Hexagonal Boron Nitride-Graphene Heterostructures: Synthesis and Interfacial Properties.
Research on in-plane and vertically-stacked heterostructures of graphene and hexagonal boron nitride (h-BN) have attracted intense attentions for energy band engineering and device performance optimization of graphene. In this review article, recent advances in the controlled syntheses, interfacial structures, and electronic properties, as well as novel device constructions of h-BN and graphene heterostructures are highlighted. Firstly, diverse synthesis approaches for in-plane h-BN and graphene (h-BN-G) heterostructures are reviewed, and their applications in nanoelectronics are briefly introduced. Moreover, the interfacial structures and electronic properties of h-BN-G heterojunctions are discussed, and a zigzag type interface is found to preferentially evolve at the linking edge of the two structural analogues. Secondly, several synthetic routes for the vertically-stacked graphene/h-BN (G/h-BN) heterostructures are also reviewed. The role of h-BN as perfect dielectric layers in promoting the device performance of graphene is presented. Finally, future research directions in the synthesis and application of such heterostructures are discussed.


Structural and serological characterisation of the O-antigenic polysaccharide of the lipopolysaccharide from Acinetobacter junii strain 65.
A polysaccharide containing rhamnose (Rha) and Gal was isolated by acetic acid hydrolysis, followed by gel-permeation chromatography, from the water-soluble lipopolysaccharide (phenol/water extracted) from Acinetobacter junii strain 65. The polysaccharide was characterised by means of monosaccharide analyses, Smith degradation, and NMR studies, and was shown to have a linear pentasaccharide repeating unit, as depicted below. This structure was specifically recognised in western blots and enzyme immunoassays by polyclonal rabbit antisera. [structure in text]


Megakaryocyte DNA content and platelet formation in rats after a sublethal dose of thio-TEPA.
The megakaryocytopoiesis in rats was studied following a single dose of thio-TEPA to determine the mechanisms for the thrombocytopenia and subsequent recovery. The blood platelet number, platelet production (measured by 35S incorporation into platelets), mean platelet volume, and the number and DNA content of bone marrow megakaryocytes (MK) were observed. The blood platelet counts, platelet production, and total MK number decreased to low values following the administration of thio-TEPA, and stayed low until regeneration started around day 10. The mean platelet volume increased from the normal 6.6 fl to 7.8 fl during the early regeneration days 8-14. The MK were divided into four ploidy classes: 2N-4N, 8N, 16N, and 32N-64N. The number of MK within all ploidy classes decreased to nearly zero within four days after the injection of thio-TEPA. The regeneration started around day 10 with increasing numbers of 2N-4N and 8N MK, while the number of 16N and 32N-64N MK increased more than four days later. It is concluded that decreased or blocked influx of progenitor cells into the MK compartment is the main reason for thrombocytopenia after exposure to thio-TEPA.


An effective method and pathways of acrylonitrile degradation to acrylic acid through an alkaline hydrothermal system.
Degradation of pollution for specific chemicals represents an optimal approach to high-strength wastewater treatment. One-pot selective conversion of acrylonitrile to acrylic acid in a hydrothermal system with NaOH as a catalyst was carried out. The influence factors were evaluated, including initial acrylonitrile concentration, reaction temperature, reaction time and amount of alkali. Experimental results showed that the highest yield of acrylic acid (55%) was obtained at the initial acrylonitrile concentration of 3 × 103 mg/L, 300°C for 90 s with 1.0 M NaOH. To determine the reaction path, intermediates analysis and calculation of carbon and nitrogen balance were carried out by means of HPLC, GC and TOC/TN methods. Two probable reaction pathways were proposed as follows: (1) Acrylonitrile was hydrolyzed into acrylamide, and acrylic acid was obtained via further hydrolysis. (2) Acrylonitrile was converted into 3-hydroxy-propionitrile via additive reaction, and this product was readily converted to 3-hydroxy-propionic acid through two steps of hydrolysis, followed by dehydration reaction to produce acrylic acid. This study offered not only an efficient method to transfer highly toxic pollutants into valuable chemical, but also a better understanding of hydrothermal alkali catalytic reaction.


[Ophthalmic complications and local anesthesia. Pathophysiology and types of eye complications after intraoral dental anesthesia, and clinical recommendations].
The present article reviews the different types of ophthalmologic complications following administration of intraoral local anesthesia. Since the first report by Brain in 1936, case reports about that topic have been published regularly in the literature. However, clinical studies evaluating the incidence of ophthalmologic complications after intraoral local anesthesia are rarely available. Previous data point to a frequency ranging from 0.03% to 0.13%. The most frequently described ophthalmologic complications include diplopia (double vision), ptosis (drooping of upper eyelid), and mydriasis (dilatation of pupil). Disorders that rather affect periorbital structures than the eye directly include facial paralysis and periorbital blanching (angiospasm). Diverse pathophysiologic mechanisms and causes have been reported in the literature, with the inadvertent intravascular administration of the local anesthetic considered the primary reason. The agent as well as the vasopressor is transported retrogradely via arteries or veins to the orbit or to periorbital structures (such as the cavernous sinus) with subsequent anesthesia of nerves and paralysis of muscles distant from the oral cavity. In general the ophthalmologic complications begin shortly after administration of the local anesthesia, and disappear once the local anesthesia has subsided.


Integrated biorefinery concept for grass silage using a combination of adapted pulping methods for advanced saccharification and extraction of lignin.
An integrated refining and pulping process for ensiled biomass from permanent grassland was established on laboratory scale. The liquid phase, containing the majority of water-soluble components, including 24% of the initial dry matter (DM), was first separated by mechanical pressing. The fiber fraction was subjected to high solid load saccharification (25% DM) to enhance the lignin content in the feed for subsequent organosolvation. The saccharification enzymes were pre-selected applying experimental design approaches. Cellulose convertibility was improved by a secondary pressing step during liquefaction. Combined saccharification and organosolvation showed high degree of saccharide solubilization with recovery of 98% of the glucan and 73% of the xylan from the fiber fraction in the hydrolysates, and enabled the recovery of 41% of the grass silage lignin. The effects of the treatment were confirmed by XRD and SEM tracking of cellulose crystallinity and fiber morphology throughout the pulping procedure.


Association between Trichomonas vaginalis infection and cervical lesions: a population-based, nested case-control study in Taiwan.
Trichomonas vaginalis is the most common nonviral sexually transmitted infection. According to the 2019 WHO cancer report, cervical cancer is the fourth most frequent cancer in women. However, previous research, which has not included a large-scale study to date, has revealed that Trichomonas vaginalis increases cervical cancer risk. In this study, we investigated a group of Asian females in Taiwan to determine the association between trichomoniasis and the risk of developing cervical lesions, including cancer, neoplasm, and dysplasia. We conducted a nested case-control study by using the National Health Insurance (NHI) program database in Taiwan. The International Classification of Diseases, 9th Revision classifications (ICD-9-CM) was used to categorize all of the medical conditions for each patient in the case and control groups. The adjusted odds ratio (AOR) and 95% confidence interval (CI) for the association between trichomoniasis and cervical lesions were estimated using multivariable conditional logistic regression to adjust for all comorbidities and variables. In total, 54,003 individuals were enrolled in the case group and 216,012 were enrolled in the control group. Trichomonas vaginalis exposure had a significant association with cervical lesions (AOR 2.656, 95% CI = 1.411-5.353, p = 0.003), especially cervical cancer (AOR 3.684, 95% CI = 1.622-6.094, p = 0.001). In patients with both trichomoniasis and depression, the relative risk increased 7.480-fold compared to those without trichomoniasis or depression. In conclusion, female patients with Trichomonas vaginalis exposure had a significantly higher risk of developing cervical lesions (especially cervical cancer) than those without exposure.


Selection of recipients for donor organs in transplant medicine.
This paper deals with a problem which has received a great deal of attention in the ethical literature, but about which very little is known empirically: the selection of recipients for organs in transplant medicine. Based on a larger study, it is shown how this problem is practically resolved in one European country, Germany. It is demonstrated that most of the criteria used to determine recipients are non-medical in nature, even though they generally tend to be rationalized in medical terms. Moreover, the choice of criteria depends as much on prognostic considerations as on personal indiosyncrasies and values held by individual physicians who are in charge at the various programs. Several examples of the extremely diverse policies in which this results are presented.


Differences in penicillin-binding proteins of Streptococcus pyogenes and two derived, stabilized L forms.
The penicillin-binding proteins (PBPs) of Streptococcus pyogenes and two of its derived, stabilized (i.e., nonreverting) L forms, an osmotically fragile L form and a physiologic isotonic L form, were compared. The numbers of PBPs in the membranes of these organisms were 6, 4, and 2 for the coccus and the osmotically fragile and physiologic isotonic L forms, respectively. Likewise, the relative amounts of total PBPs were 1.00: 1.48:0.32 for this coccus and the osmotically fragile and physiologic isotonic L forms, respectively. The two largest PBPs (PBPs 1 and 2) of the coccus were absent in both L forms, while the smallest PBPs (PBPs 5 and 6) were found in all three membranes. Deacylation (half-life) of three of the four PBPs in the osmotically fragile L form membrane required a significantly longer time than did deacylation of these presumed identical enzymes in the parental coccal membrane. Conversely, there was no such difference between the only two PBPs of the physiologic isotonic L form and the same coccal membrane proteins. Intact cells of all three organisms secreted PBPs and what appeared to be penicilloic acid and a minimal amount of free penicillin. A greater amount of these PBPs was secreted by both L forms than by the coccus. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis patterns and ratios of secreted PBPs were identical to those from labeled membrane preparations. These differences are correlated with some of our previous findings and are discussed in terms of inhibition of cell wall synthesis and resulting membrane changes in these two derived, stabilized coccal L forms.


Biological imaging using light-addressable potentiometric sensors and scanning photo-induced impedance microscopy.
Light-addressable potentiometric sensors (LAPS) and scanning photo-induced impedance microscopy (SPIM) use photocurrent measurements at electrolyte-insulator-semiconductor substrates for spatio-temporal imaging of electrical potentials and impedance. The techniques have been used for the interrogation of sensor arrays and the imaging of biological systems. Sensor applications range from the detection of different types of ions and the label-free detection of charged molecules such as DNA and proteins to enzyme-based biosensors. Imaging applications include the temporal imaging of extracellular potentials and dynamic concentration changes in microfluidic channels and the lateral imaging of cell surface charges and cell metabolism. This paper will investigate the current state of the art of the measurement technology with a focus on spatial and temporal resolution and review the biological applications, these techniques have been used for. An outlook on future developments in the field will be given.


Enhanced antimicrobial efficacy of thermal-reduced silver nanoparticles supported by titanium dioxide.
The antimicrobial efficacy of silver nanoparticles (AgNPs) is influenced by many factors, including the particle size, AgNP oxidation state and support materials. In this study, AgNPs are synthesized and supported by two types of TiO2 powders (P25 and Merck TiO2) using two heat-treatment temperatures (120 and 200°C). The formation of well-dispersed AgNPs with diameters ranging from 3.2 to 5.7nm was confirmed using transmission electron microscopy. X-ray photoelectron spectroscopy and X-ray diffraction indicated that the majority of the AgNPs were reduced from Ag+ to Ag0 at 200°C. The AgNP antimicrobial activity was determined by the zone of inhibition against three fungi, A. niger, P. spinulosum and S. chartarum, and two bacteria, E. coli (Gram-negative) and S. epidermidis (Gram-positive). The antimicrobial activity of metallic AgNPs was more pronounced than that of silver nitrate and some antimicrobial drugs. The AgNPs exhibited optimal antimicrobial efficacy when the AgNP dispersion on the surface of TiO2 was in the region between 0.2 and 0.7μg-Ag/m2. The minimum (critical) AgNP concentrations needed to inhibit the growth of bacteria (E. coli) and fungi (A. niger) were 13.48 and 25.4μg/mL, respectively. The results indicate that AgNPs/TiO2 nanocomposites are a promising disinfectant against both bacteria and fungi.


Inflammatory neuropathies.
Although not quite as well protected as in the CNS, nerve fibres in peripheral nerves are relatively protected from systemic immune responses and inflammatory reactions by the specialized endoneurial endothelial and perineurial barriers. Expression of MHC class II molecules is restricted to a few macrophage-like cells. Compared with peripheral nerve trunks, there are more of these cells and more permeable blood vessels in the dorsal root ganglia and spinal roots. These are sites of predilection for the inflammatory response in experimental allergic neuritis. This experimental disease can be induced by immunization with either of two myelin proteins, P0 and P2, and a similar but less inflammatory, more chronic demyelinating neuropathy can be induced in rabbits with the glycolipid galactocerebroside. In myelin protein induced EAN CD4+ T helper cell responses are sufficient to transfer full-blown disease but antibodies, of undefined specificity, may also play a part. In rabbit galactocerebroside neuritis, antibodies are probably more important and are directed predominantly against a haptenic group including galactose. Experimental allergic neuritis provides an accurate histological model of GBS and CIDP. A small proportion of patients with GBS and CIDP show T-cell responses to P0 and/or P2 which may mark important pathogenetic reactions. Also some patients with GBS and CIDP have antibodies to gangliosides, including for instance the most abundant peripheral nerve ganglioside LM1, which may also be important. In particular, patients with acute severe GBS and marked axonal degeneration often have IgG antibodies to GM1 and GD1b, while patients with Miller Fisher syndrome are characterized by antibodies to GQ1b. IgM antibodies to ganglioside GM1 are often found in multifocal motor neuropathy with conduction block, but are not a sensitive or specific test for that condition. Antibodies to sulphatide have recently been found in some patients with distal predominantly sensory axonal neuropathy. High titres of antibody to MAG which also react with SGPG are specific for IgM paraproteinaemic demyelinating neuropathy. Antibodies to an approximately 37kDa protein present in neuronal nuclei (Hu) are specific for paraneoplastic sensory neuronopathy usually associated with SCLC. Autoimmune responses to neural antigens have become useful diagnostically in some diseases and probably indicate important pathogenetic mechanisms. In inflammatory demyelinating neuropathy, macrophage-mediated demyelination is probably targetted by both antibody and T-cell mediated autoimmune responses. The nature of the autoantigen and the relative importance of T- versus B-cell responses are likely to vary depending on the nature of any initiating immunization and the host immunogenetic background.(ABSTRACT TRUNCATED AT 400 WORDS)


Is tumour size an underestimated feature in the current TNM system for malignancies of the pancreatic head?
As the long-term survival of pancreatic head malignancies remains dismal, efforts have been made for a better patient selection and a tailored treatment. Tumour size could also be used for patient stratification. One hundred and fourteen patients underwent a pancreaticoduodenectomy for pancreatic adenocarcinoma, peri-ampullary and biliary cancer stratified according to: ≤20 mm, 21-34 mm, 35-45 mm and >45 mm tumour size. Patients with tumour sizes of ≤20 mm had a N1 rate of 41% and a R1/2 rate of 7%. The median survival was 3.4 years. N1 and R1/2 rates increased to 84% and 31% for tumour sizes of 21-34 mm (P = 0.0002 for N, P = 0.02 for R). The median survival decreased to 1.6 years (P = 0.0003). A further increase in tumour size of 35-45 mm revealed a further increase of N1 and R1/2 rates of 93% (P < 0.0001) and 33%, respectively. The median survival was 1.2 years (P = 0.004). Tumour sizes >45 mm were related to a further decreased median survival of 1.1 years (P = 0.2), whereas N1 and R1/2 rates were 87% and 20%, respectively. Tumour size is an important feature of pancreatic head malignancies. A tumour diameter of 20 mm seems to be the cut-off above which an increased rate of incomplete resections and metastatic lymph nodes must be encountered and the median survival is reduced.


[Prevention of hepatic metastases in rabbits by administration of an oily anticancer agent into the portal vein].
We studied one kind of prophylactic chemotherapy against hepatic metastases. The therapy was carried out with a lymphographic oily contrast medium. Lipiodol, and a high-molecular-weight anticancer agent known as SMANCS. SMANCS was dissolved in Lipiodol by sonication (SMANCS/Lipiodol, 1 mg of SMANCS in 1 ml of Lipiodol). SMANCS/Lipiodol, administered into the portal vein, remained for a long time in the portal vein and was eliminated gradually through the bile and urine. SMANCS/Lipiodol (0.4ml/kg) was injected into the mesenteric vein in rabbits, which were then inoculated with the highly malignant carcinoma VX-2. Rabbits injected with SMANCS/Lipiodol before inoculation had significantly fewer hepatic metastases than the control 12 days later (P less than 0.001). Survival was significantly longer (P less than 0.005; 36.0 +/- 7.7 days) with SMANCS/Lipiodol before inoculation than without treatment (23.5 +/- 3.0 days). Hepatic metastases might thus be prevented by portal administration of an appropriate oily anticancer agent.


Laparoscopic treatment for suspected gallbladder cancer confined to the wall: a 10-year study from a single institution.
Although laparoscopic treatment of gallbladder cancer (GBC) has been explored in the last decade, long-term results are still rare. This study evaluates long-term results of intended laparoscopic treatment for suspected GBC confined to the gallbladder wall, based on our experience over 10 years. Between August 2006 and December 2015, 164 patients with suspected GBC confined to the wall were enrolled in the protocol for laparoscopic surgery. The process for GBC treatment was analyzed to evaluate the feasibility of computed tomography (CT) and/or magnetic resonance imaging (MRI) combined with frozen-section examination in identifying GBC confined to the wall. Of 159 patients who underwent the intended laparoscopic radical treatment, 47 with pathologically proven GBC were investigated to determine the safety and oncologic outcomes of a laparoscopic approach to GBC. Among the 164 patients, 5 patients avoided further radical surgery because of unresectable disease and 12 were converted to open surgery; in the remaining 147 patients, totally laparoscopic treatment was successfully accomplished. Extended cholecystectomy was performed in 37 patients and simple cholecystectomy in 10. The T stages based on final pathology were Tis (n=6), T1a (n=2), T1b (n=9), T2 (n=26), and T3 (n=4). Recurrence was detected in 11 patients over a median follow-up of 51 months. The disease-specific 5-year survival rate of these 47 patients was 68.8%, and rose to 85% for patients with a normal cancer antigen 19-9 (CA19-9) level. The favorable long-term outcomes demonstrate the feasibility of combined CT/MRI and frozen-section examination in the selection of patients with GBC confined to the gallbladder wall, confirm the oncologic safety of laparoscopic treatment in selected GBC patients, and favor measurement of preoperative CA19-9 in the selection of GBCs suitable for laparoscopic treatment.


Clinical experience with misonidazole.
A total of 62 patients with advanced tumours have now been treated by a fractionated course of radiotherapy, with misonidazole. The prime purpose of the administration of the drug to these patients was to determine safe dosage and suitable regimes for use in clinical radiotherapy. The reaction of normal tissues did not seem enhanced but there was an impression of increased tumour response.


Conscious thought as simulation of behaviour and perception.
A 'simulation' theory of cognitive function can be based on three assumptions about brain function. First, behaviour can be simulated by activating motor structures, as during an overt action but suppressing its execution. Second, perception can be simulated by internal activation of sensory cortex, as during normal perception of external stimuli. Third, both overt and covert actions can elicit perceptual simulation of their normal consequences. A large body of evidence supports these assumptions. It is argued that the simulation approach can explain the relations between motor, sensory and cognitive functions and the appearance of an inner world.


Spin polarization of CrO2 at and across an artificial barrier.
We report a systematic study of the spin polarization of epitaxial CrO2 films at and across an interface using planar junctions with a superconducting counterelectrode. By chemical modification of the CrO2 surface before the deposition of the superconductor, junctions with a wide range of barrier strength were obtained. Analysis of the conductance data on these junctions, especially under Zeeman splitting of the superconducting density of states, yields consistent, close to full spin polarization for CrO2 regardless of the barrier strength.


Treatment of intracapsular hip fractures by the Deyerle method. A comparative review of one hundred and nineteen cases.
In a retrospective review of 119 intracapsular hip fractures treated by the Deyerle method (seventy-nine patients treated at San Francisco General Hospital and forty at Brookside Community Hospital), fifty-nine patients were available for follow-up after two or more years or were rated as failures before that time. In the San Francisco General series the incidence of avascular necrosis was 43 per cent and of non-union, 23 per cent, while in the Brookside series the incidences were 12.5 per cent and 12.5 per cent, respectively. The functional end results in the San Francisco General series were rated excellent or satisfactory in 40 per cent and failures in 60 per cent, and in the Brookside series there were 75 per cent excellent or satisfactory results and 25 per cent failures.


Molecular cloning and characterization of the full-length Hsp90 gene from Matricaria recutita.
Heat shock protein 90 (Hsp90) is one of the most abundant and conserved chaperone proteins and plays important roles in plant growth and responses to environmental stimuli. However, little is known regarding the sequence and function of Hsp90s in Matricaria recutita. In the present study, we cloned the full-length cDNA sequence of the hsp90 gene from this species. Using rapid amplification of cDNA ends technologies with 2 degenerate primers that were designed based on the hsp90 gene sequence from other members of Asteraceae, we isolated and characterized an Hsp90 homolog gene from M. recutita (Mr-Hsp90). The full-length Mr-hsp90 cDNA sequence, containing 2097 base pairs, encodes a protein of 698 amino acids. Based on amino acid sequence identity, Mr-Hsp90 showed high similarity to other cloned Hsp90 proteins. The Mr-Hsp90 protein was closely clustered with the Lactuca sativa in a phylogenetic tree. These results indicate that the cloned sequence of Mr-Hsp90 is a member of the Hsp90 family, which is reported for the first time in M. recutita. Next, we conducted a salt stress experiment to determine the protein's function under salt stress conditions. Survival of chamomile seedlings subjected to heat-shock pretreatment was significantly increased compared with groups that had not undergone heat-shock pretreatment in a salt stress environment. This indicates that Mr-Hsp90 plays an important role in the salt resistance of chamomile seedlings.


Peridomestic structure, farming activity and triatomine infestation.
The role of peridomestic structure and farming activity on triatomine infestation was studied on two vector species of Chagas disease (Triatoma pseudomaculata and T. brasiliensis) in Bahia State, northeastern Brazil. A randomly selected population issued from 136 farms was divided into four categories according to the householder activity. At regional scale, the dwellings of farmers working on degraded land of irrigated farms are less exposed to T. pseudomaculata infestation. At premises scale, the farmers and casual workers, who have smaller peridomiciles and less cattle, are also less exposed to T. pseudomaculata. The association of T. brosiliensis with the most mobile populations (casual workers and young breeders) suggests a passive transport of this competitive species. Finally, the retired farmers that own large premises and cattle, but have more sedentary behavior, are the most exposed to T. pseudomaculata infestation.


[Effect of trapidil and papaverine on thrombocyte aggregation and phosphodiesterase activity].
Trapidil effect on platelet aggregation in vitro and in vivo as well as on phosphodiesterase (PDE) activity was studied. Both ADP- and collagen-induced aggregation of human and rabbit platelets was inhibited by trapidil at concentrations of 60 mumol/l. The PDE activity of human platelet lysates was blocked at concentrations that were necessary to inhibit aggregation. Papaverine exerted 5 times higher inhibitory effects on aggregation and PDE activity as compared to trapidil. Infusion of trapidil to rabbits caused aggregation inhibition in vivo. Papaverine at equimolar doses was more effective than trapidil. At therapeutic doses trapidil is unlikely to produce adequate plasma levels for inhibition of platelet aggregation.


Cumulative cancer risk from air pollution in Houston: disparities in risk burden and social disadvantage.
Air toxics are of particular concern in Greater Houston, home to one of the world's largest petrochemical complexes and a quarter ofthe nation's refining capacity. Much of this complex lies along a navigable ship channel that flows 50 miles from east of the central business district through Galveston Bay and into the Gulf of Mexico. Numerous communities, including both poor and affluent neighborhoods, are located in close proximity to the 200 facilities along this channel. Our aim is to examine the spatial distribution of cumulative, air-pollution-related cancer risks in Houston and Harris County, with particular emphasis on identifying ethnic, economic, and social disparities. We employ exposure estimates from NATA-1999 and census data to assess whether the cumulative cancer risks from air toxics in Houston (and Harris County) fall disproportionately on certain ethnicities and on the socially and economically disadvantaged. The cancer risk burden across Harris County census tracts increases with the proportion of residents who are Hispanic and with key indicators of relative social disadvantage. Aggregate disadvantage grows at each higher level of cancer risk. The highest cancer risk in Harris County is concentrated along a corridor flanking the ship channel. These high-risk neighborhoods, however, vary markedly in relative disadvantage, as well as in emission source mix. Much of the risk they face appears to be driven by only a few hazardous air pollutants. Results provide evidence of risk disparities from hazardous air pollution based on ethnicity and social disadvantage. At the highest levels of risk the pattern is more complex, arguing for a neighborhood level of analysis, especially when proximity to high-emissions industries is a substantial contributor to cumulative cancer risk.


Hybrid breast reconstruction.
We present a new reconstructive system encompassing prostheses and fat grafting as integrated tools to improve the final reconstructive outcome. Fat grafting in our view is a preoperatively planned part of the reconstruction. The final volume we achieve will be made up of fat and implants in a variable percentage according to patient's body contour and breast morphology. We used the hybrid breast reconstruction technique in more than 350 reconstructions, both immediate and delayed, two-stage and DTI, without experiencing higher loco-regional recurrence and complication rates when compared with conventional two-stage reconstructions, obtaining excellent aesthetic results and high patients' satisfaction levels.


Two Independent Mutations in ADAMTS17 Are Associated with Primary Open Angle Glaucoma in the Basset Hound and Basset Fauve de Bretagne Breeds of Dog.
Mutations in ADAMTS10 (CFA20) have previously been associated with primary open angle glaucoma (POAG) in the Beagle and Norwegian Elkhound. The closely related gene, ADAMTS17, has also been associated with several different ocular phenotypes in multiple breeds of dog, including primary lens luxation and POAG. We investigated ADAMTS17 as a candidate gene for POAG in the Basset Hound and Basset Fauve de Bretagne dog breeds. We performed ADAMTS17 exon resequencing in three Basset Hounds and three Basset Fauve de Bretagne dogs with POAG. Identified variants were genotyped in additional sample cohorts of both breeds and dogs of other breeds to confirm their association with disease. All affected Basset Hounds were homozygous for a 19 bp deletion in exon 2 that alters the reading frame and is predicted to lead to a truncated protein. Fifty clinically unaffected Basset Hounds were genotyped for this mutation and all were either heterozygous or homozygous for the wild type allele. Genotyping of 223 Basset Hounds recruited for a different study revealed a mutation frequency of 0.081 and predicted frequency of affected dogs in the population to be 0.007. Based on the entire genotyping dataset the association statistic for the POAG-associated deletion was p = 1.26 x 10-10. All affected Basset Fauve de Bretagne dogs were homozygous for a missense mutation in exon 11 causing a glycine to serine amino acid substitution (G519S) in the disintegrin-like domain of ADAMTS17 which is predicted to alter protein function. Unaffected Basset Fauve de Bretagne dogs were either heterozygous for the mutation (5/24) or homozygous for the wild type allele (19/24). Based on the entire genotyping dataset the association statistic for the POAG-associated deletion was p = 2.80 x 10-7. Genotyping of 85 dogs of unrelated breeds and 90 dogs of related breeds for this variant was negative. This report documents strong associations between two independent ADAMTS17 mutations and POAG in two different dog breeds.


Body composition and cardiorespiratory fitness of overweight COVID-19 survivors in different severity degrees: a cohort study.
COVID-19 sequelae are varied, and whether they are temporary or permanent is still unknown. Identifying these sequelae may guide therapeutic strategies to improve these individuals' recovery. This prospective cohort aimed to assess body composition, cardiopulmonary fitness, and long-term symptoms of overweight individuals affected by COVID-19. Participants (n = 90) were divided into three groups according to the severity of acute COVID-19: mild (no hospitalization), moderate (hospitalization, without oxygen support), and severe/critical cases (hospitalized in Intensive Care Unit). We assessed body composition with a tetrapolar multifrequency bioimpedance, hemodynamic variables (heart rate, blood pressure, and peripheral oxygen saturation-SpO2) at rest, and the Bruce test with direct gas exchange. Two assessments with a one-year interval were performed. The most prevalent long-term symptoms were memory deficit (66.7%), lack of concentration (51.7%), fatigue (65.6%), and dyspnea (40%). Bruce test presented a time effect with an increase in the distance walked after 1 year just for severe/critical group (p < 0.05). SpO2 was significantly lower in the severe/critical group up to 5 min after the Bruce test when compared to the mild group, and diastolic blood pressure at the end of the Bruce test was significantly higher in the severe/critical group when compared to mild group (p < 0.05; for all comparisons). A time effect was observed for body composition, with increased lean mass, skeletal muscle mass, fat-free mass, and lean mass just for the severe/critical group after 1 year (p < 0.05). Cardiopulmonary fitness parameters did not differ among the groups, except for respiratory quotient with higher values for the severe/critical group when compared to itself after 1 year. All COVID-19 patients might present long-term sequelae, regardless of the acute disease severity. Reassessing and identifying the most prevalent long-term sequelae are essential to perform more precise health promotion interventions.


Pre-stroke anticoagulation for atrial fibrillation in primary English speakers and non-primary English speakers: a multicentre retrospective cohort study.
Anticoagulation can prevent most strokes in individuals with atrial fibrillation (AF); however, many people presenting with stroke and known AF are not anticoagulated. Language barriers and poor health literacy have previously been associated with decreased patient medication adherence. The association between language barriers and initiation of anticoagulation therapy for AF is uncertain. The aims of this study were to determine whether demographic factors, including non-English primary language, were (1) associated with not being initiated on anticoagulation for known AF prior to admission with stroke, and (2) associated with non-adherence to anticoagulation in the setting of known AF prior to admission with stroke. A multicentre retrospective cohort study was conducted for consecutive individuals admitted to the three South Australian tertiary hospitals with stroke units over a 5-year period. There were 6829 individuals admitted with stroke. These cases included 5835 ischaemic stroke patients, 1333 of whom had pre-existing AF. Only 40.0% presenting with ischaemic stroke in the setting of known pre-existing AF were anticoagulated. When controlling for demographics, socioeconomic status and past medical history (including the components of the CHADS2VASC score and anticoagulation contraindications), having a primary language other than English was associated with a lower likelihood of having been commenced on anticoagulant for known pre-stroke AF (odds ratio: 0.52, 95% confidence interval: 0.36-0.77, P = 0.001), but was not associated with a differing likelihood of anticoagulation adherence. A significant proportion of patients with stroke have pre-existing unanticoagulated AF; these rates are substantially higher if the primary language is other than English. Targeted research and interventions to minimise evidence-treatment gaps in this cohort may significantly reduce stroke burden.


Can the basal metabolic rate of endotherms be explained by biophysical modeling? Response to "a new model for the body size-metabolism relationship".
The physiological mechanisms that determine basal metabolic rate (BMR) of endotherms have long been debated. This journal has recently presented a new model, based on biophysical principles of heat flux through the tissues of mammals, that attempts to explain the allometric relationship between BMR and body size. We offer a critique of the model and conclude that although the model may describe the physics of heat transfer through the body, it cannot explain mechanistically the level of BMR. BMR determines some of the key variables of the model, but no combination of the variables determines BMR. The model arrives at an equation relating BMR to body mass that is similar to descriptive empirical equations, but this coincidence results from the geometry of the model and the empirical values put into it.


Quality of life in adults living in the community with previous self-reported myocardial infarction.
Quality of life (QoL) is one of the most important patient-reported outcomes in chronic diseases. Using a population-based cohort, our objective was to assess health-related QoL in individuals with a previous myocardial infarction (MI). This study was conducted on a large database representative of the adult Portuguese population aged 18 years or over, living in the community. Participants were assessed through telephone interview. A standardized questionnaire was applied to every individual about self-reported chronic diseases, including previous MI. QoL was assessed with the EQ-5D-3L version of EuroQol. The prevalence of previous MI was calculated and linear regression analysis was performed. The estimated prevalence of previous MI in the adult Portuguese population was 1.1%. These patients were older and more often male, had lower income and lower education levels, and were more often from urban areas. Respondents with self-reported MI assigned a lower self-perception to their health status in all domains, particularly in mobility and anxiety/depression. The mean EQ-5D-3L score in patients with MI was 0.73±0.34, significantly lower than in patients without MI (0.78±0.29). Also, the number of chronic diseases was significantly higher in patients with MI (5.0±2.2 vs. 1.7±1.8). Previous MI was not independently associated with QoL, which was related to age, gender and number of comorbidities. Adults with previous MI have a worse self-perceived health status and QoL. Previous MI was not an independent predictor of health-related QoL after controlling for age, gender and associated chronic diseases.


Multimodal Representation Learning via Maximization of Local Mutual Information.
We propose and demonstrate a representation learning approach by maximizing the mutual information between local features of images and text. The goal of this approach is to learn useful image representations by taking advantage of the rich information contained in the free text that describes the findings in the image. Our method trains image and text encoders by encouraging the resulting representations to exhibit high local mutual information. We make use of recent advances in mutual information estimation with neural network discriminators. We argue that the sum of local mutual information is typically a lower bound on the global mutual information. Our experimental results in the downstream image classification tasks demonstrate the advantages of using local features for image-text representation learning. Our code is available at: https://github.com/RayRuizhiLiao/mutual_info_img_txt.


The evidence base for HRT: what can we believe?
Prior to the unexpected early termination of the Women's Health Initiative (WHI) trial of continuous conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA), the prevailing view was that hormone replacement therapy (HRT) was a low-risk intervention with immediate value for symptom relief in recently menopausal women, and that it probably conferred long-term protection against the major chronic diseases that affect women after menopause. Rather than replicating prior studies, the WHI was designed to test whether the beneficial associations consistently seen in women starting HRT near menopause would be found in women well beyond menopause. Views of the benefits and risks of HRT changed dramatically in 2002 with the unexpected early termination of the CEE + MPA trial and the alarming initial WHI report. HRT use plummeted world-wide, driven by fear of breast cancer and skepticism about cardiovascular benefits. Stunningly, the contrasting findings of the WHI trial of CEE alone reported 2 years later - suggesting prevention of coronary heart disease in women who began HRT at age <60 years, and a reduction in breast cancer overall - were largely ignored. Key lessons from the WHI are that the effects of HRT on most organ systems vary by age and time since last physiologic exposure to hormones and that there are differences between regimens. In the years since the first WHI report, we have learned much about the characteristics of women who are likely to benefit from HRT. The range of HRT regimens has also increased. Not all women have indications for HRT, but for those who do and who initiate within 10 years of menopause, benefits are both short-term (vasomotor, dyspareunia), and long-term (bone health, coronary risk reduction). Critically, the 'facts' that most women and clinicians consider in making the decision to use, or not use, HRT are frequently wrong or incorrectly applied.


Room temperature multiferroicity in hydrogenated triapentafulvalene and pentaheptafulvalene oligomers.
To search for new organic multiferroics, we perform a systematic study on the magnetic and ferroelectric properties of fused triapentafulvalene and pentaheptafulvalene oligomers (n = 2-6), by using the density functional theory and quantum Monte Carlo method. It is found that the oligomers without hydrogenation always lie in the spin singlet (nonmagnetic) state, while a selective hydrogenation of carbon atoms at the ends of oligomers can result in the spin triplet (ferromagnetic) state, which is tens to hundreds meV lower than the nonmagnetic state. The formation of ferromagnetism can be attributed to the hydrogenation-induced near degeneracy between the highest occupied and lowest unoccupied molecular orbitals. Simultaneously, there exists a finite dipole moment in the ferromagnetic state, due to the breaking of the inversion symmetry of oligomers. Our results imply that the hydrogenated triapentafulvalene and pentaheptafulvalene oligomers could be promising candidates in the development of room temperature organic multiferroics.


Diagnosing appendicitis: What works, what does not and where to go from here?
Although acute appendicitis is the most common reason for emergency abdominal surgery in children, diagnosis is far from straightforward. Delays in diagnosis can result in significant complications, whereas over-diagnosis can result in costly inter-hospital transfers and unnecessary surgery. This article aims to describe current evidence-based assessment of children with possible appendicitis presenting to the emergency department. We provide an overview of the literature relating to the various available diagnostic approaches, including the application of history, examination, pathology tests, imaging, and clinical decision rules.


The clinical outcomes of total femur prosthesis in patients with musculoskeletal tumors.
Reconstruction using a total femur prosthesis (TFP) remains a challenging procedure in musculoskeletal tumor surgery. The purpose of this study was to show the clinical outcomes of total femur replacement (TFR) in our institute. Nine patients underwent reconstruction with a TFP after the wide resection of malignant bone and soft-tissue tumors of the femur between January 2003 and April 2014. The mean age of the patients at the time of TFR was 47.5 years, and the mean follow-up period was 52.9 months. The histological diagnoses were as follows: bone sarcoma (n = 4), soft-tissue sarcoma invading the femoral bones (n = 4), and metastatic bone tumor (n = 1). The oncological outcomes were as follows: three patients achieved continuous disease free, two patients were alive with disease, and four patients died from disease. The 3- and 5-year overall survival rates were 88.9% and 55.6%, respectively. The rate of the overall survival in patients with primary bone tumors (100% at 5 years) was significantly better than that in patients with primary soft tissue sarcomas (0% at 5 years) (p = 0.015). A deep infection occurred postoperatively in one patient, but the patient was successfully treated with surgical debridement and revision surgery. There were no patients who showed dislocation or aseptic loosening. The mean Musculo-Skeletal Tumor Society functional score was 58.5% (46.7-80.0), with scores of 65.5% in patients with a primary bone tumor and 50.8% in those with a primary soft-tissue sarcoma. In the present study, the patients who underwent TFR due to bone invasion by soft tissue sarcoma had a worse prognosis than the bone sarcoma patients.


Influence of pinholes on MgO-tunnel junction barrier parameters obtained from current-voltage characteristics.
Magnetic tunnel junctions (MTJs) with thin barriers are already used as read sensors in recording media. However, the presence of pinholes across such few A thick barriers cannot be excluded and one needs to investigate their effect on the MTJ-transport properties. By applying large electrical currents we could change the electrical resistance of the studied MgO MTJs (due to pinhole-size variations), and study how pinholes influence the barrier parameters (thickness t and height phi) obtained by fitting current-voltage characteristics to Simmons' model. We found that, with decreasing resistance, the barrier thickness (height) decreases (increases). These results were well reproduced by a model of parallel-resistances, allowing us to estimate pinhole-free barrier parameters.


The amino terminus of Epstein-Barr virus glycoprotein gH is important for fusion with epithelial and B cells.
Epstein-Barr virus (EBV) infects B lymphocytes and epithelial cells. While the glycoproteins required for entry into these two cell types differ, the gH/gL glycoprotein complex is essential for entry into both epithelial and B cells. Analysis of gH protein sequences from three gammaherpesviruses (EBV, marmoset, and rhesus) revealed a potential coiled-coil domain in the N terminus. Four leucines located in this region in EBV gH were replaced by alanines by site-directed mutagenesis and analyzed for cell-cell membrane fusion with B cells and epithelial cells. Reduction in fusion activity was observed for mutants containing L65A and/or L69A mutations, while substitutions in L55 and L74 enhanced the fusion activity of the mutant gH/gL complexes with both cell types. All of the mutants displayed levels of cell surface expression similar to those of wild-type gH and interacted with gL and gp42. The observation that a conservative mutation of leucine to alanine in the N terminus of EBV gH results in fusion-defective mutant gH/gL complexes is striking and points to an important role for this region in EBV-mediated membrane fusion with B lymphocytes and epithelial cells.


DNA-decorated carbon nanotubes for chemical sensing.
We demonstrate a new, versatile class of nanoscale chemical sensors based on single-stranded DNA (ss-DNA) as the chemical recognition site and single-walled carbon nanotube field effect transistors (swCN-FETs) as the electronic read-out component. swCN-FETs with a nanoscale coating of ss-DNA respond to gas odors that do not cause a detectable conductivity change in bare devices. Responses of ss-DNA/swCN-FETs differ in sign and magnitude for different gases and can be tuned by choosing the base sequence of the ss-DNA. ss-DNA/swCN-FET sensors detect a variety of odors, with rapid response and recovery times on the scale of seconds. The sensor surface is self-regenerating: samples maintain a constant response with no need for sensor refreshing through at least 50 gas exposure cycles. This remarkable set of attributes makes sensors based on ss-DNA decorated nanotubes very promising for "electronic nose" and "electronic tongue" applications ranging from homeland security to disease diagnosis.


Esophageal Suspension Method for Hand-Sewn Esophagojejunostomy After Totally Laparoscopic Total Gastrectomy: A Simple, Safe, and Feasible Suturing Technique.
Background: Totally laparoscopic total gastrectomy (TLTG) not only is difficult to operate but also has high technical requirements and a long learning curve. Therefore, it has not been widely carried out yet, and esophagojejunostomy is one of its difficulties. Relevant studies have shown that intracorporeal hand-sewn esophagojejunostomy is safe, feasible and low-cost, but it is complicated and time-consuming and requires a high-suture technique. This study introduces a simple, safe and feasible hand-sewn technique. Methods: The clinical data of 32 patients with the esophageal suspension method for hand-sewn esophagojejunostomy (suspension group) after TLTG were collected from February 2018 to June 2019. During the same period, 32 patients with traditional hand-sewn esophagojejunostomy (traditional group) after TLTG were used as the control group. Results: The operative time, anastomosis time, exhaust time and hospitalization time of the suspension group were shorter than those of the traditional group. The intraoperative blood loss in the suspension group was less than that in the traditional group. There were no postoperative complications associated with the suspension group. Conclusion: For those who have some experience in laparoscopic suture technique, the esophageal suspension method for hand-sewn esophagojejunostomy after TLTG is a simple, safe, and feasible suture technique.


Pathophysiological and motor factors associated with collision avoidance behavior in individuals with stroke.
High collision rates and frequency of entering the opening from non-paretic sides are associated with collision in individuals with stroke. To identify factors associated with collision avoidance behavior when individuals with stroke walked through narrow openings. Participants with subacute or chronic stroke walked through a narrow opening and had to avoid colliding with obstacles. Multiple regression analyses were conducted with pathophysiology, motor function, and judgment ability as predictor variables; collision rate and frequency of entering the opening from non-paretic sides were outcome variables. Sixty-one eligible individuals with stroke aged 63±12 years were enrolled. Thirty participants collided twice or more and 37 entered the opening from the non-paretic side. Higher collision occurrence was associated with slower Timed Up and Go tests and left-right sway (odds ratios, 1.2 and 5.6; 95% confidence intervals, 1.1-1.3 and 1.3-28.2; p = .008 and.025, respectively). Entering from non-paretic sides was associated with lesions in the thalamus, left-sided hemiplegia, and Brunnstrom stage 3 or lower (odds ratios, 6.6, 8.7, and 6.7; 95% confidence intervals, 1.3-52.5, 2.5-36.5, and 1.2-57.5; and p = .038,.001, and.048, respectively). Walking ability is associated with avoiding obstacle collision, while pathophysiological characteristics and degree of paralysis are associated with a preference for which side of the body enters an opening first. Interventions to improve walking ability may improve collision avoidance. Avoidance behavior during intervention varies depending on the lesion position.


Perioperative management of peritoneal dialysis patients: review of abdominal surgery.
On abdominal computed tomography scan for evaluation of hematuria, the index patient, a 23-year-old male, was found to have multiple renal cysts bilaterally. He had been on peritoneal dialysis for 6 years, complicated by intermittent episodes of exit-site infection and peritonitis. Over time, he developed recurrent urinary tract infection and nephrolithiasis with intermittent hematuria. His maintenance dose of recombinant erythropoietin was discontinued, and he maintained a normal hemoglobin level. Annual surveillance of the bilateral renal cysts with magnetic resonance imaging revealed development of a complex cystic mass that warranted further investigation. Following a urology consultation, laparoscopic nephrectomy was performed without complications and with minimal interruption of PD. Pathology evaluation revealed renal cell carcinoma within the renal parenchyma and multiple cystic structures consistent with acquired cystic kidney disease. No clear recommendations exist in the literature regarding continuation or interruption of PD in the perioperative period for planned nephrectomy, tumor resection, or other uncomplicated abdominal or retroperitoneal procedures. A perioperative management strategy for PD patients requiring abdominal or retroperitoneal surgery is outlined here. If these recommendations are followed, patients may continue PD with minimal interruption, preservation of the peritoneal membrane, and few complications.


Vibration Induced Transport of Enclosed Droplets.
The droplet response to vibrations has been well characterized on open substrates, but microfluidic applications for droplets on open systems are limited by rapid evaporation rates and prone to environmental contamination. However, the response of enclosed droplets to vibration is less understood. Here, we investigate the effects of a dual-plate enclosure on droplet transport for the anisotropic ratchet conveyor system. This system uses an asymmetric pattern of hydrophilic rungs to transport droplets with an applied vibration. Through this work, we discovered that the addition of a substrate on top of the droplet, held in place with a 3D printed fixture, extends the functional frequency range for droplet transport and normalizes the device performance for droplets of different volumes. Furthermore, we found that the edge movements are anti-phasic between top and bottom substrates, providing a velocity profile that is correlated to vibration frequency, unlike the resonance-dependent profiles observed on open systems. These results expand the capabilities of this system, providing avenues for new applications and innovation, but also new insights for droplet mechanics in response to applied vibration.


Effect of digoxin on plasma clearance and anticoagulant effect of warfarin in rats.
The possible effects of digoxin on the elimination and anticoagulant action of warfarin were examined in rats. The pharmacokinetic parameters of warfarin after a single i.v. (1.2 mg/kg) or repeated oral coadministration with anticoagulant (0.6 mg/kg on day 1, thereafter 0.3 mg/kg) and digoxin (50 micrograms/kg) were not significantly different as compared with those in the group treated with warfarin alone. However, prothrombin complex activity (PCA) following coadministration with the diuretic was significantly and relatively rapidly recovered as compared with that in the warfarin group. The amounts of warfarin extracted by liver 2 and 6 h after a single i.v. dosing or 3 and 8 h after repeated oral dosing in the coadministered group were significantly decreased as compared with those in the group received warfarin alone. The renal function (renal plasma flow rate (RPF) and glomerular filtration rate) in the group coadministered with digoxin was significantly higher than that in the group receiving warfarin alone. On the other hand, the fraction of warfarin bound to BSA or rat plasma and the plasma water were little changed in the presence of digoxin. These results suggest that a pharmacological interaction, the decrease in the anticoagulant action, is induced between warfarin and digoxin coadministered.


Trends, Outcomes, and Predictors of Sepsis and Severe Sepsis in Patients with Left Ventricular Assist Devices.
Left ventricular assist device (LVAD) is used in end-stage heart failure that is refractory to medical treatment. However, there is a paucity of data looking at the rates of sepsis and severe sepsis (SSS). Therefore, this study was conceived with the purpose of analyzing the SSS burden and outcomes associated with LVAD implantation. The national inpatient sample database was queried from 2010 to 2014 using ICD-9 procedure code for LVAD use among patients 18 years or older and 2359 patients were identified. During the five-year study period, the average incidence of SSS was 11.8% and it was noted that cases with SSS were associated with an increased likelihood of mortality, greater length of hospital stay (LOS), and higher hospital-related charges (p < .001) compared to controls. Controlling for age, sex, and LOS, hierarchical multivariate logistic regression revealed that significant predictors of SSS were acute kidney injury [Adjusted odd's ratio (AOR) = 2.75, 95% CI = 1.87, 4.14)], mechanical ventilation (AOR = 2.34, 95% CI = 1.70, 3.23), venous thromboembolism (AOR = 1.76, 95% CI = 1.12, 2.75), gastrointestinal bleed (AOR = 1.77, 95% CI = 1.12, 2.76), chronic obstructive pulmonary disease (COPD) (AOR = 0.55, 95% CI = 0.40, 0.77), acute myocardial infarction (AOR = 0.54, 95% CI = 0.36, 0.80) and mild liver disease (AOR = 2.18, 95% CI = 1.55, 3.06). The rate of incidence of sepsis has remained constant and is often associated with a worse clinical outcome. This provides a basis to identify high-risk groups and helps argue for earlier detection of such patients and better patient selection so as to reduce infectious complications.


Bispecific antibody pretargeting of tumor neovasculature for improved systemic radiotherapy of solid tumors.
Extra domain B (ED-B) fibronectin is a specific tumor matrix marker for targeting angiogenesis in solid tumors. In this study, the radiotherapeutic potential of the directly radioiodinated divalent anti-ED-B antibody fragment, L19 small immunoprotein (L19-SIP; 75,000 Da), was compared with a pretargeting approach using the bispecific antibody AP39xm679 (bsMAb; 75,000 Da). The bsMAb was prepared by coupling an anti-ED-B single-chain Fv (AP39) to the Fab' of the murine antibody m679, which binds to the small peptidic hapten histamine-succinyl-glycine (HSG). As an effector molecule for the pretargeting approach, the 111In-labeled HSG-DOTA complex was injected 25 or 41 hours after the bsMAb. The kinetics of both the iodinated bsMAb and the pretargeted 111In-labeled HSG hapten were investigated in mice bearing human glioblastoma xenografts (U251) and compared with the kinetics and tumor accumulation of radioiodinated L19-SIP. 111In and 125I were used as surrogate marker for the therapeutic radioisotopes 90Y/177Lu and 131I, respectively. Tumor uptake of the pretargeted 111In-labeled peptide was significantly higher than 125I-L19-SIP over 7 days. At the calculated maximally tolerated dose for each agent (with the kidney being the dose-limiting organ for pretargeting and the bone marrow for direct targeting), a mouse tumor dose of 146 Gy could be given by pretargeting versus 45 Gy delivered by the direct approach. These data suggest that pretargeting of ED-B with AP39xm679 and subsequent injection of the 90Y-hapten-peptide would improve the therapeutic efficacy in solid tumors by >3-fold compared with directly radiolabeled 131I-L19-SIP.


[Experimental model of auxiliary heterotopic liver-intestinal transplantation].
In pigs, orthotopic liver-intestine transplantation (LITX) has high per operative morbidity and mortality. It is due to hemodynamic, coagulation and metabolism disorders during native liver hepatectomy (total hepatic vascular exclusion) and the postoperative diarrhea secondary to initial dysfunction of the graft and enterectomy of native intestine. To avoid those disturbances and to increase the survival, we have developed a porcine model of auxiliary heterotopic LITX. The allograft was harvested in-bloc, containing the liver, duodenum, pancreas, and jejunum. In the recipient, the liver and intestine were left intact. The allograft was implanted heterotopically, caudal to the native liver. Venous drainage was achieved with anastomosis of donor (D) to recipient (R) infrahepatic cava; and arterialization with anastomosis of D aortic conduit containing the celiac axis and SMA to infra-renal R aorta. The D jejunum was hooked-up to R jejunum. The experiment was performed in 16 animals without intraoperative deaths, hemodynamic stability and no blood requirements. Four animals were left alive 7 days with functioning grafts, suggesting the model viability.


The lack of association between vascular endothelial growth factor and retinopathy of prematurity in an observational study.
The objective of this study was to investigate the association between prematurity, vascular endothelial growth factor A (VEGF-A), VEGFR-1 (soluble fms-like tyrosine kinase-1 (sFLT-1)) and retinopathy of prematurity (ROP). A cohort of 53 neonates (gestation <28 weeks) was recruited into this study and peripheral venous samples for VEGF and sFLT-1 measurement were obtained between gestational ages 320-326 weeks. The mean birth weight for the preterm neonates was 850 (178) g and the median gestational age was 26.4 [24.7-27.4] weeks. The median VEGF-A level was 1348 [608-2216] pg/mL and the median sFLT-1 level was 178 [103-244] pg/mL. Thirty-three neonates (33/53) developed various stages of ROP during their stay in the neonatal unit but only five neonates developed severe (stage 3) ROP needing treatment. The neonates with ROP were smaller (birth weight 801 (111) vs. 990 (175) g; p < .0001), more preterm (gestation 25.4 [24.2-26.0] vs. 27.1 [26.8-27.9] weeks; p < .0001) and received supplemental oxygen for a longer duration (1140 [218-1813] vs. 04 [40-434] hours; p= .012). There was no statistically significant difference in the VEGF-A level or sFLT-1 levels between those who developed ROP and those who did not. There was a positive correlation between VEGF and both birth weight and gestation, respectively. There was no correlation between sFLT1 and birth weight or gestation. VEGF-A/sFLT-1 ratio in babies treated for ROP was significantly lower compared to those not treated (2.8 [1.0-5.7] vs. 9.9 [5.6-13.7]; p = .04). A logistic regression model identified gestational age to be a statistically significant predictor of ROP (odds ratio 0.03 (0.001-0.550); p = .019). There is no direct correlation between systemic VEGF-A or sFLT-1 plasma levels and severity of ROP in extremely preterm neonates. The link between VEGF and ROP remains to be fully understood.


Turning the medical gaze in upon itself: root cause analysis and the investigation of clinical error.
In this paper, we discuss how a technique borrowed from defense and manufacturing is being deployed in hospitals across the industrialized world to investigate clinical errors. We open with a discussion of the levers used by policy makers to mandate that clinicians not just report errors, but also gather to investigate those errors using root cause analysis (RCA). We focus on the tensions created for clinicians as they are expected to formulate 'systems solutions' that go beyond blame. In addressing these matters, we present a discourse analysis of data derived during an evaluation of the NSW Health Safety Improvement Program. Data include transcripts of RCA meetings which were recorded in a local metropolitan teaching hospital. From this analysis we move back to the argument that RCA involves clinicians in 'immaterial labour', or the production of communication and information, and that this new labour realizes two important developments. First, because RCA is anchored in the principle of health care practitioners not just scrutinizing each other, but scrutinizing each others'errors, RCA is a challenging task. Second, thanks to turning the clinical gaze in on the clinical observer, RCA engenders a new level of reflexivity of clinical self and of clinical practice. We conclude with asking whether this reflexivity will lock the clinical gaze into a micro-sociology of error, or whether it will enable this gaze to influence matters superordinate to the specifics of practice and the design of clinical treatments; that is, the over-arching governance and structuring of hospital care.


Emergence of fexA in Mediating Resistance to Florfenicols in Campylobacter.
Florfenicol belongs to a class of phenicol antimicrobials widely used as feed additives and for the treatment of respiratory infections. In recent years, increasing resistance to florfenicol has been reported in Campylobacter spp., the leading foodborne enteric pathogens causing diarrheal diseases worldwide. Here, we reported the identification of fexA, a novel mobile florfenicol resistance gene in Campylobacter Of the 100 Campylobacter jejuni strains isolated from poultry in Zhejiang, China, 9 were shown to be fexA positive, and their whole-genome sequences were further determined by integration of Illumina short-read and MinION long-read sequencing. The fexA gene was found in the plasmid of one strain and chromosomes of eight strains, and its location was verified by S1 nuclease pulsed-field gel electrophoresis (S1-PFGE) and Southern blotting. Based on comparative analysis, the fexA gene was located within a region with the tet(L)-fexA-catA-tet(O) gene arrangement, demonstrated to be successfully transferable among C. jejuni strains. Functional cloning indicated that acquisition of the single fexA gene significantly increased resistance to florfenicol, whereas its inactivation resulted in increased susceptibility to florfenicol in Campylobacter Taken together, these results indicated that the emerging fexA resistance is horizontally transferable, which might greatly facilitate the adaptation of Campylobacter in food production environments where florfenicols are frequently used.


Birth weight and subsequent risk of childhood primary brain tumors: a meta-analysis.
The etiology of primary brain tumors is largely unknown. Since a peak of incidence occurs during childhood, factors operating very early in life might play a key role. Previous studies have suggested that high birth weight is associated with an increased brain tumor risk. The authors conducted a meta-analysis on the association between birth weight and risk of specific histologic types of primary brain tumors. They included published studies (1966-2007) that reported odds ratios and 95% confidence intervals for brain tumors associated with birth weight. The authors identified eight studies involving 1,748,964 children, of whom 4,162 suffered from brain tumors of three histologic types (astrocytoma, medulloblastoma, and ependymoma). For astrocytoma, high birth weight (>4,000 g) was associated with increased risk (odds ratio = 1.38, 95% confidence interval (CI): 1.07, 1.79), with each 1,000-g increase in birth weight being associated with a 19% (95% CI: 4, 36) increase in risk. For medulloblastoma, high birth weight was also positively associated with increased risk (odds ratio = 1.27, 95% CI: 1.02, 1.60). No association was found for ependymoma. These findings indicate that birth weight is related to the development of childhood brain tumors, with high birth weight being a risk factor for the two most common types of brain tumors.


Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study.
The rate of cesarean delivery is increasing in North America. Surgical site infection following this operation can make it difficult to recover, care for a baby and return home. We aimed to determine the incidence of surgical site infection to 30 days following cesarean delivery, associated risk factors and whether risk factors differed for predischarge versus postdischarge infection. We identified a retrospective cohort in Nova Scotia by linking the provincial perinatal database to hospital admissions and physician billings databases to follow women for 30 days after they had given birth by cesarean delivery between Jan. 1, 1997 and Dec. 31, 2012. Logistic regression with generalized estimating equations was used to determine risk factors for infection. A total of 25 123 women had 33 991 cesarean deliveries over the study period. Of the 25 123, 923 had surgical site infections, giving an incidence rate of 2.7% (95% CI 2.54%-2.89%); the incidence decreased over time. Risk factors for infection (adjusted odds ratios ≥ 1.5) were prepregnancy weight 87.0 kg or more, gaining 30.0 kg or more during pregnancy, chorioamnionitis, maternal blood transfusion, anticoagulation therapy, alcohol or drug abuse, second stage of labour before surgery, delivery in 1997-2000 and delivery in a hospital performing 130-1249 cesarean deliveries annually. Women who gave birth earlier in the study period, those who gave birth in a hospital with 130-949 cesarean deliveries per year and those with more than 1 fetus were at a significantly higher risk for surgical site infection before discharge; women who smoked were at significantly higher risk for surgical site infection after discharge. Most risk factors are known before delivery, and some are potentially modifiable. Although the incidence of surgical site infection decreased over time, targeted clinical and infection prevention and control interventions could further reduce the burden of illness associated with this health-care-related infection.


Production and Characterization of Monoclonal Antibody against Vit v1: A Grape Allergen Belonging to Lipid Transfer Protein Family.
Allergy to non-specific lipidtransfer protein (nsLTP), the major allergen of grape (Vit v1), is considered as one of the most common fruit allergies in Iran. Therefore, a specific monoclonal antibody (mAb) can be used for the characterization and assessment of. Accordingly, this study aimed to generate and characterize a mAb against Vit v1 with a diagnostic purpose. To this end, Vit v1 allergen (9 kDa) was extracted using a modified Bjorksten extraction method. Natural Vit v1-immunized mouse splenocytes were fused with SP2/0Ag-14 myeloma cells for generating hybridoma cells. Specific antibody-secreting Hybridoma cells were selected using ELISA. Finally, anti-Vit v1 mAb was characterized by western blotting, ELISA, and isotyping methods. In the current study, a 9 kDa (Vit v1) protein was attained fromcrude and fresh juice of grape extracts and the isotype of desired anti-Vit v1 mAb was determined as IgM with k light chain. In addition, The ELISA results demonstrated that anti-Vit v1 mAb was specified against natural Vit v1 in the grape cultivar and related LTP allergens, such as Pla or 3 (p<0.0001). In the present study, a specific mAb was produced for detecting the LTP allergen. This mAb with a confirmed specificity can be utilized for evaluating the LTP allergens and their allergenicity in different grape cultivars.


Differential behavior of mesangial cells derived from 12/15-lipoxygenase knockout mice relative to control mice.
The 12/15-lipoxygenase (12/15-LO) enzyme has been implicated in the pathogenesis of diabetic nephropathy since lipoxygenase products induce cellular hypertrophy and extracellular matrix deposition in mesangial cells. In this study, in order to determine the potential in vivo functional role of 12/15-LO in kidney disease, we compared mouse mesangial cells (MMCs) derived from 12/15-LO knockout mice with those from genetic control wild-type mice. MMCs were isolated from wild-type and 12/15-LO knockout mice. Cellular growth, activation of mitogen-activated protein kinases (MAPKs), transcription factors, superoxide levels, and fibronectin expression were compared in the two cell types. Levels of the 12/15-LO product and protein were lower in MMC from 12/15-LO knockout relative to wild-type. MMCs from 12/15-LO knockout mice grew slower than wild-type cells, and also showed lower rates of tritiated thymidine and leucine incorporation (21% and 15% of wild-type, respectively, P < 0.001). Levels of superoxide and the matrix protein fibronectin were also lower in 12/15-LO knockout mice cells. Serum and angiotensin II (Ang II)-stimulated activities of p38 or ERK1/2 MAPKs, and cyclic adenosine monophosphate (cAMP)-responsive element binding protein (CREB) transcription factor were lower in 12/15-LO knockout relative to wild-type cells. In addition, DNA binding and transcriptional activities of activated protein-1 (AP-1) and CREB were lower in 12/15-LO knockout cells. Furthermore, stable 12/15-LO overexpression in MMC led to reciprocal increase in p38 MAPK activation and fibronectin expression. The differential activation of oxidant stress, specific signaling pathways, transcription factors, and growth and matrix genes may lead to reduced growth and growth factor responses in 12/15-LO knockout versus wild-type MMCs. These results provide ex vivo functional evidence for the first time that 12/15-LO activation plays a key role in mesangial cell responses associated with renal diseases such as diabetic nephropathy.


Effects of 1,7-substituted methylxanthine derivatives on LPS-stimulated expression of cytokines and chemokines in Raw 264.7 and HK-2 cells.
Chronic kidney diseases are based on uncontrolled immunological and inflammatory responses to pathophysiological renal circumstances such as glomerulonephritis, which is caused by immunological mechanisms of glomerular inflammation with increased production of renal pro-inflammatory cytokines. Pentoxifylline (PTX) exhibits anti-inflammatory properties by inhibiting cytokine and chemokine production through aggregation of erythrocytes and thrombocytes. We synthesized a series of 1,7-substituted methylxanthine derivatives by the Traube purine reaction, and the formation of purine ring was completed through nitrosation, a reduction of the nitroso to the amine by catalytic hydrogenation as derivatives of PTX. Then we studied biological activities such as renal anti-inflammatory effects of the synthesized compounds in the production of cytokines such as nitric oxide (NO), interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) and of chemokines such as monocyte chemoattractant protein-1 and IL-8 in Raw 264.7 and HK-2 cells. Renal antiinflammatory activities of this novel series of N-1 and N-7-substituted methylxanthine showed that the N-7 methyl-group-substituted analogs (S7b) showed selective 61% and 77% inhibition of the production of NO and IL-8. The other replacement of the N-1-(CH2)4COCH3 group, as in the case of compound S6c, also showed an effective 50% and 77% inhibition of TNF-α and IL-8 production in LPS-stimulated Raw 264.7 and HK-2 cells.


Pancreatic allograft thrombosis: Suggestion for a CT grading system and management algorithm.
Pancreatic allograft thrombosis (PAT) remains the leading cause of nonimmunologic graft failure. Here, we propose a new computed tomography (CT) grading system of PAT to identify risk factors for allograft loss and outline a management algorithm by retrospective review of consecutive pancreatic transplantations between 2009 and 2014. Triple-phase CT scans were graded independently by 2 radiologists as grade 0, no thrombosis; grade 1, peripheral thrombosis; grade 2, intermediate non-occlusive thrombosis; and grade 3, central occlusive thrombosis. Twenty-four (23.3%) of 103 recipients were diagnosed with PAT (including grade 1). Three (2.9%) grafts were lost due to portal vein thrombosis. On multivariate analysis, pancreas after simultaneous pancreas-kidney transplantation/solitary pancreatic transplantation, acute rejection, and CT findings of peripancreatic edema and/or inflammatory change were significant risk factors for PAT. Retrospective review of CT scans revealed more grade 1 and 2 thromboses than were initially reported. There was no significant difference in graft or patient survival, postoperative stay, or morbidity of recipients with grade 1 or 2 thrombosis who were or were not anticoagulated. Our data suggest that therapeutic anticoagulation is not necessary for grade 1 and 2 arterial and grade 1 venous thrombosis. The proposed grading system can assist clinicians in decision-making and provide standardized reporting for future studies.


Case report: Unique ultrasound feature of thyroid metastases in occult breast cancer.
Occult breast cancer is an uncommon type of breast cancer. Metastases of occult breast cancer to other tissues are rather rare. We present a rare case of thyroid metastases in a 46-year-old woman who underwent occult breast cancer. The first ultrasound (US) examination of the thyroid showed that the left lobe was enlarged but had normal thyroid function. At first, this case was misdiagnosed as thyroiditis based on the thyroid US features. However, the cytological and histological results showed that nests of the neoplastic cells were found. Further immunohistochemistry results confirmed that these neoplasms were derived from breast tissue. Analysis using the successive US scans revealed that the sizes and echo of the thyroid repeatedly changed after the radiotherapy and chemotherapy treatment. To our knowledge, this is the first reported case of occult breast carcinoma presenting with thyroid metastases. This case can easily be misdiagnosed as thyroiditis due to the metastasis area not manifesting as regular suspicious nodules or diffused punctate calcifications.


Fast direct injection mass-spectrometric characterization of stimuli for insect electrophysiology by proton transfer reaction-time of flight mass-spectrometry (PTR-ToF-MS).
Electrophysiological techniques are used in insect neuroscience to measure the response of olfactory neurons to volatile odour stimuli. Widely used systems to deliver an olfactory stimulus to a test insect include airstream guided flow through glass cartridges loaded with a given volatile compound on a sorbent support. Precise measurement of the quantity of compound reaching the sensory organ of the test organism is an urgent task in insect electrophysiology. In this study we evaluated the performances of the recent realised proton transfer reaction-time of flight mass-spectrometry (PTR-ToF-MS) as a fast and selective gas sensor. In particular, we characterised the gas emission from cartridges loaded with a set of volatile compounds belonging to different chemical classes and commonly used in electrophysiological experiments. PTR-ToF-MS allowed a fast monitoring of all investigated compounds with sufficient sensitivity and time resolution. The detection and the quantification of air contaminants and solvent or synthetic standards impurities allowed a precise quantification of the stimulus exiting the cartridge. The outcome of this study was twofold: on one hand we showed that PTR-ToF-MS allows monitoring fast processes with high sensitivity by real time detection of a broad number of compounds; on the other hand we provided a tool to solve an important issue in insect electrophysiology.


Estimating the number of adults with severe and persistent mental illness who have complex, multi-agency needs.
A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of individuals with severe mental illness. We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among individuals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. Agreed indicators of complex, multi-agency needs are required to refine these estimates. Closer alignment of information collected about possible service needs across epidemiological surveys is needed.


Correction: Substituent interference on supramolecular assembly in urea gelators: synthesis, structure prediction and NMR.
Correction for 'Substituent interference on supramolecular assembly in urea gelators: synthesis, structure prediction and NMR' by Francesca Piana et al., Soft Matter, 2016, 12, 4034-4043.


[Forensic sequelae of changes in ethanol metabolism in chronic alcoholics].
The author summarizes some views on possible factors influencing ethanol metabolism. Ethanol metabolism can be affected by altered hepatic activity in chronic alcoholics and mentions also possible effect of some pharmacological preparations on ethanol metabolism.


4q27 as a psoriasis susceptibility locus in the Northeastern Chinese Han population.
Psoriasis is an autoimmune inflammatory skin disease with genetic components. Chromosome 4q27 is related to many autoimmune diseases, however, the relationship between psoriasis and 4q27 has not been fully established yet. The objective of this study is to investigate the association between chromosome 4q27 and psoriasis in the Northeastern Chinese Han population. Four common single nucleotide polymorphisms (rs2069762, rs4833837, rs6840978, and rs7684187) from chromosome 4q27 were genotyped in 400 psoriasis cases and 398 controls from the Northeastern Chinese Han population using the Multiplex SNaPSHOT method. Single nucleotide polymorphism and haplotype frequencies were analyzed using spss 13.0. Our data indicated that rs2069762 GG, TG genotypes [GG: odds ratio (OR) = 2.6875, 95% confidence interval (CI) = 1.5948-4.5290, P < 0.0001; TG: OR = 1.6159, 95% CI = 1.2044-2.1681, P = 0.0013], and H3 haplotype (OR = 1.717, 95% CI = 1.050-2.808, P = 0.030) increased the risk of psoriasis. Furthermore, rs4833837 GG, GA genotypes (GG: OR = 0.2071, 95% CI = 0.0685-0.6266, P = 0.0022; GA: OR = 0.4711, 95% CI = 0.3289-0.6746, P < 0.0001), and H5 haplotype (OR = 0.482, 95% CI = 0.238-0.978, P = 0.039) were identified as protective factors for psoriasis. 4q27 polymorphisms are associated with psoriasis in the Northeastern Chinese Han population.


[Lumbar synovial cysts : six case studies].
The purpose of this study is to discuss the clinical and radiological aspects as well as the controversies in the management of lumbar synovial cysts. We report a retrospective analysis of a series of 6 cases of lumbar synovial cysts. Patients presented with unilateral radicular pain mimicking a disc herniation. An MRI (magnetic resonance imaging) was performed in all patients. A computerized tomography scan was performed in one case and X rays in 2 cases. All patients were operated on and the cyst resected. Arthrodesis was not performed in any of our patients. Functional outcome was marked by a significant improvement. Excellent results were found in 4 patients. Three patients who presented with a motor deficit recovered after the surgery. Lumbar synovial cysts should be considered in the differential diagnosis of any radicular compression. MRI is the examination of choice. Surgical resection is the definitive treatment with low rates of complications and recurrences.


Human cortical traveling waves: dynamical properties and correlations with responses.
The spatiotemporal behavior of human EEG oscillations is investigated. Traveling waves in the alpha and theta ranges are found to be common in both prestimulus and poststimulus EEG activity. The dynamical properties of these waves, including their speeds, directions, and durations, are systematically characterized for the first time, and the results show that there are significant changes of prestimulus spontaneous waves in the presence of an external stimulus. Furthermore, the functional relevance of these waves is examined by studying how they are correlated with reaction times on a single trial basis; prestimulus alpha waves traveling in the frontal-to-occipital direction are found to be most correlated to reaction speeds. These findings suggest that propagating waves of brain oscillations might be involved in mediating long-range interactions between widely distributed parts of human cortex.


[Detection of the neurotropic properties of the serum of schizophrenia patients].
A method of testing neurotropic properties of the serum of schizophrenic patients is proposed. This method was tested on 27 schizophrenic patients and based on experimental data. In all cases there was a narrowing of the width of the glomerular zone in the adrenal glands of rats administered the serum of schizophrenic patients intravenously. There was a significant difference in the width of the zone depending upon the stage of the disease and exacerbation, while in experiments, depending upon the presence of antibodies to brain subcommissural organs.


Poly[diacetonitrile-[μ(3)-difluoro-(oxalato)borato]sodium].
The title compound, [Na(C(2)BF(2)O(4))(CH(3)CN)(2)](n), forms infinite two-dimensional layers running parallel to (010). The layers lie across crystallographic mirror planes at y = 1/4 and 3/4. The Na, B and two F atoms reside on these mirror planes. The Na(+) cations are six-coordinate. Two equatorial coordination positions are occupied by acetonitrile mol-ecules. The other two equatorial coordination sites are occupied by the chelating O atoms from the difluoro-(oxalato)borate anion (DFOB(-)). The axial coordination sites are occupied by two F atoms from two different DFOB(-) anions.


False-positive pregnancy test secondary to ectopic expression of human chorionic gonadotropin by a gastrointestinal stromal tumor.
Tumors can rarely overexpress human chorionic gonadotropin (hCG) resulting in false-positive pregnancy tests. Here, we report a 44-year-old female with a metastatic gastrointestinal stromal tumor (GIST) who presented with a positive urine pregnancy test before radiotherapy. Further workup ruled out pregnancy. Following radiotherapy, her metastatic disease progressed and her hCG level continued to rise. To the best of our knowledge, this is the first report of a GIST tumor overexpressing hCG.


A survey of naturally occurring diseases of the Syrian hamster.
Questionnaires on research activities, mortality rates observed in various age groups, extent of examination of dead hamsters, and natural disease conditions and their relative importance were returned by 24 of 43 organisations surveyed in the United States. The average preweaning mortality rate due to all causes was 11-9%. Comparative data from 6 organisations that raised 87 880 hamsters in the calendar year 1971 indicated that 97-5% of total preweaning mortality was due to cannibalism. 13-7% of all animals died before use for experiments. "Wet tail" was the most frequently recognized disease (71%), and it was also listed as the most important. Pneumonia was recognized by 43% of the respondents and was most commonly listed as second in importance. A selective review of the literature is presented on those diseases recognized by more than one survey respondent.


Copper-Catalyzed Enantioselective and Regiodivergent Allylation of Ketones with Allenylsilanes.
We report herein a regiodivergent and enantioselective allyl addition to ketones with allenylsilanes through copper catalysis. With the combination of CuOAc, a Josiphos-type bidentate phosphine ligand and PhSiH3 , allyl addition to a variety of ketones furnishes branched products in excellent enantioselectivities. The regioselectivity is completely reversed by employing the P-stereogenic ligand BenzP*, affording the linear products with excellent enantioselectivities and good Z-selectivities. The linear Z-product could be converted to E-product via a catalytic geometric isomerization of the Z-alkene group. The silyl group in the products could provide a handle for downstream elaboration.


Modification of elastic stable intramedullary nailing with a 3rd nail in a femoral spiral fracture model - results of biomechanical testing and a prospective clinical study.
Elastic stable intramedullary nailing (ESIN) is the standard treatment for displaced diaphyseal femoral fractures in children. However, high complication rates (10-50%) are reported in complex fractures. This biomechanical study compares the stiffness with a 3rd nail implanted to that in the classical 2C-shaped configuration and presents the application into clinical practice. For each of the 3 configurations of ESIN-osteosynthesis with titanium nails eight composite femoral grafts (Sawbones®) with an identical spiral fracture were used: 2C configuration (2C-shaped nails, 2 × 3.5 mm), 3CM configuration (3rd nail from medial) and 3CL configuration (3rd nail from lateral). Each group underwent biomechanical testing in 4-point bending, internal/external rotation and axial compression. 2C and 3CM configurations showed no significant differences in this spiroid type fracture model. 3CL had a significantly higher stiffness during anterior-posterior bending, internal rotation and 9° compression than 2C, and was stiffer in the lateral-medial direction than 3CM. The 3CL was less stable during p-a bending and external rotation than both the others. As biomechanical testing showed a higher stability for the 3CL configuration in two (a-p corresponding to recurvation and 9° compression to shortening) of three directions associated with the most important clinical problems, we added a 3rd nail in ESIN-osteosynthesis for femoral fractures. 11 boys and 6 girls (2.5-15 years) were treated with modified ESIN of whom 12 were '3CL'; due to the individual character of the fractures 4 patients were treated with '3CM' (third nail from medial) and as an exception 1 adolescent with 4 nails and one boy with plate osteosynthesis. No additional stabilizations or re-operations were necessary. All patients achieved full points in the Harris-Score at follow-up; no limb length discrepancy occurred. The 3CL configuration provided a significantly higher stiffness than 2C and 3CM configurations in this biomechanical model. These results were successfully transmitted into clinical practice. All children, treated by 3CL or 3CM according to the individual character of each fracture, needed no additional stabilization and had no Re-Do operations. As a consequence, at our hospital all children with femoral diaphyseal fractures with open physis are treated with this modified ESIN-technique.


Heartbeat Detection in Gyrocardiography Signals without Concurrent ECG Tracings.
A heartbeat generates tiny mechanical vibrations, mainly due to the opening and closing of heart valves. These vibrations can be recorded by accelerometers and gyroscopes applied on a subject's chest. In particular, the local 3D linear accelerations and 3D angular velocities of the chest wall are referred to as seismocardiograms (SCG) and gyrocardiograms (GCG), respectively. These signals usually exhibit a low signal-to-noise ratio, as well as non-negligible amplitude and morphological changes due to changes in posture and the sensors' location, respiratory activity, as well as other sources of intra-subject and inter-subject variability. These factors make heartbeat detection a complex task; therefore, a reference electrocardiogram (ECG) lead is usually acquired in SCG and GCG studies to ensure correct localization of heartbeats. Recently, a template matching technique based on cross correlation has proven to be particularly effective in recognizing individual heartbeats in SCG signals. This study aims to verify the performance of this technique when applied on GCG signals. Tests were conducted on a public database consisting of SCG, GCG, and ECG signals recorded synchronously on 100 patients with valvular heart diseases. The results show that the template matching technique identified heartbeats in GCG signals with a sensitivity and positive predictive value (PPV) of 87% and 92%, respectively. Regression, correlation, and Bland-Altman analyses carried out on inter-beat intervals obtained from GCG and ECG (assumed as reference) reported a slope of 0.995, an intercept of 4.06 ms (R2 > 0.99), a Pearson's correlation coefficient of 0.9993, and limits of agreement of about ±13 ms with a negligible bias. A comparison with the results of a previous study obtained on SCG signals from the same database revealed that GCG enabled effective cardiac monitoring in significantly more patients than SCG (95 vs. 77). This result suggests that GCG could ensure more robust and reliable cardiac monitoring in patients with heart diseases with respect to SCG.


Osteopontin gene expression and protein synthesis in cultured rat mesangial cells.
It is controversial whether osteopontin (OP) is expressed in glomeruli and involved in glomerular diseases. We examined whether the OP expression is present at gene and protein levels in cultured rat mesangial cells (MCs). Northern blotting revealed a 1.7 kb OP-mRNA expression in MCs. Fetal calf serum (FCS) and TNF-alpha increased OP gene expression in serum-starved MCs by 2.7- and 1.8-fold over 24- and 12-hour periods, respectively. PDGF, IL-1beta, and TGF-beta had little effect on OP gene expression. Western blotting detected the OP protein expression (69 kDa). FCS and TNF-alpha increased OP protein expression in serum-starved MCs over 48- and 24-hour periods, respectively. The present study clearly demonstrated the expression of OP gene and protein in cultured rat MCs. Increased OP production under serum or TNF-alpha stimulation suggests that intraglomerular OP may contribute to the development of glomerular diseases.


High-rate amorphous SnO2 nanomembrane anodes for Li-ion batteries with a long cycling life.
Amorphous SnO2 nanomembranes as anodes for lithium ion batteries demonstrate a long cycling life of 1000 cycles at 1600 mA g(-1) with a high reversible capacity of 854 mA h g(-1) and high rate capability up to 40 A g(-1). The superior performance is because of the structural features of the amorphous SnO2 nanomembranes. The nanoscale thickness provides considerably reduced diffusion paths for Li(+). The amorphous structure can accommodate the strain of lithiation/delithiation, especially during the initial lithiation. More importantly, the mechanical feature of deformation can buffer the strain of repeated lithiation/delithiation, thus putting off pulverization. In addition, the two-dimensional transport pathways in between nanomembranes make the pseudo-capacitance more prominent. The encouraging results demonstrate the significant potential of nanomembranes for high power batteries.


Performance of prognostic scores and staging systems in predicting long-term survival outcomes after surgery for intrahepatic cholangiocarcinoma.
We sought to validate the commonly used prognostic models and staging systems for intrahepatic cholangiocarcinoma (ICC) in a large multi-center patient cohort. The overall (OS) and disease free survival (DFS) prognostic discriminatory ability of various commonly used models were assessed in a large retrospective cohort. Harrell's concordance index (c-index) was used to determine accuracy of model prediction. Among 1054 ICC patients, median OS was 37.7 months and 1-, 3-, and 5-year survival, were 78.8%, 51.5%, and 39.3%, respectively. Recurrence of disease occurred in 454 (43.0%) patients with a median DFS of 29.6 months. One-, 3- and 5- year DFS were 64.6%, 46.5 % and 44.4%, respectively. The prognostic models associated with the best OS prediction were the Wang nomogram (c-index 0.668) and the Nathan staging system (c-index 0.639). No model was proficient in predicting DFS. Only the Wang nomogram exceeded a c-index of 0.6 for DFS (c-index 0.602). The c-index for the AJCC staging system was 0.637 for OS and 0.582 for DFS. While the Wang nomogram had the best discriminatory ability relative to OS and DFS, no ICC staging system or nomogram demonstrated excellent prognostic discrimination. The AJCC staging for ICC performed reasonably, although its overall discrimination was only modest-to-good.