SEROUS NEUROSENSORY RETINAL DETACHMENT ASSOCIATED WITH ATYPICAL COGAN SYNDROME: A CASE REPORT.
To present a case of a 71-year-old woman with possible focal choroiditis and secondary serous neurosensory retinal detachment associated with atypical Cogan syndrome. Retrospective case report. On initial evaluation, the patient had decreased vision with photopsias and distortion in the affected eye. Her history revealed 3 years of preexisting neurosensory hearing loss and corneal scarring in the affected eye. Examination findings were significant for unilateral interstitial keratitis and focal macular neurosensory retinal detachment. Fluorescein and indocyanine green angiography demonstrated focal macular leakage and staining. Treatment with intravitreal and periocular steroid injections resulted in complete resolution of the subretinal fluid and visual improvement. Posterior segment manifestations associated with Cogan syndrome are exceedingly rare. This is the first known case of a serous neurosensory retinal detachment from suspected choroidal inflammation associated with Cogan syndrome. Prompt recognition and treatment with corticosteroids may result in anatomical and functional visual improvement, as in this case.


[Combination of improved sex therapy and sildenafil for erectile dysfunction in Uigur men: retrospective analysis of 2505 cases].
The sex therapy is not yet popularized at present. This study aimed to evaluate the effect of the combination of the improved sex therapy and oral sildenafil on erectile dysfunction (ED). A total of 3130 Uigur cases of ED received in Xinjiang Bogda Hospital were divided into a control group (n=625) and a trial group (n=2505), the former treated with oral sildenafil alone, and the latter by the combination of the improved genital therapy and sildenafil, both for 3 months and followed up at 6 and 12 months after the treatment. The therapeutic effects were evaluated and compared using IIEF-5. The IIEF-5 scores of the control group were 12.80 +/- 3.76 and 18.10 +/- 2.61 before and after the treatment, and 17.35 +/- 2.73 and 16.64 +/- 2.63 at 6 and 12 months, respectively, while those of the trial group were 12.73 +/- 3.52 and 19.06 +/- 4.07 before and af- ter the treatment, and 19.86 +/- 2.42 and 20.47 +/- 2.38 at 6 and 12 months, respectively, with statistically significant differences either between pre- and post-treatment (P < 0.05) or between the control and trial groups at 6 and 12 months (P < 0.05). The combination of the improved sex therapy and oral sildenafil is superior to sildenafil alone in the treatment of ED, and its efficacy is relatively stable at 12 months.


Subcutaneously Administered Self-Cleaving Hydrogel-Octreotide Conjugates Provide Very Long-Acting Octreotide.
We developed a long-acting drug-delivery system that supports subcutaneous administration of the peptidic somatostatin agonist octreotide-a blockbuster drug used to treat acromegaly and neuroendocrine tumors. The current once-a-month polymer-encapsulated octreotide, Sandostatin LAR, requires a painful intragluteal injection through a large needle by a health-care professional. To overcome such shortcomings, Tetra-PEG hydrogel microspheres were covalently attached to the α-amine of d-Phe(1) or the ε-amine of Lys(5) of octreotide by a self-cleaving β-eliminative linker; upon subcutaneous injection in the rat using a small-bore needle, octreotide was slowly released. The released drug from the ε-octreotide conjugate showed a remarkably long serum half-life that exceeded two months. The α-octreotide conjugate had a half-life of ∼2 weeks, and showed an excellent correlation of in vitro and in vivo drug release. Pharmacokinetic models indicate these microspheres should support once-weekly to once-monthly self-administered subcutaneous dosing in humans. The hydrogel-octreotide conjugate shows the favorable pharmacokinetics of Sandostatin LAR without its drawbacks.


Simulations of X and Y retinal ganglion cell behavior with a nonlinear push-pull model of spatiotemporal retinal processing.
This article describes a nonlinear model of neural processing in the vertebrate retina, comprising model photoreceptors, model push-pull bipolar cells, and model ganglion cells. Previous analyses and simulations have shown that with a choice of parameters that mimics beta cells, the model exhibits X-like linear spatial summation (null response to contrast-reversed gratings) in spite of photoreceptor nonlinearities; on the other hand, a choice of parameters that mimics alpha cells leads to Y-like frequency doubling. This article extends the previous work by showing that the model can replicate qualitatively many of the original findings on X and Y cells with a fixed choice of parameters. The results generally support the hypothesis that X and Y cells can be seen as functional variants of a single neural circuit. The model also suggests that both depolarizing and hyperpolarizing bipolar cells converge onto both ON and OFF ganglion cell types. The push-pull connectivity enables ganglion cells to remain sensitive to deviations about the mean output level of nonlinear photoreceptors. These and other properties of the push-pull model are discussed in the general context of retinal processing of spatiotemporal luminance patterns.


Blood alcohol concentration as a measure of risk among pedestrian fatalities in the U.S., 2016-2020.
In the United States, deaths among pedestrians have increased dramatically since 2009 relative to other vulnerable road users, with substance use described as an important risk factor. This study aimed to explore blood alcohol concentrations (BAC g/dL) among pedestrian fatalities in the United States between 2016 and 2020. Exploring the presence of alcohol among pedestrian cases will support targeted interventions designed to reduce risk. This study utilized pedestrian fatality and alcohol screening data provided by the Fatality Analysis Reporting System (FARS). Logistic models were examined to identify statistical associations (ORs, 95% CI) by age, race, and sex relative to positive BAC exposure (BAC > 0.0 g/dL), mild exposure (BAC > 0.0 < .079 g/dL), moderate to severe alcohol exposure (BAC 0.08-.299 g/dL), and severe exposure (BAC ≥ 0.30 g/dL). Between 2016 and 2020, 33,375 pedestrian fatalities were reported to FARS with 75.1% of cases retained for analysis (n = 25,077). Fatalities were more likely to be White (69.3%), male (69.9%), and between 25-64 years of age (67.3%). 74.0% of fatalities were tested for alcohol, with 40.9% screening positive. Females, cases ≥ 75 years of age, and those identified as Asians reported the lowest odds of being positive for alcohol exposure. Results suggest an ongoing threat to pedestrians due to alcohol consumption and that exposure odds vary by demographic characteristics. Unfortunately, analytical approaches to understanding the roles played by drugs and alcohol among vulnerable road users tend to be marginalized in the literature. Analytical, evidence-based investigations are needed to curtail the risk of pedestrian fatalities in the U.S.


Evaluation of Brassicas in grazing systems for sheep: II. Blood composition and nutrient status.
Blood composition of lambs grazing Brassicas and stockpiled grass or grass-clover pastures in the fall of 4 yr was monitored to assess possible effects of plant metabolites (e.g., glucosinolates, S-methyl cysteine sulfoxide) on health and performance. Serum thyroxine (T4) concentrations in lambs grazing Brassicas decreased upon initiation of grazing, with a subsequent recovery, and concentrations were increased by oral dosing with I or I+CuO. Serum triiodothyronine (T3) increased gradually with time and did not differ between lambs on Brassicas and on pasture at most time periods. In Exp. 3 and 4, T4 levels were lower in lambs grazing Tyfon chinese cabbage hybrid (Brassica rapa L. x B. pekinensis [Lour.] Rupr.) than in lambs on Forage Star hybrid turnip (B. rapa L.). Heinz body formation increased rapidly in lambs on Brassicas, with small decreases in packed cell volume (PCV); dosing with I+CuO reduced Heinz bodies in lambs on Tyfon and turnip pastures. In Exp. 2, I+CuO treatment increased liver Cu concentrations but had no effect on serum Cu. Serum cholesterol and urea N concentrations declined rapidly in lambs on Brassicas, with little change in lambs on stockpiled pastures. Decreases in serum triglycerides, and an increase in glucose concentration, were noted in Exp. 3 and 4 in lambs grazing Tyfon and Forage Star turnip. Although a number of differences related to plant composition were noted in blood of lambs grazing Brassica forages relative to stockpiled pastures, the changes did not seem sufficiently severe to affect animal performance.


A role for biomarkers in the screening and diagnosis of breast cancer in younger women.
The widespread usage of screening mammography has resulted in an increase in the detection of early-stage disease, particularly in situ (stage 0) and early-stage (stage 1) cancers. However, incidence of stage 2 and 3 disease has not fallen commensurately, suggesting a bias in the detection of indolent cancers rather than aggressive cancers. Improved screening and diagnosis of a broader range of cancers is therefore an important need. Although MRI is a very sensitive breast cancer detection tool that has become standard for women at very high risk, it lacks sufficient specificity and cost-effectiveness for use as a general screen. The greatest opportunity for molecular tools to improve breast cancer outcomes is to better discern biologically aggressive cancers, especially in women under the age of 50 years. In this age group, presentation in stage 2 or 3 is more common and mammographic screening is less efficacious. We propose a multi-tiered triage strategy that uses emerging markers of susceptibility to segment the population for more focused screening with imaging. In particular, it would be helpful to identify a subset of at-risk, younger women who would benefit from intensive surveillance or preventive interventions. It is likely that tests for susceptibility, unless they are highly specific, will need to be combined with indicators of short-term risk. Although the combined sensitivity and specificity of screening must be high, each individual test does not require high specificity. It is important, however, for the susceptibility tests and short-term risk markers to be highly sensitive. If the majority of women under 50 years of age who develop breast cancer are captured with this strategy, then mammography screening for the general population can start at age 50 years. Finally, and perhaps most importantly, biomarkers of susceptibility and short-term risk are likely to provide insight into the biology of tumors that develop, leading to new interventions to support prevention. The most effective preventive strategies will be those where a marker predicts risk for the disease, as well as the benefit from preventive interventions.


Modulation of the Left Prefrontal Cortex with High Frequency Repetitive Transcranial Magnetic Stimulation Facilitates Gait in Multiple Sclerosis.
Multiple Sclerosis (MS) is a chronic central nervous system (CNS) demyelinating disease. Gait abnormalities are common and disabling in patients with MS with limited treatment options available. Emerging evidence suggests a role of prefrontal attention networks in modulating gait. High-frequency repetitive transcranial magnetic stimulation (rTMS) is known to enhance cortical excitability in stimulated cortex and its correlates. We investigated the effect of high-frequency left prefrontal rTMS on gait parameters in a 51-year-old Caucasian male with chronic relapsing/remitting MS with residual disabling attention and gait symptoms. Patient received 6 Hz, rTMS at 90% motor threshold using figure of eight coil centered on F 3 location (using 10-20 electroencephalography (EEG) lead localization system). GAITRite gait analysis system was used to collect objective gait measures before and after one session and in another occasion three consecutive daily sessions of rTMS. Two-tailed within subject repeated measure t-test showed significant enhancement in ambulation time, gait velocity, and cadence after three consecutive daily sessions of rTMS. Modulating left prefrontal cortex excitability using rTMS resulted in significant change in gait parameters after three sessions. To our knowledge, this is the first report that demonstrates the effect of rTMS applied to the prefrontal cortex on gait in MS patients.


Rising trend in the prevalence of HIV infection among blood donors.
The prevalence of HIV infection among blood donors was analysed, for the five year period from April 1988 to March 1993. All donors were patients' relatives or volunteers; no paid/commercial donors were accepted. Each year between 14,084 and 15,544 donor blood samples were screened by ELISA and those found reactive were tested by Western blot. Western blot positive samples were considered to be infected with HIV. The prevalence rates were 1.5 per 1000 (1988-89), 1.1 per 1000 (1989-90 and 1990-91) 1.9 per 1000 (1991-92) and 3.1 per 1000 (1992-93). When the mean prevalence rate over the first three years [1.3 per 1000 (1988-89 to 1990-91)] was compared to the prevalence in 1991-92 (1.9/1000), increase was statistically significant (P < 0.05). The prevalence rate in 1992-93 (3/1000) was significantly higher than that of the previous year (P < 0.01). These data suggest that the prevalence of HIV infection in blood donors is increasing and this could be a reflection of the rising prevalence of HIV infection in the general population.


Diagnostic value of OMOM capsule endoscopy for small bowel diseases in adults.
The present study aimed to determine the diagnostic yield of OMOM capsule endoscopy for small bowel diseases in adults. A total of 89 patients, including 45 cases of obscure abdominal pain, 22 of chronic diarrhea, 18 of obscure gastrointestinal bleeding and 4 of obscure anemia were enrolled in the present study. The transit time of the endoscopy capsule in the digestive tract was recorded and the testing results were analyzed. All detections were completed except for four capsule retentions and the completion rate was 95.51%. The average transit time of the endoscopy capsule in the esophagus, stomach and small intestine was 62.18±64.23 sec, 67.46±63.13 and 346.53±102.81 min, respectively. Of the 89 patients, 54 (60.67%) were found to have lesions, among which 19 had mucosal erosion (21.35%), 15 had anabrosis (16.85%), 9 were diagnosed with polyps (10.11%), 5 with angiodysplasia (5.62%); furthermore, tumors were identified in 5 patients (5.62%) and ancylostomiasis in 1 patient (1.12%). The results confirmed the feasibility and validity of OMOM capsule endoscopy for diagnosing small bowel diseases in adults.


Association between the rs2004640 functional polymorphism of interferon regulatory factor 5 and systemic lupus erythematosus: a meta-analysis.
The aim of this study is to determine whether the functional interferon regulatory factor 5 (IRF5) polymorphism, rs2004640, confers susceptibility to systemic lupus erythematosus (SLE) in multiple ethic populations. A meta-analysis was conducted on the T allele of the IRF5 rs2004640 polymorphism and 12 studies were included in the meta-analysis. Meta-analysis revealed an association between SLE and the IRF5 rs2004640 T allele in all subjects without inter-study heterogeneity (OR 1.429, 95% CI 1.359-1.503, P < 0.001). The IRF5 rs2004640 T allele was significantly associated with SLE in European and Asians. The Asian population had a much lower prevalence of the T allele (34.4%) than any other population studied. and Europeans had the highest frequency of the IRF5 rs2004640 T allele (51.8%). In conclusion, this meta-analysis confirms that the IRF5 rs2004640 polymorphism is associated with SLE susceptibility in different ethnic groups, and that its prevalence is ethnicity dependent.


Transferring knowledge from one system to another.
Although knowledge is contained in many systems, moving it from one system to another is not an easy task because each system is tailored in its own unique way and because knowledge configurations are usually copyrighted. To populate our FRAMEMED knowledge base we turned to the NLM Metathesaurus as a readily-available open source of knowledge. We were disappointed by the greatly variable granularity of the concepts and the lack of definitions that could be borrowed. Some reference books in electronic form seem attractive but reformatting will require excessive human intervention and copyright negotiation.


[Autophagy, fitness and longevity].
Autophagy is a key mechanism for the maintenance of intracellular and organismal homeostasis. Accordingly, defects in core components of the autophagic machinery are etiologically associated with a variety of human pathologies, including infectious disorders, cardiovascular diseases, neurodegenerative conditions, and cancer. Intriguingly, several maneuvers that increase the lifespan of model organisms in the laboratory, like caloric restriction, do so in an autophagy-dependent manner. Here, we briefly discuss the intimate relationship between the autophagic preservation of intracellular and organismal fitness and healthy aging.


Coping styles of older adults with ostomies.
Various clinical studies throughout the years have shown that individuals with ostomies are a unique group facing adjustment demands. One of the most important challenges for an individual with an ostomy is coping with the physiological and psychological changes. The purpose of this study was to describe coping styles of older adults after undergoing ostomy surgery and to explore its helpfulness in dealing with the stressors related to having an ostomy. Lazarus and Folkman's theory on stress and coping was used as the framework to guide this study. A sample of 27 participants ranging from age 50 to 84 years was obtained from an ostomy association in southeastern Louisiana. Participants were asked to complete a demographic data form and the Revised Jalowiec Coping Scale. This revised scale measured eight coping styles related to Use and Effectiveness. Findings revealed significant differences existed among the means of the eight measures for both Use and Effectiveness at p < .01. Results demonstrated that the optimistic and self-reliant styles of coping were the most frequently used as effective styles for coping with an ostomy. This indicated a positive outlook and dependence on oneself rather than dependence on others when coping with the stressors of having an ostomy. There were no statistically significant differences related to gender or ostomy type. Also, aging did not appear to be a factor when considering coping styles of older adults with ostomies. The nursing role should include assessment of the individual preoperatively to identify fears, concerns, and stressors related to having an ostomy. Also, nurses can provide education on disease management, assist with identification of ineffective coping mechanisms, and promote effective coping skills and stress management techniques.


Reactivation and dissemination of blastomycosis complicating Hodgkin's disease: a case report and review of the literature.
Patients presenting with Hodgkin's disease (HD) may show lung involvement characterized by contiguous spread from ipsilateral hilar lymph nodes. Lung consolidation or noncontiguous pulmonary involvement makes an alternative diagnosis more likely. This report describes a patient with HD in whom concurrent pulmonary blastomycosis was recognized only after chemotherapy had started and dissemination had occurred. Although Blastomyces dermatitidis may behave as an opportunist pathogen, there are no previous reports of blastomycosis in patients with HD. Undiagnosed active opportunistic infection at the time of diagnosis of HD may complicate staging as well as treatment. Biopsy of lung lesions with stain and culture for opportunistic pathogens should be considered in patients with newly diagnosed HD disease and atypical patterns of lung involvement.


N-Acetylcysteine rapidly replenishes central nervous system glutathione measured via magnetic resonance spectroscopy in human neonates with hypoxic-ischemic encephalopathy.
Persistent oxidative stress depletes reduced glutathione (GSH), an intracellular antioxidant and an important determinant of CNS injury after hypoxia ischemia. We used standard, short echo time Stimulated Echo Acquisition Mode (STEAM) to detect GSH by magnetic resonance spectroscopy (MRS) in 24 term neonates with hypoxic-ischemic encephalopathy (HIE), on day of life 5-6, after rewarming from therapeutic hypothermia. MRS demonstrated reliable, consistent GSH of 1·64 ± 0·20 mM in the basal ganglia immediately before intravenous infusion of N-acetylcysteine. N-acetylcysteine resulted in a rapid and significant GSH increase to 1·93 ± 0.23 mM within 12-30 min after completion of infusion ( n = 21, p < 0.0001, paired t-test), compared with those who did not receive N-acetylcysteine ( n = 3, GSH = 1.66 ± 0.06 mM and 1.64 ± 0.09 mM). In one perinatal stroke patient, GSH in the diffusion-restricted stroke area was 1.0 mM, indicating significant compromise of intracellular redox potential, which also improved after N-acetylcysteine. For comparison, GSH in healthy term neonates has been reported at 2.5 ± 0.9 mM in the thalamus. This is the first report to show persistent oxidative stress reflected in GSH during the subacute phase in neonates with HIE and rapid response to N-acetylcysteine, using a short echo MRS sequence that is available on all clinical scanners without spectral editing.


UvrD helicase unwinds DNA one base pair at a time by a two-part power stroke.
Helicases use the energy derived from nucleoside triphosphate hydrolysis to unwind double helices in essentially every metabolic pathway involving nucleic acids. Earlier crystal structures have suggested that DNA helicases translocate along a single-stranded DNA in an inchworm fashion. We report here a series of crystal structures of the UvrD helicase complexed with DNA and ATP hydrolysis intermediates. These structures reveal that ATP binding alone leads to unwinding of 1 base pair by directional rotation and translation of the DNA duplex, and ADP and Pi release leads to translocation of the developing single strand. Thus DNA unwinding is achieved by a two-part power stroke in a combined wrench-and-inchworm mechanism. The rotational angle and translational distance of DNA define the unwinding step to be 1 base pair per ATP hydrolyzed. Finally, a gateway for ssDNA translocation and an alternative strand-displacement mode may explain the varying step sizes reported previously.


Trends of PCB, hexachlorobenzene, and beta-benzene hexachloride levels in the adipose tissue of the U.S. population.
Results are presented on the levels of selected toxic chemicals in the adipose tissue of the U.S. population. Estimates of baseline levels and time trends are presented for the chemicals beta-benzene hexachloride (beta-BHC), hexachlorobenzene, and polychlorinated biphenyls (PCBs). The statistical analyses are based on chemical data obtained from analysis of tissue specimens collected from a nationally representative sample of autopsied cadavers and surgical patients by EPA's National Human Adipose Tissue Survey during the period 1970 through 1983. The results show that while nearly the entire U.S. population has detectable levels of these chemicals, the actual concentration levels of beta-BHC and PCBs are steadily decreasing and the levels of HCB are remaining fairly constant. Comparisons of levels across demographic subpopulations show that there are some differences in concentration levels across geographic regions, age groups, and race groups.


Genome-Wide Approaches for RNA Structure Probing.
RNA molecules of all types fold into complex secondary and tertiary structures that are important for their function and regulation. Structural and catalytic RNAs such as ribosomal RNA (rRNA) and transfer RNA (tRNA) are central players in protein synthesis, and only function through their proper folding into intricate three-dimensional structures. Studies of messenger RNA (mRNA) regulation have also revealed that structural elements embedded within these RNA species are important for the proper regulation of their total level in the transcriptome. More recently, the discovery of microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) has shed light on the importance of RNA structure to genome, transcriptome, and proteome regulation. Due to the relatively small number, high conservation, and importance of structural and catalytic RNAs to all life, much early work in RNA structure analysis mapped out a detailed view of these molecules. Computational and physical methods were used in concert with enzymatic and chemical structure probing to create high-resolution models of these fundamental biological molecules. However, the recent expansion in our knowledge of the importance of RNA structure to coding and regulatory RNAs has left the field in need of faster and scalable methods for high-throughput structural analysis. To address this, nuclease and chemical RNA structure probing methodologies have been adapted for genome-wide analysis. These methods have been deployed to globally characterize thousands of RNA structures in a single experiment. Here, we review these experimental methodologies for high-throughput RNA structure determination and discuss the insights gained from each approach.


Practices and Perceptions of Family Practice Residency Directors toward International Medical Graduate Applicants: A National Survey.
Purpose - International Medical Graduates (IMGs) are increasingly filling Family Medicine residency positions. (1) To what extent are residency programs recruiting and accepting IMG applicants? (2) What are program directors' perceptions of IMG applicants? (3) What program characteristics are associated with their practices and perceptions? Methods - A 2002 national survey of Family Medicine program directors assessed program demographics and directors' recruiting practices and perceptions regarding IMG applicants. Results - Although 88% of respondents would rank IMG applicants, only 40% agreed that they would perform as well as U.S. graduates. Programs with IMG faculty were more likely to have IMG residents (p˂0.01). Program directors with IMG faculty or more IMG residents reported more positive perceptions of IMG residents' performance (p˂0.01). Conclusion - More experience with IMGs, such as having IMG faculty or higher numbers of IMG residents, is associated with recruitment of IMG residents and may contribute to more positive beliefs about their performance.


Environmental consequences of uranium atmospheric releases from fuel cycle facility: II. The atmospheric deposition of uranium and thorium on plants.
Uranium and thorium isotopes were measured in cypress leaves, wheat grains and lettuce taken in the surroundings of the uranium conversion facility of Malvési (South of France). The comparison of activity levels and activity ratios (namely (238)U/(232)Th and (230)Th/(232)Th) in plants with those in aerosols taken at this site and plants taken far from it shows that aerosols emitted by the nuclear site (uranium releases in the atmosphere by stacks and (230)Th-rich particles emitted from artificial ponds collecting radioactive waste mud) accounts for the high activities recorded in the plant samples close to the site. The atmospheric deposition process onto the plants appears to be the dominant process in plant contamination. Dry deposition velocities of airborne uranium and thorium were measured as 4.6 × 10(-3) and 5.0 × 10(-3) m s(-1), respectively.


Education curriculum assessment for teaching electrocardiography: Rationale and design for the prospective, international, randomized controlled EDUCATE trial.
Electrocardiogram (ECG) interpretation training is a fundamental component of medical education across disciplines. However, the skill of interpreting ECGs is not universal among medical graduates, and numerous barriers and challenges exist in medical training and clinical practice. An evidence-based and widely accessible learning solution is needed. The EDUcation Curriculum Assessment for Teaching Electrocardiography (EDUCATE) Trial is a prospective, international, investigator-initiated, open-label, randomized controlled trial designed to determine the efficacy of self-directed and active-learning approaches of a web-based educational platform for improving ECG interpretation proficiency. Target enrollment is 1000 medical professionals from a variety of medical disciplines and training levels. Participants will complete a pre-intervention baseline survey and an ECG interpretation proficiency test. After completion, participants will be randomized into one of four groups in a 1:1:1:1 fashion: (i) an online, question-based learning resource, (ii) an online, lecture-based learning resource, (iii) an online, hybrid question- and lecture-based learning resource, or (iv) a control group with no ECG learning resources. The primary endpoint will be the change in overall ECG interpretation performance according to pre- and post-intervention tests, and it will be measured within and compared between medical professional groups. Secondary endpoints will include changes in ECG interpretation time, self-reported confidence, and interpretation accuracy for specific ECG findings. The EDUCATE Trial is a pioneering initiative aiming to establish a practical, widely available, evidence-based solution to enhance ECG interpretation proficiency among medical professionals. Through its innovative study design, it tackles the currently unaddressed challenges of ECG interpretation education in the modern era. The trial seeks to pinpoint performance gaps across medical professions, compare the effectiveness of different web-based ECG content delivery methods, and create initial evidence for competency-based standards. If successful, the EDUCATE Trial will represent a significant stride towards data-driven solutions for improving ECG interpretation skills in the medical community.


Study of fluoride in ground water around the BALCO, Korba area (India).
The present study was undertaken for the determination of fluoride ions in drinking water at the BALCO, Korba region by the ion selective electrode method. The ground water samples of thirty four villages of this region were collected. The fluoride concentration values varied from 1.07 ppm to 3.10 ppm. In this area, villagers were found suffering with dental and skeletal fluorosis. The villagers were suggested to use alum, lime and Nalgonda technique to avoid all type of fluorosis. It was found that fluoride was present within the permissible limit (1.5 ppm) in most of the villages studied but the fluoride level was unacceptable in drinking water samples taken from some villages of BALCO, Korba area.


Diagnostic Difficulties in Woman with Crohn's Disease, Ascites, and Elevated Value of Serum CA125 Antigen.
Variety of symptoms and atypical clinical course of Crohn's disease (CD) often create the need for additional diagnostic procedures. In the described case of woman with CD, there was a suspicion of coexistence of ovarian cancer. This issue is particularly important in patients treated with immunosuppressants and biological agents. The discussion focused on the usefulness of CA125 (cancer antigen 125, mucin 16) serum level estimation in clinical practice and draws attention to the possible reasons for the increase of its value which is not associated to ovarian cancer.


A structural mechanism for maintaining the 'on-state' of the CaMKII memory switch in the post-synaptic density.
Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) is activated by Ca(2+) entry into neurons. Autophosphorylation of T286 is of special importance because it makes the enzyme active in the absence of Ca(2+), providing a biochemical memory that is critical for plasticity. To understand the factors controlling the duration of this state of CaMKII, we studied dephosphorylation of CaMKII in the post-synaptic density (PSD), a structure that defines a neuronal subcompartment critical for plasticity. We found that PSD-resident PP1 can dephosphorylate many sites on CaMKII, but not the T286 site that produces Ca(2+)-independent activity. This, together with previous work showing that soluble PP2A cannot dephosphorylate PSD CaMKII, provides a novel explanation for the in vivo persistence of T286 phosphorylation: after activated CaMKII translocates from the cytoplasm to the PSD, structural constraints prevent phosphatases from dephosphorylating T286. These results also suggest that the PSD is more than a simple scaffold for synaptic proteins; it may act to regulate the activity of proteins by positioning them in orientations that either prevent or favor specific biochemical reactions.


Noncoding dsRNA induces retinoic acid synthesis to stimulate hair follicle regeneration via TLR3.
How developmental programs reactivate in regeneration is a fundamental question in biology. We addressed this question through the study of Wound Induced Hair follicle Neogenesis (WIHN), an adult organogenesis model where stem cells regenerate de novo hair follicles following deep wounding. The exact mechanism is uncertain. Here we show that self-noncoding dsRNA activates the anti-viral receptor toll like receptor 3 (TLR3) to induce intrinsic retinoic acid (RA) synthesis in a pattern that predicts new hair follicle formation after wounding in mice. Additionally, in humans, rejuvenation lasers induce gene expression signatures for dsRNA and RA, with measurable increases in intrinsic RA synthesis. These results demonstrate a potent stimulus for RA synthesis by non-coding dsRNA, relevant to their broad functions in development and immunity.


NMR characterization of hydrocarbon adsorption on calcite surfaces: a first principles study.
The electronic and coordination environment of minerals surfaces, as calcite, are very difficult to characterize experimentally. This is mainly due to the fact that there are relatively few spectroscopic techniques able to detect Ca(2+). Since calcite is a major constituent of sedimentary rocks in oil reservoir, a more detailed characterization of the interaction between hydrocarbon molecules and mineral surfaces is highly desirable. Here we perform a first principles study on the adsorption of hydrocarbon molecules on calcite surface (CaCO3 (101¯4)). The simulations were based on Density Functional Theory with Solid State Nuclear Magnetic Resonance (SS-NMR) calculations. The Gauge-Including Projector Augmented Wave method was used to compute mainly SS-NMR parameters for (43)Ca, (13)C, and (17)O in calcite surface. It was possible to assign the peaks in the theoretical NMR spectra for all structures studied. Besides showing different chemical shifts for atoms located on different environments (bulk and surface) for calcite, the results also display changes on the chemical shift, mainly for Ca sites, when the hydrocarbon molecules are present. Even though the interaction of the benzene molecule with the calcite surface is weak, there is a clearly distinguishable displacement of the signal of the Ca sites over which the hydrocarbon molecule is located. A similar effect is also observed for hexane adsorption. Through NMR spectroscopy, we show that aromatic and alkane hydrocarbon molecules adsorbed on carbonate surfaces can be differentiated.


Overcoming cardiac allograft vasculopathy (CAV) by inducing tolerance.
There is compelling evidence that MHC-driven immune processes play a dominant role in the development of cardiac allograft vasculopathy. Thus, it makes intuitive sense that tolerance, which eliminates donor alloreactivity, should protect against CAV. However, in the experimental literature, there are examples of CAV occurring in recipients rendered tolerant by either peripheral or central induction protocols. Why does transplant arteriopathy occur in recipients that have achieved a robust state of tolerance or in the animals devoid of T or B cell immunity? There may be immunological blindspots that persist even after a state of tolerance is achieved. These blindspots could contribute to the pathogenesis of chronic rejection (CR).


Venomics Reveals Venom Complexity of the Piscivorous Cone Snail, Conus tulipa.
The piscivorous cone snail Conus tulipa has evolved a net-hunting strategy, akin to the deadly Conus geographus, and is considered the second most dangerous cone snail to humans. Here, we present the first venomics study of C. tulipa venom using integrated transcriptomic and proteomic approaches. Parallel transcriptomic analysis of two C. tulipa specimens revealed striking differences in conopeptide expression levels (2.5-fold) between individuals, identifying 522 and 328 conotoxin precursors from 18 known gene superfamilies. Despite broad overlap at the superfamily level, only 86 precursors (11%) were common to both specimens. Conantokins (NMDA antagonists) from the superfamily B1 dominated the transcriptome and proteome of C. tulipa venom, along with superfamilies B2, A, O1, O3, con-ikot-ikot and conopressins, plus novel putative conotoxins precursors T1.3, T6.2, T6.3, T6.4 and T8.1. Thus, C. tulipa venom comprised both paralytic (putative ion channel modulating α-, ω-, μ-, δ-) and non-paralytic (conantokins, con-ikot-ikots, conopressins) conotoxins. This venomic study confirms the potential for non-paralytic conotoxins to contribute to the net-hunting strategy of C. tulipa.


Left ventricular end-diastolic volume index, age, and maximum heart rate at peak exercise predict survival in patients referred for heart transplantation.
This study sought to define clinical predictors of survival in patients under consideration for heart transplantation and demonstrate possible improvements in the prediction of outcome when considering the identified predictors in addition to peak oxygen consumption. Peak oxygen consumption is currently the most important criterion for determining the timing and appropriateness of heart transplantation in ambulatory patients. To identify other possible predictors of survival in patients with heart failure, we reviewed clinical, exercise, and radionuclide ventriculographic data on 112 patients referred for heart transplantation evaluation. Predictors of 1-year (n = 86) and overall (n = 112) survival to the combined end point of freedom from death or pretransplantation admission for inotropic or mechanical support were identified in multivariate analysis. The mean age was 51+/-9 years, and the mean duration of follow-up was 408+/-366 days. The mean left ventricular ejection fraction was 0.22+/-0.07, and the mean peak oxygen consumption was 12.3+/-3.7 ml/min/kg. Age (odds ratio 1.087, 95% confidence interval [CI] 1.021 to 1.157), percentage of the maximum predicted heart rate at peak exercise (odds ratio 0.958, 95% CI 0.924 to 0.992), and left ventricular end-diastolic volume index (odds ratio 1.019, 95% CI 1.006 to 1.033) were independent predictors of the 1-year combined end point. Age, heart rate at peak exercise, and left ventricular end-diastolic volume index are independent predictors of prognosis in patients with advanced heart failure and may provide additional prognostic information for the risk-stratification of potential heart transplant recipients.


[Etiology and physiopathology in insulin resistance and type 2 diabetes--results of twin studies].
Twin studies have provided important insights into a complicated interplay between genetic and both prenatal and postnatal environmental factors implicated in the aetiology and pathophysiology of Type 2 diabetes. Although our present knowledge is too insufficient to discard the results of classical twin studies into the relative roles of genes versus environment for the development of diabetes and its metabolic defects, it is nevertheless clear that the classical twin model has been challenged by the thrifty phenotype hypothesis and its implications of an adverse intrauterine environment for the development of diseases in man, including diabetes. However, twins with their special intrauterine conditions may represent a helpful tool in the continual search for the mechanisms, and the extent to which early environment may play a role in the development of Type 2-diabetes and its various defects of glucose homoeostasis, including insulin resistance. In addition, twin studies have proved instrumental in molecular biology studies of genotype-phenotype associations and of muscle gene expression patterns in Type 2-diabetes and/or insulin resistance.


Growth of textured nanocrystalline cobalt ferrite thin films by pulsed laser deposition.
Cobalt ferrite thin films have been deposited on fused quartz substrates by pulsed laser deposition at various substrate temperatures, T(s) (25 degrees C, 300 degrees C, 550 degrees C and 750 degrees C). Single phase, nanocrystalline, spinel cobalt ferrite formation is confirmed by X-ray diffraction (XRD) for T(s) > or = 300 degrees C. Conventional XRD studies reveal strong (111) texturing in the as deposited films with T(s) > or = 550 degrees C. Bulk texture measurements using X-ray orientation distribution function confirmed (111) preferred orientation in the films with T(s) > or = 550 degrees C. Grain size (13-16 nm for T(s) > or = 300 degrees C) estimation using grazing incidence X-ray line broadening analysis shows insignificant grain growth with increasing T(s), which is in good agreement with grain size data obtained from transmission electron microscopy.


Genetic associations with lipoprotein subfraction measures differ by ethnicity in the multi-ethnic study of atherosclerosis (MESA).
A recent genome-wide association study associated 62 single nucleotide polymorphisms (SNPs) from 43 genomic loci, with fasting lipoprotein subfractions in European-Americans (EAs) at genome-wide levels of significance across three independent samples. Whether these associations are consistent across ethnicities with a non-European ancestry is unknown. We analyzed 15 lipoprotein subfraction measures, on 1677 African-Americans (AAs), 1450 Hispanic-Americans (HAs), and 775 Chinese-Americans (CHN) participating in the multi-ethnic study of atherosclerosis (MESA). Genome-wide data were obtained using the Affymetrix 6.0 and Illumina HumanOmni chips. Linear regression models between genetic variables and lipoprotein subfractions were adjusted for age, gender, body mass index, smoking, study center, and genetic ancestry (based on principal components), and additionally adjusted for Mexican/Non-Mexican status in HAs. A false discovery rate correction was applied separately within the results for each ethnicity to correct for multiple testing. Power calculations revealed that we did not have the power for SNP-based measures of association, so we analyzed phenotype-specific genetic risk scores (GRSs), constructed as in the original genome-wide analysis. We successfully replicated all 15 GRS-lipoprotein associations in 2527 EAs. Among the 15 significant GRS-lipoprotein associations in EAs, 11 were significant in AAs, 13 in HAs, and 1 in CHNs. Further analyses revealed that ethnicity differences could not be explained by differences in linkage disequilibrium, lipid lowering drugs, diabetes, or gender. Our study emphasizes the importance of ethnicity (here indexing genetic ancestry) in genetic risk for CVD and highlights the need to identify ethnicity-specific genetic variants associated with CVD risk.


Molar tubal ectopic pregnancy: Report of two cases.
Ectopic molar pregnancy is a rare occurrence and consequently not often considered as a diagnostic possibility. We report two cases of molar hydatidiform tubal pregnancy. Diagnosis of ectopic pregnancy was confirmed on clinical biological and sonographic investigations. Diagnosis of molar pregnancy was done on histopathology. The clinical course was favorable for both patients. Although rare, molar changes can occur at any site of an ectopic pregnancy. Clinical diagnosis of a molar pregnancy is difficult but histopathology is the gold standard for diagnosis.


Plasma constituents and mortality in rat pups given chronic insulin via injection, pellet, or osmotic minipump.
Two studies compared the glucose responses of 9-day-old rats given subcutaneous insulin, either continuously or via daily injection, for 10 days. In Experiment 1, implanted pellets released a total of 0, 1.9, or 5.7 U insulin/kg the first 24 h. Injected doses were larger, 0 or 8 U/kg. Injections caused no deaths, but insulin-releasing pellets caused high mortality within 24 h. Pups surviving the pellets were normoglycemic by treatment day 8. In Experiment 2, pups received 0.184 U of insulin daily, approximately 8 U/kg at 9 days, via either injection or osmotic minipump. All pups survived. Injected pups were hypoglycemic 2 h postinjection through treatment day 10, whereas pups with insulin minipumps were normoglycemic by day 5. Insulin injections, but not minipumps, lowered plasma triglycerides on day 10. To examine age differences in response to insulin, additional pups and adults received daily injections of 0 or 8 U/kg for 10 days. All survived. Insulin lowered plasma glucose more in pups than in adults and reduced triglycerides in pups but not in adults. The rapid development of normoglycemia in pups with insulin minipumps, compared with pups injected daily with the same dose, suggests that continuous early insulin may produce insulin resistance.


Outcome following autogenous soft tissue interpositional arthroplasty for end-stage hallux rigidus: a systematic review.
Autogenous soft tissue interpositional arthroplasty has been proposed as an alternative to arthrodesis and other forms of arthroplasty for treatment of end-stage hallux rigidus because of the perceived safety and efficacy. The author undertook a systematic review of electronic databases and other relevant sources to identify material relating to the outcomes following autogenous soft tissue interpositional arthroplasty for end-stage hallux rigidus. Information from peer-reviewed journals, as well as from non-peer-reviewed publications, abstracts and posters, textbooks, and unpublished works, were also considered. In an effort to procure the highest quality studies available, studies were eligible for inclusion only if they involved consecutively enrolled patients undergoing isolated autogenous soft tissue interpositional arthroplasty for the treatment of end-stage hallux rigidus, evaluated patients at mean follow-up of 12-months' duration or longer, included pre- and postoperative range of motion of the first metatarsal-phalangeal joint, determined pre- and postoperative outcomes using a scoring system, and documented any complications. Two studies involving a total of 28 autogenous soft tissue interpositional arthroplasties for end-stage hallux rigidus were identified that met the inclusion criteria. There were 12 men (52%) and 11 women (48%) with a mean age of 58.2 years followed for a mean of 21.6 months. Both studies used the AOFAS First Metatarsal-Phalangeal-Hallux Scoring System, which had a mean of 26.0 preoperatively rising to 89.4 postoperatively. First metatarsal-phalangeal joint dorsiflexion had a mean of 16.7 degrees preoperatively rising to 51.1 degrees postoperatively. Complications occurred in 4 (14.3%) feet and no feet required surgical revision. The results of this systematic review demonstrate improvement in patient outcomes and first metatarsal-phalangeal joint dorsiflexion, as well as few complications following autogenous soft tissue interpositional arthroplasty for end-stage hallux rigidus. However, there is still a need for methodologically sound prospective cohort studies that compare autogenous soft tissue interpositional arthroplasty with other forms of arthroplasty and arthrodesis for end-stage hallux rigidus.


Photoprotection of normal human hematopoietic progenitors by the tetrapeptide N-AcSDKP.
The tetrapeptide AcSDKP (Ser-Asp-Lys-Pro) is a reversible inhibitor of normal human hematopoietic progenitor growth. In this paper, we report that preincubation of bone-marrow mononuclear cells (MNC) with AcSDKP at 10(-10) M for 20 hours protects the granulocyte-macrophage colony-forming unit (CFU-GM) progenitors against photofrin II-mediated phototherapy. This protective effect was observed after short-term exposure to photofrin (2.5 micrograms/mL) and irradiation by high-energy doses at 514 nm. Nevertheless, AcSD-KP, which has no effect on leukemic cell proliferation, does not protect the HL-60 and K-562 leukemic cell lines against photosensitization.


Comparison of the Clinicopathologic Characteristics of Intraductal Papillary Neoplasm of the Bile Duct according to Morphological and Anatomical Classifications.
Intraductal papillary neoplasm of the bile duct (IPNB) is a recently defined entity and its clinical characteristics and classifications have yet to be established. We aimed to clarify the clinical features of IPNB and determine the optimal morphological classification criteria. From 2003 to 2016, 112 patients with IPNB who underwent surgery were included in the analysis. After pathologic reexamination by a specialized biliary-pancreas pathologist, previously suggested morphological and anatomical classifications were compared using the clinicopathologic characteristics of IPNB. In terms of histologic subtypes, most patients had the intestinal type (n = 53; 48.6%) or pancreatobiliary type (n = 33; 30.3%). The simple "modified anatomical classification" showed that extrahepatic IPNB comprised more of the intestinal type and tended to be removed by bile duct resection or pancreatoduodenectomy. Intrahepatic IPNB had an equally high proportion of intestinal and pancreatobiliary types and tended to be removed by hepatobiliary resection. Morphologic classifications and histologic subtypes had no effect on survival, whereas a positive resection margin (75.9% vs. 25.7%; P = 0.004) and lymph node metastasis (75.3% vs. 30.0%; P = 0.091) were associated with a poor five-year overall survival rate. In the multivariate analysis, a positive resection margin and perineural invasion were important risk factors for survival. IPNB showed better long-term outcomes after optimal surgical resection. The "modified anatomical classification" is simple and intuitive and can help to select a treatment strategy and establish the proper scope of the operation.


Birth planning and sterilization in China.
Sterilization is the most prevalent method of contraception in China. Approximately half of all women of reproductive age report that they or their husbands are sterilized. Using data from the China Health and Nutrition Survey we describe patterns of sterilization in eight Chinese provinces. With a discrete-time event history model we investigate the link between characteristics of local birth planning policy and the risk of sterilization. After controlling for parity, the risk of sterilization is highest in communities where birth planning policy is least strong as measured by exceptions to the one-child policy. These results suggest that couples with more flexibility in family building may have less control over contraceptive method use. Other factors affecting the risk of sterilization are a woman's age, parity, and whether or not she has a son. Our results emphasize the importance of taking into account multiple dimensions of reproductive behaviour when assessing one-child policy changes.


[Isolation, classification and antimicrobial activity of endophytic actinomycetes from plant leaves].
Leave samples of Paeonia lactiflora and Trifalium repens were collected from Sichuan Province and Beijing respectively to study their endophytic actinmycetes. After a well-established surface-sterilized procedure, the samples were plated on agar media of TWYE, HV, YECD, NA and WA, followed by incubation at 28 degrees C for 2 - 4 weeks. With the help of light microscope, 15 actinomycetes strains were isolated from the plates. Comparison of cultural features and fingerprinting analyses of BOX-PCR products were performed to cluster the isolates, with the result that all the strains were assigned to 12 different genotypes, half of them from Paeonia lactiflora and half from Trifalium repens. A combination of morphological and 16S rRNA gene sequence data showed that except strains C4 and C5, which belonged to Pseudonocardia, 13 of the isolates were streptomycetes. Most isolates share high 16S rRNA gene sequence similarities to known type strains. However, strain C12 shares low values, 96.6% in maximum, and strain C5 shares 97.9% in maximum; more assays are needed to ascertain their taxonomic positions. In the tests of antimicrobial activity against 7 bacteria, 3 fungi and 1 yeast, 11 isolates were positive in one or more tests, and 55% of the positive ones could inhibit the growth of Rhizoctonia solani, a significant pathogen of plants.


The extreme aged: sampling, measurement, and statistical models in cross-sectional estimation and forecasting.
Little effort has been directed toward studying the relationship between morbidity and mortality at exceptional ages, perhaps for no better reason than it has been difficult to do given available data resources. Two study innovations/adjustments are required to adequately represent count data with reports of health from aged sample persons. These design features are oversampling of the exceptional group and linkage to detailed administrative reports. The National Long-Term Care Survey (NLTCS) has made it possible to study health and functioning in the context of exceptional longevity.


SARS-CoV-2 suppresses TLR4-induced immunity by dendritic cells via C-type lectin receptor DC-SIGN.
SARS-CoV-2 causes COVID-19, an infectious disease with symptoms ranging from a mild cold to severe pneumonia, inflammation, and even death. Although strong inflammatory responses are a major factor in causing morbidity and mortality, superinfections with bacteria during severe COVID-19 often cause pneumonia, bacteremia and sepsis. Aberrant immune responses might underlie increased sensitivity to bacteria during COVID-19 but the mechanisms remain unclear. Here we investigated whether SARS-CoV-2 directly suppresses immune responses to bacteria. We studied the functionality of human dendritic cells (DCs) towards a variety of bacterial triggers after exposure to SARS-CoV-2 Spike (S) protein and SARS-CoV-2 primary isolate (hCoV-19/Italy). Notably, pre-exposure of DCs to either SARS-CoV-2 S protein or a SARS-CoV-2 isolate led to reduced type I interferon (IFN) and cytokine responses in response to Toll-like receptor (TLR)4 agonist lipopolysaccharide (LPS), whereas other TLR agonists were not affected. SARS-CoV-2 S protein interacted with the C-type lectin receptor DC-SIGN and, notably, blocking DC-SIGN with antibodies restored type I IFN and cytokine responses to LPS. Moreover, blocking the kinase Raf-1 by a small molecule inhibitor restored immune responses to LPS. These results suggest that SARS-CoV-2 modulates DC function upon TLR4 triggering via DC-SIGN-induced Raf-1 pathway. These data imply that SARS-CoV-2 actively suppresses DC function via DC-SIGN, which might account for the higher mortality rates observed in patients with COVID-19 and bacterial superinfections.


The use of zootherapeutics in folk veterinary medicine in the district of Cubati, Paraíba State, Brazil.
The present work addresses the use of zootherapy in folk veterinary medicine (ethnoveterinary) by the residents of the municipal district of Cubati, microregion of Seridó, Paraíba State, Brazil. It sought to identify the principal animals used as medicinal sources for zootherapeutics and to contribute to the preservation and sustainability of this traditional knowledge. Field research was undertaken on a weekly or biweekly basis during the period November, 2006, to January, 2007. Free, semi-structured, and open interviews were made with local residents of the municipal district of Cubati (in both urban and rural settings) as well as with venders in public markets. A total of 25 individuals of both sexes were interviewed (with ages varying from 26 to 78 years) although only 16 were finally chosen as informants as these people demonstrated the greatest degree of knowledge concerning zootherapeutics. Graphs and percentages were generated using Microsoft Excel 2007 software, and the species were identified by photographic registration and subsequent bibliographical surveys. Mammals constitute the main medicinal zootherapeutic source for folk veterinary medicines in the studied area, both in terms of the total number of species used and the frequency of their citation. Sheep (Ovis aries), pigs (Sus scrofa), cattle (Bos taurus), and foxes (Cerdocyon thous) were mentioned by 62.5, 43.75, 37.5, and 31.25% of the informants, respectively, as being used in folk veterinary medicine. Additionally, chameleons (Iguana iguana), chickens (Gallus domesticus), and rattlesnakes (Crotalus durissus) were mentioned by 75, 43.75, and 31.25% of the informants, respectively. Relatively simple animal illnesses, such as furuncles, or injuries resulting from embedded thorns or skin eruptions are responsible for the largest number of zootherapeutic treatment, while, diseases of greater complexity, such as rabies and brucellosis, were not even mentioned. Fat from various animals constituted the most frequently cited resource used for its medicinal-veterinary properties. The examination of folk knowledge and health practices allows a better understanding of human interactions with their local environment, and aids in the formulation of appropriate strategies for natural resource conservation.


Visible reflectance hyperspectral imaging: characterization of a noninvasive, in vivo system for determining tissue perfusion.
We characterize a visible reflectance hyperspectral imaging system for noninvasive, in vivo, quantitative analysis of human tissue in a clinical environment. The subject area is illuminated with a quartz-tungsten-halogen light source, and the reflected light is spectrally discriminated by a liquid crystal tunable filter (LCTF) and imaged onto a silicon charge-coupled device detector. The LCTF is continuously tunable within its useful visible spectral range (525-725 nm) with an average spectral full width at half-height bandwidth of 0.38 nm and an average transmittance of 10.0%. A standard resolution target placed 5.5 ft from the system results in a field of view with a 17-cm diameter and an optimal spatial resolution of 0.45 mm. The measured reflectance spectra are quantified in terms of apparent absorbance and formatted as a hyperspectral image cube. As a clinical example, we examine a model of vascular dysfunction involving both ischemia and reactive hyperemia during tissue reperfusion. In this model, spectral images, based upon oxyhemoglobin and deoxyhemoblobin signals in the 525-645-nm region, are deconvoluted using a multivariate least-squares regression analysis to visualize the spatial distribution of the percentages of oxyhemoglobin and deoxyhemoglobin in specific skin tissue areas.


Effect of cellulase and lactic acid bacteria on the fermentation quality, carbohydrate conversion, and microbial community of ensiling oat with different moisture contents.
Oat (Avena sativa L.) is one of the most widely cultivated crops used as forage. The aim of this study was to evaluate the effects of cellulase and Lactobacillus plantarum interactions with different moisture contents on oat ensiling. Oats with three moisture contents were treated with nothing (C), cellulase (CE), lactic acid bacteria (LP), or CE+LP and ensiled for 30 and 60 days. Compared with the control, LP and CE treatments increased crude protein and lactic acid concentrations and reduced the pH and ammonia nitrogen/total nitrogen (NH3-N/TN) ratios of silages. The addition of CE improved lignocellulosic degradation, compared with approximately 67% (LD) and 81% moisture content (HD) ensiling, CE (CE, CE+LP) ensiling in the approximately 75% moisture content (MD) group retained higher water-soluble carbohydrate, glucose, sucrose and fructose concents. The LP and CE inoculations significantly reduced the microbial community diversity, and lower values for the observed species, ACE, Chao1, and Shannon indices compared with CK-treated samples. Additives inhibited the growth of unfavorable bacteria (such as Clostridium) and increased the abundances of lactic acid bacteria (LAB); the maximum increases in the Lactiplantibacillus abundance were obtained in the LP- and CE+LP-treated samples, improving the microbial community structure in silage. In summary, adding LP and CE effectively improved the oat fermentation quality, and better performances in ensiling oat and lignocellulose degradation were obtained with LP and CE combinations, especially for the MD group of silages that were ensiled for 60 days. The addition of CE and LP at the appropriate moisture content might be helpful for producing high-quality oat silage, and also provide a simple and feasible method to enhance the effects of bacteria and enzymes.


The reproducibility of perceptually regulated exercise responses during short-term cycle ergometry.
The purpose of this study was to assess the reproducibility over four trials of perceptually regulated exercise intensity during short-term cycle ergometry. Recent research has suggested that an improvement in the reproducibility (better agreement) of the exercise output would be observed with a repeated practice using regulatory tools such as Borg's 6 - 20 rating of perceived exertion (RPE) scale. Eighteen healthy active volunteers (nine males, mean age (+/- SD) 24.7 +/- 3.4 yr, and nine females 27.6 +/- 5.4 yr) completed four identical intermittent effort production trials on a cycle ergometer over a period of two - three weeks, with all trials being between three and five days apart. After warm-up, the volunteers were asked to produce four x three-minute bouts of exercise at RPE levels: 13, 15, 9, and 17 (in this order). Power output (W), percentage maximum heart rate reserve (%MHRR), and oxygen consumption (VO(2); ml x kg(-1) x min(-1)) were recorded in the final minute of each bout. Analysis revealed that the 95 % limits of agreement (LoA) between repeated trials did not decrease for the objective markers of exercise intensity, remaining wide throughout. In the worst case comparisons the LoA represented changes (expressed as a proportion of the mean of two trials) of up to 58.3 % in power output (T2 vs. T3 at RPE 9), 65.5 % in % MHRR (T1 vs. T2 at RPE 13) and 36.5 % in VO(2) (T3 vs. T4 at RPE 17). These findings question the use of ratings of perceived exertion to regulate exercise effort. That the reproducibility of effort is also not seen to improve with practice raises doubts about the validity of using the RPE scale to provide training intensities for this type of exercise.


Creative Person-Centered Psychopharmacotherapy in the Context of Prenatal Psychiatry - Dilemmas and Challenges.
The authors presented a psychopharmacotherapeutic approach to the treatment of women in the prenatal period that requires a personalized, person-centered treatment plan. Treatment should include care for the mental health of women of childbearing age, pregnancy planning, during the prenatal period, and then during the postpartum period. The authors highlighted creative psychopharmacotherapy which is the foundation of holistic and integrative treatment of mental disorders. They emphasize the significant role of the mother in the emotional development of the child, which begins while the child is still in the womb. Mothers who stop taking psychotropic drugs during pregnancy have an increased risk of recurrence of the mental disorder after childbirth because the mother's psychiatric illness is not a benign event and can cause significant morbidity for both the mother and her child, therefore, discontinuation or denial of medication during pregnancy is not always the safest option. For more serious disorders, such as schizophrenia, bipolar disorder, and severe depression, medications may be needed during pregnancy and lactation, despite complex evidence based on the effects of psychotropic medications on the fetus and newborn. Perinatal mental health has become a significant focus of interest in recent years. The randomized controlled examinations provide evidence of the effectiveness of psychological and psychosocial interventions at the individual level. It is necessary to make a new conceptual shift in the approach to maintaining the mental health of pregnant women and newborns, and that is to optimize the mental health of pregnant women, and not simply reduce the symptoms of mental disorders from which they suffer before conception, during pregnancy and after childbirth. Dilemmas and challenges of psychopharmacotherapeutic treatment in the prenatal period are intensified by the knowledge that the psychological difficulties of mothers can significantly affect the integrity of the safe relationship between mother and child, which is essential for the emotional, cognitive, and behavioral development of the child. Often, these problems existed before pregnancy or occurred during pregnancy, and they are often the deterioration of the mental state due to discontinuation of pharmacotherapy during this period. The quality of the biopsychosocial milieu in the fetal period and childhood during the early neuroplastic development phase is one of the determinants of risk for diseases during the life cycle. For this reason, the mental health of pregnant women and mothers must be optimized. For many of these women, health is optimized with pharmacotherapy.


Regulation of EphA8 gene expression by TALE homeobox transcription factors during development of the mesencephalon.
The mouse ephA8 gene is expressed in a rostral-to-caudal gradient in the developing superior colliculus, and these EphA gradients may contribute to the proper development of the retinocollicular projection. Thus, it is of considerable interest to elucidate how the ephA8 gene expression is controlled by upstream regulators during the development of the mesencephalon. In this study, we employed in vivo expression analysis in transgenic mouse embryos to dissect the cis-acting DNA regulatory region, leading to the identification of a CGGTCA sequence critical for the ephA8 enhancer activity. Using this element as the target in a yeast one-hybrid system, we identified a Meis homeobox transcription factor. Significantly, DNA binding sites for Pbx, another TALE homeobox transcription factor, were also identified in the ephA8 enhancer region. Meis2 and Pbx1/2 are specifically expressed in the entire region of the dorsal mesencephalon, where specific colocalization of EphA8 and Meis is restricted to a subset of cells. Meis2 and Pbx2 synergistically bind the ephA8 regulatory sequence in vitro, and this interaction is critical for the transcriptional activation of a reporter construct bearing the ephA8 regulatory region in the presence of histone deacetylase inhibitor. More importantly, when expressed in the embryonic midbrain, the dominant-negative form of Meis down-regulates endogenous ephA8. Interestingly, we found that both Meis2 and Pbx2 are constitutively bound in the ephA8 regulatory region in the dorsal mesencephalon. These studies strongly suggest that Meis and Pbx homeobox transcription factors tightly associate with the ephA8 regulatory sequence and require an additional unidentified regulator to ensure the specific activation of ephA8.


Serum levels of IL-6, IL-8, and IL-10 are indicators of prognosis in pancreatic cancer.
Early detection and prognosis prediction are critical to improve patient survival in pancreatic cancer. This study aimed to investigate whether interleukins could serve as indicators of prognosis in pancreatic cancer. Sixty-eight patients with pancreatic cancer were enrolled in the study during the period between 2012 and 2014. The serum levels of a broad spectrum of interleukins in these patients were determined, including IL-1β, IL-2, IL-6, IL-8, IL-10, IL-13, IL-15, and IL-23. IL-6, IL-8, and IL-10 showed significant positive correlations with each other. Moreover, high levels of serum IL-6, IL-8, and IL-10 were independently strongly associated with poor survival of patients with pancreatic cancer. Our results suggest that serum levels of IL-6, IL-8, and IL-10 could be useful markers for prediction of prognosis in patients with pancreatic cancer.


Draft genome sequence of Streptomyces coelicoflavus ZG0656 reveals the putative biosynthetic gene cluster of acarviostatin family α-amylase inhibitors.
The aims of this study are to obtain the draft genome sequence of Streptomyces coelicoflavus ZG0656, which produces novel acarviostatin family α-amylase inhibitors, and then to reveal the putative acarviostatin-related gene cluster and the biosynthetic pathway. The draft genome sequence of S. coelicoflavus ZG0656 was generated using a shotgun approach employing a combination of 454 and Solexa sequencing technologies. Genome analysis revealed a putative gene cluster for acarviostatin biosynthesis, termed sct-cluster. The cluster contains 13 acarviostatin synthetic genes, six transporter genes, four starch degrading or transglycosylation enzyme genes and two regulator genes. On the basis of bioinformatic analysis, we proposed a putative biosynthetic pathway of acarviostatins. The intracellular steps produce a structural core, acarviostatin I00-7-P, and the extracellular assemblies lead to diverse acarviostatin end products. The draft genome sequence of S. coelicoflavus ZG0656 revealed the putative biosynthetic gene cluster of acarviostatins and a putative pathway of acarviostatin production. To our knowledge, S. coelicoflavus ZG0656 is the first strain in this species for which a genome sequence has been reported. The analysis of sct-cluster provided important insights into the biosynthesis of acarviostatins. This work will be a platform for producing novel variants and yield improvement.


Absorption, distribution and elimination of carnosic acid, a natural antioxidant from Rosmarinus officinalis, in rats.
The absorption, distribution and elimination of carnosic acid, the main antioxidant found in rosemary was studied, in vivo, in rats. Therefore, carnosic acid was administrated in a single dose, intravenously (20.5 ± 4.2 mg/kg) and orally (64.3 ± 5.8 mg/kg), to four and nine rats, respectively. Blood samples were collected at different time points, and plasma concentrations of carnosic acid were determined using LC-MS. Furthermore, total collection of urine and feces was done during 4 h and 24 h for the intravenous and oral administrations, respectively. After euthanizing the rats, intestinal content, liver and muscle tissue were sampled to determine carnosic acid concentrations. The bioavailability of carnosic acid, after 360 min, was 40.1%. Traces of carnosic acid were found in the rats intestinal content, liver and muscle tissue of abdomen and legs. The recovery of carnosic acid in the feces, 24 h after oral administration, was 15.6 ± 8.2%. Carnosic acid is absorbed into the bloodstream after oral administration in rats and is therefore bioavailable. It was found that carnosic acid in vivo is present in its free form and that its main elimination route is the fecal route.


Comparison of Suicides Among Younger and Older Adolescents in Virginia, 2008-2017.
Objective: Suicide is the second leading cause of death in youth and is of public health importance. Characteristics and precipitating circumstances may differ by adolescent age groups. Understanding these differences may inform prevention efforts that are population-specific. Therefore, we sought to compare suicides between younger and older adolescents in Virginia from 2008 to 2017.Methods: We used data from the Virginia Violent Death Reporting System (VVDRS), part of the National Violent Death Reporting System (NVDRS). We included suicides of all adolescents aged 10-17 who were residents of Virginia from 2008 to 2017. Descriptive statistics and unadjusted logistic regression were used to compare characteristics and circumstances between younger (10-14) and older (15-17) adolescents.Results: Three hundred and 24 (324) adolescents died by suicide between 2008 and 2017 in Virginia, of which 20% were younger adolescents, and 80% were older adolescents. Suicides of younger adolescents increased significantly over the 10-year period. Younger adolescent suicides seemed to occur after a crisis, while suicides among older adolescents occurred due to intimate partner problems and substance use. Mental health issues were common in both.Conclusions: Suicides may be more impulsive among younger adolescents and warrants further attention, while strategies to cope with intimate partner problems and substance use may be important for older adolescents and should be considered when implementing services and interventions. HIGHLIGHTSImpulsivity may be an issue among younger adolescents.Strategies for relationship and substance use issues may benefit older adolescents.Targeted interventions may be necessary for younger and older adolescents.


Fine mapping of a quantitative trait locus for spikelet number per panicle in a new plant type rice and evaluation of a near-isogenic line for grain productivity.
Total spikelet number per panicle (TSN) is one of the determinants of grain productivity in rice (Oryza sativa L.). In this study, we attempted to detect quantitative trait loci (QTLs) for TSN in the introgression lines with high TSN, derived from the cross of Indica Group variety IR 64 with new plant type lines. Two QTLs were detected on the long arm of chromosome 12: qTSN12.1 in the BC4F2 population of YTH63/IR 64 and qTSN12.2 in the BC4F3 population of YTH83/IR 64. TSN of the main tiller was significantly higher in near-isogenic lines (NILs) for qTSN12.1 (IR 64-NIL1; 188.6) and for qTSN12.2 (IR 64-NIL12; 199.4) than in IR 64 (141.2), owing to a significant increase in both primary and secondary branch numbers. These results suggest the critical function of these QTLs in the promotion of rachis branching at the panicle formation stage. Fine mapping of qTSN12.2 revealed six candidate genes in a 92-kb region of the Nipponbare reference genome sequence between flanking markers RM28746 and RM28753. Detailed phenotyping of agronomic traits of IR 64-NIL12 carrying qTSN12.2 showed drastic changes in plant architecture: this line had lower panicle number, longer culm, and longer and wider leaves compared with IR 64. Percentage of fertility and 1000-grain weight tended to be greater, and grain yield per square meter was also greater in IR 64-NIL12 than in IR 64. The newly identified QTLs will be useful for genetic improvement of the yield potential of Indica Group varieties. The markers tightly linked to qTSN12.2 are available for marker-assisted breeding.


Overexpression of TMPRSS4 promotes tumor proliferation and aggressiveness in breast cancer.
Transmembrane protease serine 4 (TMPRSS4) is a novel type II transmembrane serine protease that is overexpressed in various types of human cancers and has an important function in cancer progression. However, there is a paucity of data available regarding the biological effects of TMPRSS4 on breast cancer (BC) cells and the underlying mechanisms. In this study, expression of TMPRSS4 in BC tissues was detected by immunohistochemistry. The relationship between TMPRSS4 expression and clinicopathological characteristics as well as prognosis was evaluated. The effects of TMPRSS4 on cell proliferation, migration and invasion were investigated in BC cell lines in vitro. Additionally, RT-qPCR and western blot analysis were used to determine the expressions of epithelial-mesenchymal transition (EMT) biomarkers and TMPRSS4 in BC cell lines. We found that TMPRSS4 was overexpressed in BC tissues and its expression level was closely correlated with tumor size, histological grade, lymph node metastasis, clinical stage as well as poor survival (all P<0.05) and could be recognized as an independent prognostic factor for BC patients. Overexpression of TMPRSS4 promoted the proliferation, migration and invasion of BC cells in vitro. Moreover, TMPRSS4 knockdown significantly enhanced the expression of E-cadherin and claudin-1 and inhibited the expression of vimentin and Slug, indicating suppression of EMT. Our results suggest that TMPRSS4 plays a crucial role in the progression of BC. Moreover, TMPRSS4 overexpression promoted the proliferation, invasion and migration of BC cells by possibly inducing EMT. To conclude, TMPRSS4 may be a potential therapeutic target for cancer treatment.


Aggregation of the high affinity IgE receptor results in the tyrosine phosphorylation of the surface adhesion protein PECAM-1 (CD31).
One of the earliest events after aggregation of the high affinity receptor for IgE (FcepsilonRI) on mast cells is the activation of protein tyrosine kinases resulting in tyrosine phosphorylation of numerous proteins. Using a monoclonal antibody raised against the rat basophilic leukemia RBL-2H3 cells, we identified that platelet/endothelial cell adhesion molecule 1 (PECAM-1 or CD31) was tyrosine phosphorylated in these cells. Aggregation of PECAM-1 did not induce a detectable increase in its tyrosine phosphorylation, nor did it result in degranulation. However, the minimal tyrosine phosphorylation of PECAM-1 in nonstimulated cells was dramatically increased after FcepsilonRI aggregation. This receptor-induced tyrosine phosphorylation of PECAM-1 was an early event, independent of Ca2+ influx or of the activation of protein kinase C and of cell adhesion. PECAM-1 is an adhesion molecule that is required for the transmigration of leukocytes across the endothelium into sites of inflammation. Therefore tyrosine phosphorylation of PECAM-1 may modulate its interaction with other molecules, thereby regulating the migration of basophils into inflammatory sites.


Fluorescence resonance energy transfer (FRET) based molecular detection of a genetically modified PCB degrader in soil.
Genetic analysis of the location of a mini-Tn5 promoted insertion of the LB400 bph operon in the rhizosphere coloniser Pseudomonas fluorescens F113rifPCB, allowed the development of a specific PCR detection system based on the unique DNA sequence at this insertion site. Real time PCR using both SYBR green chemistry and Fluorescence Resonance Energy Transfer probes allowed the precise identification of the recombinant strain and its quantitative detection in soil microcosms over a (bacteria/g) range of five orders of magnitude. This new assay can detect the genetically modified microorganism from soil in less than 90 min and at levels below the detection limits of standard PCR or cultivable counts on selective media.


Malignancy in horseshoe kidney.
We have reported two cases of adenocarcinoma in a horseshoe kidney and their successful surgical treatment. Review of the literature suggests that transitional cell carcinoma and Wilms' tumor are seen more often than adenocarcinoma in horseshoe kidneys.


[Mass on the neck].
Malignant peripheral nerve sheath tumors (MPNST) are rare. But especially in patients with known neurofibromatosis type 1 (von Recklinghausen), this entity of tumors should not be forgotten. The indication for open biopsy or excision should be made generously. In the following, we report a rare case of MPNST, which highlights the importance of rapid diagnosis and treatment.


[Intrathecal morphine administration for oral and maxillofacial malignomas].
The intraventricular administration of morphine results in lesser systemic side effects, with an extremely satisfactorily pain relief going along with it (2, 5, 6). The subcutaneous pump which administers morphine intraventricularly is an interesting, non-destructive alternative of medium-term pain therapy for patients suffering from incurable pain caused by a malignant tumor in the oropharyngeal region. The morphine pump even makes it possible to go through terminal stages of the malignant disease well-relieved and in the familiar environment at home.


Leukoaraiosis, a common brain magnetic resonance imaging finding, as a predictor of traffic crashes.
There are no reported studies on the relationship between traffic crashes and brain tissue changes in healthy drivers. The relationship between traffic crashes and leukoaraiosis, a common magnetic resonance imaging finding, was investigated in this study. A total of 3,930 automobile drivers (2,037 men and 1,893 women; age, 21-87 years) who underwent brain magnetic resonance imaging as part of total health check-ups and answered a road traffic questionnaire were examined to determine whether asymptomatic leukoaraiosis was associated with various types of traffic crashes. Multiple logistic regression analysis was performed to elucidate the relationship between leukoaraiosis and various types of traffic crashes. Subcortical leukoaraiosis was diagnosed in 28.52% of all subjects, whereas periventricular leukoaraiosis was diagnosed in 9.57% of all subjects. Adjusted odds ratios for involvement in all types of traffic crashes were not significant for subjects with periventricular leukoaraiosis; however, they were significant for subjects with multiple and large multiple subcortical leukoaraiosis. Adjusted odds ratios for involvement in crashes at crossroads were 1.09 (95% confidence interval [CI], 0.60-2.00) for subjects with single subcortical leukoaraiosis, 3.35 (95% CI, 2.36-4.77) for subjects with multiple subcortical leukoaraiosis, and 2.45 (95% CI, 2.36-4.98) for subjects with large multiple subcortical leukoaraiosis. Periventricular leukoaraiosis was not significantly associated with crossroad crashes. Involvement in crashes of any type, parking lot crashes, and rear-end collisions showed no significant association with either subcortical or periventricular leukoaraiosis. Multiple subcortical leukoaraiosis, but not periventricular leukoaraiosis, is significantly associated with traffic crashes, in particular, crossroad crashes. This association is independent of sex, age, and driving exposure. To our knowledge, this is the first evidence describing the relationship between brain tissue changes and traffic crashes.


Diversity of aromatic hydroxylating dioxygenase genes in mangrove microbiome and their biogeographic patterns across global sites.
Aromatic hydrocarbons (AH), such as polycyclic aromatic hydrocarbons, are compounds largely found in nature. Aromatic-ring-hydroxylating dioxygenases (ARHD) are proteins involved in AH degradation pathways. We used ARHD functional genes from an oil-impacted mangrove area and compared their diversity with other sites around the world to understand the ARHD biogeographic distribution patterns. For this, a comprehensive database was established with 166 operational protein families (OPFs) from 1,758 gene sequences obtained from 15 different sites worldwide, of which twelve are already published studies and three are unpublished. Based on a deduced ARHD peptide sequences consensus phylogeny, we examined trends and divergences in the sequence phylogenetic clustering from the different sites. The taxonomic affiliation of the OPF revealed that Pseudomonas, Streptomyces, Variovorax, Bordetella and Rhodococcus were the five most abundant genera, considering all sites. The functional diversity analysis showed the enzymatic prevalence of benzene 1,2-dioxygenase, 3-phenylpropionate dioxygenase and naphthalene 1,2-dioxygenase, in addition to 10.98% of undefined category ARHDs. The ARHD gene correlation analysis among different sites was essentially important to gain insights on spatial distribution patterns, genetic congruence and ecological coherence of the bacterial groups found. This work revealed the genetic potential from the mangrove sediment for AH biodegradation and a considerable evolutionary proximity among the dioxygenase OPFs found in Antarctica and South America sites, in addition to high level of endemism in each continental region.


Maintenance of the ratio of alpha and beta globin synthesis in rabbit reticulocytes.
The synthesis of rabbit alpha and beta globins under various conditions was studied using intact reticulocytes and reticulocyte cell-free systems. Raising salt concentration of media in which reticulocytes were incubated with radioactive amino acids reduced the total protein synthesis but did not affect the ratio of alpha to beta globins produced. Using a reticulocyte lysate which had been incubated with micrococcal nuclease to remove the endogenous globin messenger RNA activity, it was found that unlike the intact cell or the untreated lysate very little alpha globin was synthesised on adding purified globin mRNA. These results are discussed in terms of their compatibility with some proposed models of coordination of alpha and beta globin production.


How is the effectiveness of root cause analysis measured in healthcare?
If a hundred healthcare executives were polled about their definitions of root cause analysis, there would be a hundred different answers. Herein lies the problem-understanding the intent and power of root cause analysis (RCA). For this reason, RCA is viewed as having either limited or phenomenal value to an organization. This article will seek to strip away the labels associated with RCA brands and focus on the processes, their results, and how they are communicated (or miscommunicated) to executive management. Effective RCA efforts can fail because of their inability to demonstrate their value to the bottom line of the organization.


Intrahepatic delivery of alpha-galactosylceramide-pulsed dendritic cells suppresses liver tumor.
Alpha-galactosylceramide, a glycosphingolipid, mediates interaction of dendritic cells (DCs) and NKT cells, leading to activation of both innate and acquired immunity. For cancer treatment, conventional DC-based vaccine has been tried, but its clinical efficacy is limited against liver cancer. Intrahepatic injection of alpha-Galactosylceramide-pulsed DCs (alphaGCDC) has not yet been tested in the liver that contains abundant immune cells such as NK, NKT, and T cells. In the present study, we examined the efficacy of alphaGCDC administration in comparison with p53 peptide-pulsed DCs using a well-established murine CMS4 tumor model. Injection of alphaGCDC into CMS4 liver tumors resulted in complete tumor rejection and established long-term survival of the animals, while injection of p53(232-240) peptide-pulsed DCs (pepDC) only partially suppressed tumor growth in the liver. The levels of IFN-gamma in sera of alphaGCDC-treated mice were significantly higher than those of pepDC-treated mice. Hepatic NK cells were efficiently activated by alphaGCDC injection and played a critical role in liver tumor rejection as evidenced by an in vivo antibody-mediated NK cell depletion study. Injection of alphaGCDC into liver tumor led to higher p53(232-240) peptide-specific CD8+ T cell response than that of pepDC. The mice that had been protected from CMS4 liver tumor by alphaGCDC injection became resistant to subcutaneous CMS4 rechallenge, but not to Colon26 rechallenge. These results demonstrate that alphaGCDC injection into the liver can efficiently activate NK cells that in turn reject liver tumors to establish potent acquired immunity against the original tumor.


[Scannographic investigation in the diagnosis of inguinoscrotal bladder hernia].
We report the case of a 67-year old patient with a personal history of inguinal hernia, presenting with a large painless bag associated with urinary disorders, similar to pollakiuria, evolving for several months. Ultrasound allowed to reveal an emptiness in the bladder bag, urinary stasis and a collection of fluid in the scrotum, evoking a hydrocele. Abdominal/pelvic CT scan showed right intrascrotal bladder associated with left direct inguinal hernia and bilateral urinary stasis. The diagnosis was confirmed by surgical exploration. The postoperative course was uneventful. Inguinoscrotal hernia containing exclusively urinary bladder is an exceptional entity. CT scan should be recommended for patients with inguinoscrotal hernia associated with urinary disorders (Mery's Sign).


Characterization of the human aqueous humour proteome: A comparison of the genders.
Aqueous humour (AH) is an important biologic fluid that maintains normal intraocular pressure and contains proteins that regulate the homeostasis of ocular tissues. Any alterations in the protein compositions are correlated to the pathogenesis of various ocular disorders. In recent years, gender-based medicine has emerged as an important research focus considering the prevalence of certain diseases, which are higher in a particular sex. Nevertheless, the inter-gender variations in the AH proteome are unknown. Therefore, this study endeavoured to characterize the AH proteome to assess the differences between genders. Thirty AH samples of patients who underwent cataract surgery were categorized according to their gender. Label-free quantitative discovery mass spectrometry-based proteomics strategy was employed to characterize the AH proteome. A total of 147 proteins were identified with a false discovery rate of less than 1% and only the top 10 major AH proteins make up almost 90% of the total identified proteins. A large number of proteins identified were correlated to defence, immune and inflammatory mechanisms, and response to wounding. Four proteins were found to be differentially abundant between the genders, comprising SERPINF1, SERPINA3, SERPING1 and PTGDS. The findings emerging from our study provide the first insight into the gender-based proteome differences in the AH and also highlight the importance in considering potential sex-dependent changes in the proteome of ocular pathologies in future studies employing the AH.


Entanglement Equilibrium and the Einstein Equation.
A link between the semiclassical Einstein equation and a maximal vacuum entanglement hypothesis is established. The hypothesis asserts that entanglement entropy in small geodesic balls is maximized at fixed volume in a locally maximally symmetric vacuum state of geometry and quantum fields. A qualitative argument suggests that the Einstein equation implies the validity of the hypothesis. A more precise argument shows that, for first-order variations of the local vacuum state of conformal quantum fields, the vacuum entanglement is stationary if and only if the Einstein equation holds. For nonconformal fields, the same conclusion follows modulo a conjecture about the variation of entanglement entropy.


Uncertainty and urban water recharge for managing groundwater availability using decision support.
Quantifying groundwater availability depends upon sound methods and the use of integrated models. To determine availability or sustainable yield, the influence of scientific uncertainty from key sources, such as anthropogenic recharge, must be considered. This study evaluates uncertainty in recharge interpretations on the modeled available water balance for an urban case in Texas, USA. Analyses are completed using the Groundwater Decision Support System, which is a research code-base for an integrated modeling. The case study develops spatially and temporally resolved recharge interpretations based on NEXRAD precipitation and detailed land use data. Results demonstrate the implications of scientific uncertainty as it influences recommendations for policy and urban water management decisions that are based on modeled outputs. Geospatial methods account for spatial and temporal components and can be replicated for other systems. These methods are also useful for resolving uncertainty in relation to the influence of urbanization on recharge through land use change.


[Microbiological study of dehydrated garlic (Allium sativum L.) and onion (Allium cepa L.)].
A microbiological study during the process and the storage of garlic (Allium sativum L.) and onion (Allium cepa L.) dehydrated, with the additional barriers of blanching or brine immersion, was made. In all raw materials the average counts of aerobic mesophilic bacteria expressed in CFU/g ranged from 1.2 x 10(2) to 1.6 x 10(3), molds and yeasts from 60 to 1.6 x 10(3), Lactobacillus spp. and Leuconostoc mesenteroides subsp. mesenteroides between 10 and 50. Microorganisms identified were Penicillium spp., Monilia spp., Lactobacillus brevis, Leuconostoc mesenteroides subsp. mesenteroides and yeasts in garlic; Mucor spp., Penicillium spp., Monilia spp., Lactobacillus brevis and yeasts in both types of onions. Leuconostoc mesenteroides subsp. mesenteroides was detected in only kind of onion. In dehydrated garlic storage, Penicillium spp., Monilia spp., Lactobacillus brevis and yeasts were detected. In garlic, when a blanching step was carried out no microflora was detected. Mucor spp., Penicillium spp., Monilia spp. and Lactobacillus brevis were identified in both types of dehydrated onions. When brine immersion was included the microflora detected was significantly lower and only Penicillium spp. were found. The use of additional barriers such as blanching or brine immersion produces an important effect on the microbiological stability in these products.


BRCA1 is required for common-fragile-site stability via its G2/M checkpoint function.
Common fragile sites are loci that form chromosome gaps or breaks when DNA synthesis is partially inhibited. Fragile sites are prone to deletions, translocations, and other rearrangements that can cause the inactivation of associated tumor suppressor genes in cancer cells. It was previously shown that ATR is critical to fragile-site stability and that ATR-deficient cells have greatly elevated fragile-site expression (A. M. Casper, P. Nghiem, M. F. Arlt, and T. W. Glover, Cell 111:779-789, 2002). Here we demonstrate that mouse and human cells deficient for BRCA1, due to mutation or knockdown by RNA interference, also have elevated fragile-site expression. We further show that BRCA1 functions in the induction of the G(2)/M checkpoint after aphidicolin-induced replication stalling and that this checkpoint function is involved in fragile-site stability. These data indicate that BRCA1 is important in fragile-site stability and that fragile sites are recognized by the G(2)/M checkpoint pathway, in which BRCA1 plays a key role. Furthermore, they suggest that mutations in BRCA1 or interacting proteins could lead to rearrangements at fragile sites in cancer cells.


The Cerebellar Predictions for Social Interactions: Theory of Mind Abilities in Patients With Degenerative Cerebellar Atrophy.
Recent studies have focused on the role of the cerebellum in the social domain, including in Theory of Mind (ToM). ToM, or the "mentalizing" process, is the ability to attribute mental states, such as emotion, intentions and beliefs, to others to explain and predict their behavior. It is a fundamental aspect of social cognition and crucial for social interactions, together with more automatic mechanisms, such as emotion contagion. Social cognition requires complex interactions between limbic, associative areas and subcortical structures, including the cerebellum. It has been hypothesized that the typical cerebellar role in adaptive control and predictive coding could also be extended to social behavior. The present study aimed to investigate the social cognition abilities of patients with degenerative cerebellar atrophy to understand whether the cerebellum acts in specific ToM components playing a role as predictive structure. To this aim, an ad hoc social cognition battery was administered to 27 patients with degenerative cerebellar pathology and 27 healthy controls. In addition, 3D T1-weighted and resting-state fMRI scans were collected to characterize the structural and functional changes in cerebello-cortical loops. The results evidenced that the patients were impaired in lower-level processes of immediate perception as well as in the more complex conceptual level of mentalization. Furthermore, they presented a pattern of GM reduction in cerebellar portions that are involved in the social domain such as crus I-II, lobule IX and lobule VIIIa. These areas showed decreased functional connectivity with projection cerebral areas involved in specific aspects of social cognition. These findings boost the idea that the cerebellar modulatory function on the cortical projection areas subtends the social cognition process at different levels. Particularly, regarding the lower-level processes, the cerebellum may act by implicitly matching the external information (i.e., expression of the eyes) with the respective internal representation to guarantee an immediate judgment about the mental state of others. Otherwise, at a more complex conceptual level, the cerebellum seems to be involved in the construction of internal models of mental processes during social interactions in which the prediction of sequential events plays a role, allowing us to anticipate the other person's behavior.


[Breast self-examination also valuable in women participating in a screening programme].
To evaluate the different methods of detection of breast cancer in women who at time of diagnosis underwent screening mammographies as participants in the Dutch National Breast Cancer Screening Programme (BOB group), and in women who participated in an intensive screening programme for a familial or genetic predisposition to breast cancer (FAM group). Partly retrospective, partly prospective, descriptive. All patients who had surgery for invasive breast cancer at the VU University Medical Center, Amsterdam, the Netherlands, from 1 January 1995 to 30 June 2006 and who were participating in one of the abovementioned screening programmes at the time of diagnosis, were included. Data concerning the palpability of the tumour at time of diagnosis and the diagnostic method that first led to breast cancer being diagnosed, were collected. The BOB group consisted of 397 women with invasive carcinoma of which 57% (227/397) tumours were palpable at the time of diagnosis. The majority (64%; 146/227) of the palpable tumours were discovered by breast self-examination as an interval carcinoma. 31% (71/227) were detected by screening mammography and were also palpable. During the same period, 490 women participated in the high risk screening programme; in this FAM group, 23 invasive tumours were detected. A total of 61% (14/23) of these lesions were found during breast self-examination; 7 lesions (30%) were found by imaging. In women who participated in one of the 2 screening programmes, the majority of invasive breast cancers were palpable and more than half were detected by breast self-examination. Performing breast self-examination on a regular basis may contribute to early detection of breast cancer. Therefore, the teaching of breast self-examination to women should be encouraged, even if they are participating in a breast cancer screening programme.