Ground and excited state resonance Raman spectra of an azacrown-substituted [(bpy)Re(CO)3L]+ complex: characterization of excited states, determination of structure and bonding, and observation of metal cation release from the azacrown.
A [(bpy)Re(CO)3L+] complex (bpy = 2,2'-bipyridine) in which L contains a phenyl-azacrown ether that is attached to Re via an amidopyridyl linking group has been studied by steady state and nanosecond time-resolved resonance Raman spectroscopy. Vibrational band assignments have been aided by studies of model complexes in which a similar electron-donating dimethylamino group replaces the azacrown or in which an electron-donor group is absent, and by density functional theory calculations. The ground state resonance Raman spectra show nu(bpy) and nu(CO) bands of the (bpy)Re(CO)3 group when excitation is exclusively in resonance with the Re --> bpy metal-to-ligand charge-transfer (MLCT) transition, whereas L ligand bands are dominant when it is in resonance with the strong intra-ligand charge-transfer (ILCT) transition present for L ligands with electron-donor groups. Transient resonance Raman (RR) spectra obtained on single color (385 nm) pulsed excitation of the complexes in which an electron-donor group is absent show bpy*- bands of the MLCT excited state, whereas those of the complexes with electron-donor groups show both bpy*- bands and a down-shifted nu(CO) band that together are characteristic of an L-to-bpy ligand-to-ligand charge-transfer (LLCT) excited state. Samples in which a metal cation (Li+, Na+, Ca2+, Ba2+) is bound to the azacrown in the ground state show bands from both excited states, consistent with a mechanism in which the LLCT state forms after metal cation release from the MLCT state. Nanosecond time-resolved RR spectra from two-color (355 nm pump, 500 nm probe) experiments on the electron-donor systems show L-ligand bands characteristic of the LLCT state; the same bands are observed from samples in which a metal cation is bound to the azacrown in the ground state, and their time dependence is consistent with the proposed mechanism in which the rate constant for ion release in the MLCT state depends on the identity of the metal cation.


Comparison of Three Different New Bipolar Energy Modalities and Classic Bipolar in Vivo for Tissue Thermal Spread.
The aim of this study was to compare three different new bipolar energy modalities and classic bipolar in vivo for tissue thermal spread. This prospective, randomized, single-blind study was conducted between Septemsber 2012 and July 2013. Eighteen patients aged 40-65 years undergoing hysterectomy and bilateral salpingectomy for benign etiology were included in the study. Before the hysterectomy operation began, it was marked nearly distal third cm started from uterine corn and proximal close third cm started from fimbrial bottoms by visualizing both fallopian tubes. The surgery was performed using one 5 mm applicator of PlasmaKinetics™, EnSeal®, LigaSure™ or classic bipolar energy modality. The time each device was used was standardized as the minimum time of the audible warning of the device for tissue impedance and as tissue vaporization on classic bipolar. Tissues were dyed by both H&E and Masson's Trichrome in the pathology laboratory. Thermal spread was compared. Evaluation of the damage on the uterine tubes by each device used revealed that LigaSure™ was associated with increased thermal injury compared to PlasmaKinetics™ (p=0.007). Apart from PlasmaKineticsTM (p=0.022), there was no statistically significant difference between the three devices in terms of thermal damage spread in the distal and proximal fallopian tubes. To reduce lateral thermal damage, Plasmakinetics™ may be preferable to Ligasure™ among the three different new bipolar energy modalities.


[Electrical injury].
Electrical injury can be classified into true electrical injury, are burn. In true electrical injury, large or small, dry, dark brown necrotic wounds (electric current spots) are observed on the skin at the entrance and exit sites of the electric current, and progressive necrosis develops in surrounding tissues. As generalized symptoms, ventricular fibrillation, respiratory arrest, and loss of consciousness may be observed temporarily immediately after the injury. Necrosis also occurs in deep tissues including muscles, and pathology resembling crush injury is seen. Myoglobin released into the circulation due to muscle necrosis tissue causes myoglobinuria and increases the risk of acute renal failure. Treatment consists of emergency resuscitation and fluid supplementation with lactated Ringer's solution. However, more fluid should be administered than in cases of common burns to accelerate urinary excretion of myoglobin in the circulation. For local treatment, debridement should be performed in areas with clear third-degree burns, but in the presence of progressive necrosis, repair and reconstruction after debridement should be postponed for 2-3 weeks.


Assessing medical home mechanisms: certification, asthma education, and outcomes.
Patient-centered medical homes (PCMHs) represent a widespread model of healthcare transformation. Despite evidence that PCMHs can improve care quality, the mechanisms by which they improve outcomes are relatively unexamined. We aimed to assess the mechanisms linking certification as a Health Care Home (HCH), a statewide PCMH initiative, with asthma care quality and outcomes. We compared direct certification effects versus indirect clinical effects (via improved care process). This was an observational study using statewide patient-level data on asthma care quality and asthma outcomes. This study examined care quality for 296,662 adults and children with asthma in 501 HCH-certified and non-HCH clinics in Minnesota from 2010 to 2013. Using endogenous treatment effects models, we assessed the effects of HCH certification on care process (patient education using asthma action plans [AAPs]) and outcomes (asthma controlled; having no exacerbations) and asthma education's effect on outcomes. We used logistic regression to formally decompose direct (certification) versus indirect (via education/AAPs) effects. Adults' adjusted rates of process and outcomes targets were double for HCH versus non-HCH clinics; children's rates were also significantly higher for HCHs. Tests of the indirect/care process effect showed that rates of meeting outcomes targets were 7 to 9 times higher with education using an AAP. Decomposition indicated that the indirect effect (via education/AAPs) constituted 16% to 35% of the total HCH effect on outcomes. HCHs were associated with better asthma care and outcomes. Asthma education with AAPs also was associated with better outcomes despite being a minority of HCHs' total effect. These findings suggest that HCHs improve outcomes partially via increased care management activity, but also via other mechanisms (eg, electronic health records, registries).


An Overview of Recent Progress in Engineering Three-Dimensional Scaffolds for Cultured Meat Production.
Cultured meat is a new type of green, safe, healthy, and sustainable alternative to traditional meat that will potentially alleviate the environmental impact of animal farming and reduce the requirement for animal slaughter. However, the cultured meat structures that have been prepared lack sufficient tissue alignment. To create a product that is similar in texture and taste to traditional animal meat, muscle stem cells must be organized in a way that imitates the natural structure of animal tissue. Recently, various scaffold technologies and biomaterials have been developed to support the three-dimensional (3D) cultivation and organization of muscle stem cells. Hence, we propose an overview of the latest advancements and challenges in creating three-dimensional scaffolds for the biomanufacturing of cultured meat.


Na2BaB12O18F4: A Mixed Alkali/Alkaline-Earth Metal Fluorooxoborate with Two Unprecedented Interpenetrating Three-Dimensional B-O/F Anionic Networks and a Short Ultraviolet Cutoff Edge.
Fluorooxoborates are promising yet largely untapped crystal materials for linear and nonlinear optical applications. The introduction of a strong electronegative F atom into an oxyboron anionic group offers a virtually unlimited chance for structural engineering and ultimately purposeful tuning of the macroscopic optical properties of the crystal. Herein, a new mixed alkali/alkaline-earth fluorooxoborate, Na2BaB12O18F4, was synthesized in a closed system. Na2BaB12O18F4 features a [B6O11F2] fundamental building unit (FBB), which polymerizes into two new (first example) independent interpenetrating three-dimensional (3D) B-O/F anionic networks constructed entirely from BO3 and BO3F units. Based on optical characterizations and the first-principles calculations, Na2BaB12O18F4 exhibits a moderate birefringence (0.054 @ 1064 nm) and a short ultraviolet (UV) cutoff edge (below 190 nm). The successful synthesis and characterization of Na2BaB12O18F4 may speed up the subsequent discovery of other mixed alkali/alkaline-earth metal fluorooxoborates.


Morphological variation and taxonomy of Atractus latifrons (Günther, 1868) (Serpentes: Dipsadidae).
As currently understood Atractus latifrons is widely distributed in South America, occurring from Suriname to the east of the Andes in Bolivia. Throughout this widespread distribution, at least three distinct color patterns were previously reported in the literature. Here, we test whether quantitative variation and qualitative distribution of morphological characters are correlated with any color pattern displayed by the species along its range. We recognize three aposematic color patterns (bicolor in monads, tricolor in dyads, and tricolor in tetrads) for A. latifrons. We found no obvious correspondence between these patterns and any character systems analyzed herein. Additionally, we redescribe the holotype of A. latifrons and report on morphological variability (meristics, morphometrics, color patterns, and hemipenis) and geographical distribution (extending its distribution to the state Roraima, Brazil) of the species.


Pre-Interventional Kynurenine Predicts Medium-Term Outcome after Contrast Media Exposure Due to Coronary Angiography.
Contrast induced acute kidney injury (CI-AKI) remains a serious complication of contrast media enhanced procedures like coronary angiography. There is still a lack of established biomarkers that help to identify patients at high risk for short and long-term complications. The aim of the current study was to evaluate plasma kynurenine as a predictive biomarker for CI-AKI and long-term complications, measured by the combined endpoint "major adverse kidney events" (MAKE) up to 120 days after CM application. In this prospective cohort study 245 patients undergoing coronary angiography were analyzed. Blood samples were obtained at baseline, 24h and 48h after contrast media (CM) application to diagnose CI-AKI. Patients were followed for 120 days for adverse clinical events including death, the need for dialysis, and a doubling of plasma creatinine. Occurrence of any of these events was summarized in the combined endpoint MAKE. Preinterventional plasma kynurenine was not associated with CI-AKI. Patients who later developed MAKE displayed significantly increased preinterventional plasma kynurenine levels (p<0.0001). ROC analysis revealed that preinterventional kynurenine is highly predictive for MAKE (AUC=0.838; p<0.0001). The optimal cutoff was found at ≥3.5 µmol/L Using this cutoff, the Kaplan-Meier estimator demonstrated that concentrations of plasma kynurenine ≥3.5 µmol/L were significantly associated with a higher prevalence of MAKE until follow up (p<0.0001). This association remained significant in multivariate Cox regression models adjusted for relevant factors of long-term renal outcome. Preinterventional plasma kynurenine might serve as a highly predictive biomarker for MAKE up to 120 days after coronary angiography.


A high resolution two-dimensional gel electrophoresis and silver staining protocol demonstrated with nuclear matrix proteins.
An improved two-dimensional gel electrophoresis procedure has been developed utilizing isolated nuclear matrix proteins. The proteins of the cellular nuclear matrix are tissue specific. They are an example of a protein set whose two-dimensional electrophoretic patterns afford much information of clinical significance. However, current two-dimensional gel techniques were not completely satisfactory for the small amounts of protein present in tissue samples. There was a need for a two-dimensional gel procedure which was capable of increased sensitivity and resolution and at the same time was reliable and reproducible. This has been accomplished by implementing several modifications to the current two-dimensional gel procedures. In addition, changes were introduced in the silver staining process of the gels to increase the signal to background ratio. The overall procedure affects a dramatic increase in the resolution and clarity of the proteins visualized on two-dimensional gels and is no more laborious than current techniques.


Innovation and Emerging Roles of Populus trichocarpa TEOSINTE BRANCHED1/CYCLOIDEA/PROLIFERATING CELL FACTOR Transcription Factors in Abiotic Stresses by Whole-Genome Duplication.
The TEOSINTE BRANCHED1/CYCLOIDEA/PROLIFERATING CELL FACTOR (TCP) family proteins are plant-specific transcription factors that have been well-acknowledged for designing the architectures of plant branch, shoot, and inflorescence. However, evidence for their innovation and emerging role in abiotic stress has been lacking. In this study, we identified a total of 36 TCP genes in Populus trichocarpa, 50% more than that in Arabidopsis (i.e., 24). Comparative intra-genomes showed that such significant innovation was mainly due to the most recent whole genome duplication (rWGD) in Populus lineage around Cretaceous-Paleogene (K-Pg) boundary after the divergence from Arabidopsis. Transcriptome analysis showed that the expressions of PtrTCP genes varied among leaf, stem, and root, and they could also be elaborately regulated by abiotic stresses (e.g., cold and salt). Moreover, co-expression network identified a cold-associated regulatory module including PtrTCP31, PtrTCP10, and PtrTCP36. Of them, PtrTCP10 was rWGD-duplicated from PtrTCP31 and evolved a strong capability of cold induction, which might suggest a neofunctionalization of PtrTCP genes and contribute to the adaptation of Populus lineage during the Cenozoic global cooling. Evidentially, overexpression of PtrTCP10 into Arabidopsis increased freezing tolerance and salt susceptibility. Integrating co-expression network and cis-regulatory element analysis confirmed that PtrTCP10 can regulate the well-known cold- and salt-relevant genes (e.g., ZAT10, GolS2, and SOS1), proving that PtrTCP10 is an evolutionary innovation in P. trichocarpa response to environmental changes. Altogether, our results provide evidence of the rWGD in P. trichocarpa responsible for the innovation of PtrTCP genes and their emerging roles in environmental stresses.


Adherence and satisfaction of rheumatoid arthritis patients with a long-term intensive dynamic exercise program (RAPIT program).
To evaluate adherence and satisfaction of patients with rheumatoid arthritis (RA) in a long-term intensive dynamic exercise program. A total of 146 RA patients started an intensive (strength and endurance training for 75 minutes, twice a week, for 2 years) exercise program (Rheumatoid Arthritis Patients In Training) aimed at improving physical fitness. Program attendance and satisfaction were examined. Additional assessments at baseline were done to find possible predictors of attendance. Median (interquartile range) age and disease duration of the patients were 54 (45-61) and 5 (3-10) years, respectively. After 2 years, 118 (81%) patients still participated in an exercise class. The median attendance rate of all patients was 74%. Low attendance was weakly associated with high disease activity, low functional ability, and low quality of life at baseline but not with the severity of joint damage at baseline. At the end, 78% of all participants would (strongly) recommend the program to other RA patients. Adherence and satisfaction of RA patients with an intensive dynamic exercise program over a prolonged time can be high. Disease severity parameters do not strongly predict the compliance of participants in an intensive exercise program.


Dural Arteriovenous Fistula With Sinus Thrombosis and Venous Reflux Presenting as Parkinsonism: A Case Report.
The occurrence of dural arteriovenous fistula (DAVF) is rare. The clinical manifestation varies and depends on the location and venous drainage pattern. We present a case of a 57-year-old man with a left transverse sinus DAVF along with sigmoid thrombosis, cortical venous reflux, and congestion, that initially presented as parkinsonism. The patient was alert and fully oriented; however, decreased facial expressions were noted. His left forearm showed rigidity and bradykinesia, and it was difficult for the patient to smoothly perform rapid alternating movement testing. His complaints about hearing a rhythmic bruit above the left ear, particularly when lying down, alerted the physician of the presence of vascular lesions. Magnetic resonance imaging and angiography confirmed the diagnosis of DAVF. The patient received a combined surgical and endovascular approach to permanently block the fistula blood flow. The motion and movement of his left upper limb improved after fistula embolization. Images at the 1-month follow-up showed a decrease in the volume of tortuous vessels, and the fistula was completely occluded.


Analysis of the association between glomerular filtration rate, proteinuria and metabolic syndrome in chronic kidney patients based on longitudinal data.
Chronic kidney disease (CKD) is a group of chronic diseases caused by kidney damage from multiple causes. Metabolic syndrome (MS) manifests as dysfunction of endothelial cells and chronic functional inflammatory states, and may be involved in pathological changes related to renal impairment. Based on longitudinal data analysis of the association between estimated glomerular filtration rate (eGFR), proteinuria and MS in patients with CKD, this study aims to provide new ideas for the pathophysiological mechanism of CKD and a theoretical basis for the early prevention and effective intervention of MS-related kidney damage. A total of 126 patients with CKD were divided into non-MS group and MS group. According to the eGFR level, 126 patients with CKD were divided into G1 group, G2 group, G3a group, G3b group, G4 group and G5 group. Serum markers such as eGFR, urine protein, and triglycerides (TG) were collected. The correlation between eGFR, urine protein and MS-related indexes was analysed, and the risk factors affecting CKD complicated by MS were analysed. In patients with CKD, the levels of urine protein, abdominal circumference, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FPG) were increased with the course of the disease, but the levels of eGFR and high density lipoprotein (HDL-C) were decreased (p < 0.05). Abdominal circumference, TG, SBP, DBP, FP were significantly negatively correlated with eGFR, but HDL-C was positively correlated with eGFR (p < 0.05). Diabetes, hyperlipidemia, UA, and SBP were independent risk factors affecting CKD complicated MS, and eGFR were independent protective factors (p < 0.05). The combination of diabetes, hyperlipidemia, UA, SBP, and eGFR exhibited higher prediction value for the CKD patients complicated by MS. There was a certain correlation between between MS components with eGFR and urinary protein in patients with CKD. The early intervention treatment of MS was helpful in delaying the development of CKD and reducing proteinuria.


MCMC genome rearrangement.
As more and more genomes have been sequenced, genomic data is rapidly accumulating. Genome-wide mutations are believed more neutral than local mutations such as substitutions, insertions and deletions, therefore phylogenetic investigations based on inversions, transpositions and inverted transpositions are less biased by the hypothesis on neutral evolution. Although efficient algorithms exist for obtaining the inversion distance of two signed permutations, there is no reliable algorithm when both inversions and transpositions are considered. Moreover, different type of mutations happen with different rates, and it is not clear how to weight them in a distance based approach. We introduce a Markov Chain Monte Carlo method to genome rearrangement based on a stochastic model of evolution, which can estimate the number of different evolutionary events needed to sort a signed permutation. The performance of the method was tested on simulated data, and the estimated numbers of different types of mutations were reliable. Human and Drosophila mitochondrial data were also analysed with the new method. The mixing time of the Markov Chain is short both in terms of CPU times and number of proposals. The source code in C is available on request from the author.


Stem cell therapy in veterinary dermatology.
Adult stem cells come from many sources and have the capacity to differentiate into many cell types, including those of the skin. The most commonly studied stem cells are those termed mesenchymal stem cells (MSCs), which are easily isolated from bone marrow and adipose tissue. Mesenchymal stem cells are known to produce a wide array of cytokines that modulate the regeneration process. The ease of collection, propagation and use of these MSCs in therapy of traumatic, ischaemic and immune-mediated skin conditions is emerging. In traumatic and ischaemic skin damage, MSCs are used in tissue-engineered skin and by direct injection into damaged tissue. For immune-mediated diseases, systemic administration of stem cells can modulate the immune system. The earliest clinical work has been with autologous stem cell sources, such as adipose tissue and bone marrow. In immune-mediated diseases, the MSCs are used to downregulate production of inflammatory cytokines and to block T-cell activation. Cells are generally given intravenously. Multiple sclerosis, rheumatoid arthritis and lupus have been successfully treated in human clinical trials. Mesenchymal stem cells can also stimulate resident local cells, such as keratinocytes and progenitor cells, to proliferate, migrate and repair skin injury and disease. The discovery of the MSC in adipose tissue has spawned a global effort to utilize these cells in therapy of a wide range of diseases of the skin. Reconstructive surgery, scar blocking and resolution and skin regeneration have all been shown to be possible in human and animal studies.


Role of protein degradation in the survival of carbon-starved Escherichia coli and Salmonella typhimurium.
When an Escherichia coli K-12 culture was starved for glucose, 50% of the cells lost viability in about 6 days. When a K-12 mutant lacking five distinct peptidase activities, CM89, was starved in the same manner, viability was lost much more rapidly; 50% of the cells lost viability in about 2 days, whereas a parent strain lacking only one peptidase activity lost 50% viability in about 4 days. Compared with the wild-type strain and with its parent strain CM17, CM89 was defective in both protein degradation and protein synthesis during carbon starvation. Similar results were obtained with glucose-starved Salmonella typhimurium LT2 and LT2-derived mutants lacking various peptidase activities. An S. typhimurium mutant lacking four peptidases, TN852, which was deficient in both protein degradation and synthesis during carbon starvation (Yen et al., J. Mol. Biol. 143:21-33, 1980), was roughly one-third as stable as the isogenic wild type. Isogenic S. typhimurium strains that lacked various combinations of three of four peptidases and that displayed protein degradation and synthesis rates intermediate between those of LT2 and TN852 (Yen et al., J. Mol. Biol. 143:21-33, 1980) displayed corresponding stabilities during carbon starvation. These results point to a role for protein degradation in the survival of bacteria during starvation for carbon.


HOXD-AS1 is a novel lncRNA encoded in HOXD cluster and a marker of neuroblastoma progression revealed via integrative analysis of noncoding transcriptome.
Long noncoding RNAs (lncRNAs) constitute a major, but poorly characterized part of human transcriptome. Recent evidence indicates that many lncRNAs are involved in cancer and can be used as predictive and prognostic biomarkers. Significant fraction of lncRNAs is represented on widely used microarray platforms, however they have usually been ignored in cancer studies. We developed a computational pipeline to annotate lncRNAs on popular Affymetrix U133 microarrays, creating a resource allowing measurement of expression of 1581 lncRNAs. This resource can be utilized to interrogate existing microarray datasets for various lncRNA studies. We found that these lncRNAs fall into three distinct classes according to their statistical distribution by length. Remarkably, these three classes of lncRNAs were co-localized with protein coding genes exhibiting distinct gene ontology groups. This annotation was applied to microarray analysis which identified a 159 lncRNA signature that discriminates between localized and metastatic stages of neuroblastoma. Analysis of an independent patient cohort revealed that this signature differentiates also relapsing from non-relapsing primary tumors. This is the first example of the signature developed via the analysis of expression of lncRNAs solely. One of these lncRNAs, termed HOXD-AS1, is encoded in HOXD cluster. HOXD-AS1 is evolutionary conserved among hominids and has all bona fide features of a gene. Studying retinoid acid (RA) response of SH-SY5Y cell line, a model of human metastatic neuroblastoma, we found that HOXD-AS1 is a subject to morphogenic regulation, is activated by PI3K/Akt pathway and itself is involved in control of RA-induced cell differentiation. Knock-down experiments revealed that HOXD-AS1 controls expression levels of clinically significant protein-coding genes involved in angiogenesis and inflammation, the hallmarks of metastatic cancer. Our findings greatly extend the number of noncoding RNAs functionally implicated in tumor development and patient treatment and highlight their role as potential prognostic biomarkers of neuroblastomas.


Characterization and antagonistic potentials of selected rhizosphere Trichoderma species against some Fusarium species.
Trichoderma fungi have been proved as efficient bioagents with great antifungal properties while many species in the plant's rhizospheres have been characterized as plant growth-promoting agents. However, many rhizosphere Trichoderma are yet to be fully explored for plant disease management. In this study, Trichoderma species were isolated from the rhizosphere of maize, banana, and cassava, and their biocontrol potentials were screened against some Fusarium species from oak leaves (F2B and F3) and laboratory cultures (Fus 296 and Fus 294). The isolated rhizosphere Trichoderma were identified as Trichoderma virens 1 (TCIV), T. virens 2 (TCVII), T. virens 3 (TMSI), T. hazianum strain 1 (TCVI), T. harzianum strain 2 (TCVIII), T. erinaceum (TMZI), and T. koningiopsis (TMZII). The dual culture experiment recorded the highest percentage inhibition in TMZII against OakF2B (31.17%), TCVIII against Fus 294 (45.18%), TMZI against Fus 296 (47.37%), while TCIV was most effective against Oak F3 (44.15%). Among the Trichoderma culture filtrates evaluated, TCIV showed the highest percentage inhibition against Oak F3 (52.39%), Oak F2B (48.54%), Fus 294 (46.65%), and Fus 296 (44.48%). All the Trichoderma isolates demonstrated expressed varying levels of antagonism against the Fusarium pathogens in vitro.


Correlations Between Intestinal Microbial Community and Hematological Profile in Native Tibetans and Han Immigrants.
Hematological features are one of the best-known aspects of high-altitude adaptation in Tibetans. However, it is still unclear whether the intestinal microbiota is associated with the hematology profile. In this study, routine blood tests and 16S rRNA gene sequencing were used to investigate the differences in the intestinal microbiota and hematological parameters of native Tibetan herders and Han immigrants sampled at 3,900 m. The blood test results suggested that the platelet counts (PLTs) were significantly higher in native Tibetans than the Han immigrants. The feces of the native Tibetans had significantly greater microbial diversity (more different species: Simpson's and Shannon's indices) than that of the Han immigrants. The native Tibetans also had a different fecal microbial community structure than the Han immigrants. A Bray-Curtis distance-based redundancy analysis and envfit function test showed that body mass index (BMI) and PLT were significant explanatory variables that correlated with the fecal microbial community structure in native Tibetans. Spearman's correlation analysis showed that Megamonas correlated positively with BMI, whereas Bifidobacterium correlated negatively with BMI. Alistipes and Parabacteroides correlated positively with the PLT. Succinivibrio correlated positively with SpO2. Intestinibacter correlated negatively with the red blood cell count, hemoglobin, and hematocrit (HCT). Romboutsia correlated negatively with HCT, whereas Phascolarctobacterium correlated positively with HCT. A functional analysis showed that the functional capacity of the gut microbial community in the native Tibetans was significantly related to carbohydrate metabolism. These findings suggest that the hematological profile is associated with the fecal microbial community, which may influence the high-altitude adaptation/acclimatization of Tibetans.


Uptrend prevalence of varicella parallel with low serum antibodies and low second-dose rate among children 10-14 years old in Wenzhou, China.
In recent years, the incidence of varicella cases is rising, and outbreaks of varicella are frequently being reported worldwide. Our study aims to analyze the association between the varicella incidence and serum antibody level in the post-vaccine era. We retrieved and analyzed the incidence and prevalence data for children age 1-14 years in Wenzhou, China during 2010-2018. A cross-sectional seroepidemiology analysis was carried out in a series of 168 general healthy children age 1-14 years as well as children at a varicella outbreak in Wenzhou. Our data showed a significant surge in the incidence and prevalence of varicella in children aged 10-14 years in 2017 and 2018 while they were kept relatively stable in 2010-2016. The seroepidemiological analysis revealed a 7.3-fold significantly higher level of serum varicella IgG in healthy control students who exposed at the outbreak than that in general healthy children (median 523.5 vs. 71.7 mIU/mL, p < .01). The children 10-14 years old had the lowest rate of second-dose vaccination among the three age classes (7%, 41%, and 65% in 10-14, 5-9, and 2-4 age class, respectively), and children 5-9 years old who received the second dose had a higher level of serum protective IgG than those who did not (254.7 vs 98 mIU/mL, p = .06). The findings from the present study warn a two-dose vaccine schedule to reduce the climbing incidence and prevalence observed in the older children and suggest a higher serum IgG threshold for effective protection of children from the varicella outbreak.


Dendritic cell secretion of IL-15 is induced by recombinant huCD40LT and augments the stimulation of antigen-specific cytolytic T cells.
Dendritic cells (DC) are professional antigen-presenting cells which stimulate strong proliferative and cytolytic T cell responses. Stimulation of CD40 on dendritic cells by its ligands and anti-CD40 antibodies induces maturation and enhances DC stimulatory ability. In order to understand the mechanism by which ligand:CD40 interactions augment DC function, we assessed the role of T cell stimulatory cytokines IL-12 and IL-15 in the function of DC stimulated with soluble trimeric CD40L, a recombinant fusion protein incorporating three covalently linked extracellular CD40L domains (huCD40LT). Peripheral blood derived DC treated with huCD40LT and/or IFN-gamma were used to stimulate T cell responses in vitro to specific antigens. DC treated with huCD40LT or IFN-gamma/huCD40LT stimulated enhanced T cell proliferation to CASTA, a soluble protein from C. albicans, induced T cells with augmented antigen-specific lysis, and increased the yield of antigen-specific IFN-gamma-producing T cells. IL-15 production by DC was enhanced in cultures treated with huCD40LT and correlated with expansion of antigen-specific cytolytic T cells. Addition of a neutralizing anti-IL-15 monoclonal antibody inhibited the expansion of viral and tumor antigen-specific T cells stimulated by IFN-gamma and huCD40LT-treated DC. In contrast, this enhanced stimulatory ability of DC did not appear to depend on synthesis of IL-12 since huCD40LT treatment stimulated the generation of antigen-specific cytokine producing and cytolytic T cells without increased IL-12 production. Addition of anti-IL-12 monoclonal antibody did not inhibit expansion of these cells. These data suggest that production of IL-15 but not IL-12 is an important factor in the enhanced immunostimulatory ability of huCD40LT-treated DC.


A spontaneously occurring malignant pituicytoma in a male sprague dawley rat.
Pituicytoma is an extremely rare neoplasm derived from pituicytes, which are glial cells in the posterior lobe of the pituitary gland. A malignant pituicytoma was found in the intracranial cavity of a 55-week-old male Sprague-Dawley rat. Macroscopically, the tumor was located on the sphenoid bone and involved the pituitary gland. The tumor was composed of sheets of fusiform cells with spindle- or pleomorphic-shaped nuclei and abundant eosinophilic cytoplasms. The cells were arranged in a whirling or irregular growth pattern. Some tumor cells were bizarre multinucleated giant cells with cytoplasmic eosinophilic hyaline droplets. Many tumor cells were strongly positive for vimentin and glial fibrillary acidic protein, and some cells were positive for ED-1 and S-100. These findings closely resembled those of a giant cell glioblastoma derived from the pituitary gland, suggesting anaplastic pituicytoma. From our review of the literature, we believe this is the first report of a spontaneous malignant pituicytoma in a rodent.


Imaging department organization in a stroke center and workflow processes in acute stroke.
The imaging department is an integral part of the stroke management task force and plays a critical role. Accurate and timely interpretation of images obtained in the emergency department and involvement in decision-making has contributed immensely in stroke care. In fact, the treatment paradigm has changed considerably after the recent positive endovascular clinical trials; and so is the hospital workflow and treatment site. As a result, the imaging department has become the site of maximum activity during an acute stroke protocol. Time management, teamwork and standardized institutional protocols contribute to improve functional outcome. In this review article, we emphasize the critical role an Imaging department's organization plays in a stroke center and the workflow involved in management of acute stroke.


5-Hydroxypyrimidine deoxynucleoside triphosphates are more efficiently incorporated into DNA by exonuclease-free Klenow fragment than 8-oxopurine deoxynucleoside triphosphates.
Recent studies with 8-oxodeoxyguanosine triphosphate (8-oxodGTP) have suggested that incorporation of oxidized nucleotides from the precursor pool into DNA may have deleterious effects. Here we show that 5-hydroxydeoxycytosine triphosphate (5-OHdCTP) and 5-hydroxydeoxyuridine triphosphate (5-OHdUTP) are more efficient substrates than 8-oxodGTP for Escherichia coli DNA polymerase I Klenow fragment lacking proofreading activity, while 8-oxodeoxyadenosine triphosphate (8-oxodGTP, 5-OHdCTP can mispair with dA in DNA but with lower efficiency. Since the 5-hydroxypyrimidines are present in normal and oxidized cellular DNA in amounts similar to the 8-oxopurines, these data suggest that enzymatic mechanisms might exist for removing them from the DNA precursor pools.


Butyl Methacrylate-Co-Ethylene Glycol Dimethacrylate Monolith for Online in-Tube SPME-UHPLC-MS/MS to Determine Chlopromazine, Clozapine, Quetiapine, Olanzapine, and Their Metabolites in Plasma Samples.
This manuscript describes a sensitive, selective, and online in-tube solid-phase microextraction coupled with an ultrahigh performance liquid chromatography-tandem mass spectrometry (in-tube SPME-UHPLC-MS/MS) method to determine chlopromazine, clozapine, quetiapine, olanzapine, and their metabolites in plasma samples from schizophrenic patients. Organic poly(butyl methacrylate-co-ethylene glycol dimethacrylate) monolith was synthesized on the internal surface of a fused silica capillary (covalent bonds) for in-tube SPME. Analyte extraction and analysis was conducted by connecting the monolithic capillary to an UHPLC-MS/MS system. The monolith was characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectrometry (FTIR). The developed method presented adequate linearity for all the target antipsychotics: R² was higher than 0.9975, lack-of-fit ranged from 0.115 to 0.955, precision had variation coefficients lower than 14.2%, and accuracy had relative standard error values ranging from -13.5% to 14.6%, with the exception of the lower limit of quantification (LLOQ). The LLOQ values in plasma samples were 10 ng mL-1 for all analytes. The developed method was successfully applied to determine antipsychotics and their metabolites in plasma samples from schizophrenic patients.


Views from 'crabworld': the spatial distribution of light in a tropical mudflat.
Natural scene analysis has been extensively used to understand how the invariant structure of the visual environment may have shaped biological image processing strategies. This paper deals with four crucial, but hitherto largely neglected aspects of natural scenes: (1) the viewpoint of specific animals; (2) the fact that image statistics are not independent of the position within the visual field; (3) the influence of the direction of illumination on luminance, spectral and polarization contrast in a scene; and (4) the biologically relevant information content of natural scenes. To address these issues, I recorded the spatial distribution of light in a tropical mudflat with a spectrographic imager equipped with a polarizing filter in an attempt to describe quantitatively the visual environment of fiddler crabs. The environment viewed by the crabs has a distinct structure. Depending on the position of the sun, the luminance, the spectral composition, and the polarization characteristics of horizontal light distribution are not uniform. This is true for both skylight and for reflections from the mudflat surface. The high-contrast feature of the line of horizon dominates the vertical distribution of light and is a discontinuity in terms of luminance, spectral distribution and of image statistics. On a clear day, skylight intensity increases towards the horizon due to multiple scattering, and its spectral composition increasingly resembles that of sunlight. Sky-substratum contrast is highest at short wavelengths. I discuss the consequences of this extreme example of the topography of vision for extracting biologically relevant information from natural scenes.


Tielle: a hydropolymer dressing.
Exuding wounds such as pressure sores and leg ulcers are often difficult to manage. Tielle is a foamed gel dressing with an exudate handling system that is different in structure from that of a hydrocolloid.


Coiled-coil domains in glycoproteins B and H are involved in human cytomegalovirus membrane fusion.
Human cytomegalovirus (CMV) utilizes a complex route of entry into cells that involves multiple interactions between viral envelope proteins and cellular receptors. Three conserved viral glycoproteins, gB, gH, and gL, are required for CMV-mediated membrane fusion, but little is known of how these proteins cooperate during entry (E. R. Kinzler and T. Compton, submitted for publication). The goal of this study was to begin defining the molecular mechanisms that underlie membrane fusion mediated by herpesviruses. We identified heptad repeat sequences predicted to form alpha-helical coiled coils in two glycoproteins required for fusion, gB and gH. Peptides derived from gB and gH containing the heptad repeat sequences inhibited virus entry when introduced coincident with virus inoculation onto cells or when mixed with virus prior to inoculation. Neither peptide affected binding of CMV to fibroblasts, suggesting that the peptides inhibit membrane fusion. Both gB and gH coiled-coil peptides blocked entry of several laboratory-adapted and clinical strains of human CMV, but neither peptide affected entry of murine CMV or herpes simplex virus type 1 (HSV-1). Although murine CMV and HSV-1 gB and gH have heptad repeat regions, the ability of human CMV gB and gH peptides to inhibit virus entry correlates with the specific residues that comprise the heptad repeat region. The ability of gB and gH coiled-coil peptides to inhibit virus entry independently of cell contact suggests that the coiled-coil regions of gB and gH function differently from those of class I, single-component fusion proteins. Taken together, these data support a critical role for alpha-helical coiled coils in gB and gH in the entry pathway of CMV.


Ocular Inflammation Associated with Polymyalgia Rheumatica without Concomitant Giant-Cell Arteritis: A Report of Three Cases.
We report three cases of ocular inflammation and polymyalgia rheumatica without concomitant giant-cell arteritis. Report of three cases. Polymyalgia rheumatica onset was at a mean age of 66.7 years, and ocular inflammation, which developed 7-21 months later, was bilateral in all patients. Ocular inflammation presented as episcleritis, scleritis, or anterior uveitis, and it emerged during the tapering of low-dose prednisolone prescribed for polymyalgia rheumatica in all patients. Recurrence of ocular inflammation was observed in two patients. Ocular inflammation associated with polymyalgia rheumatica was often bilateral and occurred during steroid tapering. Although this presentation is relatively uncommon, polymyalgia rheumatica should be considered in the differential diagnosis of older patients presenting with ocular inflammation, especially those with proximal myalgia and elevated inflammatory markers.


First record of Apiosoma piscicola (Blanchard, 1885) (Ciliophora: Epistylididae) in common carp (Cyprinus carpio Linnaeus, 1758) (Pisces: Cyprinidae) from aquaculture facilities in North Macedonia.
A total of 578 specimens of common carp (Cyprinus carpio) from eight the most significant and larger cyprinid aquaculture facilities in Macedonia (fish farms and cage culture systems) were examined for parasitological investigation. Protozoa Apiosoma piscicola was found in cage culture system on Globochica reservoir. In this fish farm, a total of 127 fish samples were examined for parasitological investigation, in which parasite infestation with A. piscicola was found on fins and gills in 79 specimens of common carp, in winter season. The prevalence of A. piscicola in common carp was 62.20%, while the mean intensity was 17.58. Our findings of A. piscicola in common carp (C. carpio) are first recorded in Macedonia. At the same time, common carp represent new host for A. piscicola in Macedonian waters.


Information Entropy as a Reliable Measure of Nanoparticle Dispersity.
Nanoparticle size impacts properties vital to applications ranging from drug delivery to diagnostics and catalysis. As such, evaluating nanoparticle size dispersity is of fundamental importance. Conventional approaches, such as standard deviation, usually require the nanoparticle population to follow a known distribution and are ill-equipped to deal with highly poly- or heterodisperse populations. Herein, we propose the use of information entropy as an alternative and assumption-free method for describing nanoparticle size distributions. This measure works equally well for mono-, poly-, and heterodisperse populations and represents an unbiased route to evaluation and optimization of nanoparticle synthesis. We provide intuitive software tools for analysis and supply guidelines for interpretation with respect to known standards.


[Phenotypic and genetic analysis of a boy with a 10p15.3 deletion and partial trisomy 18p syndrome].
To delineate the nature and origin of chromosomal aberration in a girl with mental retardation. Genomic DNA was analyzed by using single nucleotide polymorphism-based array (SNP array). The proband and her parents were subjected to routine G-banded chromosomal karyotyping analysis. SNP array has identified a 1.2 Mb microdeletion at 10p15.3 and a duplication at 18p11.21-pter in the proband. The patient was also found to harbor a structural aberration involving 10p. The karyotype of her father was 46,XY,t(10;18)(p15;p11.2), while her mother was found to be normal. The structural aberration of 10p carried by the patient has derived from her father whom has carried a balanced translocation of t(10;18). Her karyotype was finally determined as 46,XX,der(10)t(10;18)(p15;p11.2)pat. The abnormal phenotype of the patient can probably be attributed to the presence of 10p15.3 microdeletion and 18p11.21-pter duplication.


Spontaneous variation regarding grape berry skin color: A comprehensive study of berry development by means of biochemical and molecular markers.
Understanding grape berry development and the metabolism of different classes of compounds responsible for traits like berry's color is imperative to control and improve quality aspects of grapes. A colorimetric, biochemical and molecular characterization allowed the comprehensive description of the pigment-related characteristics of nine berry skin color somatic variants, belonging to four different varieties. Although the observed berry skin color variability was not fully explained by MybA locus, the phenolic profiles allowed inferring about specific interferences among the biosynthetic pathways. Data were consistent concerning that grapes showing cyanidin-3-O-glucoside as the major anthocyanin and flavonols with two substituent groups in the lateral B-ring are generally originated by a white ancestor. After retro-mutation, these grapes seem to keep the dysfunction on flavonoid hydroxylases enzymes, which negatively affect the synthesis of both flavonols and anthocyanins with three substituent groups in the lateral B-ring. Overall, the obtained results indicate that the color differences observed between somatic variants are not solely the result of the total amount of compounds synthesized, but rather reflect a different dynamics of the phenolic pathway among the different color variants of the same variety. Gallic acid (PubChem CID: 370); Caftaric acid (PubChem CID: 6,440,397); Catechin (PubChem CID: 73,160); Epigallocatechin gallate (PubChem CID: 65,064); Quercetin-3-O-galactoside (PubChem CID: 5,281,643); Quercetin-3-O-glucoside (PubChem CID: 25,203,368); Malvidin-3-O-glucoside (PubChem CID: 443,652); Peonidin-3-O-p-coumaroylglucoside (PubChem CID: 44,256,849); Malvidin-3-O-p-coumaroylglucoside (PubChem CID: 44,256,988); Resveratrol-3-O-glucoside (PubChem CID: 25,579,167).


Characterization of the MacA-MacB efflux system in Neisseria gonorrhoeae.
A homologue of the MacA-MacB ABC transporter of Escherichia coli, which recognizes and exports macrolides, was identified in Neisseria gonorrhoeae. This study was undertaken to determine whether gonococci could use the MacA-MacB homologue to express decreased susceptibility to macrolides. Techniques of DNA sequencing, gene cloning and expression of recombinant proteins in E. coli, gene mutation construction, transcriptional analysis and antimicrobial susceptibility testing were used in the study. Although the gonococcal MacA-MacB efflux pump enhanced bacterial resistance to macrolides when overexpressed in an E. coli background, its loss in a gonococcal clinical isolate only slightly decreased bacterial resistance to azithromycin and erythromycin. However, a mutation in the -10 sequence of the promoter used in macAB expression enhanced the macrolide resistance of gonococci that produced a defective MtrC-MtrD-MtrE pump, which also recognizes macrolides. The results from this study indicate that gonococci can employ both the MacA-MacB and MtrC-MtrD-MtrE efflux pumps to develop resistance to macrolides, particularly if mutations develop in the promoter that drives transcription of macAB.


[Aneurysmal subarachnoid hemorrhage. Significance and complications].
Despite substantial improvement in the management of patients with aneurysmal subarachnoid hemorrhage (SAH), including early aneurysm occlusion by endovascular techniques and surgical procedures, a significant percentage of patients with SAH still experience serious sequelae of neurological or cognitive deficits as a result of primary hemorrhage and/or secondary brain damage. Available neuromonitoring methods for early recognition of ischemia include, among others, measurement of brain tissue O(2) partial pressure, brain metabolism with microdialysis and monitoring of regional blood flow. The triple-H therapy (arterial hypertension, hypervolemia and hemodilution) is the treatment of choice of a symptomatic vasospasm and leads to an enduring recession of ischemic symptoms, if initiated early after the onset of a vasospasm-linked ischemic neurological deficit. Further promising therapy approaches are the administration of highly selective ET(A) receptor antagonists and intracisternal administration of vasodilators in depot form. This review summarizes the major neurological and non-neurological complications following aneurysm occlusion. Possible neuromonitoring techniques to improve diagnosis and therapy for treatment of symptomatic vasospasm as well as extracranial complications are discussed.


Multi-site phasic neural activity mediates the execution of an auditory continuous performance task: a PET and electrophysiological study.
We studied an auditory continuous performance task with positron emission tomography(PET) and EEG-derived current density reconstructions (CDRs) to define the spatial and temporal aspects of auditory attention. The CDRs were employed to segregate responses to targets and non-targets at sites identified by PET. We then studied the time course of brain activity using statistical parametric mapping (SPM) of the CDR data. In contrast to target EEG activity, non-targets did not produce significant peaks after 300 ms. Pre-300 ms biphasic activation of auditory, left posterior frontal, left supplemental,and primary motor cortices and the anterior cingulate (AC) and biphasic suppression of posterior cingulate and occipital cortex were identical for targets and non-targets and may mediate the target non-target decision. SPM analysis of post-300 ms CDRs showed cingulate cortices were the first to be reactivated, remained active through 672 ms, and were accompanied by reactivation and deactivation of the same sites observed in the pre-P300 responses. The cingulate may play an important role in post-decisional activity and control activity at other sites involved in post-decisional cognitive processing.


Learning and attention reveal a general relationship between population activity and behavior.
Prior studies have demonstrated that correlated variability changes with cognitive processes that improve perceptual performance. We tested whether correlated variability covaries with subjects' performance-whether performance improves quickly with attention or slowly with perceptual learning. We found a single, consistent relationship between correlated variability and behavioral performance, regardless of the time frame of correlated variability change. This correlated variability was oriented along the dimensions in population space used by the animal on a trial-by-trial basis to make decisions. That subjects' choices were predicted by specific dimensions that were aligned with the correlated variability axis clarifies long-standing paradoxes about the relationship between shared variability and behavior.


Modulation of Bordetella pertussis infection with monoclonal antibodies to pertussis toxin.
Three monoclonal antibodies to pertussis toxin were characterized and used to investigate its role in immunity. Antibody affinity correlated with toxin neutralization in in vivo and in vitro assays but was not the only determinant of protection against Bordetella pertussis infection. B9, a high-affinity anti-S3 antibody, was the most effective in neutralizing toxin-induced CHO cell clustering and hemagglutination in vitro and lymphocytosis and histamine sensitization in vivo. A4, a similar-affinity anti-S1 antibody, was less active in the toxin neutralization assays but more protective in the mouse infection model. A12, a low-affinity anti-S1 antibody, was least active in the assays of toxin neutralization but as effective as B9 in the infection model. These data suggest that epitopes on the A protomer and B oligomer may induce protective immunity. Measurement of pertussis toxin neutralization by monoclonal antibodies in in vitro and in vivo assays may not accurately predict protection against infection with B. pertussis.


Pain reduction, physical performance, and psychological status compared between Hatha yoga and stretching exercise to treat sedentary office workers with mild/moderate neck/shoulder pain: A randomized controlled non-inferiority trial.
To investigate pain reduction, physical performance, and psychological status compared between Hatha yoga and stretching exercises. Randomized controlled non-inferiority trial SUBJECTS: 150 sedentary office workers with mild/moderate neck/shoulder pain. Participants received group Hatha yoga or stretching exercise once a week (30 min for 4 weeks), and were asked to practice at home. Subjects were followed up at 4 and 8 weeks. The primary outcome was a numeric rating scale (NRS) score. The secondary outcomes were a sit-and-reach test, Functional Reach Test, Neck Disability Index, pain pressure threshold, Patient Health Questionnaire-9, General Anxiety Disorder-7, and the EuroQoL. Of the 150 subjects, 59 and 71 participants in the Hatha yoga and stretching groups were analyzed. At baseline, no significant differences between groups were found. After 4 weeks, the mean difference in the NRS score was statistically significant between groups (p < 0.001), including a 95% confidence level of < 1 score, but there was no significant difference between groups for any other outcome. Most participants reported being satisfied with their assigned treatment (98.3-100%), and rated themselves as improved or much improved (91.8-98.3%) (both p > 0.05 between groups). The most common adverse events were musculoskeletal pain and muscle tension. Repeated measures analysis of variance that compared among weeks 0, 4, and 8 revealed no significant difference between groups. Hatha yoga was tentatively found to be non-inferior to stretching exercise relative to safety, for decreasing pain, anxiety, and depression, and for improving flexibility, neck functions, and quality of life.


Intravenous infusion of a medium-chain triglyceride-enriched lipid emulsion.
There has been much interest in the parenteral use of medium-chain triglycerides (MCT) as a noncarbohydrate energy source. This study examines the effects of infusion iv into postabsorptive normal subjects with three doses (0.5, 1.0, 1.5 g/kg.15 h) of an emulsion containing 56% MCT and 44% long-chain triglyceride (LCT) and comparing its metabolic effect with infusions of normal saline (NS) and an emulsion containing LCT alone. There were significant increases in serum beta-hydroxybutyrate and acetoacetate 5 and 15 h after the start of the MCT-LCT infusions. Increases were seen only after 15 h of NS, while none was observed during LCT alone. Triglycerides were increased in a dose-related fashion with MCT-LCT and were increased even further with LCT alone. Glycerol increased in a dose-related fashion both during the MCT-LCT and LCT infusion beginning immediately (0.5 h) after the start of the infusion. With NS infusion, glycerol increased significantly only after 15 h of infusion. The MCT-LCT mixture and the highest LCT dose resulted in a significant (12%) increase in oxygen consumption after 5 h of infusion. There was no difference in oral glucose tolerance between the various infusions. Infusion of MCT results in significant ketogenesis and more study is needed to determine its clinical utility.


Potential regulation of glioma through the induction of apoptosis signaling via Egl-9 family hypoxia-inducible factor 3.
Glioma is an aggressive form of brain cancer that occurs following the abnormal proliferation of glial cells. Although glioma cannot spread to other organs, the morbidity and mortality rates of the disease are high, even following surgery, radiotherapy and chemotherapy. The function of Egl-9 family hypoxia-inducible factor 3 (Egln3) in cancer is controversial, and it is debated as to whether Egln3 positively or negatively regulates tumors. In the present study, a mouse model of low-grade glioma was successfully established. Through the use of immunohistochemical and western blot analyses, it was demonstrated that Egln3 expression in glioma tissue performed an important role in regulation by amplifying the signals for apoptosis, as determined by an increase in DNA fragments. Furthermore, Egln3 expression was inhibited by the administration of dimethyloxalylglycine, and the downregulated expression of Egln3 had marked effects on the regulation of glioma through apoptosis. The present study therefore provides evidence of an association between Egln3 expression and apoptosis in low-grade glioma.


Investigation of circumferential resection margin in rectal cancer surgery.
Literature data suggest that investigation of the circumferential resection margin (CRM) in rectal cancer surgery gives significant information for prognosis of the disease and the quality of the performed operation. The aim of this study was to analyze the clinical and morphological aspects of CRM in pT3 tumors in relation to their significance for rectal cancer treatment and staging. Thirty patients with radically operated pT3 stage rectal cancer were investigated. The resected specimens were studied both macroscopically and microscopically to assess CRM and the quality of the performed operation. Six (20%) patients had positive CRM (CRM +; tumor cells in the margin or < 1 mm from it). These cases were characterized with deep infiltration (> 4 mm) in the rectal adventitia (perirectal tissue). Statistically significant correlation was found between CRM status and quality of the resected specimen (including the presence of rectal fascia in CRM). There was no correlation between pathological characteristics of the tumor and the status of CRM. The status of CRM is a factor independent from TNM classification. The presence of rectal fascia in CRM confirms the good quality of the operation. CRM+ could be a result of inadequate surgery or advanced disease. The status of CRM could be used in the decision-making for postoperative adjuvant treatment.


Seeking informed consent to cancer clinical trials; evaluating the efficacy of doctor communication skills training.
Clinical trials have come to be regarded as the gold standard for treatment evaluation. However, many doctors and their patients experience difficulties when discussing trial participation, leading to poor accrual to trials and questionable quality of informed consent. We have previously developed a communication skills training program based on a typology for ethical communication about Phase II and III clinical trials within four categories. The training program consisted of a 1 day experiential workshop that included didactic teaching, exemplary video and role play. The aim of this study was to evaluate the effectiveness of the communication skills training workshop. Oncologists were recruited from three major teaching hospitals conducting oncology outpatient clinics in three Australian capital cities. Ten oncologists and 90 of their adult cancer patients who were eligible for a Phase II or III clinical trial participated. Ninety informed consent consultations were audiotaped before (n = 59) and after (n = 31) training, and fully transcribed. The presence or absence of each domain component was coded and these were summed within categories. A coding manual was produced which enabled standardization of the coding procedure. Patients completed questionnaires before and after the consultation, and doctors completed a short measure of satisfaction after the consultation. Doctors increased their use of some aspects of shared decision-making behavior (t(87) = -1.945, p = 0.05) and described some aspects of essential ethical/clinical information more commonly. In addition they used less coercive behaviors (z = -1.976, p = 0.048). However, they did not provide more clinical information or structure their consultations in the recommended fashion. Patients in the post-training cohort reported more positive attitudes to clinical trials, but other outcomes were not affected by the intervention. This short training programme demonstrated limited success in improving the oncologist's communication skills when gaining informed consent. A larger randomized controlled trial of extended training is now underway.


Transnasal microsurgical correction of choanal atresia.
Experience with the transnasal microsurgical correction of bilateral congenital choanal atresia is presented. Four case reports are presented to illustrate the advantages of this surgical approach utilizing standard otosurgical instruments and supplemental fiberoptic nasopharyngeal visualization.


Mercury contamination in some marine biota species from Khuzestan shore, Persian Gulf.
In this study, concentrations of mercury (Hg) were analyzed in some marine biota species (fish, shrimp, and crab) from Khuzestan shore, north part of the Persian Gulf. It was also our intention to evaluate potential risks to human health associated with seafood consumption. The results indicated that concentrations of Hg in the fish and crustacean were different among the species and tissues. Liver in fish and hepatopancreas in crustacean exhibited higher Hg concentration than the other tissues. The highest concentration of Hg was detected in Acanthopagrus latus liver (1.37 µg/g), followed by Labeo rohita (0.87 µg/g), Johnius belangerii (0.79 µg/g), and Barbus grypus (0.69 µg/g), respectively. Also the highest Hg concentrations were detected in shrimp species, Penaeus semisulcatus hepatopancreas (0.95 µg/g), followed by blue crab Portunus pelagicus (0.76 µg/g) and Metapenaues affinis (0.64 µg/g), respectively. The comparison indicated that benthic species were more contaminated than were other pelagic species. The results indicated that highest concentrations of Hg between different stations were detected in Musa estuary. The Hg concentration in all species were low than standards, expect in A. latus and P. semisulcatus collected from Musa estuary (S4). The variation in Hg levels among the species is likely to have resulted from metal bioavailability, changes in tissue composition, habitat,s and locations.


Family of Well-Defined Chiral-at-Cobalt(III) Complexes as Metal-Templated Hydrogen-Bond-Donor Catalysts: Effect of Chirality at the Metal Center on the Stereochemical Outcome of the Reaction.
A family of well-defined Λ- and Δ-diastereomeric octahedral cationic chiral-at-cobalt complexes were obtained by a simple two-step reaction of (R,R)-1,2-diaminocyclohexane, (R,R)-1,2-diphenylethylenediamine, or (S)-2-(aminomethyl)pyrrolidine and substituted salicylaldehydes with a cobalt(III) salt. It was observed for the first time that the use of an excess of cobalt(III) salt provides both the enantiopure Λ and Δ forms of the corresponding cobalt(III) complexes 1 and 2 in a ratio of diastereomers ranging from 1:1.6 to >20:1 (Λ/Δ) and in 31-95% combined yields. The obtained complexes were robust, air- and bench-stable, soluble in most of organic solvents, and insoluble in water. Through variation of the substituents in the phenyl ring of the salicylaldehyde moiety, it was shown that both steric and electronic effects of substituents have a significant impact on the formation of Λ and Δ isomers. Next, the efficacies of the enantiopure metal-templated complexes 1-3 were investigated in three benchmark asymmetric reactions in order to compare their catalytic activity. The chiral cobalt(III) complexes 1-3 were tested as enantioselective hydrogen-bond-donor catalysts in such important reactions as the Michael addition of the O'Donnell substrate to methyl acrylate, epoxidation of chalcone, and trimethylsilylcyanation of benzaldehyde. It was clearly demonstrated that the chirality at the cobalt center has an impact on the stereochemical outcome of the reactions. In particular, the Λ(R,R)-1 and Δ(R,R)-1 complexes acted as "pseudoenantiomeric" catalysts in the epoxidation and trimethylsilylcyanoation reactions, providing both enantiomers of the products with up to 57% enantiomeric excess.


A receptor kinase gene of the LysM type is involved in legume perception of rhizobial signals.
Plants belonging to the legume family develop nitrogen-fixing root nodules in symbiosis with bacteria commonly known as rhizobia. The legume host encodes all of the functions necessary to build the specialized symbiotic organ, the nodule, but the process is elicited by the bacteria. Molecular communication initiates the interaction, and signals, usually flavones, secreted by the legume root induce the bacteria to produce a lipochitin-oligosaccharide signal molecule (Nod-factor), which in turn triggers the plant organogenic process. An important determinant of bacterial host specificity is the structure of the Nod-factor, suggesting that a plant receptor is involved in signal perception and signal transduction initiating the plant developmental response. Here we describe the cloning of a putative Nod-factor receptor kinase gene (NFR5) from Lotus japonicus. NFR5 is essential for Nod-factor perception and encodes an unusual transmembrane serine/threonine receptor-like kinase required for the earliest detectable plant responses to bacteria and Nod-factor. The extracellular domain of the putative receptor has three modules with similarity to LysM domains known from peptidoglycan-binding proteins and chitinases. Together with an atypical kinase domain structure this characterizes an unusual receptor-like kinase.


Eicosapentaenoic acid and branched-chain amino acids fortified complete nutrition drink improved muscle strength in older individuals with inadequate protein intake.
Elevated inflammation and negative nutritional balance contribute to sarcopenia, a progressive loss of muscle mass, strength, and function. This study investigated the effect of energy supplementation and the combination of anti-inflammatory factor (eicosapentaenoic acid; EPA) and muscle-synthesis promotor (branched-chain amino acids; BCAA) on body composition, muscle, and inflammatory biomarkers in elderly with inadequate protein intake. A randomized blinded placebo-controlled trial was conducted on 84 elderly with inadequate protein intake. The participants were randomly assigned into four groups receiving a complete nutrition drink; (1) control formula, (2) fortified with 2.2 g EPA, (3) with 2.2 g EPA and 5 g BCAA (2:1:1 of Leu: Ile: Val), and (4) with 2.2 g EPA plus 5g BCAA (4:1:1 of Leu: Ile: Val). Each subject consumed two sachets of the drink to gain 500 kcal/day and performed arm muscle exercises for 3 weeks. Body compositions and handgrip strength were measured using BIA and a dynamometer, respectively. Plasma EPA and BCAA levels were determined using LC-MS/MS to ensure compliance. Muscle protein biomarkers including histidine, β-alanine, and carnosine were measured using LC-MS/MS. Serum inflammatory (IL-6) and anti-inflammatory cytokines (IL-10) were measured by using ELISA. No symptoms and signs of adverse events were observed. The right arm muscle mass and handgrip strength were significantly increased after consuming a complete nutrition drink fortified with EPA + BCAA 2:1:1 and 4:1:1 of Leu: Ile: Val (p < 0.05 and p < 0.01, respectively. Consistently, consuming such combinatory formula non-significantly elevated carnosine with reduced histidine, and increased IL-10 with decreased IL-6. All relevant intervention groups showed a significant increase in plasma levels of BCAA and EPA. Consuming a complete nutrition drink fortified with 2.2g EPA and 5g BCAA 2:1:1 or 4:1:1 of Leu: Ile: Val for 3 weeks may increase right arm muscle mass and strength in elderly with inadequate protein intake. The tendency of increased dipeptide (carnosine)/decreased free amino acid (histidine) suggests a shift toward muscle protein synthesis. The trend of decreased inflammatory/increased anti-inflammatory cytokines suggests an anti-inflammatory effect. Future long-term studies are warranted to confirm the combinatory effect of BCAA and EPA in the prevention of sarcopenia. Thailand Clinical Trial Registry No. TCTR20230116005.


Effects of Age at Cochlear Implantation on Learning and Cognition: A Critical Assessment.
Purpose Age at cochlear implantation frequently is assumed to be a key predictor of pediatric implantation benefits, but outcomes related to learning and cognition appear inconsistent. This critical assessment examines relevant literature in an effort to evaluate the impact of age at implantation in those domains for individuals who received their devices as children. Method We examined 44 peer-reviewed articles from 2003 to 2018 considering age at implantation and conducted statistical analyses regarding its impact on several domains, including literacy, academic achievement, memory, and theory of mind. Results Across 167 assessments in various experiments and conditions, only 21% of the analyses related to age at implantation yielded evidence in favor of earlier implantation, providing greater benefits to academic achievement, learning, or cognition compared to implantation later in childhood. Among studies that considered cognitive processing (e.g., executive function, memory, visual-spatial functioning), over twice as many analyses indicated significant benefits of earlier implantation when it was considered as a discrete rather than a continuous variable. Conclusion Findings raise methodological, practical, and theoretical questions concerning how "early" is defined in studies concerning early cochlear implantation, the impact of confounding factors, and the use of nonstandard outcome measures. The present results and convergent findings from other studies are discussed in terms of the larger range of variables that need to be considered in evaluating the benefits of cochlear implantation and question the utility of considering age at implantation as a "gold standard" with regard to evaluating long-term outcomes of the procedure as a medical treatment/intervention for hearing loss. Supplemental Material https://doi.org/10.23641/asha.8323625.


Addition of alpha-tocopherol to culture medium improves the quality and cryosurvival of nuclear-transferred ovine embryos.
The aim of this study was to reconstruct and cryopreserve somatic cell nuclear transferred (SCNT) ovine embryos and evaluate the effect of alpha-tocopherol on blastocyst development and subsequent cryosurvival of the SCNT embryos. The alpha-tocopherol (100 microg/ml) was added into culture medium for the SCNT embryos, the yield and total cell numbers of blastocysts were determined and the apoptosis incidences of the blastocysts were evaluated using the TUNEL assay. The blastocysts from the alpha-tocopherol and untreated groups were then frozen-thawed, and their cryosurvival was assessed by in vitro culture for 48 h. The results showed that there were no significant differences in blastocyst yield (26.3 vs. 22.3%) and total cell number (68.2 vs. 64.3) between the alpha-tocopherol and untreated groups. However, addition of alpha-tocopherol to the culture medium significantly decreased the apoptotic cell number (3.4 vs. 5.5) and significantly increased the cryosurvival of SCNT blastocysts (66.8 vs. 50.7%). In conclusion, addition of alpha-tocopherol to SCNT embryo culture medium was beneficial for improving embryo quality by decreasing the apoptotic blastocyst cell number and improving the tolerance of the embryos to cryopreservation.


Dynamics of goal pursuit and personality make-up among emerging adults: typology, change over time, and adaptation.
In recent years young people's lives have been characterized by postponement of developmental timetables, inconsistencies of transitions, and loss of direction in life. Data from a longitudinal study of Israeli young adults show that the capacity for setting realistic work and love goals reflects inner strengths and is associated with adaptive outcomes. Less-articulated love and work goals are associated with underlying personality difficulties and are predictive of less stable and less adaptive outcomes. The interplay of goal constellations and personality constructs, and its association with adaptive and less adaptive outcomes is presented and discussed.


An endemic focus of visceral leishmaniasis in Meshkin-Shahr, east Azerbaijan province, north-west part of Iran and IFA serological survey of the disease in this area.
The incidence of visceral leishmaniasis has being increased in Iran during the recent decade. Since 1980, more than 200 cases have been diagnosed from East Azerbaijan province, mostly, from Meshkin-Shahr area. It seems, that kala-azar has being endemic in this area for a long time. The majority (86%) of kala-azar cases were found among children up to 4 years. The sex incidence ratio of males/females was 1.27/1. In IFA serological survey, sero-positive rate in females was higher than males. However, geometric mean of leishmanial antibody titers in males was, slightly, more than females. These serological findings indicate that females are exposed to the infection at least as much as males. The cross-sectional IFA serological survey, relatively reflected the kala-azar status among different studied groups with various incidences of the disease in Meshkin-Shahr area. IFAT showed also a good efficiency in the assessment of the treatment in the treated kala-azar patients.


[Treatment of hyperthyroidism in children with antithyroid drugs].
Sixteen cases of pediatric hyperthyroidism treated by antithyroid drugs are reported. First-line treatment with carbimazole in a mean dose of 19 mg/m2 initially and 7 mg/m2 after one year ensured control of the disease within 6 weeks. Mean follow-up was 4 years. Only two children were able to discontinue the drug, after 9.1 years and 4.6 years. Two other patients had thyroidectomy, after 6.7 years and 3.4 years. The main disadvantages of antithyroid drugs are the need for prolonged treatment and the risk of recurrence. An attempt at treatment discontinuation is warranted in patients with good disease control of 2 to 3 years duration, goiter size reduction, improved exophthalmos, and decreased anti-TSH receptor antibodies.


Double outlet right ventricle, non-committed ventricular septal defect and pulmonic stenosis. Anatomical and surgical considerations.
A case of double outlet right ventricle with pulmonary stenosis, a non-committed muscular ventricular septal defect occupying the sinus and trabecular portions of the ventricular septum, an additional small subtricuspid ventricular septal defect, situs solitus, atrioventricular concordance and aortic d-position is described. Atrioventricular valvular canal type malformations, splenic, systemic or pulmonary venous anomalies, all frequently seen in double outlet right ventricle with uncommitted VSD, were not present.


Criminal and psychiatric histories of Finnish arsonists.
We investigated psychiatric and demographic variables and lifetime criminality among arsonists referred for a pre-trial psychiatric assessment. The medical and criminal records of 282 arsonists were studied in order to compare first-time and repeat offenders with regard to diagnostic, demographic and biological variables. Alcohol dependence and antisocial personality disorder were common among recidivist offenders. This finding was especially prominent among offenders who committed violent crimes. Recidivist offenders commonly had a history of long-lasting enuresis during their childhood. They were younger at the time of their first offence, and were more often intoxicated with alcohol during the arson attempt. Among arsonists, lifetime criminal recidivism was primarily associated with alcohol dependence and antisocial personality disorder. Psychosis was a common diagnosis among subjects who had no record of recidivist criminal offences.


["Cardiac packages" for garden gnomes].
Garden gnomes tend to be obese, to smoke and to be physically inactive. Further, they are often socioeconomically deprived which adversely influences the risk and prognosis of cardiovascular disease. It is likely that garden gnomes will not benefit from the "cardiac packages", describing how Danish patients supposed to suffer from cardiovascular disease are entitled to timely and structured assessment in outpatient departments. This paper suggests that cardiovascular assessment and rehabilitation of garden gnomes must address their sociocultural needs (such as targeted dietary counselling). This is probably best achieved by special outreach clinics.


Vacuole inheritance regulates cell size and branching frequency of Candida albicans hyphae.
Hyphal growth of Candida albicans is characterized by asymmetric cell divisions in which the subapical mother cell inherits most of the vacuolar space and becomes cell cycle arrested in G1, while the apical daughter cell acquires most of the cell cytoplasm and progresses through G1 into the next mitotic cell cycle. Consequently, branch formation in hyphal compartments is delayed until sufficient cytoplasm is synthesized to execute the G1 'START' function. To test the hypothesis that this mode of vacuole inheritance determines cell cycle progression and therefore the branching of hyphae, eight tetracycline-regulated conditional mutants were constructed that were affected at different stages of the vacuole inheritance pathway. Under repressing conditions, vac7, vac8 and fab1 mutants generated mycelial compartments with more symmetrically distributed vacuoles and increased branching frequencies. Repression of VAC1, VAM2 and VAM3 resulted in sparsely branched hyphae, with large vacuoles and enlarged hyphal compartments. Therefore, during hyphal growth of C. albicans the cell cycle, growth and branch formation can be uncoupled, resulting in the investment of cytoplasm to support hyphal extension at the expense of hyphal branching.


microRNA-106b-5p Promotes Cell Growth and Sensitizes Chemosensitivity to Sorafenib by Targeting the BTG3/Bcl-xL/p27 Signaling Pathway in Hepatocellular Carcinoma.
microRNAs (miRNAs) and miRNA-mediated regulatory networks are promising candidates in the prevention and treatment of cancer, but the role of specific miRNAs involved in hepatocellular carcinoma (HCC) remains to be elusive. Herein, we found that miR-106b-5p is upregulated in both HCC patients' tumor tissues and HCC cell lines. The miR-106b-5p expression level was positively correlated with α-fetoprotein (AFP), hepatitis B surface antigen (HBsAg), and tumor size. Overexpression of miR-106b-5p promoted cell proliferation, migration, cell cycle G1/S transition, and tumor growth, while decreased miR-106b-5p expression had opposite effects. Mechanistic studies showed that B-cell translocation gene 3 (BTG3), a known antiproliferative protein, was a direct target of miR-106b-5p, whose expression level is inversely correlated with miR-106b-5p expression. Moreover, miR-106b-5p positively regulates cell proliferation in a BTG3-dependent manner, resulting in upregulation of Bcl-xL, cyclin E1, and CDK2, as well as downregulation of p27. More importantly, we also demonstrated that miR-106b-5p enhances the resistance to sorafenib treatment in a BTG3-dependent manner. The in vivo findings showed that mice treated with a miR-106b-5p sponge presented a smaller tumor burden than controls, while the mice injected cells treated with miR-106b-5p had more considerable tumor burden than controls. Altogether, these data suggest that miR-106b-5p promotes cell proliferation and cell cycle and increases HCC cells' resistance to sorafenib through the BTG3/Bcl-xL/p27 signaling pathway.


Detection of low abundance RNA molecules in individual cells by flow cytometry.
A variety of RNA analysis technologies are available for the detection of RNA transcripts from bulk cell populations. However, the techniques for RNA detection from individual cells have been limited. Here we adapt a novel in situ signal amplification method (the RNAScope® detection platform) for the analysis of intracellular RNAs in individual cells by flow cytometry. Using novel target-specific probes that were designed to suppress background signals, we demonstrate the specific detection of HIV gag RNAs in HIV-infected cellular samples, in addition to bcr and abl mRNAs in the K562 cell line. This method was capable of distinguishing cells expressing low abundance RNA transcripts and correlated well with quantitative imaging analysis. Furthermore, multiple distinct RNA targets were simultaneously detected with a high specificity without interference. Overall, the sensitivity and specificity of this method will be useful for the analysis of functionally important RNA species from individual cells, even at very low copy numbers.


Stanniocalcin 1 promotes cell proliferation via cyclin E1/cyclin‑dependent kinase 2 in human prostate carcinoma.
Stanniocalcin 1 (STC1) is a glycoprotein hormone that is involved in calcium/phosphate homeostasis. Increasing evidence suggests that STC1 is involved in carcinogenesis; however, few studies have defined the mechanisms and functional roles of STC1 activity in prostate carcinogenesis. In the present study, MTT, flow cytometry and colony formation assays, and small interfering RNA (siRNA) and overexpression in multiple cell lines were used to investigate the function of STC1 in prostate carcinoma in vivo and in vivo. Knockdown of endogenous STC1 using a siRNA decreased the proliferation of DU145 and LNCaP2 cells. These results were consistent with the changes in the protein levels of cyclin E1 and cyclin‑dependent kinase 2. By contrast, increased expression of STC1 in RWPE-1 cells led to increased cell proliferation, suggesting that STC1 promotes prostate carcinoma cell proliferation. In summary, the present study investigated the impact of STC1 on the proliferation and growth of prostate cancer in an effort to evaluate STC1 as a predictive biomarker and as a potential target for therapy.


Reactivation of chronic hepatitis C after withdrawal of immunosuppressive therapy.
A patient with immune-mediated thrombocytopenia (ITP) and chronic hepatitis C virus (HCV) infection for 11 years was given immunosuppressive treatment because of an activation of his ITP. After 6 weeks of treatment with cyclophosphamide, cyclosporin A and cortisone the patient decided not to continue taking his medication. One month later he was readmitted to hospital due to fever, cough and jaundice. Clinical investigation revealed his condition to be caused by an activation of his HCV infection. It is concluded that, in parallel to the situation in hepatitis B, immunosuppressive treatment of patients with HCV infection may lead to increased viral replication, resulting in severe liver damage when immunocompetence is regained.


Cognitive behavioral treatment for suicidal alcohol abusing adolescents: development and pilot testing.
The purpose of this study was to pilot a cognitive behavioral treatment protocol for adolescents with co-occurring alcohol use disorder and suicidality, examine its association with symptomatic improvement, and determine its feasibility and acceptability. Treatment consisted of a 6 month acute treatment phase, 3 month maintenance phase, and a 3 month booster phase, as well as case management services. Participants were also permitted to receive concurrent pharmacotherapy. Five of six families completed the protocol. Measures of alcohol use and suicidality were collected at intake, end of acute treatment, and post-treatment. Decreases in alcohol use and suicidal ideation were reported for all participants. Two of the five participants, both with a prior history of suicide attempts, re-attempted during the course of the protocol. Both were maintained in the study and improved over the subsequent portion of the treatment. A high retention rate, strong therapeutic alliance ratings, and low perceived treatment obstacles provide support for the feasibility and acceptability of this intervention. Preliminary results suggest that integrated outpatient cognitive behavioral treatment for alcohol abusing suicidal adolescents is feasible, acceptable, and associated with symptomatic improvement.


Plastic Surgery Faces the Web: Analysis of the Popular Social Media for Plastic Surgeons.
The use of social media is growing tremendously along with its impact on the practice of plastic surgery, for better or for worse. Patients are increasingly using social media to obtain information about either the procedure or the surgeon. The aims of this study were to examine social media posting regarding plastic surgery and to analyze successful online communication methods of the plastic surgeons with the public. A prospective analysis of 3 popular, global social media networks was performed, using the English language key phrases "plastic surgery" and "#plastic_surgery." Three hundred posts related to plastic surgery published on Instagram, YouTube, and Facebook in November 2017 were assessed by the following parameters: author identity, subject (self-promotion, educational, commercial, and personal posts), "social media currency" (likes, shares, comments, and views), and if special effects (videos, photos, etc.) or viral subjects such as reality stars or shaming were utilized. Sixty-three percentage of the posts on Instagram originated with plastic surgeons, compared with 18% on Facebook and only 13% on YouTube (P < 0.01); together, the plastic surgeons' posts comprise 31% of the total posts, whereas 49% of posts published by commercial companies (P < 0.01). Most of the posts on Instagram were self-promotional (83%), in comparison to Facebook (29%) or YouTube (6%); P < 0.01. YouTube posts are more personal in nature compared with Instagram and Facebook [39%, 7%, 9%, respectively (P < 0.01)]. Educational content in the posts accounts for only 16% of them, P < 0.01. Shaming is seen in 21% of the posts, especially in Facebook (39%), and mainly related to famous public figures (25%); P < 0.05. Celebrity endorsed posts received more attention in every aspect of social media currency (likes, comments, shares, and views). The use of images of women attracts attention and is widely used in social media posts of plastic surgery (68%). Posts that chose to include videos (22%) are generously rewarded. Online shaming also attracts attention, mostly found in Facebook (39%), and mainly of a public figure (25%). The 10 most powerful attention drawing motives were jokes, attractive female plastic surgeons, celebrities, personal stories, provocative surgeries, videos or photos of surgeries, sex, shaming, and patient education. Social media have become an important tool for self-promotion and a means to providing better customer service. This trend applies to the plastic surgeon as well. The study's main insights were to use Instagram, personal stories, educational post, videos and other unique inputs, and involve celebrities in the posts. In general, it would be wise to invest and understand these communication platforms, as they have become the path to dominate the field.


Impairment of thymus-dependent immune functions by exposure of the developing immune system to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD).
The effects of TCDD exposure on the developing immune system were investigated in F344 rats. Fetal and neonatal rats were exposed to TCDD through maternal dosing (5 microgram/kg) on day 18 of gestation and on days 0, 7, and 14 of postnatal life (group I). Another group of neonatal rats was exposed to TCDD through maternal dosing on days 0, 7, and 14 of postnatal life only (group II). Body weights and thymus/body weight ratios were found to be suppressed up to 145 days of age in group I, but only up to 39 days of age in group II. Parameters of cell-mediated and humoral immune function were investigated. TCDD suppressed cell-mediated immune function without affecting humoral immune function. Suppression of T-cell function was selective in that "helper" cell function was not suppressed.


Aglomerular kidney function when challenged with exogenous MgSO4 loading or environmental MgSO4 depletion.
The goal of this study was to investigate the role of MgSO4 in aglomerular kidney function, independent of changes in NaCl. The renal handling of MgSO4 was manipulated by intravenous infusion of an isoosmotic solution containing 80 mmol/L MgSO4 or through exposure to an environment that was reduced in MgSO4 concentration by 90%. Intravenous infusion resulted in a transient increase in circulating Mg2+ and SO4 (2-) levels; however, the concentration of both divalent ions in the urine remained elevated throughout the entire infusion period. Infusion also resulted in a transient increase in urine flow rate and apparent glomerular filtration rate, measured using the glomerular filtration rate marker, [3H] PEG 4000. Exposure to MgSO4-depleted conditions resulted in a significant decrease in plasma and urine concentrations of Mg2+ and in the urine concentrations of SO4 (2-); correspondingly, urine flow rate was significantly depressed. The urinary excretion of both Mg2+ and SO4 (2-) demonstrated nonlinear saturation kinetics. The urinary excretion of Mg2+ was significantly correlated with plasma Mg2+ concentration (r=0.75, P=0.04) and yielded a Michealis constant (Km) of 1.67+/-1.43 mmol/L; P=0.26 and a maximal velocity (Vmax) of 117.4+/-47.0 micromol/kg/hr; P=0.046. The urinary excretion of SO4 (2-) was significantly correlated with plasma SO4 (2-) concentration (r=0.94, P<0.02) with a Km of 0.76+/-0.54; P=0.26 and a Vmax of 59.3+/-13.1; P=0.02.


Civilian casualties of Iranian cities by ballistic missile attacks during the Iraq-Iran war (1980-1988).
To determine the nature and extent of Iranian casualties by ballistic missile attacks during the eight years of the Iraq-Iran war. The data collected about Iraqi missile strikes on Iranian cities included the following: date and time, number and type of missiles, cities targeted, and injuries and deaths resulting from impacts of missiles in civilian areas. The data were extracted from a database that was constructed by the army staff headquarters based on daily reports of Iranian army units during the war. Over a period of eight years (1980-1988), Iraqi army fired 533 ballistic missiles at Iranian territories. From those, 414 missiles (77.7%) landed on Iranian cities. The impacts of these missiles caused the deaths of 2,312 civilians and injured 11,625 others. Three types of ballistic missiles were used: FROG-7, Scud, and Al-Hussein (a modified version of the Scud missile). Twenty-seven cities in Iran were struck by Iraqi ballistic missiles. The highest mortalities from ballistic missiles were in Dezful and Tehran. Iraqi missile attacks continued for 90 months (2,748 days). Our results point to the necessity of investigating the psychological consequences of Iraqi ballistic missile attacks among survivors in 27 Iranian cities during the eight years of the Iraq-Iran war.


Lactobacillus rhamnosus GG ATCC53103 and Lactobacillus plantarum JL01 improved nitrogen metabolism in weaned piglets by regulating the intestinal flora structure and portal vein metabolites.
At present, most studies have shown that probiotics have a positive regulatory effect on the nutritional metabolism of the body, but the mechanism is still unclear. Here, 48 piglets were divided into four groups. The control group was not fed probiotics, the Lac group was fed L. Rhamnosus GG ATCC53103, the Rha group was fed L. Plantarum JL01, and the mix group was fed two types of probiotics. Nitrogen metabolism and mRNA levels of mTOR and S6K in skeletal muscle were observed in each group. Then, metagenome and non-targeted metabonomics were used to observe the changes of intestinal microorganisms and plasma metabolites in portal channels after probiotics feeding. Finally, we combined the results of omics analysis to reveal the mechanism of probiotics on nitrogen metabolism in weaned piglets. The results showed that L. Rhmnosus GG ATCC53103 and L. Plantarum JL01 increased nitrogen apparent digestibility, nitrogen deposition rate, and nitrogen utilization rate of weaned piglets (P < 0.05); the relative expression of mTOR and SK6 mRNA in skeletal muscle increased significantly (P < 0.05). When L. rhamnosus GG ATCC53103 and L. plantarum JL01 were combined, we found that Clostridium and Prevotella significantly increased in the jejunum (P < 0.05). The relative abundance of Lactobacillus, Ruminococcus, Streptococcus, and Prevotella in the ileum increased significantly (P < 0.05). Compared with the control group, L-Tryptophan, 3-Phosphonyloxypyruvate, cis-Aconitate, and Carbamoyl phosphate were significantly increased in the mixed group portal vein. The result of the combinatorial analysis showed that the significantly increased microorganisms could encode the enzyme genes for the synthesis of L-Tryptophan, 3-Phosphonooxypyruvate, cis-Aconitate, and Carbamoyl phosphate. In summary, our results demonstrated that L. Rhamnosus GG ATCC53103 and L. Plantarum JL01 could stimulate the expression of skeletal muscle protein synthesis genes of weaned piglets by modulating the structure of the gut microbiota and its metabolites, thereby improving nitrogen metabolism in weaned piglets.


Ablation of CD8α(+) dendritic cell mediated cross-presentation does not impact atherosclerosis in hyperlipidemic mice.
Clinical complications of atherosclerosis are almost exclusively linked to destabilization of the atherosclerotic plaque. Batf3-dependent dendritic cells specialize in cross-presentation of necrotic tissue-derived epitopes to directly activate cytolytic CD8 Tcells. The mature plaque (necrotic, containing dendritic cells and CD8 Tcells) could offer the ideal environment for cross-presentation, resulting in cytotoxic immunity and plaque destabilization. Ldlr(-/-) mice were transplanted with batf3(-/-) or wt bone marrow and put on a western type diet. Hematopoietic batf3 deficiency sharply decreased CD8α(+) DC numbers in spleen and lymph nodes (>80%; P < 0,001). Concordantly, batf3(-/-) chimeras had a 75% reduction in OT-I cross-priming capacity in vivo. Batf3(-/-) chimeric mice did not show lower Tcell or other leukocyte subset numbers. Despite dampened cross-presentation capacity, batf3(-/-) chimeras had equal atherosclerosis burden in aortic arch and root. Likewise, batf3(-/-) chimeras and wt mice revealed no differences in parameters of plaque stability: plaque Tcell infiltration, cell death, collagen composition, and macrophage and vascular smooth muscle cell content were unchanged. These results show that CD8α(+) DC loss in hyperlipidemic mice profoundly reduces cross-priming ability, nevertheless it does not influence lesion development. Taken together, we clearly demonstrate that CD8α(+) DC-mediated cross-presentation does not significantly contribute to atherosclerotic plaque formation and stability.


Etravirine in combination with darunavir/ritonavir and optimized background regimen results in suppression of HIV replication in treatment-experienced patients. Evaluation of Katlama C, Haubrich R, Lalezari J, et al. Efficacy and safety of etravirine in treatment-experienced HIV-1 patients: pooled 48-week analysis of two randomized, controlled trials. AIDS 2009; 23: 2289-300.
Therapeutic options for treatment-experienced HIV-infected patients have been limited. The DUET trial evaluated the use of etravirine, a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI), or placebo, in 1203 treatment-experienced, HIV-infected patients. Eligible patients had to have evidence of NNRTI and protease inhibitor resistance-associated mutations, and evidence of virologic failure, as defined as a plasma viral load > 5000 copies/ml on antiretroviral therapy at the time of screening. Patients in both arms received an optimized background regimen including darunavir/ritonavir. DUET demonstrated superior outcomes in virologic suppression (plasma viral load < 50 copies/ml) and clinical end points including new AIDS-defining illnesses and death, in those randomized to receive etravirine. These results were maintained at 48 weeks of follow-up. Furthermore, etravirine was shown to be safe and well-tolerated over this period. In exploratory analyses, patients in the DUET study with greater number of active agents within the background regimen were more likely to have a fully suppressive response. Taken together, the DUET results highlight the high rates of virological success that can be achieved using new active agents, such as ritonavir-boosted darunavir and etravirine, in treatment-experienced patients with underlying drug-resistant HIV infection.