The Prognostic Value of Right Ventricular Deformation Imaging in Early Arrhythmogenic Right Ventricular Cardiomyopathy.
The aim of this study was to investigate the prognostic value of echocardiographic deformation imaging in arrhythmogenic right ventricular cardiomyopathy (ARVC) to optimize family screening protocols. ARVC is characterized by variable disease expressivity among family members, which complicates family screening protocols. Previous reports have shown that echocardiographic deformation imaging detects abnormal right ventricular (RV) deformation in the absence of established disease expression in ARVC. First-degree relatives of patients with ARVC were evaluated according to 2010 task force criteria, including RV deformation imaging (n = 128). Relatives fulfilling structural task force criteria were excluded for further analysis. At baseline, deformation patterns of the subtricuspid region were scored as type I (normal deformation), type II (delayed onset, decreased systolic peak, and post-systolic shortening), or type III (systolic stretching and large post-systolic shortening). The final study population comprised relatives who underwent a second evaluation during follow-up. Disease progression was defined as the development of a new 2010 task force criterion during follow-up that was absent at baseline. Sixty-five relatives underwent a second evaluation after a mean follow-up period of 3.7 ± 2.1 years. At baseline, 28 relatives (43%) had normal deformation (type I), and 37 relatives (57%) had abnormal deformation (type II or III) in the subtricuspid region. Disease progression occurred in 4% of the relatives with normal deformation at baseline and in 43% of the relatives with abnormal deformation at baseline (p < 0.001). Positive and negative predictive values of abnormal deformation were, respectively, 43% (95% confidence interval: 27% to 61%) and 96% (95% confidence interval: 82% to 100%). Normal RV deformation in the subtricuspid region is associated with absence of disease progression during nearly 4-year follow-up in relatives of patients with ARVC. Abnormal RV deformation seems to precede the established signs of ARVC. RV deformation imaging may potentially play an important role in ARVC family screening protocols.


Optical Coherence Tomography to Measure Sound-Induced Motions Within the Mouse Organ of Corti In Vivo.
The measurement of mechanical vibrations within the living cochlea is critical to understanding the first nonlinear steps in auditory processing, hair cell stimulation, and cochlear amplification. However, it has proven to be a challenging endeavor. This chapter describes how optical coherence tomography (OCT) can be used to measure vibrations within the tissues of the organ of Corti. These experimental measurements can be performed within the unopened cochlea of living mice routinely and reliably.


Folding pathways and rates for the three-stranded beta-sheet peptide Beta3s using discrete path sampling.
The discrete path sampling method was used to investigate the folding of a three-stranded antiparallel beta-sheet peptide, Beta3s, described by an empirical potential and implicit solvent model. After application of a coarse-graining scheme that groups together sets of minima in local equilibrium, the calculated folding time was in reasonable agreement with other simulations and consistent with the experimental upper bound. The folding mechanism exhibited by the most significant discrete paths involves early formation of the C-terminal hairpin followed by docking of the N-terminal strand.


Dielectric Loss Mechanism in Electromagnetic Wave Absorbing Materials.
Electromagnetic (EM) wave absorbing materials play an increasingly important role in modern society for their multi-functional in military stealth and incoming 5G smart era. Dielectric loss EM wave absorbers and underlying loss mechanism investigation are of great significance to unveil EM wave attenuation behaviors of materials and guide novel dielectric loss materials design. However, current researches focus more on materials synthesis rather than in-depth mechanism study. Herein, comprehensive views toward dielectric loss mechanisms including interfacial polarization, dipolar polarization, conductive loss, and defect-induced polarization are provided. Particularly, some misunderstandings and ambiguous concepts for each mechanism are highlighted. Besides, in-depth dielectric loss study and novel dielectric loss mechanisms are emphasized. Moreover, new dielectric loss mechanism regulation strategies instead of regular components compositing are summarized to provide inspiring thoughts toward simple and effective EM wave attenuation behavior modulation.


Exercise pathophysiology and the role of oxygen therapy in idiopathic interstitial pneumonia.
Exercise limitation is a common feature in idiopathic interstitial pneumonia (IIP). There are multiple contributing pathophysiological mechanisms, including ventilatory mechanical limitation, impaired gas exchange, pulmonary vascular insufficiency and peripheral muscle dysfunction. Progressive exertional dyspnoea and functional incapacity impact significantly on quality of life. Exercise-induced desaturation is frequently observed and is predictive of poorer outcomes. Tests to assess the cardiorespiratory system under stress (e.g. cardiopulmonary exercise testing and the 6-min walk test) can provide important physiologic and prognostic information as adjuncts to resting measurements of lung function. Despite many advances in understanding disease mechanisms, therapies to improve exercise capacity, symptom burden and quality of life are lacking. Exercise training and supplemental oxygen are two potential interventions that require closer evaluation in patients with IIP.


Alcohol consumption and risk of myelodysplastic syndromes: A meta-analysis of epidemiological studies.
Previous studies on the association between alcohol intake and the risk of myelodysplastic syndromes (MDS) have been inconclusive. We conducted a meta-analysis to evaluate alcohol intake as a risk factor for MDS. We performed a systematic literature search of articles published before March, 2014 using Web of Science, PubMed and the Cochrane Library. Two evaluators independently selected and reviewed studies based on predetermined selection criteria. The fixed- or random-effects models were used to summarize the estimates of odds ratios (ORs) with 95% confidence intervals (CIs). A total of 9 studies (8 case-control and 1 cohort) met the inclusion criteria of this meta-analysis. No significant association was observed between alcohol consumption and MDS when comparing drinkers to non-drinkers (OR=1.16, 95% CI: 0.88-1.53) or between subgroups stratified by alcohol history, gender, ethnicity, study design, source of patients or MDS subtypes. However, the data indicated a stronger association of alcohol with MDS in individuals who consumed ≥10 g/day (OR=1.55, 95% CI: 1.08-2.21) vs. those who consumed <10 g/day (OR=1.09, 95% CI: 0.78-1.53). This meta-analysis suggests that alcohol intake may increase the risk of MDS in a dose-dependent manner. However, additional well-designed, prospective cohort studies are required to verify these findings and identify other risk factors associated with MDS.


Distribution of HLA antigens in breast cancer.
Investigation of various tumor-specific markers has a critical role in early diagnosis and treatment of breast cancer. The aim of the this study is to investigate the Human Leukocyte Antigen (HLA) alleles, the molecules that play an important role in immunity and tumor response of the body, and its relationship with breast cancer. In this prospective clinical study, after obtaining approval from the ethics committee of Istanbul University Experimental Medical Research Institute, 22 female patients who have been hospitalized in Istanbul University Cerrahpasa Faculty of Medicine the Department of General Surgery with a diagnosis of breast cancer were selected. In the control group, there were 22 healthy women who had no relationship and were donor candidates for renal transplantation. After collecting blood in 5 ml tubes with EDTA, HLA A, B and DR groups were measured with SSP method using the GenoVision Olerup SSP (Olerup SSP, Stockholm, Sweden) kit in Istanbul University Cerrahpasa Faculty of Medicine Blood Center Tissue Type Determination Laboratory. In patient and control group, totally 53 alleles; 17 alleles of HLA-A gene, 22 alleles of B gene, 14 alleles of DR gene were detected. A statistically significant relationship was determined between HLA-B55:01 and HLA-DRb1*18:01 alleles and the development of breast cancer (p<0.05). HLA-B13:01 antigen is determined only in the control group. It was concluded that HLA-B13:01 antigen, determined only in the control group, may be protective for breast cancer and HLA-B55:01 and HLA-DRb1*18:01 antigens, determined only in the patient group, may be a risk factor for breast cancer (Tab. 5, Ref. 22).


[ISO 9001:2015 Certification in Quality Management].
Quality management improves the structures, processes and results of organizations of all kinds. Many practices and clinics have their existing quality management system certified according to ISO 9001, (e.g., to check their own quality management system or to obtain a testimonial against third parties). The latest version ISO 9001:2015 contains some changes, both structurally and in terms of content. These changes can be met with reasonable efforts. An ISO 9001:2015 certification represents a value for your organization, but these advantages are often not directly measurable.


COVID-19 patients with negative results on initial screening: Experience of Brunei Darussalam.
In any infectious disease outbreak, early diagnosis, isolation of cases and quarantine of contacts are central to disease containment. In Brunei Darussalam, suspected cases of coronavirus disease 2019 (COVID-19) were quarantined either at home or at designated centres and were tested immediately for severe acute respiratory syndrome coronavirus 2. We report on 10 cases of COVID-19 that initially tested negative for COVID-19 and were positive on re-testing after becoming symptomatic. These cases comprised 3.8% of the 266 total confirmed COVID-19 cases in Brunei Darussalam as of 9 July 2021, when this study was conducted. All the cases were in quarantine at home and were tested early during their quarantine period. Since then, home quarantine has been replaced by quarantine at designated centres only, with testing on the 12th day of quarantine.


Silylating reagents: a powerful tool for the construction of isosteric analogs of highly branched odorants.
We have discovered that alpha-[dimethyl(thexyl)silyl]acetaldehyde (= [dimethyl(1,1,2-trimethylpropyl)silyl]acetaldehyde; 31) has a strong, woody odor. Structural analysis has shown resemblance to known odorants with similar organoleptic properties. On the basis of structure-odor relationships, new and more-powerful woody and ambery sila odorants were prepared. Further derivatization led to a set of compounds with very interesting organoleptic properties. Selected chiral compounds were also prepared stereoselectively. The influence of the absolute configuration on the olfactory properties was in agreement with theoretical assumptions. We also designed other groups of organosilicon odorants. The compounds discovered can be obtained in a few simple steps from commercially available reagents, and may find application in the fragrance and flavor industry. Their structures provide interesting data for further research on structure-odor relationships.


[Indication for preventive measures in benign colonic diseases].
For non-malignant colon diseases the indications for preventive measures can be of tumorous and non-tumorous nature. In case of ulcerative colitis and Crohn's colitis local and systemic complications may demand a colectomy. The operative procedures in this case are proctomucosectomy with ileumpouch or ileorectostomy , if continence can be preserved. Mucosal proctectomy with ileumpouch will prevent the obligatory malignant change in familial adenomatosis. The preventive resection in diverticulitis bewares of the complication of the progressive phlegmonous infection of the colonic wall.


Acute Liver Failure Due to Severe Hepatic Metastasis of Small-cell Lung Cancer Producing Adrenocorticotropic Hormone Complicating Ectopic Cushing Syndrome.
A 72-year-old man was admitted to a general hospital with progressive liver dysfunction, hypokalemia, hyperglycemia, and nodules in the lung and liver and then transferred to our institution on the seventh hospital day. Plasma levels of adrenocorticotropic hormone (ACTH), cortisol, and neuron-specific enolase concentrations were extremely high. He developed acute liver failure, his consciousness and general condition deteriorated rapidly, and he died on Day 11. At the postmortem examination, he was found to have extensive metastases from small-cell lung cancer, including advanced hepatic metastases. This is the first reported case of acute liver failure caused by metastases derived from an ACTH-producing pulmonary small-cell carcinoma.


Influence of endurance exercise training status and gender on postexercise hypotension.
In sedentary individuals, postexercise hypotension after a single bout of aerobic exercise is due to a peripheral vasodilation. Endurance exercise training has the potential to modify this response and perhaps reduce the degree of postexercise hypotension. We tested the hypothesis that endurance exercise-trained men and women would have blunted postexercise hypotension compared with sedentary subjects but that the mechanism of hypotension would be similar (i.e., vasodilation). We studied 16 endurance-trained and 16 sedentary men and women. Arterial pressure, cardiac output, and total peripheral resistance were determined before and after a single 60-min bout of exercise at 60% peak oxygen consumption. All groups exhibited a similar degree of postexercise hypotension (approximately 4-5 mmHg; P < 0.05 vs. preexercise). In sedentary men and women, hypotension was the result of vasodilation (Deltaresistance: -8.9 +/- 2.2%). In endurance-trained women, hypotension was also the result of vasodilation (-8.1 +/- 4.1%). However, in endurance-trained men, hypotension was the result of a reduced cardiac output (-5.2 +/- 2.4%; P < 0.05 vs. all others) and vasodilation was absent (-0.7 +/- 3.3%; P < 0.05 vs. all others). Thus we conclude the magnitude of postexercise hypotension is similar in sedentary and endurance-trained men and women but that endurance-trained men and women achieve this fall in pressure via different mechanisms.


The pro-cell death Bcl-2 family member, BNIP3, is localized to the nucleus of human glial cells: Implications for glioblastoma multiforme tumor cell survival under hypoxia.
The Bcl-2 nineteen kilodalton interacting protein 3 (BNIP3) is a hypoxia-inducible proapoptotic member of the Bcl-2 family that induces cell death by associating with the mitochondria. Under normal conditions, BNIP3 is expressed in skeletal muscle and in the brain at low levels. In many human solid tumors, BNIP3 is upregulated in hypoxic regions but paradoxically, this BNIP3 expression fails to induce cell death. Herein, we have determined that BNIP3 is primarily localized to the nucleus of glial cells of the normal human brain, as well as in the malignant glioma cell line U251. Upon exposure of U251 cells to hypoxia, BNIP3 expression in the cytoplasm increases and localizes with the mitochondria, contributing to induction of cell death. In contrast, when BNIP3 is forcibly over expressed in the nucleus, it fails to induce cell death. Expression of N-terminal BNIP3 (lacking the transmembrane and conserved domains) in U251 cells blocks hypoxia-induced cell death acting as a dominant negative protein by binding to wild-type BNIP3 and blocking its association with the mitochondria. In glioblastoma multiforme (GBM) tumors, BNIP3 expression is increased in hypoxic regions of the tumor and is primarily localized to the nucleus in approximately 80% of tumors. Hence, BNIP3 is sequestered in the nucleus within the brain but under hypoxic conditions, BNIP3 becomes primarily cytoplasmic, promoting cell death. In GBMs, BNIP3 expression is increased but it remains sequestered in the nucleus in hypoxic regions, thereby blocking BNIP3's ability to associate with the mitochondria, providing tumor cells with a possible survival advantage.


[Zollinger-Ellison syndrome].
Medical management of patients with Zollinger-Ellison syndrome has considerably evolved since initial reports in 1955 and especially over the last decade. Control of gastric hypersecretion by effective antisecretory drugs, accurate localization and staging of the tumoral process by modern medical imaging techniques as well as progress in surgical skill undoubtedly account for higher rates of gastrinoma definitive or long-lasting cure. Elective surgery for gastrinoma removal may indeed be safely undertaken in selected patients. Current diagnostic and treatment strategies have been discussed here, by reference to the literature and a large personal series of patients followed at Bichat-Claude-Bernard Hospital for 30 years. The specific case of gastrinoma associated with multiple endocrine neoplasia type I is also discussed.


Evaluation of oral medication delivery devices provided by community pharmacies.
Oral liquids remain common medication dosage forms used for patients who have difficulty swallowing. However, liquids require a delivery device and thus have been linked to medication administration errors. This study identified medication delivery devices available at pharmacies. Delivery devices were obtained from area pharmacies and analyzed for units of measurement, abbreviations, and largest/smallest measurable volume. A total of 58 devices were collected from 22 pharmacies. All devices were marked with mL, and 79% were additionally marked in teaspoons. The 5-mL syringe was the only device dispensed at 14% of locations. Other devices included the dosing spoon, dropper, and cup. The largest measurable volume was 30 mL, whereas the smallest was 0.01 mL, with significant variability among devices. A more consistent approach in prescribing units of measurement is needed. Prescribing in milliliters is an optimal choice because of the accessibility of measuring devices containing this measurement.


Pushing the Limits of MALDI-TOF Mass Spectrometry: Beyond Fungal Species Identification.
Matrix assisted laser desorption ionization time of flight (MALDI-TOF) is a powerful analytical tool that has revolutionized microbial identification. Routinely used for bacterial identification, MALDI-TOF has recently been applied to both yeast and filamentous fungi, confirming its pivotal role in the rapid and reliable diagnosis of infections. Subspecies-level identification holds an important role in epidemiological investigations aimed at tracing virulent or drug resistant clones. This review focuses on present and future applications of this versatile tool in the clinical mycology laboratory.


Callosal and intrahemispheric connectivity of the prefrontal association cortex in rhesus monkey: relation between intraparietal and principal sulcal cortex.
Horseradish peroxidase (HRP) histochemistry and double labeling with the fluorescent dyes nuclear yellow (NY) and fast blue (FB) were used to examine and compare the laminar and tangential arrangement of ipsilateral (associational) and contralateral (callosal) neurons and their relative density in three regions of prefrontal granular cortex: Walker's area 46 (principal sulcus), area 8A (superior limb of the arcuate sulcus), and area 11 (lateral orbital sulcus). In all three prefrontal regions, neurons with ipsilateral projections were labeled following injections of tracers into the intraparietal sulcus (IPS) and neurons with callosal projections were sequentially or simultaneously labeled with injections into the contralateral principal sulcus (PS). Quantitative analysis indicates that associational and callosal neurons in prefrontal cortex are distinct cell populations with strikingly similar organization including (1) common topography; (2) common laminar positions in layers III, IV, and V; (3) two- to three-fold higher densities in supragranular than infragranular layers; (4) common morphologies including a high proportion of nonpyramidal soma in the deeper cortical layers; (5) common uneven tangential distribution reminiscent of the interdigitation of their terminal fields; and (6) common subpopulations differing on the basis of terminal arbors. These findings indicate that the posterior parietal cortex and the prefrontal cortex form part of an integrated neural system important for spatiotemporal behaviors.


Characterization of a novel prolactin-related protein from bovine fetal placenta.
The bovine fetal placenta transcribes a family of PRL-related genes that are distinct from the bovine placental lactogen gene. To demonstrate that one of these cDNAs, bovine PRL-related cDNA-I (bPRCI), is expressed at the protein level, a recombinant form of the bPRCI product was overexpressed in Escherichia coli. An antiserum raised against this recombinant product did not cross-react with the pituitary members of the PRL-GH family or with bovine placental lactogen, although cross-reactivity within the bPRC subfamily cannot be ruled out. The antiserum detected a doublet with apparent mol wt of 34,000 and 35,000 in bovine fetal placenta, but not in other fetal tissues. Treatment with several glycosidases revealed a glycoprotein with asparagine-linked carbohydrates of the biantennary complex or hybrid type. We conclude that the bovine fetal placenta expresses at least one of the novel members of this gene family at the protein level.


[Effect of bone marrow cells transplantation on the decidua formation in pseudopregnant rats].
One of the most common causes of the current pregnancy loss is the failure of the decidual reaction of endometrial cells. It is assumed that a partial source of decidual cells in endometrial tissue is bone marrow cells (BMCs). In the present work, we have studied possible effect of BMCs transplantation on the process of decidualization using the model of pseudopregnancy in rats. BMCs were flushed from the rat femurs and tibias. The obtained suspension of single BMCs was injected into one of rat uterine horns on the 5th day of pseudopregnancy. PBS without cells was injected into the contralateral horn served as the control. Rats were sacrificed on the 11th day of pseudopregnancy. Decidua formed in the experimental uterine horn showed an increase in the meso-antimezometral direction of their diameter of about 1.5-2 times as compared with a control horn. The weight of decidual tissue in the experimental horn exceeded 3 times the weight of the control one. The presence of transplanted BMCs in decidual tissue was documented by preliminary double staining of BMCs with membrane dye PKH 26 Red and nuclear dye Hoechst 33342. Histological analysis of decidua sections after transplantation revealed any alterations neither in cell differentiation nor in tissue structure. We conclude that BMCs transplantation stimulates decidualization in animals.


Ergonomic risk and preventive measures of musculoskeletal disorders in the dentistry environment: an umbrella review.
Dental practitioners are exposed to different occupational hazards during the course of their professional activity, such as physical, chemical, biological, ergonomic factors. The ergonomic hazards, caused by strained posture and prolonged repetitive movements, can induce musculoskeletal disorders. It occurs in 54-93% of dental professionals and involve the spine, shoulder and hand-wrist tract. Through a systematic review of international literature, we analyzed specific ergonomic risk factors and preventive measures of musculoskeletal disorders in professional dental activity. This systematic review is coherent with the PRISMA statement. The scientific research on the major online databases was based on the following keywords: dentist, prevention, ergonomic, dentistry, musculoskeletal, neck pain, posture, ergonomics, work and occupational. The studies included in this review focus on disorders related to ergonomics and on the most effective preventive measures to be adopted. No restrictions were applied for language or publication type. We excluded reports not related to ergonomic prevention in dentistry, reports of minor academic significance, editorial articles, individual contributions, and studies published in scientific conferences. Online research indicated 4188 references: PubMed (2919), Scopus (1257) e Cochrane Library (12). We excluded 3012 of these, because they were unrelated to ergonomics theme and 187 due to duplication. From the remaining 989 studies, 960 papers did not meet inclusion criteria and they were excluded. Therefore, we analyzed 29 articles, including 16 narrative reviews and 13 original article. The main risk factor for the development of musculoskeletal disorders found in our analysis is static posture adopted during work, highlighted in 87.5% of reviews and 84% of original articles. With regard to preventive measures, 75% of the reviews highlighted the importance of stretching after each working session and at the end of the working day, while 61.5% of the original articles emphasized the use of modern and ergonomic instruments. This review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis.


Robot-assisted T12 pediculectomy and resection of a ventral thoracic meningioma.
Spinal meningiomas represent 25%-45% of intradural spinal tumors and are commonly seen in the thoracic spine. Ventral midline spinal meningiomas in the thoracic spine are challenging lesions to resect given their location in relation to the spinal cord. Resection for symptomatic or growing lesions requires adequate bone removal to limit retraction of the spinal cord. Surgical adjuncts such as intraoperative navigation, robotics, and ultrasound can improve the efficiency of and safety for resection of these lesions. The authors present a case of a complete resection of a ventral thoracic meningioma using a T12 transpedicular approach with robot-assisted navigated pediculectomy and intraoperative ultrasonography.


Non-apical root canal ramifications in the teeth of dogs.
The roots of 130 extracted teeth were examined for non-apical ramifications from the main canal. Following decalcification and dehydration, the root canals were identified with an Indian ink gel. Secondary canals were found in 4 of the 130 teeth (2.4%), and stumps that may represent incomplete lateral canals were identified in two teeth. We conclude that non-apical root canal ramifications are much less common in dogs compared to humans.


Activities of xanthine oxidoreductase and antioxidant enzymes in different tissues of diabetic rats.
Oxidative stress is an important pathogenic constituent in diabetic endothelial dysfunction. The aim of this study was to investigate whether an increase in oxidative stress related to xanthine oxidoreductase occurs in diabetes. Liver, brain, heart, and kidney xanthine oxidase (XO), xanthine dehydrogenase (XDH), antioxidant enzymes (glutathione peroxidase, superoxide dismutase, catalase), and nitrite levels were measured in control and early and late diabetic rat models. Although diabetes had no impact on liver XO and XDH activity, XDH activity in heart, kidney, and brain was significantly greater in late diabetic rats than in controls. Selenium glutathione peroxidase (GPx) activity was found to be lower in the liver, brain, kidney, and heart of late diabetic rats than in controls. The measured decrease in selenium GPx activity was also observed in early diabetic heart, kidney, and brain. No significant change was observed in liver, brain, and kidney copper/zinc superoxide dismutase (Cu/Zn SOD) activity in early and late diabetic rat models compared with that in controls, whereas heart Cu/Zn SOD activity was significantly decreased in both early and late diabetic rats. Liver and brain catalase activity remained similar among the different experimental groups, whereas increased heart and kidney catalase activity was observed in both early and late diabetic rats. Liver, kidney, and brain nitrite levels were found to be increased in early diabetic rat models compared with those in controls. These data suggest that the increased XDH and decreased selenium GPx activity observed in the later stages of diabetes leads to enhanced oxidative stress in the heart, kidney, and brain, resulting in secondary organ damage associated with the disease.


Pilot clinical study of a fluoride resin and conditioning paste for desensitising dentine.
The clinical trial was carried out on 34 'hypersensitive' teeth in 10 subjects. Dentine sensitivity was measured as the pain perception thresholds to controlled air and probe stimuli. In each subject, pairs of teeth of comparable initial sensitivity were randomly assigned to a test (T) or control (C) treatment. All teeth were cleaned and a conditioning paste applied. Group T was treated with a topically-applied light-cured resin; Group C received a placebo, sham light-cured. Air sensitivity was remeasured after treatment, and the procedures were repeated after 1, 2, and 3 weeks. When comparing air thresholds before and after treatment at each visit, the test agent caused significantly greater reduction in sensitivity than the control. The median increase in air threshold in the test group was 2.5 s at visit no. 1, 1.3 s at visit no. 2 and 0.8 s at visit no. 3. Comparisons of the initial thresholds at each visit showed no significant long-term changes in sensitivity in either group.


Role of inflammation and apoptosis in multiple sclerosis: Comparative analysis between the periphery and the central nervous system.
Multiple sclerosis (MS) is a complex, multifactorial disease associated with damage to the axonal myelin sheaths and neuronal degeneration. The pathognomonic event in MS is oligodendrocyte loss accompanied by axonal damage, blood-brain barrier leakage, inflammation and infiltration of immune cells. The etiopathogenesis of MS is far from being elucidated. However, increasing evidence suggests that the inflammatory and apoptotic responses, occurring in patients either at the peripheral level or the central nervous system (CNS), can play a role. In this review, we give a comprehensive picture of general aspects of inflammation and apoptosis in MS, with special emphasis on the until now not well highlighted possible links between phenomena relevant to these aspects occurring in either the periphery or in the CNS during MS.


Molecular identification of pseudouridine-metabolizing enzymes.
Pseudouridine, a non-classical nucleoside present in human urine as a degradation product of RNAs, is one of the few molecules that has a glycosidic C-C bond. Through a data base mining approach involving transcriptomic data, we have molecularly identified two enzymes that are involved in the metabolism of pseudouridine in uropathogenic Escherichia coli, the principal agent of urinary tract infections in humans. The first enzyme, coded by the gene yeiC, specifically phosphorylates pseudouridine to pseudouridine 5'-phosphate. Accordingly, yeiC(-) mutants are unable to metabolize pseudouridine, in contrast to wild-type E. coli UTI89. The second enzyme, encoded by the gene yeiN belonging to the same operon as yeiC, catalyzes the conversion of pseudouridine 5'-phosphate to uracil and ribose 5-phosphate in a divalent cation-dependent manner. Remarkably, the glycosidic C-C bond of pseudouridine is cleaved in the course of this reaction, indicating that YeiN is the first molecularly identified enzyme able to hydrolyze a glycosidic C-C bond. Though this reaction is easily reversible, the association of YeiN with pseudouridine kinase indicates that it serves physiologically to metabolize pseudouridine 5'-phosphate rather than to form it. YeiN is homologous to Thermotoga maritima IndA, a protein with a new fold, which we now show to act also as a pseudouridine-5'-phosphate glycosidase. Data base mining indicates that most eukaryotes possess homologues of pseudouridine kinase and pseudouridine-5'-phosphate glycosidase and that these are most often associated in a single bifunctional protein. The gene encoding this bifunctional protein is absent from the genomes of man and other mammals, indicating that the capacity for metabolizing pseudouridine has been lost late in evolution.


Relationship between Adherence to the 2019 Canada's Food Guide Recommendations on Healthy Food Choices and Nutrient Intakes in Older Adults.
Following Canada's food guide (CFG) recommendations should ensure adequate nutrient intakes. Older adults have increased needs for certain nutrients and nutrient density; the extent to which adherence to CFG recommendations can help reduce inadequate nutrient intakes is unknown. We aimed to assess the relationship between adherence to CFG recommendations on healthy food choices and intake of key nutrients in adults 65 y and older from the Canadian Community Health Survey 2015 - Nutrition. Secondary analysis of data from 4093 older adults of the Canadian Community Health Survey 2015 - Nutrition (mean age, 73.6 y, 54% females). Dietary intakes were measured using an interviewer-administered 24-h dietary recall, including 1 repeat in a subsample (42%). The National Cancer Institute multivariate method was used to estimate usual (i.e., long-term) dietary intakes. Adherence to CFG recommendations was measured using the Healthy Eating Food Index (HEFI)-2019 score. Simple linear and logistic regression models estimated the effect of increased HEFI-2019 score on usual nutrient intakes and the prevalence of inadequate nutrient intakes (i.e., below the estimated average requirements), respectively. Compared with the prevalence of inadequate intakes at median HEFI-2019 score (46.4/80 points), a higher HEFI-2019 (+11 points) was associated with reductions in the prevalence of inadequate intakes of magnesium, vitamin B6 and protein [-19.8% (95% confidence interval (CI): -30.8, -8.9), -12.7% (95% CI: -22.5, -3.0), and -4.7% (95% CI: -9.4, -0.1), respectively]. In contrast, data for higher HEFI-2019 scores were compatible with increased prevalence of inadequate intakes of folate, vitamin D, and calcium [4.0% (95% CI: -8.4, 16.3), 2.6% (95% CI: 1.1, 4.0), and 2.3% (95% CI: -3.0, 7.5), respectively]. Based on dietary intakes of Canadian older adults in 2015, increasing the degree of adherence to CFG recommendations on healthy food choices may reduce nutrient intake inadequacy for most key nutrients except folate, vitamin D, and calcium.


[Study on the correlation between the polymorphism of --1997g/T site of collagen I alpha 1 gene and bone mineral density in postmenopausal women].
To investigate the relationships between --1997G/T polymorphisms in collagen I alpha 1 gene (COL I A1) upstream regulatory region and bone mineral density(BMD) in postmenopausal women. There were 318 voluntary subjects in Chengdu city enrolled (212 osteoporotic postmenopausal women and 106 normal control subjects) and their BMD were measured by dual-energy X-ray absorptiometry (DEXA ) at lumbar spine (L2-L4). 2 mL peripheral blood was drawn and genomic DNA was extracted from white blood cells. Specific fragment which includes the objective gene was amplified by polymerase chain reaction (PCR); the genotypes of --1997G/T site in COL I A1 were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The PCR products were digested with restriction endonuclease Eco31 I and the result was observed by agarose gel electrophoresis. In the osteoporotic postmenopausal women group, 82 GG, 99 GT and 31 TT were found. In the normal control group, the number of GG, GT and TT were 51, 45 and 10. The subjects in osteoporotic group had higher T allele frequencies than those in normal control group (P < 0.05). In the osteoporotic postmenopausal women, the carriers with TT genotype of -1997G/T polymorphism had lower spine BMD than those with GG genotype or GT genotype (P < 0.05). There is a correlation between -1997G/T polymorphisms in COL I A1 upstream regulatory region and BMD. The TT genotype individuals have lower BMD than other genotype individuals.


Occupational exposure to mineral fibres: analysis of results stored on colchic database.
The aim of this paper is to present fibre exposure data recorded on the COLCHIC database. This database consolidates all occupational exposure data collected in French companies by the Caisses Régionales d'Assurance Maladie (regional health insurance funds, CRAM) and the Institut National de Recherche et de Sécurité (national institute for research and safety, INRS). A total of 8029 concentration results, expressed in number of fibres measured by phase-contrast optical microscopy, are available for exposure to asbestos fibres, ceramic fibres and man-made mineral fibres other than ceramic fibres. Presentation of base data by activity branch, activity sector or workplace permits identification of situations, for which prevention efforts are most essential. Analysis of exposure levels during the 1986-2004 period show that these are broadly influenced by changes in the exposure limit values. Wearing of respiratory protection equipment by employees is also discussed. The data may be helpful to occupational physicians performing occupational screening of exposed workers and to epidemiologists seeking information for building job-exposures matrices. In this respect, a database (FIBREX) will be available on the INRS web site (www.inrs.fr) at the beginning of 2007. This database will provide a higher level of detail in activity and workplace description than that which was possible for practical reasons in this paper.


Acute hypotensive effect of calcium antagonists and endogenous digitalis-like immunoreactivity in human essential hypertension.
Evidence has been provided on the increased presence, in essential hypertension, of endogenous digitalis-like factor(s) [DLIS, digoxin-like immunoreactive substance(s)] able to cross-react with antidigoxin antibodies and to inhibit the membrane-bound sodium-potassium pump. An inhibition of the sodium pump could lead, in smooth muscle cells, to an increase of intracellular calcium ions and to an increase of total peripheral resistances. In this study the relation between plasma levels of DLIS and the acute hypotensive effect of a calcium antagonist (nifedipine) has been evaluated in a group of borderline to severe hypertensive patients and in a control group of normotensive subjects. The results obtained confirm that the hypotensive effect of nifedipine is related to pretreatment blood pressure and show, only in hypertensive patients, a significant relation of DLIS with both pretreatment blood pressure and blood pressure decrement induced by nifedipine. These findings are compatible with a possible role of DLIS in modulating cellular calcium handling.


Daily and yearly burnout symptoms in Israeli shift work residents.
Burnout is a syndrome of physical and emotional exhaustion that develops among individuals who are open to public demands. In view of their heavy work load and sleep deprivation, we decided to evaluate the impact of long working hours on burnout and psychological status among a sample of residents during the first 2 years of their residency. Seventy-eight residents participated in the study, all residents completed self-administered questionnaires, and their sleep-wake cycle was monitored by a wrist-worn actigraph for a period of 5-7 days. The questionnaires included a short form suitable for Experience Sampling Method (ESM), and a longer background Questionnaire. The results revealed that sleep duration, Work Load and the interaction between them, explain the Negative Mood the day after the night shift. However, positive mood, and fatigue were not affected by sleep duration or workload. In general, after one year of residency, residents become more stressed, less involved in the job, and had a high level of burnout and psychosomatic symptoms. However, after the second year, the burnout symptoms were almost the same as at the beginning except for the level of stress that remained high. Sleep duration was unrelated to the burnout symptoms.


Impact of extent of resection on outcome from glioblastoma using the RANO resect group classification system: a retrospective, population-based cohort study.
Extent of resection (EOR) is associated with survival in glioblastoma. A standardized classification for EOR was lacking until a system was recently proposed by the response assessment in neuro-oncology (RANO) resect group. We aimed to assess EOR in an unselected glioblastoma cohort and use this classification system to evaluate the impact on survival in a real-world setting. We retrospectively identified all patients with histologically confirmed glioblastoma in Western Norway between 1.1.2007 and 31.12.2014. Volumetric analyses were performed using a semi-automated method. EOR was categorized according to the recent classification system. Kaplan-Meier method and Cox proportional hazard ratios were applied for survival analyses. Among 235 included patients, biopsy (EOR class 4) was performed in 50 patients (21.3%), submaximal contrast enhancement (CE) resection (EOR class 3) in 66 patients (28.1%), and maximal CE resection (EOR class 2) in 119 patients (50.6%). Median survival was 6.2 months, 9.2 months, and 14.9 months, respectively. Within EOR class 2, 80 patients underwent complete CE resection (EOR class 2A) and had a median survival of 20.0 months, while 39 patients had a near-total CE resection, with ≤1 cm3 CE residual volume (EOR class 2B), and a median survival of 11.1 months, P < 0.001. The 2-year survival rate in EOR class 2A was 40.0%, compared to 7.7% in EOR class 2B. RANO resect group classification for the extent of resection reflected outcome from glioblastoma in a real-world setting. There was significantly superior survival after complete CE resection compared to near-total resection.


Mid-regional pro-atrial natriuretic peptide as a prognostic marker for all-cause mortality in patients with symptomatic coronary artery disease.
In the present study, we investigated the prognostic value of MR-proANP (mid-regional pro-atrial natriuretic peptide). We consecutively evaluated a catheterization laboratory cohort of 2700 patients with symptomatic CAD (coronary artery disease) [74.1% male; ACS (acute coronary syndrome), n=1316; SAP (stable angina pectoris), n=1384] presenting to the Cardiology Department of a large primary care hospital, all of whom underwent coronary angiography. Serum MR-proANP and other laboratory markers were sampled at the time of presentation or in the catheterization laboratory. Clinical outcome was assessed by hospital chart analysis and telephone interviews. The primary end point was all-cause death at 3 months after enrolment. Follow-up data were complete in 2621 patients (97.1%). Using ROC (receiver operating characteristic) curves, the AUC (area under the curve) of 0.73 [95% CI (confidence interval), 0.67-0.79] for MR-proANP was significantly higher compared with 0.58 (95% CI, 0.55-0.62) for Tn-I (troponin-I; DeLong test, P=0.0024). According to ROC analysis, the optimal cut-off value of MR-proANP was at 236 pmol/l for all-cause death, which helped to find a significantly increased rate of all-cause death (n=76) at 3 months in patients with elevated baseline concentrations (≥236 pmol/l) compared with patients with a lower concentration level in Kaplan-Meier survival analysis (log rank, P<0.001). The predictive performance of MR-proANP was independent of other clinical variables or cardiovascular risk factors, and superior to that of Tn-I or other cardiac biomarkers (all: P<0.0001). MR-proANP may help in the prediction of all-cause death in patients with symptomatic CAD. Further studies should verify its prognostic value and confirm the appropriate cut-off value.


Magnetic excitations in the normal and nematic phases of iron pnictides.
In this paper, we theoretically study the behaviors of the magnetic excitations (MEs) in the normal and nematic phases of iron pnictides. The normal state MEs exhibit commensurability to diamond and square-like structure transition with the increase of energy. This structure transition persists in the spin and orbital scenarios of nematic phases, although the MEs show anisotropic behaviors due to the C 4 symmetry breaking induced by the nematic orders. The MEs exhibit distinct energy evolution behaviors between the spin and orbital scenarios of nematicity. For the spin-nematic scenario, the anisotropy of the MEs persists up to the high energy region. In contrast, for the orbital-nematic scenario, it reduces dramatically in the low energy region and is negligible in the high energy region. These distinct behaviors of the MEs are attributed to the different origins between the spin and orbital scenarios of nematic orders.


Comparison of Pax1/9 locus reveals 500-Myr-old syntenic block and evolutionary conserved noncoding regions.
Identification of conserved genomic regions within and between different genomes is crucial when studying genome evolution. Here, we described regions of strong synteny conservation between vertebrate deuterostomes (tetrapods and teleosts) and invertebrate deuterostomes (amphioxus and sea urchin). The shared gene contents across phylogenetically distant species demonstrate that the conservation of the regions stemmed from an ancestral segment instead of a series of independent convergent events. Comparison of the syntenic regions allows us to postulate the primitive gene organization in the last common ancestor of deuterostomes and the evolutionary events that occurred to the 3 distinct lineages of sea urchin, amphioxus, and vertebrates after their separation. In addition, alignment of the syntenic regions led to the identification of 8 noncoding evolutionarily conserved regions shared between amphioxus and vertebrates. To our knowledge, this is the first report of conserved noncoding sequences shared by vertebrates and nonvertebrates. These noncoding sequences have high possibility of being elements that regulate neighboring genes. They are likely to be a factor in the maintenance of conserved synteny over long phylogenetic distance in different deuterostome lineages.


Identification of chicken nebulin isoforms of the 31-residue motifs and non-muscle nebulin.
Nebulin is a very large (M(r) 600-900kDa) actin-binding protein that is specific to skeletal muscle, and which is thought to act as a molecular template that regulates the length of sarcomere thin filaments. The 31-residue motif of nebulin contains a unique PEhXRVKXNQ consensus sequence. We have previously identified 11 different human nebulin isoforms of these 31-residue motifs. Here we present the identification of seven different isoforms (types II, III, IVa, IVb, V, VI, and X) of the 31-residue motifs in 15-day-old chicken embryo breast muscle. Isoform types II and III are also expressed in the brain, and type III is also detected in the heart, stomach, and liver. Chicken nebulin contains 11 copies of the 31-residue motif (R1a/b, R2, R3, R4, R5, R6, R7, R8, R9, R10, and R11), whereas human nebulin contains 13 copies. We confirmed the expression of nebulin in the heart, stomach, and brain in 15-day-old chicken embryos by immunofluorescence microscopy. The presence of nebulin in brain was further confirmed by in situ hybridization. These data suggest that there is even more diversity in nebulin isoforms than was previously known; this diversity likely contributes to the distinct actin filament architecture of different tissues.


Bambuterol: clinical effects of three doses of bambuterol once daily in asthmatic patients.
Twenty-two asthmatics received bambuterol solution, a terbutaline pro-drug, once every evening. The following doses were each given orally for 7 days in a double-blind cross-over study: 0.185, 0.270 and 0.400 mg/kg. Bambuterol 0.270 mg/kg was preferable regarding clinical effects and side effects. The plasma concentration of generated terbutaline showed a slow linear decrease at all doses. Tests of two methods for objective measurements of tremor in five patients did not add any new data compared with the subjective recordings.


Effects of the nitric oxide releasing biomimetic nanomatrix gel on pulp-dentin regeneration: Pilot study.
Successful disinfection alongside complete endodontic tissue regeneration and revascularization are the most desired clinical outcomes of regenerative endodontics. Despite reported clinical successes, significant limitations to the current regenerative endodontic procedure (REP) have been elucidated. To improve the current REP, an antibiotics and nitric oxide (NO) releasing biomimetic nanomatrix gel was developed. The study evaluates antibacterial effects of an antibiotics and NO releasing biomimetic nanomatrix gel on multispecies endodontic bacteria. Antibiotics, ciprofloxacin (CF) and metronidazole (MN) were mixed and encapsulated within the NO releasing biomimetic nanomatrix gel. The gel was synthesized and self-assembled from peptide amphiphiles containing various functional groups. Antibacterial effects of the antibiotics and NO releasing biomimetic nanomatrix gel were evaluated using bacterial viability assays involving endodontic microorganisms including clinical samples. Pulp-dentin regeneration was evaluated via animal-model experiments. The antibiotics and NO releasing biomimetic nanomatrix gel demonstrated a concentration dependent antibacterial effect. In addition, NO alone demonstrated a concentration dependent antibacterial effect on endodontic microorganism. An in vivo analysis demonstrated the antibiotics and NO releasing biomimetic nanomatrix gel promoted tooth revascularization with maturation of root canals. An optimal concentration of and NO releasing nanomatrix gel is suggested for its potential as a root treatment material for REP and an appropriate protocol for human trials. Further investigation is required to obtain a larger sample size and decide upon ideal growth factor incorporation.


Ultralow 0.034 dB/m loss wafer-scale integrated photonics realizing 720 million Q and 380 μW threshold Brillouin lasing.
We demonstrate 0.034 dB/m loss waveguides in a 200-mm wafer-scale, silicon nitride (Si3N4) CMOS-foundry-compatible integration platform. We fabricate resonators that measure up to a 720 million intrinsic Q resonator at 1615 nm wavelength with a 258 kHz intrinsic linewidth. This resonator is used to realize a Brillouin laser with an energy-efficient 380 µW threshold power. The performance is achieved by reducing scattering losses through a combination of single-mode TM waveguide design and an etched blanket-layer low-pressure chemical vapor deposition (LPCVD) 80 nm Si3N4 waveguide core combined with thermal oxide lower and tetraethoxysilane plasma-enhanced chemical vapor deposition (TEOS-PECVD) upper oxide cladding. This level of performance will enable photon preservation and energy-efficient generation of the spectrally pure light needed for photonic integration of a wide range of future precision scientific applications, including quantum, precision metrology, and optical atomic clocks.


Quantitative in vivo assay of human granulocyte colony-stimulating factor using cyclophosphamide-induced neutropenic mice.
Administration of human granulocyte colony-stimulating factor (hG-CSF) to mice with cyclophosphamide (CPA)-induced neutropenia for 4 consecutive days from the day after the CPA dosing (100 mg/kg) resulted in a dose-dependent increase in the peripheral blood neutrophil count 6 hours after the final hG-CSF injection. Within the hG-CSF dose range of 0.1 to 10 micrograms per mouse per day, there was a strong linear relationship (r greater than .9) between the logarithm of the dose and the peripheral blood neutrophil count in the treated mice. Using the same hG-CSF preparation, 38 experiments indicated that the regression lines are highly reproducible. Such an association never occurred with intact mice, and 100 mg/kg of CPA induced the highest response to hG-CSF. This linear relationship between the two variables allows us to determine the biologic potency of a test hG-CSF preparation relative to a reference standard using a parallel line assay, with a coefficient of precision of around .2. When assayed by this bioassay procedure, which we have termed CPA-mouse assay, natural hG-CSF and recombinant hG-CSF (produced by Chinese hamster ovary cells) were nearly equipotent in specific biologic activity. These results confirm the CPA-mouse assay as an especially useful assay method for quantifying the in vivo activity of hG-CSF.


Volume scattering ratios determined by the polar and the integrating nephelometer: a comparison.
Polar nephelometer and integrating nephelometer measurements of the volume scattering coefficient for well-documented aerosols were made as a part of the First International Workshop on light absorption by aerosol partioles. These measurements showed a good overall agreement between the two methods, with an average difference between the polar nephelometer and integrating nephelometer data of approximately 10%.


Transcriptome and molecular regulatory mechanisms analysis of gills in the black tiger shrimp Penaeus monodon under chronic low-salinity stress.
Background: Salinity is one of the main influencing factors in the culture environment and is extremely important for the survival, growth, development and reproduction of aquatic animals. Methods: In this study, a comparative transcriptome analysis (maintained for 45 days in three different salinities, 30 psu (HC group), 18 psu (MC group) and 3 psu (LC group)) was performed by high-throughput sequencing of economically cultured Penaeus monodon. P. monodon gill tissues from each treatment were collected for RNA-seq analysis to identify potential genes and pathways in response to low salinity stress. Results: A total of 64,475 unigenes were annotated in this study. There were 1,140 upregulated genes and 1,531 downregulated genes observed in the LC vs. HC group and 1,000 upregulated genes and 1,062 downregulated genes observed in the MC vs. HC group. In the LC vs. HC group, 583 DEGs significantly mapped to 37 signaling pathways, such as the NOD-like receptor signaling pathway, Toll-like receptor signaling pathway, and PI3K-Akt signaling pathway; in the MC vs. HC group, 444 DEGs significantly mapped to 28 signaling pathways, such as the MAPK signaling pathway, Hippo signaling pathway and calcium signaling pathway. These pathways were significantly associated mainly with signal transduction, immunity and metabolism. Conclusions: These results suggest that low salinity stress may affect regulatory mechanisms such as metabolism, immunity, and signal transduction in addition to osmolarity in P. monodon. The greater the difference in salinity, the more significant the difference in genes. This study provides some guidance for understanding the low-salt domestication culture of P. monodon.


Approach to pain management in chronic opioid users undergoing orthopaedic surgery.
Opioids are commonly used for the management of pain in patients with musculoskeletal disorders; however, national attention has highlighted the potential adverse effects of the use of opioid analgesia in this and other nonmalignant pain settings. Chronic opioid users undergoing orthopaedic surgery represent a particularly challenging patient population in regard to their perioperative pain control and outcomes. Preoperative evaluation provides an opportunity to estimate a patient's preoperative opioid intake, discuss pain-related fears, and identify potential psychiatric comorbidities. Patients using high levels of opioids may also require referral to an addiction specialist. Various regional blockade and pharmaceutical options are available to help control perioperative pain, and a multimodal pain management approach may be of particular benefit in chronic opioid users undergoing orthopaedic surgery.


Reverse sural flap for ankle and heel soft tissues reconstruction.
Introduction: The potential of the medial calf integument, as donor site for a free flap based on musculocutaneous branches of the medial sural artery, was first identified by Taylor and Daniel, following cadaver investigation. In 1981, Pontén described the fasciocutaneous sural flap as a reconstructive option for soft tissue loss of the lower extremity, particularly around the knee. Two years later, Donski and Fogdestram presented the distally based fasciocutaneous flap from the sural region followed by Montegut and Allen who considered the sural artery perforator flap as a viable alternative for the gastrocnemius myocutaneous flap. The sural flap proved a considerable versatility at the level of the lower leg (from the knee to the ankle and heel) as well as for other anatomical regions. The most common usage of the flap is for the distal-third defects of the leg. Materials and method: A group of 10 patients with soft tissue losses at the ankle or heal due to a various etiopathogeny represented by cancer excision, trauma, unstable scars, chronic osteomyelitis, in which a microsurgical free transfer had no indication or was not wanted, was presented. Our group reported a 30% complication rate in a high-risk patient population, including patients with diabetes mellitus, peripheral vascular disease, and venous insufficiency. Results: All the defects were covered successfully, without major complications. Usually, only a minor margin of the tip of the flap was lost, which was easily solved with a guided secondary healing. Most flaps showed a slight venous congestion, which cleared in a few days. The functional result was very good in all the patients, while the aesthetic appearance was acceptable even in female patients. Discussion: An ideal indication of a reverse sural flap may be a defect over an intact but partially exposed Achilles tendon. Conclusions: The sural reverse flap is useful in the ankle and foot soft tissues reconstruction whenever we have reasons not to use a microsurgical free transfer. Venous congestion with consecutive partial or complete flap loss is a common complication, so this would not be recommended in patients with obvious acute or chronic venous stasis. The reverse sural island flap should no longer be regarded as a flap of secondary choice to free tissue transfer, but as an equally valuable alternative for small and midsized defects around the ankle and heel.


Halothane abuse in hospital personnel.
Deaths assoicated with halothane abuse have occurred in employees in three different hospitals. The medical profession should be aware of the potential for abuse in this anesthetic drug.


A domain of the thyroid adenoma associated gene (THADA) conserved in vertebrates becomes destroyed by chromosomal rearrangements observed in thyroid adenomas.
THADA, mapping to chromosomal band 2p21 is target gene of specific chromosomal rearrangements observed in thyroid benign tumors. Thus, it is one of the most common gene targets in chromosomal rearrangements in benign epithelial tumors. Nevertheless, nothing is known about the function of its protein. Therefore, we have analyzed the genetic structure of THADA homologous genes in selected vertebrates (Canis familiaris, Chlorocebus aethiops, Gallus gallus, and Mus musculus), which are not characterized up to now. The coding sequences of the mRNA of these species have been sequenced and analyzed revealing similarities to ARM repeat structures which indicates an involvement in protein-protein interactions. Using multiple alignments we identified the most conserved part of the protein (aa 1033-1415 Homo sapiens) with an identity of 70.5% between the most different organisms implying a putative important functional domain. The truncations observed in human thyroid adenomas disrupt this conserved domain of the protein indicating a loss of function of THADA contributing to the development of the follicular neoplasias of the thyroid.


Risk Assessment in Mental Health Practice: An Integrative Review.
Although risk assessment in mental health practice can influence and measure treatment outcomes and level of care provision, risk assessment practices are not standardised and different screening tools are used. The aim of this integrative review was to review the literature on risk assessment in mental health practice to promote evidence-based care. Electronic databases were searched for articles available in English and published from 2013 to 2019. The findings from 12 articles evaluated the evidence for risk assessment tools utilised and discussed the justification, barriers and enabling factors for risk assessment. Lastly, recommendations were made to improve risk assessment.


Signification of forkhead box A1 (FOXA1) expression in thyroid cancers.
Forkhead box A1 (FOXA1) plays an important role in several tumors. This study investigated the potential role of FOXA1 expression in thyroid tumors. We conducted a retrospective study of 110 thyroid lesions and tumors diagnosed during 1995-2018. The expression of FOXA1 was analyzed by immunohistochemistry on archival material. No FOXA1 immunostaining was observed in all cases of Graves' disease, Hashimoto's disease, multi-nodular goiter, and adenoma. FOXA1 expression was absent as well in all papillary and follicular carcinomas, Hurthle cell carcinoma, and undifferentiated sarcoma. Only three anaplastic carcinomas exhibited focally FOXA1 staining. However, FOXA1 was expressed in all medullary carcinomas. No significant correlation was found with all clinicopathological features (p > 0.05 for all). The pattern of FOXA1 staining was similar to that of calcitonin and chromogranin A (p = 0.04 and p = 0.003, respectively). FOXA1 is expressed mostly in all medullary thyroid carcinomas. Hence, FOXA1 could serve as an additional marker for refining the diagnosis of medullary thyroid carcinoma.


Surgical outcomes in 31 patients with craniopharyngiomas extending outside the suprasellar cistern: an evaluation of the frontobasal interhemispheric approach.
Craniopharyngiomas frequently grow from remnants of the Rathke pouch, which is located on the cisternal surface of the hypothalamic region. These lesions can also extend elsewhere in the infundibulohypophyseal axis. The aim of this study was to establish the usefulness of the frontobasal approach made through a relatively small craniotomy window for the removal of tumors protruding from the sellar-suprasellar region into the third and basal cistern. Thirty-one patients who were surgically treated for craniopharyngiomas extending outside the sellar-suprasellar region were evaluated. The diagnoses were established in all cases by using magnetic resonance and computerized tomography imaging. The initial symptoms and signs were increased intracranial pressure in eight, vision impairment or visual field defect in 16, hypopituitarism in 17, and psychological disturbances in three cases. All patients underwent surgery via the frontobasal interhemispheric approach, and the average follow-up period was 30 months. Total removal of the lesion was achieved in 22 cases, six patients underwent subtotal resection, and three underwent partial removal due to tumor recurrence after previous surgeries performed with or without adjunctive radiotherapy. Major complications, including impairment of the cranial nerves, were not observed in the immediate postoperative period. One patient exhibited transient memory disturbance due to infarction of the perforating vessels; after 3 months this symptom was ameliorated. None of the patients died during long-term follow up; however, four of the 22 who underwent total removal and six of the nine patients who underwent subtotal or partial removal suffered recurrence. Of the 10 patients with recurrence, six experienced a small recurrence of the lesion (average 3 months postsurgery); after gamma knife surgery (GKS), the size of two of the lesions was unchanged and in four reoperation was performed due to tumor enlargement during the follow-up period. Ultimately, a total of eight patients (four with recurrence and four who had been treated with GKS) underwent reoperation, with gross-total removal via the same approach or combined with the orbitozygomatic approach in patients with very short optic nerves. In no patient was deterioration of visual acuity and visual field observed after surgery. Although all patients except four children and one adult were receiving some form of hormone replacement therapy, their endocrine status was stably controllable. In the authors' experience, the frontobasal interhemispheric approach, even made through a small craniotomy window, is a valid choice for the removal of craniopharyngiomas extending outside the sellar-suprasellar region. Via this approach, tumors can be removed without significant sequelae related to the surgical method, due to ease of preservation of the pituitary stalk, hypothalamic structures, and perforating vessels. This approach offers a safe and minimally invasive means of treating craniopharyngiomas.


Low-energy theory for strained graphene: an approach up to second-order in the strain tensor.
An analytical study of low-energy electronic excited states in uniformly strained graphene is carried out up to second-order in the strain tensor. We report a new effective Dirac Hamiltonian with an anisotropic Fermi velocity tensor, which reveals the graphene trigonal symmetry being absent in first-order low-energy theories. In particular, we demonstrate the dependence of the Dirac-cone elliptical deformation on the stretching direction with respect to graphene lattice orientation. We further analytically calculate the optical conductivity tensor of strained graphene and its transmittance for a linearly polarized light with normal incidence. Finally, the obtained analytical expression of the Dirac point shift allows a better determination and understanding of pseudomagnetic fields induced by nonuniform strains.


Treating rheumatoid arthritis.
Rheumatoid arthritis (RA) affects about 1% of the world's population and can lead to loss of joint function, reduced mobility, and permanent damage to cartilage and bone. Treatment options for RA primarily include disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, but the development of new drugs has complicated treatment decisions. Weighing treatment options for patients with RA largely depends on three major factors: efficacy, adverse reaction profile, and cost. A review of the literature supports methotrexate monotherapy as the current best-practice model for treating RA, compared with combination therapy of methotrexate and/or other DMARDs.


Recording of the retruded position of the mandible in patients with mandibular dysfunction.
The precision (reproducibility) of active and passive recordings of the retruded position of the mandible was studied by two examiners on 10 patients with mandibular dysfunction symptoms. The position of the mandible was recorded with an intra-oral graphic method, before and after treatment of the symptoms. The precision of the recording was highest when the retruded position was recorded by passive hinge movement and lowest when it was recorded by active hinge movement and when recording habitual closure. Both systematical and accidental errors tended to be somewhat larger among these patients than that previously found among individuals without signs or symptoms of mandibular dysfunction. The accidental errors in antero-posterior and medio-lateral directions were the same fo both examiners and of the same magnitude before and after treatment of the symptoms. Both examiners recorded the retruded position on the average 0.20 mm more posterior after treatment than before. The results showed that because of its good reproducibility the retruded position of the mandible can be recommended as a reference position in functional analysis of occlusion and for jaw recordings also in patients with TMJ muscle-pain dysfunction symptoms. During the recording the conventional technique with passive hinge movement and a posterior pressure should be used.


Expression of transient receptor potential melastatin 7 up-regulated in the early stage of renal ischemia-reperfusion.
Transient receptor potential melastatin 7 (TRPM7), a bifunctional protein with kinase and ion channel activities, was first reported in 2001. Later studies suggested that the functions of TRPM7 related to cancer, ischemic injury, and hypertension. We examined whether TRPM7 expression changed in renal ischemia-reperfusion injury (RIRI). Seventy male Sprague-Dawley rats weighing 220-250 g were randomly divided into 7 groups of 7 rats each; every group had a sham-operated cohort of 3 rats. After the right kidney was removed, the rats underwent 45 minutes of left renal artery occlusion followed by reperfusion for 1, 12, 24, 48, 72, or 96 hours. There after the expression of TRPM7 messenger RNA (mRNA) was measured using real-time polymerase chain reaction (RT-PCR) and the protein using Western blot. Compared with the control group, the expression of TRPM7 mRNA was significantly up-regulated at 24 hours after ischemia-reperfusion. We set the expression of TRPM7 mRNA of the control group as the baseline (1.0), with the 1-hour, 12-hour, 24-hour, 48-hour, 72-hour and 96-hours showing 2.83, 3.16, 3.95, 0.31, 0.82, and 1.13, respectively (n = 7; P < .05). TRPM7 protein expression showed the same trends as the mRNA. The main change in TRPM7 protein was located in tubular cells. The expressions of TRPM7 mRNA and protein levels was up-regulated at 24 hours after renal ischemia.


Olfactory Dysfunction in IgG4-Related Disease.
IgG4-related disease is a newly recognized systemic disease, and its elucidation is progressing. However, little is known about its sinonasal manifestations. The aim of this study was to assess the olfaction of patients with IgG4-related disease. Twenty-five patients with IgG4-related disease underwent T&T olfactometry to measure olfactory function. We analyzed the clinical features, including serum IgG4 and IgE levels, involved organs, and sinonasal computed tomography scores to explore the etiology of olfactory dysfunction. Thirteen patients with IgG4-related disease were found to have moderate to severe olfactory dysfunction (52%). There were no differences in the clinical features between the olfactory dysfunction group and the normal group. In 7 patients, the inferior turbinate was biopsied to study the correlation between olfaction score and the number of IgG4-positive cells, but no such correlation was found. Six hyposmia patients recovered to a normal state. Five patients recovered after corticosteroid treatment and 1 recovered spontaneously. We found that the prevalence of olfactory dysfunction was high in patients with IgG4-related disease and that it could be reversed. Olfactory dysfunction appears to be a novel important manifestation of IgG4-related disease.


Association of Supported Employment With Cognitive Functioning and Employment Outcomes.
Cognitive functioning affects employment outcomes in supported employment. This study examined which cognitive parameters are associated with employment outcomes for persons with mental illnesses and discusses possible mechanisms involved. Data stem from a randomized controlled trial conducted as part of the Zürich Impulse Program for the Sustainable Development of Mental Health Services (ZInEP). A sample of 116 patients in supported employment was recruited, coached, and followed up. Factor analysis and logistic regression were used to determine cognitive parameters associated with employment outcomes. Results showed that verbal learning was positively associated with better employment outcomes (any job and employment for at least three months). Results of this study imply that training in verbal learning should be included in supported employment programs. More generally, elaborated models are needed to explain interactions between cognitive functioning, supported employment, and employment outcomes and to enhance understanding of the interrelationships between cognitive functioning, employment outcomes, and any mediating and moderating variables.


Updates in weight loss surgery and gastrointestinal peptides.
Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy are referred to as 'metabolic surgery' due to hormonal shifts with impacts on diabetes remission and weight loss. The purpose of this review is to summarize recent findings in mechanisms underlying beneficial effects of weight loss surgery. Importantly, gut hormone secretion is altered after RYGB and sleeve gastrectomy due to accelerated transit of nutrients to distal parts of the small intestine, leading to excessive release of L-cell peptide hormones [e.g. glucagon-like peptide-1 (GLP-1), peptide YY].Improved glucose metabolism after RYGB and sleeve gastrectomy involves several mechanisms: early increased hepatic insulin sensitivity, resulting from reduced liver fat content in response to the postoperative caloric restriction, improved beta-cell function mediated by exaggerated postprandial GLP-1 secretion; as demonstrated by relapse of impaired glucose tolerance in studies blocking the GLP-1 receptor by exendin 9-39, and later after major weight loss increased peripheral insulin sensitivity. Gut hormone secretion changes towards a more anorectic profile and is likely important for less caloric intake and weight loss. Changes in gut hormone secretion after RYGB and sleeve gastrectomy surgery induce the beneficial effects on weight and glycemic control through the influence on appetite regulation and insulin secretion.


Horses seropositive for Toxoplasma gondii, Sarcocystis spp. and Neospora spp.: Possible risk factors for infection in Brazil.
Many parasitic diseases are considered asymptomatic, even though some studies have shown that they may cause pathological changes in the host. Therefore, the aim of this study was to evaluate the occurrence of antibodies against Toxoplasma gondii, Neospora spp. and Sarcocystis spp. in horses, and to identify the risk factors for disease. For this, 174 horses were studied, 90 males and 84 females aged between two and 20 years old. Blood samples were collected and stored in tubes without anticoagulant to obtain serum, which was subjected to serological tests for T. gondii, Sarcocystis spp., and Neospora spp. using indirect immunofluorescence assay (IFA). IFA results were as follows: Sarcocystis spp. 41.37% (72/174) (CI95%-34.05-49.09); T. gondii 32.18% (56/174) (CI95%-25.42-39.74) and Neospora spp. 48.27% (84/174) (CI95%-40.68.50-55.93). Out of 174 horses, 81 had simple infection, 61 had mixed infections with two or three of these pathogens, and therefore, only 32 horses showed no antibodies to any of these pathogens. No risk factors for Sarcocystis spp. and T. gondii infection were identified. However, there was a significant (1.22-CI95%-1.02-1.52) relationship between animal age and Neospora spp. infection, since older animals showed higher prevalence. Therefore, it was possible to conclude that T. gondii and Neospora spp. affect horses in Southern Brazil, however all the animals studied were asymptomatic without reproductive, neurological or locomotor problems.


Gender differences in sociodemographic and behavioural factors associated with BMI in an adult population in rural Burkina Faso - an AWI-Gen sub-study.
The global health transition is linked with an increased burden of non-communicable diseases with cardiovascular diseases leading the epidemic. In sub-Saharan Africa (SSA), the prevalence of obesity has increased during the past decades and there is a need to investigate the associated driving factors. In Burkina Faso obesity remains low, especially in rural areas. In this study we recruited middle-aged adults, as part of a larger study on genetic and environmental contributions to cardiometabolic disease among Africans. To investigate the distribution of BMI and prevalence of obesity in a cross-sectional population-based study and to determine the sociodemographic and behavioural correlates with BMI. Participants (N = 2,076) were recruited from the Nanoro Health and Demographic Surveillance System area and were aged 40-60 years. We applied hierarchical modelling to identify factors associated with BMI and structural equation modelling to identify mediated effects of sociodemographic and behavioural variables on BMI. Data are presented on 2,076 participants (49.9% female). Men had significantly higher BMI than women with medians of 21.1 (19.2 - 23.4) vs 19.8 (18.1 - 21.6) (p < 0.001), and there were significantly more underweight women compared to men (31.0% vs 17.4%) (p < 0.001). More men were overweight and obese than women (11.9% vs 5.2% and 2.2% vs 1.4%). Socioeconomic status was the major contributor to increased BMI for men, and education was the main contributor in women. Tobacco smoking and chewing, and problematic alcohol consumption were associated with a decrease in BMI in men and women. Overweight and obesity are relatively low among adults in rural Burkina Faso, and men had a higher median BMI than women. Behavioural factors, including tobacco use and alcohol consumption, contributed to a decrease in BMI, whereas socioeconomic status and education (which were both generally low in this community) contributed to an increase in BMI.


Trace Ammonia Sensors Based on Fluorescent Near-Infrared-Emitting aza-BODIPY Dyes.
Highly sensitive ammonia sensors for environmental monitoring are presented. The sensing materials are based on fluorescent BF2-chelated tetraarylazadipyrromethene dyes (aza-BODIPYs) dyes physically entrapped in polyurethane hydrogels and dispersed in silicone rubber. This layer is covered by a hydrophobic porous Teflon membrane used as an additional proton barrier and light scattering layer. The dual-lifetime referenced (DLR) sensors make use of near-infrared (NIR)-emitting Egyptian blue as a reference material and in combination with optical fibers are read-out via a compact phase-fluorometer. The detectable concentration range can be tuned by the choice of aza-BODIPY dye or/and the hydrogel matrix. The most sensitive sensor has a limit of detection (LOD) of 0.11 μg/L and the upper detectable concentration of 300 μg/L. No cross-sensitivity toward pH is observed. The sensors show remarkable operational stability with no noticeable drift over a period of 2 weeks.


Invasive mould infections in the ICU setting: complexities and solutions.
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution. ICU patients should start adequate antifungal therapy upon suspicion of invasive aspergillosis, without awaiting definitive proof. Voriconazole, and now isavuconazole, are the drugs of choice. Mucormycosis is a rare, but increasingly prevalent disease that occurs mainly in patients with uncontrolled diabetes mellitus, immunocompromised individuals or previously healthy patients with open wounds contaminated with Mucorales. A high proportion of cases are diagnosed in the ICU. Rapidly progressing necrotizing lesions in the rhino-sinusal area, the lungs or skin and soft tissues are the characteristic presentation. Confirmation of diagnosis is based on demonstration of tissue invasion by non-septate hyphae, and by new promising molecular techniques. Control of underlying predisposing conditions, rapid surgical resection and administration of liposomal amphotericin B are the main therapeutic actions, but new agents such as isavuconazole are a promising alternative. Patients with mucormycosis receive a substantial part of their care in ICUs and, despite advances in diagnosis and treatment, mortality remains very high.


Dilated Thoracic Esophagus Presenting with Painful Progressive Persistent Dysphagia and Leukocytosis of Unknown Origin.
Esophageal cancer is the eighth-most common cause of cancer-related mortality worldwide. The most common presenting symptom in advanced distal esophageal cancer is the sensation of sticking food, but it may sometimes present with bleeding and related complications, or asymptomatic leukocytosis. We present the case of a 77-year-old afebrile man with chronic alcoholism and a dilated thoracic esophagus with painful, progressive, and persistent dysphagia and leukocytosis of unknown origin. A 77-year-old man with a past medical history of hypertension and colonic cancer status post right hemicolectomy (surveillance negative) presented to the emergency department with painful, progressive, persistent, and worsening dysphagia for the past three weeks. It was associated with an unintentional weight loss of ten pounds in one month and nausea with non-bilious and non-bloody vomiting for several days. He denied fever, diarrhea, hoarseness of voice, change in bowel movement, hematemesis, hematochezia, melena, orthopnea, dyspnea at rest, palpitation, and abdominal pain. A chest x-ray (lateral view) showed debris in a dilated thoracic esophagus with fluid. An esophagogram showed a 10 x 3 cm obstructive mass with irregular mucosa within the proximal esophagus from the thoracic vertebra levels four to ten. A computed tomography scan of the chest with contrast showed long segment dilatation of the upper and mid-thoracic esophagus with generalized circumferential thickening of the distal esophagus. He was empirically on cefazolin and metronidazole but later switched to piperacillin, tazobactam, and fluconazole. Cardiac risk stratification was done for an esophagogastroduodenoscopy. However, the patient and the family opted for palliative care and agreed to a do-not-resuscitate/do-not-intubate status. In esophageal cancers, tumor-related leukocytosis and neutrophilia are common presentations. However, there is no standardized routine screening test for esophageal cancers. Thus, when asymptomatic afebrile elderly patients present with leukocytosis of unknown origin, clinicians should have suspicions of occult malignancy such as esophageal cancers, gastric cancer, and pancreatic cancer.


Asymmetry of methylation with FMR-1 full mutation in two 45,X/46,XX mosaic females associated with normal intellect.
The full FMR-1 mutation is known to cause the fragile X syndrome [Fra(X)], but variable expression in females, including normal to deficient intellect, may be related to random X-inactivation (lyonization). We have evaluated 2 mosaic 45,X/46,XX females who are cytogenetically fra(X) positive, have an FMR-1 full mutation, and are of normal intellect. There were 50% fra(X) chromosomes in the 45,X cells of one of the females; this has not been reported previously. In both patients, there was a strong asymmetry of FMR-1 methylation with the normal allele being totally or 90% unmethylated and the mutant allele being similarly methylated. Thus, the apparent selective inactivation of the full mutant FMR-1 allele appears to have resulted in limited expression with normal intellect. The presence of the fra(X) chromosome in 45,X cells is unique; however, there may be no relationship to the asymmetric inactivation of the mutant allele which could be due to chance or a mechanism yet to be delineated.


[Possibilities of Computed Tomography of the Heart in Risk Stratification and Determination of Optimal Strategy of Primary Prevention of Cardiovascular Complications of Atherosclerosis].
Modern strategies of primary prevention of cardiovascular complications of atherosclerotic etiology are presented in this article: traditional approach based on assessment of risk of development of complication and coming to replace it concept of prevention based on direct application of results of prospective clinical studies. The article contains detailed presentation of new opportunities of computer tomography of the heart allowing to substantially elevate precision of assessment of risk of cardiovascular complications of atherosclerotic etiology. Main attention is paid to the coronary artery calcification index, which determination substantially simpli- fies decision making relative to strategy of primary prevention in clinical practice.


Changes in the tumor marker concentration in female patients with hyper-, eu-, and hypothyroidism.
The levels of 6 circulating tumor markers were evaluated in a total of 131 female subjects with altered thyroid states; 36 normal subjects, 46 hyperthyroid patients with Graves' disease, and 49 primary hypothyroid patients. The mean CEA concentration was observed to be significantly higher (p less than 0.02) in hypothyroid patients than in normal and hyperthyroid patients (1.1 +/- 0.1 ng/ml, 0.8 +/- 0.1 ng/ml and 0.8 +/- 0.1 ng/ml, respectively). Similarly, the mean serum CA 125 concentration in hypothyroid patients was higher (p less than 0.02) than in normal and hyperthyroid patients (13.0 +/- 2.6 U/ml, 7.6 +/- 1.1 U/ml and 5.5 +/- 0.8 U/ml, respectively), and the mean serum CA 15-3 concentration in hypothyroid patients was significantly higher than in normal subjects (p less than 0.01) and hyperthyroid patients (p less than 0.001) (16.2 +/- 0.9 U/ml, 13.9 +/- 0.6 U/ml and 10.6 +/- 0.5 U/ml, respectively). No statistical difference was found in mean CA 19-9 in the three subject groups. AFP in the hypothyroid patients (3.6 +/- 0.3 ng/ml) was significantly higher (p less than 0.05) than in normal subjects (2.6 +/- 0.2 ng/ml) and hyperthyroid patients (1.7 +/- 0.2 ng/ml) (p less than 0.01). On the other hand, serum ferritin was low in the hypothyroid patients (65.9 8.0 ng/ml) and significantly increased (69.1 +/- 9.0 ng/ml) (p less than 0.02) with the normalization of thyroid function. In hyperthyroidism, serum ferritin (70.2 +/- 7.0 ng/ml) was significantly higher than in the hypothyroid patients (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)


Yup'ik identity and socioeconomic status are associated with child consumption of traditional food and weight in rural Yup'ik communities.
In remote, Alaska Native communities, traditional foods remain a significant source of essential nutrients and appear to protect against the development of chronic diseases. Relatively low intake of traditional foods among Alaska Native children is therefore of concern. The aim of this study was to identify household and parental predictors of child traditional food (TF) consumption and weight in remote Yup'ik communities of Alaska. Children (10-18 years old) and parents in two communities (populations <500) were invited to participate in this cross-sectional study. Intake of traditional foods among children and parents was estimated from two-24 h recalls using NDS-R. Weight and height were measured and BMI calculated. Sociodemographic factors, including income and education, were collected from parents. A partial least square path modeling analysis and bootstrapping were performed to identify predictors of child TF consumption and weight. Parental intake of traditional foods, Yup'ik identity and income were positively associated with child intake of traditional foods. Further, parental intake of traditional foods predicted lower child BMI. Parental education was negatively associated with child traditional food intake and positively associated with child BMI. Findings suggest that interventions targeting parents may be an effective strategy to increase intake of traditional foods and improve diet quality among Alaska Native youth.


Prelicensure Nursing Students' Attitudes and Perceptions of End-of-Life Care.
It is important that education on palliative care begin early in prelicensure nursing education because of the complex care needs of patients requiring end-of-life care. Nursing students often lack confidence and skills in providing quality care for these patients. Nursing students' attitudes on end-of-life care were assessed using the Frommelt Attitudes Toward Care of the Dying scale. Students were tested as sophomores, then again as seniors, in a nursing program where the End-of-Life Nursing Education Consortium (ELNEC) curriculum had previously been integrated. Seniors reported improved comfort levels providing end-of-life care. Assessing for improved comfort levels among nursing students who receive ELNEC training could help support ongoing efforts to integrate this education in all nursing programs. Students who had formal education in end-of-life care were more comfortable caring for patients at end of life and had a better understanding of their role.


[Clinical experiences of Professor Li Zhi-dao's acupuncture technique at muscle belly for arthralgia].
Professor LI Zhi-dao's acupuncture technique at muscle belly and its clinical experiences for the treatment of arthralgia are introduced. From aspects of TCM, anatomical physiology and sports biomechanics, the theory basis of this technique is explained, while its method is elaborated in details from acupoint selection and manipulation combined with classic medical cases. The acupuncture technique at muscle belly is applied at the muscles which already have pathological changes, avoiding re-stimulation on the pain area. It provides new thinking methods and references for acupuncture to treat arthralgia.


New 4-methoxy-naphthalene derivatives as promisor antifungal agents for paracoccidioidomycosis treatment.
Novel 4-methoxy-naphthalene derivatives were synthesized based on hits structures in order to evaluate the antifungal activity against Paracoccidioides spp. Antifungal activity of compounds was evaluated against P. brasiliensis and most promising compounds 2 and 3 were tested against eight clinically important fungal species. Compound 3 was the more active compound with MIC 8 to 32 μg.ml-1 for Paracoccidioides spp without toxicity monkey kidney and murine macrophagecells. Carbohydrazide 3 showed good synergistic antifungal activity with amphotericin B against P. brasiliensis specie. Titration assay of carbohydrazide 3 with PbHSD enzyme demonstrates the binding ligand-protein. Molecular dynamics simulations show that ligand 3 let the PbHSD protein more stable. New carbohydrazide 3 is an attractive lead for drug development to treat paracoccidioidomycoses.


How Do Microorganisms Influence the Development of Endometriosis? Participation of Genital, Intestinal and Oral Microbiota in Metabolic Regulation and Immunopathogenesis of Endometriosis.
Microorganisms inhabiting the human body play an extremely key role in its proper functioning, as well as in the development of the immune system, which, by maintaining the immune balance, allows you to enjoy health. Dysbiosis of the intestinal microbiota, or in the oral cavity or reproductive tract, understood as a change in the number and diversity of all microorganisms inhabiting them, may correlate with the development of many diseases, including endometriosis, as researchers have emphasized. Endometriosis is an inflammatory, estrogen-dependent gynecological condition defined by the growth of endometrial cells outside the uterine cavity. Deregulation of immune homeostasis resulting from microbiological disorders may generate chronic inflammation, thus creating an environment conducive to the increased adhesion and angiogenesis involved in the development of endometriosis. In addition, research in recent years has implicated bacterial contamination and immune activation, reduced gastrointestinal function by cytokines, altered estrogen metabolism and signaling, and abnormal progenitor and stem cell homeostasis, in the pathogenesis of endometriosis. The aim of this review was to present the influence of intestinal, oral and genital microbiota dysbiosis in the metabolic regulation and immunopathogenesis of endometriosis.


Dermatophagoides pteronyssinus group 2 allergen bound to 8-OH modified adenine reduces the Th2-mediated airway inflammation without inducing a Th17 response and autoimmunity.
8-OH modified adenine bound to Dermatophagoides pteronyssinus group 2 (nDer p2-Conj), a novel allergen-TLR7 agonist conjugate, improves murine airway inflammation in priming and therapeutic settings, however no data are known on the activity of this construct on Th17 cells. The aim of the study was to evaluate if nDer p2-Conj elicited in vivo Th17 cells and Th17-driven autoimmune responses, by using both short- and long-term priming and therapeutic protocols in a nDer p2-driven model of murine airway inflammation. The conjugate induced the in vitro production of cytokines favouring the Th17 polarization by bone marrow-derived dendritic cells. In short-term protocols, the priming or treatment with the conjugate ameliorated the airway inflammation by shifting Th2 allergen-specific cells into T cells producing IFN-γ, IL-10, but not IL-17A. Similar results were found in long-term protocol where the conjugate down-regulated airway inflammation without any evidence of autoimmune response and B cell compartment expansion. nDer p2-Conj also failed to shorten the spontaneous onset of diabetes on conjugates-primed NOD/LtJ mice. We found that neutrophils in BALF, ROR-γt and IL-17A expression in lungs were increased in conjugate-treated IL-10KO mice. These data emphasize the role of conjugate-driven IL-10 production, which can regulate the activity of memory Th17 cells and prevent the onset of autoimmune response.


Structure and diffusion in amorphous aluminum silicate: a molecular dynamics computer simulation.
The amorphous aluminum silicate (Al2O3)2(SiO2) [AS2] is investigated by means of large scale molecular dynamics computer simulations. We consider fully equilibrated melts in the temperature range 6100 K> or =T> or =2300 K as well as glass configurations that were obtained from cooling runs from T=2300 to 300 K with a cooling rate of about 10(12) K/s. Already at temperatures as high as 4000 K, most of the Al and Si atoms are fourfold coordinated by oxygen atoms. Thus, the structure of AS2 is that of a disordered tetrahedral network. The packing of AlO4 tetrahedra is very different from that of SiO4 tetrahedra in that Al is involved with a relatively high probability in small-membered rings and in triclusters in which an O atom is surrounded by four cations. We find as typical configurations two-membered rings with two Al atoms in which the shared O atoms form a tricluster. On larger length scales, the system shows a microphase separation in which the Al-rich network structure percolates through the SiO2 network. The latter structure gives rise to a prepeak in the static structure factor at a wave number q=0.5 A(-1). A comparison of experimental x-ray data with the results from the simulation shows good agreement for the structure function. The diffusion dynamics in AS2 is found to be much faster than in SiO2. We show that the self-diffusion constants for O and Al are very similar and that they are by a factor of 2-3 larger than the one for Si.


Common rotational variations in children.
Most rotational variations in young children, such as in-toeing, out-toeing, and torticollis, are benign and resolve spontaneously. Understanding the normal variations in otherwise healthy children is vital to identifying true structural abnormalities that require intervention. A deliberate assessment of the rotational profile is necessary when evaluating children who in-toe or out-toe. In-toeing is usually attributable to metatarsus adductus in the infant, internal tibial torsion in the toddler, and femoral anteversion in children younger than 10 years. Out-toeing patterns largely result from external rotation hip contracture, external tibial torsion, and external femoral torsion. Although congenital muscular torticollis is the most common explanation for the atypical head posture in children, more serious disorders, including osseous malformations, inflammation, and neurogenic disorders, should be excluded.