Gait parameters associated with balance in healthy 2- to 4-year-old children.
The use of validated measurements of gait and balance are crucial to establish baseline function and assess effectiveness of therapeutic interventions. Gait in children changes with motor development requiring frequent observations to effectively track progress. Standardized baseline spatiotemporal measurements and a greater understanding of the relationship between gait and balance would provide important feedback to clinicians regarding the effectiveness of rehabilitation and guide treatment modifications. 84 subjects (2.0-4.9 years) walked along the GAITRite(®), a walkway that records spatiotemporal parameters. The Pediatric Balance Scale (PBS) was administered to assess balance. Comparison of spatiotemporal parameter means between age groups showed trends associated with motor development similar to the ones described in the literature such as decreased cadence and increased step/stride length with increasing age. However, no significant differences in normalized spatiotemporal parameters were found between age groups. Age, leg length, cadence, step/stride length, step/stance time, and single/double support time showed significant correlation with balance scores. When the parameters were grouped into spatial, temporal, and age-related components using principal components analysis and included in a multiple regression model, they significantly predicted 51% of the balance score variance. Age-related components most strongly predicted balance outcomes. We suggest that balance can potentially be evaluated by assessment of spatial, temporal, and age-related characteristics of gait such as step length, cadence, and leg length. This suggests the possibility of developing new gait measurement technology that could provide functional assessment and track improvements during rehabilitation regimens. If the same model can be applied to monitor treatment efficacy in children with gait abnormalities remains to be addressed.


Evaluation of the accuracy and clinical practicality of a calculation system for patient positional displacement in carbon ion radiotherapy at five sites.
We developed a system for calculating patient positional displacement between digital radiography images (DRs) and digitally reconstructed radiography images (DRRs) to reduce patient radiation exposure, minimize individual differences between radiological technologists in patient positioning, and decrease positioning time. The accuracy of this system at five sites was evaluated with clinical data from cancer patients. The dependence of calculation accuracy on the size of the region of interest (ROI) and initial position was evaluated for clinical use. For a preliminary verification, treatment planning and positioning data from eight setup patterns using a head and neck phantom were evaluated. Following this, data from 50 patients with prostate, lung, head and neck, liver, or pancreatic cancer (n = 10 each) were evaluated. Root mean square errors (RMSEs) between the results calculated by our system and the reference positions were assessed. The reference positions were manually determined by two radiological technologists to best-matching positions with orthogonal DRs and DRRs in six axial directions. The ROI size dependence was evaluated by comparing RMSEs for three different ROI sizes. Additionally, dependence on initial position parameters was evaluated by comparing RMSEs for four position patterns. For the phantom study, the average (± standard deviation) translation error was 0.17 ± 0.05, rotation error was 0.17 ± 0.07, and ΔD was 0.14 ± 0.05. Using the optimal ROI size for each patient site, all cases of prostate, lung, and head and neck cancer with initial position parameters of 10 mm or under were acceptable in our tolerance. However, only four liver cancer cases and three pancreatic cancer cases were acceptable, because of low-reproducibility regions in the ROIs. Our system has clinical practicality for prostate, lung, and head and neck cancer cases. Additionally, our findings suggest ROI size dependence in some cases.


Personal technique for wrist dorsal approach.
In hand disorders surgical procedures are more and more widely used and often it's necessary to approach the wrist by the dorsal way. Beneath anatomy of this region is well known, there is still room enough to develop new surgical exposure techniques mostly related to physiology and biomechanics. Our goals are to present an innovative surgical dorsal exposure of the wrist, to show its use for different problems solving, and to evaluate its mini-invasive and functional outcome. Our inedited surgical technique is presented. Since November 1999 to February 2008, this technique has been used by the same surgeon in 60 cases for different pathologies and procedures: 14 SNAC-SLAC wrists III-IV treated by proximal row resection and Resurface-Capitate Pyrocarbon Implant (RCPI), 2 Fenton syndromes by bone graft and RCPI, 6 SNACSLAC II by proximal row resection +/- radial styloidectomy, 2 SLAC III by scaphoidectomy and capito-lunate arthrodesis, 12 scapho-lunate recent dissociations by ligamentoplasty (double approach), 4 scapho-lunate inveterate dissociations by Cuenod Saffar-Romano modified technique and 4 by synthetic ligaments, 1 fracture of the scaphoid proximal pole by synthesis-revascularization-S.L.ligament reconstruction, 15 Kienbock's diseases revascularized by II m.c. artery +/- radial osteotomy. Patients have been evaluated at follow up through the DASH disability questionnaire, the Mayo score for the force, ROM, pain, satisfaction grade. Results are good and encouraging for these applications. In conclusion this new technique with its limited exposure permits an early mobilization with a lower risk of stiffness and can be considered mini-invasive.


Comparison of Shear Bond Strength and Microleakage between Activa™ Bioactive Restorative™ and Bulk-Fill Composites-An In Vitro Study.
Bioactive materials have emerged as a promising alternative to conventional restorative materials as part of more conservative dentistry. The aim of this study was to evaluate and compare the shear bond strength (SBS) and microleakage of a new bioactive restorative material, two bulk-fill restorative composites, and a conventional composite at 24 h, 4 weeks, and 8 weeks. Three hundred and sixty molars and premolars were divided into four groups: ACTIVA™ BioACTIVE Restorative™, Filtek™ Bulk-Fill Restorative Composite, Tetric® N-Ceram Bulk-Fill Composite, and G-aenial® Composite. The normality of the data was determined with the Kolmogorov-Smirnov test, then the two-way ANOVA and Fisher's test were used for analyzing SBS data, and the Kruskal-Wallis and DSCF tests were conducted to analyze the microleakage. In the SBS test, there were no statistically significant differences between materials (p = 0.587), and the relation between material and time (p = 0.467), time points showed statistically significant differences (p = 0.016). As for the microleakage, statistically significant differences were found for all three time periods (p < 0.05), showing the conventional composite to have the lowest microleakage, followed by the bioactive material, and lastly the two bulk-fill composites. In conclusion, the new bioactive material has similar evaluated properties to bulk-fill composites (bond strength) and conventional composites (bond strength and microleakage) and can be used as an alternative restorative material.


Routine preoperative venous and arterial mapping increases both, construction and maturation rate of upper arm autogenous arteriovenous fistulae.
To test the hypothesis that routine preoperative mapping and transposed brachial-basilic vein fistula (TBBVF) increases arteriovenous fistulae (AVFs) construction rates, without altering maturation rate. Over a 4-year period, 709 vascular accesses were performed, including 467 AVFs (radial-cephalic fistula [RCF], n = 217, brachial-cephalic fistula [BCF], n = 139, TBBVF, n = 111) and 251 prosthetic grafts. During the last 2 years, preoperative mapping was performed routinely by means of ultrasound, and TBBVFs were preferentially used over arteriovenous grafts (AVGs). Over the study, construction rate of upper arm AVF increased significantly from 12% to 53% and use of prosthetic grafts decreased from 55% to 19% (P < .001). Maturation rate of RCFs, BCFs, and TBBVFs during the first part of the study was 75%, 50%, and 30% (P = .003), compared to 79%, 82%, and 86% (P = .43), respectively, during the second part. Routine preoperative upper extremity mapping with ultrasound increases not only AVF construction rate, but also their maturation likelihood.


n-3 polyunsaturated fatty acids in phospholipid or triacylglycerol form attenuate nonalcoholic fatty liver disease via mediating cannabinoid receptor 1/adiponectin/ceramide pathway.
n-3 polyunsaturated fatty acids (PUFA) have shown to exert beneficial effects in the treatment of nonalcoholic fatty liver disease (NAFLD). Supplements of n-3 PUFA occur in either phospholipid or triacylglycerol form. The present study aimed to compare whether the different n-3 PUFA of marine-origin, namely krill oil, DHA/EPA-phospholipid (PL), and EPA/DHA-triacylglycerol (TAG) forms had differential abilities to ameliorate NAFLD. The NAFLD model was established in mice fed a high-fat and high-cholesterol diet (HFD). The mice showed evidence of weight gain, dyslipidemia, insulin resistance and hepatic steatosis after 9 weeks of HFD, while the three forms of the n-3 PUFA reduced hepatic TAG accumulation, fatty liver and improved insulin instance, and hepatic biomarkers after 9 weeks of intervention. Of these, krill oil intervention significantly reduced adipocyte hypertrophy and hepatic steatosis in comparison with DHA/EPA-PL and EPA/DHA-TAG groups. Importantly, only krill oil intervention significantly reduced serum alanine transaminase, aspartate transaminase concentrations and low-density lipoprotein-cholesterol, compared with the HFD group. Supplemental n-3 PUFA lowered circulating anandamide (AEA) and 2-arachidonoylglycerol (2-AG) concentrations, compared with the HFD group, which was associated with down-regulating CB1 and upregulating adiponectin expressions in adipose tissue. Besides, targeted lipidomic analyses indicated that the increased adiponectin levels were accompanied by reductions in hepatic ceramide levels. The reduced ceramide levels were associated with inhibiting lipid synthesis and increasing fatty acid β-oxidation, finally inhibiting TAG accumulation in the liver. Through mediating CB1/adiponectin/ceramide pathway, the present study suggested that administration of krill oil had superior health effects in the therapy of NAFLD in comparison with DHA/EPA-PL and EPA/DHA-TAG.


Earthworm immune responses.
The knowledge of the immunity in annelids started with the use of earthworms as biomarkers indicating changes caused by environmental pollution. Defence strategies effectively protect earthworms against bacterial infections and parasitic invasion. A natural immunity formed by anatomical and chemical protective barriers prevents damage of the underlying tissues, body fluid losses, and microbial infections of the body cavity. The internal defence mechanisms of annelids involve phagocytosis, nodule formation and encapsulation, blood coagulation and wound repair, and antibacterial immune proteins. The antibacterial activity of coelomic fluid associated with lysozyme-like substances and inducible humoral molecules support haemocytic reactions in the annelid defence system.


The effectiveness of various disinfectants used as endodontic intracanal medications: an in vitro study.
The purpose of this study was to compare in vitro the suitability of four disinfectants as intracanal medications: calcium hydroxide, chlorhexidine gel, chlorhexidine in the form of a controlled-release delivery system (PerioChip), and the combination of chlorhexidine gel with calcium hydroxide. Saline was used as the control. The disinfectants were tested at three different time periods (3, 8, and 14 days) by using human tooth specimens that had been previously contaminated with Enterococcus faecalis. Calcium hydroxide worked very efficiently in killing E. faecalis in the 3-day group and 8-day group. It was not as effective in the 14-day group. The different chlorhexidine formulations were also found to be effective for all time periods. More specifically, the combination of chlorhexidine gel with calcium hydroxide and the chlorhexidine gel worked slightly better than the PerioChip, but there was no significant difference among the medications.


Accuracy of positioning and irradiation targeting for multiple targets in intracranial image-guided radiation therapy: a phantom study.
This study investigated the accuracy of positioning and irradiation targeting for multiple off-isocenter targets in intracranial image-guided radiation therapy (IGRT). A phantom with nine circular targets was created to evaluate both accuracies. First, the central point of the isocenter target was positioned with a combination of an ExacTrac x-ray (ETX) and a 6D couch. The positioning accuracy was determined from the deviations of coordinates of the central point in each target obtained from the kV-cone beam computed tomography (kV-CBCT) for IGRT and the planning CT. Similarly, the irradiation targeting accuracy was evaluated from the deviations of the coordinates between the central point of each target and the central point of each multi-leaf collimator (MLC) field for multiple targets. Secondly, the 6D couch was intentionally rotated together with both roll and pitch angles of 0.5° and 1° at the isocenter and similarly the deviations were evaluated. The positioning accuracy for all targets was less than 1 mm after 6D positioning corrections. The irradiation targeting accuracy was up to 1.3 mm in the anteroposterior (AP) direction for a target 87 mm away from isocenter. For the 6D couch rotations with both roll and pitch angles of 0.5° and 1°, the positioning accuracy was up to 1.0 mm and 2.3 mm in the AP direction for the target 87 mm away from the isocenter, respectively. The irradiation targeting accuracy was up to 2.1 mm and 2.6 mm in the AP direction for the target 87 mm away from the isocenter, respectively. The off-isocenter irradiation targeting accuracy became worse than the positioning accuracy. Both off-isocenter accuracies worsened in proportion to rotation angles and the distance from the isocenter to the targets. It is necessary to examine the set-up margin for off-isocenter multiple targets at each institution because irradiation targeting accuracy is peculiar to the linac machine.


Swimming With Sharks: Left Main Coronary Obstruction Following Transcatheter Aortic Valve Implantation.
Delayed coronary obstruction (DCO) occurs when there is obstruction of the coronary ostia following a transcatheter aortic valvular implantation (TAVI). It is an uncommon but serious complication that often leads to death, usually presents as severe hypotension after TAVI, and should be suspected if migration of the valve occurs. We report the case of a 70-year-old female patient with severe aortic stenosis who underwent TAVI using a 26-mm CoreValve Evolut Pro (Medtronic, Dublin, Ireland). Although the valve was implanted successfully, she experienced hypotension with intermittent ST elevations and had a cardiac arrest shortly after, requiring Advanced Cardiovascular Life Support (ACLS). An aortogram showed sealing of the sinotubular junction (STJ) by CoreValve, without coronary flow. CoreValve was then snared and repositioned in the ascending aorta recovering coronary flow and cardiac pulsatility. A second TAVI was performed and an Edwards 20 mm Sapiens 3 valve (Edwards Lifesciences, Irvine, CA, USA) was implanted as standard procedure.


The prevalence of psychiatric morbidity in solvent workers in Britain.
Using data originally collected in Britain as part of the study of morbidity in general practice in 1970-71, we have made an estimate of the prevalence of minor psychiatric illness amongst workers exposed to organic solvents. No differences were found between the rates of consultation for mental illness in any solvent exposed group either male or female. Nor was any difference found in the prevalence of mental illness found between workers exposed to solvents and non-exposed referents when we examined data from two smaller studies.


[The main reasons for late diagnosis and errors in the early period of treatment of intrahospital myocardial infarction in a general hospital].
The purpose of the study was to investigate the reasons for late diagnosis and late transfer of hospitalized patients with myocardial infarction (MI) to a specialized cardiological department. The study shows that the main reasons are an atypical clinical picture of MI and a low "infarct alert" of doctors of different specialties. The authors analyzed the fullness of urgent medical aid and the beginning of treatment in cases of intrahospital MI in patients being treated in different hospital departments. The analysis revealed the main objective and subjective factors that cause a low frequency of administration of thrombolytics, anticoagulants, and disaggregants.


[Laparoscopic cholecystectomy in morbid obesity].
In the early days of laparoscopic cholecystectomy (LC) morbid obesity was considered a relative contraindication for this procedure. With increased experience the procedure has been used in obese patients too. To evaluate the influence of morbid obesity on feasibility and outcome of LC, we performed a prospective study in 136 patients in whom LC was attempted between January 1991 and January 1992. Conversion to open cholecystectomy was necessary in 26 cases (19%). The remaining patients were divided into two groups. Group 1 consisted of 92 normal or slightly obese individuals, whereas 18 morbidly obese patients were included in group 2. Intraoperative problems (42% vs 61%) and postoperative morbidity (2% vs 11%) were less frequent in group 1, although not statistically significant. There was no difference in operating time (median for both groups: 110 minutes) and length of hospital stay (4 days). The incidence of late complications (3% vs 6%) was similar. We conclude that LC in morbidly obese patients, as in open surgery, is technically more demanding than in normal individuals. The operative risk was elevated (p < 0.05) as evidenced by a tendency to higher intra- and postoperative complication rates. Cholecystolithiasis in morbidly obese patients is a good indication for LC in the hands of well trained laparoscopic surgeons who are ready to convert to open surgery if problems arise.


Modelling the influence of radiosensitivity on development of second primary cancer in out-of-field organs following proton therapy for paediatric cranial cancer.
Radiobiological modelling the risks of second primary cancer (SPC) after proton therapy (PT) for childhood cranial cancer remains largely unknown. Organ-specific dose-response risk factors such as radiosensitivity require exploration. This study compared the influence of radiosensitivity data (slope of βEAR) on children's lifetime attributable risks (LAR) of SPC development in out-of-field organs following cranial scattering and scanning PT. Out-of-field radiosensitivity parameter estimates for organs (α/β and βEAR) were sourced from literature. Physical distances for 13 out-of-field organs were measured and input into Schneider's SPC model. Sensitivity analyses were performed as a function of radiosensitivity (α/β of 1-10 Gy) and initial slope (βEAR) from Japanese/UK data to estimate the influence on the risk of radiation-induced SPC following scattering and scanning PT. Models showed similar LAR of SPC estimates for age and sex-matched paediatric phantoms, however, for breast there was a significant increase using Japanese βEAR data. For most organs, scattering PT demonstrated a larger risk of LAR for SPC which increased with α/β. Breast tissue exhibited the highest susceptibility in calculated LAR risk, demonstrating the importance for accurate data input when estimating LAR of SPC. The findings of this study demonstrated younger female patients undergoing cranial proton therapy have a higher risk of developing second primary cancer of the breast tissue. Long-term multicenter registries are important to improve predictive radiobiological modelling studies of side effects.


Prioritizing Treatment Goals of People Diagnosed with Bipolar I Disorder in the US: Best-Worst Scaling Results.
Bipolar I disorder (BP-I) is associated with significant disease burden, but evidence on treatment goals in people diagnosed with BP-I is scarce. This study sought to quantify treatment goals related to the pharmacological management of BP-I in adults in the US and to identify if subgroups of people with similar treatment goals exist. A best-worst scaling (BWS) of treatment goals was developed based on available literature and input from experts and patients and was distributed as part of a survey between August and September 2021. Survey participants were adults with a self-reported diagnosis of BP-I who were recruited via an online panel in the US. Participants were asked to prioritize the importance of 16 treatment goals using BWS. BWS scores were computed using multinomial logistic regression, with the scores across all goals summing to 100 for each participant. Subgroups of people with similar preferences were identified using latent class analysis. The most important treatment goals for people diagnosed with BP-I (N=255) were "being less impulsive, angry, or irritable" (score: 9.73), or being "able to feel pleasure or happiness" (score: 9.54). Goals related to reducing the incidence of various potential adverse events of medication (scores: ≤4.51) or "reducing dependence on others" (score: 3.04) were less important. Two subgroups were identified. One subgroup (n=111) prioritized symptom-focused goals, considering "reducing frequency of mania, depression, and mixed episodes" and "being less impulsive, angry or irritable" the most important (scores: 12.46 and 11.85, respectively). The other subgroup (n=144) placed significantly more importance on social functioning-focused goals, including beginning or maintaining a relationship with a partner/significant other, and with family and/or friends (scores: 8.45 and 7.70, respectively). People diagnosed with BP-I prioritized emotional improvements. Subgroups of people with BP-I prioritized either symptom-focused or social functioning-focused treatment goals.


Tubulins in C. elegans.
The C. elegans tubulin family is composed of nine α-, six β-, and one γ-tubulin. Tubulins are highly conserved, functioning as α-β heterodimers that assemble into microtubules. These cylindrical and ubiquitous components of the cytoskeleton are critical for nearly all cellular and developmental processes. C. elegans has provided a model for the study of microtubules in multiple settings including separation of chromosomes, cellular polarity, and neuronal sensation. Tubulins and microtubules interact with a long list of other cellular proteins that regulate tubulin homeostasis, modify microtubule dynamics, and control incorporation into or disassociation of higher-order cellular structures such as spindles or ciliary axonemes. A collection of enzymes modifies tubulins, often at the variable carboxyl-terminal tail, adding another layer of regulation to microtubule structure and function. Genetic and cytological studies in C. elegans have revealed roles for tubulin and its associated proteins in numerous contexts from embryogenesis to adult behavior.


Medical advances during the Civil War.
The contributions to medical care that developed during the Civil War have not been fully appreciated, probably because the quality of care administered was compared against modern standards rather than the standards of the time. The specific accomplishments that constituted major advances were as follows. 1. Accumulation of adequate records and detailed reports for the first time permitted a complete military medical history. This led to the publication of the Medical and Surgical History of the War of the Rebellion, which was identified in Europe as the first major academic accomplishment by US medicine. 2. Development of a system of managing mass casualties, including aid stations, field hospitals, and general hospitals, set the pattern for management of the wounded in World War I, World War II, and the Korean War. 3. The pavilion-style general hospitals, which were well ventilated and clean, were copied in the design of large civilian hospitals over the next 75 years. 4. The importance of immediate, definitive treatment of wounds and fractures was demonstrated and it was shown that major operative procedures, such as amputation, were optimally carried out in the first 24 hours after wounding. 5. The importance of sanitation and hygiene in preventing infection, disease, and death among the troops in the field was demonstrated. 6. Female nurses were introduced to hospital care and Catholic orders entered the hospital business. 7. The experience and training of thousands of physicians were upgraded and they were introduced to new ideas and standards of care. These included familiarity with prevention and treatment of infectious disease, with anesthetic agents, and with surgical principles that rapidly advanced the overall quality of American medical practice. 8. The Sanitary Commission was formed, a civilian-organized soldier's relief society that set the pattern for the development of the American Red Cross.


Data-Knowledge-Driven Modeling and Operational Adjustment for the Pharmaceutical Tablet Manufacturing Process via Wet Granulation.
In the context of Pharma 4.0, pharmaceutical quality control (PQC) is beset by issues such as uncertainties from ever-changing critical material attributes and strong coupling between variables in the multi-unit pharmaceutical tablet manufacturing process (PTMP), and how to timely adjust the operational variables to deal with such challenges has become a key problem in PQC. In this study, we propose a novel data-knowledge-driven modeling and operational adjustment framework for PTMP by integrating Bayesian network (BN) and case-based reasoning (CBR). At the modeling level, first, a distributed concept is introduced, i.e., the BN model for each subunit of PTMP is established in accordance with the operation process sequence, and the transition variables are given by the BN model established first and retrieved as the new query for the next unit. Once the BN models of all subunits are built, they are integrated into a global BN model. At the operational adjustment level, by taking the expected critical quality attributes (CQAs) and related prior information as evidence, the operational adjustment is achieved through global BN reasoning. Finally, the case study in a sprayed fluidized-bed granulation-based PTMP demonstrates the feasibility and effectiveness in improving the terminal CQAs of the proposed method, which is also compared with other methods to showcase its efficacy and merits.


Effects of chain length of polyethylene glycol molecular crowders on a mutant Tetrahymena group I ribozyme lacking large peripheral module.
While current group I ribozymes use several distinct strategies to function under conditions of low Mg2+ concentration (≤ 3 mM), a deletion mutant of the Tetrahymena ribozyme (ΔP5 ribozyme) is virtually inactive with 3 mM Mg2+ due to removal of the large peripheral module, P5abc, supporting the active conformation of the core module. We investigated the molecular crowding effects of synthetic polyethylene glycols (PEGs) on the activity of the ΔP5 ribozyme. Among PEG molecules with different chain lengths, PEG600 improved the activity of the ΔP5 ribozyme most effectively in the presence of 3 mM Mg2+.


Pyrrolizidine alkaloids in floral honeys of tropical Ghana: a health risk assessment.
There is a vast amount of information about the nutritional and medicinal properties of honey as a result of its numerous benefits. However, honeys have been found to be contaminated with hepatotoxic and carcinogenic pyrrolizidine alkaloids (PAs) on account of bees foraging on PA-containing plants. This study deals with the analysis of PAs in tropical honeys emanating from different agro-ecological zones of Ghana in order to assess its potential health risk. PAs of 48 honey samples were analysed using high-performance liquid chromatography-electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS). The results show that a total of 85% of the honeys from various agro-ecological zones were PA positive including all honeys from supermarkets. The highest concentration of PAs was 2639 μg kg-1, while the average PA concentration of the samples was 283 μg kg-1. The study also found Chromolaena odorata pollens in majority of the honeys, thus indicating the plant as major source of PA contamination of honeys in the tropical regions.


Determining acute health hazard ratings in the absence of applicable toxicological data.
Health, safety, and emergency planning professionals have a responsibility to identify acute hazards associated with chemicals and to find a way to transmit that information to chemical users, emergency responders, and others. Various organizations such as the Department of Energy are considering acute health hazard ratings as triggers that would mandate various activities. A paradigm shift away from a "lists" based approach to determining whether a chemical is sufficiently hazardous to require further analysis for emergency planning purposes is under way. Various toxicological data sources and approaches in use to develop an acute health hazard rating are discussed. Methods of extrapolating data from published and unpublished supporting documentation to develop an acute health hazard rating in the absence of toxicological data by animal species, chemical structure similarities, MSDS estimated values, and data mining are discussed. The process described analyzes applicable data and allows the analyst to determine reasonable health hazard rating numbers for chemicals without published hazard ratings and for mixtures of chemicals. The level and amount of resources available will determine which methods will be used in the process.


Lumbar Arthroplasty Core Herniation Presenting With Cauda Equina Syndrome: Case Report of a Rare Complication.
Treatment failures of artificial disc implantation are well-described, but posterior herniation of the arthroplasty core is rare. We present a case of posterior herniation of the arthroplasty core resulting in cauda equina syndrome in a 36-yr-old woman. Preoperative imaging studies including computed tomography (CT), magnetic resonance imaging (MRI), and CT Myelogram were performed; only the CT Myelogram demonstrated the severe compression well. This report highlights the radiographic findings on multiple imaging modalities, clinical implications, and management considerations of posterior arthroplasty failures. To demonstrate a rare complication of lumbar arthroplasties. The biomechanical considerations, surgical management, and thorough radiographic work-up demonstrate successful diagnosis and treatment of this unusual complication. The patient's chart was reviewed for medical history, laboratory and radiographic studies, and outpatient clinical follow-up. After imaging work-up, this patient was found to have a herniation of the arthroplasty core at L5-S1. She was taken emergently to the operating room for a decompression at L5-S1 and arthroplasty core removal. She made some recovery neurological, but over 3 mo time, she developed a spondylolisthesis with new back pain and radiculopathy. This ultimately responded well to an L5-S1 instrumented posterior fusion. Posterior herniation of the lumbar arthroplasty core is a rare complication from implantation of an artificial lumbar disc. Confirmation of the diagnosis is best confirmed with a CT Myelogram. Furthermore, this case underscores the biomechanical importance of the artificial disc given the development of the spondylolisthesis after removal, and fusion after arthroplasty core removal should be considered.


Can a virtual reality cognitive training application fulfill a dual role? Using the virtual supermarket cognitive training application as a screening tool for mild cognitive impairment.
Recent research advocates the potential of virtual reality (VR) applications in assessing cognitive functions highlighting the possibility of using a VR application for mild cognitive impairment (MCI) screening. The aim of this study is to investigate whether a VR cognitive training application, the virtual supermarket (VSM), can be used as a screening tool for MCI. Two groups, one of healthy older adults (n = 21) and one of MCI patients (n = 34), were recruited from day centers for cognitive disorders and administered the VSM and a neuropsychological test battery. The performance of the two groups in the VSM was compared and correlated with performance in established neuropsychological tests. At the same time, the effectiveness of a combination of traditional neuropsychological tests and the VSM was examined. VSM displayed a correct classification rate (CCR) of 87.30% when differentiating between MCI patients and healthy older adults, while it was unable to differentiate between MCI subtypes. At the same time, the VSM correlates with various established neuropsychological tests. A limited number of tests were able to improve the CCR of the VSM when combined with the VSM for screening purposes. VSM appears to be a valid method of screening for MCI in an older adult population though it cannot be used for MCI subtype assessment. VSM's concurrent validity is supported by the large number of correlations between the VSM and established tests. It is considered a robust test on its own as the inclusion of other tests failed to improve its CCR significantly.


Effects of surfactants on foliar uptake of herbicides - a complex scenario.
Surfactants are almost always present in herbicide treatment solutions with the aim to improve spray droplet retention on and penetration of active ingredients (a.i.s) into plant foliage. The effects of surfactants on the foliar uptake of herbicides are complex and only partially understood. The influence of a range of non-ionic polyoxyethylene surfactants on the uptake of two herbicides, glyphosate and 2,4-dichlorophenoxyacetic acid (2,4-D), was compared using three plant species, wheat, broad bean and common lambsquarters. Surfactants of higher ethylene oxide (EO) content provided greater uptake enhancement for glyphosate, whereas those of lower EO content were more beneficial for 2,4-D uptake. Among surfactants of the same EO content, those containing a C(13)/C(15) linear alkane hydrophobe moiety appeared to be more efficient for promoting the uptake of both herbicides. When a suitable surfactant was used, glyphosate uptake into both bean and wheat foliage increased steadily with increasing surfactant concentration and reached a maximum at 0.5%. In the presence of a constant surfactant, higher percentage uptake of herbicide was obtained with higher a.i. concentrations for glyphosate, but with lower a.i. concentrations in the case of 2,4-D. In the presence of an organosilicone surfactant, the stomatal uptake of glyphosate varied with both surfactant concentration and plant species. The effect of non-silicone surfactants on the cuticular uptake of glyphosate also varied with plant species. It can be concluded that the effects of surfactants on foliar uptake of herbicides depend not only on their chemical structures (hydrophobe and hydrophile moieties) and concentration, but also on the physicochemical properties and concentration of a.i.s and the leaf surface character of the plant species.


Blend of cellulose ester and enteric polymers for delayed and enteric coating of core tablets of hydrophilic and hydrophobic drugs.
The focus of this work was to explore feasibility of using blends of cellulose esters (CA 320S, CA 3980-10 or CAB 171-15) and enteric polymers (C-A-P, Eudragit® L100 or HPMCP HP-55) for delayed and enteric coating of tablets containing either diclofenac sodium (DFS, high dose) or prednisone (PDS, low dose) drug. The core tablets of DFS or PDS were coated with polymer blends to achieve approximate weight gain of 5% and 10%. The coated tablets were characterized for dissolution (0.1 N HCl and phosphate buffer pH 6.8) and surface morphology. The surface morphology of CA 398-10 or CAB 171-15 based polymer blends was rough and fibrous. Less than 0.5% drug was dissolved in 120 min from 5% w/w coated tablets in acid-phase dissolution testing. The dissolution in phosphate buffer pH 6.8 medium varied from 16.2 ± 0.2 to 98 ± 2.1%, and 30.1 ± 0.5% to 101.7 ± 3.4% in 120 min from DFS and PDS coated tablets, respectively. Dissolution was less in CA 320S based blends compared to CA 398-10 or CAB 171-15 blends in phosphate buffer medium. Furthermore, there were no significant differences observed in dissolution profiles of coated tablets of DFS or PDS. This can be explained by dose of the drugs. Additionally, dissolution was higher in tablets coated with enteric polymer alone compared with the blends. In conclusion, core tablets can be coated with cellulose ester and enteric polymers blend to impart both delayed and enteric release feature to the tablets containing hydrophilic or hydrophobic drug.


[Pathogenesis, classification, diagnostic criteria for depression].
There is the concern that adaptation range of depression is enlarged, because operation diagnosis methods of ICD-10 and DSM-IV-TR spread in a clinic of psychiatry. On the other hand, clinical condition of depressive state may diversify. This is a review of the pathogenesis, classification and diagnostic criteria of depression. In the pathogenesis, we discussed about the biological origin (a neurotransmitter-related model, a neuroendocrine model et al) and the psychosocial origin with focus on a historic flow and recent knowledge of the pathogenetic theory. In the classification and diagnostic criteria, we mainly explained the points to notice and the problems on ICD-10 and DSM-IV-TR. It is necessity to arise the problem such as clinical symptoms are inconsistent with the classification and diagnostic criteria of ICD-10 and DSM-IV-TR, because all the pathogenesis is not elucidated now. A development of the classification and criteria of depression is expected in future by scientific elucidation advancing.


Ursolic acid prevents endoplasmic reticulum stress-mediated apoptosis induced by heat stress in mouse cardiac myocytes.
Heat stress causes serious physiological dysfunction of cardiac myocytes and is associated with several types of cardiovascular diseases. However, the underlying mechanisms and therapeutic strategies to alleviate heat stress-induced myocardial damage are not available. The objective of this study was to (1) investigate the functional role of endoplasmic reticulum (ER) stress-mediated apoptosis in heat exposure-induced myocardial damage, and (2) to evaluate the effects of ursolic acid on the myocardial apoptosis as well as the underlying mechanisms in mouse cardiac myocytes. We show here that heat stress-induced apoptosis is predominantly mediated by the activation of PERK-eIF2α-CHOP unfolded protein response which up-regulates the protein expression of Puma, and by the modulation of cellular redox state. Intriguingly, the myocardial apoptosis is markedly attenuated by ursolic acid treatment. Mechanistically, the protective effects of ursolic acid are mediated, at least partly, by reestablishing the intracellular redox state and inducing the expression of the anti-apoptotic protein Mcl-1, which, in turn, inactivating CHOP-induced Puma up-regulation. The striking finding that ursolic acid has both anti-apoptotic and antioxidative activities against ER stress-associated myocardial damage suggests that supplementation of ursolic acid might be a potential strategy to reduce the detrimental effects of heat stress in cardiomyocytes.


Generation of suppressive blood cells for control of allograft rejection.
Our previous studies in rats showed that incubation of monocytic dendritic cells (DCs) with the chemotherapeutic drug mitomycin C (MMC) renders the cells immunosuppressive. Donor-derived MMC-DCs injected into the recipient prior to transplantation prolonged heart allograft survival. Although the generation of DCs is labour-intensive and time-consuming, peripheral blood mononuclear cells (PBMCs) can be easily harvested. In the present study, we analyse under which conditions DCs can be replaced by PBMCs and examine their mode of action. When injected into rats, MMC-incubated donor PBMCs (MICs) strongly prolonged heart allograft survival. Removal of monocytes from PBMCs completely abrogated their suppressive effect, indicating that monocytes are the active cell population. Suppression of rejection was donor-specific. The injected MICs migrated into peripheral lymphoid organs and led to an increased number of regulatory T-cells (Tregs) expressing cluster of differentiation (CD) markers CD4 and CD25 and forkhead box protein 3 (FoxP3). Tolerance could be transferred to syngeneic recipients with blood or spleen cells. Depletion of Tregs from tolerogenic cells abrogated their suppressive effect, arguing for mediation of immunosuppression by CD4⁺CD25⁺FoxP3⁺ Tregs. Donor-derived MICs also prolonged kidney allograft survival in pigs. MICs generated from donor monocytes were applied for the first time in humans in a patient suffering from therapy-resistant rejection of a haploidentical stem cell transplant. We describe, in the present paper, a simple method for in vitro generation of suppressor blood cells for potential use in clinical organ transplantation. Although the case report does not allow us to draw any conclusion about their therapeutic effectiveness, it shows that MICs can be easily generated and applied in humans.


Laparoscopic adjustable gastric banding: surgical technique.
Laparoscopic adjustable gastric banding is an effective and safe surgical treatment for morbid obesity. Initial experience with the Lap-Band system (Inamed Health, Santa Barbara, California) in the United States and Australia has demonstrated that surgical technique can affect outcomes in terms of weight loss, quality of life, and complication rates. Placement of the gastric band by means of the perigastric technique is associated with high rates of gastric prolapse, food intolerance, and weight loss failure that frequently lead to band explantation. In the pars flaccida technique, band placement higher on the stomach results in the formation of a smaller pouch and lower rates of gastric prolapse, which may contribute to greater weight loss and improved quality of life. This article describes the technical aspects of the pars flaccida approach in the laparoscopic placement of adjustable gastric bands.


[Effect of smoking withdrawal on hearing loss induced by occupational exposure to noise. A preliminary study].
Smoking and occupational exposure to noise are factors with independent predisposition to sensorineural hearing loss. This is a sinergistic and additive effect. Nevertheless, we have observed that withdrawal of smoking stops the progression on hearing loss in occupational groups with an acoustic exposition lesser than 80 dB SPL. Actually, there is not an unique ethiologic hypothesis.


A Facile Approach for Preparing Ag Functionalized Nonwoven Polypropylene Membrane to Improve Its Electrical Conductivity and Electromagnetic Shielding Performance.
The commonly used preparation methods of polypropylene functionalization require special equipment to be put into use or take a long time, which limits its application. Therefore, a simple and economical method for preparing silver functionalized nonwoven polypropylene membrane was studied herein. Triethanolamine was first coated on the surface of the polypropylene, and then Ag was deposited on the surface of polypropylene using a continuous reduction reaction of triethanolamine and silver ions. Surface morphology, crystal structure, and surface chemistry during the preparation of Ag functionalized nonwoven polypropylene were investigated. The electrical conductivity, electromagnetic shielding properties, and washing durability of the treated nonwoven polypropylene were also studied. It was found that Ag was uniformly deposited on the surface of the nonwoven polypropylene, and the coating reaction did not change the chemical structure of the polypropylene. The crystallinity and thermal stability of polypropylene were improved after silver coated polypropylene. The washing experiment results showed that the weight gain rate of the treated nonwoven relative to the untreated sample after the 90 min washing ranged from 6.72% to 9.64%. The resistance test results showed that the maximum surface resistivity of Ag coated nonwoven polypropylene was about 1.95 × 10⁵ Ω, which was 64,615 times lower than the original. In addition, the results showed that the maximum electromagnetic shielding effectiveness of the Ag coated nonwoven polypropylene was about 71.6 dB, showing a very good electromagnetic shielding effect.


Dynamin2 controls Rap1 activation and integrin clustering in human T lymphocyte adhesion.
Leukocyte trafficking is crucial to facilitate efficient immune responses. Here, we report that the large GTPase dynamin2, which is generally considered to have a key role in endocytosis and membrane remodeling, is an essential regulator of integrin-dependent human T lymphocyte adhesion and migration. Chemical inhibition or knockdown of dynamin2 expression significantly reduced integrin-dependent T cell adhesion in vitro. This phenotype was not observed when T cells were treated with various chemical inhibitors which abrogate endocytosis or actin polymerization. We furthermore detected dynamin2 in signaling complexes and propose that it controls T cell adhesion via FAK/Pyk2- and RapGEF1-mediated Rap1 activation. In addition, the dynamin2 inhibitor-induced reduction of lymphocyte adhesion can be rescued by Rap1a overexpression. We demonstrate that the dynamin2 effect on T cell adhesion does not involve integrin affinity regulation but instead relies on its ability to modulate integrin valency. Taken together, we suggest a previously unidentified role of dynamin2 in the regulation of integrin-mediated lymphocyte adhesion via a Rap1 signaling pathway.


Emergence of a prestressed eukaryotic nucleus during cellular differentiation and development.
Nuclear shape and size are emerging as mechanistic regulators of genome function. Yet, the coupling between chromatin assembly and various nuclear and cytoplasmic scaffolds is poorly understood. The present work explores the structural organization of a prestressed nucleus in a variety of cellular systems ranging from cells in culture to those in an organism. A combination of laser ablation and cellular perturbations was used to decipher the dynamic nature of the nucleo-cytoplasmic contacts. In primary mouse embryonic fibroblasts, ablation of heterochromatin nodes caused an anisotropic shrinkage of the nucleus. Depolymerization of actin and microtubules, and inhibition of myosin motors, resulted in the differential stresses that these cytoplasmic systems exert on the nucleus. The onset of nuclear prestress was then mapped in two contexts--first, in the differentiation of embryonic stem cells, where signatures of prestress appeared with differentiation; second, at an organism level, where nuclear or cytoplasmic laser ablations of cells in the early Drosophila embryo induced a collapse of the nucleus only after cellularization. We thus show that the interplay of physical connections bridging the nucleus with the cytoplasm governs the size and shape of a prestressed eukaryotic nucleus.


miRNAs in Normal and Malignant Hematopoiesis.
Lineage specification is primarily regulated at the transcriptional level and lineage-specific transcription factors determine cell fates. MicroRNAs (miRNAs) are 18-24 nucleotide-long non-coding RNAs that post-transcriptionally decrease the translation of target mRNAs and are essential for many cellular functions. miRNAs also regulate lineage specification during hematopoiesis. This review highlights the roles of miRNAs in B-cell development and malignancies, and discusses how miRNA expression profiles correlate with disease prognoses and phenotypes. We also discuss the potential for miRNAs as therapeutic targets and diagnostic tools for B-cell malignancies.


[Results of using the dosing Valsalva-Weber test to determine autonomic disorders in patients with vasovagal syncope].
To estimate the value of the dosing Valsalva-Weber test (VWT) in the diagnosis of autonomic disorders in patients with vasovagal syncope (VVS). The dosing VWT using a specialized Task Force Monitor unit ("CNSystem", Austria) with synchronous noninvasive ECG and blood pressure (BP) monitoring was carried out in 30 patients (mean age 32 ± 14 years) with VVS and 12 healthy individuals (31 ± 7 years). The analysis of the test results encompassed the visual assessment of BP change curves and heart rate in different test phases and the calculation of pressure indices, Valsalva coefficient, arterial baroreflex sensitivity, and other parameters (a total of 26). The abnormally changed form of the mean BP curve, which was characterized by that BP by the end of Phase II test failed to achieve the baseline level, was recorded in 10 (33%) patients with VVS and in none of the healthy individuals (p = 0.04). An individual analysis of the gender- and age-adjusted Valsalva coefficient revealed its reduction in 9 (30%) patients while this indicator was within the normal range in all the healthy individuals (p = 0.04). During the dosing VWT, the signs of sympathetic insufficiency (impaired adrenergic regulation of BP) are found in 33% of the patients with VVS and those of parasympathetic insufficiency (impaired vagus regulation of cardiochronotropic function) are in 30%.


Too hard to control: compromised pain anticipation and modulation in mild traumatic brain injury.
Mild traumatic brain injury (MTBI) is a vulnerability factor for the development of pain-related conditions above and beyond those related to comorbid traumatic and emotional symptoms. We acquired functional magnetic resonance imaging (fMRI) on a validated pain anticipation task and tested the hypotheses that individuals with a reported history of MTBI, compared with healthy comparison subjects, would show increased brain response to pain anticipation and ineffective pain modulation after controlling for psychiatric symptoms. Eighteen male subjects with a reported history of blast-related MTBI related to combat, and eighteen healthy male subjects with no reported history of MTBI (healthy controls) underwent fMRI during an event-related experimental pain paradigm with cued high or low intensity painful heat stimuli. No subjects in either group met diagnostic criteria for current mood or anxiety disorder. We found that relative to healthy comparison subjects, after controlling for traumatic and depressive symptoms, participants with a reported history of MTBI showed significantly stronger activations within midbrain periaqueductual grey (PAG), right dorsolateral prefrontal cortex and cuneus during pain anticipation. Furthermore, we found that brain injury was a significant moderator of the relationship between anticipatory PAG activation and reported subjective pain. Our results suggest that a potentially disrupted neurocognitive anticipatory network may result from damage to the endogenous pain modulatory system and underlie difficulties with regulatory pain processing following MTBI. In other words, our findings are consistent with a notion that brain injury makes it more difficult to control acute pain. Understanding these mechanisms of dysfunctional acute pain processing following MTBI may help shed light on the underlying causes of increased vulnerability for the development of pain-related conditions in this population.


Metal-Free Hydrosilylation Polymerization by Borane Catalyst.
The first example of metal-free hydrosilylation polymerization between dienes and disilanes is developed by using a borane catalyst, B(C6F5)3 to replace precious transition-metal-based systems. Under the easy-to-handle and mild conditions, a step-growth polymerization of two readily available diene and disilane units was achieved with high degrees of polymerization. Various combinations of dienes and disilanes produced polycarbosilanes with a broad range of structures and properties.


Selection of protective epitopes for Brucella melitensis by DNA vaccination.
The Brucella melitensis 16M genome was examined for proteins in excess of 100 amino acids and for immunogenicity-associated genes. One subset of 32 annotated genes or open reading frames was identified, and each of these were cloned into the eukaryotic vector pcDNA3.1. Purified recombinant plasmids were used to intramuscularly (i.m.) immunize BALB/c mice. After challenge with B. melitensis 16M strain, two protective antigens were found: the periplasmic protein, bp26, and the chaperone protein, trigger factor (TF). Protective efficacy was confirmed with DNA vaccines for these two B. melitensis proteins and, when combined, protection against wild-type challenge was significantly enhanced. Both proteins were found to be immunogenic since elevated serum immunoglobulin G (IgG) antibodies without a specific IgG subclass bias were induced subsequent to i.m. DNA immunization. Antigen-restimulation assays revealed that bp26 and TF stimulated gamma interferon and only bp26 induced interleukin-4 (IL-4), IL-5, and IL-6 cytokines as measured by cytokine enzyme-linked immunospot assay. These collective results suggest that both bp26 and TF are excellent candidates for use in future vaccination studies against brucellosis.


Anesthesia for massive retrosternal goiter with severe intrathoracic tracheal narrowing: the challenges imposed -A case report-.
Anesthetic management of patients with mediastinal masses remains challenging as acute cardiorespiratory decompensation may follow induction of anesthesia. We describe a 57 year old lady with massive retrosternal goiter and severe intrathoracic tracheal compression who had a total thyroidectomy. Comprehensive contingency plans were an essential prerequisite for successful management of difficult airway, including multidisciplinary involvement of otorhinolaryngologic and cardiothoracic surgeons preparing for rigid bronchoscopy and cardiopulmonary bypass. Awake oral fiberoptic intubation was performed under dexmedetomidine sedation. Severe tracheal narrowing necessitated usage of a 5.0 mm uncuffed flexometallic endotracheal tube. Anesthesia was maintained with sevoflurane and dexmedetomidine infusion with target controlled infusion of remifentanil as analgesia. No muscle relaxant was given. Surgical manipulation led to intermittent total tracheal compression and inadequate ventilation. The tumor was successfully removed via the cervical approach. A close working relationship between anesthesiologists and surgeons was the key to the safe use of anesthesia and uneventful recovery of this patient.


Restoration of antibody responsiveness in early thymectomized Xenopus by implantation of major histocompatibility complex-mismatched larval thymus.
The restorative potential of isogeneic and fully allogeneic thymic implants to restore in vivo antibody responsiveness to a thymus-dependent antigen has been examined in thymectomized clawed toads. Isogeneic clones (Xenopus laevis/gilli and X. laevis/muelleri hybrids) of known major histocompatability complex (MHC) haplotypes were thymectomized at 5-7 days, implanted with MHC-identical or -mismatched (normal or irradiated ) thymuses from 5-week-old larvae and 4 months later injected with dinitrophenylated keyhole limpet hemocyanin. IgM antibody responsiveness (measured by phage inactivation) was restored in terms of its quantity, affinity and specificity in those thymectomized animals given two haplotype-different thymuses. Isoelectric focusing data revealed that low molecular weight antibody production was also restored with isogeneic and allogeneic thymus and that the antibody spectrotypes were of the host type. The finding that in vivo T-B collaboration in thymectomized animals develops normally following thymus implantation, even when the thymus genotype is disparate from the host, is discussed both in the light of previous experiments revealing MHC restriction of Xenopus T helper cells in vitro and in terms of the role of the thymus in promoting adaptive differentiation of this lymphocyte subset.


Clinical study of urine NMP 22 (nuclear matrix protein 22) as a tumor marker in urinary epithelial cancer.
The prognosis of urinary epithelial cancer is still poor, and early detection of this cancer is strongly desirable. The sensitivity of conventional urinary cytology is not satisfactory enough. It is hoped that a specific tumor marker will be established. In recent years, it has been reported that urine NMP 22 is very useful and that urine BFP is also relatively useful. We have now determined urine NMP22 and BFP and studied their clinical usefulness as a tumor marker. Using patients diagnosed with histologically confirmed urinary epithelial cancer as the subjects, we retrospectively studied the usefulness of NMP 22, BFP and cytology mainly with regard to the sensitivity (positivity rate), and also in relation to atypia, degree of infiltration and clinical course.


Effectiveness and cost-effectiveness of implantable cardioverter defibrillators in the treatment of ventricular arrhythmias among medicare beneficiaries.
The implantable cardioverter defibrillator has been assessed in randomized trials, but the generalizability of trial results to broader clinical settings is unclear. Our purpose was to evaluate the outcomes and costs of defibrillator use in an unselected population. We identified 125,892 Medicare patients who were discharged between 1987 and 1995 after hospitalization with a primary diagnosis of ventricular tachycardia or ventricular fibrillation, 7789 of whom (6.2%) received a defibrillator. We used a multivariable propensity score that included patient and hospital characteristics to match pairs of patients, in which one patient received a defibrillator and the other did not. We compared mortality and costs in these 7612 matched pairs during 8 years of follow-up. Patients who received a defibrillator were more likely to be younger, white, male, and urban dwelling, and to have ischemic heart disease, heart failure, or a history of ventricular fibrillation. In the matched-pairs analysis, those who received a defibrillator had significantly lower mortality: 11% versus 19% at 1 year (odds ratio [OR] = 0.57; 95% confidence interval [CI]: 0.51 to 0.63), 20% versus 30% at 2 years (OR = 0.66; 95% CI: 0.60 to 0.72), and 28% versus 39% at 3 years (OR = 0.70; 95% CI: 0.63 to 0.77). These patients also had lower mortality at 8 years (P = 0.0001), although this advantage over patients who received medical treatment only decreased over time. Expenditures among defibrillator recipients were consistently higher, with a cost-effectiveness ratio of $78,400 per life-year gained. The use of implantable defibrillators was associated with significantly lower mortality and higher costs, whereas the cost-effectiveness was higher than many, but not all, generally accepted therapies.


Hemodynamic and Cardiorespiratory Predictors of Sport Rock Climbing Performance.
Fryer, SM, Giles, D, Garrido Palomino, I, de la O Puerta, A, and España-Romero, V. Hemodynamic and cardiorespiratory predictors of sport rock climbing performance. J Strength Cond Res 32(12): 3543-3550, 2018-Rock climbing performance has been suggested to involve a notable contribution from aerobic metabolism. Previously, it has been shown that forearm oxygenation kinetics can be used to distinguish ability groups and predict red-point sport climbing performance. Currently, it is not known if forearm oxygenation kinetics or a sport-specific assessment of cardiorespiratory fitness best predicts sport rock climbing performance. The aim of the study was to determine whether forearm oxidative capacity index, maximal deoxygenation (Δ score) during a treadwall V[Combining Dot Above]O2peak test, treadwall V[Combining Dot Above]O2peak, or running V[Combining Dot Above]O2max best predicts self-reported sport climbing performance. Twenty-one male sport rock climbers completed a treadwall V[Combining Dot Above]O2peak, running V[Combining Dot Above]O2max, and an assessment of near-infrared spectroscopy-derived oxidative capacity index. Linear regression, adjusted for age and experience (years), revealed that forearm oxidative capacity index, treadwall maximal deoxygenation (Δ), and treadwall V[Combining Dot Above]O2peak all significantly predicted self-reported red-point sport climbing ability (Adj R = -0.398, -0.255, and 0.374, respectively), whereas treadmill running V[Combining Dot Above]O2max did not (Adj R = -0.052). Additionally, multiple regression suggested that the combined significant aerobic predictors accounted for 67% of the variance in red-point climbing ability. Findings suggest that training for sport rock climbing performance should look to incorporate modalities that focus on (a) improving local forearm aerobic capacity and (b) improving whole-body aerobic capacity using sport-specific apparatus, such as treadwalls.


Therapeutic strategy of nephrotic syndrome in patients over eighty.
In the present paper, we report four very elderly patients (80 years of age or older) with primary nephrotic syndrome. In all patients, oral prednisolone (PSL) alternative day therapy was attempted and three patients responded very well (complete remission 2, partial remission 1). However, one patient exhibited no effect of PSL and died from acute oliguric renal failure in spite of aggressive measures including hemodialysis. Fracture of the femoral neck occurred in one patient during PSL therapy, although the relationship between the fracture and PSL therapy was uncertain. In addition to our reported cases, 5 cases of nephrotic syndrome in similar patients reported elsewhere are analyzed together with our cohort. PSL was commonly effective in inducing remission in very elderly patients (7 of 9 patients; 78%). Very elderly patients with nephrotic syndrome frequently suffer from oliguric renal failure, which has a potentially high mortality. Based on these data, we conclude that PSL therapy can ameliorate primary nephrotic syndrome in patients over the age of eighty years. However, the complications both of the disease and its treatment, (e.g., acute oliguric renal failure, hip fracture) must be carefully monitored.


Perindopril, a new angiotensin converting enzyme inhibitor--clinical pharmacological studies in healthy subjects.
Perindopril is a new angiotensin converting enzyme (ACE) inhibitor which is activated after hydrolysis in vivo to a diacid (S9780). Oral administration of perindopril (1-16 mg) to groups of 6 healthy males led to a long lasting and dose-elated inhibition of plasma ACE and rises in plasma renin activity with no evidence of accumulation of drug or effect. At higher doses there was a modest fall in blood pressure. S9780 given intravenously in doses of 1,2 or 4 mg caused an immediate inhibition of plasma ACE. The concentration of S9780 in plasma which led to 50% inhibition of plasma ACE was 1.55 +/- 1.14 ng/ml (mean +/- S.D.). Clinical trials with 2-8 mg once daily in essential hypertension are currently in progress.


Cell stimulation versus cell death induced by sequential treatments with pulsed electric fields and cold atmospheric pressure plasma.
Pulsed electric fields (PEFs) and cold atmospheric pressure plasma (CAP) are currently both investigated for medical applications. The exposure of cells to PEFs can induce the formation of pores in cell membranes and consequently facilitate the uptake of molecules. In contrast, CAP mainly acts through reactive species that are generated in the liquid environment. The objective of this study was to determine, if PEFs combined with plasma-treated cell culture medium can mutually reinforce effects on viability of mammalian cells. Experiments were conducted with rat liver epithelial WB-F344 cells and their tumorigenic counterpart WB-ras for a direct comparison of non-tumorigenic and tumorigenic cells from the same origin. Viability after treatments strongly depended on cell type and applied field strength. Notably, tumorigenic WB-ras cells responded more sensitive to the respective treatments than non-tumorigenic WB-F344 cells. More cells were killed when plasma-treated medium was applied first in combination with treatments with 100-μs PEFs. For the reversed treatment order, i.e. application of PEFs first, the combination with 100-ns PEFs resulted in a stimulating effect for non-tumorigenic but not for tumorigenic cells. The results suggest that other mechanisms, besides simple pore formation, contributed to the mutually reinforcing effects of the two methods.


Enhanced renin levels after discontinuation of furosemide: additional effects of loop diuretics on renin release.
The rate of recovery of the renin-angiotensin-aldosterone axis after stopping diuretic administration was examined in 18 male patients with essential hypertension. Upright plasma renin activity (PRA) and plasma aldosterone (PA) were measured during sodium restriction (10 mEq sodium intake), after three days of furosemide administration (40 mg BID po) and for five days following cessation of the diuretic. After diuretic administration, the mean PRA level (8.2 +/- 1.7 ng/ml/hr) was significantly elevated compared to the level on low sodium diet (4.2 +/- 0.5 ng/ml/hr). However, the major finding was that PRA levels continued to increase significantly compared to levels during diuresis on days 1 (11.3 +/- 1.7 ng/ml/hr) and 2 (10.8 +/- 1.5 ng/ml/hr) of the postdiuretic period. Mean PA values paralleled PRA responses in the study. Infusion of normal saline on postdiuretic day 1 failed to suppress PRA to levels seen in subjects not receiving diuretics. The postdiuretic period was accompanied by increased urinary sodium reabsorption and decreased urinary potassium excretion and by significant decreases in creatinine, PAH and free water clearance. The mechanism of this sustained renin response several days after cessation of diuretic therapy may be best explained by a prolonged action of furosemide or by partial ongoing volume depletion with reduced sodium load to the distal nephron. Since all patients demonstrated a marked and consistent PRA response after diuretic withdrawal, this time period represents a potent stimulatory challenge for monitering renin responses.


The effect of cellulose on crystal formation in the kidneys of guinea pigs fed diet rich in calcium and sodium.
Our earlier report showed that diet rich in calcium and sodium fed to guinea pigs can be urolithogenic. In this study, we investigated the effect of adding 3% or 15% cellulose as a source of fiber into similar diet to asses the formation of kidney calculus. From the result, animals fed diet with 3% cellulose showed a relatively high concentration of urinary oxalate, urate and large number of crystals in the kidneys. When the cellulose level was raised to 15%, the concentrations of urinary calcium, urate and the number of crystals formed in the kidneys were lowered. We therefore, conclude that high fiber diet may be beneficial in reducing the incidence of kidney stones of calcium origin.


Soil compaction effects on water status of ponderosa pine assessed through 13C/12C composition.
Soil compaction is a side effect of forest reestablishment practices resulting from use of heavy equipment and site preparation. Soil compaction often alters soil properties resulting in changes in plant-available water. The use of pressure chamber methods to assess plant water stress has two drawbacks: (1) the measurements are not integrative; and (2) the method is difficult to apply extensively to establish seasonal soil water status. We evaluated leaf carbon isotopic composition (delta13C) as a means of assessing effects of soil compaction on water status and growth of young ponderosa pine (Pinus ponderosa var. ponderosa Dougl. ex Laws) stands across a range of soil textures. Leaf delta13C in cellulose and whole foliar tissue were highly correlated. Leaf delta13C in both whole tissue and cellulose (holocellulose) was up to 1.0 per thousand lower in trees growing in non-compacted (NC) loam or clay soils than in compacted (SC) loam or clay soils. Soil compaction had the opposite effect on leaf delta13C in trees growing on sandy loam soil, indicating that compaction increased water availability in this soil type. Tree growth response to compaction also varied with soil texture, with no effect, a negative effect and a positive effect as a result of compaction of loam, clay and sandy loam soils, respectively. There was a significant correlation between 13C signature and tree growth along the range of soil textures. Leaf delta13C trends were correlated with midday stem water potentials. We conclude that leaf delta13C can be used to measure retrospective water status and to assess the impact of site preparation on tree growth. The advantage of the leaf delta13C approach is that it provides an integrative assessment of past water status in different aged leaves.


Gallium scintigraphy demonstration of an appendiceal mucocele: a proposed mechanism of uptake.
An appendiceal mucocele demonstrated intense early avidity for Ga-67, despite the lack of inflammatory cells to account for the uptake. It is proposed that the acid mucopolysaccharide component of the mucus within the lumen and lining cells accounted for the uptake of the gallium ion, in a similar manner to the uptake of its analogue, the ferric ion, as demonstrated by intense staining of mucus by the colloidal iron technique.


MicroRNA-335 acts as a candidate tumor suppressor in prostate cancer.
MicroRNA-335 (miR-335) acts as a tumor suppressor or a tumor promoter in different human malignancies. However, the involvement of miR-335 in prostate cancer (PCa) is still unclear. The purpose of this study was to investigate the functional and clinical significance of miR-335 in PCa. miR-335 expression in 3 PCa cell lines (LNCaP/DU145/PC3) and in 20 clinical PCa tissues were detected by real-time quantitative reverse transcriptase-PCR compared with corresponding controls. The function of miR-335 was investigated for cell proliferation, invasion and migration in PCa cells transfected with agents containing EGFP-miR-335 expression vector. Additionally, miR-335 expression in 104 clinical PCa tissues was detected by in situ hybridization. Its assocaitions with clinicopathological features and prognosis in patients with PCa were also determined. miR-335 was significantly down-regulated in PCa cell lines than in the normal prostate cell line (P < 0.01). With the similar results in vitro, the reduced expression of miR-335 was also found in human PCa tissues comparing with paired adjacent benign prostate tissues (P < 0.05). Moreover, the increased expression of miR-335 suppressed cell proliferation, invasion and migration of PCa cell lines in vitro. Turning to its clinical significance, the low expression of miR-335 was significantly associated with high Gleason Score (P = 0.04), advanced clinical stage (P = 0.04), and positive metastasis (P = 0.02), but not with prognosis in PCa patients. Our data demonstrated for the first time the inhibitory effect of miR-335 on cell proliferation and invasion for PCa cells. The loss of this microRNA might be associated with clinical progression of PCa patients.


Comparison between Seed and Foliar Treatment as a Tool in Integrated Pest Management.
A study into doses of seed treatments and foliar plant protection products containing an identical active substance registered to control the same pest in the same crops was carried out in the European Union. The results show that, for fungicides, the use of seed treatment is often connected with a significantly lower release of active substance per hectare when compared to foliar treatments. In 11 of 13 cases, the difference was 8-fold or higher. For insecticides, in most of the cases, the consumption of an active substance was several times higher for seed treatment, in one case for foliar application.


Arteriogenic gene therapy in patients with unreconstructable critical limb ischemia: a randomized, placebo-controlled clinical trial of adenovirus 5-delivered fibroblast growth factor-4.
The objectives of this study were to assess the safety and potential clinical efficacy of adenovirus-delivered fibroblast growth factor-4 (Ad5FGF-4) by intramuscular injection into patients with critical limb ischemia (CLI). This study was a double-blind, randomized, placebo-controlled study with escalating dose groups of 2.87 x 10(8) to 2.87 x 10(10) viral particles. Thirteen patients with CLI were randomized to receive active drug (n = 10) or placebo (n = 3). Safety evaluations and efficacy parameters (ankle-brachial index, digital subtraction angiograms, magnetic resonance imaging, and scintigraphy) were performed at baseline and for 12 weeks after treatment. Injections of Ad5FGF-4 were generally well tolerated and considered safe. Transfection efficacy at these concentrations may have been limited or local. The small sample size did not allow any firm conclusions regarding clinical efficacy but a trend toward more and slightly larger blood vessels was observed in the angiograms. It is concluded that intramuscular injection of Ad5FGF-4 into CLI patients seemed safe, but transfection efficacy was limited at the assessed doses. Conclusions regarding clinical efficacy are impossible to draw from this small patient cohort.


Purification of Chymotrypsin Inhibitors from Larval Hemolymph of the Silkworm, Bombyx mori.
Chymotrypsin inhibitors were purified from larval hemolymph of Bombyx mori. The purification steps involved ammonium sulfate fractionation (30-70%) and liquid chromatography on Butyl-Toyopearl 650M, Sephadex G-75, concanavalin A-Sepharose, Mono-Q, and Mono-S columns. Fourteen isoforms of chymotrypsin inhibitor were resolved in hybrid crosses: ten isoforms from c60 × n511, eight from k03 × FJl, and nine from i10 × p50. Chromatographic and electrophoretic studies on the inhibitors suggested that they were expressed co-dominantly and could be classified into three molecular-size groups: 8-13 kDa, 40 kDa, and 42kDa. CI-b4, CI-13a, CI-13b, and CI-13c in the first group, CI-3 in the second group, and CI-8 in the third group were present in all of the hybrids. Inhibitors in the third size group had an affinity for concanavalin A-Sepharose. It was found that CI-13 was composed of three different inhibitors.


Diagnosis of Breast Cancer Using Computational Intelligence Models and IoT Applications.
The use of computer-aided diagnostic (CAD) models has been proposed to aid in the detection and classification of breast cancer. In this work, we evaluated the performance of multilayer perceptron neural network and nonlinear support vector machine models to classify breast cancer nodules. From the contour of 569 samples, ten morphological features were used as input to the classifiers. The average results obtained in the set of 50 simulations performed show that the proposed models showed good performance (all exceeded 90.0%) in terms of accuracy in the test set. The nonlinear support vector machine algorithm stands out when compared to the proposed multilayer perceptron neural network algorithm, with 99% accuracy and a 2% false-negative rate. The neural network model presented lower performance than the nonlinear support vector machine classifier. With the application of the proposed models, the average results obtained are promising in the classification of breast cancer.


On the linearization of eruption series of the permanent teeth.
In order to confirm the linearization of permanent eruption, Masuyama's linearization method was applied to the data of Kitamura's study. At first, we considered the eruption age t alpha i of permanent teeth T alpha, where alpha corresponds a tooth of every description, and examined the linear regression of Y alpha i = log10 t alpha i on m(y) alpha (the mean of Y alpha i with respect to i), but the result was not good. For the correlation coefficient r between two variables in linear regression, the percentage of subjects with r > or = 0.970 was only 10.3% in males and 28.8% in females in Kitamura's study. Next we took notice of the eruption age u beta i of each tooth, which is the beta-th in order of eruption. The fitness of the linear regression of Z beta i = log10 u beta i on mz beta (the mean of Z beta i) was very good. The percentage of subjects with r > or = 0.970 increased to 80.0% in males and 86.0% in females. Then we used m(y) (beta) (rearranged m(y) alpha in order of increasing size) instead of mz beta as an independent variable in the linear regression. The degree of the linearization was slightly inferior to that using mz beta. In every linearization, a quasi-fixed point with coordinates (C, C) existed on the linearized dentition plot, where the value of C was almost equal in each way, i.e., C = 10.23 (years) for males and C = 8.91 (years) for females in Kitamura's data. This linearized dentition plot will be useful in detecting certain growth disturbances. The existence of a quasi-fixed point may be useful in forecasting the age of the eruption of subsequent teeth, once the first eruption is observed.


[Renal artery computed tomography angiography for the application of severe bleeding after PCNL].
To evaluate the clinical values of computed tomography angiography (CTA) for severe hemorrhage after percutaneous nephrolithotomy (PCNL). A total of 50 patients with bleeding after PCNL were enrolled. All patients underwent renal artery CTA. There were 34 males and 16 females with an average age of 45.7 years. Left (n = 31) and right (n = 19) sides were affected. The criteria of severe bleeding included a one-off amount of bleeding over 400 ml after PCNL or/and hemoglobin decreased 20 g/L after PCNL. Among them, CTA showed pseudoaneurysm (n = 24), arteriovenous fistula (n = 6), suspicious bleeding spot (n = 4) and no obvious bleeding spot (n = 16). And 24 pseudoaneurysm and 6 arterovenous fistula patients underwent digital subtraction angiography (DSA) immediately. The bleeding spots were successfully intervened and coil embolization treatment was performed. Three of 4 suspicious bleeding cases had rebleeding mini-pseudoaneurysms. The remaining one case of rebleeding was successfully controlled by conservative measures. Renal artery CTA is the first-line screening technique for severe bleeding after PCNL. But for arterial hemorrhage patients, DSA examination may be directly conducted.


Hormesis, Gompertz functions, and risk assessment.
A historical survey of the literature indicates that benefits derived from low doses of toxic substances have been reported over many centuries. Hippocrates, Paracelsus, Arndt, Schulz, and Hahnemann (founder of homeopathy) have all reported that low doses of toxic substances may be "stimulatory" or otherwise beneficial. Assessment of mortality data from modern-day bioassay studies indicates that low-dose animal exposure to a variety of toxic agents can, through an unknown mechanism, also induce beneficial changes which promote health and prolong life (longevity hormesis). This nonspecific and apparently reversible phenomenon has been modeled kinetically through use of age-specific mortality rate and a generalized Gompertz function; the basic assumption is that mortality in an interval is a function of the weighted sum of intensities of physiologic injury during that interval. It was assumed that longevity-enhancing hormetic reduction in population injury may be decremented from life-shortening injury produced through the aging process and concomitant toxicity. At low exposure levels, a net reduction in age-specific mortality rate can sometimes be observed. The implications for risk assessment are significant. It is tacitly assumed in generating virtually all estimates of risk that toxic manifestations observed at higher doses are the sole effects elicited at lower doses. This appears to be qualitatively incorrect.


Surveillance of Oseltamivir-Resistant Influenza A(H1N1)pdm09 in Guanajuato State, Mexico from 2009 to 2012.
The influenza A(H1N1)pdm09 virus was first identified in Mexico in April 2009, subsequently spreading worldwide. Soon after the WHO declared a pandemic, a series of cases involving oseltamivir-resistant viruses were described, following concerns about the spread of strains resistant to neuraminidase inhibitors that could hamper control measures. To study the prevalence of oseltamivir-resistant influenza A(H1N1)pdm09, we implemented a surveillance program across the state of Guanajuato, Mexico. We collected respiratory samples from patients with confirmed infection with influenza A(H1N1)pdm09 virus between 2009 and 2012 in rural and urban regions in Guanajuato, Mexico. Specimens were screened for the H275Y mutation by Sanger sequencing. A total of 1,192 laboratory confirmed influenza A(H1N1)pdm09-positive samples were processed between 2009 and 2012. Using two endpoint real-time polymerase chain reaction, 575 samples were sequenced. Two different clusters, I and II, were identified. The H275Y substitution was found in only one sample from cluster I. The prevalence of oseltamivir-resistant influenza A(H1N1)pdm09 2009 viruses during the pandemic period and following years was very low in our State.


A bacterial amber suppressor in Saccharomyces cerevisiae is selectively recognized by a bacterial aminoacyl-tRNA synthetase.
Little is known about the conservation of determinants for the identities of tRNAs between organisms. We showed previously that Escherichia coli tyrosine tRNA synthetase can charge the Saccharomyces cerevisiae mitochondrial tyrosine tRNA in vivo, even though there are substantial sequence differences between the yeast mitochondrial and bacterial tRNAs. The S. cerevisiae cytoplasmic tyrosine tRNA differs in sequence from both its yeast mitochondrial and E. coli counterparts. To test whether the yeast cytoplasmic tyrosyl-tRNA synthetase recognizes the E. coli tRNA, we expressed various amounts of an E. coli tyrosine tRNA amber suppressor in S. cerevisiae. The bacterial tRNA did not suppress any of three yeast amber alleles, suggesting that the yeast enzymes retain high specificity in vivo for their homologous tRNAs. Moreover, the nucleotides in the sequence of the E. coli suppressor that are not shared with the yeast cytoplasmic tyrosine tRNA do not create determinants which are efficiently recognized by other yeast charging enzymes. Therefore, at least some of the determinants that influence in vivo recognition of the tyrosine tRNA are specific to the cell compartment and organism. In contrast, expression of the cognate bacterial tyrosyl-tRNA synthetase together with the bacterial suppressor tRNA led to suppression of all three amber alleles. The bacterial enzyme recognized its substrate in vivo, even when the amount of bacterial tRNA was less than about 0.05% of that of the total cytoplasmic tRNA.


Long-term Safety of Growth Hormone in Adults With Growth Hormone Deficiency: Overview of 15 809 GH-Treated Patients.
Data on long-term safety of growth hormone (GH) replacement in adults with GH deficiency (GHD) are needed. We aimed to evaluate the safety of GH in the full KIMS (Pfizer International Metabolic Database) cohort. The worldwide, observational KIMS study included adults and adolescents with confirmed GHD. Patients were treated with GH (Genotropin [somatropin]; Pfizer, NY) and followed through routine clinical practice. Adverse events (AEs) and clinical characteristics (eg, lipid profile, glucose) were collected. A cohort of 15 809 GH-treated patients were analyzed (mean follow-up of 5.3 years). AEs were reported in 51.2% of patients (treatment-related in 18.8%). Crude AE rate was higher in patients who were older, had GHD due to pituitary/hypothalamic tumors, or adult-onset GHD. AE rate analysis adjusted for age, gender, etiology, and follow-up time showed no correlation with GH dose. A total of 606 deaths (3.8%) were reported (146 by neoplasms, 71 by cardiac/vascular disorders, 48 by cerebrovascular disorders). Overall, de novo cancer incidence was comparable to that in the general population (standard incidence ratio 0.92; 95% CI, 0.83-1.01). De novo cancer risk was significantly lower in patients with idiopathic/congenital GHD (0.64; 0.43-0.91), but similar in those with pituitary/hypothalamic tumors or other etiologies versus the general population. Neither adult-onset nor childhood-onset GHD was associated with increased de novo cancer risks. Neutral effects were observed in lipids/fasting blood glucose levels. These final KIMS cohort data support the safety of long-term GH replacement in adults with GHD as prescribed in routine clinical practice.


Abnormal PTPN11 enhancer methylation promotes rheumatoid arthritis fibroblast-like synoviocyte aggressiveness and joint inflammation.
The PTPN11 gene, encoding the tyrosine phosphatase SHP-2, is overexpressed in rheumatoid arthritis (RA) fibroblast-like synoviocytes (FLS) compared with osteoarthritis (OA) FLS and promotes RA FLS invasiveness. Here, we explored the molecular basis for PTPN11 overexpression in RA FLS and the role of SHP-2 in RA pathogenesis. Using computational methods, we identified a putative enhancer in PTPN11 intron 1, which contained a glucocorticoid receptor- binding (GR-binding) motif. This region displayed enhancer function in RA FLS and contained 2 hypermethylation sites in RA compared with OA FLS. RA FLS stimulation with the glucocorticoid dexamethasone induced GR binding to the enhancer and PTPN11 expression. Glucocorticoid responsiveness of PTPN11 was significantly higher in RA FLS than OA FLS and required the differentially methylated CpGs for full enhancer function. SHP-2 expression was enriched in the RA synovial lining, and heterozygous Ptpn11 deletion in radioresistant or innate immune cells attenuated K/BxN serum transfer arthritis in mice. Treatment with SHP-2 inhibitor 11a-1 reduced RA FLS migration and responsiveness to TNF and IL-1β stimulation and reduced arthritis severity in mice. Our findings demonstrate how abnormal epigenetic regulation of a pathogenic gene determines FLS behavior and demonstrate that targeting SHP-2 or the SHP-2 pathway could be a therapeutic strategy for RA.


Obesity and Its Relation to Excessive Daytime Sleepiness in Civilian Pilots.
INTRODUCTION: Excessive daytime sleepiness (EDS) is often associated with decreased work performance and fatigue in civil pilots. However, aeromedical recommendations for the evaluation of EDS are associated with suspicion of obstructive sleep apnea (OSA). Currently, many studies have found an association between obesity and EDS, regardless of OSA. This study aims to determine whether there is a relationship between obesity and EDS in Indonesian civilian pilots, as well as its risks for developing OSA.METHODS: This study used a cross-sectional design and was carried out at the Directorate General Civil Aviation Medical. Subjects were asked to fill out questionnaires, including the Epworth Sleepiness Scale to measure EDS and STOP-Bang to assess OSA risk, followed by anthropometric measurements for body mass index (BMI) and waist circumference as obesity indicators.RESULTS: A total of 156 subjects were obtained, with an EDS prevalence of 16.7%. There was no significant relationship between obesity and EDS, but the prevalence of EDS was higher in obese subjects based on waist circumference than based on BMI (17.8% vs. 15.6%). Most obese pilots with EDS had a low risk of OSA (83.3% and 80%).CONCLUSION: The prevalence of EDS was found to be higher in pilots with central obesity compared to BMI-categorized obesity. The incidence of EDS was not correlated with the risk of OSA.Brahmanti RS, Sampurna B, Ibrahim N, Adi NP, Siagian M, Werdhani RA. Obesity and its relation to excessive daytime sleepiness in civilian pilots. Aerosp Med Hum Perform. 2023; 94(11):815-820.


Beta-catenin interacts with the FUS proto-oncogene product and regulates pre-mRNA splicing.
beta-Catenin is a downstream effector of the Wnt signaling pathway and is believed to exert its oncogenic function by activating T-cell factor (TCF)/lymphoid enhancer factor (LEF) family transcriptional factors. However, it is still uncertain whether the diverse effects of beta-catenin are caused solely by aberrant gene transactivation. In this study, we used a proteomics approach to obtain further insight into the functional properties of nuclear beta-catenin. The protein assembly of a native beta-catenin-containing complex in nuclear extracts from a colorectal cancer cell line, DLD-1, was identified using immunoprecipitation and mass spectrometry. beta-Catenin physically interacted with fusion (FUS)/translocated in liposarcoma (TLS) and various RNA-binding proteins. The expression of FUS/TLS was closely associated with the accumulation of beta-catenin and with the undifferentiated status of intestinal epithelial cells. The transient transfection of FUS suppressed beta-catenin-evoked gene transactivation of TCF/LEF, and beta-catenin transfection affected the splicing pattern of the E1A minigene and induced a novel splicing variant of estrogen receptor (ER)-beta exerting a dominant-negative activity. Human cancer expresses a large variety of alternatively spliced messenger RNA (mRNA), but the precise molecular mechanisms responsible for cancer-related alternative splicing are largely unknown. In this study, we demonstrated the interaction of beta-catenin with FUS/TLS and other RNA-binding proteins involved in the regulation of pre-mRNA splicing. Certain mRNA splicing abbreviations seen in human cancers may be induced by the activation of the Wnt signaling pathway.


Ultra-short bowel syndrome during infancy: improving outcomes and novel therapies.
Ultra-short bowel syndrome is relatively rare and has not yet been extensively reported. In ultra-short bowel syndrome, poor absorption of nutrients and dysmotility, interfere with fluid, energy, electrolyte and micronutrient balance. Patients with this disorder are managed through prolonged parenteral nutrition with the ultimate goal of achieving enteral autonomy. Overall outcomes of these patients are dependent on postsurgical bowel anatomy (residual length, intact colon, ostomy closure timing), incidence of sepsis, and care by a multidisciplinary specialized team. Over the years, standardization of management has improved outcomes. This includes central line care, lipid alternatives, enteral therapy, medications (antidiarrheal agents, acid suppression medications, bile acid binding salts, and enteral antibiotics) including Teduglutide. Bowel lengthening procedures have also proven beneficial, and finally bowel transplant does remain an option for a patient in whom rehabilitation has failed. Although there are many factors that influence outcomes of ultra-short bowel patients, novel therapies such as Teduglutide have been introduced with the aim of improving intestinal adaptation. Surgical lengthening and transplant are viable options in the setting of failed rehabilitation.


Levels of erythrocyte malonyldialdehyde, vitamin E, reduced glutathione, G6PD activity & plasma urate in patients of pregnancy induced hypertension.
To assess the oxidative stress across the cell membrane in patients suffering from pregnancy induced hypertension, erythrocyte malonyldialdehyde, vitamin E, reduced glutathione, glucose-6-phosphate dehydrogenase activity and plasma urate levels were estimated in 25 non pregnant women, 40 normotensive pregnant women and 40 women with pregnancy induced hypertension (PIH). As compared to non pregnant women, there was a significant increase in the levels of erythrocyte malonyldialdehyde and plasma urate in normotensive pregnant women, which were further increased in women with PIH. Erythrocyte glutathione levels were raised in normotensive pregnant women as compared to non pregnant women. Its levels were decreased in patients of PIH as compared to normotensive pregnant women. Cellular bio-availability of vitamin E was depressed in both normotensive pregnancy as well as patients with pregnancy induced hypertension as compared to non pregnant women.


Overcoming professionals' challenging experiences to promote a trustful therapeutic alliance in addiction treatment: A qualitative study.
A good therapeutic alliance plays a major role in the healing process. Professionals working in addiction treatment report high levels of psychological distress related to work and this may challenge the establishment of a trustful therapeutic alliance, and lead to a loss of care quality provided to service users. The purpose of this study was to investigate the experience of specialized professionals, its effects on trust and the therapeutic alliance, and the means to restore them. We conducted a qualitative study using a semi-structured questionnaire and a narrative tool. Discourse was extracted from focus groups and individual interviews and analyzed following the Interpretative Phenomenological Analysis method. Twenty-six professionals from three addiction treatment centers in the Paris area were interviewed. The difficulties weighing on the care alliance were described by the participants in terms of their nature, their effects and means to overcome them. Emotional drain leads to a climate of relational distrust and the temptation to desert or over-control patients. Teambuilding, specific training and self-care are viewed as means to restore a therapeutic alliance based on an appropriate type of trust. Distrust deriving from professionals' challenging experiences may lead to worrying consequences. Promoting democratic organization of care structures, specific training, and also responsible self-care on the part of professionals could help to restore a type of trust that helps to establish a therapeutic alliance suited to service user individualities. This could ultimately be beneficial for user care, professional wellbeing and team functioning.


The relationship between childhood abuse and violent victimization in homeless and marginally housed women: The role of dissociation as a potential mediator.
Previous studies have established a link between childhood abuse and dissociation. Other work has shown childhood abuse increases the likelihood of violent victimization in adulthood. Although it has been posited that dissociation may mediate childhood abuse and adult violent victimization, research investigating this hypothesis is sparse, particularly for extremely vulnerable populations such as homeless and unstably housed individuals. investigated the relationship between childhood abuse and dissociation on violent victimization in a cohort of homeless and unstably housed women. We also assessed whether dissociation mediated childhood abuse and violent victimization in this sample. Participants were asked at an initial assessment and a 6-month follow-up to report any physical or sexual violence experienced in the previous 6 months. Questionnaires recording history of specific types of childhood abuse, dissociation, and other factors were also recorded at the initial assessment. Hierarchical logistic regression models revealed that childhood sexual abuse (Odds ratio [OR] = 3.10, p < .01) and severe dissociation (OR = 1.99, p < .01) were significantly associated with recent physical violence, and childhood sexual abuse (OR = 3.88, p < .01) and dissociation (OR = 1.87, p < .05) were also associated with recent sexual violence. Dissociation mediated neither childhood abuse on recent physical violence or recent sexual violence. Developing approaches that effectively identify and treat dissociation as a part of an overall framework of trauma-informed care in homeless and unstably housed women may be an effective way to decrease future physical violence in this vulnerable population. (PsycINFO Database Record


Addition of leukocytapheresis to steroid therapy: is it beneficial in recurrence of moderate-to-severe ulcerative colitis?
In Japan, leukocytapheresis has become an accepted therapy for ulcerative colitis. The purpose of this retrospective study was to determine the efficacy of additional leukocytapheresis in patients with moderate-to-severe recurrence of ulcerative colitis. From 1998 to 2002, 35 patients with moderate-to-severe recurrence of ulcerative colitis were treated by intravenous prednisolone only or prednisolone plus leukocytapheresis once per week. Previous clinical features of ulcerative colitis, activity index at four weeks, and subsequent course were compared between patients with leukocytapheresis and those without. Sixteen patients were treated with prednisolone only (prednisolone group), and 19 patients were treated with prednisolone plus leukocytapheresis (leukocytapheresis group). Previous prednisolone dose (13.6 +/- 10.4 g vs. 7.9 +/- 9.8 g; P < 0.05) was higher in the leukocytapheresis group than the prednisolone group. Clinical response rate at four weeks was not different between the two groups (leukocytapheresis group, 68.4 percent vs. prednisolone group, 75 percent). However, ulcerative colitis activity index at four weeks was significantly higher in the leukocytapheresis group than the prednisolone group (180.5 +/- 44.2 vs. 142.5 +/- 45.3; P < 0.05). During the subsequent clinical course, 15 of 35 patients required proctocolectomy (leukocytapheresis group, 11 patients vs. prednisolone group, 4 patients). Proctocolectomy rate was significantly different when patients were divided by previous prednisolone dose (P = 0.0029) and ulcerative colitis activity index at four weeks (P = 0.002), but it was not different according to the application of leukocytapheresis. Cox proportional hazards model revealed previous prednisolone dose to be the only independent risk factor for proctocolectomy. Addition of leukocytapheresis to prednisolone therapy does not seem beneficial in ulcerative colitis patients with moderate-to-severe recurrence.