GDF11/BMP11 as a novel tumor marker for liver cancer.
Growth differentiation factor 11 (GDF11), also known as bone morphogenetic protein 11, a member of the transforming growth factor-β superfamily, has been reported to be involved in colorectal cancer. However, the roles of GDF11 in Chinese patients with liver cancer and the underlying mechanisms have remained elusive. The present study assessed the expression of GDF11 in 10 paired samples of cancerous and normal tissues from Chinese liver cancer patients. The results indicated that the expression of GDF11 was significantly lower in cancerous tissues than in normal tissues. In vitro, the expression of GDF11 was reduced in a panel of liver cancer cell lines compared with that in a normal liver cell line at the mRNA and protein level. Treatment with GDF11 reduced the viability of HepG2 for up to 72 h and GDF11 treatment reduced the viability of SMMC-7721 after 48 and 72 h. Furthermore, GDF11 activated Smad2/3 signaling in HepG2 cells. In conclusion, GDF11 has a tumor suppressor role in liver cancer, exerts its effects through Smad2/3 signaling and may serve as a novel tumor marker in liver cancer diagnosis.


Transforming information for computer-aided instruction: using a Socratic Dialogue method to teach gross anatomy.
Traditional teaching of anatomy can be a difficult process of rote memorization. Computers allow information presentation to be much more dynamic, and interactive; the same information can be presented in multiple organizations. Using this idea, we have implemented a new pedagogy for computer-assisted instruction in The Anatomy Lesson, an interactive digital teacher which uses a "Socratic Dialogue" metaphor, as well as a textbook-like approach, to facilitate conceptual learning in anatomy.


Computer anxiety in nursing: an investigation from Turkish nurses.
The purpose of this study was to determine and analyze levels of computer anxiety in nurses at a public university hospital in Turkey. This study investigated the dimensions of computer anxiety in terms of computer literacy, self-efficacy, physical arousal, affective feelings, positive beliefs, and negative beliefs. Moreover in this study it was aimed to analyze relationships among computer anxiety and some characteristics of nurses (age, gender etc.). This study based on Beckers and Schmidt's computer anxiety model. The Beckers and Schmidt's Computer Anxiety Scale (BSCAS) was used for data collection. BSCAS comprises six factors: computer literacy, self-efficacy, physical arousal in the presence of computers, affective feelings towards computers, positive beliefs, and negative beliefs. At the end of the data collection period, 175 nurses were received from the population. The response rate was 43.75%. This study showed that a majority of nurses had medium levels of computer anxiety. Overall computer anxiety means score was 12.11±1.72. Computer anxiety has significant relationship with age (r=-.153; p<.05), personal computer ownership (r=.171; p<.05). The highest correlation was between overall computer anxiety and self efficacy (r=-.859), the lowest correlation was between overall computer and negative beliefs (r=-.653). Multiple regression analysis revealed that computer anxiety of nurses was predicted significantly by self efficacy, affective feelings, physical arousal, computer literacy, positive beliefs, and negative beliefs, respectively.


[Psychiatry and narration].
In this presentation we will develop some ideas about possible relationships between literary narratives and psychiatry. To carry out this task we will analyze the work of some authors (Vila Matas, Guerriero, Kleinman, Franzen and others) in order to share a reflection on the current situation of psychiatry and medicine.


Cu-catalyzed controllable C-H mono-/di-/triarylations of imidazolium salts for ionic functional materials.
Herein the Cu-catalyzed direct C-H mono-, di- and triarylations of imidazolium salts with aryl iodides/bromides are accomplished for the first time. The unprecedented alkenylation and alkynylation are also realized using alkenyl and alkynyl iodides, respectively. Moreover, triarylated imidazolium salts with different substituents can be accessed in a modular and one-pot manner. This protocol provides an efficient tool for the assembly of diverse imidazolium-based ionic functional materials. As applicable examples, an electrochromic bisbenzimidazolium salt 7 and a photochromic triarylimidazolium salt 8 are easily obtained.


The Effects of Time Restricted Feeding on Overweight, Older Adults: A Pilot Study.
A growing body of evidence indicates that time restricted feeding (TRF), a popular form of intermittent fasting, can activate similar biological pathways as caloric restriction, the only intervention consistently found to extend healthy lifespan in a variety of species. Thus, TRF may have the potential to also improve function in older adults. Given the challenges many individuals have in following calorie restriction regimens over long-time periods, evaluation of alternative approaches that may produce weight loss and improve function in overweight, older adults is important. Ten overweight, sedentary older adults (≥65 years) at risk for, or with mobility impairments, defined by slow gait speed (<1.0 m/s) participated in this trial. All participants received the intervention and were instructed to fast for approximately 16 h per day over the entire four-week intervention. Outcomes included changes in body weight, waist circumference, cognitive and physical function, health-related quality of life, and adverse events. Adherence levels were high (mean = 84%) based on days goal was met, and mean weight loss was 2.6 kg (p < 0.01). Since body composition was not measured in this study, it is unclear if the observed weight loss was due to loss of fat mass, muscle mass, or the combination of fat and muscle mass. There were no significant changes in other outcomes; however, there were clinically meaningful changes in walking speed and improvements in quality of life, with few reported adverse events. The findings of this pilot study suggest that time restricted feeding is an acceptable and feasible eating pattern for overweight, sedentary older adults to follow.


Evaluating the Platelet Distribution Width-to-Plateletcrit Ratio as a Prognostic Marker for Patients With Breast Cancer.
This study aimed to evaluate plateletcrit (PCT) and platelet distribution width-to-PCT ratio (PDW/PCT) as potential prognostic biomarkers in patients with breast cancer. Information of 337 patients was retrospectively reviewed. The Cox regression proportional hazards model was used to evaluate the prognostic value of PCT and PDW/PCT compared to the platelet distribution width-to-platelet count ratio (PDW/P) and red cell distribution width-to-platelet count ratio (RDW/P). Large tumor size (p<0.01), lymph node involvement, and increased PDW/P, RDW/P, and PDW/PCT (p<0.05) were significantly associated with inferior disease-free survival (DFS) according to the univariate analysis. The multivariate analysis showed that large tumor size (p<0.01) and increased PDW/PCT (p<0.05) were significant prognostic factors for poor DFS. To our knowledge, this is the first report to show that PDW/PCT is a significant prognostic factor for patients with breast cancer. Therefore, it might be an attractive biomarker providing additional prognostic information for these patients.


Outcome of iatrogenic choroidal neovascularisation in sickle cell disease.
Choroidal neovascularisation developed in 62/66 (94%) eyes followed up for a mean period of 11.2 years after treatment with xenon arc feeder vessel coagulation for proliferative sickle retinopathy (PSR). In 27 eyes the neovascularisation was chorioretinal alone and in 35 eyes choriovitreal. Chorioretinal neovascularisation (CRN) was a benign complication but may convert to choriovitreal neovascularisation (CVN). Late sequelae of CVN included vitreous haemorrhage, posterior vitreous face fibrosis, and tractional retinal detachment. Visual loss (of greater than or equal to 3 Snellen lines for greater than or equal to 3 months) occurred in nine eyes affected by choroidal neovascularisation, though because of other pathology this could not always be attributed to the choroidal neovascularisation. The incidence of visual loss in CVN affected eyes was significantly greater, by survival curve analysis, than in eyes affected by CRN alone. Permanent visual loss from tractional retinal detachment definitely attributable to CVN occurred in 2/35 (6%) eyes.


Systematic Review and Meta-Analysis on the Incidence of Level-Specific Cervical Nodal Metastasis in Primary Parotid Malignancies.
In primary parotid gland malignancies, the incidence of level-specific cervical lymph node metastasis in clinically node-positive necks remains unclear. This study aimed to determine the incidence of level-specific cervical node metastasis in clinically node-negative (cN0) and node-positive (cN+) patients who presented with primary parotid malignancies. Electronic databases (MEDLINE, EMBASE, PubMed, Cochrane). Random-effects meta-analysis was used to calculate pooled estimate incidence of level-specific nodal metastasis for parotid malignancies with 95% confidence intervals (CIs). Subgroup analyses of cN0 and cN+ were performed. Thirteen publications consisting of 818 patients were included. The overall incidence of cervical nodal involvement in all neck dissections was 47% (95% CI, 31%-63%). Among those who were cN+, the incidence of nodal positivity was 89% (95% CI, 75%-98%). Those who were cN0 had an incidence of 32% (95% CI, 14%-53%). In cN+ patients, the incidence of nodal metastasis was high at all levels (level I 33%, level II 73%, level III 48%, level IV 39%, and level V 37%). In cN0 patients, the incidence of nodal metastasis was highest at levels II (28%) and III (11%). For primary parotid malignancies, the incidence of occult metastases was 32% compared to 89% in a clinically positive neck. It is recommended that individuals with a primary parotid malignancy requiring elective treatment of the neck have a selective neck dissection which involves levels II to III, with the inclusion of level IV based on clinical judgment. Those undergoing a therapeutic neck dissection should undergo a comprehensive neck dissection (levels I-V).


Overview of Piezoelectric Biosensors, Immunosensors and DNA Sensors and Their Applications.
Piezoelectric biosensors are a group of analytical devices working on a principle of affinity interaction recording. A piezoelectric platform or piezoelectric crystal is a sensor part working on the principle of oscillations change due to a mass bound on the piezoelectric crystal surface. In this review, biosensors having their surface modified with an antibody or antigen, with a molecularly imprinted polymer, with genetic information like single stranded DNA, and biosensors with bound receptors of organic of biochemical origin, are presented and discussed. The mentioned recognition parts are frequently combined with use of nanoparticles and applications in this way are also introduced. An overview of the current literature is given and the methods presented are commented upon.


Fast and precise collision detection for detailed and complex physiological structures.
Virtual reality has been proved indispensable in computer-assisted surgery, especially for surgical planning, and simulation systems. Collision detection is an essential part of surgery simulators and its accuracy and computational efficiency play a decisive role in the fidelity of simulations. Nevertheless, current collision detection methods in surgical simulation and planning struggle to meet precise requirements, especially for detailed and complex physiological structures. To address this, the primary objective of this study was to develop a new algorithm that enables fast and precise collision detection to facilitate the improvement of the realism of virtual reality surgical procedures. The method consists of two main parts, bounding spheres formation and two-level collision detection. A specified surface subdivision method is devised to reduce the radius of basic bounding spheres formed by circumcenters of underlying triangles. The spheres are then clustered and adjusted to obtain a compact personalized hierarchy whose position is updated in real time during surgical simulation, followed by two-level collision detection. Triangular facets with collision potential through interaction between hierarchies and then accurate results are obtained by means of precise detection phase. The effectiveness of the algorithm was evaluated in various models and surgical scenarios and was compared with prior relevant implementations. Results on multiple models demonstrated that the method can generate a personalized hierarchy with fewer and smaller bounding spheres for tight wrapping. Simulation experiments proved that the proposed approach is significantly superior to comparable methods under the premise of error-free detection, even for severe model-model collision. The algorithm proposed through this study enables higher numerical efficiency and detection accuracy, which is capable of significantly enlarging the fidelity/realism of haptic simulators and surgical planning methods.


Functional recovery in hemiparkinsonian primates transplanted with polymer-encapsulated PC12 cells.
Cross-species neural grafting of cell lines immunoisolated by a permselective polymer membrane represents a promising source of neuroactive molecules for the treatment of neurodegenerative diseases. Utilization of a cell line of xenogeneic origin is advantageous since the transplanted cells will be rejected by the host immune system in case of breakage of the immunoisolating envelope. Polymer-encapsulated PC12 cells, a dopaminergic cell line derived from a rat pheochromocytoma, were transplanted in five Macaca fascicularis monkeys which had been previously rendered hemiparkinsonian by a unilateral carotid injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Well-preserved, tyrosine hydroxylase positive encapsulated PC12 cells were observed in the lesioned striatum for up to 5 months after implantation. Four out of five monkeys which received polymer-encapsulated PC12 cells showed significant behavioral improvement, whereas three monkeys implanted with either encapsulated bovine chromaffin cells or empty polymer envelopes showed no amelioration.


Functional Connectivity Changes in Multiple-Frequency Bands in Acute Basal Ganglia Ischemic Stroke Patients: A Machine Learning Approach.
Several functional magnetic resonance imaging (fMRI) studies have investigated the resting-state functional connectivity (rs-FC) changes in the primary motor cortex (M1) in patients with acute basal ganglia ischemic stroke (BGIS). However, the frequency-specific FC changes of M1 in acute BGIS patients are still unclear. Our study was aimed at exploring the altered FC of M1 in three frequency bands and the potential features as biomarkers for the identification by using a support vector machine (SVM). We included 28 acute BGIS patients and 42 healthy controls (HCs). Seed-based FC of two regions of interest (ROI, bilateral M1s) were calculated in conventional, slow-5, and slow-4 frequency bands. The abnormal voxel-wise FC values were defined as the features for SVM in different frequency bands. In the ipsilesional M1, the acute BGIS patients exhibited decreased FC with the right lingual gyrus in the conventional and slow-4 frequency band. Besides, the acute BGIS patients showed increased FC with the right medial superior frontal gyrus (SFGmed) in the conventional and slow-5 frequency band and decreased FC with the left lingual gyrus in the slow-5 frequency band. In the contralesional M1, the BGIS patients showed lower FC with the right SFGmed in the conventional frequency band. The higher FC values with the right lingual gyrus and left SFGmed were detected in the slow-4 frequency band. In the slow-5 frequency band, the BGIS patients showed decreased FC with the left calcarine sulcus. SVM results showed that the combined features (slow-4+slow-5) had the highest accuracy in classification prediction of acute BGIS patients, with an area under curve (AUC) of 0.86. Acute BGIS patients had frequency-specific alterations in FC; SVM is a promising method for exploring these frequency-dependent FC alterations. The abnormal brain regions might be potential targets for future researchers in the rehabilitation and treatment of stroke patients.


[Cholesterol granuloma of the orbits--clinicopathologic study].
Unilateral exophthalmos was caused by a cholesterol granuloma in a 42-year-old patient. The clinical picture, roentgenographic and NMR tomographic changes, surgical therapy and histopathological results are described and discussed with regard to the etiology and differential diagnosis of this disease.


Pathogenesis of early nephritis in lupus prone mice with a genetic accelerating (lpr) factor.
We investigated the relative roles of B cell activity, circulating immune complexes, complement concentration and kinetics of disappearance and uptake of immune complexes from the circulation in the pathogenesis of early nephritis of MRL/lpr mice. In comparison to data in control (C57BL/6J) mice, B cell activity was enhanced and the concentration of autoantibodies and endogenous immune complexes in plasma were increased, whereas complement (C3) concentration was not significantly different in MRL/lpr mice. The kinetics of disappearance of radiolabeled immune complexes from the circulation were similar in MRL/lpr and control mice, whereas uptake of radiolabeled immune complexes by the liver was decreased in MRL/lpr mice. Features of polyclonal B cell activation and impaired mononuclear phagocyte function are early events that may set the stage for progressive systemic involvement in MRL/lpr mice.


Aloperine activates the Nrf2-ARE pathway when ameliorating early brain injury in a subarachnoid hemorrhage model.
Aloperine (ALO) exhibits neuroprotective effects against oxidative stress in vitro; however, its protective effect in early brain injury (EBI) following experimental subarachnoid hemorrhage (SAH) remains to be elucidated. The aim of the current study was to evaluate the antioxidant activity of ALO in EBI, and its association with nuclear factor erythroid-related factor 2 and the antioxidant responsive element (Nrf2-ARE) survival pathway. In the present study, an experimental SAH model was induced in rats following a prechiasmatic cistern injection. All rats were randomly divided into five groups: Sham, SAH, SAH+ vehicle, and an SAH+ ALO group (including low and high doses). ALO was administrated intraperitoneally at 2 and 24 h following induction of the SAH model. Brain samples were collected from each group at 48 h after SAH induction. Subsequently, western blotting, immunohistochemistry and cell apoptosis assays were performed, along with assessments for brain edema, neurological deficit, and the activity of oxidant/antioxidant factors. It was observed that the expression of Nrf2-ARE pathway-associated agents, including Nrf2, and heme oxygenase-1, were markedly increased in the high concentration ALO group compared with that of the SAH group. In addition, the level of oxidative damage was reduced. Furthermore, early brain damage, including brain edema, neurological deficit and cellular apoptosis were significantly ameliorated. In conclusion, the results of the present study indicate that ALO can ameliorate oxidative damage against EBI following SAH, most likely via the Nrf2-ARE survival pathway.


Reliability and validity of the Nurse Practitioners' Roles and Competencies Scale.
The objective of this study was to test the reliability and construct validity of the Nurse Practitioners' Roles and Competencies Scale. The role of nurse practitioners has attracted international attention. The advanced nursing role played by nurse practitioners varies with national conditions and medical environments. To date, no suitable measurement tool has been available for assessing the roles and competencies of nurse practitioners in Asian countries. Secondary analysis of data from three studies related to nurse practitioners' role competencies. We analysed data from 563 valid questionnaires completed in three studies to identify the factor structure of the Nurse Practitioners' Roles and Competencies Scale. To this end, we performed exploratory factor analysis using principal component analysis extraction with varimax orthogonal rotation. The internal consistency reliabilities of the overall scale and its subscales were examined using Cronbach's alpha coefficient. The scale had six factors: professionalism, direct care, clinical research, practical guidance, medical assistance, as well as leadership and reform. These factors explained 67·5% of the total variance in nurse practitioners' role competencies. Cronbach's alpha coefficient for the overall scale was 0·98, and those of its subscales ranged from 0·83-0·97. The internal consistency reliability and construct validity of the Nurse Practitioners' Roles and Competencies Scale were good. The high internal consistency reliabilities suggest item redundancy, which should be minimised by using item response theory to enhance the applicability of this questionnaire for future academic and clinical studies. The Nurse Practitioners' Roles and Competencies Scale can be used as a tool for assessing the roles and competencies of nurse practitioners in Taiwan. Our findings can also serve as a reference for other Asian countries to develop the nurse practitioner role.


Stereoselective synthesis of 3-oxygenated-cis-dialkyl-2,5-substituted tetrahydrofurans from cyclohexadienediols.
The 3-oxygenated-cis-dialkyl-2,5-substituted tetrahydrofuran system, present in several natural products, was prepared with good selectivity by acidic cyclization of 5-alkene-1,2,4-triol derivatives. The starting alkenol was obtained in few steps from a chiral cis-diol resulting from microbial oxidation of bromobenzene. The study of the cyclization allowed the rationalization of all experimental results by assuming a complete ionization at the allylic position and a model close to the one proposed by Labelle for homoallylic induction in five-membered ring closures.


Complexes of 5,5'-aminoacido-substituted 2,2'-bipyridyl ligands: control of diastereoselectivity with a pH switch and a chloride-responsive combinatorial library.
The synthesis and coordination chemistry of a new chiral ligand, 2,2'-bipyridine substituted at the 5 and 5' positions by N-methyl-L-valine methyl ester (5), is presented. The ligand readily forms complexes [M(5)3]2+ where M = Co(II) and Fe(II) in CH3CN, and the complexation reaction is slightly diastereoselective (d.e. =ca. 20%) in favour of the Delta diastereomer. The addition of six equivalents of HCl to these complexes [M(II)(5)3]2+ leads to formation of Delta-[M(II)(5H2)3]8+ with a d.e. of 100%. This high diastereoselectivity can be reversed by the addition of base i.e. the diastereoselectivity can be controlled by the pH. Delta-[Fe(5H2)3]8+ was found to bind chloride ions in CD3OD-CD3CN (6:1) with a binding constant of 260 M(-1). [Co(II)(5)3]2+ can be oxidised to Delta-[Co(III)(5H2)3]9+. Formation constants for both [Co(II)(5)3]2+ and [Co(II)(5H2)3]8+ in acetonitrile were obtained by spectrophotometric titrations. In the former case, the stability constant, log beta3 = 19.5(8), is very similar to that measured for [Co(II)(bipy)3]2+ (log beta3 = 19.3(7)) but this drops significantly when the amine groups of are protonated (log beta3 = 16.5(2)). A dynamic combinatorial library was prepared by mixing three equivalents of, three equivalents of bipy, and two equivalents of Co(II) in CD3CN. The presence of all possible Delta- and Lambda-[Co(II)(5)x(bipy)(3-x)]2+ complexes was inferred from 1H NMR and ES-MS spectra. Addition of protons to this library reduced the number of components by inducing diastereoselectivity, and presence of chloride further simplified the 1H NMR spectrum, indicating that [Cl2 ligand Delta-[Co(II)(5H2)3]]6+ and [Co(II)(bipy)3]2+ were the dominant products.


THE INFLUENCE OF POPULATION SIZE AND ISOLATION ON GENE FLOW BY POLLEN IN SILENE ALBA.
In a series of experiments conducted over two seasons, we used arrays of experimental populations to examine the effects of flower number and distance between patches on gene flow by pollen. For this study we used the dioecious, short-lived perennial plant Silene alba (Caryophyllaceae). This species lives in disturbed roadside and agricultural habitats and displays a weedy population dynamic with high colonization and extinction rates. The motivation for the study was to understand what factors may be influencing genetic connectedness among newly colonized populations within a regional metapopulation. By using experimental populations composed of genotypes homozygous at a diagnostic locus, it was possible to identify explicitly pollen movement into a focal patch as a function of flower number and distance to the nearest neighboring patch. Overall, the mean immigration rate (measured as the fraction of seeds sired by males outside the focal patch) at 20 m was just over 47%, whereas at 80 m immigration rates were less than 6%. In addition, by knowing the context in which each of these gene-flow events occurred, it was possible to understand some of the factors that influenced the exchange of genes. Both the number of flowers in the focal population (target) and in the neighboring populations (source) had a significant effect on the frequency of gene flow. Our experimental data also demonstrate that factors that influence gene flow at one spatial scale may not act in the same way at another. Specifically, the influence of target size and the relative size of the target and source patches on rates of gene flow depended on whether the patches were separated by 20 m or 80 m. These data suggest that the patterns of gene flow within a metapopulation system can be complex and may vary within a growing season.


Electrostatic Repulsion between Unique Arginine Residues Is Essential for the Efficient in Vitro Assembly of the Transmembrane Domain of a Trimeric Autotransporter.
Haemophilus influenzae adhesin (Hia) belongs to the trimeric autotransporter family and mediates the adherence of these bacteria to the epithelial cells of host organisms. Hia contains a passenger and a transmembrane domain. The transmembrane domain forms a 12-stranded β-barrel in which four strands are provided by each subunit. The β-barrel has a pore that is traversed by three α-helices. This domain has a unique arginine cluster, in which the side chains of the three arginine residues located at position 1077 (Arg1077) protrude into the pore of the β-barrel. This arrangement seems to be unfavorable for assembly, because of repulsion between the positive charges. In this study, we investigated the in vitro assembly of the Hia transmembrane minimum domain (mHiaTD) and found that the dissociated mHiaTD reassembled in detergent solution. To investigate the role of Arg1077 in trimer assembly, we generated mutant proteins in which Arg1077 was replaced with methionine or lysine. The reassembly kinetics of the mutants was compared with that of the wild-type protein. The methionine mutant showed misassembly, whereas the lysine mutant showed reversible assembly, similar to that observed for the wild-type protein. These results show that electrostatic repulsion between the positive charges of Arg1077 is important for preventing the formation of misassembled oligomers by the mHiaTD in vitro.


[Contemplations on responsibility for oral healthcare].
The academic dental education in The Netherlands has been extended to 6 years, among other reasons in order to make it possible for responsibility for oral healthcare to be borne in a wide medical context. It is the job of the 3 national dental schools to make this happen. The new dentist should know and recognize all (peri-)oral disorders and oral symptoms of systemic diseases, and he should be able to deliver oral healthcare to medically compromised patients. Accepting this responsibility is required for dentistry to be transformed into medical oral healthcare and for dentists to be upgraded to oral physicians.


Responses to affect subtypes differentially associate with anxious and depressive symptom severity.
Responses to affect include cognitive processes (i.e., perseverative vs. non-perseverative) and valence (i.e., modulation of positive vs. negative affect). However, little research has examined how the factor structure of responses to affect is defined along one or both of these dimensions. The present study conducted an exploratory factor analysis (EFA) of items from assessments of repetitive negative thinking, rumination on positive affect (PA), and dampening. We also examined the associations between emergent factors and measures of depressive symptoms, social anxiety symptoms, and non-social state anxiety. EFA results suggested a three-factor model of repetitive negative thinking, dampening, and rumination on PA. There was a significant association between repetitive negative thinking and dampening factors, but not between other factors. Repetitive negative thinking and dampening were associated with greater internalizing symptoms, whereas rumination on PA was associated with fewer internalizing symptoms. These findings clarify the structure of these responses to affect and their differential associations with symptoms, which may be used to tailor cognitive interventions for anxiety and/or depression.


Evaluation of prokinetic agents used in the treatment of gastroparesis.
Background/Aim: Hospitalizations due to gastroparesis have increased in the last 20 years with limited advancements in pharmacologic therapy. Although therapy primarily consists of prokinetic agents, little is known about their effects on hospital outcomes. The aim of our study was to determine whether common prokinetic therapies (metoclopramide and erythromycin) improve outcomes in gastroparesis patients. Methods: A retrospective review of adult patients admitted with a primary diagnosis of gastroparesis between 7 January 2011 and 7 January 2014 was conducted. Patients were divided into two groups based on whether they received prokinetic therapy (PRO) during hospitalization or not (NO). Groups were compared to determine length of stay (LOS), 30-day readmission rates, and risk factors affecting these outcomes. Results: Of the 82 patients included in our study, 57 received prokinetic therapy. Mean length of stay (LOS) was 5.8 ± 4.2 days, with a significantly shorter LOS in the NO group (3.7 ± 1.9 vs. 6.7 ± 4.5; p = 0.002). Among patients studied, 30.5% were readmitted within 30 days from discharge with no significant reduction in the PRO group (35.1% PRO vs. 20% NO; p =0.23). Patients with idiopathic gastroparesis had significantly longer LOS (6.9 ± 4.6 vs. 4.2 ± 2.8; p = 0.003). In the PRO group, those who received intravenous (IV) therapy had a significantly shorter LOS (4.9 ± 2.5 IV vs. 8.0 ± 5.3 oral; p = 0.01). Conclusions: Treatment of gastroparesis patients with prokinetic agents did not shorten the LOS nor decrease 30-day readmission rates. In those receiving prokinetics, the IV route was associated with reduced LOS.


IGK with conserved IGΚV/IGΚJ repertoire is expressed in acute myeloid leukemia and promotes leukemic cell migration.
We have previously reported that immunoglobulin heavy chain genes were expressed in myeloblasts and mature myeloid cells. In this study, we further demonstrated that rearranged Ig κ light chain was also frequently expressed in acute myeloid leukemia cell lines (6/6), primary myeloblasts from patients with acute myeloid leukemia (17/18), and mature monocytes (11/12) and neutrophils (3/12) from patients with non-hematopoietic neoplasms, but not or only rarely expressed in mature neutrophils (0/8) or monocytes (1/8) from healthy individuals. Interestingly, myeloblasts and mature monocytes/neutrophils shared several restricted IGKV and IGKJ gene usages but with different expression frequency. Surprisingly, almost all of the acute myeloid leukemia-derived IGKV showed somatic hypermutation; in contrast, mature myeloid cells-derived IGKV rarely had somatic hypermutation. More importantly, although IGK expression appeared not to affect cell proliferation, reduced IGK expression led to a decrease in cell migration in acute myeloid leukemia cell lines HL-60 and NB4, whereas increased IGK expression promoted their motility. In summary, IGK is expressed in myeloblasts and mature myeloid cells from patients with non-hematopoietic neoplasms, and is involved in cell migration. These results suggest that myeloid cells-derived IgK may have a role in leukemogenesis and may serve as a novel tumor marker for monitoring minimal residual disease and developing target therapy.


Contralesional macrostructural plasticity of the insular cortex in patients with glioma: A VBM study.
To assess the homotopic structural plasticity in case of unilateral damage of the insula. To detect changes in gray matter volumes of the contralesional insula from structural MRIs, we used voxel-based morphometry (VBM) in a sample of 84 patients with a diffuse low-grade glioma invading the left insula (insL group; n = 47) or the right insula (insR group; n = 37). The region of interest-based VBM analysis highlighted a large cluster of voxels with gray matter volume increase in the contralesional insula in both patient groups (k = 2,214 voxels for insL and k = 879 voxels for insR, p < 0.05, family-wise error corrected) compared with 24 age-matched healthy controls. Gray matter volume was increased for the entire insula (t 69 = 3.63, p = 0.0016 for insL; t 59 = 3.54, p = 0.0024 for insR, Bonferroni corrected), whereas no significant changes were found in 2 control regions for both patient groups. Furthermore, an increase of 24.6% and 31.6% in the gray matter volume was observed in the insula-related VBM cluster for insL and insR patients, respectively, compared with healthy controls (t 69 = 7.39, p = 2.59 × 10-10 and t 59 = 7.51, p = 3.61 × 10-10). The reported results demonstrate that slow-growing but massive lesion infiltration of the insula induces marked increase of gray matter volume in the contralateral one. Our findings give support for a homotopic reorganization that might be a physiologic basis for the high level of functional compensation observed in patients with glioma.


Swiss Blood Stem Cells: More than Just a Registry.
Swiss Transfusion SRC, division Swiss Blood Stem Cells (SBSC), is an important national organization for all matters relating to blood stem cells. Not only has its name changed several times over the years but also its role has developed steadily and today goes beyond registry alone. For example, on order of and in close collaboration with transplant doctors, the organization searches for suitable donors worldwide. Searching for unrelated donors for Swiss patients and organizing the deliveries of the transplant tissues for Swiss and foreign patients are the most time-consuming procedures at SBSC. Additionally, the organization pays special attention to the problem of donor follow-up. Here it has made important contributions to the field of data collection (minimal data set) and helped to strengthen international coordination. As of January 2011, the organization has a new structure, because it has joined forces with the SRC Blood Transfusion Service. The new organization will be called Swiss Transfusion SRC, but SBSC remains as a main operational unit of the new organization. In 2009, SBSC implemented a successful new strategy to increase the numbers of donors: donors can now register online. This step led to a remarkable increase of donor numbers from 2009 to 2010.


In Vitro Toxicity of Local Anesthetics and Corticosteroids on Chondrocyte and Synoviocyte Viability and Metabolism.
There is growing concern that intra-articular injection of local anesthetic and/or corticosteroids may cause significant morbidity, including potential toxicity to chondrocytes and synoviocytes, after even a single exposure. We demonstrate that full thickness canine chondral and synovial samples exposed to various local anesthetics and corticosteroids exhibit decreased loss of cell viability compared with prior in vitro studies using monolayer culture, due to the protective effects of intact extracellular matrix and cell heterogeneity. Full-thickness cartilage and synovial explants were obtained from canine cadavers and exposed in culture media to the following for 24 hours: 1% lidocaine, 0.5% lidocaine, 0.25% bupivacaine, 0.125% bupvacaine, 0.0625% bupivacaine, betamethasone acetate, methylprednisolone acetate, triamcinolone acetonide, or culture media only (control). Cell viability was determined on days 1 and 7 of culture using a microscopic live-dead and alamar blue metabolic assays. Complete loss of chondrocyte and synoviocyte viability was noted in the 1% and 0.5% lidocaine group, 0.25% and 0.125% bupivacaine group, betamethasone group, and methylprednisolone groups after 1 and 7 days of culture. Treatment with 0.0625% bupivacaine and triamcinolone demonstrated no decrease in cell viability or metabolism when compared to negative control. In this canine explant model, 1% and 0.5% lidocaine, 0.25% and 0.125% bupivacaine, betamethasone acetate, and methylpresdnisolone acetate were severely chondrotoxic and synoviotoxic after a single exposure, despite intact extracellular matrix. In contrast, chondrocytes and synoviocytes exposed to 0.0625% bupivacaine and triamcinolone remained viable after treatment. Further in vivo study is needed before definitive recommendations can be made.


The Expression and Functional Significance of Runx2 in Hepatocellular Carcinoma: Its Role in Vasculogenic Mimicry and Epithelial-Mesenchymal Transition.
The transcription factor Runx2 has been reported to promote epithelial-mesenchymal transition (EMT) in many tumors. Vasculogenic mimicry (VM) is described as the mimicry of endothelial cells by tumor cells to form microvascular tubes in aggressive tumors. Galectin-3 has been reported to regulate cell invasion, migration, and VM formation; it could be regulated by Runx2. However, the relationship between Runx2, Galectin-3, EMT, and VM has not been studied in hepatocellular carcinoma (HCC). We examined Runx2 expression in 89 human HCC samples and found Runx2 expression was associated with VM. Clinical-pathological data analysis revealed that Runx2 expression was associated with a shorter survival period. Overexpression of Runx2 promoted EMT and enhanced cell migration, invasion, and VM formation in HepG2 cells. Conversely, the downregulation of Runx2 inhibited EMT and reduced cell invasion, migration, and VM formation in SMMC7721. Galectin-3 expression declined following the downregulation of Runx2 in HepG2 cells, and increased in SMMC7721 cells after Runx2 knockdown. We consistently demonstrated that the downregulation of LGALS3 in HepG2-Runx2 cells reduced cell migration; invasion and VM formation; while upregulation of LGALS3 in SMMC7721-shRunx2 cells enhanced cell migration, invasion, and VM formation. The results indicate that Runx2 could promote EMT and VM formation in HCC and Galectin-3 might have some function in this process.


Effect of interlamellar interactions on shear induced multilamellar vesicle formation.
Shear-induced multilamellar vesicle (MLV) formation has been studied by coupling the small-angle neutron scattering (SANS) technique with neutron spin echo (NSE) spectroscopy. A 10% mass fraction of the nonionic surfactant pentaethylene glycol dodecyl ether (C12E5) in water was selected as a model system for studying weak inter-lamellar interactions. These interactions are controlled either by adding an anionic surfactant, sodium dodecyl sulfate, or an antagonistic salt, rubidium tetraphenylborate. Increasing the charge density in the bilayer induces an enhanced ordering of the lamellar structure. The charge density dependence of the membrane bending modulus was determined by NSE and showed an increasing trend with charge. This behavior is well explained by a classical theoretical model. By considering the Caillé parameters calculated from the SANS data, the layer compressibility modulus B¯ is estimated and the nature of the dominant inter-lamellar interaction is determined. Shear flow induces MLV formation around a shear rate of 10 s-1, when a small amount of charge is included in the membrane. The flow-induced layer undulations are in-phase between neighboring layers when the inter-lamellar interaction is sufficiently strong. Under these conditions, MLV formation can occur without significantly changing the inter-lamellar spacing. On the other hand, in the case of weak inter-lamellar interactions, the flow-induced undulations are not in-phase, and greater steric repulsion leads to an increase in the inter-lamellar spacing with shear rate. In this case, MLV formation occurs as the amplitude of the undulations gets larger and the steric interaction leads to in-phase undulations between neighboring membranes.


[Results of using botulism toxin in the treatment of spasmodic dysphonia].
Spasmodic Dysphonia (SD) is a dystonia involving laryngeal musculature thus causing a characteristic voice disorder. Two main types of SD have been described. The adductor type is the commonest and it is characterized by a strain-strangle, choked voice. The abductor type can be distinguished from the previous one by episodes of a blown and whispering voice, interrupting speech. Botulism toxin (BTX) has demonstrated to be the most effective treatment for this condition. Thirty patients diagnosed of SD (twenty-nine adductor type/one abductor type) were included. Their degree of dysphonia was evaluated using both functional and visual-analogue scales. They were treated with BTX vocal cord injections using a percutaneous technique under EMG guidance. Improvements up to a 100% of the normal vocal function were obtained, with an average of 82% in the adductor type. The adverse effects were mild and transient. Hypophonia affected 61.3% of patients lasting an average of 11.3 days. Dysphagia was reported in 44.1% of cases lasting an average of 5.8 days.


Blood pressure lowering and life expectancy based on a Markov model of cardiovascular events.
The life expectancy benefits of antihypertensive treatment, based on both systolic and diastolic blood pressure reduction, was estimated with a cardiovascular disease event Markov model with prospective data from 57 573 men and women. Seven patient states were defined, including (1) no cardiovascular disease, (2) stroke, (3) myocardial infarction, (4) revascularization, (5) history of cardiovascular disease, (6) noncardiovascular disease death, and (7) cardiovascular death. Risk functions were developed from gender-specific multivariate Cox proportional hazards models for primary events and age-, smoking-, and diabetes-adjusted models for secondary events. At baseline we assumed (1) hypothetical pretreatment blood pressures of 160/95 or 150/90 mm Hg; (2) strategies A and B lower blood pressure by 20/13 and 13/8 mm Hg, respectively; and (3) baseline age of 35 years. For subjects initially at 160/95 mm Hg, those with antihypertensive treatment, antihypertensive treatment and diabetes, or antihypertensive treatment, diabetes, and currently smoking had corresponding gains in life expectancy of 2.43, 2.80, and 2.43 years for Strategy A. An initial blood pressure of 150/90 mm Hg resulted in similar gains. Compared with Strategy B, with blood pressure reductions of 13/8 mm Hg, Strategy A provided additional gains in life expectancy of 0.84, 0.99, and 0.87 years for those with antihypertensive treatment, antihypertensive treatment and diabetes, or antihypertensive treatment, diabetes, and currently smoking. The initial blood pressure level did not affect the magnitude of life expectancy gains for equivalent blood pressure reductions. Greater gains in life expectancy among hypertensive and diabetic women suggest that blood pressure lowering may yield greater benefits in selected subgroups.


The interdental space.
There is a close relationship between the contact, contour, and shape of the teeth that creates the interproximal space with the help of the interdental gingiva. The interdental gingiva, composed of the facial and lingual papillae and the col, is a unique area anatomically and histologically. The high incidence of caries and periodontal disease in the interproximal area is partially the result of this histologic and anatomic make-up and the great accumulation of bacterial plaque. In restorative dentistry, it is important to recreate an interproximal area that will minimize a long facial-lingual col area, provide adequate space for interdental gingiva, minimize food impaction and retention, and allow for ease in plaque removal by the patient.


A pilot and feasibility study to assess children's consumption in quick-service restaurants using plate waste methodology.
Children regularly consume foods from quick-service restaurants (QSR), but little is known about the foods that children order, the calories and nutrients consumed, the accuracy of stated calorie information, or the ability to assess food orders and consumption in QSRs. This study evaluated the feasibility of plate waste collection in QSRs and examined children's orders and consumption of meals from the standard and children's menus. Additional aims were to examine if the meals ordered met healthier standards for children's menu items and determine the accuracy of the QSR-stated energy content of foods. Fifteen QSRs, two malls, and 116 eligible parents were approached to participate in the study in 2015. Among the families recruited, children's meal orders and consumption were analyzed using plate waste methodology, and a subsample of foods was analyzed using bomb calorimetry in 2015. Two individual QSRs and one mall food court with two QSRs agreed to participate, and n = 50 participants (parents with children between the ages of 5-10 years) were recruited. Children consumed on average 519 calories, 5.7 g saturated fat, 957 mg sodium, 3.7 g fiber, and 22.7 g sugar. Children ordered and consumed significantly fewer calories and less sodium and sugar with meals ordered exclusively from the children's menu compared with the standard menu. Overall there were no significant differences between the measured and stated energy contents of the QSR foods. Conducting plate waste research in QSRs is feasible and there is concordance with stated calorie information. Consuming foods exclusively from the children's menu may help limit overconsumption in QSRs.


[Application of near infrared sensor to the technology of automobile transformation].
Using reflective near infrared sensor and voice record-reproducing assembly, the present article studies the voice anticollision-prompting device for backing an automobile. If there is a man or an object within a certain distance behind the backing automobile, part of the infrared signal will be reflected by the man or the object, and received by the photosensitive tube installed with a transmitting tube, and transformed to a similar frequency electric signal. The electric signal will be amplified, demodulated, and shaped by the circuit of module. After comparing and processing, the control signal will be output, which controls the work of voice record-reproducing assembly, and reminds the driver that there is a man or an object behind the backing automobile. With both the near infrared sensor and voice record-reproducing assembly being integrated, the distance-warning device has the advantages of low costs, simple wiring, strong anti-detonation ability, precise measuring, and working stability. It is suitable for being installed and used on the automobile.


In vivo diagnostics of early abiotic plant stress response via Raman spectroscopy.
Development of a phenotyping platform capable of noninvasive biochemical sensing could offer researchers, breeders, and producers a tool for precise response detection. In particular, the ability to measure plant stress in vivo responses is becoming increasingly important. In this work, a Raman spectroscopic technique is developed for high-throughput stress phenotyping of plants. We show the early (within 48 h) in vivo detection of plant stress responses. Coleus (Plectranthus scutellarioides) plants were subjected to four common abiotic stress conditions individually: high soil salinity, drought, chilling exposure, and light saturation. Plants were examined poststress induction in vivo, and changes in the concentration levels of the reactive oxygen-scavenging pigments were observed by Raman microscopic and remote spectroscopic systems. The molecular concentration changes were further validated by commonly accepted chemical extraction (destructive) methods. Raman spectroscopy also allows simultaneous interrogation of various pigments in plants. For example, we found a unique negative correlation in concentration levels of anthocyanins and carotenoids, which clearly indicates that plant stress response is fine-tuned to protect against stress-induced damages. This precision spectroscopic technique holds promise for the future development of high-throughput screening for plant phenotyping and the quantification of biologically or commercially relevant molecules, such as antioxidants and pigments.


Subdiffusion in a bounded domain with a partially absorbing-reflecting boundary.
The exit time of a subdiffusive process from a bounded domain with a partially absorbing/reflecting boundary is considered. The short-time and long-time behaviors of the exit time probability density are investigated by using a spectral decomposition on the basis of the Laplace operator eigenfunctions. Rotation-invariant domains are analyzed in depth in order to illustrate the use of theoretical formulas and to compare them to numerical simulations. The asymptotic results obtained are relevant for describing subdiffusion inside a living cell with a semipermeable membrane, in a chemical reactor filled with catalytic grains of finite reactivity, or in mineral or biological samples which are probed by nuclear magnetic resonance measurements subject to surface relaxation.


Internet of Medical Things (IoMT) and Reflective Belief Design-Based Big Data Analytics with Convolution Neural Network-Metaheuristic Optimization Procedure (CNN-MOP).
In recent times, the Internet of Medical Things (IoMT) is a new loomed technology, which has been deliberated as a promising technology designed for various and broadly connected networks. In an intelligent healthcare system, the framework of IoMT observes the health circumstances of the patients dynamically and responds to backings their needs, which helps detect the symptoms of critical rare body conditions based on the data collected. Metaheuristic algorithms have proven effective, robust, and efficient in deciphering real-world optimization, clustering, forecasting, classification, and other engineering problems. The emergence of extraordinary, very large-scale data being generated from various sources such as the web, sensors, and social media has led the world to the era of big data. Big data poses a new contest to metaheuristic algorithms. So, this research work presents the metaheuristic optimization algorithm for big data analysis in the IoMT using gravitational search optimization algorithm (GSOA) and reflective belief network with convolutional neural networks (DBN-CNNs). Here the data optimization has been carried out using GSOA for the collected input data. The input data were collected for the diabetes prediction with cardiac risk prediction based on the damage in blood vessels and cardiac nerves. Collected data have been classified to predict abnormal and normal diabetes range, and based on this range, the risk for a cardiac attack has been predicted using SVM. The performance analysis is made to reveal that GSOA-DBN_CNN performs well in predicting diseases. The simulation results illustrate that the GSOA-DBN_CNN model used for prediction improves accuracy, precision, recall, F1-score, and PSNR.


The moderating effect of social support on the relationship between physical health and suicidal thoughts among Chinese rural elderly: A nursing home sample.
Suicide rate is relatively high among Chinese rural elderly. While there has been some exciting work on reporting and preventing suicide among community-dwelling elderly, only a few published studies have addressed the issues of rural nursing homes in China. This study aimed to investigate the relationship among perceived social support, physical health, and suicidal thoughts of the elderly living in Chinese rural nursing homes. It also examined the moderating effects of social support on the path from physical health to suicidal thoughts of the rural institutional elderly in China. This study investigated 205 participants aged 60 years and above in Chinese rural nursing homes. Participants' suicidal thoughts, perceived social support, and physical health were assessed. This study conducted descriptive analysis, Student's t-test, and Pearson's chi-square test to test how physical health and social support predicted suicidal thoughts, as well as the moderating effects of family's, friends', and others' social support on physical health and suicidal thoughts. Both physical health and perceived social support were significantly related to suicidal thoughts. Perceived social support from family, friends, and significant others moderated the relationship between physical health and suicidal thoughts. Findings of this study suggested that increasing social support and improving physical health would be effective in both suicide prevention and intervention for the residents in Chinese rural nursing homes.


Self-healing stretchable wires for reconfigurable circuit wiring and 3D microfluidics.
This article describes the fabrication of self-healing stretchable wires formed by embedding liquid metal wires in microchannels composed of self-healing polymer. These stretchable wires can be completely severed with scissors and rapidly self-heal both mechanically and electrically at ambient conditions. By cutting the channels strategically, the pieces can be re-assembled in a different order to form complex microfluidic networks in 2D or 3D space.


An extrachromosomal form of the Mu transposons of maize.
Maize lines known as Robertson's Mutator (Mu) lines generate unstable recessive mutations at high frequencies. These lines carry actively transposing copies of the transposons (Tn) Mu1 and Mu1.7. TnMu1 and TnMu1.7 are approximately 1400 and 1700 base pairs long, respectively, and they have 210-base-pair terminal inverted repeats. We report here extrachromosomal forms of TnMu1 and TnMu1.7. The extrachromosomal Mu1 and Mu1.7 molecules are resistant to alkaline denaturation and to proteinase treatment and have circular restriction maps; therefore, they are probably covalently closed circular DNA. Further, we show that their occurrence is correlated with Mu activity, so they are probably generated during Mu transposition as transposition intermediates or as products of Mu excision. When the total extrachromosomal supercoiled DNA from immature male flowers of a Mu line was examined by electron microscopy, the Mu transposons appeared to constitute a significant fraction of the extrachromosomal DNA circles in Mu lines.


Social correlates of malnutrition among Filipino street children.
This study has sought to identify subgroups of street children at high risk for nutritional deficiency in metropolitan Manila in the Philippines. A sample of 150 street children ages six through 18 were weighed, measured, and interviewed to establish nutritional parameters and to explore the interrelationships of nutritional status with social conditions. Two variables showed the highest association with low weight for age: children using drugs and children not in school. These variables should be seen as indicative of a range of variation among Filipino street children, in whom those on drugs and not in school represent the sector at greatest risk and one to which nutritional programs should be targeted.


Deletion of transient receptor potential vanilloid type 1 receptors exaggerates renal damage in deoxycorticosterone acetate-salt hypertension.
To determine whether the transient receptor potential vanilloid type 1 (TRPV1) channel provides protection against hypertension-induced renal damage, hypertension was induced by uninephrectomy and by giving deoxycorticosterone acetate (DOCA)-salt in wild-type (WT) and TRPV1-null mutant (TRPV1-/-) mice. Mean arterial pressure, as determined by radiotelemetry, increased significantly and reached the peak 7 days after DOCA-salt treatment in both WT and TRPV1-/- mice. There was no difference in mean arterial pressure between the 2 strains at the baseline or at the peak that lasted for 4 treatment weeks. DOCA-salt treatment in both WT and TRPV1-/- mice led to increased urinary excretion of albumin and 8-isoprostane, glomerulosclerosis, renal cortical tubulointerstitial injury, tubulointerstitial fibrosis, increased number of tubular proliferating cell nuclear antigen-positive cells, and renal monocyte/macrophage infiltration, all of which were much more severe in DOCA-salt-treated TRPV1-/- compared with DOCA-salt-treated WT mice. Renal TRPV1 protein expression, but not the renal anandamide content, was elevated in DOCA-salt-treated WT compared with vehicle-treated WT mice. Renal anandamide levels were markedly elevated in DOCA-salt-treated TRPV1-/- but not in vehicle-treated TRPV1-/- mice. Thus, our data show that ablation of the TRPV1 gene exacerbates renal damage induced by DOCA-salt hypertension, indicating that TRPV1 may constitute a protective mechanism against end-organ damage induced by hypertension.


Role of bile acids and neutral sterols in carcinogenesis.
Epidemiological evidence regarding cancer causation suggests the existence of a strong link to diet-related lifestyles. Neutral sterols and bile acids constitute a group of metabolic endproducts known to have multiple interactions both from the standpoint of being influenced by diet as well as from the standpoint of their role in cellular and molecular processes relating to carcinogenesis. Epidemiological and experimental studies on the possible role of these steroid metabolites are reviewed.


[Changes in the tryptophan content in the body of layers under the effect of an environmental temperature-humidity regimen].
Experiments were carried out with a total of 60 layers of the White Plymouth Rock breed acclimatized to a temperature regime of 15 degrees C and a relative air humidity of 60 per cent and raised under zoohygiene conditions that met the requirements of the industrial technology for the production of eggs. The following temperature and moisture regimes of the air were tested in the course of seven days in a climatic chamber of the Zootron type: I--20 degrees C and 70 per cent; II--24 degrees C and 70 per cent; III--28 degrees C and 50 per cent; and IV--33 degrees C and 50 per cent. The birds of the control group were kept at 15 degrees C and 60-70 per cent relative air humidity. At the end of the first 24-hour period and the end of the seventh 24-hour period the birds were killed after a 12-hour starvation regime in order to determine the tryptophane content in the liver, blood serum, and heart muscle. It was found that under the Ist and IInd regime the amount of tryptophane in the organs studied was higher. The third and fourth regimes led to a dependable decrease in the content of tryptophane in these organs.


Evaluating the Impact of Patient No-Shows on Service Quality.
Patient no-shows are long-standing issues affecting resource utilization and posing risks to the quality of healthcare services. They also lead to loss of anticipated revenue, particularly in services where resources are expensive and in great demand. In order to address common reasons why patients miss appointments, this study reviews the current literature and investigates various tools and methods that have been implemented to mitigate such issues. Further, a case study is conducted to identify the rate of no-shows and underlying causes at a radiology department in one of the leading hospitals in the MENA region. Our results show that the no-shows are high due to multiple factors, such as patient behavior, patients' financial situation, environmental factors and scheduling policy. In conclusion, we generate a list of recommendations that can help in reducing the rate of patient no-shows, such as patient education, application of dynamic scheduling policies and effective appointment reminder systems to patients.


Evaluation of the Radiance FN soft tissue filler for facial soft tissue augmentation.
To evaluate the clinical efficacy and patient satisfaction of Radiance FN (fine needle) (BioForm Inc, Franksville, Wis), a highly biocompatible, calcium hydroxylapatite-based implant, when used for facial soft tissue augmentation. Ninety patients aged between 25 and 85 years underwent subdermal injection with Radiance FN. The primary areas treated were lips, nasolabial folds, glabellar rhytids, marionette lines, prejowl depressions, acne scars, and surgical soft tissue defects. Patients were surveyed after treatment and for up to 6 months for pain, ecchymosis, skin erythema, nodules, softness, appearance, and satisfaction. In terms of efficacy, at 6 months, appearance, softness, and overall patient satisfaction were rated good or excellent in 74%, 80%, and 88% of patients, respectively. Moderate or severe pain occurred with injection in 59% of patients but disappeared 2 to 5 minutes after injection. Erythema, edema, and ecchymosis were common immediately after treatment but resolved in all patients within 2 weeks. Seven patients had persistent visible mucosal lip nodules, 4 of whom required intervention. Radiance FN is highly effective and well tolerated when used for facial soft tissue augmentation. Additional experience with longer follow-up will help determine the most appropriate use and long-term safety for the implant.


Ischemic preconditioning provides both acute and delayed protection against renal ischemia and reperfusion injury in mice.
Acute as well as delayed ischemic preconditioning (IPC) provides protection against cardiac and neuronal ischemia reperfusion (IR) injury. This study determined whether delayed preconditioning occurs in the kidney and further elucidated the mechanisms of renal IPC in mice. Mice were subjected to IPC (four cycles of 5 min of ischemia and reperfusion) and then to 30 min of renal ischemia either 15 min (acute IPC) or 24 h (delayed IPC) later. Both acute and delayed renal IPC provided powerful protection against renal IR injury. Inhibition of Akt but not extracellular signal-regulated kinase phosphorylation prevented the protection that was afforded by acute IPC. Neither extracellular signal-regulated kinase nor Akt inhibition prevented protection that was afforded by delayed renal IPC. Pretreatment with an antioxidant, N-(2-mercaptopropionyl)-glycine, to scavenge free radicals prevented the protection that was provided by acute but not delayed renal IPC. Inhibition of protein kinase C or pertussis toxin-sensitive G-proteins attenuated protection from both acute and delayed renal IPC. Delayed renal IPC increased inducible nitric oxide synthase (iNOS) as well as heat-shock protein 27 synthesis, and the renal protective effects of delayed preconditioning were attenuated by a selective inhibitor of iNOS (l-N(6)[1-iminoethyl]lysine). Moreover, delayed IPC was not observed in iNOS knockout mice. Both acute and delayed IPC were independent of A(1) adenosine receptors (AR) as a selective A(1)AR antagonist failed to block preconditioning and acute and delayed preconditioning occurred in mice that lacked A(1)AR. Therefore, this study demonstrated that acute or delayed IPC provides renal protection against IR injury in mice but involves distinct signaling pathways.


Prevalence and Risk Factors of Anxiety in a Clinical Dutch Sample of Children with an Autism Spectrum Disorder.
Anxiety is highly prevalent in children with an autism spectrum disorder (ASD). However, there is inconsistency in studies investigating the prevalence and risk factors of anxiety in children with ASD. Therefore, the first aim of this study was to give an overview of the prevalence of anxiety symptoms in a clinical Dutch sample of children with ASD. The second aim was to investigate age, gender, ASD subtype, and IQ as potential risk factors for anxiety in this sample. In total, 172 children with ASD (age, 8-15 years) and their parents participated in this study. Specialized services in which children with ASD were recruited were two mental health institutes and one secondary special education school. The findings showed that more than 60% of the participating children with ASD had at least subclinical anxiety symptoms according to children. More than 80% of the children with ASD had at least subclinical anxiety symptoms according to parents. It was found that younger children and girls with ASD had more anxiety symptoms than older children and boys with ASD. Moreover, it was found that children with a higher performance (non-verbal) IQ and lower verbal IQ had more specific phobia symptoms. The findings suggest that in a clinical context, children with ASD have a high risk to have co-occurring anxiety symptoms, especially girls and younger children with ASD. Therefore, early prevention and treatment of anxiety in children with ASD who are most at risk is important.


3.0-T MRI of the supraspinatus tendon.
MRI of the shoulder has been found to be highly sensitive and specific for detection of full-thickness supraspinatus tendon tears at 1.5-T or lower field strength compared with arthroscopy. MRI of the shoulder at 3.0 T has not been specifically assessed. This study assesses the sensitivity and specificity of MRI at 3.0 T for supraspinatus tendon tears compared with arthroscopy. Two experienced musculoskeletal radiologists retrospectively reviewed MR images of the shoulder in 150 consecutive patients who had subsequent arthroscopy. All patients had oblique coronal and sagittal T1-weighted and fat-saturated T2-weighted axial, oblique coronal, and sagittal imaging performed. The radiologists interpreted the MR images by consensus without knowledge of the arthroscopy results. Scans were interpreted for full-thickness or partial-thickness supraspinatus tendon tears. If partial-thickness supraspinatus tendon tears were seen on MRI, the reviewers noted whether the partial-thickness tear was articular or bursal in location. The radiologists also separated the supraspinatus tendon tears into small (< 1 cm retraction from the humeral head) and large (> 1 cm retraction from the humeral head). All 150 patients went on to arthroscopy. After consensus review of the MR images, arthroscopy results were compared with consensus MR interpretations. Ninety-eight of the 150 patients had full-thickness supraspinatus tendon tears at arthroscopy. Twenty-six of the 150 patients had partial-thickness supraspinatus tendon tears. Seventeen of these 26 partial-thickness tears were along the articular surface and nine were along the bursal surface. Ninety-six of 98 full-thickness tears seen at arthroscopy were seen on consensus MRI interpretation. All 26 partial-thickness tears seen at arthroscopy were seen at consensus MR interpretation; however, two of the partial-thickness articular surface tears seen at arthroscopy were interpreted as full-thickness tears on consensus MRI interpretation. Twenty-eight of the 98 full-thickness supraspinatus tendon tears were small tears (< 1 cm retraction from the humeral head) on arthroscopy. Two of these 28 small tears seen on arthroscopy were not seen on consensus MRI interpretation. Twenty-six patients had intact supraspinatus tendons on both retrospective consensus MRI interpretation and at arthroscopy. MRI of the shoulder at 3.0 T is highly sensitive and specific compared with arthroscopy in the detection of full-thickness and partial-thickness supraspinatus tendon tears.


Does the pelleting process affect the nutritive value of a pre-starter diet for suckling piglets? Ex vivo studies on mineral absorption.
The effects of pelleting on the extent of the Maillard reaction (MR) and on calcium, magnesium and zinc solubility and absorption were analysed in a conventional pre-starter diet for suckling piglets. Development was tested measuring colour, absorbance (280/420 nm), fluorescence, residual free lysine, furosine, hydroxymethylfurfural (HMF) and furfural contents before and after pelleting. Fluorescence, absorbance and mineral solubility were also measured after in vitro digestion of diets. The effects on mineral absorption were tested using Caco-2 cells. MR indexes confirmed the development of the reaction during the pelleting of this particular diet compared with the meal diet. The CIE-Lab colour parameters showed a decrease in luminosity (L*) and progress of the colour to the red zone (a*) in the pelleted diet. A 36% decrease in free lysine content was observed. Significant correlations were observed between fluorescence intensity and furosine levels, HMF and furfural. The pelleting process did not modify calcium and magnesium solubility after in vitro digestion, but soluble zinc increased. The efficiency of calcium and zinc transport across Caco-2 cell monolayers was greater in the pelleted diet. Evidence of MR development is shown, resulting in various nutritional consequences. Optimisation of pelleting could result in a better formulation of diets for feedstuffs.


Concomitant Cerebral Venous Thrombosis and Intracranial Hemorrhages in Presentation of a Patient with Secondary Polycythemia: A Case Report.
BACKGROUND Cerebral ischemia and hemorrhages were reported to be the main complications of polycythemia vera (PV). The relationship between PV and increased risk of the cerebrovascular events has been established. Some patients with secondary polycythemia have thromboembolic events comparable to those of PV. However, secondary polycythemia that leads to cerebrovascular events is uncommon. CASE REPORT A 35-year-old man without any prior medical history presented with mild clinical acute ischemic stroke and polycythemia. The patient then showed worsening neurological deficits that were later attributed to the concurrent cerebral venous thrombosis, which led to malignant cerebral infarction with hemorrhagic transformation, and subarachnoid hemorrhage. His polycythemia appeared to be secondary to bacterial infection. The treatments for the secondary polycythemia were first phlebotomy and intravenous hydration, followed by intravenous broad-spectrum antibiotics. PV was excluded because the JAK2 V617F mutation was absent, the patient's peripheral blood smear suggested secondary polycythemia due to bacterial infection, and there were improvements in hemoglobin, erythrocyte count, and hematocrit after intravenous antibiotics. At the 1-month follow-up, he was moderately dependent, and hemoglobin, erythrocyte count, and hematocrit were within normal limits, without receiving any further phlebotomy or cytoreductive agents. CONCLUSIONS This case highlights the plausible causation of secondary polycythemia that could lead to concomitant cerebral thrombosis and hemorrhagic events. The diagnosis of cerebral venous thrombosis should be considered in a patient who presents with headache, focal neurological deficits, polycythemia, and normal head computed tomography scan.


Blood collection for biochemical analysis in adult zebrafish.
The zebrafish has been used as an animal model for studies of several human diseases. It can serve as a powerful preclinical platform for studies of molecular events and therapeutic strategies as well as for evaluating the physiological mechanisms of some pathologies. There are relatively few publications related to adult zebrafish physiology of organs and systems, which may lead researchers to infer that the basic techniques needed to allow the exploration of zebrafish systems are lacking. Hematologic biochemical values of zebrafish were first reported in 2003 by Murtha and colleagues who employed a blood collection technique first described by Jagadeeswaran and colleagues in 1999. Briefly, blood was collected via a micropipette tip through a lateral incision, approximately 0.3 cm in length, in the region of the dorsal aorta. Because of the minute dimensions involved, this is a high-precision technique requiring a highly skilled practitioner. The same technique was used by the same group in another publication in that same year. In 2010, Eames and colleagues assessed whole blood glucose levels in zebrafish. They gained access to the blood by performing decapitations with scissors and then inserting a heparinized microcapillary collection tube into the pectoral articulation. They mention difficulties with hemolysis that were solved with an appropriate storage temperature based on the work Kilpatrick et al. When attempting to use Jagadeeswaran's technique in our laboratory, we found that it was difficult to make the incision in precisely the right place as not to allow a significant amount of blood to be lost before collection could be started. Recently, Gupta et al. described how to dissect adult zebrafish organs, Kinkle et al. described how to perform intraperitoneal injections, and Pugach et al. described how to perform retro-orbital injections. However, more work is needed to more fully explore basic techniques for research in zebrafish. The small size of zebrafish presents challenges for researchers using it as an experimental model. Furthermore, given this smallness of scale, it is important that simple techniques are developed to enable researchers to explore the advantages of the zebrafish model.


Corticofugal modulation of peripheral auditory responses.
The auditory efferent system originates in the auditory cortex and projects to the medial geniculate body (MGB), inferior colliculus (IC), cochlear nucleus (CN) and superior olivary complex (SOC) reaching the cochlea through olivocochlear (OC) fibers. This unique neuronal network is organized in several afferent-efferent feedback loops including: the (i) colliculo-thalamic-cortico-collicular; (ii) cortico-(collicular)-OC; and (iii) cortico-(collicular)-CN pathways. Recent experiments demonstrate that blocking ongoing auditory-cortex activity with pharmacological and physical methods modulates the amplitude of cochlear potentials. In addition, auditory-cortex microstimulation independently modulates cochlear sensitivity and the strength of the OC reflex. In this mini-review, anatomical and physiological evidence supporting the presence of a functional efferent network from the auditory cortex to the cochlear receptor is presented. Special emphasis is given to the corticofugal effects on initial auditory processing, that is, on CN, auditory nerve and cochlear responses. A working model of three parallel pathways from the auditory cortex to the cochlea and auditory nerve is proposed.


The Lived Experience of Breast Cancer Patients during the COVID-19 Pandemic.
This article seeks to understand the impact of the COVID-19 pandemic on women currently undergoing treatment for breast cancer. As part of a mixed-methods study of 69 women who have or currently live with breast cancer, 27 participants opted into a Phase II semistructured interview to further discuss their experiences of emotional coping during the treatment process, beliefs about therapy, and the impact of COVID-19 on their emotional experience during treatment. Thematic narrative analysis was used to identify common themes. Participants shared about the unique stressors and impact of the COVID-19 pandemic during their treatment and how it complicated the already emotional experience of coping with cancer. Five identified themes include (1) logistical impact of COVID-19 and its effects on accessing medical care, (2) concerns related to accessing emotional support, (3) emotional reactions to battling breast cancer while living through a global pandemic, (4) ways in which loss was experienced, and (5) benefits to technology-based psychoeducation and social supports that were identified during the pandemic. COVID-19 had a significant impact on those currently in treatment for breast cancer including increasing fear, decreasing social support, and increased logistical challenges. Changes to psychotherapeutic treatment protocols to include technologically enhanced psychological support during treatment and digitally based psychoeducation curriculum are warranted.


Endoscopic retrograde cholangiopancreatography-related complications: risk stratification, prevention, and management.
Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient's clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.


Using graph convolutional network to characterize individuals with major depressive disorder across multiple imaging sites.
Establishing objective and quantitative neuroimaging biomarkers at individual level can assist in early and accurate diagnosis of major depressive disorder (MDD). However, most previous studies using machine learning to identify MDD were based on small sample size and did not account for the brain connectome that is associated with the pathophysiology of MDD. Here, we addressed these limitations by applying graph convolutional network (GCN) in a large multi-site MDD dataset. Resting-state functional MRI scans of 1586 participants (821 MDD vs. 765 controls) across 16 sites of Rest-meta-MDD consortium were collected. GCN model was trained with individual whole-brain functional network to identify MDD patients from controls, characterize the most salient regions contributing to classification, and explore the relationship between topological characteristics of salient regions and clinical measures. GCN achieved an accuracy of 81·5% (95%CI: 80·5-82·5%, AUC: 0·865), which was higher than other common machine learning classifiers. The most salient regions contributing to classification were primarily identified within the default mode, fronto-parietal, and cingulo-opercular networks. Nodal topologies of the left inferior parietal lobule and left dorsolateral prefrontal cortex were associated with depressive severity and illness duration, respectively. These findings based on a large, multi-site dataset support the feasibility and effectiveness of GCN in characterizing MDD, and also illustrate the potential utility of GCN for enhancing understanding of the neurobiology of MDD by detecting clinically-relevant disruption in functional network topology. This study was supported by the National Natural Science Foundation of China (Grant Nos. 81621003, 82027808, 81820108018).


Bypass vs. Endovascular Therapy of Infrapopliteal Lesions for Critical Limb Ischemia.
This study was conducted to determine whether to perform endovascular intervention or bypass surgery as a treatment option for critical limb ischemia (CLI) with lesions in the popliteal artery or below. A total of 150 patients (164 limbs) with CLI underwent endovascular intervention or bypass surgery for lesions in the popliteal artery or below at our department between May 1995 and June 2011. Therapeutic outcomes were examined by surgical technique. An indication for endovascular intervention was established with the combination of (1) poor general condition, and (2) a stenotic or occlusive lesion ≤5 cm. The bypass group (group B) comprised 119 patients (99 males, 20 females) with 131 affected limbs at 46 to 89 years of age (mean: 70 years). The endovascular intervention group (group E) comprised 31 patients (25 males, 6 females) with 33 affected limbs at 47 to 89 years of age (mean: 72 years). There was no significant difference in patient demography between the two groups. Regarding preoperative complications, hypertension was observed in 54% and 61% of the subjects in groups B and E, respectively, diabetes in 36% and 55%, renal dysfunction in 29% and 58%, ischemic heart disease in 27% and 32%, and cerebrovascular disorder in 18% and 23%; renal dysfunction accounted for a significantly higher percentage in group E. As for early postoperative complications, subjects in group B experienced wound infections (6 patients), hemorrhage (2), thrombosis (2), pneumonia (1), and another complication (1), and those in group E experienced wound infections (1) and another complication (1). The hospital mortality rate was 0.8% (1 patient) for group B and 0% for group E. The 3-year cumulative primary patency rate was 72% for group B and 54% for group E; the rate was significantly higher for group B. The 3-year secondary patency rate was 82% for group B and 60% for group E. The 3-year limb salvage rate was 86% for group B and 82% for group E; there was no significant difference between the two groups. The 5-year survival rate was 57% for group B and 42% for group E; the survival rate was significantly lower for group E. For the study population of CLI patients with lesions in the popliteal artery or below, the patency rate was higher for the bypass group than for the endovascular intervention group, whereas there was no difference in the limb salvage rate. Based on the findings in prognosis for survival, the indication for endovascular intervention at our department is believed to be appropriate. (English translation of Jpn J Vasc Surg 2013; 22: 715-718).


Determinants of 4-aminobiphenyl-DNA adducts in bladder cancer biopsies.
Exposure to 4-aminobiphenyl (4-ABP) is an important determinant of urinary bladder cancer in humans. We have analyzed by gas chromatography-mass spectrometry the DNA adducts of 4-ABP in 75 bladder cancer biopsies. The purpose was to understand whether smoking, N-acetyltransferase 2 (NAT2) polymorphism, diet or tumor grade were determinants of 4-ABP-DNA levels. 4-ABP-DNA adducts were above the detection limit of 0.1 fmol/microg DNA for 37/75 patients. Overall the level of adducts was 2.7 +/- 0.7 (mean +/- SE) fmol/microg DNA (86 +/- 22 adducts/10(8) normal nucleotides, mean +/- SE). A strong association with grade was observed. In the group of patients with detectable 4-ABP-DNA adducts the odds ratio for having a tumor grade of 2 or 3 was respectively 4.3 (95% CI 0.8-21.9) and 6 (1.3-27.5), compared with grade 1. A non-statistically significant association was found between adduct levels and the deduced slow acetylator phenotype in grades 2 and 3. The intake of fruit and vegetables produced a lower frequency of detectable adducts, though the association was not statistically significant. Detectable 4-ABP-DNA adducts were clearly associated with current smoking in higher tumor grades (grade 3 versus grades 1 + 2, odds ratios 10.4; 95% CI 1.7-63.1). Overall, our findings indicate that higher levels of DNA adducts characterize more invasive tumors (higher tumor grades). This seems to be facilitated by smoking and contrasted by the intake of fruit and vegetables.


A comparative review of use of sulphate and phosphate salts for colonoscopy preparations and their potential for nephrotoxicity.
Background and study aims Colonoscopy is a widely used diagnostic procedure which requires prior cleansing of the bowel. Many different bowel cleansing preparations have been developed, all of which have specific advantages and disadvantages. This review compares two low-volume high-osmolarity bowel cleansing preparations, oral phosphate salts and oral sulphate salts, with a particular focus on risk of nephrotoxicity. Patients and methods An electronic search of the Medline database was performed using the search terms "(phosphates OR sulfates) AND cathartics [MeSH Term] AND kidney" restricted to humans with a cut-off date of December 31, 2016. Results Introduction of oral phosphate salts offered the advantage of low intake volume and low risk of bowel irritation compared to previous options. However, phosphate salts have been associated with renal toxicity (acute phosphate nephropathy [APN]), thought to arise due to perturbations of calcium and phosphate homeostasis as a consequence of increases in serum phosphate. This results in high concentrations of calcium phosphate in the distal tubule and collecting ducts of the kidney, where it may precipitate. Although APN is rare, it may lead to permanent kidney damage. For this reason, phosphate salts are contraindicated in vulnerable patient groups. As an alternative to phosphate salts, oral sulphate salts have recently been introduced. Because sulphate absorption from the intestinal tract is saturable, serum sulphate concentrations increase only minimally after ingestion. Furthermore, excretion of sulphate in the kidney is not accompanied by calcium excretion and urine calcium levels are unchanged. For these theoretical reasons, use of sulphate salts as bowel cleansing solutions is not expected to lead to calcium precipitation in the nephron. Conclusions Oral phosphate salts are no longer recommended for routine use as bowel cleansing preparations as they carry significant risk of kidney damage and a safer alternative is available in the form of oral sulphate solutions. To date, use of sulphate salts has not been associated with elevations in serum creatinine or other markers of renal impairment, nor with clinical manifestations of kidney injury. Nonetheless, experience with sulphate salts in everyday practice is limited and physicians should be vigilant in detecting potential safety issues.


What is public health ethics for the geriatric community?
A growing ageing community puts additional demands on the public health system. This will contribute to ethical consequences for the health care sector. A public health ethics framework can contribute towards addressing the ethical challenges faced by the geriatric community. This article intends to contribute to a public health ethics framework for the geriatric community from a South African perspective. Twenty-two participants from six geriatric institutions, two each in the three provinces, participated in the research. The provinces are the Free State, Northern Cape and North West. Fifteen statements were rated using a five-point Likert scale questionnaire. The statements were grouped into three indexes, namely what is ethics, what is public health ethics and what is public health ethics for the geriatric community? Ethical behaviour is observable not only from person to person but also through systems, processes and practices. The need is to understand how to apply ethical principles to the working environment. A public health ethic can be understood from applied, professional and social ethics. Public health ethics is the application of health care principles through a professional ethic resulting in care and relationship-building. The core of what public health is should be the basis to identify a public health ethic where the focus is on the community and improvement of the quality of health and well-being of the community. No evidence of a public health ethics framework for the geriatric community could be identified in South Africa.


Progesterone induces neuroprotection following reperfusion-promoted mitochondrial dysfunction after focal cerebral ischemia in rats.
Organelle damage and increases in mitochondrial permeabilization are key events in the development of cerebral ischemic tissue injury because they cause both modifications in ATP turnover and cellular apoptosis/necrosis. Early restoration of blood flow and improvement of mitochondrial function might reverse the situation and help in recovery following an onset of stroke. Mitochondria and related bioenergetic processes can be effectively used as pharmacological targets. Progesterone (P4), one of the promising neurosteroids, has been found to be neuroprotective in various models of neurological diseases, through a number of mechanisms. This influenced us to investigate the possible role of P4 in the mitochondria-mediated neuroprotective mechanism in an ischemic stroke model of rat. In this study, we have shown the positive effect of P4 administration on behavioral deficits and mitochondrial health in an ischemic stroke injury model of transient middle cerebral artery occlusion (tMCAO). After induction of tMCAO, the rats received an initial intraperitoneal injection of P4 (8 mg/kg body weight) or vehicle at 1 h post-occlusion followed by subcutaneous injections at 6, 12 and 18 h. Behavioral assessment for functional deficits included grip strength, motor coordination and gait analysis. Findings revealed a significant improvement with P4 treatment in tMCAO animals. Staining of isolated brain slices from P4-treated rats with 2,3,5-triphenyltetrazolium chloride (TTC) showed a reduction in the infarct area in comparison to the vehicle group, indicating the presence of an increased number of viable mitochondria. P4 treatment was also able to attenuate mitochondrial reactive oxygen species (ROS) production, as well as block the mitochondrial permeability transition pore (mPTP), in the tMCAO injury model. In addition, it was also able to ameliorate the altered mitochondrial membrane potential and respiration ratio in the ischemic animals, thereby suggesting that P4 has a positive effect on mitochondrial bioenergetics. In conclusion, these results demonstrate that P4 treatment is beneficial in preserving the mitochondrial functions that are altered in cerebral ischemic injury and thus can help in defining better therapies.


Dimethyl Sulfide is a Chemical Attractant for Reef Fish Larvae.
Transport of coral reef fish larvae is driven by advection in ocean currents and larval swimming. However, for swimming to be advantageous, larvae must use external stimuli as guides. One potential stimulus is "odor" emanating from settlement sites (e.g., coral reefs), signaling the upstream location of desirable settlement habitat. However, specific chemicals used by fish larvae have not been identified. Dimethyl sulfide (DMS) is produced in large quantities at coral reefs and may be important in larval orientation. In this study, a choice-chamber (shuttle box) was used to assess preference of 28 pre-settlement stage larvae from reef fish species for seawater with DMS. Swimming behavior was examined by video-tracking of larval swimming patterns in control and DMS seawater. We found common responses to DMS across reef fish taxa - a preference for water with DMS and change in swimming behavior - reflecting a switch to "exploratory behavior". An open water species displayed no response to DMS. Affinity for and swimming response to DMS would allow a fish larva to locate its source and enhance its ability to find settlement habitat. Moreover, it may help them locate prey accumulating in fronts, eddies, and thin layers, where DMS is also produced.


Complex Regional Pain Syndrome: The Importance of Early Diagnosis.
Complex regional pain syndrome (CRPS) is a potentially life-altering, neuropathic pain condition that often affects an extremity in response to surgery or even minor trauma. The pain is often disproportionate to the injury sustained or the surgical procedure performed-and it has been described as excruciating and unbearable. CRPS can result in irreversible, disabling changes in the affected limb. In some cases it has resulted in amputation or severe psychological issues. However, CRPS outcomes are generally more successful with early detection and treatment. This article presents an overview of CRPS and discusses the critical role nurses can play in recognizing the condition early, assisting with treatment, and providing psychological support.


Distributed and Mobile Collaboration for Real Time Epidemiological Surveillance during Forces Deployments.
This paper presents a pilot project of a real time syndromic surveillance system in French armed forces for early warning of biological attack by mass destruction weapons. For simulating the situation of a theatre of operations and its organisation, an electronic syndromic surveillance system covering all branches of service in French Guiana (about 3,000 persons) has been deployed and connected to a surveillance centre in France. This system has been design taking in account a collaborative view of epidemiological surveillance and the mobility of forces in extreme conditions. Several kinds of hardware, from rugged personal digital assistant to desktop computer, and several telecommunication links, from PSTN to satellite data links, are used. This system allows a quick report of cases, which are georeferenced. In the first results, some problems associated with the human and the technical aspects have been reported, in association with some immediate advantages.


A role of adenylate cyclase stimulation in energy metabolism of reticulocytes.
The effects of beta-adrenergic stimulation of adenylate cyclase on energy metabolism of rat reticulocytes were studied. A large initial rate of cAMP formation induced a rapid short-term stimulation of glycolysis which was followed by an exponential decline at maintained high cellular cAMP level. The decrease of glycolytic activity signifies a "metabolic desensitization" by a permanently increased cAMP concentration. Stimulation of PFK activity was found to be the main reason for the increased glycolytic rate which is due to the several fold increase of cAMP and in part to ATP-depletion. Total and coupled respiration, as well as the ATP/ADP ratio were not changed. The data indicate that stimulation of adenylate cyclase of reticulocytes selectively activates glycolysis, i.e. the cytosolic energy compartment with no detectable influence on oxydative phosphorylation.


MicroRNA-7 promotes motor function recovery following spinal cord injury in mice.
Spinal cord injury (SCI) is a devastating neurological condition for which there are no effective therapies. Following an initial injury, there is a cascade of multiple downstream events termed secondary injury. Thus, therapeutic approaches targeting a single pathway may not offer the best solution for treating SCI. One of the most attractive properties of microRNAs (miR) as potential therapeutics is that they are highly effective in regulating complex biological pathways by targeting multiple genes and pathways. The current study investigated the role of miR-7-5p (miR-7), which was previously shown to have neuroprotective functions, in promoting motor function recovery following SCI. We used an adeno-associated virus 1 (AAV1) vector to deliver the gene encoding miR-7 to the spinal cord of adult mice and found that this virus was mainly transduced into the neurons of the spinal cord. Transduction of AAV1-miR-7 improved hindlimb locomotor function following SCI over an 8-week observation period. This improvement was accompanied by reduced neuronal loss in the lesion. In addition, the beneficial effect of miR-7 was associated with enhanced levels of TH-positive axons in the lesion. Taken together, we suggest that miR-7 improves motor function recovery after SCI by protecting neuronal death and increasing axon levels. These findings suggest that miR-7 could be developed as a potential treatment for SCI in human.


A simple polymerase chain reaction method for detection and cloning of low-abundance transcripts.
A simplified polymerase chain reaction (PCR) technique for the detection, semiquantitation and cloning of low-abundance RNAs is described. This assay involves first-strand cDNA synthesis by reverse transcription of mRNA with specific oligonucleotide primers, followed by second-strand synthesis and PCR amplification, in the same tube with only the addition of TaqI DNA polymerase. The assay is sufficiently sensitive to detect target RNA from as little as 1 ng of total RNA. The beta-actin transcripts may also be simultaneously reverse transcribed, amplified and used as an internal standard to determine relative expression of specific RNAs. Using this simple technique, expression of the multidrug resistance (mdr 1) gene can easily be detected in human breast tumors. The technique is also applicable for the cloning of rare transcripts.