image registration for dose accumulation of high-dose regions in bladder and rectum in locally advanced cervical cancer.
To compare the dose accumulation for bladder and rectum by deformable image registration (DIR) and direct addition (DA) of dose volume histogram parameters in magnetic resonance image-guided adaptive brachytherapy (IGABT). Two DIR algorithms, contour- and intensity-based, also have been analyzed. Patients (n = 21) treated with IGABT for carcinoma cervix under the IntErnational study on MRI-guided BRachytherapy in locally Advanced CErvical cancer protocol were analyzed. Each patient underwent two HDR-BT applications, 1-week apart with two fractions of 7 Gy each delivered per application. For each application, magnetic resonance imaging, volume delineation, reconstruction, treatment planning (BT1 and BT2), and dose evaluation were carried out. BT1 and BT2 images were registered using an intensity-based DIR, followed by deformable dose accumulation (DDA), which was then compared with DA. To compare the intensity-based DIR to other DIR approaches, nine patients were further evaluated using an in-house contour-based DIR algorithm for bladder dose accumulation. Mean (±standard deviation; range) percentage variation between DA and DDA was found to be 2.4% (±3.3;-1.8, 11.5) and 5.2% (±5.1;-1.7, 16.5) for the rectum and bladder, respectively. The differences between the DA and DDA were found to be statistically significant for both rectum (p = 0.008) and bladder (p = 0.0003). Intensity-based DIR algorithm resulted in a larger mean deviation between DDA and DA as compared with contour-based DIR, although statistically insignificant (p = 0.32). The difference between DDA and DA was 2.4 ± 2.0% and 1.3 ± 1.2%, for intensity- and contour-based DIR, respectively. DA of dose volume histogram parameters provides a good estimate to the dose to the organs at risk; DIR based on image intensities may lead to systematic underestimation of dose due to implausible DIR.


Olanzapine Overdose in a Two-Year-Old Girl Resulting in Both High Serum and Plasma Levels.
The antipsychotic olanzapine is used increasingly to treat various psychiatric illnesses. Accidental olanzapine overdose is uncommon among children. Here, we report a case of a child presenting with an unexplained coma. Accidental ingestion of olanzapine (20 mg) was confirmed by measurement of drug concentrations in both serum and plasma.


Trifluoromethylation of a Well-Defined Square-Planar Aryl-NiII Complex involving NiIII /CF3. and NiIV -CF3 Intermediate Species.
Ni-mediated trifluoromethylation of an aryl-Br bond in model macrocyclic ligands (Ln -Br) has been thoroughly studied, starting with an oxidative addition at Ni0 to obtain well-defined aryl-NiII -Br complexes ([Ln -NiII ]Br). Abstraction of the halide with AgX (X=OTf- or ClO4- ) thereafter provides [Ln -NiII ](OTf). The nitrate analogue has been obtained through a direct C-H activation of an aryl-H bond using NiII salts, and this route has been studied by X-ray absorption spectroscopy (XAS). Crystallographic XRD and XAS characterization has shown a tight macrocyclic coordination in the aryl-NiII complex, which may hamper direct reaction with nucleophiles. On the contrary, enhanced reactivity is observed with oxidants, and the reaction of [Ln -NiII ](OTf) with CF3+ sources afforded Ln -CF3 products in quantitative yield. A combined experimental and theoretical mechanistic study provides new insights into the operative mechanism for this transformation. Computational analysis indicates the occurrence of an initial single electron transfer (SET) to 5-(trifluoromethyl)dibenzothiophenium triflate (TDTT), producing a transient L1 -NiIII /CF3. adduct, which rapidly recombines to form a [L1 -NiIV -CF3 ](X)2 intermediate species. A final facile reductive elimination affords L1 -CF3 . The well-defined square-planar model system studied here permits to gain fundamental knowledge on the rich redox chemistry of nickel, which is sought to facilitate the development of new Ni-based trifluoromethylation methodologies.


Education of speech and language therapists in the Republic of Ireland and in the UK.
A brief history of speech and language therapy education in the Republic of Ireland and in the UK is provided, with reference to early 20th century developments. Current practice regarding the regulation and accreditation processes of education courses in the two countries is outlined. A general account of the development of undergraduate curricula of speech and language therapy is provided.


[Malignant mesothelioma in families of asbestos workers].
Malignant mesothelioma is primarily an occupational disease of asbestos workers. While there is usually a latent period of 20-40 years between exposure and appearance of the tumor, the duration of exposure may be as short as a single month. Rarely, it may appear in family members and others living with asbestos workers who might be exposed to asbestos from work clothes during laundering, or from fibers on the skin or hair of the asbestos worker. Attention should therefore be paid to those with nonoccupational contact with asbestos. We report 2 cases of pleural mesothelioma in families of asbestos workers. In both cases the laundering of work clothes was done at home. The first was a 33-year-old man; during his childhood his father worked with asbestos boards for 5 years. The second was a 76-year-old woman whose husband worked in an asbestos factory for 32 years, up to 18 years before diagnosis.


Research Advances in the Role of Bromodomain-containing Protein 4 in Epithelial-mesenchymal Transition in Asthma.
Asthma is a chronic airway disease characterized by airway inflammation and airway remodeling. Chronic airway inflammation can be involved in airway remodeling in asthmatic patients by incuding epithelial-mesenchymal transition (EMT).Bromodomain-containing protein 4 (BRD4) is a key transcriptional regulator in mammals,and many evidences have shown that BRD4 plays a pivotal role in airway remodeling via nuclear factor-κB/RelA signaling pathway. This review summarizes the recent advances in the role of BRD4 in regulating EMT,with an attempt to elucidate the molecular mechanisms of asthma and inform the prevention and control of asthma.


Characterization of plasma polymerized silicone coatings useful as biomaterials.
Plasma polymerization techniques were used to deposit a layer of filler-free silicone rubber on a variety of substrate materials. The thickness of the deposited film was 0.5-0.8 micron. As it is the surface of the biomaterial that comes in direct contact with the body fluids, the surface of the biomaterial is of paramount importance. In this study, the plasma polymerized biomaterials were characterized. Thus, the scanning electron microscope (SEM) showed the surfaces to be smooth. To study the surface layer of the deposited polymer, Fourier-transform infrared spectrometry in the attenuated total reflection (ATR) mode was used. The deposited material was indeed silicone polymer with adsorption bands at 1262, 1020, and 802 cm-1 for the Si-CH3 bending, Si-0-Si stretching, and Si-CH3 bending, respectively. To find the bonding nature of the polymer, electron spectrometry for chemical analysis (ESCA) was used. The silicone polymer was shown to be highly cross-linked. To find the molecular weight between cross-links, swelling studies were done. Thus the results of the study show that the plasma polymerization could produce a filler-free silicone layer on a variety of substrate materials.


Nano-sized Ultrasound Contrast Agents for Cancer Therapy and Theranostics.
Ultrasound contrast agents (UCA) represented by gas-filled microbubble, can provide simultaneous and co-localized enhancement on image contrast to help disease diagnosis by highlighting tissue borders. Nowadays, Some UCAs (e.g. Levovist®, Optison®, Definity®, and Sonovue®) are commercially available, and have been clinically utilized for enhanced ultrasonography in the US, Canada, Europe, Asia and so on. However, their large diameters (1~10 µm) mainly hinder more precise and deeper applications in the imaging of capillaryabundant organs or tissues (e.g. tumor), and undersized nanoscale UCAs also lack enough backscattering echo intensity to distinguish abnormal distribution of vessels. So novel shapes, structures and materials of nano-sized UCAs are constantly emerging for cancer ultrasonic imaging. Particularly, the cavitation effect of diagnostic ultrasound can accelerate effusion of loaded contents from UCAs, following cellular uptake. This will inevitably contribute to develop other potential applications of nano-sized UCAs towards cancer therapy and theranostics.


Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality.
The CT component of SPECT-CT is required for attenuation correction and anatomical localization of the uptake on SPECT but there is no guideline about the optimal CT acquisition parameters. In our department, a standard CT acquisition protocol was changed in 2013 to give lower radiation dose to the patient. In this study, we retrospectively compared the effects on patient dose as well as the CT image quality with current versus older CT protocols. Ninety nine consecutive patients [n=51 Standard dose 'old' protocol (SDP); n=48 lower dose 'new' protocol (LDP)] with lumbar spine SPECT-CT for bone scan were examined. The main differences between the two protocols were that SDP used 130 kVp tube voltage and reference current-time product of 70 mAs whereas the LDP used 110 kVp and 40 mAs respectively. Various quantitative parameters from the CT images were obtained and the images were also rated blindly by two experienced nuclear medicine physicians for bony definition and noise. The mean calculated dose length product of the LDP group (121.5±39.6 mGy.cm) was significantly lower compared to the SDP group patients (266.9±96.9 mGy.cm; P<0.0001). This translated into a significant reduction in the mean effective dose to 1.8 mSv from 4.0 mSv. The physicians reported better CT image quality for the bony structures in LDP group although for soft tissue structures, the SDP group had better image quality. The optimized new CT acquisition protocol significantly reduced the radiation dose to the patient and in-fact improved CT image quality for the assessment of bony structures.


Do early therapeutic alliance, motivation, and stages of change predict therapy change for high-risk, psychopathic violent prisoners?
Examination of the extent of offenders' engagement in change, and in rehabilitation programmes, is important to understanding success or failure following rehabilitation. In treatment programmes, the alliance between therapist and offender, and the therapy process itself appear central to progress offenders make that may reduce their criminal risk. But research with offenders seldom has measured therapeutic alliance and clinical writing suggests that it is difficult to form an alliance with those not ready to change their behaviour; especially with higher risk and psychopathic offenders. This study outlines the course of the therapeutic alliance in an 8-month treatment programme for high-risk, PCL-psychopathic violent prisoners. It examines relationships between early-treatment therapeutic alliance, therapists' global ratings of motivation to change, and initial stage of change on dynamic risk factors. In addition, it investigates which factors best predict who will complete treatment and change behaviourally during treatment. In this challenging, high-needs client group, early-programme stage of change, therapists' perceptions of motivation, therapeutic alliance and psychopathy did not predict how much change prisoners made. Regardless of initial levels, prisoners whose alliance increased the most over the course of treatment made the most change.


Challenges in Diagnosis and Functional Assessment of Coronary Artery Disease in Patients With Severe Aortic Stenosis.
More than half of patients with severe aortic stenosis (AS) over 70 years old have coronary artery disease (CAD). Exertional angina is often present in AS-patients, even in the absence of significant CAD, as a result of oxygen supply/demand mismatch and exercise-induced myocardial ischemia. Moreover, persistent myocardial ischemia leads to extensive myocardial fibrosis and subsequent coronary microvascular dysfunction (CMD) which is defined as reduced coronary vasodilatory capacity below ischemic threshold. Therefore, angina, as well as noninvasive stress tests, have a low specificity and positive predictive value (PPV) for the assessment of epicardial coronary stenosis severity in AS-patients. Moreover, in symptomatic patients with severe AS exercise testing is even contraindicated. Given the limitations of noninvasive stress tests, coronary angiography remains the standard examination for determining the presence and severity of CAD in AS-patients, although angiography alone has poor accuracy in the evaluation of its functional severity. To overcome this limitation, the well-established invasive indices for the assessment of coronary stenosis severity, such as fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR), are now in focus, especially in the contemporary era with the rapid increment of transcatheter aortic valve replacement (TAVR) for the treatment of AS-patients. TAVR induces an immediate decrease in hyperemic microcirculatory resistance and a concomitant increase in hyperemic flow velocity, whereas resting coronary hemodynamics remain unaltered. These findings suggest that FFR may underestimate coronary stenosis severity in AS-patients, whereas iFR as the non-hyperemic index is independent of the AS severity. However, because resting coronary hemodynamics do not improve immediately after TAVR, the coronary vasodilatory capacity in AS-patients treated by TAVR remain impaired, and thus the iFR may overestimate coronary stenosis severity in these patients. The optimal method for evaluating myocardial ischemia in patients with AS and co-existing CAD has not yet been fully established, and this important issue is under further investigation. This review is focused on challenges, limitations, and future perspectives in the functional assessment of coronary stenosis severity in these patients, bearing in mind the complexity of coronary physiology in the presence of this valvular heart disease.


Spontaneous State Detection Using Time-Frequency and Time-Domain Features Extracted From Stereo-Electroencephalography Traces.
As a minimally invasive recording technique, stereo-electroencephalography (SEEG) measures intracranial signals directly by inserting depth electrodes shafts into the human brain, and thus can capture neural activities in both cortical layers and subcortical structures. Despite gradually increasing SEEG-based brain-computer interface (BCI) studies, the features utilized were usually confined to the amplitude of the event-related potential (ERP) or band power, and the decoding capabilities of other time-frequency and time-domain features have not been demonstrated for SEEG recordings yet. In this study, we aimed to verify the validity of time-domain and time-frequency features of SEEG, where classification performances served as evaluating indicators. To do this, using SEEG signals under intermittent auditory stimuli, we extracted features including the average amplitude, root mean square, slope of linear regression, and line-length from the ERP trace and three traces of band power activities (high-gamma, beta, and alpha). These features were used to detect the active state (including activations to two types of names) against the idle state. Results suggested that valid time-domain and time-frequency features distributed across multiple regions, including the temporal lobe, parietal lobe, and deeper structures such as the insula. Among all feature types, the average amplitude, root mean square, and line-length extracted from high-gamma (60-140 Hz) power and the line-length extracted from ERP were the most informative. Using a hidden Markov model (HMM), we could precisely detect the onset and the end of the active state with a sensitivity of 95.7 ± 1.3% and a precision of 91.7 ± 1.6%. The valid features derived from high-gamma power and ERP in this work provided new insights into the feature selection procedure for further SEEG-based BCI applications.


Environmental conditions, anthropometric parameters and arterial blood pressure.
The influence of environmental conditions and anthropometric parameters on arterial blood pressure level was studied in 280 healthy Kashmiri subjects, aged 18-50 years (140 males, 140 females) Men in the age group of 18-20 years had higher blood pressure than women and their systolic blood pressure showed significant correlation with height, weight and skinfold thickness. Females (18-20 years) showed association of diastolic blood pressure with weight, skinfold thickness. Females (18-20) years) showed association of diastolic blood pressure with weight, skinfold thickness and mid-arm circumference. After the age of 20 years females had higher blood pressure than males. Height and weight decreased with age in both the sexes. Skinfold thickness and midarm circumference increased with age in females. A comparison between the present study and those reported from Haryana and Delhi revealed a higher diastolic pressure in Kashmiris.


Diffraction of optical communication Gaussian beams by volume gratings: comparison of simulations and experimental results.
The diffraction effects induced by a thick holographic grating on the propagation of a finite Gaussian beam are theoretically analyzed by means of the coupled-wave theory and the beam propagation method. Distortion of the transmitted and diffracted beams is simulated as a function of the grating parameters. Theoretical results are verified by experimentation realized by use of LiNbO3 volume gratings read out by a 1550-nm Gaussian beam, typical of optical fiber communications. This analysis can be implemented as a useful tool to aid with the design of volume grating-based devices employed in optical communications.


High-dose treatment with a long-acting somatostatin analogue in patients with advanced midgut carcinoid tumours.
High-dose somatostatin analogue treatment has shown an antiproliferative effect in one study including patients with neuroendocrine tumours. To explore this therapeutic strategy further, we have studied the effect of a high-dose formula of octreotide, octreotide pamoate, in midgut carcinoid patients. Twelve patients with advanced midgut carcinoid tumours with a median duration of disease of more than 5 years were included. All were in a progressive state despite several previous treatment modalities. Octreotide pamoate (160 mg) was given as an intramuscular injection every 2 weeks for 2 months and then monthly. Radiological and biochemical responses were monitored. Tumour size and biochemical markers were stabilised for a median of 12 months in 75% of the patients. Ten patients had symptomatic improvement of flush and diarrhoea. In this group of patients with advanced midgut carcinoid tumours and progressive disease, octreotide pamoate managed to improve symptoms, and stabilise hormone production and tumour growth in 75% of the patients. We believe that high-dose treatment with somatostatin analogues can be an important addition to the therapeutic arsenal for patients with advanced progressive midgut carcinoid tumours.


Urinary leukotriene E4 levels in atopic and non-atopic preschool children with recurrent episodic (viral) wheezing: a potential marker?
Backround: Reliable biological markers for the differentiation of asthma phenotypes in preschool children with wheezing are lacking. The purpose of the study is to assess the relationship of urinary Leukotriene E4 (U-LTE4) to particular asthma phenotypes in preschool children with recurrent episodic (viral) wheezing following upper respiratory tract infections with or without atopic predisposition. Ninety-six preschool patients with recurrent episodic wheezing participated, 52 atopic and 44 non-atopic, during exacerbation and in remission. Exacerbation was defined on clinical basis (wheeze in the presence of coryzal symptoms). Atopy was determined by specific serum IgE measurement and skin-prick testing. U-LTE4 was determined by enzyme immunoassay. Thirty-six age-matched, non-asthmatic, non-atopic children served as controls. During exacerbation, U-LTE4 was significantly higher in all children with recurrent episodic wheezing in comparison to A: Remission: 642.20 ± 268 versus 399.45 ± 204, p value <0.001 and B: 642.20 ± 268 versus 271.39 ± 83, p value <0.001. Atopic patients demonstrated significantly higher levels of U-LTE4 compared to non-atopic, both during exacerbation 872.13 ± 246 versus 613.15 ± 150, p value = 0.0013 and during remission 507.59 ± 182 versus 283.59 ± 160, p value <0.001. During remission, a highly significant difference of U-LTE4 was found when controls were compared to atopic patients: 271.39 ± 83 versus 507.59 ± 182, p value = 0.002 but not when compared to non-atopic ones: 271.39 ± 83 versus 283.59 ± 160, p value = 0.432. U-LTE4 is strongly associated with the acute wheeze episode in preschool children, more so in atopics. Increased basal levels of U-LTE4 occur only in atopics. This suggests a potential role of U-LTE4 as a marker of atopic, virus-induced asthma in preschool children.


Self-care requirements for activity and rest: an Orem nursing focus.
According to Orem's self-care deficit nursing theory, helping people to maintain a balance between activity and rest (a universal self-care requisite) is a legitimate concern of nursing. The meaning of activity and rest, the requirements and potential measures for meeting this self-care requisite, and factors that might influence the process are explored. Criteria for determining a need for nursing, guides for a nursing clinical assessment, and guides for nursing action are suggested as potential ways to assist persons to meet the action demands associated with this self-care requisite.


Determinants of occurrence and recovery from hallucinations in daily life.
Data related to the dynamics of hallucinatory experiences of patients suffering from schizophrenia are scarce. Detecting antecedent conditions and coping strategies may aid development of targeted psychological interventions. We studied hallucinating and non-hallucinating patients suffering from schizophrenia spectrum disorder (n = 57), and non-schizophrenic severe mentally ill patients with depression (n = 37). Data were collected using the Experience Sampling Method (ESM) over a period of 1 week. Contingent on a randomly signalling beep, subjects filled in reports of ongoing hallucinations as well as thought, mood, current activity, social circumstances and places frequented. More subjects suffering from schizophrenia reported hallucinations, but for all hallucinating subjects the qualities of hallucination episodes were quite similar. More subjects reported visual hallucinations at least once. In contrast, the intensity of auditory hallucinations was higher. Anxiety was the most prominent emotion during hallucinations and reports of anxiety intensity exceeded baseline levels before the first report of auditory hallucinations. Context modified hallucination intensity over the course of an episode. Social withdrawal resulted in a decrease of hallucinatory intensity (AH > VH), while social engagement slightly raised intensity levels (VH > AH). Doing nothing (VH > AH) and work activities (AH > VH) led to decreases in intensity levels over time, while passive leisure activities (watching TV) resulted in increases in intensity levels of hallucinations (AH > VH). The results suggest that hallucinating experiences are subject to a host of contextual influences. Understanding variation offers useful insights for therapy.


Wounds Difficult to Heal: An Effective Treatment Strategy.
Treatment of wounds difficult to heal concerns 50% of the elderly population in Italy and is therefore a relevant social burden. The present study shows how the treatment with autologous leuco-platelets reduces the healing time of wounds improving the functional recovery. Patients (n=100) with ulcers of the legs were divided in two groups: 1) 50 patients treated with conventional therapies; 2) 50 patients treated with autologous leuco-platelet concentrate (LPC) and hyaluronic acid (HIAFF, Hyalofill-F® ) as a scaffold. After 2 months, a 49% reduction in wound area was observed in the second group and in about 65% wound reduction was achieved in 15 days (4 LPC dressings). In contrast, patients treated by conventional therapies, showed a longer healing time and a greater percentage of failures. Morphometric analysis of biopsy samples obtained from the edge as well as from the bottom of the lesions obtained from the LPC group, detected an abundant presence of neoformed capillaries, characterized by a cubic, "reactive endothelium", close to the site of LPC infiltration. These results suggest that healing was promoted not only by limiting bacterial infections but also by the release of chemotactic and proangiogenic factors from leukocytes and platelets, improving the neoformation of capillaries.


[Computer-assisted stress analysis in rehabilitation with ABBA (job requirements and capacity analysis)].
ABBA is a recently devised, ergology-based expert system software for vocational analysis, documentation and evaluation--inter alia in the context of medical and vocational rehabilitation-, drawing on some 20 years of experience in job analysis with the AET (Arbeitswissenschaftliches Erhebungsverfahren zur Tätigkeitsanalyse). Designed for broad and differentiated coverage, a PARADOX data bank comprising the entire data collected enables comparison of job requirements and client performance potential, reaching for beyond individual analysis on account of its integration of job profiles for a given industry or occupation, or for an entire company. The related, and easy-to use, software for data processing and appraisal is now being made available by ABBA along with dialogue-based ergological know-how.