Serological studies of yaws in Thailand.
The serological aspects of anti-yaws campaigns are discussed. Serological reactions in untreated yaws are considered according to each type of lesion and by age-groups; the serological pattern in types I and II show much similarity in that the majority of cases fall in the high titre levels while with types IV and V there appears to be a more even distribution of cases at all titre levels. A uniform serological response is seen in the early lesions for all age-groups and this is also true of hyperkeratosis cases. There are more type IV cases among the younger age-groups showing high titres, while in the older groups there is an upward trend towards the negative side. Type V also shows a regressive serology.The serological response to treatment with penicillin in three different schedules (4 ml x 2, 2 ml x 2, and a single injection of 4 ml) is then compared. There was no marked difference between the response at the end of one year with all three schedules; with a larger amount of material, however, it is likely that the 2 ml x 2 dosage would be seen to be less effective than the other two schedules. Serological response to treatment with any schedule would be governed by the number of cases having a high initial titre among the group under consideration. The decrease in titre, after being comparatively rapid in the first six months after treatment, is slow, and reversal to seronegativity at the end of a year occurs only in a small number of cases.The role of mass serological examinations in large-scale campaigns is considered. While the serological approach is shown to be the only scientific one, the impracticability of mass serological investigation is brought out. It is stressed, however, that in a mass campaign a serological service is essential for pilot studies, orientation of incidence of latent yaws, check on diagnosis, and assessment of dosage and of the necessity for re-treatment.The possible reasons for prozone phenomena in slide flocculation tests are discussed. The presence of reagin-like substances of extraneous origin to treponemal infection, as well as of reagin, in yaws patients may be responsible for some of these phenomena.


Promoting transportation safety in adolescence: the drivingly randomized controlled trial.
The impact of young drivers' motor vehicle crashes (MVC) is substantial, with young drivers constituting only 14% of the US population, but contributing to 30% of all fatal and nonfatal injuries due to MVCs and 35% ($25 billion) of the all medical and lost productivity costs. The current best-practice policy approach, Graduated Driver Licensing (GDL) programs, are effective primarily by delaying licensure and restricting crash opportunity. There is a critical need for interventions that target families to complement GDL. Consequently, we will determine if a comprehensive parent-teen intervention, the Drivingly Program, reduces teens' risk for a police-reported MVC in the first 12 months of licensure. Drivingly is based on strong preliminary data and targets multiple risk and protective factors by delivering intervention content to teens, and their parents, at the learner and early independent licensing phases. Eligible participants are aged 16-17.33 years of age, have a learner's permit in Pennsylvania, have practiced no more than 10 h, and have at least one parent/caregiver supervising. Participants are recruited from the general community and through the Children's Hospital of Philadelphia's Recruitment Enhancement Core. Teen-parent dyads are randomized 1:1 to Drivingly or usual practice control group. Drivingly participants receive access to an online curriculum which has 16 lessons for parents and 13 for teens and an online logbook; website usage is tracked. Parents receive two, brief, psychoeducational sessions with a trained health coach and teens receive an on-road driving intervention and feedback session after 4.5 months in the study and access to DriverZed, the AAA Foundation's online hazard training program. Teens complete surveys at baseline, 3 months post-baseline, at licensure, 3months post-licensure, 6 months post-licensure, and 12 months post-licensure. Parents complete surveys at baseline, 3 months post-baseline, and at teen licensure. The primary end-point is police-reported MVCs within the first 12 months of licensure; crash data are provided by the Pennsylvania Department of Transportation. Most evaluations of teen driver safety programs have significant methodological limitations including lack of random assignment, insufficient statistical power, and reliance on self-reported MVCs instead of police reports. Results will identify pragmatic and sustainable solutions for MVC prevention in adolescence. ClinicalTrials.gov # NCT03639753.


Prevalence of domestic violence in an inpatient female population.
Studies have evaluated the prevalence of domestic violence in populations of patients in emergency and primary care settings, but there are little data on patients admitted to hospitals. We undertook a study to evaluate the prevalence of domestic violence among female inpatients. Of 131 consecutive female patients between the ages of 18 and 60 admitted to a nontrauma urban teaching hospital asked to complete a self-administered survey about domestic violence, 101 completed the questionnaire. Twenty-six percent of the respondents reported being in an abusive relationship at one time. Two patients felt that domestic violence contributed to their current reason for admission. No respondents were asked about domestic violence by health care providers. Domestic violence is an uncommon but important precipitant to nontrauma hospital admissions. Physicians should query all female inpatients about domestic assault.


Staff views on orthopaedic patients' accommodation.
Alternative accommodation to traditional wards may be suitable for some orthopaedic patients. Doctors and nurses in this study had different views about patient accommodation. Little reference to patient choice was made by either doctors or nurses. Further research is needed on different staff groups regarding factors influencing discharge decision-making.


Association Analysis of Charcoal Rot Disease Resistance in Soybean.
In this research, the relationships among the 31 microsatellite markers with charcoal rot disease resistance related indices in 130 different soybean cultivars and lines were evaluated using association analysis based on the general linear model (GLM) and the mixed linear model (MLM) by the Structure and Tassel software. The results of microsatellite markers showed that the genetic structure of the studied population has three subpopulations (K=3) which the results of bar plat also confirmed it. In association analysis based on GLM and MLM models, 31 and 35 loci showed significant relationships with the evaluated traits, respectively, and confirmed considerable variation of the studied traits. The identified markers related to some of the studied traits were the same which can probably be due to pleiotropic effects or tight linkage among the genomic regions controlling these traits. Some of these relationships were including, the relationship between Sat_252 marker with amount of charcoal rot disease, Satt359, Satt190 and Sat_169 markers with number of microsclerota in stem, amount of charcoal rot disease and severity of charcoal rot disease, Sat_416 marker with number of microsclerota in stem and amount of charcoal rot disease and the Satt460 marker with number of microsclerota in stem and severity of charcoal rot disease. The results of this research and the linked microsatellite markers with the charcoal rot disease-related characteristics can be used to identify the suitable parents and to improve the soybean population in future breeding programs.


Mini-microform cleft lip with complete cleft alveolus and palate: A case report.
Cleft lip and cleft alveolus are caused by incomplete fusion of the frontonasal and maxillary prominences. However, milder forms of cleft lip are rarely accompanied by cleft alveolus. Here, we report a rare case of mini-microform cleft lip with complete cleft alveolus and cleft palate. No findings suggestive of cleft lip were evident on initial examination. However, three-dimensional facial measurements confirmed the presence of cleft lip despite no evidence of orbicularis oris muscle (OOM) rupture on ultrasonography. Collapsed nostril, as observed in this case, is usually associated with OOM rupture. However, it can also be caused by skeletal abnormalities, such as cleft alveolus. Three-dimensional facial measurements and ultrasonography can assist in accurate diagnosis when visual examination is ambiguous.


Energy decomposition analysis of the chemical bond in main group and transition metal compounds.
The nature of the chemical bond in the main group diborane(4) compounds X2B-BX2 (X = H,F,Cl,Br,I) and in the Fischer- and Schrock-type transition metal carbene and carbyne complexes and heavier homologues (CO)5W-CH2, (CO)5W-E(OH)2, Cl4W-EH2, Cl(CO)4W-EH and Cl3W-EH (E = C,Si,Ge,Sn,Pb) have been investigated with an energy decomposition analysis (EDA). The results give a deep insight into the nature of the chemical interactions. The EDA results can be used as a bridge between the heuristic models of experimental chemists which have been proven as useful ordering schemes for experimental observations and the physical mechanism which leads to a chemical bond. At the time the data give a well defined qantitative answer to the questions about the strength of the covalent and electrostatic interactions and about the contributions of sigma and pi electrons to the covalent bond.


Ventilator setting in ICUs: comparing a Dutch with a European cohort.
From data collected during the third International Study on Mechanical Ventilation (ISMV), we compared data from a Dutch cohort with a European cohort. We hypothesised that tidal volumes were smaller and applied positive end-expiratory pressure (PEEP) was higher in the Netherlands, compared with the European cohort. We also compared use of non-invasive ventilation (NIV) and outcomes in both cohorts. A post-hoc analysis of a prospective observational study of patients receiving mechanical ventilation. Tidal volumes were smaller (7.6 vs. 8.1 ml÷kg predicted bodyweight) in the Dutch cohort and applied PEEP was higher (8 vs. 6 cm H2O). Fewer patients admitted in the Netherlands received NIV as first mode of mechanical ventilation (7.1 vs. 16.7%). Fewer patients in the Dutch cohort developed an ICU-acquired pneumonia (4.5 vs. 12.3%, p < 0.01) and sepsis (5.7 vs. 10.9%, p = 0.03), but more patients were diagnosed as having delirium (15.8 vs. 4.6%, p < 0.01). ICU and in-hospital mortality rates were 19% and 25%, respectively, in Dutch ICUs vs. 26% and 33% in Europe (p = 0.06 and 0.03). Tidal volumes were smaller and applied PEEP was higher in the Dutch cohort compared with international data, but both Dutch and international patients received larger tidal volumes than recommended for prevention or treatment of acute respiratory distress syndrome. NIV as first mode of mechanical ventilation is less commonly used in the Netherlands. The incidence of ICU-acquired pneumonia is lower and of delirium higher in the Netherlands compared with international data.


Towards effective implementation of a pediatric asthma guideline: integration of decision support and clinical workflow support.
Successful local implementation of national guideline recommendations requires attention to factors that promote clinician compliance. Design of a computerized system is described that will implement recommendations from a recently published guideline for outpatient management of childhood asthma exacerbations. Logical analysis of the guideline shows that it is incomplete and contains several ambiguities that must be addressed before the guideline can be operationalized. Once the user-audience is defined guideline decision points are examined and a structured data entry system is devised. Support of clinicians' workflow is provided by an integrated capability for encounter documentation, dosage calculation, and prescription-writing. A pen-based, graphical interface represents an appropriate platform for implementation of the system because of its ease of use and portability.


miR‑140‑5p inhibits human glioma cell growth and invasion by targeting JAG1.
miR‑140‑5p has been reported to be a tumor suppressor in several types of human cancer, however, little is known about its expression and function in human gliomas. The present study aimed to detect the expression of miR‑140‑5p in human glioma tissues and cell lines, and to investigate the effect of miR‑140‑5p on glioma cell growth, invasion and adhesion using in vitro gain‑of‑function and loss‑of‑function experiments. Furthermore, the hypothesis that Jagged1 (JAG1) may be a target gene of miR‑140‑5p was tested. Reverse transcription‑quantitative polymerase chain reaction analysis revealed that miR‑140‑5p was significantly downregulated in human glioma tissues and cell lines compared with normal tissues, and that its expression was correlated with the grade of gliomas. Transfection of a miR‑140‑5p mimic into SW1783 glioma cells promoted cell growth, invasion and adhesion, as determined by MTT, Transwell and cell adhesion assays respectively. By contrast, transfection of a miR‑140‑5p inhibitor had the opposite effect. A dual‑luciferase reporter assay confirmed that JAG1 was a target gene of miR‑140‑5p, and miR‑140‑5p inhibited JAG1 expression both at the mRNA and protein level. In addition, JAG1 overexpression reversed the effect of miR‑140‑5p on glioma cell growth, invasion and adhesion. In conclusion, the present study is the first to reveal that miR‑140‑5p acts as a tumor suppressor in human gliomas. JAG1 was demonstrated to be a novel target of miR‑140‑5p, and miR‑140‑5p exerted its inhibitory effect on human glioma growth and invasion, partly by suppressing JAG1. The present study may provide useful information toward novel targets for the treatment of gliomas.


Lelystad virus and the porcine epidemic abortion and respiratory syndrome.
Lelystad virus is the causal agent of a relatively new pig disease, variously known as mystery swine disease, porcine epidemic abortion and respiratory syndrome and porcine reproductive and respiratory syndrome. The virus is a small, enveloped RNA virus, that tentatively can be included in a new virus family, the Arteriviridae. The virus has infected pigs throughout the world and seems to persist in many pig populations and in individual pigs. Clinical signs of an infection with Lelystad virus are characterized by late term abortions and still birth in sows, and respiratory disease in piglets.


[Pharmacological action of SN-408, a novel long-acting selective beta 2-adrenoceptor agonist].
The bronchodilating effect and other related pharmacological properties of SN-408 were studied in comparison with those of isoproterenol, salbutamol and procaterol. SN-408 caused concentration-dependent relaxation of isolated guinea pig trachea via the beta 2-adrenoceptor. The order of relaxation potency was: procaterol greater than SN-408 greater than or equal to isoproterenol greater than salbutamol, but the duration of the action of SN-408 was far longer than those of other beta-agonists. Positive chronotropic and inotropic actions of SN-408 in isolated guinea pig right atria and left atria were less potent than those of other beta-agonists. In isolated guinea pig lung tissues, SN-408 increased cyclic AMP contents. Also in vivo, SN-408 showed dose-dependent bronchodilating action by i.v. administration in anesthetized guinea pigs and by inhalation in conscious guinea pigs. Bronchodilating actions of SN-408 were less potent than those of procaterol and isoproterenol, but the duration of action of SN-408 was far longer than those of other beta-agonists. SN-408 showed no evidence of the development of tolerance to the bronchodilating action. SN-408 caused small tachycardia in guinea pigs by i.v. and inhalation. SN-408 given i.v. suppressed vascular permeability in mice. These results indicate that SN-408 is a long-acting and selective beta 2-stimulant bronchodilator.


[Allelic imbalance of loci 17p13.1 (TP53), 1p36.1 (RUNX3), 16p22 (CDH1) and microsatellite instability in gastric cancer].
We examined allelic imbalance (AI) on loci 17p13.1 (TP53), 1p36.1 (RUNX) and 16p22 (CDHI) and microsatellite instability (MI) with BAT26 in 78 patients with gastric cancer. We have shown a significant difference in the frequency of allelic imbalance of the studied loci among different types of gastric cancer. Frequency of AI in 16p22.1 (CDH1) (p = 0.023), 17p13.1 (TP53) (p = 0.038), microsatellite instability (p = 0.047) and AD two and more loci in a single sample (p = 0.0176) was significantly higher in the intestinal type of gastric cancer than in the diffuse type. We have shown, that, frequency of AI in 16p22.1 (CDH1), and AD two and more loci in a single sample, was higher in thetumors with high or moderate type of tumor cells differentiation (p = 0.0414, p = 0.0057 respectively). We found no significant differences in the groups with metastases in regional lymph nodes, different tumor stage, localization of tumors and the generalization process.


Daily walking kinematic characteristics of the elderly in different residential settings: experimental study on Chinese community-living elderly and long-term nursing home residents.
Long-term nursing home (NH) care helps NH residents with their daily activities and improves their quality of life, but negatively affects their independent physical activities and increases the risk of dangerous events. Dangerous events in the elderly usually occur in the conversion of walking periods when forward striding has already happened, but the body has not yet entered a completely steady walking. Compare the gait characteristics in Chinese long-term NH residents and community-living elderly during the walking Transitional Period (TP) and Stabilization Period (SP). 32 long-term NH residents and 33 age- and sex-matched community-living elderly were recruited. The 30-Second Chair Stand Test (30-s CST), Timed Up and Go Test (TUGT), and Modified Falls Efficacy Scale (MFES) were used to assess their body function. The Xsens MVN BIOMECH system was used to collect and analyze the gait parameters of participants. Compared to community-living elderly, NH residents had fewer numbers of 30-s CST, took more time to complete TUGT, and lower MEFS scores. NH residents showed slower gait speed (P < 0.001), less peak hip flexion (P = 0.022) and extension (P = 0.003), knee internal rotation (P = 0.023), and ankle plantarflexion (P = 0.001) and internal rotation (P = 0.007) angles during walking. When walking progressed from TP to SP, NH residents showed increased ankle dorsiflexion (P < 0.001), decreased hip internal rotation (P < 0.001), and community-living elderly had increased hip extension (P = 0.005) angles. Chinese long-term NH residents had reduced lower extremities strength and postural balance, and higher fear of falling compared to community-living elderly. Their walking performance also showed high fall risk. Besides, long-term NH residents adopted a distal strategy to propel the body forward, which may be a compensatory measure to compensate for inadequate proximal joint control from forward walking to stable walking, and long-term NH residents have reduced postural stability during this process.


MASH: MEDIATION ANALYSIS OF SURVIVAL OUTCOME AND HIGH-DIMENSIONAL OMICS MEDIATORS WITH APPLICATION TO COMPLEX DISEASES.
Environmental exposures such as cigarette smoking influence health outcomes through intermediate molecular phenotypes, such as the methylome, transcriptome, and metabolome. Mediation analysis is a useful tool for investigating the role of potentially high-dimensional intermediate phenotypes in the relationship between environmental exposures and health outcomes. However, little work has been done on mediation analysis when the mediators are high-dimensional and the outcome is a survival endpoint, and none of it has provided a robust measure of total mediation effect. To this end, we propose an estimation procedure for Mediation Analysis of Survival outcome and High-dimensional omics mediators (MASH) based on a second-moment-based measure of total mediation effect for survival data analogous to the R2 measure in a linear model. In addition, we propose a three-step mediator selection procedure to mitigate potential bias induced by non-mediators. Extensive simulations showed good performance of MASH in estimating the total mediation effect and identifying true mediators. By applying MASH to the metabolomics data of 1919 subjects in the Framingham Heart Study, we identified five metabolites as mediators of the effect of cigarette smoking on coronary heart disease risk (total mediation effect, 51.1%) and two metabolites as mediators between smoking and risk of cancer (total mediation effect, 50.7%). Application of MASH to a diffuse large B-cell lymphoma genomics data set identified copy-number variations for eight genes as mediators between the baseline International Prognostic Index score and overall survival.


Integrated Design and Simulation of Tunable, Multi-State Structures Fabricated Monolithically with Multi-Material 3D Printing.
Multi-material 3D printing has created new opportunities for fabricating deployable structures. We design reversible, deployable structures that are fabricated flat, have defined load bearing capacity, and multiple, predictable activated geometries. These structures are designed with a hierarchical framework where the proposed bistable actuator serves as the base building block. The actuator is designed to maximise its stroke length, with the expansion ratio approaching one when serially connected. The activation force of the actuator is parameterised through its joint material and joint length. Simulation and experimental results show that the bistability triggering force can be tuned between 0.5 and 5.0 N. Incorporating this bistable actuator, the first group of hierarchical designs demonstrate the deployment of space frame structures with a tetrahedron module consisting of three active edges, each containing four serially connected actuators. The second group shows the design of flat structures that assume either positive or negative Gaussian curvature once activated. By flipping the initial configuration of the unit actuators, structures such as a dome and an enclosure are demonstrated. A modified Dynamic Relaxation method is used to simulate all possible geometries of the hierarchical structures. Measured geometries differ by less than 5% compared to simulation results.


[Secondary glaucoma after congenital cataract surgery].
In a retrospective study, the incidence of secondary glaucoma after congenital cataract extraction was evaluated. Causes of this type of secondary glaucoma include peripheral anterior adhesions which obstruct the anterior chamber angle and prevent normal outflow of aqueous humor, pupillary block, intraocular hemorrhage, and chronic uveitis, among others. During the past 12 years 41 children (57 eyes) were operated for congenital cataract. Secondary glaucoma was found in a 1-month-old boy and a 1-month-old girl (5.3%; 3 eyes). Follow-up in most patients was less than 5 years. A similar incidence of secondary glaucoma has been reported by others. In spite of the low incidence of this complication, secondary glaucoma should be excluded during routine follow-up of these children.


Minimizing the risks from elective induction of labor.
A systematic review of the literature was performed on the risks associated with elective induction of labor. A MEDLINE search was undertaken of articles based on the criterion that elective induction was central to the article. Manuscripts were in English in core clinical journals from 1996 to 2005. Articles before 1996 were included if they added historical information relevant to the topics. Despite not being evidence based, elective inductions are becoming more acceptable and account for approximately 10% of deliveries. A high cesarean rate for nulliparas is the most undesired effect when undergoing induction with an unfavorable cervix. A longer intrapartum course can overutilize resources. Until larger, prospective clinical trials are performed, it will be difficult to evaluate the impact of the elective induction of labor on populationwide cesarean delivery rates. More attention should be directed toward whether the experience of elective induction is satisfactory to the patient, obstetrician and intrapartum crew.


Hydraulic redistribution under moderate drought among English oak, European beech and Norway spruce determined by deuterium isotope labeling in a split-root experiment.
Hydraulic redistribution (HR) of soil water through plant roots is a crucial phenomenon improving the water balance of plants and ecosystems. It is mostly described under severe drought, and not yet studied under moderate drought. We tested the potential of HR under moderate drought, hypothesizing that (H1) tree species redistribute soil water in their roots even under moderate drought and that (H2) neighboring plants are supported with water provided by redistributing plants. Trees were planted in split-root systems with one individual (i.e., split-root plant, SRP) having its roots divided between two pots with one additional tree each. Species were 2- to 4-year-old English oak (Quercus robur L.), European beech (Fagus sylvatica L.) and Norway spruce (Picea abies (L.) Karst). A gradient in soil water potential (ψsoil) was established between the two pots (-0.55 ± 0.02 MPa and -0.29 ± 0.03 MPa), and HR was observed by labeling with deuterium-enriched water. Irrespective of species identity, 93% of the SRPs redistributed deuterium enriched water from the moist to the drier side, supporting H1. Eighty-eight percent of the plants in the drier pots were deuterium enriched in their roots, with 61 ± 6% of the root water originating from SRP roots. Differences in HR among species were related to their root anatomy with diffuse-porous xylem structure in both beech and-opposing the stem structure-oak roots. In spruce, we found exclusively tracheids. We conclude that water can be redistributed within roots of different tree species along a moderate ψsoil gradient, accentuating HR as an important water source for drought-stressed plants, with potential implications for ecohydrological and plant physiological sciences. It remains to be shown to what extent HR occurs under field conditions in Central Europe.


[Variability of the INV gene fragment encoding a functionally important domain of Yersinia pseudotuberculosis invasin].
A total of 84 Y. pseudotuberculosis isolates were studied. The isolates were obtained in Russian Federation in 1967-2008. The majority of Y. pseudotuberculosis isolates (n = 55) were of clinical origin and were isolated from feces of patients with the clinically and serologically proved diagnosis of pseudotuberculosis/Far East scarlet-like fever. These isolates included 18 isolates obtained from 3 outbreaks. Nine isolates were isolated from the internal organs of wild rodents. Other isolates were obtained from environmental sources. Ten Y. pseudotuberculosis isolates belonged to the serovar III and the other isolates belonged to the serovar I. The sequences of 600 b.p. fragment of the inv gene that encodes 667 through 866 invasin amino acids were determined for all isolates. Totally, 3 allelic variants were found. The most abundant allele 1 was found in 76 isolates. The allele 1 is represented in the database Genbank by the strain IP31758 isolated in the Far East of Russia (Eppinger et al., 2007). The allele 2 differed from allele 1 in 3 positions: G,2299N, O2300N, and O2302N. Substitutions in positions 2299 and 2302 were non-synonymous and resulted in amino acid substitutions Ser768 Thr and Val769 Ala. Six isolates carried allele 2. Allele 3 was found in two isolates different from allele 2 by a synonymous substitution G2324O. This allele is similar to the sequence found in Y. pestis strains, represented in the GenBank. The allelic distribution was not serovar specific: Y. pseudotuberculosis of serovar III and majority of serovar I isolates carried allele 1. The analysis of the allelic distribution among subpopulations formed on the base of a source of isolation revealed a statistically significant difference in spreading of alleles among clinical and wild rodent isolates (p < 0.05). Allele 1 prevailed over clinical isolates (95%), while allele 1 and allele 2 were disseminated equally among rodent isolates (55 % and 45 %, respectively).


Synthesis and characterisation of cyclopentadienyl complexes of barium: precursors for atomic layer deposition of BaTiO3.
Cyclopentadienyl complexes Ba(C5Me5)2(THF)2 (1), Ba(C5Me5)2(A) (A = THF, dien, trien, diglyme, triglyme) (2-5), Ba(Pr(i)3C5H2)2(THF)2 (6), Ba(Bu(t)3C5H2)2(THF) (7), Ba(Me2NC2H4C5Me4)2 (8) and Ba(EtOC2H4C5Me4)2 (9) were prepared and characterised with TGA/SDTA, NMR and MS. Crystal structures of 2, 4, 5, 7, 8 and 9 are presented. All complexes prepared sublime under reduced pressure and complexes 1, 6 and 7 showed volatility also under atmospheric pressure. Complexes 1, 6 and 7 lose the coordinated THF when evaporated while complexes 2-5 are sublimable as complete molecules under reduced pressure. Complexes with bulky cyclopentadienyl ligands (6 and 7) are the most thermally stable and volatile among the prepared barocenes. X-ray structure determinations reveal that all the complexes studied are monomeric. Complexes 1, 7 and 8 were successfully tested in BaTiO3 thin film depositions by atomic layer deposition (ALD).


Observation on the Effect of Intelligent Machine-Assisted Surgery and Perioperative Nursing.
Orthopedic surgery and care during the perioperative period are the key to the treatment of orthopedic diseases, which can quickly and effectively treat orthopedic diseases and can quickly recover during the perioperative period. Therefore, this paper focuses on the observation of the effect of intelligent machine-assisted surgery and perioperative care, combined with smart wearable devices and C-arm camera calibration; the details of the bone surgery are assisted by the machine, and then the recognition ability is accelerated by writing into the digital bone bank. Based on machine vision, CNN training and learning are designed to design a machine-assisted perioperative nursing method. This paper also designed a bone surgery test experiment and perioperative adverse event data analysis, combined with the data obtained from the experiment, designed a comparison experiment with traditional surgery and perioperative nursing. The experimental results show that the success rate of machine-assisted surgery is increased by nearly 2%-15% compared with traditional surgery; and the rehabilitation degree of machine-assisted perioperative nursing is 15.83% higher than that of traditional perioperative nursing.


Palliative chemotherapy in patients with salivary gland neoplasms and preliminary reports of 2 recent phase II studies with trastuzumab and gemcitabine.
Salivary gland malignancies are a diverse group of neoplasms. Patients are usually treated with surgery followed by adjuvant radiation therapy. Those presenting with recurrent or metastatic disease have limited treatment options for these patients and discuss the results of 2 recent studies that used trastuzumab and gemcitabine as single agents in patients with incurable disease.


Endogenous endophthalmitis with lenticular abscess caused by Enterobacter agglomerans (Erwinia species).
We report for the first time a case of metastatic endophthalmitis caused by the gram-negative organism Enterobacter agglomerans (Erwinia species). One day following internal hemorrhoidal ligation, the patient developed anterior uveitis that progressed to panophthalmitis with a lenticular abscess and a necrotic retina. Despite aggressive surgery and appropriate antibiotic therapy, the affected eye lost useful vision.


[Involvement of Ca2+ and calmodulin in the regulation of H2O2-induced heat tolerance in maize seedlings].
Exogenous H(2)O(2) pretreatment significantly increased the endogenous H(2)O(2) content and calmodulin activity in maize seedlings, alleviated rapid loss of calmodulin activity, and raised the survival rate of maize seedlings under heat stress (Figs. 1, 4). The formation of H(2)O(2)-induced heat tolerance in maize seedlings was strengthened by exogenous Ca(2+) treatment, and weakened by Ca(2+) chelator EGTA, plasma-membrame-channel blocker La(3+), intracellular channel blocker ruthenium red, calmodulin antagonists chlorpromazine and trifluoperazine treatment (Figs. 1, 2). These results confirmed that Ca(2+) and calmodulin are involved in the regulation of H(2)O(2)-induced heat tolerance in maize seedlings.


Temporal Trends on Percutaneous Mitral Commissurotomy: 30 Years of Experience.
Background Percutaneous mitral commissurotomy ( PMC ) was the first available transcatheter technique for treatment of mitral valve diseases. Experience has led to extending the indications to patients with less favorable characteristics. We aimed to analyze (1) the temporal trends in characteristic and outcomes of patients undergoing PMC in a single center over 30 years and (2) the predictive factors of poor immediate results of PMC . Methods and Results From 1987 to 2016, 1 full year for each decade was analyzed: 1987, 1996, 2006, and 2016. Poor immediate results of PMC were defined as a mitral valve area <1.5 cm2 or MR (mitral regurgitation) grade >2. Mitral anatomy was assessed using the Cormier classification and the fluoroscopic extent of calcification. Six hundred three patients were included: 111, 202, 205, and 85, respectively. Mean age increased >10 years over time ( P<0.0001). Mitral anatomy was less favorable over the years: the presence of calcification increased from 25% of patients at the beginning of PMC to >40% during the past decade ( P<0.0001) with a 3-fold increase in severe mitral calcification. Consistently, the proportion of good immediate results decreased over time ( P<0.05) but remained at 76% in 2016. Multivariate analysis showed 3 predictive factors of poor immediate results: smaller baseline mitral valve area ( P<0.0001), pre- PMC MR grade 2 ( P<0.01), and the presence or amount of calcification ( P<0.001). Conclusions This clinic's patients became significantly older with more frequent and severe calcification in the past decade. Predictive factors of poor immediate results were related to valve anatomy, including calcification. Despite challenges raised by severe calcification, PMC was still successful in >3 out of 4 patients in recent years.


[Defects in the prostaglandin system. VI. Acquired plasma factor defect].
A 44 year-old male was admitted to hospital in October 1984 presenting with enzymatic and electrocardiographic signs of posterior wall myocardial infarction. At this time 2 separate examinations revealed normal plasma factor activity. At the 1 year follow-up (November 1985) plasma factor activity was still present. However, in February 1987 for the first time, the patient's plasma failed to enhance PGI2 synthesis from vascular tissue in vitro. 3 further follow-up examinations within the next 6 weeks again revealed an acquired absence of plasma factor activity of unknown cause. No deterioration in clinical condition occurred. All relatives tested showed normal plasma factor activity.


A case of prostate B-cell lymphoma recognized in the contents of an irreducible perineal hernia in a dog.
We present a case of an intact 14-year-old male dog with a prostate B-cell lymphoma recognized in the contents of an irreducible perineal hernia. The enlarged prostate was replaced after reducing its size by partial excision, and the perineal hernia was repaired using the tunica vaginalis communis. However, the pelvic cavity was largely occupied by the replaced prostate, and urinary retention developed. The prostate was resected on the next day via abdominal median incision, and a bladder-urethra anastomosis was performed. Lymphoma has rarely been demonstrated to develop in the prostate, with the lesion comprising the hernia contents. The present study suggests the necessity of early treatment for perineal hernias and the possibility that lymphoma may be present in the hernia contents.


Expanding bifactor models of psychological traits to account for multiple sources of measurement error.
Over the last decade, applications of bifactor modeling within clinical settings have increased markedly but typically rely on data collected on single occasions. A shortcoming of such research is that reliability coefficients are likely inflated because key sources of measurement error are inadequately modeled and/or confounded with construct variance. We address these problems using three variations of multi-occasion bifactor models with Bayesian-derived parameter estimates to separate systematic variance into general and group factor effects and measurement error into three subcomponents (transient, specific-factor, and random-response). Collectively, these models produce indices of reliability and validity aligned with both standard confirmatory factor models and generalizability designs that extend interpretations of results to the broader domains from which items and occasions are sampled. We demonstrate how these techniques can provide new insights into psychometric properties of scores using Negative Emotionality domain and facet scales from the newly updated Big Five Inventory (BFI-2; Soto & John, 2017). Overall, the two-occasion congeneric bifactor model provided the best fit to the data and most informative indices for revising measures, examining dimensionality of composite and subscale scores, and evaluating the viability of those scores. We include code in R for analyzing all models in our extended online Supplemental Material. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


[Phenotypic and genetic analysis of a child with blepharophimosis, ptosis, epicanthus inverses syndrome and tetralogy of Fallot].
OBJECTIVE To determine the genetic cause of a child with blepharophimosis, ptosis, and epicanthus inverses syndrome and tetralogy of Fallot, and to correlate the phenotype with the genotype. METHODS Routine G-banding has been previously performed on the patient and her parents. Chromosome microarray analysis (CMA) was performed for the three individuals and the fetus. RESULTS Chromosomal analysis has suggested normal karyotypes for the child and her parents. However, a de novo 8.9 Mb deletion on chromosome 3q22.1-q23 was detected by CMA. The deleted region has encompassed 74 genes including 41 disease-related genes, and this is also the most frequent region involved in interstitial 3q deletion. Patients with deletion of this region often have a common feature of dysplasia of eyelids, as well as a spectrum of other anomalies according to different breakpoints, including microcephaly, skeletal anomalies, congenital heart defects, cranial anomalies, intellectual disability and developmental delay. The patient's phenotype was in accordance with such spectrum. Her parents and sib did not show this variation by CMA. CONCLUSION The de novo interstitial deletion of 3q22.1-q23 probably underlies the main clinical manifestation in this child. CMA can provide more detailed information and allow further investigation of the genotype-phenotype correlation.


Tubercular dactylitis and multifocal osteoarticular tuberculosis--two rare cases of extrapulmonary tuberculosis.
Involvement of small bones of hand and feet leading to tuberculous dactylitis involvement is a rare presentation of extrapulmonary tuberculosis. Even rarer is the association of tuberculous dactylitis with multifocal skeletal involvement, even in countries like ours, where tuberculosis is endemic. The authors report two cases, one of tuberculous dactylitis in a 55-year-old male and another of multifocal skeletal tuberculosis in a 4-year-old male. Both the patients were effectively treated with antitubercular drugs.


Magnetic flux array for spontaneous magnetic reconnection experiments.
Experimental investigation of reconnection in magnetized plasmas relies on accurate characterization of the evolving magnetic fields. In experimental configurations where the plasma dynamics are reproducible, magnetic data can be collected in multiple discharges and combined to provide spatially resolved profiles of the plasma dynamics. However, in experiments on spontaneous magnetic reconnection recently undertaken at the Versatile Toroidal Facility at MIT, the reconnection process is not reproducible and all information on the plasma must be collected in a single discharge. This paper describes a newly developed magnetic flux array which directly measures the toroidal component of the magnetic vector potential, A(phi). From the measured A(phi), the magnetic field geometry, current density, and reconnection rate are readily obtained, facilitating studies of the three-dimensional dynamics of spontaneous magnetic reconnection. The novel design of the probe array allows for accurate characterization of profiles of A(phi) at multiple toroidal angles using a relatively small number of signal channels and with minimal disturbance of the plasma.


Low-Cost Automated Design of Compact Branch-Line Couplers.
Branch-line couplers (BLCs) are important components of wireless communication systems. Conventional BLCs are often characterized by large footprints which make miniaturization an important pre-requisite for their application in modern devices. State-of-the-art approaches to design compact BLCs are largely based on the use of high-permittivity substrates and multi-layer topologies. Alternative methods involve replacement of transmission-line sections of the circuit, with their composite counterparts, referred to as compact cells (CCs). Due to the efficient use of available space, CC-based couplers are often characterized by small footprints. The design of compact BLCs is normally conducted based on engineering experience. The process is laborious and requires many adjustments of topology followed by manual or, semi-automatic tuning of design parameters. In this work, a framework for low-cost automated design of compact BLCs using pre-defined CCs is proposed. The low cost of the presented design technique is ensured using equivalent-circuit models, space mapping correction methods, and trust-region-based local optimization algorithms. The performance of the framework is demonstrated based on three examples, concerning the design of unequal-power split coupler, comparison of automatically generated compact BLCs, as well as rapid re-design of the coupler for different substrates. Furthermore, the approach has been benchmarked against the state-of-the-art methods for low-cost design of circuits.


Podocyte-secreted angiopoietin-like-4 mediates proteinuria in glucocorticoid-sensitive nephrotic syndrome.
The main manifestations of nephrotic syndrome include proteinuria, hypoalbuminemia, edema, hyperlipidemia and lipiduria. Common causes of nephrotic syndrome are diabetic nephropathy, minimal change disease (MCD), focal and segmental glomerulosclerosis (FSGS) and membranous nephropathy. Among the primary glomerular diseases, MCD is usually sensitive to glucocorticoid treatment, whereas the other diseases show variable responses. Despite the identification of key structural proteins in the glomerular capillary loop which may contribute to defects in ultrafiltration, many of the disease mechanisms of nephrotic syndrome remain unresolved. In this study, we show that the glomerular expression of angiopoietin-like-4 (Angptl4), a secreted glycoprotein, is glucocorticoid sensitive and is highly upregulated in the serum and in podocytes in experimental models of MCD and in the human disease. Podocyte-specific transgenic overexpression of Angptl4 (NPHS2-Angptl4) in rats induced nephrotic-range, and selective, proteinuria (over 500-fold increase in albuminuria), loss of glomerular basement membrane (GBM) charge and foot process effacement, whereas transgenic expression specifically in the adipose tissue (aP2-Angptl4) resulted in increased circulating Angptl4, but no proteinuria. Angptl4(-/-) mice that were injected with lipopolysaccharide (LPS) or nephritogenic antisera developed markedly less proteinuria than did control mice. Angptl4 secreted from podocytes in some forms of nephrotic syndrome lacks normal sialylation. When we fed the sialic acid precursor N-acetyl-D-mannosamine (ManNAc) to NPHS2-Angptl4 transgenic rats it increased the sialylation of Angptl4 and decreased albuminuria by more than 40%. These results suggest that podocyte-secreted Angptl4 has a key role in nephrotic syndrome.


The evaluation of parameters affecting accidents in companies using industrial radioactive sources in Iran.
More than 1000 radiation workers are engaged in about 70 private industrial radiography companies (IRCs) using 312 mobile gamma radiography devices (GRDs) in Iran. These companies mainly carry out radiography in open areas using 192Ir radioactive sources, ranging from 0.07 to 3 TBq (2-80 Ci). The radiation accidents that occurred in these companies led to acute radiation syndrome in 13 workers and overexposure of 36 workers since 1998. The facilities and operating procedures of the Iranian private IRCs have been investigated during the past 5 y. According to this study, in spite of the fact that most of the accidents were found to be due to the failure of critical components of GRDs, the main parameters affecting overexposures and deterministic effects were found to be incorrect or there was insufficient implementation of the monitoring programme, training and local rules in the IRCs.


Retinal topography and thickness mapping in atrophic age related macular degeneration.
To determine the relation between alterations in the retinal topography and thickness, visual acuity, and retinal pigment epithelium hypopigmentation in atrophic age related macular degeneration (AMD). 22 patients, mean age 74 (SD 8) years, with atrophic AMD were recruited. An optical imaging system based on the retinal thickness analyser (RTA) was applied to generate a series of 20 optical section images that encompass 2 mm x 2 mm retinal areas. The optical section images were digitised and analysed to provide topographic maps of the vitreoretinal and chorioretinal surfaces and the retinal thickness. Vitreoretinal and chorioretinal surface elevations and retinal thickness were determined. Variation in the vitreoretinal surface height was moderately correlated with visual acuity (r = -0.4; p = 0.03; n = 22). Increase in variation of chorioretinal surface height was correlated with decrease in visual acuity (r = -0.5; p = 0.01; n = 22). The retinal thickness was not associated with visual acuity (r = 0.2; p = 0.2; n=22). Relative height of the vitreoretinal surface in eyes with retinal pigment epithelium (RPE) hypopigmentation was significantly less than eyes without RPE hypopigmentation (p = 0.005). Eyes with and without RPE hypopigmentation had a similar relative height of the chorioretinal surface (p = 0.4). Retinal thickness in eyes with RPE hypopigmentation was less than in eyes without RPE hypopigmentation (p = 0.04). Mapping of chorioretinal and vitreoretinal topography and retinal thickness provides objective and quantitative measurements of retinal structural abnormalities and shows promise as an adjunct for the evaluation of retinal structural changes due to AMD.


Near-Infrared Light-Triggered Unfolding Microneedle Patch for Minimally Invasive Treatment of Myocardial Ischemia.
It is hard to achieve safe, effective, and minimally invasive therapies on myocardial infarction (MI) via conventional treatments. To address this challenge, a vascular endothelial growth factor (VEGF)-loaded and near-infrared (NIR)-triggered self-unfolding graphene oxide (GO)-poly(vinyl alcohol) (PVA) microneedle (MN) patch was designed and fabricated to treat MI through a minimally invasive surgery (MIS). The folded MN patch can be easily placed into the chest cavity through a small cut (4 mm) and quickly recover to its original shape with 10 s of irradiation of NIR light (1.5 W/cm2, beam diameter = 0.5 cm), thanks to its excellent shape memory effect and fast shape recovery ability. Meanwhile, the unfolded MN patch can be readily punctured into the heart and wrap the heart tightly, thanks to its sufficient mechanical strength and adjustable morphological structure, thus ensuring a high fixation strength to withstand the high-frequency pulsation of the heart. In addition, the prepared MN patch has low cytotoxicity and controllable and sustainable release of VEGF. More importantly, the MN patch can effectively promote neovascularization, reduce myocardial fibrosis, and restore cardiac function, which indicates its promising application prospects in MIS.


Selective HDAC6 inhibition protects against blood-brain barrier dysfunction after intracerebral hemorrhage.
Blood-brain barrier (BBB) disruption after intracerebral hemorrhage (ICH) significantly induces neurological impairment. Previous studies showed that HDAC6 knockdown or TubA can protect the TNF-induced endothelial dysfunction. However, the role of HDAC6 inhibition on ICH-induced BBB disruption remains unknown. Hemin-induced human brain microvascular endothelial cells (HBMECs) and collagenase-induced rats were employed to investigated the underlying impact of the HDAC6 inhibition in BBB lesion and neuronal dysfunction after ICH. We found a significant decrease in acetylated α-tubulin during early phase of ICH. Both 25 or 40 mg/kg of TubA could relieve neurological deficits, perihematomal cell apoptosis, and ipsilateral brain edema in ICH animal model. TubA or specific siRNA of HDAC6 inhibited apoptosis and reduced the endothelial permeability of HBMECs. HDAC6 inhibition rescued the degradation of TJ proteins and repaired TJs collapses after ICH induction. Finally, the results suggested that the protective effects on BBB after ICH induction were exerted via upregulating the acetylated α-tubulin and reducing stress fiber formation. Inhibition of HDAC6 expression showed beneficial effects against BBB disruption after experimental ICH, which suggested that HDAC6 could be a novel and promising target for ICH treatment.


Reciprocality of recombination events that rearrange the chromosome.
We describe a genetic system for studying the reciprocality of chromosomal recombination; all substrates and recombination functions involved are provided exclusively by the bacterial chromosome. The genetic system allows the recovery of both recombinant products from a single recombination event. The system was used to demonstrate the full reciprocality of three different types of recombination events: (1) intrachromosomal recombination between direct repeats, causing deletions; (2) intrachromosomal recombination between inverse homologies, causing inversion of a segment of the bacterial chromosome; and (3) circle to circle recombination (in the absence of any plasmid or phage functions). Results suggest that intrachromosomal recombination in bacteria is frequently fully reciprocal.


Facile assembly and loading of theranostic polymersomes via multi-impingement flash nanoprecipitation.
Flash nanoprecipitation (FNP) has proven to be a powerful tool for the rapid and scalable assembly of solid-core nanoparticles from block copolymers. The process can be performed using a simple confined impingement jets mixer and provides an efficient and reproducible method of loading micelles with hydrophobic drugs. To date, FNP has not been applied for the fabrication of complex or vesicular nanoarchitectures capable of encapsulating hydrophilic molecules or bioactive protein therapeutics. Here, we present FNP as a single customizable method for the assembly of bicontinuous nanospheres, filomicelles and vesicular, multilamellar and tubular polymersomes from poly(ethylene glycol)-bl-poly(propylene sulfide) block copolymers. Multiple impingements of polymersomes assembled via FNP were shown to decrease vesicle diameter and polydispersity, allowing gram-scale fabrication of monodisperse polymersomes within minutes. Furthermore, we demonstrate that FNP supports the simultaneous loading of both hydrophobic and hydrophilic molecules respectively into the polymersome membrane and aqueous lumen, and encapsulated enzymes were found to be released and remain active following vesicle lysis. As an example application, theranostic polymersomes were generated via FNP that were dual loaded with the immunosuppressant rapamycin and a fluorescent dye to link targeted immune cells with the elicited immunomodulation of T cells. By expanding the capabilities of FNP, we present a rapid, scalable and reproducible method of nanofabrication for a wide range of nanoarchitectures that are typically challenging to assemble and load with therapeutics for controlled delivery and theranostic strategies.


[An experimental study on targeting suicide gene therapy for lung cancer with HSV-TK driven by hTERT promoter].
To study the approach of targeting expression of suicide gene HSV-TK driven by human telomerase catalytic subunit (hTERT) promoter in lung cancer cells, and to investigate inhibitory effect of HSV-TK/GCV driven by hTERT promoter on proliferation of lung cancer cell line A549 in vitro and in vivo. (1) Recombinant expression vectors of HSV-TK driven by hTERT promoter and SV40 promoter (pGL3-hTp-TK and pGL3-SV40-TK) were transfected into telomerase-positive human lung adenocarcinoma cell A549 and telomerase-negative human embryonic lung fibroblast cell MRC-5. The mRNA expression of TK gene was detected with RT-PCR method; (2) With the treatment of GCV, the proliferation of above transfected cells was investigated by MTT assay; Influence of GCV on apoptosis and cell cycle of these cells was evaluated with flow cytometry; (3) After the subcutaneously transplantation of A549 cells into nude mice, intra-tumor injection of plasmid-liposome as well as intra-peritoneal injection of GCV were performed to stUdy anti-tumor effects of pGL3-hTp-TK/GCV and pGL3-SV40-TK/GCV in vivo. (1) Enzyme digestion and PCR suggested that recombinant plasmids of pGL3-hTp-TK and pGL3-SV40-TK were successfully constructed; TK mRNA expression was detected in both A549 and MRC-5 cells transfected with pGL3-SV40-TK, also in A549 transfected with pGL3-hTp-TK, but not in MRC-5 transfected with pGL3-hTp-TK; (2) GCV showed significant inhibition effect on proliferation of A549 and MRC-5 transfected with pGL3-SV40-TK in vitro, also on that of A549 transfected with pGL3-hTp-TK, but not of MRC-5 transfected with pGL3-hTp-TK; With the treatment of GCV, apoptosis index (AI) of A549 cells transfected with pGL3-SV40-TK and pGL3-hTp-TK (21.58% and 23.19% respectively) increased significantly, compared with that of A549 transfected with pGL3-hTp and blank control; GCV enhanced the effects on AI in MRC-5 transfected with pGL3-SV40-TK (9.35%), but not with pGL3-hTp-TK (0.88%); (3) Inhibition ratio of pGL3-SV40-TK/GCV and pGL3-hTp-TK/GCV to transplanted tumor of A549 in nude mice (46.7% and 40.5% respectively) were significantly higher than that of negative control groups (9.7%, 14.3%, 7.0% and 8.0% respectively). TK gene driven by hTERT promoter could express selectively in lung cancer cell. Lung cancer cell could be specifically inhibited by HSV-TK/GCV driven by hTERT promoter in vitro and in vivo.


[Experimental diabetic neuropathy. Morphometric studies of spinal ganglia cells in short-term streptozotocin-induced diabetes].
Ganglion cells of both the left and right dorsal root ganglia L5 were investigated morphometrically in 8 diabetic rats 35 or 44 d after the administration of streptozotocin, as well as in 8 controls. The quantitative study included the analysis of mean neuron volume, maximal cell diameter, cell number per volume, by cell size class and the analysis of histograms. There were no changes in cell size. Whereas in experimental short-term diabetes the peripheral nerves demonstrate morphologic changes correlating to the biochemical abnormalities (reduced amino-acid uptake, decreased activity of Na+, K+-ATPase) no such correlations can be observed in the perikarya.


Kinetic Aspects of Surfactant-Induced Structural Changes of Proteins - Unsolved Problems of Two-State Model for Protein Denaturation -.
The kinetic mechanism of surfactant-induced protein denaturation is discussed on the basis of not only stopped-flow kinetic data but also the changes of protein helicities caused by the surfactants and the discontinuous mobility changes of surfactant-protein complexes. For example, the α-helical structures of bovine serum albumin (BSA) are partially disrupted due to the addition of sodium dodecyl sulfate (SDS). Formation of SDS-BSA complex can lead to only four complex types with specific mobilities depending on the surfactant concentration. On the other hand, the apparent rate constant of the structural change of BSA increases with an increase of SDS concentration, indicating that the rate of the structural change becomes fast as the degree of the change increases. When a certain amount of surfactant ions bind to proteins, their native structures transform directly to particular structures without passing through intermediate stages that might be induced due to the binding of fewer amounts of the surfactant ions. Furthermore, this review brings up a question about two-state and three-state models, N⇌D and N⇌D'⇌D (N: native state, D: denatured sate, D': intermediate between N and D), which have been often adopted without hesitation in discussion on general denaturations of proteins. First of all, doubtful is whether any equilibrium relationship exists in such denaturation reactions. It cannot be disregarded that the D states in these models differ depending on the changes of intensities of the denaturing factors. The authors emphasize that the denaturations or the structural changes of proteins should be discussed assuming one-way reaction models with no backward processes rather than assuming the reversible two-state reaction models or similar modified reaction models.


Observation of the stark-tuned Förster resonance between two Rydberg atoms.
Cold atoms in highly excited Rydberg states are promising candidates to implement quantum logic gates of a quantum computer via long-range dipole-dipole interaction. Two-qubit gates require a controlled interaction of only two close Rydberg atoms. We report on the first spectroscopic observation of the resonant dipole-dipole interaction between two cold rubidium Rydberg atoms confined in a small laser excitation volume. The interaction strength was controlled by fine-tuning of the Rydberg levels into a Förster resonance using the Stark effect. The observed resonance line shapes are in good agreement with numerical Monte Carlo simulations.


Multiple primary pleomorphic adenomas in a single parotid gland: report of a new case.
The development of multiple primary pleomorphic adenomas in a single parotid gland is extremely rare in previously untreated patients, as only nine cases have been previously reported. In this article, we report the tenth such case, which occurred in an 87-year-old Japanese women. We also report the results of our 7-plus-year review of the types of parotid tumors seen at our institution. We identified 98 tumors in 89 patients; pleomorphic adenomas were the most common tumors, accounting for 45.9% of the total.


Epidemiology of vertebral fractures in women.
Vertebral fracture prevalence was assessed in an age-stratified random sample of Rochester, Minnesota women aged 50 years and over. Vertebral fractures, including wedge and concavity as well as compression fractures, were common and increased with age. The estimated incidence of new vertebral fractures also rose with age, reaching 29.6 per 1,000 person-years in women aged greater than or equal to 85 years. The prevalence of one or more vertebral fractures also increased with declining bone mass, reaching 42% in women with spinal bone mineral density less than 0.6 g/cm2 by dual photon absorptiometry. Bone mass and age contributed independently to the risk of vertebral fracture, but "age" may reflect other manifestations of osteoporosis.


Isolation and characterization of a carboxysome shell gene from Thiobacillus neapolitanus.
The gene coding for the major carboxysome shell peptide (csoS1) from Thiobacillus neapolitanus has been isolated and sequenced. Oligonucleotide primers for polymerase chain reaction (PCR) amplification of the 5' end of the gene were made possible by amino acid sequencing of the N-terminal residues of the shell peptide. A 41 bp PCR product was used as a probe to isolate the gene. The deduced amino acid composition of the 216 bp gene shows a high degree of hydrophobicity. The gene is located within a series of three repeated regions of DNA and appears to have arisen via gene duplication. The transcript of csoS1 is approximately 400 bases in length. The shell peptide shares significant homology with Synechococcus open reading frames implicated in carboxysome structure/assembly. These open reading frames and csoS1 are related and are probably members of a carboxysome gene family.


Thromboprophylaxis adherence to the ninth edition of American college of chest physicians antithrombotic guidelines in a tertiary care centre: a cross-sectional study.
Venous thromboembolic disease is a source of significant morbidity in hospitalized patients. The American College of Chest Physicians published the ninth edition of antithrombotic therapy and prevention guidelines (AT9) in 2012, addressing thromboprophylaxis in hospitalized patients. A notable difference from previous guidelines was utilization of risk assessment models for thrombosis and bleeding to classify patients into risk categories. This study's objective was to evaluate thromboprophylaxis adherence to AT9 guidelines in a population of patients at the Centre intégré universitaire de santé et de service sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke. A cross-sectional study at the Centre intégré universitaire de santé et de service sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke was performed between June and December 2012. Patients' risk factors for thrombosis and bleeding, and thromboprophylaxis use were documented. The Padua and Caprini models were used to determine thrombotic risk, and the International Medical Prevention Registry on Venous Thromboembolism bleeding risk score was used for bleeding risk. A total of 290 patients were included for analysis. Overall, 200 patients (70%) received some form of thromboprophylaxis. However, according to AT9 guidelines, only 162 patients (55.9%) received recommended prophylaxis, 91 (31.4%) had overuse of prophylaxis and 37 (12.7%) had underuse of prophylaxis. Appropriate prophylaxis use was higher in surgical (61.8%) than in medical (46.7%) patients. There was a high rate of inappropriate thromboembolic prophylaxis in our centre according to AT9 guidelines, mostly from overuse of prophylaxis. Utilization of risk assessment models in AT9 guidelines adds to the complexity of physician's decisions to prescribe thromboprophylaxis and needs further validation.


A De Novo sSMC (22) Characterized by High-Resolution Chromosome Microarray Analysis in a Chinese Boy with Cat-Eye Syndrome.
We report a 15-year-old boy with cat-eye syndrome (CES) without short stature or intellectual disorder. The boy was confirmed by cytogenetic and high-resolution chromosome microarray analysis (CMA). The G-banding karyotype confirmed the de novo of the patient. Also, the CMA result showed 1.76 Mb tetrasomy of proximal 22Q11.1 ⟶ 22Q11.21 consistent with CES {arr22q11.1q11.21 (16,888,899-18,644,241) X4}, a typical small type I CES chromosome. The patient has many of the basic characteristics of CES; however, he is taller than his peers instead of shorter. It is rarely reported in the past since short stature is a common feature of this syndrome. Furthermore, the boy has no intellectual disorder and attends a normal school since he was six-year-old. What bothered him most were recurrent respiratory infections, retromicrognathia, and heart defects.


Transpupillary thermotherapy in the treatment of central serous chorioretinopathy.
A 40-year-old man had persistent central serous chorioretinopathy at the foveal region for 20 months. The pretreatment best-corrected visual acuity was 0.3. The leaking point was close to the fovea, making the use of argon laser photocoagulation treatment unsafe. Transpupillary thermal therapy with diode laser (power setting = 120 mW, spot size = 1.2 mm, and duration = 60 seconds) was performed to cover the whole detached area. The subretinal fluid decreased 1 week later. Fluorescein angiography 2 months later revealed neither further leakage nor any subretinal fluid. After 3 months of follow-up, best-corrected visual acuity improved to 0.4. Transpupillary thermal therapy may be a useful alternative for the treatment of chronic, persistent central serous chorioretinopathy at the fovea.


Steroid hormone metabolism in women with pelvic organ prolapse.
To identify whether endogenous steroid hormone metabolism in women with pelvic organ prolapse (POP) is different from that in normal women and the relationship between endogenous steroid hormone metabolites and POP stage. Twenty postmenopausal women who were clinically diagnosed as having POP and 20 volunteer postmenopausal women without prolapse were included in the study. We compared the urinary profiles of endogenous steroids between the two groups and investigated the relationship between urinary profiles of endogenous steroids and degree of prolapse. Urinary profiles of endogenous steroids were assayed by gas chromatography/mass spectrometry. The ages of the patients and control group were 64.6 +/- 6.5 and 63.5 +/- 3.9 years, and the body mass index was 23.96 +/- 3.14 and 24.11 +/- 2.73 kg/m2 in patients and normal subjects, respectively. The number of patients were 4 at stage I, 4 at stage II, 6 at stage III and 6 at stage IV. 5-Androstene-3 beta,16 beta,17 beta-triol (5-AT), 11 beta-hydroxy an and 17 beta-estradiol were significantly increased in the POP group as compared with the control group (0.76 +/- 0.67 vs. 0.06 +/- 0.03 mumol/g creatinine, P = .002, 1.16 +/- 0.83 vs. 0.65 +/- 0.23 mumol/g creatinine, P = .04; and 15.08 +/- 9.81 vs. 8.53 +/- 6.19 mumol/g creatinine, P = .04). However, tetrahydrocortisone (THE) was significantly increased in the control group as compared with the patient group (9.80 +/- 6.21 vs. 5.22 +/- 4.89 mumol/g creatinine, P = .04). Androgen metabolites 5-AT and THE significantly correlated with the pelvic organ prolapse quantitation (POP-Q) stage (R = .418; P = .027; R = .46, P = .016). Among the estrogen metabolites, 17 beta-estradiol correlated with POP-Q stage, but not significantly so (R = .38, P = .05), and the 17 beta-estradiol/estrone ratio weakly correlated with stage (R = .14, P = .49). The metabolites of endogenous steroid hormones could be contributing factors in the pathogenesis of POP.


Convergence of Computed Aqueous Absorption Spectra with Explicit Quantum Mechanical Solvent.
For reliable condensed phase simulations, an accurate model that includes both short- and long-range interactions is required. Short- and long-range interactions can be particularly strong in aqueous solution, where hydrogen-bonding may play a large role at short range and polarization may play a large role at long range. Although short-range solute-solvent interactions such as charge transfer, hydrogen bonding, and solute-solvent polarization can be taken into account with a quantum mechanical (QM) treatment of the solvent, it is unclear how much QM solvent is necessary to accurately model interactions with different solutes. In this work, we investigate the effect of explicit QM solvent on absorption spectra computed for a series of solutes with decreasing polarity. By adjusting the boundary between QM and classical molecular mechanical solvent to include up to 400 QM water molecules, convergence of the calculated absorption spectra with respect to the size of the QM region is achieved. We find that the rate of convergence does not correlate with solute polarity when excitation energies are calculated using time-dependent density functional theory with a range-separated hybrid functional, but it does correlate with solute polarity when using configuration interaction singles. We also find that larger basis sets converge the computed spectrum with fewer QM solvent molecules. To optimize the computational cost with respect to convergence, we test a mixed basis set with more basis functions for atoms of the chromophore and the solvent molecules that are nearest to it and fewer basis functions for the atoms of the remaining solvent molecules in the QM region. Our results show that using a mixed basis set is a potentially effective way to significantly lower the computational cost while reproducing the results computed with larger basis sets.


Cisplatin-based combination chemotherapy in the treatment of advanced-stage testicular cancer: cost-benefit analysis.
A cost-benefit analysis of the impact of cisplatin-based combination chemotherapy for treatment of disseminated testicular cancer showed that the annual estimated economic value of this treatment innovation in the United States is approximately $150 million. The estimate was based on the human capital approach, which conservatively values a human life in terms of economic productivity. Because testicular cancer predominantly strikes young adult males, the savings reported were due to the future earning potential of the survivors. A comparison of relevant National Cancer Institute (NCI) costs for drug development and clinical trials versus annual savings realized indicated that the total costs over a 17-year period are recovered in less than 1 year. This report is an example of health care cost savings resulting from NCI support of biomedical research.


Hybridoma-derived human suppressor factors: differential effects on mouse lymphocytes.
We have recently identified a family of suppressor factors produced by certain human T-T cell hybridomas that we developed (references 1 and 2) and by the Jurkat T cell line. These suppressor factors significantly inhibited proliferative responses to mitogens and allogeneic cells in mixed lymphocyte culture and antibody production by human peripheral blood mononuclear cells. We investigated and report here the effect of these suppressor factors on certain in vitro murine immune responses. Suppressor factors produced by certain of these hybrids, such as 153, 160, 170 and by the Jurkat T-cell line were able to inhibit: (1) proliferative responses to mitogens of mouse thymocytes and splenocytes; (2) proliferative responses of mouse splenocytes to allogeneic cells in mixed lymphocyte cultures; (3) primary in vitro antibody responses of mouse spleen lymphocytes to sheep erythrocytes; (4) primary in vitro antibody responses of mouse spleen lymphocytes to a T-cell independent antigen (TNP-Ficoll). Inhibition of murine immune responses in vitro by these suppressor factors was regular and reproducible and it was observed in a large number of experiments. In contrast, suppressor factors produced by the 169 and by the 77(38F3) hybrids did not suppress the murine immune responses. The basis for these differences are not known at the present. The ability of human suppressor factors to inhibit effectively mouse immune responses provides an additional opportunity for the characterization of the properties of these factors in vivo using mouse models of human disease.


[Neonatal morbidity and mortality in very low birth weight infants according to exposure to chorioamnionitis].
To study differences in the incidence of neonatal morbidity and mortality among newborns weighing less than 1,500 g according to exposure to chorioamnionitis (CA). A case-control study of 135 newborns weighing less than 1,500 g at birth and born between 1988 and 1998 was performed. The case group was composed of 45 newborns exposed to clinical or subclinical levels of maternal CA. Each newborn in the case group was matched with two controls, both weighing less than 1,500 g, one of them born immediately before and the other one immediately after. Perinatal records, neonatal morbidity and mortality were analyzed. The mean gestational age was 28.5 weeks (range: 24-38 weeks) with a mean weight of 1,131 g (range: 520-1,500 g). The time of membrane rupture was significantly greater in the case group (176 h vs 57 h; p < 0.001). Forty percent of the cases presented sepsis in the first 72 h of life compared with 10 % of the controls (p < 0.0001). No significant differences in morbidity or mortality were found between the groups, although chronic lung disease (20 % vs 13 %) and intraventricular hemorrhage (24 % vs 17 %) were more frequent in infants exposed to CA. Resuscitation (77.8 % vs 45.6 %; p 0.001) and mechanical ventilation (73 % vs 50 %; p 0.016) were required by a great number of cases than controls. The presence of CA was associated with a higher risk of early onset infection and the need for neonatal resuscitation and mechanical ventilation. No significant differences were found in morbidity or mortality.


The Paediatric Vault Score (PVS)-A Novel Scoring Tool for Prioritisation of Surgical Management of Craniosynostosis Patients.
Craniosynostosis is the premature fusion of the skull sutures, resulting in abnormal skull shape and volume. Timely management is a priority in avoiding raised intracranial pressure which can result in blindness and neurodevelopmental delay. Due to the COVID-19 pandemic, theater access was reduced. A risk stratification scoring system was thus devised to score patients attending surgery and aid in prioritization according to surgical need. The authors present the Paediatric Vault Score (PVS), which can also be customized to each unit's individual protocols. Ten patients on the waiting list were randomly selected and their clinical information was summarized in uniform anonymized reports. Six craniofacial consultants were selected as assessors and given 1 week to independently rank the patients from 1 to 10. Each scorer's ranking was verified against the PVS template and concordance was analyzed using the Kendall tau correlation coefficient (KT). Three cycles of the scoring process were carried out. Improvements were made to the scoring tool following cycle 1. Cycle 1 revealed 2 clinicians to be concordant with the PVS system and 4 to be discordant. Cycle 2 revealed all 6 clinicians to be concordant, with a mean KT score of 0.61. The final cycle revealed all 6 clinicians to be concordant, with a mean KT score of 0.70. Four scorers increased their concordance once the scoring sheet was introduced. Kendall's correlation of concordance calculated the interrater reliability to be 0.81. The PVS is the first known vault scoring system to aid in risk stratification and waiting list prioritization.


Compensatory activation of Akt in response to mTOR and Raf inhibitors - a rationale for dual-targeted therapy approaches in neuroendocrine tumor disease.
Several studies have established a link between aberrant PI(3)K-Akt-mTOR- and Ras-Raf-MEK-Erk1/2 signaling and neuroendocrine tumor disease. In this study, we comparatively investigate the antitumor potential of novel small-molecule inhibitors targeting mTOR (RAD001), mTOR/PI(3)K (NVP-BEZ235) and Raf (Raf265) on human NET cell lines of heterogeneous origin. All inhibitors induced potent antitumor effects which involved the induction of apoptosis and G0/G1 arrest. However, the dual mTOR/PI(3)K inhibitor NVP-BEZ235 was more efficient compared to the single mTOR inhibitor RAD001. Consistently, NVP-BEZ235 prevented the negative feedback activation of Akt as observed after treatment with RAD001. Raf265 inhibited Erk1/2 phosphorylation but strongly induced Akt phosphorylation and VEGF secretion, suggesting the existence of a compensatory feedback loop on PI3K-Akt signaling. Finally, combined treatment with RAD001 or NVP-BEZ235 and Raf265 was more efficient than single treatment with either kinase inhibitor. Together, our data provide a rationale for dual targeting of PI(3)K-Akt-mTOR- and Ras-Raf-MEK-Erk1/2 signaling in NET disease.


Reproducibility of lysis-centrifugation cultures for quantification of Mycobacterium avium complex bacteremia.
While quantitative mycobacterial blood cultures have been accepted as the standard for evaluating response to various Mycobacterium avium complex (MAC) treatment regimens, variability in this methodology has not been evaluated in a rigorous fashion. We thus studied the reproducibility of quantitative MAC cultures by a lysis-centrifugation culture system within and among five institutions. To measure the intralaboratory variation in mycobacterial colony counts, colony counts from duplicate blood specimens collected from 52 AIDS patients with MAC bacteremia were determined. Colony counts ranged from 0 to 50,000 CFU/ml. Nonparametric analyses revealed there was no significant difference in colony counts between the 52 duplicate specimens. The agreement between the intralaboratory paired specimens, as measured by the intraclass correlation coefficient, was 0.997. To measure the interlaboratory variation, multiple 10-ml aliquots from 12 patients were distributed to five institutions and processed within 24 to 32 h by lysis-centrifugation. For the 12 specimens distributed to the five laboratories, two-way analysis of variance for repeated measures revealed no significant difference in an individual patient's colony counts between laboratories (P > 0.2). We conclude that quantitation of mycobacterial colony counts by the lysis-centrifugation system is reproducible within and between institutions. Clinical trials evaluating response to therapeutic interventions for MAC can use multiple laboratories for quantitation of mycobacteremia. Furthermore, a 24- to 32-h delay in processing appeared to have no impact on reproducibility.


Protective Effect of Pistacia lentiscus Oil Against Bleomycin-Induced Lung Fibrosis and Oxidative Stress in Rat.
We aimed in the present study to investigate the protective effect of Pistacia lentiscus oil against bleomycin-induced lung fibrosis as well as the involvement of oxidative stress in such protection. In this respect, adult male Wistar rats were used and divided into three groups of twenty each: control (NaCl, 0.9%), bleomycin, and bleomycin (4 mg/kg b.w.) + P. lentiscus oil (3 g/kg, b.w.). Animals were pretreated for 30 days before the induction of fibrosis by bleomycin and 1 wk after the induction of fibrosis. The oil principal compounds detected by gas chromatography analysis are: Linoleic and palmitic acids (70.6 and 24.7%, respectively). Our data demonstrated that P. lentiscus oil protected against bleomycin-induced fibrosis as evidenced by TGFβ immunostaining increase in lungs fibrocytes as well as inflammatory infiltrate. We also showed that acute bleomycin-induced fibrosis was accompanied by an oxidative stress in lung tissue as assessed by an increase of lipid peroxidation as well as antioxidant enzyme activities depletion such as superoxide dismutase (SOD) and catalase (CAT). More importantly, P. lentiscus oil treatment reversed all bleomycin-induced oxidative stress parameters disturbances. In conclusion, we suggest that P. lentiscus oil had potent protective effects against bleomycin-induced fibrosis due in part to its antioxidant properties.


[The role of extracellular calcium in regulating the contraction of the developing musculature in the frog Rana temporaria].
Amplitude of both single and tetanic contractile responses of m. gastrocnemius (46th-51st stages of tadpoles Rana temporaria development) in contrast to those of myotomal muscle significantly reduced after decrease of extracellular calcium ion concentration. Such an effect was not observed on later stages. Adding of strontium ions instead of calcium did not recover contraction amplitude. Effects of such specific calcium ion channel antagonists as verapamil and nickel ions on contractions are not age-dependent indicating that contraction dependence on the number of exogenous calcium ions was not mediated by calcium channel functioning. The results demonstrate that system of electromechanical contact, provided by dihydropyridine receptors of tubular membrane, on the 46th-51st stages of tadpole development is already formed and functions as in mature muscles. It is suggested that contraction regulation in developing skeletal muscle can involve calcium ions which are linked to external surface of sarcolemma.


Changes in children's lung function over two decades in relation to socioeconomic, parental and household factors in Wuhan, China.
It is important to identify risk and beneficial factors for children's lung function. This study aims to ascertain potential changes in children's lung function in relation to changes in socioeconomic, parental and household factors, based on a comparison between two periods spanning 25 years in Wuhan, the largest metropolis in central China. In two cross-sectional studies, lung function measurements and questionnaire surveys were conducted on school-age children in 1993-1996 (Period I) and in 2018 (Period II). Children of 6-12 years old from elementary schools were selected by a multistage sampling method. Demographic information, socioeconomic status, feeding methods, parental illness and behavior patterns, as well as household characteristics, were collected through a questionnaire survey. Spirometric lung function was measured, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiratory flow at 25% and 75% of the pulmonary volume (FEF25-75), and peak expiratory flow (PEF). Wilcoxon analysis of variances was used to assess the differences in lung function indexes between Period I and Period II. Multiple linear regression models were used to estimate the association of lung function with regard to socioeconomic, parental and household factors, respectively. Significant prevalence reductions were observed for household coal use, paternal smoking and maternal asthma, while the prevalence increased significantly for children sleeping in their own rooms or own beds and breastfeeding, ventilation use during cooking, and parental education level from Period I to Period II. When adjusted for age, height, weight, sex and other factors assessed in the study, children had significant lower values of FVC, FEV1, and PEF in Period II than in Period I. Enclosed kitchen was significantly associated with lower lung function in children in Period I. Urban living condition and higher maternal education level were each associated with a higher FVC, while father having no fixed income was associated with a lower FVC and a lower FEV1, respectively, in Period II. In comparison with Period I, the beneficial impact of urban living and that of breastfeeding were enhanced and the detrimental effect of poor household condition was weakened in Period II. Lung function was lower in 2018 than in 1993-1996 in school-age children living in Wuhan. Although improvements in urban living and household environmental conditions as well as increased breastfeeding in Period II could have contributed to increased lung function, other unmeasured risk factors may have played a more dominant role in leading to a net decrease in lung function from Period I to Period II. Future studies are needed to identify these risk factors.


O2A: One-Shot Observational Learning with Action Vectors.
We present O2A, a novel method for learning to perform robotic manipulation tasks from a single (one-shot) third-person demonstration video. To our knowledge, it is the first time this has been done for a single demonstration. The key novelty lies in pre-training a feature extractor for creating a perceptual representation for actions that we call "action vectors". The action vectors are extracted using a 3D-CNN model pre-trained as an action classifier on a generic action dataset. The distance between the action vectors from the observed third-person demonstration and trial robot executions is used as a reward for reinforcement learning of the demonstrated task. We report on experiments in simulation and on a real robot, with changes in viewpoint of observation, properties of the objects involved, scene background and morphology of the manipulator between the demonstration and the learning domains. O2A outperforms baseline approaches under different domain shifts and has comparable performance with an Oracle (that uses an ideal reward function). Videos of the results, including demonstrations, can be found in our: project-website.


Targeting Solid Cancers with a Cancer-Specific Monoclonal Antibody to Surface Expressed Aberrantly O-glycosylated Proteins.
The lack of antibodies with sufficient cancer selectivity is currently limiting the treatment of solid tumors by immunotherapies. Most current immunotherapeutic targets are tumor-associated antigens that are also found in healthy tissues and often do not display sufficient cancer selectivity to be used as targets for potent antibody-based immunotherapeutic treatments, such as chimeric antigen receptor (CAR) T cells. Many solid tumors, however, display aberrant glycosylation that results in expression of tumor-associated carbohydrate antigens that are distinct from healthy tissues. Targeting aberrantly glycosylated glycopeptide epitopes within existing or novel glycoprotein targets may provide the cancer selectivity needed for immunotherapy of solid tumors. However, to date only a few such glycopeptide epitopes have been targeted. Here, we used O-glycoproteomics data from multiple cell lines to identify a glycopeptide epitope in CD44v6, a cancer-associated CD44 isoform, and developed a cancer-specific mAb, 4C8, through a glycopeptide immunization strategy. 4C8 selectively binds to Tn-glycosylated CD44v6 in a site-specific manner with low nanomolar affinity. 4C8 was shown to be highly cancer specific by IHC of sections from multiple healthy and cancerous tissues. 4C8 CAR T cells demonstrated target-specific cytotoxicity in vitro and significant tumor regression and increased survival in vivo. Importantly, 4C8 CAR T cells were able to selectively kill target cells in a mixed organotypic skin cancer model having abundant CD44v6 expression without affecting healthy keratinocytes, indicating tolerability and safety.


Mechanisms of Casing Deformation during Hydraulic Fracturing in the Horizontal Wells of the Weirong Shale Field.
Casing deformation is frequent during hydraulic fracturing in the Weirong shale gas field, which impedes shale gas production. We investigated the effect of shale elastic modulus on casing deformation based on shale swelling in this work. According to field data, the silicon content in the Weirong shale gas field has a considerable impact on casing deformation during hydraulic fracturing. Furthermore, the results of the experiment show that the silicon content is positively related to the elastic modulus of shale. We conducted numerical simulations to analyze the casing deformation based on shale swelling. We observed that the shale elastic modulus was negatively correlated with the casing stress without shale swelling; however, the shale elastic modulus was positively correlated to casing stress with shale swelling. Furthermore, when the elastic modulus remained constant, casing stress was positively correlated with shale swelling. The numerical simulation results were validated using field data from the WY23-5 shale well. Moreover, factors such as injection pressure, formation pressure, and cement sheath elastic modulus can increase the impact of the shale elastic modulus on casing deformation with shale swelling. Casing deformation is greatly influenced by the distribution of the stimulated reservoir volume (SRV) area. Different SRV area behaviors result in different types of casing deformation. The symmetric distribution of the SRV area causes casing extrusion deformation, whereas the asymmetric distribution of the SRV area causes casing bending deformation. Moreover, casing stress is positively correlated with the length of the SRV area.


Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience.
Single-incision laparoscopic procedures have been gaining popularity in recent years due to their minimal incisional morbidity and improved cosmetic outcomes. Herein, we will compare the feasibility and outcomes of single-incision and conventional multiport laparoscopic distal pancreatectomy. This study involves consecutive patients who underwent either single-incision or conventional multiport laparoscopic distal pancreatectomy from March 2007 to February 2014. The patients were divided into two groups, based on the surgical approach: single-incision laparoscopic surgery (Group 1) and conventional multiport laparoscopic surgery (Group 2). The parameters evaluated included estimated blood loss, operative time, postoperative pain, duration of hospital stay, complications, conversion, and final pathology. There were a total of 20 patients, 10 in each study group. Baseline characteristics were similar, and there was no mortality in either of the groups. The low-flow pancreatic fistula was the most commonly seen morbidity, but it was ceased spontaneously in each group by a ratio of 30%. The operative time was significantly shorter in Group 2, with a mean of 116 minutes versus a mean of 180 minutes for Group 1 (p<0.001). One of the procedures in Group 2 was converted to open surgery due to peroperative bleeding. The median follow-up periods of the patients were 22 months and 56 months. The spleen was preserved in only 1 patient from Group 1, whereas in Group 2, the spleen preservation was achieved in 5 patients. The single-incision laparoscopic technique is a safe and effective alternative to standard laparoscopic distal pancreatectomy.


Molecular dynamics simulations and experimental studies of binding and mobility of 7-tert-butyldimethylsilyl-10-hydroxycamptothecin and its 20(S)-4-aminobutyrate ester in DMPC membranes.
The enhanced permeability and retention of liposomes in solid tumors makes liposomal formulations attractive for the targeting of various antitumor agents. This study explores the binding, orientation, and dynamic properties of a potent topoisomerase I inhibitor, 7-tert-butyldimethylsilyl-10-hydroxycamptothecin (DB-67), and its 20(S)-4-aminobutyrate ester prodrug (DB-67-AB) in DMPC liposomes by molecular dynamics (MD) simulations and experimental studies. MD simulations of an all-atom and fully hydrated liquid-crystalline bilayer (2 x 36 DMPC lipids) containing single molecules of DB-67 and DB-67-AB were conducted for up to 50 ns. Membrane/water partition coefficients for DB-67 and DB-67-AB vs pH were determined by ultracentrifugation. Fluorescence spectra and/or steady-state anisotropies were measured in various solvents and in DMPC liposomes. Kinetics for the reversible DB-67 lactone ring-opening in the presence and absence of DMPC liposomes were determined by HPLC with fluorescence detection. During the entire simulation time both DB-67 and DB-67-AB were located on the bilayer membrane near the polar ester groups of DMPC. The average depth of penetration for DB-67 and DB-67-AB was similar (12.4-13.2 A) with the prodrug's protonated amino group strongly solvated by surface water and lipid phosphate groups. Binding and fluorescence experiments revealed only a modest reduction in the binding affinity upon attachment of the ionized 4-aminobutyrate group onto DB-67. The binding microenvironment polarity resembles that of a polar solvent such as EtOH and DMSO. Kinetics experiments confirmed that DB-67 lactone hydrolysis is inhibited in the presence of DMPC liposomes, consistent with the reduced exposure of its lactone ring to water, as observed in the simulations. Both bound DB-67 and bound DB-67-AB have nonrandom orientations and reduced mobility in the membrane, especially for diffusion normal to the bilayer surface, and rotational relaxation, both of which are > or =2 orders of magnitude slower than in bulk water. MD simulations correctly predicted the high binding affinities for DB-67-AB to DMPC bilayers, protection of bound DB-67 toward lactone hydrolysis, and the lack of a substantial reduction in binding for the 20(S)-4-aminobutyrate prodrug of DB-67.


Phytochemistry and Pharmacological Studies of Citrus macroptera: A Medicinal Plant Review.
Citrus macroptera (family Rutaceae), commonly known as Sat Kara, is a pharmacologically diverse medicinal plant. Various parts of this plant, specifically fruit, have an immense range of medicinal uses in folk medicine directed for a number of ailments. A plethora of active phytochemical constituents of this plant have been revealed so far, namely, limonene, beta-caryophyllene, beta-pinene, geranial edulinine, ribalinine, isoplatydesmine, and so forth. Several studies demonstrated the exploration of pharmacological potential of various parts such as fruits, leaves, and stems of C. macroptera as antioxidant, cytotoxic, antimicrobial, thrombolytic, hypoglycemic, anxiolytic, antidepressant, cardioprotective, and hepatoprotective. Furthermore, inhibition of in vitro α-amylase, inhibition of paracetamol induced hepatotoxicity, and potentiation of brain antioxidant enzyme are also ascertained. In present review, comprehensive study focused on knowledge regarding several phytopharmacological activities of Citrus macroptera has been described.


High-grade dysplasia in sporadic fundic gland polyps: clinically relevant or not?
Sporadic fundic gland polyps (FGPs) are the most frequent gastric polyps. These FGPs develop almost exclusively in a normal corpus mucosa without Helicobacter pylori infection. This means that they represent an absolutely benign disease (no ulcers, almost no gastric carcinoma and mucosa associated lymphoid tissue (MALT) lymphoma). Most probably there exists a statistically accumulated coincidence rate of sporadic FGPs with colorectal epithelial neoplasias, so it is recommended to consider preventive colonoscopy. In familial adenomatous polyposis (FAP), FGPs are present in up to 80-93% of patients. In such patients, low-grade dysplasia and/or foveolar microadenomas may be present in 44-54% of cases. To date, only three case reports on early gastric carcinoma have been published. In this issue, to the best of our knowledge the first case of a high-grade dysplasia (intraepithelial neoplasia) in a sporadic FGP is reported. Recently, it has been shown that beta-catenin mutations might have led to FGP. Therefore, in the future, patients showing nuclear beta-catenin expression must undergo examination to discover whether this expression may lead to neoplasia. According to the data available at present, such a constellation must be regarded as an extremely rare event.


Can intermittent pneumatic compression cause compartment syndrome?
We report a case of a 32-year-old male patient who developed unilateral lower-limb compartment syndrome following a long surgical procedure during which intermittent pneumatic compression was used as deep-venous thrombosis prophylaxis. This complication of surgery is associated with significant morbidity. Previously published reports have suggested the possible risk factors and a way to reach a diagnosis at an early stage. The possible risk factors we present are the long operative time and the use of intermittent pneumatic compression as deep-vein thrombosis prophylaxis. These findings could be used to raise awareness in early diagnosis and treatment.


Liver toxicity mechanisms of herbs commonly used in Latin America.
Mexico owns approximately 4500 medicinal plants species, a great diversity that position it at the second place after China. According to the Mexican health department, 90% of common population consumes them to treat various diseases. Additionally, herbal remedies in Latin America (LA) are considered a common practice, but the frequency of use and the liver damage related to its consumption is still unknown. Despite the high prevalence and indiscriminate herbal consumption, the exact mechanism of hepatotoxicity and adverse effects is not fully clarified and is still questioned. Some herb products associated with herb induced liver injury (HILI) are characterized by presenting a different chemical composition that may vary from batch to batch, also the biological activity of many medicinal plants and other natural products are directly related to their most active component and its concentration. There are two main biological components that are associated with liver damage, alkaloids, and flavonoids, which are frequent constituents of commonly used herbs. The interaction with the different cytochrome P-450 isoforms, inflammatory, and oxidative activities seem to be the main damage pathway involved in the liver. It is important to know the herbal adverse effects and mechanisms involved; therefore, this article is focused on the beneficial and deleterious effects as well as the possible toxicity mechanisms and interactions of the herbs that are frequently used in LA, since the herb-host interaction may not always be the expected or desired depending on the clinical context in which it is administered.