COMBINED VITRECTOMY WITH INTRAVITREAL DEXAMETHASONE IMPLANT FOR REFRACTORY MACULAR EDEMA SECONDARY TO DIABETIC RETINOPATHY, RETINAL VEIN OCCLUSION, AND NONINFECTIOUS POSTERIOR UVEITIS.
To compare the efficacy of intraoperative intravitreal dexamethasone implant for macular edema secondary to diabetic retinopathy (DME), retinal vein occlusion (RVO), and noninfectious posterior uveitis. A retrospective review of 62 patients (29 men and 33 women; mean age 51.19 ± 14.41 years; 65 eyes) was performed. Best-corrected visual acuity (in logarithm of the minimal angle of resolution), central foveal thickness, intraocular pressure, and postoperative edema-free period were postoperatively assessed up to 1 year. The preoperative and postoperative numbers of other intravitreal injections needed were compared. Best-corrected visual acuity gradually improved in the DME group (from 0.87 to 0.51) but failed to improve from Month 3 onward in the RVO and uveitis groups. Central foveal thickness decreased in all groups, especially in the DME group (from 550.93 to 338.10 μm). Edema-free period was longest in the DME group (19.34 ± 15.12 months), followed by the uveitis (12.91 ± 7.85 months) and RVO (8.50 ± 8.76 months) groups. Subjects in the uveitis group used more intraocular pressure-lowering agents (1.00 ± 1.27) than those in the DME (0.13 ± 0.49) and RVO (0.36 ± 0.79) groups. Increased intraocular pressure events were most frequent in postoperative Week 1, especially in the uveitis group. Vitrectomy combined with intravitreal dexamethasone implant for DME, RVO, and noninfectious posterior uveitis had a favorable clinical outcome.


Imbalance of the oxytocin-vasopressin system contributes to the neuropsychiatric phenotype in the BACHD mouse model of Huntington disease.
Neuropsychiatric disturbances with altered social cognition, depression and anxiety are among the most debilitating early features in the fatal neurodegenerative disorder Huntington disease (HD) which is caused by an expanded CAG repeat in the huntingtin gene. The underlying neurobiological mechanisms are not known. Neuropathological analyses of postmortem human HD hypothalamic tissue have demonstrated loss of the neuropeptides oxytocin and vasopressin. The dynamic interplay between these neuropeptides is crucial for modulating emotional and social behavior but its role in HD is unclear. In the present study, we have investigated the effect of expressing the mutant huntingtin gene on the development of behavioral changes using the transgenic BACHD mouse model at different ages. We show for the first time that BACHD mice exhibit deficits in social behavior with parallel aberrations in the balance of the oxytocin-vasopressin system. Importantly, our data also show that restoration of the interplay within the system with an acute dose of intranasal oxytocin immediately prior to behavioral testing can rescue the depressive-like phenotype but not anxiety-like behavior in this transgenic model. These findings demonstrate that imbalances in the oxytocin-vasopressin interplay contribute to the neuropsychiatric component of HD and suggest that interventions aimed at restoring the blunted levels of oxytocin may confer therapeutic benefits for this disease.


Metabolic Engineering of Escherichia coli for High-Level Production of Lacto-N-neotetraose and Lacto-N-tetraose.
Lacto-N-neotetraose (LNnT) and lacto-N-tetraose (LNT) are important oligosaccharides found in breast milk and are commonly used as nutritional supplements in infant formula. We used metabolic engineering techniques to optimize the modified Escherichia coli BL21 star (DE3) strain for efficient synthesis of LNnT and LNT using β-1,4-galactosyltransferase (HpgalT) from Helicobacter pylori and β-1,3-galactosyltransferase (SewbdO) from Salmonella enterica subsp. salamae serovar, respectively. Further, we optimized the expression of three key genes, lgtA, galE, and HpgalT (SewbdO), to synthesize LNnT or LNT and deleted several genes (ugd, ushA, agp, wcaJ, otsA, and wcaC) to block competition in the UDP-galactose synthesis pathway. The optimized strain produced LNnT or LNT with a titer of 22.07 or 48.41 g/L, respectively, in a supplemented batch culture, producing 0.41 or 0.73 g/L/h, respectively. The strategies used in this study contribute to the development of cell factories for high-level LNnT and LNT and their derivatives.


Technical trends in functional radiology of the lung.
In functional radiology of the lung, the depiction of subtle details of circulatory and bronchial anatomy, is very important. At present, the evolution of the radiographic techniques allows to overcome the difficulty in imaging, essentially related to the marked difference in density of chest structures, producing radiographs optimized to the concomitant representation of the parenchyma and higher absorption structures. Main quality factors related to radiation beam optimization on one hand and to imaging systems on the other hand, are considered with an analysis of the evolution of methods and techniques of thoracic radiology.


The Phenomenology of Delusions in a Patient with Disorders of Sex Development.
Abnormal development of the external and internal genital organs and male pseudohermaphrodite-type disorders of sex development is one of the conditions that creates problem in determination of gender. In this case report, our aim is to discuss how disorders with psychotic symptoms may affect different cultural life styles, circumstances, experience, delusion contents of identification and acceptance in a patient diagnosed with bipolar affective disorder, and with male-pseudohermaphroditism during adulthood.


Fibroblast growth factor 2-mediated translational control of IAPs blocks mitochondrial release of Smac/DIABLO and apoptosis in small cell lung cancer cells.
The mitochondrial release of cytochrome c and Smac/DIABLO has been implicated in the activation of apoptosis in response to cell stress. Smac promotes cytochrome c-induced activation of caspases by sequestering the inhibitor of apoptosis protein (IAP) family of potent caspase suppressors. Differential release from mitochondria of cytochrome c and Smac can occur, but the underlying mechanism and physiological significance of this are unclear. Here we show that the mechanism by which fibroblast growth factor 2 (FGF-2) protects small cell lung cancer (SCLC) cells from etoposide-induced cell death involves inhibition of Smac release but not of cytochrome c release. This process is MEK dependent and correlates with an increased expression of XIAP and cellular IAP-1, mediated principally through translational regulation. Exogenous expression of XIAP is sufficient to inhibit caspase 9 activation, Smac release, and cell death induced by etoposide. Prevention of the FGF-2-promoted increase in levels of functional IAPs by RNA interference or the cell-permeant Smac amino-terminal peptide blocked FGF-2-induced protection. FGF-2 can thus protect SCLC cells from chemotherapeutic drugs by modulating IAP levels via posttranscriptional regulation, providing a mechanism for postmitochondrial survival signaling by the MEK/mitogen-activated protein kinase pathway.


A single-walker approach for studying quasi-nonergodic systems.
The jump-walking Monte-Carlo algorithm is revisited and updated to study the equilibrium properties of systems exhibiting quasi-nonergodicity. It is designed for a single processing thread as opposed to currently predominant algorithms for large parallel processing systems. The updated algorithm is tested on the Ising model and applied to the lattice-gas model for sorption in aerogel at low temperatures, when dynamics of the system is critically slowed down. It is demonstrated that the updated jump-walking simulations are able to produce equilibrium isotherms which are typically hidden by the hysteresis effect characteristic of the standard single-flip simulations.


[Differentiation of virulent strains of Shigella and entero-invasive Escherichia from their avirulent variants using modified indirect immunoenzyme analysis].
The data obtained in this investigation confirm that the modified indirect enzyme immunoassay (EIA) permits the differentiation of virulent bacteria of the genus Shigella and enteroinvasive Escherichia (group 1), regularly containing virulence plasmids with a molecular weight of 120-140 MD, from their avirulent variants which have lost these plasmids (group 2). The ratio of the optic density (OD) values of the positive control samples (the OD of group 1) to the OD values of the negative ones (the OD of group 2) is significantly higher than 2.1. As revealed by EIA, the differences between groups 1 and 3 (avirulent Shigella strains and E. coli smooth strain O124, retaining high-molecular plasmids with a molecular weight of 120-140 MD or their fragments) are statistically insignificant. The ratio of the OD of group 1 to the OD of group 3 is significantly less than 2.0. Analysis of outer membrane protein (OMP) preparations isolated from S. flexneri virulent strain 2a and its isogenic avirulent plasmid-containing variant has revealed significant differences in their EIA results. The ratio of the OP of OMP preparations isolated from the virulent strain to the OD of OMP preparations from the avirulent strain exceeds 2.1.


Frailty Screening Tools for Elderly Patients Incident to Dialysis.
A geriatric assessment is an appropriate method for identifying frail elderly patients. In CKD, it may contribute to optimize personalized care. However, a geriatric assessment is time consuming. The purpose of our study was to compare easy to apply frailty screening tools with the geriatric assessment in patients eligible for dialysis. A total of 123 patients on incident dialysis ≥65 years old were included <3 weeks before to ≤2 weeks after dialysis initiation, and all underwent a geriatric assessment. Patients with impairment in two or more geriatric domains on the geriatric assessment were considered frail. The diagnostic abilities of six frailty screening tools were compared with the geriatric assessment: the Fried Frailty Index, the Groningen Frailty Indicator, Geriatric8, the Identification of Seniors at Risk, the Hospital Safety Program, and the clinical judgment of the nephrologist. Outcome measures were sensitivity, specificity, positive predictive value, and negative predictive value. In total, 75% of patients were frail according to the geriatric assessment. Sensitivity of frailty screening tools ranged from 48% (Fried Frailty Index) to 88% (Geriatric8). The discriminating features of the clinical judgment were comparable with the other screening tools. The Identification of Seniors at Risk screening tool had the best discriminating abilities, with a sensitivity of 74%, a specificity of 80%, a positive predictive value of 91%, and a negative predictive value of 52%. The negative predictive value was poor for all tools, which means that almost one half of the patients screened as fit (nonfrail) had two or more geriatric impairments on the geriatric assessment. All frailty screening tools are able to detect geriatric impairment in elderly patients eligible for dialysis. However, all applied screening tools, including the judgment of the nephrologist, lack the discriminating abilities to adequately rule out frailty compared with a geriatric assessment.


Unlocking the 5-exo Pathway with the AuI -Catalyzed Alkoxycyclization of 1,3-Dien-5-ynes.
The first general regio- and stereoselective 5-exo gold(I)-catalyzed alkoxycyclization of a specific class of 1,5-enynes such as 1,3-dien-5-ynes has been described, despite 1,5-enynes being known to almost invariably proceed via endo cyclizations under gold-catalysis. The configuration of the terminal alkene in the starting 1,3-dien-5-yne plays a crucial role on the regiochemical outcome of the reaction. A wide variety of interesting alkoxy-functionalized alkylidenecyclopentenes have been synthesized from 1-monosubstituted (E)-1,3-dien-5-ynes. On the contrary, the corresponding Z isomers evolve affording formal 6-endo cyclization products. In addition, mechanistic exploration supports a highly stabilized carbocation as a key intermediate instead of a highly constrained cyclopropyl gold carbene from E isomers, and also accounts for the well differentiated reactivity observed between both E/Z geometrical isomers as well as for the stereochemical outcome of the reaction.


IgD allotypic determinants. II. Determinants expressed on IgD of mice of the b, e, and o Igh-C haplotypes.
Allotypic determinants expressed on membrane IgD of 27 strains of mice representing each of the major Igh-C haplotypes of inbred mice were examined with reagents specific for the IgD of mice of the b, e, and o Igh-C haplotypes. The distribution of two specificities, IgD.44 (Ig5.2) and IgD.37 (Ig5.3), recognized by two monoclonal anti-delta reagents was determined. In addition, a new specificity, IgD.46, expressed on mice of the o Igh-C type, but not of the b or a types, was detected by a BALB/c anti-AL/N spleen cell antiserum. The results also confirmed the description of the new Igh-C haplotype o, by demonstrating that the mice of this group express the IgD.37 determinant. This determinant is also expressed by mice of the b and e types, but not by mice of the d haplotype, from which the o haplotype was subdivided.


Plasma cortisol and progesterone responses to low doses of adrenocorticotropic hormone in ovariectmized lactating cows.
The objective of this study was to describe the responses of the plasma progesterone and cortisol concentrations in ovariectomized lactating cows to low doses of adrenocorticotropic hormone (ACTH). The estrous cycles in 3 lactating cows were synchronized, and the cows were ovariectomized in the luteal phase. ACTH challenge tests were conducted at doses of 3, 6, 12 and 25 IU. Blood samples were collected at 30 min intervals, and the plasma progesterone and cortisol concentrations were analyzed by EIA. A concomitant rise in plasma progesterone and plasma cortisol was observed in cows treated with 12 IU or higher doses of ACTH. Significant increments in the plasma cortisol concentrations were observed at all doses of ACTH. The means (+/- SE) of the peak plasma progesterone concentrations after the 3, 6, 12 and 25 IU ACTH challenge tests were 0.6 +/- 0.1, 1.3 +/- 0.4, 1.5 +/- 0.3 and 2.4 +/- 0.3 ng/ml, respectively. The means of the peak plasma cortisol concentrations in the 3 cows after the ACTH challenge were 14.0 +/- 1.5, 17.0 +/- 2.5, 23.3 +/- 3.0, and 33.3 +/- 7.0 ng/ml, respectively. The effects of the doses, time after treatment, and their interaction on the plasma progesterone concentrations after the ACTH challenge were significant (P<0.01). Likewise, the effects of the doses, time after treatment, and their interaction on the plasma cortisol concentrations after the ACTH challenge were significant (P<0.01). The mean AUC values for the plasma progesterone and cortisol concentrations after the ACTH treatments were also significantly affected by the dose of ACTH (P<0.01 and P<0.05, respectively). A significantly positive correlation was obtained between the peak plasma progesterone and cortisol concentrations after different doses of ACTH (r=0.7, P<0.05). The results suggest that lactating dairy cows are capable of secreting a significant amount of adrenal progesterone, reaching up to the minimal concentration necessary to cause suppression of estrus in response to 12 IU ACTH (P<0.01). The concomitant plasma cortisol concentration was 23.3 ng/ml.


Recruitment of Dental Hygiene Students from Underrepresented Minority Groups: A National Survey of U.S. Dental Hygiene Programs.
The aims of this study were to assess how U.S. undergraduate dental hygiene programs recruit students, especially students from underrepresented minority (URM) groups, and how the program directors value recruiting those students, how satisfied they are with their efforts, which practices they use, and which challenges they encounter. Relationships between diversity-related recruitment motivation and satisfaction and the program and recruitment characteristics were also explored. Survey data were collected from 56 of the 287 programs that could be successfully contacted with individual emails to their directors (response rate: 20%). The majority of responding programs recruited students into their programs by using written materials (91%), websites (91%), on-campus events (77%), and high school visits (52%). However, only 20% had written materials and 13% special events for recruiting students from URM groups. While 75% of the responding program directors considered high grade point averages (GPAs) to be a priority and 85% thought high GPAs were important/very important when recruiting students, only 17% considered it a priority to recruit URM students, and only 35% reported thinking it was important/very important to do so. The more of a priority it was to have a diverse student body and the more important the respondents considered it, the more likely they were to have written URM-specific recruitment materials (r=0.34; p<0.05/r=0.39; p<0.01). The more the respondents valued ACT scores, the less likely they were to engage in URM-specific recruitment efforts (r=-0.38; p<0.05/r=-0.34; p<0.05). If the dental hygiene profession is to better reflect the racial/ethnic makeup of the U.S. population, dental hygiene programs' considerations and efforts related to the recruitment of URM students need to be reconsidered.


Ureteral motility in sheep.
Ureteral motility was studied in twenty-five sodium pentobarbital-anaesthetized sheep. Mean frequency of the peristaltic waves was 15 per min and the range was 11-19. Frequency was the same throughout the length of the ureter. Mean contraction pressure (cm H2O) was 40 in the upper ureter, 35 in the middle ureter and 31 in the lower ureter. Mean concentration time was 1 sec and range was 0.6-1.5. Mean relaxation time was 1.1 sec and range was 0.7-1.5. Diuresis induced by rapid intravenous administration of physiologic sodium chloride solution abolished the peristaltic activity.


Neighborhood Physical Disorder in New York City.
Neighborhood physical disorder, or the deterioration of urban environments, is associated with negative mental and physical health outcomes. Eleven trained raters used CANVAS, a web-based system for conducting reliable virtual street audits, to collect data on nine indicators of physical disorder using Google Street View imagery of 532 block faces in New York City, New York, USA. We combined the block face indicator data into a disorder scale using item response theory; indicators ranged in severity from presence of litter, a weak indicator of disorder, to abandoned cars, a strong indicator. Using this scale, we estimated disorder at the center point of each sampled block. We then used ordinary kriging to interpolate estimates of disorder levels throughout the city. The resulting map condenses a complex estimation process into an interpretable visualization of the spatial distribution of physical disorder in New York City.


Work physical therapy and rehabilitation ergonomics: a review and discussion of the scope of the areas.
There has been a recent development of the work physical therapy area in Brazil. The relationship between work physical therapy and rehabilitation ergonomics needs to be highlighted to avoid segregation and fragmentation of these complementary fields. For these reasons, the purpose of this article was to review and clarify the scope of the areas of work physical therapy and rehabilitation ergonomics. The available literature discussing the roles of the areas of interest was critically reviewed. Both areas are concerned with workers' health and safety and they complement each other. Work physical therapy can be considered as rehabilitation ergonomics practiced by physical therapists with their specific interests. Hopefully, this paper will contribute to further interaction between the areas of work physical therapy and rehabilitation ergonomics not only in Brazil but worldwide. This may contribute to improved occupational disability prevention and rehabilitation.


Using posturography to measure balance control during seated tai chi.
Tai Chi for Arthritis (TCA) is recognized by the CDC as an evidenced-based program to prevent falls in older adults. Although seated Tai Chi is recommended for those unable to stand, little is known about balance control during seated TCA. To explore the use of posturography to assess differences between experts and non-expert practitioners of seated TCA. Twenty-three participants were recruited from those attending a Tai cChi workshop. While seated in a hard back chair centered on a force platform, participants performed selected forms from TCA and then did them in a continuous sequence. Center of pressure (CoP) indices to assess balance were normalized by height and then compared between expert and non-expert participants. Experts had significantly greater average velocity and path length (p = 0.02) for the entire sequence and open/close, but not for CoP 95% Confidence ellipse area. No significant differences in the CoP were found for commencement, wave hands, or single whip. A few differences in balance control while performing seated TCA movements were found. Future studies are needed to determine whether these can be accounted for by quality of the Tai Chi movements or factors associated with the seated position.


Engineering of copper sulfide mediated by phototherapy performance.
Copper sulfide based phototherapy, including photothermal therapy and photodynamic therapy, is an emerging minimally invasive treatment of tumor, which the light was converted to heat or reactive oxygen to kill the tumor cells. Compared with conventional chemotherapy and radiation therapy, Cu2-x S based phototherapy is more efficient and has fewer side effects. However, considering the dose-dependent toxicity of Cu2-x S, the performance of Cu2-x S based phototherapy still cannot meet the requirement of the clinical application to now. To overcome this limitation, engineering of Cu2-x S to improve the phototherapy performance by increasing light absorption has attracted extensive attention. For better guidance of Cu2-x S engineering, we outline the currently engineering method being explored, including (1) structural engineering, (2) compositional engineering, (3) functional engineering, and (4) performance engineering. Also, the relationship between the engineering method and phototherapy performance was discussed in this review. In addition, the further development of Cu2-x S based phototherapy is prospected, including smart materials based phototherapy, phototherapy induced immune microenvironment modulation et al. This review will provide new ideas and opportunities for engineering of Cu2-x S with better phototherapy performance. This article is categorized under: Diagnostic Tools > In Vivo Nanodiagnostics and Imaging Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease.


An empirical analysis of the association between social interaction and self-rated health.
To empirically investigate the relationship of social interactions with self-rated health status. Cross-sectional study. The United States, 1972-2008. 53,043 respondents interviewed. In-person interviews were conducted by the National Opinion Research Center. Health is measured via self-assessment, and a binary indicator defines whether the respondent reports excellent or good health. Impersonal social interaction is binary, reflecting membership in at least one organization; personal interaction is binary, reflecting whether the respondent visits relatives, neighbors, friends, or bars at least once a month. Demographic, region, and time variables are standard controls. Probit models were estimated at aggregated and disaggregated (race, gender, age, and education) levels. Impersonal interaction fell 5% between 1974 and 1994, with deeper declines (12%) in personal interaction. Neighbor visits fell most (24%), but friends gained (5%). Marginal estimates indicate both personal and impersonal interactions are associated with better health. However, friends show the strongest effect. A 1-SD increase in the probability of meeting friends versus joining a club or association is associated with a higher (.019 vs. .014) probability of being in very good or excellent health. Social interaction, impersonal or personal, is significantly associated with health. Public policy facilitating greater interactions of the type that benefits different demographic groups may be health promoting. Results are suggestive of potential network effects at the individual and community levels, which have implications for designing and targeting more effective health interventions.


[Prognostic study of malignant melanoma of the uvea treated by enucleation].
In order to evaluate the clinical and histopathologic prognosis indicators of uveal melanomas treated with enucleation, 59 patients, followed up during 1 to 18 years were included in a retrospective study. Kaplan Meier survival curves were constructed and compared using the log rank test. The overall 5 and 10 years probabilities of survival were 74.9% and 48.5% respectively. Metastases were, or might have been, responsible for death in 83.3% of the cases. The median survival was 4 years 9 months (range less than 1 to 11 years). Fifty five per cent of the metastases occurred within 4 years of the enucleation and 90% within 8 years. For the patients with spindle cell melanomas, the 5 year probability of survival was 90% against 38% for the patients with epithelioid cell tumors. The median time to tumor related death was 5 years for the first group against 3 years 8 months for the second. The analysis of our data demonstrated the tumor volume to be a statistically significant clinical prognosis indicator. The following histopathologic parameters were also statistically significant prognosis indicators: the cell type (p less than or equal to 0.001), the mitotic activity, the state of the sclera, the presence of blood lakes. Statistical adjustments and determination of the instantaneous relative risk of death showed the histopathologic factors, specially the cell type, to be the most important indicators.


Epidermotropic metastatic malignant melanoma simulating melanoma in situ. A report of 10 examples from two patients.
Epidermotropic metastatic malignant melanoma (EMMM) is a well-recognized entity that can simulate primary malignant melanoma, and in the past reports of numerous (> or = 100) such lesions were misconstrued as multiple primary lesions. We present the cases of two patients who had not only numerous epidermotropic metastases that simulated primary melanomas but also 10 lesions that mimicked melanoma in situ. After removal of a primary malignant melanoma, the two patients developed 35 and 22 epidermotropic metastases over a 4-year period before dying with brain and pulmonary metastases, respectively. In these patients, 29 and 22 of the skin lesions were excised, respectively. All had epidermotropic metastases, of which seven and three showed pagetoid melanocytes in a pagetoid pattern exclusively within the epidermis and epithelial structures of adnexa, an "epidermal only" (in situ) pattern. Other lesions showed a continuum of dermal involvement, from the more conventional description of EMMM with the extent of dermal involvement > or = epidermal (n = 2) to epidermal involvement > dermal disease (n = 36). This histologic spectrum of dermal versus epidermal involvement in conjunction with the extremely small size (2.8 mm average histologic diameter), symmetry, large number, and time course of development argues strongly that these lesions represent metastases rather than multiple primary melanomas. The lesions illustrate the diagnostic dilemma posed by EMMM that simulates primary melanoma and further exhibits an "epidermal only" (melanoma in situ) pattern.


Peripheral ossifying fibroma.
Intraoral ossifying fibromas have been described in the literature since the late 1940s. Peripheral ossifying fibroma (POF) is usually a fibroma of the gingival which shows areas of calcification or ossification. It is a nonneoplastic enlargement of gingiva. Due to its clinical and histopathological similarities, some POFs are believed to develop initially as a pyogenic granuloma that undergoes fibrous maturation and subsequent calcification. It has been suggested that POF represents a separate clinical entity rather than a transitional form of pyogenic granuloma or irritation fibroma. This paper describes a case report of a 60-year-old female patient reported with growth on gingiva in the upper left front region of mouth three years ago.


Medical Record Documentation in a Learning Disability In-patient Unit.
Consistency in clinical structure and content is an important aspect of clinical practice. The rising demands on healthcare systems and associated costs require a much more efficient and transparent means of recording and accessing reliable clinical information in order to manage and deliver good quality care to patients. The audit has been completed with an aim to highlight the local standards set for medical record documentation and to assess if the outlined standards are being met in a learning disability in-patient psychiatric setting, the Coppice. Criteria based on GMC Good Medical practice guidelines (2013), RCPsych Good Psychiatric Practice (2009) and Records Management Policy. Good practice was maintained for most parameters. Mild inaccuracies were noted with date of birth/ward name, timing and signatures. This was presented locally and measures put in place to address the gaps. A re-audit should be performed within a year in order to complete the audit cycle and to ensure that the recommendations and action plan have been followed through.


Premalignant and malignant skin lesions in renal transplant patients.
Among 129 renal transplant patients with 3-16 years of posttransplant observation time, and residents in a low ultraviolet radiation area, 25 (19.4%) had premalignant or malignant skin lesions, a 3-fold increase over a control population collected randomly. Thirteen (10.1%) had skin cancer, a 7-fold increase. Nine patients had multiple lesions; none had metastatic disease. Multiple regression analysis revealed age, outdoor occupation, and transplantation/immunosuppression to be equally significant risk factors for skin malignancy. Transplant patients should be educated and periodically examined for early detection of skin malignancies.


Role of routine 16b1 lymph node biopsy in the management of gallbladder cancer: an analysis.
Involvement of the 16b1 (interaortocaval) lymph node (LN) in gallbladder cancer (GBC) is considered to represent metastatic disease. Although this is universally accepted, the role of routine frozen-section histopathological examination (HPE) of the 16b1 LN in the management of GBC has not been previously reported. A prospective study (August 2009-November 2011) using routine biopsy of 16b1 LNs and frozen-section HPE prior to radical resection in patients deemed operable on preoperative evaluation and staging laparoscopy was carried out. Of the 451 GBC patients assessed, 251 (55.7%) were deemed operable on preoperative imaging. Of these, 68 (27.1%) were found to have disseminated disease on staging laparoscopy/laparotomy. Of the 183 patients in whom 16b1 LN biopsy was performed, 34 (18.6%) had evidence of metastases on frozen-section HPE and the planned surgical resection was abandoned (Group A). Of the remaining 149 patients (Group B), 142 (95.3%) underwent curative resection and seven (4.7%) were found to be unresectable as a result of locoregionally advanced disease. A comparison of findings in Group A with those in Group B showed no significant difference in the clinical stage of the tumour. The proportions of patients with jaundice, elevated carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels were significantly higher in Group A than in Group B (P = 0.008, P = 0.012 and P = 0.023, respectively). Routine 16b1 LN biopsy prevented non-therapeutic radical resection and its associated morbidity in 18.6% of patients deemed resectable on preoperative imaging and staging laparoscopy. The yield was higher in patients with jaundice and elevated preoperative tumour marker levels.


Role of behavioural feedback in nutrition education for enhancing nutrition knowledge and improving nutritional behaviour among adolescents.
The integration of nutrition knowledge into nutritional behaviour can help children to develop a healthy lifestyle that may be carried forward into adulthood. E-learning enables students to take ownership of recording their dietary intake and modify their diets by making their own decisions regarding food choices and portion sizes through reflective feedback. This study investigated the role of behavioural feedback in nutrition education in modifying students' nutrition knowledge and behaviour. Ninety-five secondary students studying from Secondary 1 to Secondary 3 were recruited from five schools. Moreover, 50 and 45 students were randomly assigned to experimental and control groups, respectively. Nutrition education delivered through e-learning (NeL) was adopted to record students' diets. Online reports with behavioural feedback were provided for the experimental group but not for the control group. NeL sessions lasted for 12 weeks. The energy and nutrient profiles of the students were recorded as pre-post measurements. Pre-post nutrition knowledge was assessed using a self-administered questionnaire at the baseline and after intervention. The experimental group had significantly higher scores in the 'dietary recommendation' and 'food choices' domains of the questionnaire and demonstrated significant dietary improvement in the intake of all studied macronutrients and micronutrients. Nutrition education conducted with behavioural feedback can effectively improve adolescents' nutrition knowledge and nutritional behaviour.


Dopaminergic abnormalities following traumatic brain injury.
Traumatic brain injury can reduce striatal dopamine levels. The cause of this is uncertain, but is likely to be related to damage to the nigrostriatal system. We investigated the pattern of striatal dopamine abnormalities using 123I-Ioflupane single-photon emission computed tomography (SPECT) scans and their relationship to nigrostriatal damage and clinical features. We studied 42 moderate-severe traumatic brain injury patients with cognitive impairments but no motor parkinsonism signs and 20 healthy controls. 123I-Ioflupane scanning was used to assess dopamine transporter levels. Clinical scan reports were compared to quantitative dopamine transporter results. Advanced MRI methods were used to assess the nigrostriatal system, including the area through which the nigrostriatal projections pass as defined from high-resolution Human Connectome data. Detailed clinical and neuropsychological assessments were performed. Around 20% of our moderate-severe patients had clear evidence of reduced specific binding ratios for the dopamine transporter in the striatum measured using 123I-Ioflupane SPECT. The caudate was affected more consistently than other striatal regions. Dopamine transporter abnormalities were associated with reduced substantia nigra volume. In addition, diffusion MRI provided evidence of damage to the regions through which the nigrostriatal tract passes, particularly the area traversed by dopaminergic projections to the caudate. Only a small percentage of patients had evidence of macroscopic lesions in the striatum and there was no relationship between presence of lesions and dopamine transporter specific binding ratio abnormalities. There was also no relationship between reduced volume in the striatal subregions and reduced dopamine transporter specific binding ratios. Patients with low caudate dopamine transporter specific binding ratios show impaired processing speed and executive dysfunction compared to patients with normal levels. Taken together, our results suggest that the dopaminergic system is affected by a moderate-severe traumatic brain injury in a significant proportion of patients, even in the absence of clinical motor parkinsonism. Reduced dopamine transporter levels are most commonly seen in the caudate and this is likely to reflect the pattern of nigrostriatal tract damage produced by axonal injury and associated midbrain damage.


Vitamin K distribution in rat tissues: dietary phylloquinone is a source of tissue menaquinone-4.
The present study was undertaken to determine whether there is selective tissue distribution of vitamin K in the rat and whether this distribution mirrors the distribution of tissue vitamin K metabolism. The effects of feeding a vitamin K-free diet followed by resupplementation with phylloquinone (K1) were studied. K1 was recovered in all tissues. In K1-supplemented rats, most tissues accumulated K1 relative to plasma K1 with the highest levels in liver, heart, bone, and cartilaginous tissue (sternum). Low K1 levels were found in the brain. In the K1-free rats, relatively high K1 levels were still found in heart, pancreas, bone and sternum. Surprisingly, menaquinone-4 (MK-4) was detected in all tissues, with low levels in plasma and liver, and much higher levels in pancreas, salivary gland and sternum. MK-4 levels exceeded K1 levels in brain, pancreas, salivary gland and sternum. Supplementation with K1, orally and by intravenous infusion, caused MK-4 levels to rise. Some accumulation of K1 and MK-4 in the mitochondrial fraction was found for kidney, pancreas and salivary gland. In the liver the higher menaquinones (MK-6-9) accumulated in the mitochondria. The results indicate that: (1) there is selective tissue distribution of K1 and MK-4, (2) dietary K1 is a source of MK-4. The results also suggest there may be an as yet unrecognized physiological function for vitamin K (MK-4).


Most Findings Obtained With Untimed Visual Illusions Are Confounded.
Visual illusions have been studied extensively, but their time course has not. Here we show, in a sample of more than 550 people, that unrestricted presentation times-as opposed to presentations lasting only a single second-weaken the Ebbinghaus illusion, strengthen lightness contrast with double increments, and do not alter lightness contrast with double decrements. When presentation time is unrestricted, these illusions are affected in the same way (decrease, increase, no change) by how long observers look at them. Our results imply that differences in illusion magnitude between individuals or groups are confounded with differences in inspection time, no matter whether stimuli are evaluated in matching, adjustment, or untimed comparison tasks. We offer an explanation for why these three illusions progress differently, and we spell out how our findings challenge theories of lightness, theories of global-local processing, and the interpretation of all research that has investigated visual illusions, or used them as tools, without considering inspection time.


Biological computing with diffusion and excitable calcium stores.
Intracellular signaling often employs excitable stores of calcium coupled by diffusion. We investigate the ability of various geometric configurations of such excitable stores to generate a complete set of logic gates for computation. We also describe how the mechanism of excitable calciuminduced calcium release can be used for constructing coincidence detectors for biological signals.


Enterobacter cloacae septicemia in a triple-cannula extracorporeal membrane oxygenation circulatory support treated with Seraph-100 Microbind affinity blood filter.
Bloodstream infections (BSI) are frequently encountered during extracorporeal membrane oxygenation (ECMO) support. Once septicemia is observed, treatment should be rapid, adequate, and multifaceted, particularly in advanced ECMO configurations. We report on a case of a 60-year-old male patient with acute-on-chronic heart failure due to ischemic cardiomyopathy. The treatment was complicated by cardiogenic shock requiring veno-arterial ECMO support, and, due to persistent pulmonary congestion, an upgrade with an additional left-atrial drainage cannula. After seven days of ECMO support, septicemia with shock ensued. Ex iuvantibus antibiotic treatment was started promptly. We wanted to minimize the likelihood of bacterial biofilm build-up requiring an exchange of the ECMO circuit and cannula, which was expected to be challenging. Therefore, we added a Seraph-100 Microbind affinity blood filter (providing blood purification with the potential for rapid bacterial clearance) to the ECMO circuit. Initial blood cultures tested positive for Enterobacter cloacae. Following a course of Seraph-100 treatment, bacteremia, septicemia, and shock resolved. There was no need for a circuit or cannula exchange. The additional eleven days of ECMO support were uneventful. The patient was successfully bridged to long-term mechanical circulatory support. We believe that the synergistic effect of early implementation of both broad-spectrum antibiotic treatment and blood purification with the potential for rapid bacterial clearance (such as the one provided with the Seraph-100 Microbind affinity blood filter) is crucial in BSI in patients receiving advanced ECMO.


Assessment of heavy metal nephrotoxicity in vitro using isolated rat glomeruli and proximal tubular fragments.
Nephrotoxic metals are thought to affect mainly the proximal tubule, but the pathophysiology of acute renal failure (ARF) caused by some of these compounds cannot be explained by damage to this part of the nephron alone. To compare toxic effects on different parts of the nephron, metabolic studies (de novo protein synthesis as assessed by amino acid incorporation and fatty acid oxidation) were performed in freshly isolated rat glomeruli and proximal tubular fragments (PTF) in the presence of increasing concentrations of mercury (Hg), chromium (Cr), and cadmium (Cd) salts. Glomerular protein synthesis was very sensitive to Hg (concentration to reduce protein synthesis by 50%: 3.4 microM) and Cr (15 microM), while in PTF amino acid incorporation was similarly affected by Cd and Hg (32 and 34 microM). Glomerular fatty acid synthesis was also more sensitive to Hg than that in PTF (3.2 vs 55 microM, p less than 0.005). In experiments to study the effects of reduced glutathione (0.5 and 1 mM) on the metal toxicity, preincubation of the fragments with reduced glutathione failed to protect glomeruli against subsequent exposure to the metals, but partially protected PTF (greater than 100 microM for Hg and Cd). These data show that isolated glomeruli are more susceptible to those metals with the potential to cause ARF in vivo, with Hg being the most potent toxin. The results suggest that the glomerular sensitivity to Hg may indicate an important target region of the nephron in the development of ARF which has previously not been recognized.


Emotion Analysis of Personalized Color of Beauty Package Based on NCD Image Positioning.
Purpose: Based on the Nippon Color & Design (NCD) system, this study aims to accurately discover the color preferences and image positioning of different female groups in China and, thus, to establish a color reference system, which is suitable for the packaging of beauty products. Methods: We first selected middle-aged women in the rural area of northern China as the studied group. Then, we conducted an extensive questionnaire survey on their color preferences focusing on their psychological characteristics and perception rules of emotional needs for colors. After that, we extracted colors from samples and classified them using the NCD system research method. Finally, we conducted a systematic analysis and verification to determine the color emotional preference of this group. Conclusion: We investigate the color preference of targeted customers to establish the image space of beauty product packaging. By applying SPSS for the factor analysis, we study the rural women in northern China, who are less concerned about fashion. We focus on the accurate positioning between the interaction of color, women, and environment throughout the color design process. We have conducted a series of comparative analyses of popular beauty products among the rural women. The results can accurately reflect the brand definition and positioning of color semantics and, thus, provide invaluable information for future beauty packaging designs and marketing promotion strategy.


Characteristics of childhood sexual abuse and adult psychopathology in female psychiatric patients.
The present study investigated the relationship of characteristics of childhood sexual abuse and subsequent psychopathology. Referrals to a female psychiatrist in private practice in an urban working class area provided 73 adult female subjects who reported having been sexually abused in childhood. Data were collected on age at onset, duration, physical invasiveness of the abuse, violence, and the number and relationship of abusers. Having had multiple abusers in childhood was significantly (p < 0.01) associated with every outcome measure of severe psychopathology: an initial Global Assessment Functioning score of 50 or below; both single and repeated incidents of deliberate self-harm; overdose; self-mutilation; and psychiatric hospital admission. Notably, having had multiple abusers was the only characteristic showing a reliable independent association with any of these measures. Subjects who had had multiple abusers were significantly more likely to have an earlier age of onset and longer duration of abuse, and to have experienced violent abuse.


Vegetable Cellulose Fibers in Natural Rubber Composites.
In the last decade, natural fibers have had a significant impact on the research and development of innovative composites made with natural rubber, improving their properties over those of their counterparts that incorporate polluting synthetic fibers. In recent years, this fact has stimulated the research into several modified natural rubber composites reinforced with vegetable fibers. This paper reviews the scientific literature published in the last decade about the properties and characteristics of natural vegetable fibers and natural rubber used in composites. Nowadays the use of alternative materials has become necessary, considering that synthetic materials have caused irreversible damage to the environment, being associated with global warming, for this reason research and development with materials that print a lower carbon footprint during the manufacturing process and subsequent product manufacturing. This review is an invitation to the use of vegetable fibers, as well as vegetable-type matrices, in this case natural rubber as a binder system, it is fantastic to know the different works carried out by other scientists and engineers, in this way to project new compounds linked to innovation in processes that reduce the carbon footprint and its negative impact on our planet.


Collaborative practice through nursing case management.
A 528-bed community teaching hospital redesigned its patient care delivery system, implementing a collaborative practice model on the 30-bed inpatient rehabilitation unit in April 1990. This model is a patient-centered delivery model that encourages the healthcare team to facilitate the achievement of patient outcomes within effective time frames and with an appropriate use of resources. The collaborative practice model includes a nurse case manager's role for the staff nurse, which had as its frame-work the concept of nursing case management. Tested project management techniques were used to ensure a successful implementation process. Various strategies, such as using project teams and providing educational programs, were used to respond to the issues of role conflict and overlap, especially between social workers and nurse case managers. The implementation of this model provided a number of benefits, including improved interdisciplinary relationships and decreased length of stay.


Ant colony optimization approaches to clustering of lung nodules from CT images.
Lung cancer is becoming a threat to mankind. Applying machine learning algorithms for detection and segmentation of irregular shaped lung nodules remains a remarkable milestone in CT scan image analysis research. In this paper, we apply ACO algorithm for lung nodule detection. We have compared the performance against three other algorithms, namely, Otsu algorithm, watershed algorithm, and global region based segmentation. In addition, we suggest a novel approach which involves variations of ACO, namely, refined ACO, logical ACO, and variant ACO. Variant ACO shows better reduction in false positives. In addition we propose black circular neighborhood approach to detect nodule centers from the edge detected image. Genetic algorithm based clustering is performed to cluster the nodules based on intensity, shape, and size. The performance of the overall approach is compared with hierarchical clustering to establish the improvisation in the proposed approach.


Leprosy.
Leprosy affects over 10 million people in the world. The disease is a model of graded cell-mediated immunity, in this case to the causative organism, Mycobacterium leprae. The clinical manifestations are due to (i) bacterial progression, (ii) immunologic responses of the host, (iii) peripheral nerve damage due to either or both bacterial progression and immunologic responses of the host, and (iv) preventable secondary deformities following nerve damage, which account for most of the stigma of the disease. Treatment modalities are now available to control or minimize the effects of bacterial progression, harmful immunologic responses of the host, peripheral nerve damage, and secondary deformities. Unique biochemical characteristics of M. leprae reside in the cell wall and associated macromolecules. Some of these molecules are potent immunogens in humans, while others constitute the structural integrity of the bacillus. Proteins of M. leprae are currently under intensive investigation as a result of deoxyribonucleic acid cloning of M. leprae genes. Structure-function and antigenic relationships of M. leprae proteins should become available by using recombinant deoxyribonucleic acid procedures coupled with T- and B-cell cloning to advance our understanding of the immunologic reactions encountered in Hansen's disease. Until recently, the study of the immunology of leprosy has been stymied by the lack of immunologically specific M. leprae antigens. The definition of specific antigens and production of recombinant and synthetic immunologic reagents have fostered state-of-the-art research efforts into new immunodiagnostic procedures and development of a leprosy vaccine. Also discussed is progress in understanding of the mechanism(s) underlying the M. leprae-specific immunodeficiency associated with lepromatous leprosy, including the role of suppressor T cells and defective macrophage function. Metabolic studies of M. leprae suggest intact catabolic pathways and energy generation with purine bases and catalase as possible growth factors. Special attention may also need to be given to biophysical parameters for eventual in vitro cultivation. Rapid in vitro systems, using quantitation of bacillary metabolic activity, may soon replace the lengthy mouse footpad test for determining the viability and drug susceptibility of the leprosy bacillus.


Enhanced dewatering of polyelectrolyte nanocomposites by hydrophobic polyelectrolytes.
We demonstrate that increasing the hydrophobic environment around the charge center of a polyelectrolyte (PE) not only decreases the water content of an adsorbed PE layer but can even dewater up to ~50% of an initially hydrated substrate. The results of this work are expected to yield new stratagies to dewater PE systems and have potential applications in mineral recovery, paper manufacturing, and biomedical materials. Adsorption of a series of cationically derivatized dextran polyelectrolytes onto sulfated nanocrystalline cellulose (SNC) has been studied using quartz crystal microbalance with dissipation monitoring (QCM-D) and surface plasmon resonance (SPR). Synthesized samples of (N,N-dimethylamino)ethyldextran (DMAE-Dex), (N,N-diethylamino)ethyldextran (DEAE-Dex), and (N,N-diisopropylamino)ethyldextran (DIAE-Dex) had degrees of substitution (DS) ranging from 0.05 to 0.82. DMAE-Dex, DEAE-Dex, and DIAE-Dex all showed decreasing adsorption onto SNC and decreasing water content of the adsorbed film with increasing DS. Additionally, DEAE-Dex and DIAE-Dex films adsorbed onto SNC contained less water than DMAE-Dex films with the same DS. Interestingly, QCM-D results for high DS DIAE-Dex adsorbed onto SNC revealed mass loss, whereas SPR results clearly showed DIAE-Dex adsorbed. These observations were consistent with dehydration of the SNC substrate. This study indicates that the water content of the substrate could be tailored by controlling the DS and hydrophobic character of the adsorbed polyelectrolytes.


Glycocaulis alkaliphilus sp. nov., a dimorphic prosthecate bacterium isolated from crude oil.
A bacterial strain designated 6B-8(T) was isolated from crude oil from Daqing oilfield, China. Cells of strain 6B-8(T) were Gram-negative, aerobic, dimorphic and reproduced by means of binary fission. Strain 6B-8(T) could grow at 20-37 °C, pH 8-10 and 1-5 % (w/v) NaCl. Its genomic DNA G+C content was 62.0 mol%. The predominant cellular fatty acids were C18 : 1ω7c, C17 : 0, C18 : 0 and 11-methyl C18 : 1ω7c and the main hydroxy fatty acids were C12 : 0 3-OH and C12 : 1 3-OH when grown on marine agar 2216. The major quinone was Q-10 and the major polar lipids were three unidentified glycolipids. Phylogenetic analysis revealed that strain 6B-8(T) was a member of the family Hyphomonadaceae, sharing 99.6 and 99.4 % 16S rRNA gene sequence similarity with Glycocaulis abyssi LMG 27140(T) and Glycocaulis albus SLG210-30A1(T), respectively, and less than 94.4 % similarity with the type strains of other members of the family Hyphomonadaceae. However, the DNA-DNA relatedness between strain 6B-8(T) and related strains G. abyssi LMG 27140(T) and G. albus SLG210-30A1(T) was 36±5 and 42±5 %, respectively. In addition, several phenotypic and genotypic features allowed differentiation of strain 6B-8(T) from G. abyssi LMG 27140(T) and G. albus SLG210-30A1(T). Therefore, strain 6B-8(T) represents a novel species of genus Glycocaulis, for which the name Glycocaulis alkaliphilus sp. nov. is proposed. The type strain is 6B-8(T) ( = CGMCC 1.12428(T) = LMG 27410(T)).


mir-500-Mediated GAD67 Downregulation Contributes to Neuropathic Pain.
Neuropathic pain is a common neurobiological disease involving multifaceted maladaptations ranging from gene modulation to synaptic dysfunction, but the interactions between synaptic dysfunction and the genes that are involved in persistent pain remain elusive. In the present study, we found that neuropathic pain induced by the chemotherapeutic drug paclitaxel or L5 ventral root transection significantly impaired the function of GABAergic synapses of spinal dorsal horn neurons via the reduction of the GAD67 expression. We also found that mir-500 expression was significantly increased and involved in the modulation of GAD67 expression via targeting the specific site of Gad1 gene in the dorsal horn. In addition, knock-out of mir-500 or using mir-500 antagomir rescued the GABAergic synapses in the spinal dorsal horn neurons and attenuated the sensitized pain behavior in the rats with neuropathic pain. To our knowledge, this is the first study to investigate the function significance and the underlying molecular mechanisms of mir-500 in the process of neuropathic pain, which sheds light on the development of novel therapeutic options for neuropathic pain. Neuropathic pain is a common neurobiological disease involving multifaceted maladaptations ranging from gene modulation to synaptic dysfunction, but the underlying molecular mechanisms remain elusive. The present study illustrates for the first time a mir-500-mediated mechanism underlying spinal GABAergic dysfunction and sensitized pain behavior in neuropathic pain induced by the chemotherapeutic drug paclitaxel or L5 ventral root transection, which sheds light on the development of novel therapeutic options for neuropathic pain.


A shape-memory and spiral light-emitting device for precise multisite stimulation of nerve bundles.
We previously demonstrated that for long-term spastic limb paralysis, transferring the seventh cervical nerve (C7) from the nonparalyzed side to the paralyzed side results in increase of 17.7 in Fugl-Meyer score. One strategy for further improvement in voluntary arm movement is selective activation of five target muscles innervated by C7 during recovery process. In this study, we develop an implantable multisite optogenetic stimulation device (MOSD) based on shape-memory polymer. Two-site stimulation of sciatic nerve bundles by MOSD induces precise extension or flexion movements of the ankle joint, while eight-site stimulation of C7 nerve bundles induce selective limb movement. Long-term implant of MOSD to mice with severed and anastomosed C7 nerve is proven to be both safe and effective. Our work opens up the possibility for multisite nerve bundle stimulation to induce highly-selective activations of limb muscles, which could inspire further applications in neurosurgery and neuroscience research.


Hypochlorous acid and 3,4-dihydroxyphenylalanine increase the formation of serum protein lipofuscin-like fluorophores in vitro.
Serum protein lipofuscin-like fluorophores (LLFs) that include fluorescent advanced glycation end products (AGEs), are an index of protein modification and levels are abnormally high in hemodialysis patients. To investigate the possibility that hypochlorous acid (HOCl) and 3,4-dihydroxyphenylalanine (DOPA) may contribute to high LLFs concentrations, we have examined the effect of these factors on serum protein LLF formation in vitro. Protein LLF concentration was measured at excitation 350 nm and emission 460 nm and was expressed in arbitrary units relative to quinine sulphate fluorescence. Oxidation of serum or other solutions with HOCl was carried out at room temperature for 30 minutes and serum was delipidated before measurement of protein LLFs. Serum protein LLF concentration increased non-linearly by a maximum 247% with increasing HOCl concentration in the range 6.5-32.9 mmol/L and this was mirrored by a decrease in protein tryptophan fluorescence. HOCl (32.9 mmol/L) increased LLFs in human gamma-globulin solutions (15-fold in 12 mg/mL and 5-fold in 60 mg/mL solutions) and did not alter LLFs appreciably in human serum albumin solution (60 mg/mL). Addition of DOPA (265 micromol/L) significantly (P<0.001) increased LLF formation in serum by nearly 2-fold during 3 days incubation under air. These data suggest that HOCl and DOPA are capable of generating serum protein LLFs and that gamma-globulins appear to be an important substrate for protein LLF formation in human serum. These findings may be relevant to the abnormally high concentrations of serum protein LLFs and impaired immune response in hemodialysis patients.


Use of Ultrasound to Assess Hemodynamics in Acutely Ill Patients.
Early diagnosis of AKI and preventive measures can likely decrease the severity of the injury and improve patient outcomes. Current hemodynamic monitoring variables, including BP, heart and respiratory rates, temperature, and oxygenation status, have been used to identify patients at high risk for AKI. Despite the widespread use of such variables, their ability to accurately and timely detect patients who are high risk has been questioned. Therefore, there is a critical need to develop and validate tools that can measure new and more kidney-specific hemodynamic and laboratory variables, potentially assisting with AKI risk stratification, implementing appropriate and timely preventive measures, and hopefully improved outcomes. The new ultrasonography techniques provide novel insights into kidney hemodynamics and potential management and/or therapeutic targets. Contrast-enhanced ultrasonography; Doppler flow patterns of hepatic veins, portal vein, and intrakidney veins; and ultrasound elastography are among approaches that may provide such information, particularly related to vascular changes in AKI, venous volume excess or congestion, and fluid tolerance. This review summarizes the current state of these techniques and their relevance to kidney hemodynamic management.


Transcatheter therapeutic embolization of genitourinary pathology.
With the advent of smaller vascular catheters and improved imaging techniques, percutaneous transcatheter embolization has become a valuable adjunct for the treatment of patients with various genitourinary pathologic conditions. Multiple embolic agents are now employed in an array of situations to devascularize organs, stop bleeding, and occlude passageways.


Factors determining glucose tolerance in patients with thalassemia major.
To better understand the pathophysiology of glucose intolerance secondary to iron overload in patients with thalassemia major, we performed tolbutamide-modified frequently sampled iv glucose tolerance tests (FSIGTs) in 10 thalassemic patients (6 males and 4 females; 21.7 +/- 1.2 yr old; body mass index, 19.7 +/- 0.6 kg/m2) and 10 healthy controls (5 males and 5 females; 22.4 +/- 1.3 yr; body mass index, 20.6 +/- 0.5 kg/m2). Insulin secretion and action were quantified by application of the minimal model of glucose kinetics and the combined model of insulin and C-peptide kinetics to the FSIGT data. The insulin sensitivity index was significantly lower in thalassemia patients [72 +/- 12 min-1(nmol/mL)] compared to controls [158 +/- 21 min-1(nmol/mL); P = 0.0026]. The integrated insulin response during the FSIGT was significantly greater in thalassemia patients than in controls after tolbutamide injection (P = 0.042). The difference in insulin levels was apparently due to reduced hepatic insulin extraction in thalassemia (78 +/- 2% vs. 68 +/- 3%; P = 0.0251). Seven of the 10 thalassemia patients were studied prospectively at 6-month intervals for 6-12 months. Repeated measures analysis of variance indicated that across a 6-month interval, there was a decrease in the total integrated insulin response (P = 0.002), with no change in insulin sensitivity (P = 0.86). In conclusion, patients with thalassemia major have significant insulin resistance, which may be compensated for by an elevated circulating insulin level. The elevated insulin level in response to tolbutamide appears to be due to reduced hepatic extraction of insulin and not to an enhanced insulin secretory response. Over time, patients with thalassemia experience a reduction in their circulating insulin levels. Persistent insulin resistance along with a progressive reduction in circulating insulin levels may lead to glucose intolerance and diabetes mellitus, which have a high prevalence in patients with thalassemia major.


Protective effect of C1 esterase inhibitor on acute traumatic spinal cord injury in the rat.
The complement system and activated neutrophils are thought to play a major role in initiating some of the inflammatory events that occur in spinal cord injury. The aim of the present study was to assess the effects of C1 esterase inhibitor (C1-INH) on traumatic spinal cord injury (SCI) in the rat. Thirty-eight male Wistar rats were used. Just after SCI by a pneumatic impact device, C1-INH (n=16, C1-INH group) or saline (n=16, saline group) was administered. Sham operated animals (n=6, sham group) received only laminectomy. Eighteen (six from each group) rats were killed and an assessment of leukocyte infiltration by myeloperoxidase (MPO) activity and immunoreactivity of MPO were performed 24 hours after SCI. Twenty (ten from each of C1-INH and saline groups) rats were examined using behavioral function on post-operative days. They were also examined after 7 days by histologic analysis using Luxol fast blue for axons and myelin. Lesion volume was calculated by considering a lesion as being composed of two cones with juxtaposed bases. During the experiment, sequential changes in regional spinal cord blood flow (rSCBF) were measured using the laser Doppler (LD) scanning technique. The recovery of motor function was better in the C1-INH group than in the saline group. In the C1-INH group, immunoreactivity of MPO showed a tendency to be smaller than that of the saline group. Lesion volume was significantly smaller in the C1-INH group than in the control group (p<0.01) and MPO activity was also significantly smaller in the C1-INH group than in the control group (p<0.01). After SCI, the rSCBF value decreased gradually and significantly in both injured groups. Significant differences were observed from 30 to 120 minutes after SCI (p<0.05). The results of this study provided the first evidence that C1-INH reduced accumulation of polymorphonuclear leukocytes (PMLs) and neuronal damage in acute stage after SCI. This protection was not related to an improvement in rSCBF.


MM-TRAG (MGC4175), a novel intracellular mitochondrial protein, is associated with the taxol- and doxorubicin-resistant phenotype in human cancer cell lines.
In the search for novel genes involved in the taxol resistance phenotype, prior studies of gene expression in taxol-resistant cell lines and their paired drug-sensitive parental lines using high-density Affymetrix microarrays identified MGC4175 as an overexpressed transcript. In this report, we characterize MGC4175 and demonstrate that seven of eight taxol- and doxorubicin-resistant cell lines overexpressed MGC4175 as compared to their chemotherapy naive parent lines. Sequence analyses of MGC4175 cDNA and the predicted amino acid sequence did not show significant homology to any known sequence or protein domain, with an open reading frame of 356 bp that is predicted to encode a protein product of 118 amino acids. Both the MGC4175 and MDR1 genes are located at chromosome position 7q21. Southern blot analysis demonstrated that a single copy of MGC4175 is present in the human genome, and MGC4175 overexpression is not caused by genomic amplification or gene arrangement. Human MGC4175 fused to the carboxy terminus of enhanced green fluorescent protein (EGFP) and expressed in U-2OS cells localized the protein to the perinuclear region with further studies colocalizing this protein to the mitochondria. The Cancer Profiling Arrays and the Cancer Cell Line Profiling Array demonstrated that MGC4175 is broadly expressed in various tissues with no significant difference of MGC4175 expression between chemotherapy naive tumor cells and normal cells. However, MGC4175 is overexpressed 1.2- to 12.3-fold after 48 h of taxol induction and 0.65- to 6.5-fold after doxorubicin induction in various human cancer cell lines. In light of the overexpression of MGC4175 in association with taxol exposure, drug resistance, the coexpression of MDR1 and the mitochondrial localization of its protein, we propose to name this transcript MDR1 and Mitochondrial Taxol Resistance Associated Gene (MM-TRAG) and suggest that MM-TRAG may play a role in the development of taxol resistance in human cancer.


The use of food consumption data in assessments of exposure to food chemicals including the application of probabilistic modelling.
Emphasis on public health and consumer protection, in combination with globalisation of the food market, has created a strong demand for exposure assessments of food chemicals. The food chemicals for which exposure assessments are required include food additives, pesticide residues, environmental contaminants, mycotoxins, novel food ingredients, packaging-material migrants, flavouring substances and nutrients. A wide range of methodologies exists for estimating exposure to food chemicals, and the method chosen for a particular exposure assessment is influenced by the nature of the chemical, the purpose of the assessment and the resources available. Sources of food consumption data currently used in exposure assessments range from food balance sheets to detailed food consumption surveys of individuals and duplicate-diet studies. The fitness-for-purpose of the data must be evaluated in the context of data quality and relevance to the assessment objective. Methods to combine the food consumption data with chemical concentration data may be deterministic or probabilistic. Deterministic methods estimate intakes of food chemicals that may occur in a population, but probabilistic methods provide the advantage of estimating the probability with which different levels of intake will occur. Probabilistic analysis permits the exposure assessor to model the variability (true heterogeneity) and uncertainty (lack of knowledge) that may exist in the exposure variables, including food consumption data, and thus to examine the full distribution of possible resulting exposures. Challenges for probabilistic modelling include the selection of appropriate modes of inputting food consumption data into the models.


Vascularized pancreas transplantation in the rat--details of the microsurgical techniques, results, and complications.
A detailed survey of the microsurgical techniques of vascularized pancreas transplantation in streptozotocin-diabetic rats is presented, based on the experience of 1450 transplants. Various techniques were employed to manage exocrine graft secretion. These included enteric, urinary, and free intraperitoneal drainage, as well as duct ligation and obstruction. In addition to general complications, such as anesthetic deaths, afterbleeding, and infection, a number of specific surgical complications, including graft pancreatitis, acute venous thrombosis, and hypoglycemia, occurred. The overall success rate of pancreas transplantation was 83.9%. Incidence, causes, and possible prophylaxis of early and late postoperative complications are discussed in detail.


Report on the brain of the monk seal (Monachus monachus, Hermann, 1779).
The Mediterranean monk seal (Monachus monachus, Hermann, 1779) is an endangered species of pinniped endemic to few areas of the Mediterranean Sea. Extensive hunting and poaching over the last two centuries have rendered it a rare sight, scattered mainly in the Aegean Sea and the western coast of North Africa. In a rare event, a female monk seal calf stranded and died in southern Italy (Brindisi, Puglia). During due necropsy, the brain was extracted and fixed. The present report is the first of a monk seal brain. The features reported are remarkably typical of a true seal brain, with some specific characteristics. The brain cortical circonvolutions, main fissures and the external parts are described, and an EQ was calculated. Overall, this carnivore adapted to aquatic life shares some aspects of its neuroanatomy and physiology with other seemingly distant aquatic mammals.


Episodic Memory Impairment Mediates the Loss of Awareness in Mild Cognitive Impairment.
Loss of awareness is a common symptom in Alzheimer's Disease (AD) and responsible for a significant loss of functional abilities. The mechanisms underlying loss of awareness in AD is unknown, although previous findings have implicated dysfunction of primary executive functioning (EF) or episodic memory (EM) to be the cause. Therefore, our main study objective was to explore the involvement of EF and EM dysfunction in amyloid-related loss of awareness across the clinical spectrum of AD. A total of 895 participants (362 clinically normal [CN], 422 people with mild cognitive impairment [MCI] and 111 with dementia) from the Alzheimer's Disease Neuroimaging Initiative were used for the analyses. A sub-analysis was performed in 202 participants who progressed in their clinical diagnosis from CN to MCI or MCI to dementia as well as dementia patients. Mediation models were used in each clinical group with awareness (assessed with the Everyday Cognitive function questionnaire) as a dependent variable to determine whether EF and/or EM would mediate the effect of amyloid on awareness. We also ran these analyses with subjective and informant complaints as dependent variables. Direct correlations between all variables were also performed. We found evidence for a decline in awareness across the groups, with increased awareness observed in the CN group and decreased awareness observed in the MCI and dementia groups. Our results showed that EM, and not EF, partially mediated the relationship between amyloid and awareness such that greater amyloid and lower EM performance was associated with lower awareness. When analyzing each group separately, this finding was only observed in the MCI group and in the group containing progressors and dementia patients. When repeating the analyses for subjective and informant complaints separately, the results were replicated only for the informant's complaints. Our results demonstrate that decline in EM and, to a lesser degree, EF, mediate the effect of amyloid on awareness. In line with previous studies demonstrating the development of anosognosia in the prodromal stage, our findings suggest that decreased awareness is the result of an inability for the participant to update his/her insight into his/her cognitive performance (i.e., demonstrating a petrified self).


Primary endothelial sarcoma of the thoracic aorta.
Primary malignant tumors of the aorta are extremely rare. The case of a 64-year-old woman who presented with peripheral embolism to both femoropopliteal arteries is reported. The search for a source revealed a polypoid lesion severely narrowing the lumen of the distal thoracic aorta. Differential diagnosis included thrombus and primary aortic tumor. Extirpation of the tumorous lesion was performed. Histologic examination revealed intimal aortic sarcoma of endothelial cell origin. Although the liver was the only site of suspected metastases at the time of operation, during the 18-month follow-up until the patient's death, generalized metastatic spread had developed. This case report thus demonstrates the generally poor prognosis of this rare variety of aortic sarcoma, in particular when symptoms have already occurred.


Acoustic radiation force impulse imaging for noninvasive evaluation of renal parenchyma elasticity: preliminary findings.
To evaluate the diagnostic value of acoustic radiation force impulse (ARFI) to test the elasticity of renal parenchyma by measuring the shear wave velocity (SWV) which might be used to detect chronic kidney disease (CKD). 327 healthy volunteers and 64 CKD patients were enrolled in the study. The potential influencing factors and measurement reproducibility were evaluated in the healthy volunteers. Correlations between SWV and laboratory tests were analyzed in CKD patients.?Receiver-operating characteristic curve (ROC) analyses were performed to assess the diagnostic performance of ARFI. The SWV of healthy volunteers correlated significantly to age (r = -0.22, P<0.001, n = 327) and differed significantly between men and women (2.06±0.48 m/s vs. 2.2±0.52 m/s, P = 0.018, n = 327). However, it did not correlate significantly to height, weight, body mass index, waistline, kidney dimension and the depth for SWV measurement (n = 30). Inter- and intraobserver agreement expressed as intraclass coefficient correlation were 0.64 (95% CI: 0.13 to 0.82, P = 0.011) and 0.6 (95% CI: 0.31 to 0.81, P = 0.001) (n = 40). The mean SWV in healthy volunteers was 2.15±0.51 m/s, while was 1.81±0.43 m/s, 1.79±0.29 m/s, 1.81±0.44 m/s, 1.64±0.55 m/s, and 1.36±0.17 m/s for stage 1, 2, 3, 4 and 5 in CKD patients respectively. The SWV was significantly higher for healthy volunteers compared with each stage in CKD patients. ARFI could not predict the different stages of CKD except stage 5. In CKD patients, SWV correlated to e-GFR (r = 0.3, P = 0.018), to urea nitrogen (r = -0.3, P = 0.016), and to creatinine (r = -0.41, P = 0.001). ROC analyses indicated that the area under the ROC curve was 0.752 (95% CI: 0.704 to 0.797) (P<0.001). The cut-off value for predicting CKD was 1.88 m/s (sensitivity 71.87% and specificity 69.69%). ARFI may be a potentially useful tool in detecting CKD.


PentaRay® Multielectrode Mapping Catheter for Atrial Tachyarrhythmia in Adults With Congenital Heart Disease.
Ablation of atrial tachyarrhythmia in adults with congenital heart disease (ACHD) is challenging because of complex anatomy and high scar burden. We proposed that the addition of high-density mapping with the PentaRay® (Biosense Webster, Inc) mapping catheter (EAM+P) to 3-dimensional electroanatomic mapping (EAM) allows for rapid acquisition of high-resolution maps and shorter procedure times. In this single-center, retrospective cohort study of patients with ACHD who underwent atrial arrhythmia ablation, patients were divided those who underwent ablation with EAM and those who underwent ablation with EAM+P. Fifteen ablations were performed in 13 patients using standard EAM, and 11 ablations were performed in 10 patients using EAM+P. There was no difference in mean age or complexity of congenital heart disease. The procedure duration was 1.5 times longer in the EAM than in the EAM+P group (P = .015). The dose area product was 12 times higher in the EAM than in the EAM+P group (P = .001). A higher number of venous access sites were used for EAM cases than for EAM+P cases (P = .008). Acute success rates of ablation and recurrence rates at 1 year were similar in the 2 groups. There were no procedure-related complications in either group. This is the first study to evaluate the use of the PentaRay® high-density mapping catheter for ablation of atrial tachyarrhythmia in patients with ACHD. The use of the PentaRay® high-density mapping catheter results in shorter procedure time, decreased radiation exposure, and fewer venous access sites.


Organizing complexity: the hopeful dreams and harsh realities of interdisciplinary collaboration at the rand corporation in the early cold war.
Historians argue that in the early Cold War an interdisciplinary research culture defined the RAND Corporation. However, a significant epistemological gap divided the members of RAND's Social Science Division (SSD) from the rest of the organization. While the social scientists used qualitative methods, most RAND researchers embraced quantified approaches and derided the social sciences as unscientific. This encouraged RAND's social scientists to develop a political-military simulation that embraced everything-politics, culture, and psychology-that RAND's other analysts largely ignored. Yet the fact that the SSD embraced gaming, a heuristic practiced throughout RAND, suggests that the political simulation was nonetheless inspired by social scientists' engagement with their colleagues. This indicates that the concept of interdisciplinarity should move beyond its implication of collaboration to incorporate instances in which research agendas are defined against but also shaped by colleagues in other disciplines. Such a rethinking of the term may make it possible to trace how varieties of interdisciplinary interaction historically informed knowledge production.


[A Case of Hepatocellular Carcinoma with Right Atrium Tumor Thrombus and Multiple Intrahepatic Metastases That Remarkably Responded to Combination Therapy Including Surgery].
The prognosis for hepatocellular carcinoma(HCC)with right atrium tumor thrombus(RATT)is dismal and necessary to be treated on as oncologic emergency. We report a case of HCC with RATT which was treated with multidisciplinary therapy including surgery. After repeated transarterial chemoembolization(TACE)and radiofrequency ablation(RFA), a 71-year-old man consulted to our hospital with multiple HCC, lung metastasis, and RATT. Left hemihepatectomy, thrombectomy of RATT, and 3 months of hepatic arterial infusion chemotherapy(HAIC)was performed, and intrahepatic HCCs were controlled. However, during treatment of lung metastasis by sorafenib, the patient died of brain metastasis, 3 years after the first treatment. Although surgery and HAIC may give a chance of further treatment by control of intrahepatic HCCs, stronger regimen for systemic HCC would be necessary.


Drug lymphocyte stimulation test in the diagnosis of adverse reactions to antituberculosis drugs.
Tuberculosis (TB) is a worldwide infectious disease. Recently, standard therapy has become very effective for treating patients with TB; however, as a result of this powerful regimen, serious side effects have become an important problem. The aim of this prospective study was to evaluate the usefulness of the drug lymphocyte stimulation test (DLST) to determine anti-TB drugs causing side effects. Four hundred thirty-six patients with TB were admitted to our hospital for treatment between January 2002 and August 2007. DLST was performed in patients who had certain adverse drug reactions during TB treatment. The causative drug was identified by the drug provocation test (DPT). The tested drugs were mainly isoniazid (INH), rifampin (RIF), ethambutol (EMB) and pyrazinamide (PZA). Of 436 patients, 69 patients (15.8%) had certain adverse drug reactions to anti-TB drugs. Of the 261 agents that underwent the DLST and DPT, 28 agents (10.7%) in 20 patients (28.9%) were positive by DLST, and 67 agents (25.7%) in 46 patients (66.6%) were identified as causative drugs by DPT. The sensitivity of DLST was only 14.9% for all drugs (INH, 14.3%; RIF, 13.6%; EMB, 14.3%; PZA, 0%). DLST offers little contribution to the detection of causative agents in patients with adverse anti-TB drug reactions.


Evidence for Spin Singlet Pairing with Strong Uniaxial Anisotropy in URu_{2}Si_{2} Using Nuclear Magnetic Resonance.
In order to identify the spin contribution to superconducting pairing compatible with the so-called "hidden order", ^{29}Si nuclear magnetic resonance measurements have been performed using a high-quality single crystal of URu_{2}Si_{2}. A clear reduction of the ^{29}Si Knight shift in the superconducting state has been observed under a magnetic field applied along the crystalline c axis, corresponding to the magnetic easy axis. These results provide direct evidence for the formation of spin-singlet Cooper pairs. Consequently, results indicating a very tiny change of the in-plane Knight shift reported previously demonstrate extreme uniaxial anisotropy for the spin susceptibility in the hidden order state.


High-resolution structures of variant Zif268-DNA complexes: implications for understanding zinc finger-DNA recognition.
Zinc fingers of the Cys2-His2 class comprise one of the largest families of eukaryotic DNA-binding motifs and recognize a diverse set of DNA sequences. These proteins have a relatively simple modular structure and key base contacts are typically made by a few residues from each finger. These features make the zinc finger motif an attractive system for designing novel DNA-binding proteins and for exploring fundamental principles of protein-DNA recognition. Here we report the X-ray crystal structures of zinc finger-DNA complexes involving three variants of Zif268, with multiple changes in the recognition helix of finger one. We describe the structure of each of these three-finger peptides bound to its corresponding target site. To help elucidate the differential basis for site-specific recognition, the structures of four other complexes containing various combinations of these peptides with alternative binding sites have also been determined. The protein-DNA contacts observed in these complexes reveal the basis for the specificity demonstrated by these Zif268 variants. Many, but not all, of the contacts can be rationalized in terms of a recognition code, but the predictive value of such a code is limited. The structures illustrate how modest changes in the docking arrangement accommodate the new sidechain-base and sidechain-phosphate interactions. Such adaptations help explain the versatility of naturally occurring zinc finger proteins and their utility in design.


Contrast enhanced X-ray computed tomography imaging of amyloid plaques in Alzheimer disease rat model on lab based micro CT system.
Amyloid plaques are small (~ 50 μm), highly-dense aggregates of amyloid beta (Aβ) protein in brain tissue, supposed to play a key role in pathogenesis of Alzheimer's disease (AD). Plaques´ in vivo detection, spatial distribution and quantitative characterization could be an essential marker in diagnostics and evaluation of AD progress. However, current imaging methods in clinics possess substantial limits in sensitivity towards Aβ plaques to play a considerable role in AD screening. Contrast enhanced X-ray micro computed tomography (micro CT) is an emerging highly sensitive imaging technique capable of high resolution visualization of rodent brain. In this study we show the absorption based contrast enhanced X-ray micro CT imaging is viable method for detection and 3D analysis of Aβ plaques in transgenic rodent models of Alzheimer's disease. Using iodine contrasted brain tissue isolated from the Tg-F344-AD rat model we show the micro CT imaging is capable of precise imaging of Aβ plaques, making possible to further analyze various aspects of their 3D spatial distribution and other properties.


The politics of Piketty: what political science can learn from, and contribute to, the debate on Capital in the twenty-first century.
Thomas Piketty's imposing volume has brought serious economics firmly into the mainstream of public debate on inequality, yet political science has been mostly absent from this debate. This article argues that political science has an essential contribution to make to this debate, and that Piketty's important and powerful book lacks a clear political theory. It develops this argument by first assessing and critiquing the changing nature of political science and its account of contemporary capitalism, and then suggesting how Piketty's thesis can be complemented, extended and challenged by focusing on the ways in which politics and collective action shape the economy and the distribution of income and wealth. Although Capital's principal message is that 'capital is back' and that without political interventions active political interventions will continue to grow, a political economy perspective would suggest another rather more fundamental critique: the very economic forces Piketty describes are embedded in institutional arrangements which can only be properly understood as political phenomena. In a sense capital itself - the central concept of the book - is almost meaningless without proper consideration of its political foundations. Even if the fact of capital accumulation may respond to an economic logic, the process is embedded in a very political logic. The examples of housing policy and the regulation, and failure to regulate, financial markets are used to illustrate these points.


Chloride-Promoted Formation of a Bimetallic Nanocluster Au80Ag30 and the Total Structure Determination.
We report the total structure determination of a large bimetallic nanocluster with an overall composition of [Au80Ag30(C≡CPh)42Cl9]Cl. It is the largest structurally characterized bimetallic coinage nanocluster so far. The 110 metal atoms are distributed in a concentric four-shell Russian doll arrangement, Au6@Au35@Ag30Au18@Au21. There are 42 PhC≡C- ligands and 9 μ2-chloride ligands clamping on the cluster surface. The chloride is proven to be critical for the formation of this giant cluster, as the control experiment in the absence of halide gives only smaller species. This work demonstrates that the halide can play a key role in the formation of a large metal nanocluster, and the halide effect should be considered in the design and synthesis of metal nanoclusters.


Hierarchical amplification of macromolecular helicity of dynamic helical poly(phenylacetylene)s composed of chiral and achiral phenylacetylenes in dilute solution, liquid crystal, and two-dimensional crystal.
Optically active poly(phenylacetylene) copolymers consisting of optically active and achiral phenylacetylenes bearing L-alanine decyl esters (1L) and 2-aminoisobutylic acid decyl esters (Aib) as the pendant groups (poly(1L(m)-co-Aib(n))) with various compositions were synthesized by the copolymerization of the optically active 1L with achiral Aib using a rhodium catalyst, and their chiral amplification of the macromolecular helicity in a dilute solution, a lyotropic liquid crystalline (LC) state, and a two-dimensional (2D) crystal on the substrate was investigated by measuring the circular dichroism of the copolymers, mesoscopic cholesteric twist in the LC state (cholesteric helical pitch), and high-resolution atomic force microscopy (AFM) images of the self-assembled 2D helix-bundles of the copolymer chains. We found that the macromolecular helicity of poly(1L(m)-co-Aib(n))s could be hierarchically amplified in the order of the dilute solution, LC state, and 2D crystal. In sharp contrast, almost no chiral amplification of the macromolecular helicity was observed for the homopolymer mixtures of 1L and Aib in the LC state and 2D crystal on graphite.


Association between urinary metabolic profile and the intestinal effects of cocoa in rats.
The aim of this study was to elucidate the relationship between the urinary metabolic fingerprint and the effects of cocoa and cocoa fibre on body weight, hormone metabolism, intestinal immunity and microbiota composition. To this effect, Wistar rats were fed, for 3 weeks, a diet containing 10 % cocoa (C10) or two other diets with same the proportion of fibres: one based on cocoa fibre (CF) and another containing inulin as a reference (REF) diet. The rats' 24 h urine samples were analysed by an untargeted 1H NMR spectroscopy-based metabonomic approach. Concentrations of faecal IgA and plasma metabolic hormones were also quantified. The C10 diet decreased the intestinal IgA, plasma glucagon-like peptide-1 and glucagon concentrations and increased ghrelin levels compared with those in the REF group. Clear differences were observed between the metabolic profiles from the C10 group and those from the CF group. Urine metabolites derived from cocoa correlated with the cocoa effects on body weight, immunity and the gut microbiota. Overall, cocoa intake alters the host and bacterial metabolism concerning energy and amino acid pathways, leading to a metabolic signature that can be used as a marker for consumption. This metabolic profile correlates with body weight, metabolic hormones, intestinal immunity and microbiota composition.


Purification and characterization of alpha-L-fucosidase from Bacillus circulans grown on porcine gastric mucin.
Bacillus circulans isolated from soil was found to produce two types of alpha-L-fucosidase differing in substrate specificity. One was able to liberate L-fucose from porcine gastric mucin (PGM), but not from artificial substrates, including p-nitrophenyl and methyl alpha-L-fucosides, while the other acted not on PGM but on p-nitrophenyl alpha-L-fucoside. The production of the former enzyme was enhanced about 150 times as much by PGM added to the medium as by glucose. The alpha-L-fucosidase acting on PGM was purified from the culture fluid obtained with PGM medium by ammonium sulfate fractionation and subsequent column chromatography. The purified enzyme was found to be homogeneous by PAGE and its molecular weight was estimated to be approximately 285,000. The optimum pH was found to be 5.5 to 6.5 and the stable pH range was 4.5 to 9.0. The enzyme decomposed various blood group O(H) active substances such as PGM, human milk and human saliva, and moreover acted on A-, B-, and O-erythrocytes. The enzyme was shown to cleave alpha-(1----2)-, (1----3)-, and (1----4)-L-fucosidic linkages in various glycoproteins and oligosaccharides, but failed to hydrolyze alpha-(1----6)-L-fucosic linkages in 6-O-alpha-L-fucopyranosyl-N-acetylglucosamine and intact bovine thyroglobulin.


The witches' brew of spirituality and medicine.
Recent proposals to join spirituality and medicine are facile and ill defined. The notion that physicians have the time or training to make assessments and recommendations about spirituality is misguided. Whenever a physician demonstrates personal caring for a patient, the healing process is likely enhanced, and in that sense, physicians often promote the spirituality of the patient. However, recent proposals to extend the physician's task to that of assessing religion and directing the patient toward approved forms of spirituality are inappropriate. The languages of religion and science are radically different. The cultural body-mind split will not be solved by such simplistic solutions as having physicians endorse spirituality, which will result only in denigration of both medicine and religion. Physicians are encouraged to rely on clinically trained ministers for assistance in understanding the patient's state of mind or spirit and its possible effects on the course of illness and health.


[Differential neuronal firing in globus pallidus internus of patients with Parkinson's disease and dystonia].
To explore the neuronal activity in globus pallidus internus in patients with Parkinson's disease (PD) and dystonia. Thirteen patients with Parkinson's disease and eight with dystonia undergoing stereotactic surgery of globus pallidus internus were studied. Microrecording in globus pallidus internus and electromyography on contralateral limbs to surgery were simultaneously performed. Single unit analysis, interspike intervals (ISI) and coefficient of variation of ISI were performed. ANOVA and Student t-test were employed to compare neuronal firing in globus pallidus internus between two patient groups. One hundred and eight neurons were identified from PD patients, including 19.4% tremor-related neuronal activity, 55.6% neurons with tonic firing and 25.0% neurons with irregular discharge. Further analysis revealed that neurons with tonic firing had a mean firing rate of (103.7 +/- 25.5) Hz; neurons with irregular discharge had a mean firing rate of (63.4 +/- 16.1) Hz. Forty-five neurons were identified from patients with dystonia, including 37.8% neurons with tonic firing and 62.2% neurons with irregular discharge. Further analysis showed that neurons with tonic firing had a mean firing rate of (50.2 +/- 19.1) Hz; neurons with irregular discharge had a mean firing rate of (28.5 +/- 10.5) Hz. ANOVA showed that a significance of firing rate of tonic firing and irregular discharge in globus pallidus internus was reached between two patient groups (P < 0.001). The mean firing rate of two patterns of neuronal activity in PD were significantly higher than those in dystonia (Bonferroni test, both P < 0.05). The data support the current view that an increased neuronal firing rate in globus pallidus internus is associated with PD whereas a decreased neuronal firing rate is associated with dystonia.


The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia.
To survey the demographics, risk factors, microbiology, and outcomes for infectious keratitis in Asia. Prospective, nonrandomized clinical study. Thirteen study centers and 30 sub-centers recruited consecutive subjects over 12-18 months, and performed standardized data collection. A microbiological protocol standardized the processing and reporting of all isolates. Treatment of the infectious keratitis was decided by the managing ophthalmologist. Subjects were observed for up to 6 months. Main outcome measures were final visual acuity and the need for surgery during infection. A total of 6626 eyes of 6563 subjects were studied. The majority of subjects were male (n = 3992). Trauma (n = 2279, 34.7%) and contact lens wear (n = 704, 10.7%) were the commonest risk factors. Overall, bacterial keratitis was diagnosed in 2521 eyes (38.0%) and fungal keratitis in 2166 eyes (32.7%). Of the 2831 microorganisms isolated, the most common were Fusarium species (n = 518, 18.3%), Pseudomonas aeruginosa (n = 302, 10.7%), and Aspergillus flavus (n = 236, 8.3%). Cornea transplantation was performed in 628 eyes to manage ongoing infection, but 289 grafts (46%) had failed by the end of the study. Moderate visual impairment (Snellen vision less than 20/60) was documented in 3478 eyes (53.6%). Demographic and risk factors for infection vary by country, but infections occur predominantly in male subjects and are frequently related to trauma. Overall, a similar percentage of bacterial and fungal infections were diagnosed in this study. Visual recovery after infectious keratitis is guarded, and corneal transplantation for active infection is associated with a high failure rate.


The role of standards in the development and implementation of clinical laboratory tests: a domestic and global perspective.
In the field of clinical laboratory medicine, standardization is aimed at increasing the trueness and reliability of measured values. Standardization relies on the use of written standards, reference measurement procedures and reference materials. These are important tools for the design and validation of new tests, and for establishing the metrological traceability of diagnostic assays. Their use supports the translation of research technologies into new diagnostic assays and leads to more rapid advances in science and medicine, as well as improvements in the quality of patient care. The various standardization tools are described, as are the procedures by which written standards, reference procedures and reference materials are developed. Recent efforts to develop standards for use in the field of molecular diagnostics are discussed. The recognition of standardization tools by the FDA and other regulatory authorities is noted as evidence of their important role in ensuring the safety and performance of in vitro diagnostic devices.