Comparative analysis of cluster versus conventional immunotherapy in patients with allergic rhinitis.
The present study aimed to compare the efficacy and safety of subcutaneous immunotherapy with Dermatophagoides pteronyssinus standardized extract administered in conventional and cluster immunotherapy regiments for patients with persistent allergic rhinitis. A total of 60 patients with moderate to severe allergic rhinitis caused by dust mites were treated for 1 year with either conventional immunotherapy (n=30) or cluster immunotherapy (n=30). Nasal conjunctival symptoms and signs were assessed to evaluate the clinical efficacy of the two regimens, and the incidence of local and systemic adverse reactions were also evaluated. The findings demonstrated that the cluster regimen reduced the duration between the initial and maintenance dose by >60%, and resulted in a significant improvement, as compared with the conventional regimen, after 6 weeks of observation (P<0.05). However, the incidence of local and systemic adverse reactions in the cluster regimen during the dose accumulation phase and the dose maintenance phase was not significantly different, as compared with the conventional immunotherapy regimen. These results suggest that cluster immunotherapy is efficacious and safe to treat patients who are clinically sensitive to dust mites.


[Complete detachment of the right coronary artery in a patient with acute aortic dissection type A].
Extremely rare and formidable complication of acute aortic dissection type A in a young patient is reported in the article. Clinical symptoms and features of surgical technique are described.


Cdk5 is required for the positioning and survival of GABAergic neurons in developing mouse striatum.
Cyclin-dependent kinase 5 (Cdk5) is a serine/threonine kinase, and its activity is dependent upon an association with a neuron-specific activating subunit. It was previously reported that Cdk5-/- mice exhibit perinatal lethality and defective neuronal positioning. In this study, they focused on the analysis of neuronal positioning of GABAergic neurons in the forebrain. Defective formation of the ventral striatum, nucleus accumbens, and olfactory tubercles was found in Cdk5-/- embryos. To further study this abnormal development, we generated and analyzed Dlx5/6-Cre p35 conditional KO (cKO); p39-/- mice in which forebrain GABAergic neurons have lost their Cdk5 kinase activity. Defective formation of the nucleus accumbens and olfactory tubercles as well as neuronal loss in the striatum of Dlx5/6-Cre p35cKO; p39-/- mice was found. Elevated levels of phosphorylated JNK were observed in neonatal striatal samples from Dlx5/6-Cre p35cKO; p39-/- mice, suggestive of neuronal death. These results indicate that Cdk5 is required for the formation of the ventral striatum in a cell-autonomous manner, and loss of the kinase activity of Cdk5 causes GABAergic neuronal death in the developing mouse forebrain. © 2016 Wiley Periodicals, Inc. Develop Neurobiol 77: 419-437, 2017.


[Synchronously occurring transitional cell carcinoma of the ureter with adrenocortical carcinoma].
A sixty eight-year-old man was admitted to our hospital complaining of macroscopic hematuria. Ultrasonography, X-ray and laboratory examination revealed a right ureter tumor and left non-functioning adrenal tumor. Pathological diagnosis was transitional cell carcinoma of the ureter and left adrenocortical carcinoma. A review of persistent Japanese literature revealed this case to be the 97th case of non-functioning adrenocortical carcinoma and the first case synchronously occurring with transitional cell carcinoma of the ureter. Forty eight cases of synchronously occurring transitional cell carcinoma of the ureter with cancers in other organs, especially renal cell carcinoma and gastric cancer, have been reported. Recently, an increasing number of cases of non-functioning adrenal carcinoma are detected by CT scan, ultrasonography, adrenal radioisotopic scintigraphy and urinary 17-OHCS, 17-KS.


Size of desmosomes and hemidesmosomes in normal human epidermis.
The dimensions of desmosomes and hemidesmosomes in normal human epidermis, i.e. their length and thickness, were studied in ordinary ultrathin sections. The length of desmosomes in the inner and middle squamous cell layer was 310 nm and 300 nm, while the thickness was 31 nm and 30 nm, respectively. In the outer squamous cell layer the values increased to 340 nm and 35 nm, respectively. The percentage total desmosomal length in relation to the perimeter of a cell showed the same tendency.


Isolation and Characterization of Three Antihypertension Peptides from the Mycelia of Ganoderma Lucidum (Agaricomycetes).
Ganoderma lucidum (G. lucidum) has been widely used in Asia to treat hypertension, but the active substances responsible for its antihypertensive effects remain unclear. Using the well-established angiotensin I-converting enzyme (ACE) as a target, we identified three ACE inhibitory peptides (ACEIPs), Gln-Leu-Val-Pro (QLVP), Gln-Asp-Val-Leu (QDVL), and Gln-Leu-Asp-Leu (QLDL), which account for the antihypertensive activity of G. lucidum. Notably, QLVP worked in a mixed-type manner against ACE with an IC50 value of 127.9 μmol/L. Molecular dynamics simulation suggested that the potent charge energy of QLVP, which interacted with Gln242 and Lys472 of ACE via a hydrogen bond and a salt bridge, potentially contributed to ACE inhibitory activity. Moreover, QLVP markedly activated angiotensin I-mediated phosphorylation of endothelial nitric oxide synthase in human umbilical vein endothelial cells and partly reduced mRNA and protein expression of the vasoconstrictor factor endothelin-1. This is the first report of the antihypertensive activity of small ACEIPs originating from G. lucidum mycelia, paving the way for the possible application of these peptides as potent drug candidates for treating hypertension.


Cuprous oxide nanoparticles selectively induce apoptosis of tumor cells.
In the rapid development of nanoscience and nanotechnology, many researchers have discovered that metal oxide nanoparticles have very useful pharmacological effects. Cuprous oxide nanoparticles (CONPs) can selectively induce apoptosis and suppress the proliferation of tumor cells, showing great potential as a clinical cancer therapy. Treatment with CONPs caused a G1/G0 cell cycle arrest in tumor cells. Furthermore, CONPs enclosed in vesicles entered, or were taken up by mitochondria, which damaged their membranes, thereby inducing apoptosis. CONPs can also produce reactive oxygen species (ROS) and initiate lipid peroxidation of the liposomal membrane, thereby regulating many signaling pathways and influencing the vital movements of cells. Our results demonstrate that CONPs have selective cytotoxicity towards tumor cells, and indicate that CONPs might be a potential nanomedicine for cancer therapy.


[Screening peptides binding specifically to large intestinal cancer LoVo cells from phage random peptide library].
To screen the polypeptides specifically binding to human large intestinal cancer LoVo cells from a phage-displayed peptide library for potential use as targeting vectors for large intestinal cancer therapy. With the LoVo cells as the target cells and human normal large intestinal mucosal epithelial cells as the absorber cells for subtraction biopanning from a c7c phage-display peptide library, the positive phage clones were identified by enzyme-linked immunosorbent assay (ELISA) and immunofluorescence detection. The amino acid sequences of the identified peptides were deduced by DNA sequencing. After 3 rounds of screening, 5 positive phage clones showing specific binding to LoVo cells and containing conserved motif RPMP were obtained from the 20 randomly selected clones. Specific peptide against large intestinal cancer cells can be obtained from a phage-display peptide library for use as potential vectors for targeting therapy of large intestinal cancer.


Hypoglycemic effects and biochemical mechanisms of oat products on streptozotocin-induced diabetic mice.
Oat products are abundant in β-glucan, which could lower the glycemic index of products or foods. A low glycemic index is beneficial in the control of postprandial glycemia. The study examined the hypoglycemic effects of oat products that had the same percentage of oat β-glucan and were added into the diet fed to streptozotocin-induced diabetic mice for 6 weeks, and potential mechanisms are discussed here. Oat products significantly decreased fasting blood glucose and glycosylated serum protein (p < 0.05), but the hypoglycemic effect was not more than that of metformin (p > 0.05). Oat products increased glycogen, hormone, and nuclear receptor levels (p < 0.05), decreased free fatty acid content and succinate dehydrogenase activity (p < 0.05), and inhibited pancreatic apoptosis (p < 0.05). The results showed oat products had hypoglycemic effects. Hypoglycemic effects of oat products might be regulating glucose and fat metabolisms, stimulating hormone secretion, activating the nuclear receptor, and protecting organ function.


Preferential transfer of the complete glycan is determined by the oligosaccharyltransferase complex and not by the catalytic subunit.
Most eukaryotic cells show a strong preference for the transfer in vivo and in vitro of the largest dolichol-P-P-linked glycan (Glc(3)Man(9)GlcNAc(2)) to protein chains over that of biosynthetic intermediates that lack the full complement of glucose units. The oligosaccharyltransferase (OST) is a multimeric complex containing eight different proteins, one of which (Stt3p) is the catalytic subunit. Trypanosomatid protozoa lack an OST complex and express only this last protein. Contrary to the OST complex from most eukaryotic cells, the Stt3p subunit of these parasites transfers in cell-free assays glycans with Man(7-9)GlcNAc(2) and Glc(1-3)Man(9)GlcNAc(2) compositions at the same rate. We have replaced Saccharomyces cerevisiae Stt3p by the Trypanosoma cruzi homologue and found that the complex that is formed preferentially transfers the complete glycan both in vivo and in vitro. Thus, preference for Glc(3)Man(9)GlcNAc(2) is a feature that is determined by the complex and not by the catalytic subunit.


The management of an infected total knee arthroplasty.
Periprosthetic joint infection (PJI) is one of the most feared and challenging complications following total knee arthroplasty. We provide a detailed description of our current understanding regarding the management of PJI of the knee, including diagnostic aids, pre-operative planning, surgical treatment, and outcome.


Molecular dynamics studies of polysaccharide carrier based on starch in dental cavities.
Health is an important element that influences the level of development in a community. Studies show that tooth decay has been prevalent recently. Starch incorporating curcumin can serve as an alternative approach in preventing the activity of Streptococcus mutans attributed to biofilm and plaque formation on teeth. In this research, the performance of starch nanoparticle as a carrier for curcumin, a natural anti-inflammatory and a strong antioxidant agent, in decreasing dental caries was simulated. In the first stage, the conformational rearrangements of molecules and their interactions with other molecular species in a range of environments were examined via computational techniques and molecular dynamics (MD) simulation. The charts of energy, temperature, density, cell size and the radial distribution function (RDF) derived from the simulation, confirmed that during 5 initial steps there was a stable binding between the curcumin and starch in the presence of bacteria. The energy released in the starch formed nanosphere is very high, and this indicates a full reaction in the system. However, the density-decreasing trend of nanosystem suggests that it can effectively inhibit the activity of microorganism.


Quantitation and stability of fumonisins B1 and B2 in milk.
The well-documented presence of fumonisin mycotoxins B1 and B2 (FB1 and FB2) in corn raises the possibility that these toxins are carried over into the milk of animals fed with contaminated feed. The presence of FB1 and FB2 in milk has not been assessed because of the lack of sensitive analytical techniques for this matrix. Two methods, liquid chromatography (LC) and enzyme-linked immunosorbent assay (ELISA), were adapted for the analysis of milk. The ELISA, produced commercially for screening corn, required no sample preparation and was reproducible but was of low sensitivity [concentration that inhibits color development by 50% (IC50), 1200-1600 ng FB1/mL]. The more sensitive LC method involves serial extraction of milk with methanol-acetone and strong anion exchange followed by derivatization with naphthalene-2,3-dicarboxaldehyde. Recoveries of 50 ng FB1 and FB2/mL from unpasteurized and unhomogenized milk were 84 and 83%, respectively (limit of detection, 5 ng/mL). Recoveries of FB1 from whole homogenized milk (76%) were slightly lower. Heating milk for 30 min at 62 degrees C, to mimic pasteurization, did not significantly reduce FB1 or FB2 recovery, nor did storing milk for 11 days at 4 degrees C. The LC method was applied to 165 samples of milk, only 1 of which was positive. This finding suggests that exposure of humans to FB1 and FB2 from milk is low.


An efficient micro control unit with a reconfigurable filter design for wireless body sensor networks (WBSNs).
In this paper, a low-cost, low-power and high performance micro control unit (MCU) core is proposed for wireless body sensor networks (WBSNs). It consists of an asynchronous interface, a register bank, a reconfigurable filter, a slop-feature forecast, a lossless data encoder, an error correct coding (ECC) encoder, a UART interface, a power management (PWM), and a multi-sensor controller. To improve the system performance and expansion abilities, the asynchronous interface is added for handling signal exchanges between different clock domains. To eliminate the noise of various bio-signals, the reconfigurable filter is created to provide the functions of average, binomial and sharpen filters. The slop-feature forecast and the lossless data encoder is proposed to reduce the data of various biomedical signals for transmission. Furthermore, the ECC encoder is added to improve the reliability for the wireless transmission and the UART interface is employed the proposed design to be compatible with wireless devices. For long-term healthcare monitoring application, a power management technique is developed for reducing the power consumption of the WBSN system. In addition, the proposed design can be operated with four different bio-sensors simultaneously. The proposed design was successfully tested with a FPGA verification board. The VLSI architecture of this work contains 7.67-K gate counts and consumes the power of 5.8 mW or 1.9 mW at 100 MHz or 133 MHz processing rate using a TSMC 0.18 μm or 0.13 μm CMOS process. Compared with previous techniques, this design achieves higher performance, more functions, more flexibility and higher compatibility than other micro controller designs.


Topical Ambroxol 20% for the Treatment of Classical Trigeminal Neuralgia - A New Option? Initial Clinical Case Observations.
Trigeminal neuralgia is difficult to treat and shows upregulation of sodium channels. The expectorant ambroxol acts as a strong local anesthetic, about 40 times stronger than lidocaine. It preferentially inhibits the channel subtype Nav 1.8, expressed especially in nociceptive C-fibers. It seemed reasonable to try ambroxol for the treatment with neuropathic facial pain unresponsive to other standard options. Medical records of patients suffering from classical trigeminal neuralgia (n = 5) and successful pain reduction following topical ambroxol 20% cream in addition to standard treatment are reported. All patients reported pain attacks with pain intensity between 4 and 10 NRS (numeric pain scale). In all cases they could be triggered, 3 patients reported additional spontaneous pain. Attacks were reduced in all 5 patients. Pain reduction achieved following ambroxol 20% cream was 2-8 points (NRS) earliest within 15-30 minutes and lasted for 4-6 hours mostly. This was reproducible in all cases; in one case pain was eliminated after 1 week. No patient reported side effects or skin changes; oral medication was reduced in 2 patients. For the first time, a clinically significant pain relief following topical ambroxol 20% cream in patients with trigeminal neuralgia is reported. In view of the positive side effect profile, topical ambroxol for patients with such a highly impaired quality of life should be investigated further as a matter of urgency.


A Rigorous and Integrated On-Water Monitoring System for Performance and Technique Improvement in Rowing.
This paper presents a prototype, on-water rowing monitoring system and its testing results for a single scull boat. The proposed system aims at recording critical kinetic (athlete biomechanics and oar/seat movements) and kinematic (boat position, velocity, acceleration, and attitude) parameters for sport performance evaluation and rowing technique improvement. The data acquisition unit is organized in two parts: the first part aims at logging boat kinematics based on GNSS/INS filtering, while the second one facilitates kinetics data recording using a series of analog sensors (potentiometers, strain gauges) installed on the athlete's body and the boat seat and oars. Both parts are connected to a central unit featuring analog voltage digitizers and a micro-PC for device handling and data storing. In order to test the performance of the system a series of field trials were undertaken featuring different observation scenarios as well as intentionally induced errors in the rowing technique. Analysis revealed the high performance of the system in terms of sensor completeness and setup procedures as well as operational efficiency. Moreover, system performance evaluation exercised through studying raw data recordings and resultant parameters at stroke cycle and average (standardized) stroke cycle level confirmed the fruitfulness of the proposed approach and system and its potential for implementation on a broad scale. Finally, the data acquired from the proposed system were used to compute the adopted input parameters and performance indicators to characterize the system in terms of functionality and operational efficiency.


Direct electrical measurement of the conversion of metal acetates to metal sulfides by hydrogen sulfide.
Copper acetate and related metal salt films react directly with hydrogen sulfide at room temperature to form metal sulfides, resulting in conductivity changes as large as 108. The observed changes in conductivity are related to the solubility product constant (Ksp) and the difference in conductivity between the metal salt and the resulting metal sulfide. A smaller Ksp indicates a more stable metal sulfide and, therefore, greater metal salt reactivity. Polyaniline nanofiber/metal salt composites were also examined and show metal sulfide conversion with changes in resistance up to 106. The direct electrical measurement of the conversion of metal salt to metal sulfide has the potential to be the basis of a new type of sensitive, thin-film chemical sensor.


Accurate data process for nanopore analysis.
Data analysis for nanopore experiments remains a fundamental and technological challenge because of the large data volume, the presence of unavoidable noise, and the filtering effect. Here, we present an accurate and robust data process that recognizes the current blockades and enables evaluation of the dwell time and current amplitude through a novel second-order-differential-based calibration method and an integration method, respectively. We applied the developed data process to analyze both generated blockages and experimental data. Compared to the results obtained using the conventional method, those obtained using the new method provided a significant increase in the accuracy of nanopore measurements.


H-Ras transfers from B to T cells via tunneling nanotubes.
Lymphocytes form cell-cell connections by various mechanisms, including intercellular networks through actin-supported long-range plasma membrane (PM) extensions, termed tunneling nanotubes (TNTs). In this study, we tested in vitro whether TNTs form between human antigen-presenting B cells and T cells following cell contact and whether they enable the transfer of PM-associated proteins, such as green fluorescent protein (GFP)-tagged H-Ras (GFP-H-Ras). To address this question, we employed advanced techniques, including cell trapping by optical tweezers and live-cell imaging by 4D spinning-disk confocal microscopy. First, we showed that TNTs can form after optically trapped conjugated B and T cells are being pulled apart. Next, we determined by measuring fluorescence recovery after photobleaching that GFP-H-Ras diffuses freely in the membrane of TNTs that form spontaneously between B and T cells during coculturing. Importantly, by 4D time-lapse imaging, we showed that GFP-H-Ras-enriched PM patches accumulate at the junction between TNTs and the T-cell body and subsequently transfer to the T-cell surface. Furthermore, the PM patches adopted by T cells were enriched for another B-cell-derived transmembrane receptor, CD86. As predicted, the capacity of GFP-H-Ras to transfer between B and T cells, during coculturing, was dependent on its normal post-transcriptional lipidation and consequent PM anchorage. In summary, our data indicate that TNTs connecting B and T cells provide a hitherto undescribed route for the transfer of PM patches containing, for example, H-Ras from B to T cells.


[Marjolin's ulcer in a 54-year-old skin graft].
Marjolin's ulcer (MU) is a malignant degeneration of a chronic wound and spinocellular carcinoma is the most common type. MU is described as being aggressive in nature and carries a high incidence of metastases. A 71-year-old man developed spinocellular carcinoma 54 years after a primary amputation and a construction of a skin graft due to a severe foot trauma. The carcinoma was excised and a forefoot amputation was performed.


A Decade of Experience in Creating and Maintaining Data Elements for Structured Clinical Documentation in EHRs.
Structured clinical documentation is an important component of electronic health records (EHRs) and plays an important role in clinical care, administrative functions, and research activities. Clinical data elements serve as basic building blocks for composing the templates used for generating clinical documents (such as notes and forms). We present our experience in creating and maintaining data elements for three different EHRs (one home-grown and two commercial systems) across different clinical settings, using flowsheet data elements as examples in our case studies. We identified basic but important challenges (including naming convention, links to standard terminologies, and versioning and change management) and possible solutions to address them. We also discussed more complicated challenges regarding governance, documentation vs. structured data capture, pre-coordination vs. post-coordination, reference information models, as well as monitoring, communication and training.


Characterization of Two Novel Toti-Like Viruses Co-infecting the Atlantic Blue Crab, Callinectes sapidus, in Its Northern Range of the United States.
The advancement of high throughput sequencing has greatly facilitated the exploration of viruses that infect marine hosts. For example, a number of putative virus genomes belonging to the Totiviridae family have been described in crustacean hosts. However, there has been no characterization of the most newly discovered putative viruses beyond description of their genomes. In this study, two novel double-stranded RNA (dsRNA) virus genomes were discovered in the Atlantic blue crab (Callinectes sapidus) and further investigated. Sequencing of both virus genomes revealed that they each encode RNA dependent RNA polymerase proteins (RdRps) with similarities to toti-like viruses. The viruses were tentatively named Callinectes sapidus toti-like virus 1 (CsTLV1) and Callinectes sapidus toti-like virus 2 (CsTLV2). Both genomes have typical elements required for -1 ribosomal frameshifting, which may induce the expression of an encoded ORF1-ORF2 (gag-pol) fusion protein. Phylogenetic analyses of CsTLV1 and CsTLV2 RdRp amino acid sequences suggested that they are members of two new genera in the family Totiviridae. The CsTLV1 and CsTLV2 genomes were detected in muscle, gill, and hepatopancreas of blue crabs by real-time reverse transcription quantitative PCR (RT-qPCR). The presence of ~40 nm totivirus-like viral particles in all three tissues was verified by transmission electron microscopy, and pathology associated with CsTLV1 and CsTLV2 infections were observed by histology. PCR assays showed the prevalence and geographic range of these viruses, to be restricted to the northeast United States sites sampled. The two virus genomes co-occurred in almost all cases, with the CsTLV2 genome being found on its own in 8.5% cases, and the CsTLV1 genome not yet found on its own. To our knowledge, this is the first report of toti-like viruses in C. sapidus. The information reported here provides the knowledge and tools to investigate transmission and potential pathogenicity of these viruses.


Theoretical spectroscopy of the calcium dimer in the A 1Sigma(u)+, c3Pi(u), and a3Sigma(u)+ manifolds: an ab initio nonadiabatic treatment.
Nonadiabatic theory of molecular spectra of diatomic molecules is presented. It is shown that in the fully nonadiabatic framework, the rovibrational wave functions describing the nuclear motions in diatomic molecules can be obtained from a system of coupled differential equations. The rovibrational wave functions corresponding to various electronic states are coupled through the relativistic spin-orbit coupling interaction and through different radial and angular coupling terms, while the transition intensities can be written in terms of the ground state rovibrational wave function and bound rovibrational wave functions of all excited electronic states that are electric dipole connected with the ground state. This theory was applied in the nearly exact nonadiabatic calculations of energy levels, line positions, and intensities of the calcium dimer in the A (1)Sigma(u) (+)(1 (1)S+1 (1)D), c (3)Pi(u)(1 (3)P+1 (1)S), and a (3)Sigma(u) (+)(1 (3)P+1 (1)S) manifolds of states. The excited state potentials were computed using a combination of the linear response theory within the coupled-cluster singles and doubles framework for the core-core and core-valence electronic correlations and of the full configuration interaction for the valence-valence correlation, and corrected for the one-electron relativistic terms resulting from the first-order many-electron Breit theory. The electric transition dipole moment governing the A (1)Sigma(u) (+)<--X (1)Sigma(g) (+) transitions was obtained as the first residue of the frequency-dependent polarization propagator computed with the coupled-cluster method restricted to single and double excitations, while the spin-orbit and nonadiabatic coupling matrix elements were computed with the multireference configuration interaction wave functions restricted to single and double excitations. Our theoretical results explain semiquantitatively all the features of the observed Ca(2) spectrum in the A (1)Sigma(u) (+)(1 (1)S+1 (1)D), c (3)Pi(u)(1 (3)P+1 (1)S), and a (3)Sigma(u) (+)(1 (3)P+1 (1)S) manifolds of states.


Dysgraphia and terminal delirium.
Delirium is a frequently encountered clinical condition in palliative medicine, but it is often unrecognized and misdiagnosed. The cardinal sign of delirium is that of impaired consciousness. Writing skills are reported to be a delicate indicator of consciousness impairment, and a too infrequently utilized clinical sign of delirium. Ten delirious hospice patients completed the Frenchay Aphasia Screening Test which showed that writing was the most impaired of the language dysfunctions assessed. The simple clinical task of a request to write 'name and address' revealed overt dysgraphic errors among delirious patients. This examination is clinically acceptable to hospice practice and may be an adequate and accurate bedside test of delirium.


The pollination ecology of a rare case of bee-pollinated Psittacanthus mistletoe.
The genus Psittacanthus (Loranthaceae) is widely distributed in the Neotropical region, where it is known for its large, colourful, scentless flowers. Until very recently, all Psittacanthus species were regarded as exclusively hummingbird-pollinated and the large species radiation in the genus attributed to the interactions with bird dispersers and pollinators. P. eucalyptifolius (Kunth) G.Don. is the only species reported as bee-pollinated. Here we describe the floral biology, floral visitors, and the reproductive system of P. eucalyptifolius in an Amazonian savanna, Brazil. We also compare the pollination success (reproductive performance) among different Psittacanthus species reported in previous studies. Psittacanthus eucalyptifolius produces sweet-scented flowers, and a small quantity of concentrated nectar. At least five species of scopate bees were recorded visiting and carrying pollen of P. eucalyptifolius. Xylocopa frontalis carried most pollen, visited more flowers, remained longer, and touched reproductive parts of flowers in >95% of the observed visits. Experiments indicate that P. eucalyptifolius is partially autocompatible (39% autonomous pollination) but depends on pollinators to achieve higher performance (~78% in control), indicating that bees can be as effective as birds in pollinating this group of mistletoes.


Comparison of coronary CT angiography image quality with and without breast shields.
The purpose of this study is to compare the image quality of coronary CT angiography performed with and without breast shields. This study involved a retrospective cohort of 72 women with possible angina who underwent 64-MDCT retrospective ECG-gated coronary CT angiography at a single academic tertiary medical center. Images of 36 women scanned while wearing bismuth-coated latex breast shields and 36 control subjects scanned without shields, matched by heart rate and body mass index, were graded on a standardized Likert scale for image quality, stenosis, and plaque by two independent board-certified readers blinded to breast shields. Seventy-two patients (mean [± SD] age, 53 ± 9 years) were included. The pre scan heart rate, body mass index, and Agatston score did not differ between groups. The median estimated radiation dose was 13.4 versus 16.1 mSv for those with and without breast shields (p = 0.003). For shielded versus unshielded scans, 86% versus 83% of coronary segments were rated excellent or above average (p = 0.4), median image quality was 2.0 for both groups, mean signal was 474 ± 75 and 452 ± 91 HU (p = 0.27), mean noise was 33.9 ± 8.5 and 29.8 ± 8.3 HU (p = 0.04), and median signal-to-noise ratio was 14.4 and 14.7 (p = 0.56), respectively. Breast shields for women undergoing coronary CT angiography slightly increased noise but did not negatively affect signal, signal-to-noise ratio, quality, or interpretability. Breast shield use warrants further study.


Optical spectroscopy. Pre-mammography marker.
Non-invasive optical spectroscopy consistently delineates compositional and physiologic properties of breast tissues serving as a pre-mammography risk marker for cancer or yielding a high assurance of no such risk. We believe this new non-imaging approach depends on biochemistry of tissues rather than on the macroscopic physical properties involved with most breast imaging modalities. After establishing the procedure as inexpensive, physician independent, simple, requiring only a few minutes and appealing to women, it was carried out in two institutions on 1739 women referred for routine mammography. Of 166 breast biopsies on these women 77 were cancer by histology. An automated computerized analysis of the spectroscopic data yielded a sensitivity of 87 per cent, a specificity of 74 per cent and a negative predictive value of 99 per cent. Optical spectroscopy shows promise in identifying women at a higher risk for developing cancer, cases of non-infiltration carcinomas where dense breasts limit mammographic detection, and even clustered calcifications not associated with a mass. The relative risk of breast cancer was 16.5 times as great with a positive spectroscopic value at a sensitivity range of 87 per cent. Placement of 87 per cent of all breast cancer cases in a subset of 28.7 per cent of all women will yield a population of women in whom mammography will be approximately four times as efficient.


Lithium treatment: are the present schedules optimal?
Lithium treatment is a proven and effective prophylactic treatment of bipolar affective disorders. To day patients receive their lithium in one or two daily doses, and the dosage level in the individual patient is adjusted to the lowest possible level in order to reduce side effects. In the present article we suggest an alternative treatment strategy also aiming at reducing side effects but not involving the slow process of finding the lowest possible effective lithium dose. We suggest prophylaxis may be obtained by giving lithium every second day in a dose producing 12 hour serum lithium concentrations between 0.6 and 0.9 mM, and leading to very low lithium concentrations every second day. This treatment schedule is at present being tested in the clinic.


Carbon Nanotubes: Printed Carbon Nanotube Electronics and Sensor Systems (Adv. Mater. 22/2016).
Printed electronics and sensors enable new applications ranging from low-cost disposable analytical devices to large-area sensor networks. Recent progress in printed carbon nanotube electronics in terms of materials, processing, devices, and applications is discussed on page 4397 by A. Javey and co-workers. The research challenges and opportunities regarding the processing and system-level integration are also discussed for enabling of practical applications.


Pathophysiology of subarachnoid haemorrhage. Experimental and clinical data.
When a saccular aneurysm suddenly ruptures the intracranial pressure (ICP) abruptly rises to reach a level at about the diastolic blood pressure in 1 to 2 minutes. Unless a haematoma is formed ICP will soon fall and reach a steady level in about 10 minutes. In the days following the initial SAH several pathophysiological events take place. Regional CBF and the cerebral metabolic rate of oxygen (CMRO2) are reduced resulting in so-called luxury perfusion due to an uncoupling between flow and metabolism. The arteriovenous difference of oxygen is always reduced. CMRO2 falls parallel to increasing severity of vasospasm. CBF below 20 ml/100 g/min in cases of severe diffuse spasm inevitably result in brain tissue infarction. The development of vasospasm, which reaches a maximum between the 5th and 9th day after SAH, is accompanied by CSF lactacidosis and intracranial hypertension. The reactivity of the cerebral arteries after SAH is often impaired. Cerebral autoregulation to arterial hypotension is disturbed even in mild cases, and globally fails in severe vasospasm. On the other hand the reactivity of the cerebral vasculature to changes in arterial PCO2 is always preserved although reduced. Only in the presence of severe tissue acidosis will both modes of reactivity be damaged--so-called total vasoparalysis.


Studies on toxic oil syndrome: stereoselective hydrolysis of 3-(phenylamino)propane-1,2-diol esters by human pancreatic lipase.
The ingestion of rapeseed oil batches denatured with aniline and illegally refined and distributed by street vendors was responsible for toxic oil syndrome (TOS), an intoxication episode that took place in Spain in 1981, causing over 400 deaths and affecting more than 20,000 people. Despite the intense research efforts carried out to date, the compounds responsible for that intoxication have not been elucidated. Nevertheless, epidemiological studies have pointed to fatty acid mono- and diesters of 3-phenylamino-1,2-propanediol (PAP) as the biomarkers of those toxic oil batches. The structure of these esters bears common features with that of triglycerides, which suggested that PAP esters could follow the route of lipids metabolism up to a certain extent. The incubation of racemic PAP dioleyl ester with human pancreatic lipase (hPL) led to the formation of the corresponding stereoisomeric monoesters bearing the oleyl residue at C-2, although a kinetic resolution in favor of the (S)-enantiomer was observed. These monoesters are unstable and in equilibrium with their corresponding regioisomers with the acyl residue at C-1, apparently without the intervention of the lipase. Finally, incubations of these latter monoesters with hPL led to the formation of the respective PAP enantiomers. Again, the kinetic resolution of this hydrolytic process favored the formation of the enantiomer with the (S)-configuration. Taken together, these results showed that PAP esters are substrates of hPL and that the two hydrolytic steps exhibit kinetic resolution in favor of the (S)-enantiomers.


Short-Term Efficacy and Safety of Non-Ablative Laser Treatment Alone or with Estriol or Moisturizers in Postmenopausal Women with Vulvovaginal Atrophy.
Among treatments for vulvo-vaginal atrophy (VVA), there is a new kind of energy-based device, the non-ablative CO2 laser. This study aimed to assess the efficacy and safety of the non-ablative CO2 laser in menopausal women with VVA as a monotherapy or in association with vaginal estriol or moisturizer. Seventy-five women with VVA received laser treatment (Laser group), laser plus estriol gel (Laser+E) or laser plus moisturizers (Laser+M). The study protocol consisted of 3 monthly laser sessions (t0, t1, t2) and a gynecological examination at baseline and 1 month after last laser treatment (t3). Objective measures included VHI (Vaginal Health Index) and VuHI (Vulvar Health Index); subjective symptoms of VVA (Dryness, Burning, Itching, Dysuria) evaluated via visual analog scales, sexual function evaluated by FSFI (Female Sexual Function Index), FSDS (Female Sexual Distress Score) and MENQOL (Mopause-specific Quality Of Life). Adverse events and discomfort encountered during the procedure were also assessed. Primary outcomes were the evaluation of VHI and VuHI and secondary outcomes were changes in VVA symptoms (VAS), sexual function (MENQOL, FSFI, FSDS) and discomfort during the procedure. Seventy-five women (25 in Laser, 25 in Laser+E and 25 in Laser+M group) completed the study. At t3, mean VHI, VuHI, dryness, burning and itching VAS scores improved significantly with no differences between the groups. The lubrication domain of FSFI improved significantly only in the Laser+M group, while the pain domain improved significantly in all women with no differences between the groups. FSFI and FSDS overall scores and MENQOL sexual domain improved in all women with no significant difference between the groups. The mean score of the pain during the procedure was low at t0 and did not change throughout the study. This study extends knowledge concerning the effectiveness of a new non-ablative CO2 laser in post-menopausal women with VVA. This is one of the first studies on this kind of laser and is the first to compare the effectiveness of laser treatment alone or in combination with vaginal estriol or moisturizers. Parameters of VVA and sexual function were evaluated using validated tools. Study limitations include short follow-up time, the limited number of participants and the absence of a sham-controlled group. Non-ablative CO2 laser seems to be an effective treatment for VVA in menopausal women. Our preliminary data shows that it can be effective as monotherapy or with adjuvant treatments. Alvisi S, Lami A, Baldassarre M, et al. Short-Term Efficacy and Safety of Non-Ablative Laser Treatment Alone or with Estriol or Moisturizers in Postmenopausal Women with Vulvovaginal Atrophy. J Sex Med 2022;19:761-770.


Vesicomyidae (bivalvia): current taxonomy and distribution.
Vesicomyid bivalves are a consistent component of communities of sulphide-rich reducing environments distributed worldwide from 77 degrees N to 70 degrees S at depths from 100 to 9050 m. Up-to-now the taxonomy of the family has been uncertain. In this paper, the current state of vesicomyid taxonomy and distribution at the generic rank are considered. This survey is founded on a database including information both from literature sources and also unpublished data of the authors on all recent species of vesicomyids. We suggest that the Vesicomyidae is not a synonym of Kelliellidae, and is therefore a valid family name. We propose to divide the family Vesicomyidae into two subfamilies: Vesicomyinae and Pliocardiinae. The Vesicomyinae includes one genus, Vesicomya, which comprises small-sized bivalves characterized by non-reduced gut and the absence of subfilamental tissue in gills. Symbiosis with chemoautotrophic bacteria has, so far, not been proved for Vesicomya and the genus is not restricted to sulphide-rich reducing habitats. The subfamily Pliocardiinae currently contains about 15 genera with mostly medium or large body size, characterized by the presence of subfilamental tissue in the gills. The Pliocardiinae are highly specialized for sulphide-rich reducing environments, harbouring chemoautrophic bacteria in their gills. This is the first summary of the generic structure of the family Vesicomyidae that allow us to analyze the distribution of vesicomyids at the generic level. We recognize here five different distribution patterns that are related to the specific environmental demands. The general trends in the distribution patterns of the vesicomyids are an occurrence of the majority of genera in broad geographical ranges and the prevalence of near continental type of distribution.


Effects of testosterone propionate treatment of neonatally ovariectomized rats on growth and subsequent responsiveness to oestrogen.
There was no significant difference in body weight between neonatally ovariectomized (OvX) rats whether given oil treatment or 90 mug testosterone propionate (TP) on day 3, when examined up to 23 weeks of age. When these two animals were injected with oestradiol benzoate (3 mug/day for 2 weeks), the neonatally OvX TP treated rats showed a significantly smaller depression in body weight than did the control neonatally OxX rats. Measurement of food intake also showed that TP treated rats responded significantly less to the depressant effects of oestrogen than did the controls. These data are consistent with the hypothesis that the ovary does restrain body weight in TP rats but that androgen treatment in the neonatal period may not have a specific effect on growth but may alter the sensitivity of growth regulating processes to the inhibitory effects of oestrogen.


Changes in the expression and localization of cohesin subunits during meiosis in a non-mammalian vertebrate, the medaka fish.
Until the onset of anaphase, sister chromatids are bound to each other by a multi-subunit protein complex called cohesin. Since chromosomes in meiosis behave differently from those in mitosis, the cohesion and separation of homologous chromosomes and sister chromatids in meiosis are thought to be regulated by meiosis-specific cohesin subunits. Actually, several meiosis-specific cohesin subunits, including Rec8, STAG3 and SMC1beta, are known to exist in mammals; however, there are no reports of meiosis-specific cohesin subunits in other vertebrates. To investigate the protein expression and localization of cohesin subunits during meiosis in non-mammalian species, we isolated cDNA clones encoding SMC1alpha, SMC1beta, SMC3 and Rad21 in the medaka and produced antibodies against recombinant proteins. Medaka SMC1beta was expressed solely in gonads, while SMC1alpha, SMC3 and Rad21 were also expressed in other organs and in cultured cells. SMC1beta forms a complex with SMC3 but not with Rad21, in contrast to SMC1alpha, which forms complexes with both SMC3 and Rad21. SMC1alpha and Rad21 were mainly expressed in mitotically dividing cells in the testis (somatic cells and spermatogonia), although their weak expression was detected in pre-leptotene spermatocytes. SMC1beta was expressed in spermatogonia and spermatocytes. SMC1beta was localized along the chromosomal arms as well as on the centromeres in meiotic prophase I, and its existence on the chromosomes persisted up to metaphase II, a situation different from that reported in the mouse, in which SMC1beta is lost from the chromosome arms in late pachytene despite its universal presence in vertebrates.


Debye Brownian oscillator and Debye-type noise: A series solution versus Monte Carlo simulation.
For the Debye Brownian oscillator, we present a series solution to the generalized Langevin equation describing the motion of a particle. The external potential is considered to be a harmonic potential and the spectral density of driven noise is a hard cutoff at high finite frequencies. The results are in agreement with both numerical calculations and Monte Carlo simulations. We demonstrate abnormal weak ergodic breaking; specifically, the long-time average of the observable vanishes but the corresponding ensemble average continues to oscillate with time. This Debye Brownian oscillator does not arrive at an equilibrium state and undergoes underdamped-like motion for any model parameter. Nevertheless, ergodic behavior and equilibrium can be recovered concurrently using a strong bound potential. We give an understanding of the behavior as being the consequence of discrete breather modes in the lattices similar to the formation of an additional periodic signal. Furthermore, we compare the results calculated by cutting off separately the spectral density and the correlation function of colored noise.


The Dysphagia in Multiple Sclerosis Questionnaire Correlates with Fiber-Optic Endoscopic Examination for Detecting Swallowing Deficits in MS.
Multiple sclerosis (MS) refers to chronic inflammation of the central nervous system including the brain and spinal cord. Assessing for the presence of dysphagia in subjects with MS represents a challenge for neurologists in clinical practice. The aim of the present study was to verify the relationship between DYMUS scores, a patient-reported scale, and objective symptoms using the Dysphagia Outcome Severity Score (DOSS), based on fiber-optic endoscopy. Data were collected in a multicenter study. Two hundred and fifteen MS patients were enrolled, irrespective of self-reported dysphagia. DOSS revealed dysphagia in 122 subjects (56.7%). Compared with non-dysphagic subjects, the presence of dysphagia was related to more severe disability, longer disease duration, and a progressive form of the disease. A DYMUS score of 0 strongly correlated with a DOSS of 6 (sensitivity 100%) while DYMUS score of > 2 correlated with a DOSS < 7 (specificity 82%) of the self-reported scale. The DYMUS questionnaire can be a useful clinical tool for red-flagging patients who should undergo objective testing and referral to a otorhinolaryngologist.


The effect of consuming instant black tea on postprandial plasma glucose and insulin concentrations in healthy humans.
To determine the effects of black tea on postprandial plasma glucose and insulin concentrations in healthy humans in response to an oral glucose load. A four-way randomised, crossover trial was designed in which 16 healthy fasted subjects would consume 75g of glucose in either 250ml of water (control), 250ml of water plus 0.052g of caffeine (positive control) or 250 ml of water plus 1.0g or 3.0g of instant black tea. Blood samples were collected at fasting and at 30min intervals for 150min from commencement of drink ingestion. Glucose and insulin concentrations were measured using standard methodology. The tea was chemically characterised using colorimetric and HPLC methods. Chemical analysis showed that the tea was rich in polyphenolic compounds (total, 350mg/g). Results from only 3 treatment arms are reported because the 3.0g tea drink caused gastrointestinal symptoms. Plasma glucose concentrations <60min in response to the drinks were similar, but were significantly reduced at 120min (P<0.01), following ingestion of the 1.0g tea drink, relative to the control and caffeine drinks. Tea consumption resulted in elevated insulin concentrations compared with the control and caffeine drinks at 90min (P<0.01) and compared with caffeine drink alone at 150min (P<0.01). The 1.0g tea drink reduced the late phase plasma glucose response in healthy humans with a corresponding increase in insulin. This may indicate that the attenuation in postprandial glycemia was achieved as a result of an elevated insulin response following stimulation of pancreatic beta-cells. This effect may be attributable to the presence of phenolic compounds in the tea.


Ancestral origin, antigenic resemblance and epidemiological insights of novel coronavirus (SARS-CoV-2): Global burden and Bangladesh perspective.
SARS-CoV-2, a new coronavirus strain responsible for COVID-19, has emerged in Wuhan City, China, and continuing its global pandemic nature. The availability of the complete gene sequences of the virus helps to know about the origin and molecular characteristics of this virus. In the present study, we performed bioinformatic analysis of the available gene sequence data of SARS-CoV-2 for the understanding of evolution and molecular characteristics and immunogenic resemblance of the circulating viruses. Phylogenetic analysis was performed for four types of representative viral proteins (spike, membrane, envelope and nucleoprotein) of SARS-CoV-2, HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HKU1, MERS-CoV, HKU4, HKU5 and BufCoV-HKU26. The findings demonstrated that SARS-CoV-2 exhibited convergent evolutionary relation with previously reported SARS-CoV. It was also depicted that SARS-CoV-2 proteins were highly similar and identical to SARS-CoV proteins, though proteins from other coronaviruses showed a lower level of resemblance. The cross-checked conservancy analysis of SARS-CoV-2 antigenic epitopes showed significant conservancy with antigenic epitopes derived from SARS-CoV. Descriptive epidemiological analysis on several epidemiological indices was performed on available epidemiological outbreak information from several open databases on COVID-19 (SARS-CoV-2). Satellite-derived imaging data have been employed to understand the role of temperature in the environmental persistence of the virus. Findings of the descriptive analysis were used to describe the global impact of newly emerged SARS-CoV-2, and the risk of an epidemic in Bangladesh.


[Malaria in children, with special reference to cerebral malaria (author's transl)].
Those who live in areas where Malaria is endemic, acquire immunity by continuous contact. This immunity cannot be acquired during a short holiday. Children in endemic areas acquire a more severe form of malaria during the period of developing immunity and more often suffer complications like acute hemolytic anemia and, in the case of plasmodium falciparum infection, cerebral malaria. This is a report of 39 cases of cerebral malaria which corresponds to an acute encephslopathy with high temperatures, generalized tonic-clonic spasms and unconsciousness. All children were between 6 months and 5 years old. Cerebral malaria at higher ages is rarely seen in Malawi. But its frequency depends on the intensity of endemic infection and the geographic distribution of the types of malaria. 11 (29%) of the 39 children died. Treatment was with chloroquine against which there was no resistance in East Africa for falciparum infections and with plasmaexpanders. In 1 case permanent neurologic changes a spastic cerebral paresis, were seen. Unconsciousness lasting more than 36 hours appears to be a bad prognostic sign. The CSF is clear and normal except for an occasional rise in protein never higher than 90 mg%.


Most adults show opposite-side biases in the imagined holding of infants and objects.
Three hundred university undergraduates were asked to imagine holding in their arms first an object (either an "expensive vase" or an "old shoebox") and then a young infant. For all three tasks, side biases were found that were significantly different from chance and from one another: 81% of the subjects reported holding the imagined vase in their right arm, 64% reported holding the imagined shoebox in their right arm, and 66% reported holding the imagined infant in their left arm. These results further support the hypothesis that the left-side bias is unique to infants and, for the first time, establish this through direct comparisons of holding-side biases for infants and objects within subjects. The sex and handedness of the holder as well as the qualities of the imagined object also were found to contribute to the side and strength of the bias.


Deep Neural Networks for Predicting Single-Cell Responses and Probability Landscapes.
Engineering biology relies on the accurate prediction of cell responses. However, making these predictions is challenging for a variety of reasons, including the stochasticity of biochemical reactions, variability between cells, and incomplete information about underlying biological processes. Machine learning methods, which can model diverse input-output relationships without requiring a priori mechanistic knowledge, are an ideal tool for this task. For example, such approaches can be used to predict gene expression dynamics given time-series data of past expression history. To explore this application, we computationally simulated single-cell responses, incorporating different sources of noise and alternative genetic circuit designs. We showed that deep neural networks trained on these simulated data were able to correctly infer the underlying dynamics of a cell response even in the presence of measurement noise and stochasticity in the biochemical reactions. The training set size and the amount of past data provided as inputs both affected prediction quality, with cascaded genetic circuits that introduce delays requiring more past data. We also tested prediction performance on a bistable auto-activation circuit, finding that our initial method for predicting a single trajectory was fundamentally ill-suited for multimodal dynamics. To address this, we updated the network architecture to predict the entire distribution of future states, showing it could accurately predict bimodal expression distributions. Overall, these methods can be readily applied to the diverse prediction tasks necessary to predict and control a variety of biological circuits, a key aspect of many synthetic biology applications.


Potential of CRISPR/Cas system in the diagnosis of COVID-19 infection.
Emerging novel infectious diseases and persistent pandemics with potential to destabilize normal life remain a public health concern for the whole world. The recent outbreak of pneumonia caused by Coronavirus infectious disease-2019 (COVID-19) resulted in high mortality due to a lack of effective drugs or vaccines. With a constantly increasing number of infections with mutated strains and deaths across the globe, rapid, affordable and specific detections with more accurate diagnosis and improved health treatments are needed to combat the spread of this novel pathogen COVID-19. Researchers have started to utilize the recently invented clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated proteins (CRISPR/Cas)-based tools for the rapid detection of novel COVID-19. In this review, we summarize the potential of CRISPR/Cas system for the diagnosis and enablement of efficient control of COVID-19. Multiple groups have demonstrated the potential of utilizing CRISPR-based diagnosis tools for the detection of SARS-CoV-2. In coming months, we expect more novel and rapid CRISPR-based kits for mass detection of COVID-19-infected persons within a fraction of a second. Therefore, we believe science will conquer COVID-19 in the near future.


Double-stranded RNA and the enzymology of interferon action.
Extracts from interferon-treated, not virus-infected Ehrlich ascites tumor cells differ in various biochemical characteristics from extracts of control cells. We studied three enzymes whose level is enhanced in cells upon treatment with IF and which are causing some of the differences. (2'-5')(A)n synthetase, an enzyme converting ATP into a series of (2'-5') linked oligoadenylates ((2'-5')(An)) in the presence of dsRNA was purified to homogeneity and characterized. The second enzyme, RNase L, a latent endonuclease, which can be activated by (2'-5')(A)n to cleave single-stranded RNAs, was purified several hundredfold. The activation of this enzyme is reversible and is lost upon removal of (2'-5')(A)n. The activation is not accompanied by a large change in shape of conformation of the enzyme. The third enzyme is a protein kinase which if activated by dsRNA can phosphorylate the peptide chain initiation factor eIF-2 and a protein designated P1 of 67,000 daltons. This enzyme was purified several thousandfold. The most highly purified preparation consists of three proteins with P1 as the most abundant component.


Mitotic cell rounding accelerates epithelial invagination.
Mitotic cells assume a spherical shape by increasing their surface tension and osmotic pressure by extensively reorganizing their interphase actin cytoskeleton into a cortical meshwork and their microtubules into the mitotic spindle. Mitotic entry is known to interfere with tissue morphogenetic events that require cell-shape changes controlled by the interphase cytoskeleton, such as apical constriction. However, here we show that mitosis plays an active role in the epithelial invagination of the Drosophila melanogaster tracheal placode. Invagination begins with a slow phase under the control of epidermal growth factor receptor (EGFR) signalling; in this process, the central apically constricted cells, which are surrounded by intercalating cells, form a shallow pit. This slow phase is followed by a fast phase, in which the pit is rapidly depressed, accompanied by mitotic entry, which leads to the internalization of all the cells in the placode. We found that mitotic cell rounding, but not cell division, of the central cells in the placode is required to accelerate invagination, in conjunction with EGFR-induced myosin II contractility in the surrounding cells. We propose that mitotic cell rounding causes the epithelium to buckle under pressure and acts as a switch for morphogenetic transition at the appropriate time.


Multicast Delayed Authentication For Streaming Synchrophasor Data in the Smart Grid.
Multicast authentication of synchrophasor data is challenging due to the design requirements of Smart Grid monitoring systems such as low security overhead, tolerance of lossy networks, time-criticality and high data rates. In this work, we propose inf -TESLA, Infinite Timed Efficient Stream Loss-tolerant Authentication, a multicast delayed authentication protocol for communication links used to stream synchrophasor data for wide area control of electric power networks. Our approach is based on the authentication protocol TESLA but is augmented to accommodate high frequency transmissions of unbounded length. inf TESLA protocol utilizes the Dual Offset Key Chains mechanism to reduce authentication delay and computational cost associated with key chain commitment. We provide a description of the mechanism using two different modes for disclosing keys and demonstrate its security against a man-in-the-middle attack attempt. We compare our approach against the TESLA protocol in a 2-day simulation scenario, showing a reduction of 15.82% and 47.29% in computational cost, sender and receiver respectively, and a cumulative reduction in the communication overhead.


Biobank and Genomic Research in Uganda: Are Extant Privacy and Confidentiality Regimes Adequate?
Not many African countries have been able to develop a robust system for regulating health research within their respective jurisdictions, particularly in the realm of biobanking and genomics. This is not without reason. Aside from underdevelopment and all that it entails or perhaps in consequence thereof, countries in the region have been unable to make significant strides in medical research. But there are exceptions. Amongst the few seeming success stories is Uganda. Nonetheless, although the country has developed what appears to be a functional framework to govern genomic research and biobanking, the consistency of key provisions with international standards, especially those pertaining to privacy of research participants and confidentiality of their health information, is not at all clear. Yet, making this determination - the main objective of this article - is critical in determining the adequacy of protection available to human research subjects in the country.


Control of Bacillus subtilis cell shape by RodZ.
The bacterial cell wall ensures the structural integrity of the cell and is the main determinant of cell shape. In Bacillus subtilis, three cytoskeletal proteins, MreB, MreBH and Mbl, are thought to play a crucial role in maintaining the rod cell shape. These proteins are thought to be linked with the transmembrane proteins MreC, MreD and RodA, the peptidoglycan hydrolases, and the penicillin-binding proteins that are essential for peptidoglycan elongation. Recently, a well-conserved membrane protein RodZ was discovered in most Gram-negative and Gram-positive bacteria. This protein seems to be an additional member of the elongation complex. Here, we examine the role of RodZ in B. subtilis cells. Our results indicate that RodZ is an essential protein and that downregulation of RodZ expression causes the formation of shorter and rounder cells. We also found a direct interaction between RodZ and the cytoskeletal and morphogenetic proteins MreB, MreBH, Mbl and MreD. Taken together, we demonstrated that RodZ is an important part of the cell shape determining network in B. subtilis.


The mitochondrial genome of Ruspolia dubia (Orthoptera: Conocephalidae) contains a short A+T-rich region of 70 bp in length.
The complete sequence (14 971 bp) of the Ruspolia dubia mitochondrial genome was determined and annotated. The genome contains the gene content, base composition, and codon usage typical of metazoan mitochondrial genomes. All 37 genes are conserved in the positions observed most frequently in insect mitochondrial genome structures. The secondary structures of both small subunit and large subunit rRNA were predicted. The most unusual features found were the initiation codon (TTA) of COI and a short A+T-rich region of 70 bp in length. In addition, a short, highly conserved polythymidine stretch that was previously described in Orthoptera and Diptera was also present in the A+T-rich region.


Risk-Stratified Incidence of Renal Replacement Therapy Initiation: A Longitudinal Analysis Using Medical Claims and Health Checkup Data.
Intervention for higher-risk participants of health checkups especially with diabetes has been started in Japan to prevent renal replacement therapy (RRT) initiation, but evidence about RRT initiation risk among checkup participants has been scarce. To estimate the incidence by risk factors, we conducted a retrospective cohort study using medical claims and checkup data of a community-based insurance scheme in Japan. Beneficiaries who participated in the checkup in 2012-2013 were included and followed up for about five years. We estimated the incidence of RRT initiation by the subject characteristics, followed by investigation for risk factors in bivariate analyses and multivariable regression analyses with Bayesian prior probability distributions. As a result, among 49,252 participants, 37 initiated dialysis (0.21/1,000 person-years); no kidney transplantation was performed during the period. Baseline estimated glomerular filtration rate was strongly associated with dialysis initiation. No dialysis was initiated among those without baseline hypertension; cumulative incidence by hypertension status was significantly different (p < 0.001). Diabetes was significantly associated with dialysis initiation in bivariate analysis, but the association was not significant in multivariable regression analysis [reference: no diabetes; incidence rate ratio (IRR) for diabetes without medication, 3.30 (95% credible interval, 0.48-15.56); IRR for diabetes with medication, 1.69 (95% credible interval, 0.68-3.47)]. In conclusion, potential risk factors for RRT initiation include male sex, comorbid hypertension, and current smoking status, in addition to advanced chronic kidney disease, proteinuria, and diabetes. New initiatives should consider these factors to increase the efficacy of the programs at the population level.


K-turn motifs in spatial RNA coding.
Three-dimensional architectural motifs are increasingly recognized as determinants of RNA functionality. We submit that such motifs can encode spatial information. RNAs are targeted to subcellular localities in many eukaryotic cell types, and especially in neuronal and glial cells, RNAs can be transported over long distances to their final destination sites. Such RNAs contain cis-acting long-range targeting elements, and recent evidence suggests that kink-turn motifs within such elements may act as spatial codes to direct transport. Kink-turns are complex RNA motifs that feature double- and single-stranded components and introduce a signature three-dimensional structure into helical stems. We propose that the overall architectural design as well as the individual character--as specified by nucleotide identity and arrangement--of kink-turn motifs can serve as RNA targeting determinants.


Superficial branch of the radial nerve piercing the brachioradialis tendon to become subcutaneous: an anatomical variation with clinical relevance.
We dissected 20 preserved Caucasian cadaveric upper limbs looking at the relation of the superficial branch of the radial nerve (SBRN) to the brachioradialis tendon. SBRN emerged from deep to superficial position by piercing the brachioradialis tendon near its dorsal border in four limbs. The resulting dorsal tendinous band compressed the nerve and prevented longitudinal gliding movement during ulnar flexion. This is likely to increase the risk of chronic compression neuropathy (Wartenberg's syndrome). In two of these four limbs, there was a communication between the SBRN and lateral cutaneous nerve of the forearm. No such communication was found in the remaining 16 forearms. This communication could contribute to the minimal area of sensory loss observed in Wartenberg's syndrome. We recommend that this anatomical anomaly is looked for and if present dealt with during surgical treatment of Wartenberg's syndrome, as it is likely to predispose to chronic compression neuropathy.


[Goblet cells in spontaneous colibacteriosis in pigs].
This work is a part of the studies on the intestinal barrier undertaken to cast some more light on the pathogenesis of colibacteriosis in pigs. The objective of the work was to investigate the goblet cells in the intestines of pigs ill with spontaneous colibacteriosis in the form of oedema disease and gastrointestinal form. The investigations were carried out on 26 pigs segregated into 3 groups: I group -- typical oedema disease (12 pigs), II group -- colibacteriosis in the gastrointestinal form (8 pigs), III group -- healthy controls (6 pigs). The segregation into the first two groups was based on the clinical, pathological and bacteriological criteria. In all the animals, the number of the goblet cells was counted in the duodenum, jejunum, ileum, cecum and colon. The results, analysed statistically, showed that in spontaneous colibacteriosis (oedema disease as well as the gastrointestinal form) a slight decrease of the number of the goblet cells was observed. In oedema disease, this decrease is significant only in the epithelium of the jejunal villi and in that of the colon, in the gastrointestinal form -- in the duodenal and jejunal villi. It results from the present investigations that the goblet cells, as one of the factors of the intestinal barrier, are not liable to such changes in spontaneous colibacteriosis as to explain or cast light on the pathogenesis of this disease.


Optimal treatment of replicate measurements in anthropometric studies.
Anthropometric studies often include replicates of each measurement to decrease error. The optimal method to combine these measurements is uncertain. To identify the optimal method to combine replicate measures for analysis. The authors carried out 10 000 Monte Carlo simulations to explore the effect of six approaches to combine replicate measurements in a hypothetical two-group intervention study (n = 100 per arm) in which the outcome, infant length at age 1 year, was measured two or three times. One group had a true value with a normal distribution N (mean = 76, SD = 2.4 cm). Statistical power was estimated to detect a 1 cm difference between the groups, based on a t-test. Under a realistic scenario with a measurement error distribution N (0, 0.8), highest power was reached by use of the mean and the median of pairwise averages. However, when a portion of the data (≥2%) were contaminated by greater error (e.g. due to data entry), the median of three measurements outperformed all other methods while the mean had the lowest performance. Obtaining three rather than two measures and using the median of the three replicates is a safe and robust approach to combine participants' raw data values for use in subsequent analyses.


Long-Term Survival in Patients with Cancers: Surveillance, epidemiology and end results-based analysis.
This study aimed to explore real-world data on the long-term survival of cancer patients using historical records from the Surveillance, Epidemiology, and End Results (SEER) Programme. Long-term survival is an important endpoint in the management of different malignancies. It is rarely assessed due to the unfeasibility of follow-up for a long duration of time. Besides reporting the five-year relative survival, the 10- and 20-year survival rates for different types of cancers were analysed. Additionally, survival trends as a function of time, age and tumour type were reviewed and reported. The study used SEER*Stat (Version 18.104.22.168) for data acquisition from the SEER 9 Regs (November 2019) database. Data from patients diagnosed with cancer between 1975 and 2014 were retrieved and included in the analysis. For patients diagnosed with any malignant disease (N = 4,412,024), there was a significant increase in median overall survival over time (P <0.001). The 20-, 10-, and 5-year survival rates were higher in solid tumours compared to haematological malignancies (50.8% versus 38%; 57% versus 47.4%; and 62.2% versus 57.4%, respectively). The highest 20-year relative survival rates were observed in thyroid cancer (95.2%), germ cell and trophoblastic neoplasms (90.3%), melanoma (86.8%), Wilms' tumour (86.2%) and prostate cancer (83.5%). Long-term follow-up data were suggestive of high 20-year relative survival rates for most tumour types. Relative survival showed an improving trend over time, especially in solid tumours.


Evidence for Ultralow-Energy Vibrations in Large Organic Molecules.
The quantum efficiency or the rate of conversion of incident photon to free electron in photosynthesis is known to be extremely high. It has long been thought that the origin of this efficiency are molecular vibrations leading to a very fast separation of electrons and holes within the involved molecules. However, molecular vibrations are commonly in the range above 100 meV, which is too high for excitations in an ambient environment. Here, we analyze experimental spectra of single organic molecules on metal surfaces at ∼4 K, which often exhibit a pronounced dip. We show that measurements on iron(II) [tetra-(pentafluorophenyl)]porphyrin resolve this single dip at 4 K into a series of step-shaped inelastic excitations at 0.4 K. Via extensive spectral maps under applied magnetic fields and corresponding theoretical analysis we find that the dip is due to ultralow-energy vibrations of the molecular frame, typically in the range below 20 meV. The result indicates that ultralow energy vibrations in organic molecules are much more common than currently thought and may be all-pervasive for molecules above a certain size.


The role of kisspeptin and MKRN3 in the diagnosis of central precocious puberty in girls.
To evaluate the characteristics and significance of serum kisspeptin and makorin ring finger protein 3 (MKRN3) levels for the diagnosis of central precocious puberty (CPP) in girls. Thirty four individuals with CPP, 17 individuals with premature thelarche (PT), and 28 age-matched prepubertal girls as normal control (NC) were recruited in this case-control study. Physical measurements included BMI and tests for breast, bone, and sexual characteristics. Biochemical measurements included serum LH, FSH, estradiol, insulin-like growth factor-1, MKRN3, and kisspeptin. Blood samples were taken from individuals with CPP and PT before the gonadotrophin-releasing hormone stimulation test and at 30, 60, 90, and 120 min after injection with triptorelin. Serum kisspeptin levels were higher in the CPP group when compared to the NC group (P = 0.020), while serum MKRN3 levels were lower in the two groups (P = 0.028). There were no significant differences between the CPP and PT groups as well as the PT and NC groups (all, P > 0.05). The cut-off value of serum kisspeptin differentiating patients with CPP from those without CPP was 0.40 nmol/L, with 82.4% sensitivity and 57.1% specificity, while the cut-off value of serum MKRN3 was 0.33 pmol/L, with 79.4% sensitivity and 53.6% specificity. The area under the curves (AUCs) of both kisspeptin and MKRN3 for differentiating those girls with CPP from PT were less than 0.5. Serum levels of kisspeptin and MKRN3 may play an auxiliary role in predicting CPP. However, the two measurements were not able to differentiate girls with CPP from PT and prepubertal control. This study emphasizes the need to search for markers to simplify the accurate diagnosis of CPP in girls.


Visceral Obesity and Cytokeratin-18 Antigens as Early Biomarkers of Liver Damage.
Visceral obesity is linked to the progression of fatty liver to nonalcoholic steatohepatitis (NASH). Cytokeratin-18 (CK18) epitopes M30 (CK18M30) and M65 (CK18M65) represent accurate markers for detecting NASH. The aim of this study was to evaluate the association of CK18M30 and CK18M65 levels with anthropometric and metabolic characteristics, liver stiffness, and liver indices of steatosis and fibrosis in a cohort of subjects with visceral obesity; in this cross-sectional study, transient elastography (TE-Fibroscan®), anthropometric measurements, metabolic parameters, High Sensitivity C-Reactive Protein (hsCRP), and CK18M30 and CK18M65 levels (Apoptosense ELISA, PEVIVA, Germany) were evaluated. Fatty Liver Index (FLI), Fibrosis 4 (FIB-4), and Aspartate transaminase (AST)-platelet ratio index (APRI) were calculated; among 48 subjects, 47.2% presented metabolic syndrome, 93.8% hepatic steatosis, 60.4% high liver stiffness, and 14.6% hypertransminasemia, while FIB-4 and APRI were normal. CK18M30 and CK18M65 levels were significantly correlated with waist circumference, AST, ALT, HoMA-IR, liver stiffness, and APRI (p < 0.001). Subjects with CK18 fragments above the median values showed significantly higher waist circumference, HbA1c, AST, ALT, HoMA-IR, FLI, and APRI compared to those with values below the median; CK18M30 and CK18M65 levels correlated well with anthropometric and metabolic characteristics, representing good biomarkers for early identification of NASH in subjects with visceral obesity.


Protecting privacy while sharing medical data between regional healthcare entities.
Economies of scale, corporate partnerships and a need to increase the efficiency of Information Technology in the Healthcare sector are leading to the construction of Regional Health Information Organizations (RHIOs) across the United States. RHIOs are normally aligned by service provision given by particular healthcare payers (e.g. Blue Cross-Blue Shield, PacifiCare etc.) in particular geographies. Globalization has created a transient workforce that may require their healthcare provider access their patient data across several sovereign RHIOs. The barrier to enabling RHIO to RHIO collaboration lies in the need to respect the data disclosure policy of each RHIO, to adhere to the geography-specific healthcare legislation and also to not violate the express privacy wishes of the patient(s) involved. In this paper, we propose a data-level control called Sticky Policy Enforcement which allows sharing to occur across RHIOs, while adhering to the concerns mentioned.


SurR is a master regulator of the primary electron flow pathways in the order Thermococcales.
The sulfur response regulator, SurR, is among a handful of known redox-active transcriptional regulators. First characterized from the hyperthermophile Pyrococcus furiosus, it is unique to the archaeal order Thermococcales. P. furiosus has two modes of electron disposal. Hydrogen gas is produced when the organism is grown in the absence of elemental sulfur (S0 ) and H2 S is produced when grown in its presence. Switching between these metabolic modes requires a rapid transcriptional response and this is orchestrated by SurR. We show here that deletion of SurR causes severely impaired growth in the absence of S0 since genes essential for H2 metabolism are no longer activated. Conversely, a strain containing a constitutively active SurR variant displays a growth phenotype in the presence of S0 due to constitutive repression of S0 -responsive genes. During a metabolic shift initiated by addition of S0 to the growth medium, both strains demonstrate a de-regulation of genes involved in the SurR regulon, including hydrogenase and related S0 -responsive genes. These results demonstrate that SurR is a master regulator of electron flow within P. furiosus, likely affecting the pools of ferredoxin, NADPH and NADH, as well as influencing metabolic pathways and thiol/disulfide redox balance.


Research on the cultivation of sustainable development ability of higher vocational students by creative thinking teaching method.
Education for sustainable development (ESD) is an important guideline for United Nations Sustainable Development Goals. Students' creative thinking can be applied to various disciplines, promoting sustainable learning. Most of Taiwan's beauty and hairdressing technical education teachers mainly teach students to imitate, and students' works lack creativity and thinking. A total of 43 higher vocational college students participated, 23 of whom were in the experimental group using the creative thinking teaching method and 20 of whom were in the control group using the traditional teaching method. The results show that the creative thinking teaching method can effectively improve students' learning outcomes in the multimedia material creation course, including breaking through the limitation of thinking, putting forward different ideas and answers, and constantly innovating, to make the presented results more creative and meaningful. The creative thinking teaching methods solve students' trouble in creative problem solving, enhance students' problem solving and critical thinking skills, and improve students' involvement in the study.


Rapid targeting followed by sustained deployment of visual spatial attention.
We investigated preparatory attention processes when a spatial discrimination was required at a cued location, by measuring electroencephalography following a central symbolic cue to deploy spatial attention. Electroencephalography activity in response to the cue revealed three cue-related activations: an early-onset positivity following the P1 at posterior scalp sites contralateral to the cued location, followed by cue-related frontal scalp activity and later-onset sustained activity at posterior scalp sites contralateral to the cued location. The early contralateral positivity may reflect rapid targeting of the cued location. Our results also extend the findings of cue-related frontal activity followed by posterior activity contralateral to the cued location, found with nonspatial feature discriminations, to a task requiring a spatial discrimination.


Lung transplantation in Kartagener's syndrome.
Kartagener's syndrome is associated with bronchiectasis and situs inversus and may offer an indication for lung transplantation. One case of heart and lung transplantation has been published that stresses the necessity for a modified surgical procedure creating a large single atrium to manage the situs inversus. We performed a double lung transplantation in a 46-year-old patient with this disease. No technical modifications for the different anatomic relationship were necessary; discrepancies of the bronchial lumina were easily overcome.


Use of a computer for producing microbiological reports and for data storage and processing.
A simple 'fail-safe' system is described that produces microbiology reports on a computer teleprinter and stores results on the magnetic tapes and discs of a computer for instant retrieval and epidemiological analysis. The system, which has been in operation for over a year, involves the use of a modified conventional NCR request form. The top portion, which is completed manually by the laboratory staff, is coded by writing numbers in hatched boxes. The data thus written on to the bottom portion are transcribed by punch operators on to paper tape and this data input is verified by double punching. The reports are normally produced automatically by the computer terminal telprinter, but in case of mechanical failure the manually completed request forms can be returned to wards and outpatient departments. The system permits a wide choice of options for epidemiological analysis, and six programmes are described, one of which produces a digest of the overall percentage antibiotic sensitivities of organisms from various sites.


Prevalence of retinal hemorrhages in pediatric patients after in-hospital cardiopulmonary resuscitation: a prospective study.
Child abuse occurs in 1% of children in the United States every year; 10% of the traumatic injuries suffered by children under 5 years old are nonaccidental, and 5% to 20% of these nonaccidental injuries are lethal. Rapid characterization of the injury as nonaccidental is of considerable benefit to child protection workers and police investigators seeking to safeguard the child care environment and apprehend and prosecute those who have committed the crime of child abuse. Physically abused children present with a variety of well-described injuries that are usually easily identifiable. In some cases, however, particularly those involving children with the shaken baby syndrome, obvious signs of physical injury may not exist. Although external signs of such an injury are infrequent, the rapid acceleration-deceleration forces involved often cause subdural hematomas and retinal hemorrhages, hallmarks of the syndrome. Frequently, retinal hemorrhages may be the only presenting sign that child abuse has occurred. Complicating the interpretation of the finding of retinal hemorrhages is the belief by some physicians that retinal hemorrhages may be the result of chest compressions given during resuscitative efforts. The objective of this study is to determine the prevalence of retinal hemorrhages after inpatient cardiopulmonary resuscitation (CPR) in pediatric patients hospitalized for nontraumatic illnesses in an intensive care unit. Prospective clinical study. Pediatric intensive care unit. Forty-three pediatric patients receiving at least 1 minute of chest compressions as inpatients and surviving long enough for a retinal examination. Patients were excluded if they were admitted with evidence of trauma, documented retinal hemorrhages before the arrest, suspicion of child abuse, or diagnosis of near-drowning or seizures. All of the precipitating events leading to cardiopulmonary arrest occurred in our intensive care unit, eliminating the possibility of physical abuse as an etiology. None. Examination of the retina was performed by one of two pediatric ophthalmologists within 96 hours of CPR. The chart was reviewed for pertinent demographic information; the platelet count, prothrombin time, and partial thromboplastin time proximate to the CPR were recorded if they had been determined. A total of 43 pediatric patients hospitalized with nontraumatic illnesses survived 45 episodes of inpatient CPR. The mean age was 23 months (range, 1 month to 15.8 years), and 84% of the patients were under 2 years old. The majority of the patients (44%) were admitted to the intensive care unit after surgery for congenital heart disease, and another 21% were admitted for respiratory failure. The mean duration of chest compressions was 16.4 minutes +/- 17 minutes with 58% lasting between 1 and 10 minutes. Five patients had chest compressions lasting >40 minutes, and two patients had open chest cardiac massage. All patients survived their resuscitative efforts. Ninety-three percent of patients had an elevated prothrombin time and/or partial thromboplastin time while 49% were thrombocytopenic. Sixty-two percent of the patients had low platelet counts and an elevated prothrombin time and/or partial thromboplastin time. Small punctate retinal hemorrhages were found in only one patient. Retinal hemorrhages are rarely found after chest compressions in pediatric patients with nontraumatic illnesses, and those retinal hemorrhages that are found appear to be different from the hemorrhages found in the shaken baby syndrome. Despite the small number of patients in this prospective study, we believe that these data support the idea that chest compressions do not result in retinal hemorrhages in children with a normal coagulation profile and platelet count. A larger number of patients should be evaluated in a prospective multi-institutional study to achieve statistical significance


Interventions for treating femoral shaft fractures in children and adolescents.
Fractures of the femoral shaft in children are relatively uncommon but serious injuries that disrupt the lives of children and their carers and can result in significant long-term disability. Treatment involves either surgical fixation, such as intramedullary nailing or external fixation, or conservative treatment involving prolonged immobilisation, often in hospital. To assess the effects (benefits and harms) of interventions for treating femoral shaft fractures in children and adolescents. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (accessed 16 August 2013), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2013 Issue 7), MEDLINE (1946 to August Week 1 2013), EMBASE (1980 to 2012 week 9), CINAHL (16 August 2013), clinical trials registries, conference proceedings and reference lists; and contacted trial authors and experts in the field. Randomised and quasi-randomised controlled trials comparing conservative and surgical interventions for diaphyseal fractures of the femur in children under 18 years of age. Our primary outcomes were functional outcome measures, unacceptable malunion, and serious adverse events. Two authors independently screened and selected trials, assessed risk of bias and extracted data. We assessed the overall quality of the evidence for each outcome for each comparison using the GRADE approach. We pooled data using a fixed-effect model. We included 10 trials (six randomised and four quasi-randomised) involving a total of 527 children (531 fractures). All trials were at some risk of bias, including performance bias as care provider blinding was not practical, but to a differing extent. Just one trial was at low risk of selection bias. Reflecting both the risk of bias and the imprecision of findings, we judged the quality of evidence to be 'low' for most outcomes, meaning that we are unsure about the estimates of effect. Most trials failed to report on self-assessed function or when children resumed their usual activities. The trials evaluated 10 different comparisons, belonging to three main categories. Surgical versus conservative treatment. Four trials presenting data for 264 children aged 4 to 12 years made this comparison. Low quality evidence (one trial, 101 children) showed children had very similar function assessed using the RAND health status score at two years after surgery (external fixation) compared with conservative treatment (spica cast): mean 69 versus 68. The other three trials did not report on function. There was moderate quality evidence (four trials, 264 children, aged 4 to 12 years, followed up 3 to 24 months) that surgery reduced the risk of malunion (risk ratio (RR) 0.29, 95% confidence interval (CI) 0.15 to 0.59, 4 trials). Assuming an illustrative baseline risk of 115 malunions per 1000 in children treated conservatively, these data equate to 81 fewer (95% CI 47 to 97 fewer) malunions per 1000 in surgically-treated children. Conversely, low quality evidence indicated that there were more serious adverse events such as infections after surgery (RR 2.39, 95% CI 1.10 to 5.17, 4 trials). Assuming an illustrative baseline risk of 40 serious adverse events per 1000 for conservative treatment, these data equate to 56 more (95% CI 4 to 167 more) serious adverse events per 1000 children treated surgically. There was low quality evidence (one trial, 101 children) of similar satisfaction levels in children and parents with surgery involving external fixation and plaster cast only. However, there was low quality evidence (one trial, 46 children) that more parents were satisfied with intramedullary nailing than with traction followed by a cast, and that surgery reduced the time taken off from school. Comparisons of different methods of conservative treatment. The three trials in this category made three different comparisons. We are very unsure if unacceptable malunion rates differ between immediate hip spica versus skeletal traction followed by spica in children aged 3 to 10 years followed up for six to eight weeks (RR 4.0, 95% CI 0.5 to 32.9; one trial, 42 children; very low quality evidence). Malunion rates at 5 to 10 years may not differ between traction followed by functional orthosis versus traction followed by spica cast in children aged 5 to 13 years (RR 0.98, 95% CI 0.46 to 2.12; one trial, 43 children; low quality evidence). We are very unsure (very low quality evidence) if either function or serious adverse events (zero events reported) differ between single-leg versus double-leg spica casts (one trial, 52 young children aged two to seven years). Low quality evidence on the same comparison indicates that single-leg casts are less awkward to manage by parents, more comfortable for the child and may require less time off work by the caregiver. Comparisons of different methods of surgical treatment. The three trials in this category made three different comparisons. Very low quality evidence means that we are very unsure if the rates of malunion, serious adverse events, time to return to school or parental satisfaction actually differ in children whose fractures were fixed using elastic stable intramedullary nailing or external fixation (one trial, 19 children). The same applies to the rates of serious adverse events and time to resume full weight-bearing in children treated with dynamic versus static external fixation (one trial, 52 children). Very low quality evidence (one trial, 47 children) means that we do not know if malunion, serious adverse events and time to resume weight-bearing actually differ between intramedullary nailing versus submuscular plating. However, there could be more difficulties in plate removal subsequently. There is insufficient evidence to determine if long-term function differs between surgical and conservative treatment. Surgery results in lower rates of malunion in children aged 4 to 12 years, but may increase the risk of serious adverse events. Elastic stable intramedullary nailing may reduce recovery time. There is insufficient evidence from comparisons of different methods of conservative treatment or of different methods of surgical treatment to draw conclusions on the relative effects of the treatments compared in the included trials. Different methods of treating fractures of the shaft of the thigh bone in children and adolescents Although uncommon, fractures of the femoral shaft (thigh bone) in children may require prolonged treatment in hospital and sometimes surgery. This can cause significant discomfort and can disrupt the lives of the children and their familles. This review compared different methods of treating these fractures. Surgical treatment comprises different methods of fixing the broken bones, such as internally-placed nails, or pins incorporated into an external frame (external fixation). Non-surgical or conservative treatment usually involves different types of plaster casts with or without traction (where a pulling force is applied to the leg). We searched for studies in the medical literature until August 2013. The review includes 10 randomised or quasi-randomised controlled trials that recruited 527 children. Four trials compared different surgical versus non-surgical treatments; three compared different methods of non-surgical treatment and three compared different methods of surgical treatment. Generally we are unsure about the results of these trials because some were at risk of bias, some results were contradictory and usually there was too little evidence to rule out chance findings. Most trials failed to report on self-assessed function or when children resumed their usual activities. Comparing surgical versus non-surgical treatment. Low quality evidence (one trial, 101 children) showed children had similar function at two years after having surgery, involving external fixation, compared with those treated with a plaster cast. The other three trials did not report this outcome. There was moderate quality evidence (four trials, 264 children, aged 4 to 12 years, followed up for 3 to 24 months) that surgery reduced the risk of malunion (the leg is deformed) compared with non-surgical treatment. However, low quality evidence (four trials) indicated that there were more serious adverse events such as infections after surgery. There was low quality evidence (one trial, 101 children) of similar satisfaction levels in children and parents with surgery involving external fixation and plaster cast only. However, there was low quality evidence (one trial, 46 children) that more parents were satisfied with surgery involving an internal nail than with traction followed by a cast and that surgery reduced the time taken off from school. Comparing various non-surgical treatments. Very low quality evidence means that we are very unsure if the rates of malunion differ or not between children treated with immediate plaster casts versus with traction followed by plaster cast (one trial, 42 children), or between children treated with traction followed by either a functional orthosis (a brace or cast that allows some movement) or a cast (one trial, 43 children). We are very unsure if either function or serious adverse events differ between young children (aged two to seven years) immobilised in single-leg versus double-leg casts (one trial, 52 children). However, single-leg casts appear to be easier to manage by parents and more comfortable for the child. Comparing various surgical treatments Very low quality evidence means that we are very unsure if the rates of malunion, serious adverse events, time to return to school or parental satisfaction actually differ in children whose fractures were fixed using internal nails or external fixation (one trial, 19 children). 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Study on superconducting Li-Se-H hydrides.
The structures, stabilities and superconducting properties of LiSeHn (n = 4-10) hydrides at 150-300 GPa were studied by the genetic algorithm (GA) and DFT calculation method. Three stable stoichiometries of LiSeH4, LiSeH6 and LiSeH10 were uncovered under high pressure. Four other metastable stoichiometries of LiSeH5, LiSeH7, LiSeH8, and LiSeH9 were also studied. By analyzing the electronic band structure and electronic density of states, C2 LiSeH4, Pmm2 LiSeH6 and C2 LiSeH10 were all found to be metal phases above 150 GPa. Electron-phonon coupling calculations showed that C2 LiSeH4 and Pmm2 LiSeH6 were promising superconductors. The predicted Tc values of C2 LiSeH4 and Pmm2 LiSeH6 were 77 K at 200 GPa and 111 K at 250 GPa, respectively.


Current Status of Circulating Tumor Cells in Head and Neck Squamous Cell Carcinoma: A Review.
Circulating tumor cells (CTCs) are found in the blood of patients with cancer, including head and neck squamous cell carcinomas (HNSCCs). The aim is to review the most up-to-date status of CTCs for applications in patients with HNSCC. English articles in PubMed. All the studies on CTCs in HNSCCs in the literature were reviewed. There is emerging information on the diagnostic and prognostic value of CTCs in HNSCCs. Evidence also highlights the advantages of various downstream analysis approaches over circulating tumor DNA (ctDNA), such as single-CTC analysis, ex vivo, and in vivo expansion of CTCs. Multiple phenotypic surface markers (cytokeratins, EpCAM, vimentin, etc.), used for CTCs characterization using different immunoassays, could predict disease progression as well as patients' response to treatment efficacy. Immune checkpoint inhibitors' status in CTCs could also provide better insight into treatment. Clonal expansion of CTCs and single-cell analysis of CTCs are the most emerging fields nowadays which may offer an understanding of the mechanism of tumor evolution as well as therapeutic efficacy. Although several clinical trials are ongoing, limitations still exist in the detection and characterization of CTCs. Due to the lack of a gold standard protocol, the sensitivity and specificity of CTC enumeration methods vary. Prospective clinical trials are still needed before CTCs can be employed as diagnostic and prognostic markers in the clinical management of patients with HNSCC.