E-PASS (The Estimation of Physiologic Ability and Surgical Stress) scoring system helps the prediction of postoperative morbidity and mortality in thoracic surgery.
When a new scoring system, 'E-PASS', standing for the Estimation of Physiologic Ability and Surgical Stress that predicts the postoperative surgical risk by quantification of the patient's reserve and surgical stress applied to a population of general thoracic surgery patients, it should be investigated if this system could help us or not. The comprehensive risk score (CRS) of the E-PASS and the clinical course were evaluated retrospectively in 282 consecutive patients with primary lung cancer (group A), and in 458 patients who underwent elective thoracic operations (group B). The morbidity and mortality rates in both group A and group B increased as the CRS increased. The CRS correlated significantly with the morbidity score, length of stay and cost of hospitalization. E-PASS scoring system may be useful in surgical decision-making and evaluating quality of care in patients who are tolerable for lung resection.


Intake of selected bioactive compounds from plant food supplements containing fennel (Foeniculum vulgare) among Finnish consumers.
The purpose of this study was to estimate the intake of selected bioactive compounds from fennel-containing plant food supplements (PFS) among Finnish consumers. The estimated average intake of estragole was 0.20mg/d, of trans-anethole 1.15mg/d, of rosmarinic acid 0.09mg/d, of p-coumaric acid 0.0068mg/d, of kaempferol 0.0034mg/d, of luteolin 0.0525μg/d, of quercetin 0.0246mg/d, of matairesinol 0.0066μg/d and of lignans 0.0412μg/d. The intakes of kaempferol, quercetin, luteolin, matairesinol and lignans from PFS were low in comparison with their dietary supply. The intake of estragole was usually moderate, but a heavy consumption of PFS may lead to a high intake of estragole. The intake of trans-anethole did not exceed the acceptable daily intake, but PFS should be taken into account when assessing the total exposure. To our knowledge, this study provided the first intake estimates of trans-anethole, p-coumaric acid and rosmarinic acid in human populations.


Expression of Lyt-1 by a subset of B lymphocytes.
Using two-color flow cytometry and multiparameter data analysis, we have shown that the IgM bright, large subset of mouse splenic B lymphocytes express Lyt-1. This is not due to B cell uptake of immune complexes of Lyt-1 and antibody from T cells. The IgM bright cells of autoimmune NZB mice express more Lyt-1 than normal controls. This is because IgM containing plasmablasts, which are greatly increased in NZB spleens, are Lyt-1+. NZB spleen also contains more cells that are Lyt-1+ (but perhaps Lyt-1.2-), Thy-1.2 dull, and smaller in size than cells in normal mice. Thus, Lyt-1 is common to the T and B cell precursor or is induced independently during the ontogeny of T and at least one subset of B cells. We suggest that it be called Lyt-1.


Characterization of local and peripheral immune system in pregnant and nonpregnant ewes.
Modulation of the immune system is known to be important for successful pregnancy but how immune function might differ between the lymph nodes draining the reproductive tract and peripheral lymph nodes is not well understood. Additionally, if immune system changes in response to the presence of an embryo during early pregnancy, and if this response differs in local versus peripheral immune tissue, has not been well characterized. To address these questions, we examined expression of genes important for immune function using NanoString technology in the ampulla and isthmus of the oviduct, endometrium, lymph nodes draining the reproductive tract (lumbo-aortic and medial iliac) as well as a peripheral lymph node (axillary), the spleen, and circulating immune cells from ewes on day 5 of the estrous cycle or pregnancy. Concentrations of estradiol and progesterone in plasma were also determined. Principal component analysis revealed separation of the local from the peripheral lymph nodes (MANOVA P = 3.245e-08, R2 = 0.3) as well as separation of tissues from pregnant and nonpregnant animals [lymph nodes (MANOVA P = 2.337e-09, R2 = 0.5), reproductive tissues (MANOVA P = 2.417e-14, R2 = 0.47)]. Nine genes were differentially (FDR < 0.10) expressed between lymph node types, with clear difference in expression of these genes between the lumbo-aortic and axillary lymph nodes. Expression of these genes in the medial iliac lymph node was not consistently different to either the axillary or the lumbo-aortic lymph node. Expression of IL10RB was increased (FDR < 0.05) by 24% in the reproductive tissue of the pregnant animals compared to nonpregnant animals. Analysis of gene categories revealed that expression of genes of the T-cell receptor pathway in reproductive tract tissues was associated (P < 0.05) with pregnancy status. In conclusion, assessment of gene expression of reproductive and immune tissue provides evidence for a specialization of the local immune system around the reproductive tract potentially important for successful establishment of pregnancy. Additionally, differences in gene expression patterns in reproductive tissue from pregnant and nonpregnant animals could be discerned as early as day 5 of pregnancy. This was found to be associated with expression of genes important for T-cell function and thus highlights the important role of these cells in early pregnancy.


Unrepaired tetralogy of Fallot in a 58-year-old female: factors contributing to the observed survival (case report).
Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Less than 3% of all patients with uncorrected TOF reach their 40th year of life. We present the case of a 58-year-old woman female with uncorrected TOF. The main factors contributing to her longevity are the early development of aortopulmonary collaterals channels and the relatively gradual narrowing of the right ventricular outflow tract.


Recycling of polymeric fraction of cable waste by rotational moulding.
This study focuses on the mechanical recycling of polymeric waste that is produced in considerable amount from the cable industry. Every year large amounts of cables become waste; wires recycling has traditionally focused on metal recovery, while the polymer cover has just been considered as a residue, being landfilled or incinerated. Nowadays, increasingly restrictive regulations and concern about environment make necessary to reduce landfilling as much as possible. Main novelty of the study is that the material used in the research is a post-consumer material and the entire residual material is used, without a previous purification, in contrast with similar studies. Characterization of this residue was performed by thermal analysis, showing that the material is mainly made up of a heavy fraction (84% of the residue), which is not able to melt, fact what makes recycling more difficult. Once characterized, the material was ground, blended with virgin polyethylene and reprocessed by rotational moulding. The influence of the amount of residue and parts structure (1, 2 and 3 layers) was assessed, studying the mechanical behaviour of obtained parts (tensile, flexural and impact properties). It has been found that although mechanical properties get reduced with the increased amount of residue, up to a 35% of residue can be used without an important decrease in mechanical properties. On the other hand, the use of multiple layers in the mouldings allowed obtaining a better external appearance without compromising the mechanical properties.


Oxanamide; adjunctive use of a new tranquilizer in gynecology.
Oxanamide (Quiactin(R)) was administered to 45 patients with a wide variety of gynecologic ailments associated with nervous or emotional tension. The most common conditions with which anxiety was associated in this series were premenstrual tension and the menopause. Thirty-seven of the patients were benefited. Four of the 45 patients had mild side effects.


Midface and perioral volume restoration: a conversation between the US and Italy.
There are numerous dermal fillers available to injectors in the US and Europe for the correction of age-related volume loss in the midface and perioral regions. Product availability differs between these two aesthetic markets due to US Food and Drug Administration (FDA) regulatory requirements. The purpose of this study is to discuss differences in filler selection by two practitioners in the US and Europe based upon both stylistic approach and filler availability in each market. To analyse and discuss the approach to midface as well as lip and perioral volume restoration by two independent dermatologists working in the US and Italy. Seven patients were selected for discussion and divided into two groups: 1) those requiring midface volumization and 2) those undergoing perioral or lip volume replacement. Patients in the midface group were injected with Juvéderm Voluma® XC, Juvéderm® Volift® with lidocaine, Restylane- L®, Perlane-L® or Radiesse®. Patients in the perioral and/or lip group were injected with Juvéderm® Volbella™, with lidocaine, or Belotero Balance™. Patients were photographed before and immediately after injection to evaluate aesthetic outcomes. In each case, filler selection was based upon patient characteristics, anatomical considerations and inherent filler properties. All patients were extremely satisfied with their treatments. There were no significant immediate or delayed complications following treatment with any of the dermal fillers used. Volume restoration in the midface and perioral or lip region can be effectively achieved using a variety of dermal fillers. The dermal filler portfolio available in Europe is exponentially larger than that in the US. Product selection in either market is ultimately the result of the physician's experience injecting each dermal filler, as well as his or her personal preferences.


Solvent-induced backbone fluctuations and the collective librational dynamics of lysozyme studied by terahertz spectroscopy.
THz spectroscopy is used to investigate the dynamics of the globular protein hen egg white lysozyme under varying hydration and temperature conditions. An analysis of the experimental spectra has revealed that the amount of solvent in the hydration shell has a strong influence on the low-frequency protein conformational dynamics and also the arrangement of hydrogen bonds in the protein secondary structure. Furthermore at a hydration level >0.2 we identify collective backbone fluctuations in the protein secondary structure that are not present at low hydration. It is possible that these solvent induced modes are important for the biological function of the protein.


[Intestinal angiodysplasia--a diagnostic and therapeutic challenge].
During an eight-year period we have treated 10 patients for intestinal angiodysplasia complicated by major hemorrhage. This condition represents a degenerative, acquired lesion mostly in elder people consisting of thin-walled vessels of venous origin. Angiodysplasias are usually multiple and predominantly localized in the right colon. Besides localizing the bleeding source the exclusion of concomitant lesions capable of bleeding but not responsible for hemorrhage represents the main diagnostic problem. Segmental colectomy for angiodysplasia is rarely followed by rebleeding when preoperatively the site of hemorrhage has reliably been identified, mainly by angiography. Today the colonoscopic electro- or lasercoagulation of vascular ectasia represents a valuable alternative therapeutic procedure. Subtotal colectomy should be used only as a last resort.


The effect of dance-based mind-motor activities on the quality of life in the patients recovering from COVID-19: A protocol for systematic review and meta-analysis.
Since the outbreak of coronavirus disease 2019 (COVID-19), with the improvement of diagnosis and treatment level in various countries, more and more patients have been discharged after systematic treatment. In order to effectively promote the overall recovery of patients' physical and mental function and quality of life (QOL), the focus of clinical work should be gradually shifted to rehabilitation treatment. Dance-based mind-motor activities were defined as coordinated upright mind-motor movements that emphasize dynamic balance, structured through music or an inner rhythm (e.g., breathing) and distinctive instructions or choreography, and that involve social interaction. It has positive effects on motor function, lung function, psychological mood and other aspects, so it can be used as a safe alternative therapy for patients recovering from COVID-19. At present, there are no relevant articles for systematic review. From its inception until March 2021, we will conduct a comprehensive electronic search, including Cochrane Library, MEDLINE, PubMed, Springer, EMBASE, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, Wan-fang database. Two independent researchers will conduct article retrieval, screening, quality assessment, and data analysis through the Review Manager (V. 5.3.5). The results of this study will evaluate the effectiveness and safety of dance-based mind-motor activities for the improvement of QOL in COVID-19 patients during the recovery period. The conclusion of the study will provide an evidence to judge whether dance-based mind-motor activities is effective and safe for COVID-19 in recovery period. This protocol will not evaluate individual patient information or infringe patient rights and therefore does not require ethical approval. CRD42021232995.


Blackberry anthocyanins are slightly bioavailable in rats.
Anthocyanins are phenolic compounds widely distributed in fruits and vegetables. Several positive effects of anthocyanin feeding have been described. We evaluated the absorption and metabolism of anthocyanins (cyanidin 3-glucoside and malvidin 3-glucoside) in rats adapted for 8 d to a diet enriched with a lyophilized blackberry powder. Rats had free access to an anthocyanin-containing diet for 8 h/d. Food was consumed throughout this period, and no anthocyanin accumulated in plasma at any of the times of sampling. Anthocyanins were recovered in urine as the intact glycosidic forms, whereas neither aglycone nor conjugates were detected. Moreover, peonidin 3-glucoside was present in urine and could have resulted from hepatic methylation at the 3' hydroxyl moiety position of cyanidin 3-glucoside. Urinary recovery of cyanidin 3-glucoside in either intact or methylated forms was approximately 0.26% of the ingested amount, whereas that of malvidin 3-glucoside was 0.67%. This result suggested that structure of the aglycone moiety of anthocyanins could play an important role in their metabolism. Low amounts of glucosides as well as of cyanidin were recovered in cecal contents. This could result from adaptation of microflora to anthocyanin degradation. Overall, these data indicate that blackberry anthocyanins are excreted in urine as intact and methylated glucoside forms and that their bioavailability is very low compared with other flavonoids.


Culturable and VBNC Vibrio cholerae: interactions with chironomid egg masses and their bacterial population.
Vibrio cholerae, the etiologic agent of cholera, is autochthonous to various aquatic environments. Recently, it was found that chironomid (nonbiting midges) egg masses serve as a reservoir for the cholera bacterium and that flying chironomid adults are possible windborne carriers of V. cholerae non-O1 non-O139. Chironomids are the most widely distributed insect in freshwater. Females deposit egg masses at the water's edge, and each egg mass contains eggs embedded in a gelatinous matrix. Hemagglutinin/protease, an extracellular enzyme of V. cholerae, was found to degrade chironomid egg masses and to prevent them from hatching. In a yearly survey, chironomid populations and the V. cholerae in their egg masses followed phenological succession and interaction of host-pathogen population dynamics. In this report, it is shown via FISH technique that most of the V. cholerae inhabiting the egg mass are in the viable but nonculturable (VBNC) state. The diversity of culturable bacteria from chironomid egg masses collected from two freshwater habitats was determined. In addition to V. cholerae, representatives of the following genera were isolated: Acinetobacter, Aeromonas, Klebsiella, Shewanella, Pseudomonas, Paracoccus, Exiguobacterium, and unidentified bacteria. Three important human pathogens, Aeromonas veronii, A. caviae, and A. hydrophila, were isolated from chironomid egg masses, indicating that chironomid egg masses may be a natural reservoir for pathogenic Aeromonas species in addition to V. cholerae. All isolates of V. cholerae were capable of degrading chironomid egg masses. This may help explain their host-pathogen relationship with chironomids. In contrast, almost none of the other bacteria that were isolated from the egg masses possessed this ability. Studying the interaction between chironomid egg masses, the bacteria inhabiting them, and V. cholerae could contribute to our understanding of the nature of the V. cholerae-egg mass interactions.


CT-guided iodine-125 brachytherapy as salvage therapy for local-regional recurrent breast cancer.
The treatment of local-regional recurrent breast cancer (BC) after external beam radiotherapy is challenging. We aim to evaluate the effectiveness and safety of computed tomography (CT)-guided percutaneous iodine-125 brachytherapy for local recurrent BC. We retrospectively analyzed 15 patients with local recurrent BC treated with CT-guided interstitial implantation of iodine-125 seeds. Regular contrast-enhanced CT was conducted to evaluate the tumor response. Follow-up survival, quality of life, and adverse events were analyzed. Among the 15 patients, five were elderly patients (older than 80 years) and six were complicated with chronic underlying diseases. The median number of 125I seeds implantation was 33 (range: 20-130) with median dose 90 (D90, the minimum dose covering 90% of the target volume) of 108 Gy (range: 60-120 Gy). There was no significant difference in D90, V100 (the volume of the target receiving 100% of the prescription dose), and V150 (the volume of the target receiving 150% of the prescription dose) before and after operation (p > 0.05). The median follow-up was 14 months (range: 6-18 months). Six months after operation, the ORR was 66.7% (10/15) and the LCR was 93.3% (14/15). The 6- and 12-month survival rates were 100 and 41.6%, respectively, and the median survival time was 12.5 months. PS score decreased from 1.53 ± 0.81 to 0.53 ± 0.49. The pain score decreased from 2.87 ± 1.67 before operation to 1.07 ± 1.18 after operation, and the differences were statistically significant (p< 0.05). No severe complications occurred. CT-guided iodine-125 brachytherapy provided a safe and effective choice for recurrent BC with significant local therapeutic effects and minor complications, especially for elderly patients with chronic underlying disease and those who were not eligible for surgical resection and had failed to benefit from systemic therapy.


Interactions between Bacteriophages and Eukaryotic Cells.
As the name implies, bacteriophage is a bacterium-specific virus. It infects and kills the bacterial host. Bacteriophages have gained attention as alternative antimicrobial entities in the science community in the western world since the alarming rise of antibiotic resistance among microbes. Although generally considered as prokaryote-specific viruses, recent studies indicate that bacteriophages can interact with eukaryotic organisms, including humans. In the current review, these interactions are divided into two categories, i.e., indirect and direct interactions, with the involvement of bacteriophages, bacteria, and eukaryotes. We discuss bacteriophage-related diseases, transcytosis of bacteriophages, bacteriophage interactions with cancer cells, collaboration of bacteriophages and eukaryotes against bacterial infections, and horizontal gene transfer between bacteriophages and eukaryotes. Such interactions are crucial for understanding and developing bacteriophages as the therapeutic agents and pharmaceutical delivery systems. With the advancement and combination of in silico, in vitro, and in vivo approaches and clinical trials, bacteriophages definitely serve as useful repertoire for biologic target-based drug development to manage many complex diseases in the future.


Hospice utilization by male and female cancer patients in an end-of-life transition program.
to determine if there were sex differences in patients' use of hospice services in a regional cancer center in Texas from 1998 to 2000. A quality-of-life program for patients with cancer that included an end-of-life component was initiated in 1998 at a regional cancer center. The records of 1057 female and 986 male cancer patients who died from 1998 to 2000 were reviewed. Data on demographics, use of hospice care, length of stay, and location at time of referral were collected and analyzed. Hospice utilization increased in women (47% v 64%; p<.001) and men (53% v 66%; p<.001) who died of cancer from 1998 to 2000. Length of stay (LOS) in hospice did not change for women, but decreased significantly for men over that time (31 days v 14 days, p<.001). The number of men with stays of 14 days or less increased significantly (30% v 53%, p<.001). Subjects whose LOS were less than 14 days were more likely to be hospital inpatients at time of referral. The institution of a targeted end-of-life program was associated with increased utilization of hospice services in women with cancer at this regional cancer center. Length of stay in hospice was longer for women than men, and more men had very short (less than 14 day) stays. Hospice referrals from outpatient settings were associated with longer LOS.


Serum-free mouse embryo cells: growth responses in vitro.
We have derived serum-free mouse embryo (SFME) cultures in a basal nutrient medium supplemented with insulin, transferrin, epidermal growth factor (EGF), high-density lipoprotein (HDL), and fibronectin. These cells are nontumorigenic, lack gross chromosomal aberrations, and exhibit several other unique properties, including dependence on EGF for survival and growth inhibition by serum. We have examined the concentration dependence of the growth stimulatory effects of protein supplements used in the SFME medium formulation and surveyed other supplements that might act as alternative or complementary additions to the culture medium. Insulin could be replaced by insulin-like growth factor I and EGF could be replaced by transforming growth factor alpha in the same concentration range. Transferrin could be replaced by higher concentrations of lactoferrin. Deterioration of cultures in the absence of EGF began within 8 hours of the removal of the growth factor, and could be prevented by the addition of fibroblast growth factor/heparin-binding growth factor. Attachment proteins other than fibronectin were effective on SFME cells, but limited success was obtained when substituting other lipid preparations for HDL. These data introduce a precise system for exploring the unusual characteristics of SFME cells and contribute additional information that may be useful in the extension of these approaches to other cell types and species.


Tuberculosis of the aryepiglottic fold and sinus pyriformis: a rare entity.
Tuberculosis of the larynx and hypopharynx is an uncommon entity and rarely considered in the differential diagnosis of the laryngo-pharyngeal diseases. We describe a case of a 40-year-old man with tuberculous involvement of the aryepiglottic fold and medial wall of the sinus pyriformis mimicking a malignancy. Current literature concerning the clinical, histopathological, radiological and diagnostic features of this rare entity is discussed.


Localization on encapsulated Cryptococcus neoformans of serum components opsonic for phagocytosis by macrophages and neutrophils.
Previous studies have shown that the cryptococcal capsule inhibits phagocytosis of Cryptococcus neoformans by macrophages and neutrophils. In this study, the binding sites of potential serum opsonins in immune and nonimmune sera were determined by immunoelectron microscopy, and the results were compared with the results of phagocytosis of the yeasts by mouse peritoneal macrophages and human neutrophils. Immunoglobulin G (IgG) from normal human serum showed low-density binding at the capsular surface and at sites throughout the capsule. Complement component C3 from normal serum bound heavily at the capsular surface. IgG from rabbit capsular antiserum showed relatively dense deposition at the capsular surface and at sites throughout the capsule. Cells opsonized with heat-inactivated human serum were engulfed poorly by both macrophages and neutrophils, indicating that the low-density deposition of IgG produced by normal serum was not adequate for opsonization. Yeasts opsonized with normal human serum were engulfed in large numbers by neutrophils and to a lesser extent by macrophages, indicating that neutrophils in particular were able to effectively utilize the opsonically active C3 which normal human serum deposited at the capsular surface. Yeasts opsonized with rabbit anticapsular serum were engulfed by both macrophages and neutrophils, indicating that the high density of surface IgG produced by capsular antiserum is an effective opsonin for both cells. These results suggest that the complement-neutrophil system is a possible defense mechanism in the nonimmune host.


Trends in Racial/Ethnic and Nativity Disparities in Cardiovascular Health Among Adults Without Prevalent Cardiovascular Disease in the United States, 1988 to 2014.
Trends in cardiovascular disparities are poorly understood, even as diversity increases in the United States. To examine U.S. trends in racial/ethnic and nativity disparities in cardiovascular health. Repeated cross-sectional study. NHANES (National Health and Nutrition Examination Survey), 1988 to 2014. Adults aged 25 years or older who did not report cardiovascular disease. Racial/ethnic, nativity, and period differences in Life's Simple 7 (LS7) health factors and behaviors (blood pressure, cholesterol, hemoglobin A1c, body mass index, physical activity, diet, and smoking) and optimal composite scores for cardiovascular health (LS7 score ≥10). Rates of optimal cardiovascular health remain below 40% among whites, 25% among Mexican Americans, and 15% among African Americans. Disparities in optimal cardiovascular health between whites and African Americans persisted but decreased over time. In 1988 to 1994, the percentage of African Americans with optimal LS7 scores was 22.8 percentage points (95% CI, 19.3 to 26.4 percentage points) lower than that of whites in persons aged 25 to 44 years and 8.0 percentage points (CI, 6.4 to 9.7 percentage points) lower in those aged 65 years or older. By 2011 to 2014, differences decreased to 10.6 percentage points (CI, 7.4 to 13.9 percentage points) and 3.8 percentage points (CI, 2.5 to 5.0 percentage points), respectively. Disparities in optimal LS7 scores between whites and Mexican Americans were smaller but also decreased. These decreases were due to reductions in optimal cardiovascular health among whites over all age groups and periods: Between 1988 to 1994 and 2011 to 2014, the percentage of whites with optimal cardiovascular health decreased 15.3 percentage points (CI, 11.1 to 19.4 percentage points) for those aged 25 to 44 years and 4.6 percentage points (CI, 2.7 to 6.5 percentage points) for those aged 65 years or older. Only whites, African Americans, and Mexican Americans were studied. Cardiovascular health has declined in the United States, racial/ethnic and nativity disparities persist, and decreased disparities seem to be due to worsening cardiovascular health among whites rather than gains among African Americans and Mexican Americans. Multifaceted interventions are needed to address declining population health and persistent health disparities. National Institute of Neurological Disorders and Stroke and National Center for Advancing Translational Sciences of the National Institutes of Health.


The role of heart-type fatty acid-binding protein in the evaluation of carbon monoxide poisoning in rats.
Acute carbon monoxide (CO) poisoning can cause early and persistent damages in tissues sensitive to hypoxia. This study investigated serum heart-type fatty acid-binding protein (H-FABP) levels as a biomarker of acute CO poisoning in rats. The rats were exposed to a mixture of either 3000 (group A) or 5000 (group B) parts per million (ppm) CO in air, or to ambient air (group C, control group). Blood samples were taken just before, immediately after and 6 hours after the exposure, and serum H-FABP and troponin-I levels were measured. The consciousness level was evaluated just after the exposure. The survival rate was monitored for 7 days. Serum H-FABP levels increased just after the CO exposure in both groups A and B. Additionally, H-FABP level was higher in group B than in group A, immediately after the exposure. However, serum troponin-I levels only increased at 6 hours after the CO exposure in groups A and B. Consciousness and survival rates in group B were lower than that in group A. Our results suggest that H-FABP might have potential to be an early and quantitative parameter of clinical severity and prognosis in CO poisoning.


Tissue iron distribution and urinary mineral excretion vary depending on the form of iron (FeSO4 or NaFeEDTA) and the route of administration (oral or subcutaneous) in rats given high doses of iron.
Sodium iron ethylenediaminetetraacetate (NaFeEDTA) has considerable promise as an iron fortificant in food. However, effects of administering high levels of NaFeEDTA on tissue iron distribution and mineral excretion are not well understood. The objectives of this study were to assess nonheme iron distribution in the body and urinary excretion of Ca, Mg, Cu, Fe, and Zn after daily administration of high levels of iron to rats over 21 days. Iron was either given orally with food or injected subcutaneously, as either FeSO 4 or NaFeEDTA. Selected tissues were collected for nonheme iron analysis. Estimated total body nonheme iron levels were similar in rats fed NaFeEDTA or FeSO 4, but the tissue distribution was different: it was 53% lower in the liver and 86% higher in the kidneys among rats fed NaFeEDTA than among those fed FeSO 4. In contrast, body nonheme iron was 3.2-fold higher in rats injected with FeSO 4 than in rats injected with NaFeEDTA. Administering NaFeEDTA orally elevated urinary Cu, Fe, and Zn excretion compared with FeSO 4 (1.41-, 11.9-, and 13.9-fold higher, respectively). We conclude that iron is dissociated from the EDTA complex prior to or during intestinal absorption. A portion of intact FeEDTA may be absorbed via a paracellular route at high levels of intake but is mostly excreted in the urine. Metal-free EDTA may be absorbed and cause elevated urinary excretion of Fe, Cu, and Zn.


The cost of observation care for commercially insured patients visiting the emergency department.
To examine trends in the use of ED observation stays among a national sample of patients with commercial insurance, and assess the patient cost-burden of an observation stay relative to an short inpatient hospitalization from the ED. Retrospective analysis of ED observation stays and inpatient hospitalizations from 2008 to 2015 using the Truven MarketScan® Commercial Claims and Encounters database. Index ED visits were identified from claims files and assessed for evidence of an observation or inpatient hospitalization. Total and out-of-pocket costs were calculated for the index hospitalization and a 30-day episode of care and standardized to 2015 $USD. Costs for ED patients with an observation stay were compared to a similar, propensity-matched cohort of ED patients hospitalized as inpatients. Over the 8 year period, observation stay admissions increased from 4.3% to 6.8% of total ED visits (60.5% relative increase) while inpatient admissions fell from 10.8% to 8.9% (16.6% relative decrease). In 2015, the mean total cost was $8162 for an observation stay and $22,865 for an inpatient hospitalization. Patient out-of-pocket costs were $962 and $1403, respectively. Among the propensity-matched cohorts, relative mean costs for the index hospitalization were 41% higher and patient out-of-pocket costs were 33% higher if the patient was admitted as an inpatient from the ED versus observation during their hospitalization. Observation hospitalizations are an increasingly common disposition for patients entering the hospital through the ED. Both total and patient out-of-pocket costs are lower, on average, for an observation stay compared with a similar inpatient admission for ED patients requiring hospitalization.


Eradication rate of Helicobacter Pylori infection is directly influenced by adherence to therapy in children.
Current commonly accepted strategies to eradicate Helicobacter pylori in children are a 10-day sequential treatment or a triple therapy for 7-14 days. To avoid further expensive and possibly risky investigations as well as induction of secondary antimicrobial resistance, a success rate of elimination strategies over 90% in a per-protocol analysis is the target goal but rates observed in clinical trials are lower. Antimicrobial resistance is a well-recognized risk factor for treatment failure; therefore, only a treatment tailored to susceptibility testing should be recommended. Adherence to therapy is also a risk factor for treatment failure but that has been poorly studied. The purpose of this study was to evaluate the influence of adherence to therapy on the elimination rates obtained with different treatment regimens. Cohort study analysis of children, aged 2-17 years, treated for Helicobacter pylori infection between October 2011 and December 2013. As a routine clinical practice, children infected with a strain susceptible to clarithromycin and to metronidazole received either a sequential regimen or a 10-day triple therapy while children infected with a strain resistant to clarithromycin or metronidazole received a 10-day triple regimen tailored to antimicrobial susceptibility. The eradication rate was assessed by a negative 13 C-urea breath test performed at least 8 weeks after the end of the treatment and adherence evaluated using a diary. One hundred forty-five children (67 girls/78 boys, median age 9.7 years) fulfilled the inclusion criteria, 118 being infected with a strain susceptible to both clarithromycin and metronidazole, 10 with a clarithromycin resistant, and 17 with a metronidazole resistant strain. A sequential regimen was prescribed in 44, a triple therapy containing clarithromycin in 84 and containing metronidazole in 17. Follow-up data were available for 130/145 and clearance of the infection observed in 105 of them. A concordance of more than 90% between the prescribed and the ingested drugs was observed in 109 children, between 50 and 90% in eight, less than 50% in 11 while these data were unknown for 2/130. A successful eradication was achieved for 89.9% of patients that received at least 90% of the prescribed drugs, whereas the eradication rate for nonadherent patients was 36.6%. Adherence above 90% was significantly higher in the absence of chronic concomitant disease, in the absence of adverse event and results in a significantly higher eradication rate. With the proposed strategy and an adherence higher than 90%, eradication was obtained in 98/109 children, the rate being only significantly superior to 90% with the sequential regimen. Adherence to therapy is a very important factor for the outcome and has to be assessed when evaluating the outcome of an H. pylori eradication regimen in order to understand the reasons of treatment failure. As we treated only after evaluation of the resistance of the H. Pylori strains, we were expecting to reach the given objective of 90% successful treatment. Children with adherence to treatment above 90% had a successful outcome of 89,9%, whereas nonadherent had a successful outcome of 36,8%. This is the first time that adherence has been assessed accurately.


Three yttrium crotonate complexes with diimines.
The synthesis and crystal structures of three new yttrium crotonate (crot) compounds, associated with three different nitrogenous bases, namely 1,10-phenanthroline (phen), 4-methyl-1,10-phenanthroline (mphen) and 2,2'-bipyridylamine (bpa), are presented. All three compounds organize as centrosymmetric dimers, to give tetra-micro-crotonato-bis[crotonato(1,10-phenanthroline)yttrium(III)] dihydrate, [Y(2)(C(4)H(5)O(2))(6)(C(12)H(8)N(2))(2)].2H(2)O or [Y(crot)(3)(phen)](2).2H(2)O, (I), tetra-micro-crotonato-bis[crotonato(4-methyl-1,10-phenanthroline)yttrium(III)] dihydrate, [Y(2)(C(4)H(5)O(2))(6)(C(13)H(10)N(2))(2)].2H(2)O or [Y(crot)(3)(mphen)](2).2H(2)O, (II), and tetra-micro-crotonato-bis[diaqua(crotonato)yttrium(III)] 2,2'-bipyridylamine tetrasolvate, [Y(2)(C(4)H(5)O(2))(6)(H(2)O)(4)].4C(10)H(9)N(3) or [Y(crot)(3)(aq)(2)](2).4(bpa), (III). Complexes (I) and (II) are isomorphous, with the bases acting as chelating ligands. In complex (III), the coordination sphere is built up of carboxylate and aqua ligands, with the non-coordinated diimine acting as included solvent.


Histological and molecular evaluation of patient-derived colorectal cancer explants.
Mouse models have been developed to investigate colorectal cancer etiology and evaluate new anti-cancer therapies. While genetically engineered and carcinogen-induced mouse models have provided important information with regard to the mechanisms underlying the oncogenic process, tumor xenograft models remain the standard for the evaluation of new chemotherapy and targeted drug treatments for clinical use. However, it remains unclear to what extent explanted colorectal tumor tissues retain inherent pathological features over time. In this study, we have generated a panel of 27 patient-derived colorectal cancer explants (PDCCEs) by direct transplantation of human colorectal cancer tissues into NOD-SCID mice. Using this panel, we performed a comparison of histology, gene expression and mutation status between PDCCEs and the original human tissues from which they were derived. Our findings demonstrate that PDCCEs maintain key histological features, basic gene expression patterns and KRAS/BRAF mutation status through multiple passages. Altogether, these findings suggest that PDCCEs maintain similarity to the patient tumor from which they are derived and may have the potential to serve as a reliable preclinical model that can be incorporated into future strategies to optimize individual therapy for patients with colorectal cancer.


Immunophenotype-Genotype Correlations in Clear Cell Sarcoma of Kidney-An Evaluation of Diagnostic Ancillary Studies.
The purpose of this study was to establish a reliable panel of antibodies for immunohistochemical corroboration of a diagnosis of clear cell sarcoma of kidney (CCSK), taking into consideration the various genotypic subsets of CCSK. We conducted full genotypic analysis for evidence of YWHAE-NUTM2, BCOR internal tandem duplication (ITD), and BCOR-CCNB3 in 68 archival cases of CCSK and then immunostained all cases for CCND1, TLE1, and BCOR along with 63 control samples representing tumor types that may enter into the differential diagnosis of CCSK, including 7 congenital mesoblastic nephromas, 2 desmoplastic small round cell tumors, 13 malignant rhabdoid tumors, 9 Ewing sarcomas/primitive neuroectodermal tumor, 5 synovial sarcomas, and 27 Wilms' tumors. Molecular assays showed that 54 CCSKs harbored a BCOR-ITD, 1 case expressed a YWHAE-NUTM2 fusion transcript while none expressed the BCOR-CCNB3 fusion. The remaining 13 CCSKs were designated "triple-negative" based on the molecular findings. CCND1 showed positive immunoreactivity across all subgroups. TLE1 was positive in 94% of cases, including 1 YWHAE-NUTM2 fusion-positive case. Three BCOR-ITD-positive tumors were TLE1-negative. BCOR immunostaining was most variable among subgroups, with triple-negative tumors showing the weakest staining. In all, 10/68 (15%) tumors did not stain for BCOR, of which 4 were triple-negative (4/13 = 31%) and 6 were BCOR-ITD-positive (6/54 = 11%). The single YWHAE-NUTM2-positive tumor showed strong staining for all 3 markers. No single case was negative for all 3 stains; however, 3 cases showed no reactivity for either BCOR or TLE1 of which 1 was triple-negative and 2 BCOR-ITD-positive. Having completed the first comprehensive evaluation of immunostaining of 68 fully genotyped CCSK tumors, we show herein that there is a rationale for the use of a small panel of antibodies to assist in the diagnosis of CCSK regardless of genotype, and we demonstrate that in combination CCND1, TLE1, and BCOR are compelling markers in aiding CCSK diagnosis.


Synthesis and luminescence properties of U-shaped polycyclic molecules containing syn-facial functionalized quinoxaline rings.
[reaction: see text] Rigid U-shaped molecules containing syn-facially situated quinoxaline rings have been synthesized in three steps, by a combination of the Diels-Alder reaction, the ruthenium-catalyzed oxidation, and the Zn(OAc)(2)-catalyzed condensation of the resulting bis-alpha-diketones with benzene-1,2-diamines. The unsymmetric bis-quinoxalines, with electronically different substituents, and the quinoxaline ring-attached alpha-diketones were also prepared. Their luminescence properties were examined and described.


Synchronous bilateral non-Hodgkin's diffuse large B-cell lymphoma of the breast and left breast invasive ductal carcinoma: a case report and review of literature.
Lymphoma of the breast is unusual, and synchronous bilateral lymphoma and carcinoma of the breast is extremely rare. We present the case of a 51-year-old woman who found a mass in her left breast. Ultrasound scan findings revealed nodules at the 2 o'clock position in her left breast and focal dilation of the duct at the 8-9 o'clock and 10 o'clock position in her right and left breasts, respectively. A left breast ultrasound-guided core needle biopsy and right breast segmental excisional biopsy were performed. Pathological and immunohistochemical examination revealed left breast invasive ductal carcinoma and right breast diffuse large B-cell lymphoma of the non-germinal center type. Pathological examination of the left breast modified radical mastectomy specimen revealed synchronous invasive ductal carcinoma (grade III) and diffuse large B-cell lymphoma. The patient received chemotherapy and bone marrow transplantation in another hospital. Based on a review of the relevant literature, we discuss the diagnosis, clinical features, treatment, and prognosis of synchronous breast lymphoma and invasive ductal carcinoma.


Sport in Latin America from past to present: a European perspective.
This chapter examines sport in Latin America in its social, cultural, and political contexts. An analysis of the development of sport in Latin America suggests that there have been a number of distinct phases influenced by the cultures of the Spanish, British and French. More recently, the games and pastimes of the United States have made a significant impact. It is suggested that the further development of sport in Latin America is hindered by a number of significant problems. It concludes that the problems faced by some countries are immense and that governments and international organizations in the developed world should offer help where appropriate.


Potassium channels activated by GABAB agonists and serotonin in cultured hippocampal neurons.
1. Single-channel currents were recorded in cell-attached patches on cultured hippocampal neurons in response to gamma-aminobutyric acid-B (GABAB) agonists or serotonin applied to the cell surface outside the patch area. 2. The channels activated by GABAB agonists and serotonin were potassium selective but had a different conductance and kinetic behavior. Channels activated by GABAB agonists had a higher conductance, longer open-time, and longer burst-length than channels activated by serotonin. 3. The kinetic behavior of channels activated by GABAB agonists varied with potential whereas channels activated by serotonin did not show voltage-dependent changes in kinetics. 4. In a few cell-attached patches, both types of channel were activated when the cell was exposed to GABA together with serotonin. 5. It was concluded that GABAB agonists and serotonin activate different potassium channels in the soma of cultured hippocampal neurons.


Differentially expressed protein and gene analysis revealed the effects of temperature on changes in ascorbic acid metabolism in harvested tea leaves.
Tea is an important non-alcoholic beverage worldwide. Tea quality is determined by numerous secondary metabolites in harvested tea leaves, including tea polyphenols, theanine, caffeine, and ascorbic acid (AsA). AsA metabolism in harvested tea leaves is affected by storage and transportation temperature. However, the molecular mechanisms underlying AsA metabolism in harvested tea leaves exposed to different storage and transportation temperature conditions remain unclear. Here we performed RP-HPLC to detect dynamic changes in AsA content in tea leaves subjected to high- (38 °C), low- (4 °C), or room-temperature (25 °C) treatments. The AsA distribution and levels in the treated tea leaves were analyzed using cytological-anatomical characterization methods. The differentially expressed CsAPX1 and CsDHAR2 proteins, which are involved in the AsA recycling pathway, were identified from the corresponding proteomic data using iTRAQ. We also analyzed the expression profiles of 18 genes involved in AsA metabolism, including CsAPX1 and CsDHAR2. AsA was mainly distributed in tea leaf mesophyll cells. High- and low-temperature treatments upregulated the CsAPX1 and CsDHAR2 proteins and induced CsAPX and CsDHAR2 gene expression. These results indicated that the CsAPX1 and CsDHAR2 proteins might have critical roles in AsA recycling in tea leaves. Our results provide a foundation for the in-depth investigation of AsA metabolism in tea leaves during storage and transportation, and they will promote better tea flavor in tea production.


The preoperative prevalence and postoperative incidence of thromboembolism in patients with hip fractures treated with dextran prophylaxis.
A prospective preoperative and postoperative venographic study of hip fracture patients has documented a significant preoperative prevalence and postoperative incidence of thromboembolic disease. A statistically higher incidence of deep-venous thrombosis is observed in patients with femoral neck fractures compared to patients with intertrochanteric fractures. A 9% (15 of 176) preoperative prevalence and an 11% (12 of 108) incidence of new postoperative thromboembolic disease were detected. There was a predilection for deep-venous thrombosis in the injured extremity compared to the noninjured extremity both preoperatively and postoperatively.


Tartrazine Modifies the Activity of DNMT and HDAC Genes-Is This a Link between Cancer and Neurological Disorders?
In recent years, artificial additives, especially synthetic food colorants, were found to demonstrate wider properties compared to their natural equivalents; however, their health impact is still not totally mapped. Our study aimed to determine the long-term (30 and 90 days) exposure effect of one of the commonly used artificial food colorants, tartrazine, on NMRI mice. The applied dose of tartrazine referred to the human equivalent dose for acceptable daily intake (ADI). Further, we evaluated its impact on the transcription of a range of epigenetic effectors, members of the DNA methyltransferase (DNMT) as well as histone deacetylase (HDAC) families. Following the exposure, organ biopsies were collected from the lungs, kidneys, liver, and spleen, and the gene expression levels were determined by real-time quantitative reverse transcription PCR (RT-qPCR). Our results demonstrated significant upregulation of genes in the tested organs in various patterns followed by the intake of tartrazine on ADI. Since DNMT and HDAC genes are involved in different steps of carcinogenesis, have roles in the development of neurological disorders and the effect of dose of everyday exposure is rarely studied, further investigation is warranted to study these possible associations.


Association of HIV-Induced Immunosuppression and Clinical Malaria in Nigerian Adults.
Despite the growing body of evidence on the interaction between HIV and malaria in sub-Saharan Africa, there is a dearth of data on clinical malaria in HIV-infected patients in Nigeria. We determined the burden of clinical malaria in HIV-infected adult Nigerians and further investigated the association between their immunological status and the rates of clinical malaria. Ninety seven antiretroviral treatment-naïve HIV-infected adults were enrolled in a cross-sectional study from August to December, 2009. The participants had a complete clinical evaluation, thick and thin blood films for malaria parasites and CD4 cell count quantification. Clinical malaria was defined as having fever (temperature ≥ 37.5°C or history of fever within 48 hours) and a malaria parasite density above the median value obtained for subjects with co-existing fever and parasitaemia. Clinical malaria was diagnosed in 10 out of 97 patients (10.3%). Lower CD4 cell counts were associated with increasing rates of clinical malaria which was 0% at CD4 cell count of ≥ 500, 2.6% at 200-499 and 30% at <200 cells/µL (χ(2) = 18.3, p = 0.0001). This association remained significant after controlling for other factors in a multivariate analysis (AOR=22.98, 95% C.I: 2.62-20.14, p = 0.005). An inverse relationship between CD4 cell count and parasite density was demonstrated (regression co-efficient = - 0.001, p = 0.0002). More aggressive malaria control measures are highly needed in severely immunosuppressed HIV-infected patients.


[A study of young offenders undergoing forensic psychiatric evaluation. There is a need of correctional care alternatives].
With effect from January 1, 1992, legislation regulating the practice of forensic psychiatry in Sweden, the Forensic Mental Care Act, was changed to meet more restrictive demands. A retrospective study of 15-20-year-old male offenders, investigated at the Dept. of Forensic Psychiatry in Stockholm during the period 1990-93, showed the proportion sentenced to forensic psychiatric care to have decreased by 21 per cent since the introduction of the new legislation. The majority of young offenders otherwise sentenced, mainly to correctional treatment, were suffering from personality disorders. Most of them had previously been in contact with the correctional and social service sectors. Several of them received prison sentences despite the fact that young offenders are not to be sent to prison without exceptional reasons. One such exceptional reason might be the lack of an appropriate alternative. A third treatment alternative is called for.


Pregnancy attitudes and contraceptive plans among women entering jail.
Unplanned pregnancies are an important and costly public health problem. Women entering jail are at particularly high risk for unplanned pregnancies when they leave jail, given the high rates of poverty, substance abuse and sexually transmitted infections (STIs) in this population, all of which are associated with unplanned pregnancies. Attitudes toward pregnancy vary substantially, influencing openness of incarcerated women to starting a birth control method. This study was conducted as part of a Title X service evaluation and examined varying attitudes towards pregnancy and associated plans to use contraceptives. The current study included 223 women entering jail who were, under 36 years of age, fertile, sexually active with men, and not planning to become pregnant in the near future. Nearly half of the women had negative pregnancy attitudes (PAs), indicating that they did not want to become pregnant, while 41.3% endorsed ambivalent PAs. Compared to those with ambivalent PAs, those with Negative PAs were more likely to report a previous unplanned pregnancy (90.6% vs. 75.4%), a previous pregnancy termination (40.0% vs. 22.8%), and recent consistent use of contraceptives (37.0% vs. 21.7%). Women with negative PAs were significantly more likely to want to start or to continue a birth control method compared to those with ambivalent PAs (66% vs. 47%). Tailoring services to women's specific pregnancy attitudes during periods of incarceration may aid in preventing unplanned pregnancies in populations of high-risk women.


Discitis and Osteomyelitis Caused by a Migrated Laparoscopic Adjustable Gastric Banding (LAGB) Catheter.
Laparoscopic adjustable gastric banding (LAGB) is a popular bariatric surgical procedure used to aid in weight loss. Although significant complications may occur after LAGB, they are rare. LAGB causing discitis and osteomyelitis are incredibly rare, with only one other reported case. In this case report, we describe the case of a middle-aged woman who experienced discitis and osteomyelitis due to a disengaged LAGB catheter, which had eroded through her stomach and a part of her cecum. Overall, this case highlights the rare but potential complication of LAGB causing discitis and osteomyelitis. Patients with a history of LAGB placement should be monitored for this possibility and further investigation is needed to identify and mitigate risk factors.


Fully integrated optical coherence tomography, ultrasound, and indocyanine green-based fluorescence tri-modality system for intravascular imaging.
We present a tri-modality imaging system and fully integrated tri-modality probe for intravascular imaging. The tri-modality imaging system is able to simultaneously acquire optical coherence tomography (OCT), ultrasound (US), and fluorescence imaging. Moreover, for fluorescence imaging, we used the FDA-approved indocyanine green (ICG) dye as the contrast agent to target lipid-loaded macrophages. We conducted imaging from a male New Zealand white rabbit to evaluate the performance of the tri-modality system. In addition, tri-modality images of rabbit aortas were correlated with hematoxylin and eosin (H&E) histology to check the measurement accuracy. The fully integrated miniature tri-modality probe, together with the use of ICG dye suggest that the system is of great potential for providing a more accurate assessment of vulnerable plaques in clinical applications.


Trabectedin as a single agent and in combination with pegylated liposomal doxorubicin - activity against ovarian cancer cells.
Over 225 000 new cases of ovarian cancer are diagnosed each year. Symptoms are often vague, so most cases are detected when the disease is at an advanced stage. There is a need to find new drugs which will be able to treat ovarian cancer effectively. One of the most promising antineoplastic agents is trabectedin (Yondelis), derived from the marine tunicate Ecteinascidia turbinata, approved by the European Union in July 2007 for the treatment of soft-tissue sarcomas. This drug shows a mechanism of action based on the inhibition of the nucleotide excision repair system. Trabectedin shows anti-tumour activity in vitro and in vivo in ovarian, breast, prostate, renal, melanoma and non-small cell lung cancer cell lines. Trabectedin in combination with pegylated liposomal doxorubicin demonstrates synergistic antineoplastic activity.


[The diagnosis and treatment of duodenal lipoma.].
To summarize the clinical features of the duodenal lipomas in order to explore effective diagnostic methods and appropriate treatment preoperatively. The clinical features, laboratory results, endoscopic appearance, radiological and pathological data of 8 cases of duodenal lipoma were retrospectively analyzed. Four patients suffered with repeated melena, 3 cases with epigastric discomfort, sour regurgitation or hiccup, while 1 patient without any symptoms. Liver functions, serum lipids and tumor markers were normal in all patients. Six patients had been detected lesions by gastroscopy (2 cases missed diagnosed in the first examination), these lesions were appeared in duodenal bulb (2 cases) or descendant duodenum (4 cases). Abdominal CT examination revealed partial duodenal wall thickening (6 cases), partial enteric cavity narrowing (4 cases), or low-density lesions in enteric cavity (3 cases) with CT value of -85 HU and evenly intensified when enhanced. EUS showed intensive hyperechoic lesions from submucosa, with homogeneous echo and clear margin. Biopsy under endoscopy in all patients showed chronic inflammation of mucosa, while the pathologic diagnosis was lipoma after surgical excision or endoscopic resection. Pancreaticoduodenectomy performed in 1 patient, duodenal tumorectomy in 3 patients and endoscopic resection with snare in 4 patients. Common site of duodenal lipoma is descending part, and the clinical manifestations are non-specific. Imaging and endoscopic examination are the mainly methods to detect the lesion, while EUS is significantly valuable in diagnosing and differential diagnosing. It can be treated by partial tumorectomy or endoscopic trap resection.


Food incentives improve adherence to tuberculosis drug treatment among homeless patients in Russia.
The aim of the study was to evaluate the impact of food incentives on adherence to tuberculosis (TB) drug treatment among homeless patients with TB. Food packages were thus given as a part of directly observed therapy to 142 homeless patients with TB at a dispensary in Saint Petersburg, Russian Federation. In addition, a social worker provided the patients with information and legal assistance, for example help with internal passports. Among the 142 patients, 66 were included in the study at the dispensary during their entire treatment period, while 76 patients were included in the study during shorter periods mainly because of transfer to inpatient care. In the first group, 59% of the patients continued the TB drug treatment without interruption in contrast to 31% in a control group. In the second group, that is those studied during shorter periods, 95% continued the TB drug treatment without interruption while attached to the dispensary. Food was introduced in the TB programme of the City of St. Petersburg as a consequence of this study. In conclusion, it can be stated that the food incentive had a strong positive impact on the adherence to TB drug treatment among these socially marginalized patients. The social support contributed in all probability also to the positive results.


Analysis of methyl isothiocyanate in wine by gas chromatography with dual detection.
Methyl isothiocyanate (MITC) was extracted from a 5 mL wine sample with 2 mL dichloromethane, and the extract was washed with 5% sodium chloride solution. MITC was determined by gas chromatography with a dual nitrogen-phosphorus detector (NPD) and a flame photometric detector (FPD, S mode) (DB-210 column, 30 m x 0.53 mm id, column temperature, 70 degrees C). The limit of detection and quantitation of MITC with NPD-GC were 0.003 and 0.01 ppm, respectively. Average recoveries of MITC added to wine at 1 and 0.1 ppm were over 95%. This method is simple and rapid for routine analysis of MITC in wine.


Nursing schools on the increase as the 18 year old population decreases in Japan.
Baccalaureate nursing programs have been on the increase in Japan in the past few decades. However, the 18 year old population is on the decline. While nursing programs have been increasing, the number of high school graduates has decreased. The paradoxical phenomenon has started to affect nursing education, including shortages in faculty members and in clinical sites. The purpose of the present study was to identify actual or potential problems as a result of so many nursing schools having opened in the past few decades, and to make recommendations for nurse educators in Japan.


Selenium controls the sex-specific immune response and selenoprotein expression during the acute-phase response in mice.
Selenium modifies inflammatory reactions in rodents and humans. The liver controls metabolism and transport of selenium via hepatically-derived SEPP (selenoprotein P). Intracellular SEPS (selenoprotein S) modifies endoplasmic-reticulum function and immune-cell activity. Polymorphisms in SEPS have been associated with cytokine levels and inflammatory diseases in a subset of clinical studies. In the present study, we hypothesized that sex and selenium represent decisive parameters controlling the immune response and regulation of SEPS expression in vivo. Male and female mice fed a selenium-poor diet were supplemented or not with selenite for 3 days and injected with saline or LPS (lipopolysaccharide) 24 h before analysis. Selenium supplementation mitigated the LPS-induced rise in circulating cytokines in male mice. Serum SepP and selenium concentrations decreased in response to LPS, whereas hepatic SepS was specifically up-regulated despite declining selenium concentrations in the liver. Hepatic SepS induction was mainly controlled by post-transcriptional mechanisms and attributed to hepatocytes by analysing transgenic mice. Notably, selenium supplementation was essential for an optimal SepS induction. We conclude that selenoprotein biosynthesis becomes redirected in hepatocytes during the acute-phase response at the expense of dispensable selenoproteins (e.g. SepP) and in favour of SepS expression, thereby causing declining serum selenium and improving liver function. The selenium status and sex control SepS expression and modify cytokine response patterns in serum, which might explain contradictory results on associations of SEPS genotype and inflammatory diseases in clinical studies.


Antifungal activity of Lactobacillus paracasei subsp. tolerans against Fusarium proliferatum and Fusarium graminearum in a liquid culture setting.
Lactobacillus paracasei subsp. tolerans, isolated from a traditional sourdough bread culture and previously shown to have antifungal activity against Fusarium species, was tested for inhibition of growth of Fusarium proliferatum M 5991 and M 5689 and F. graminearum R 4053 in a liquid medium setting. This isolate completely inhibited the growth of F. proliferatum M 5689 and M 5991 and F. graminearum R 4053, whereas such growth was not inhibited in the control in a supernatant agar plate assay. When this isolate was tested using 2M medium (MRS-modified Myro media) known for supporting Fusarium growth and trichothecene production, it was found to inhibit fungal growth but promote mycotoxin production at the same time. The antifungal activity was determined to be the result of organic acids and low pH. The mechanism of the mycotoxin production promotion requires further investigation.


Mediastinal downstaging after induction treatment is not a significant prognostic factor to select patients who would benefit from surgery: the clinical value of the lymph node ratio.
Multimodal management of N2 non-small-cell lung cancer is still a matter of debate. In particular, the place of surgery for persistent N2 after induction treatment is controversial and surgery is usually reserved for patients experiencing a mediastinal downstaging (pN1 and pN0). We aimed to evaluate whether there might exist subgroups of pN2 according to the lymph node ratio (LNR). Between 1996 and 2012, we retrospectively reviewed the data from 152 potentially resectable cN2 patients who underwent an induction treatment before surgery. The median follow-up time was 32 months (2-112). The average age at the time of diagnosis was 58.52 ± 10.47 years. In univariate analysis, overall survival (OS) was significantly influenced by extracapsular spread (32 ± 5.33 vs 24 ± 12.73 months, P = 0.01), pN after surgery (65 ± 2.45 months for pN0, 44 ± 2.14 months for pN1 and 19 ± 1.72 months for pN2, P <0.0001) and LNR ≥ 1/3 (30 ± 3.77 months vs 16 ± 1.39 months, P <0.0001). When pN0 and pN1 patients were staged according to the LNR, the OS was divided by two for pN1 patients with an LNR ≥ 1/3 (48 ± 2.64 months vs 26 ± 5.65 months, P <0.001), whereas it decreased from 26 ± 0.87 to 15 ± 1.85 months (P <0.0001) for pN2 patients. OS was significantly better with adjuvant radio-chemotherapy than with chemotherapy or radiation therapy alone (P <0.0001). In multivariate analysis, mediastinal downstaging {Hazard Ratio (HR): 0.184 (95% confidence interval (CI): 0.084-0.403), P <0.0001} and LNR [HR: 0.359 (95% CI: 0.194-0.665], P = 0.001) remained significantly independent prognostic factors. The LNR may potentially identify subgroups of pN+ patients and allow enhancement of adjuvant treatments. Because pN2 with a low LNR had an equivalent survival to pN1 with a high LNR, mediastinal downstaging does not seem to be a sufficient prognostic factor to exclude patients after induction treatment from surgery.


Temporal classification of multichannel near-infrared spectroscopy signals of motor imagery for developing a brain-computer interface.
There has been an increase in research interest for brain-computer interface (BCI) technology as an alternate mode of communication and environmental control for the disabled, such as patients suffering from amyotrophic lateral sclerosis (ALS), brainstem stroke and spinal cord injury. Disabled patients with appropriate physical care and cognitive ability to communicate with their social environment continue to live with a reasonable quality of life over extended periods of time. Near-infrared spectroscopy is a non-invasive technique which utilizes light in the near-infrared range (700 to 1000 nm) to determine cerebral oxygenation, blood flow and metabolic status of localized regions of the brain. In this paper, we describe a study conducted to test the feasibility of using multichannel NIRS in the development of a BCI. We used a continuous wave 20-channel NIRS system over the motor cortex of 5 healthy volunteers to measure oxygenated and deoxygenated hemoglobin changes during left-hand and right-hand motor imagery. We present results of signal analysis indicating that there exist distinct patterns of hemodynamic responses which could be utilized in a pattern classifier towards developing a BCI. We applied two different pattern recognition algorithms separately, Support Vector Machines (SVM) and Hidden Markov Model (HMM), to classify the data offline. SVM classified left-hand imagery from right-hand imagery with an average accuracy of 73% for all volunteers, while HMM performed better with an average accuracy of 89%. Our results indicate potential application of NIRS in the development of BCIs. We also discuss here future extension of our system to develop a word speller application based on a cursor control paradigm incorporating online pattern classification of single-trial NIRS data.


Recombinant human growth hormone treatment, using two dose regimens in children with chronic renal failure--a report on linear growth and adverse effects.
The aim of this study was to study the efficiency and the adverse effects of 2 or 4 IU/m2/day of growth hormone (GH) in the first year and 4 IU/m2/day in the second. Of 29 growth-retarded children with chronic renal failure (CRF) (aged 3.4-15.1 years), 23 completed the first year of therapy, and 16 completed the second year. Height velocity SDS (HVSDS) increased in the first year in the low-dose group with 3.0, and 3.8 in the high-dose group. In the second year, HVSDS increased by 1.3 in the low-dose group and by 2.1 in high-dose group (p < 0.05). The IGF-I/IGFBP-3 ratio rose identically during the first year (p < 0.01). The retarded bone age did not advance inappropriately. The integrated insulin levels (AUC) increased significantly after 1 year of therapy in both groups. HbA1c, levels did not change. The number of adverse events was highest in the low-dose group, in which one patient developed overt insulin dependent diabetes mellitus. In conclusion, glucose metabolism should be monitored in children with CRF during rhGH-treatment. GH therapy in our patients resulted in a significant increase in height velocity with no inappropriate bone age progression and few serious adverse effects, all without relation to the dose of rhGH. The low start dose (2 IU/m2/ day) was of no advantage compared to the high dose.


Three major loci involved in age-related macular degeneration are also associated with polypoidal choroidal vasculopathy.
To investigate the frequency of variants in 3 major age-related macular degeneration (AMD)-associated loci in patients of European-American descent with polypoidal choroidal vasculopathy (PCV). Cross-sectional, case-control association study. Fifty-five patients with PCV, 368 patients with advanced AMD, and 368 age-matched and ethnically matched unaffected controls of European-American descent. Association analysis of allele and genotype frequencies, determined by TaqMan assays, was performed for the following haplotype-tagging single nucleotide polymorphisms (htSNPs): risk alleles in the complement factor H (CFH) gene (Y402H and IVS14) in the ARMS2/HTRA1 locus on 10q26 (A69S) and protective alleles in CFH (IVS1 and IVS6) and in the complement factor B/complement component C2 (CFB/C2) locus (IVS10 and H9L). Allele and genotype frequencies of the htSNPs in the CFH, CFB/C2, and ARMS2/HTRA1 loci. Four AMD-associated haplotype-tagging alleles (rs547154, rs1061170, rs1410996, rs10490924) in the 3 major loci, CFH, CFB/C2, and ARMS2/HTRA1, also were statistically significantly associated with the PCV phenotype (P<0.05). Three other alleles from the same loci (rs4151667, rs529825, rs3766404) showed a trend toward association (P<0.2) but did not reach statistical significance, possibly because of the combined effects of a relatively small sample size and low minor allele frequency in the screened populations. The PCV phenotype in Caucasian patients is associated with the major alleles/genotypes in the AMD-associated loci, suggesting that PCV and AMD are genetically similar in the tested loci.


Atractylenolide I restores HO-1 expression and inhibits Ox-LDL-induced VSMCs proliferation, migration and inflammatory responses in vitro.
Pathogenesis of atherosclerosis is characterized by the proliferation and migration of vascular smooth muscle cells (VSMCs) and inflammatory lesions. The aim of this study is to elucidate the effect of atractylenolide I (AO-I) on smooth muscle cell inflammation, proliferation and migration induced by oxidized modified low density lipoprotein (Ox-LDL). Here, We found that atractylenolide I inhibited Ox-LDL-induced VSMCs proliferation and migration in a dose-dependent manner, and decreased the production of inflammatory cytokines and the expression of monocyte chemoattractant protein-1 (MCP-1) in VSMCs. The study also identified that AO-I prominently inhibited p38-MAPK and NF-κB activation. More importantly, the specific heme oxygenase-1 (HO-1) inhibitor zinc protoporphyrin (ZnPP) IX partially abolished the beneficial effects of atractylenolide I on Ox-LDL-induced VSMCs. Furthermore, atractylenolide I blocked the foam cell formation in macrophages induced by Ox-LDL. In summary, inhibitory roles of AO-I in VSMCs proliferation and migration, lipid peroxidation and subsequent inflammatory responses might contribute to the anti-atherosclerotic property of AO-I.


Autoimmune thrombocytopenia in pediatric systemic lupus erythematosus: alternative therapeutic modalities.
Three patients with pediatric systemic lupus erythematosus (PSLE) and autoimmune thrombocytopenia (AT), who developed unacceptable side effects (pseudotumor cerebri, hypertension, excessive weight gain) from treatment with steroids, were treated successfully with vincristine (2 patients) or intravenous immunoglobulin (1 patient). All patients remained off steroids without any complications for 11 to 23 months.


Genotypic change and phylogenetic analysis of porcine circovirus type 2 in Taiwanese pig herds.
Porcine circovirus type 2 (PCV2) is the primary causative agent of postweaning multisystemic wasting syndrome. Two major PCV2 genotypes, PCV2a and PCV2b, have been identified. To explore the prevalence of different subgroups of PCV2 in Taiwan, 37 PCV2 isolates collected during 2002-2011 were analyzed. The genotypes of the PCV2 isolates collected before 2007 belonged to either PCV2a or PCV2b. However, all of the isolates collected after 2008 were PCV2b. Most of the isolates obtained since 2008 have been classified into a novel genotype within a subgroup of PCV2b based on complete ORF2 sequence analysis. Moreover, analysis of the PCV2 isolates from the same pig farm but from different years revealed that the viruses shifted from a PCV2b genotype to a novel subgroup of the PCV2b genotype. Collectively, PCV2b was the dominant PCV2 genotype in Taiwan currently, and the viruses have shifted into a new emerging subgroup of the PCV2b genotype.


Gene stacking in transgenic plants--the challenge for 21st century plant biotechnology.
One of the major technical hurdles impeding the advance of plant genetic engineering and biotechnology is the fact that the expression or manipulation of multiple genes in plants is still difficult to achieve. Although a small proportion of commercial genetically modified (GM) crops present 'stacked' or 'pyramided' traits, only a handful of products have been developed by introducing three or more novel genes. On the research front, a variety of conventional and more novel methods have been employed to introduce multiple genes into plants, but all techniques suffer from certain drawbacks. In this review, the potential and problems of these various techniques and strategies are discussed, and the prospects for improving these technologies in the future are presented.


Plasmodium falciparum parasitaemia and malaria among pregnant women at first clinic visit in the mount Cameroon Area.
Pregnant women in malaria endemic areas are at high risk of P. falciparum infection and its complications. This study investigated the prevalence and risk factors for P. falciparum infection and malaria among pregnant women reporting for first antenatal care (ANC) clinic visit in the mount Cameroon area. Venous blood samples from consented pregnant women were screened for malaria parasitaemia by light microscopy. Haemoglobin levels, white blood cell (WBC) counts, lymphocyte counts and percentage were determined using an automated haematology analyser. Socio-demographic/economic data, environmental factors and use of malaria control measures were documented. Univariate and multivariate statistical analyses were used. Sixty-eight (22.4%; N = 303) of the women enrolled were positive for P. falciparum parasitaemia. Malaria parasitaemia was significantly (P < 0.001) associated with febrile illness. The overall prevalence of malaria and asymptomatic infection was 16.0% (95% CI = 11-20%) and 10.5% (95% CI = 7.3-15%) respectively. A greater proportion of the malaria cases (61%) reported at the clinic during unscheduled days meanwhile women with asymptomatic parasitaemia mostly (92.8%) seek for ANC during scheduled clinic days. Lower lymphocyte percentage was significantly associated with increase parasite density (r = - 0.34; P = 0.011) and febrile status (MU = 2.46; P = 0.014). While age and gravidity were significant factors associated with P. falciparum infection and/or malaria, the presence of bush and/or standing water around human residence was an independent risk factor of P. falciparum parasitaemia (OR = 3.3: 95% CI = 1.6-7.0; P = 0.002) and malaria (OR = 5.2: 95% CI = 2.0-14; P = 0.001). Being unmarried was significantly associated with increase risk (OR = 2.6:95% CI = 1.1-6.0; P = 0.032) of P. falciparum parasitaemia. Similarly, single women (938) had a significantly higher (t = 2.70; P = 0.009) geometric mean parasite density (GMPD) compared with married women (338). Marital status and human residence in areas with bushes and/or standing water modify risk of P. falciparum infection and malaria. Education on early ANC attendance and environmental sanitation are important public health targets for malaria control in pregnancy in this setting.


What Hydra can teach us about chemical ecology -how a simple, soft organism survives in a hostile aqueous environment.
Hydra and its fellow cnidarians - sea anemones, corals and jellyfish - are simple, mostly sessile animals that depend on bioactive chemicals for survival. In this review, we briefly describe what is known about the chemical armament of Hydra, and detail future research directions where Hydra can help illuminate major questions in chemical ecology, pharmacology, developmental biology and evolution. Focusing on two groups of putative toxins from Hydra - phospholipase A2s and proteins containing ShK and zinc metalloprotease domains, we ask: how do different venom components act together during prey paralysis? How is a venom arsenal created and how does it evolve? How is the chemical arsenal delivered to its target? To what extent does a chemical and biotic coupling exist between an organism and its environment? We propose a model whereby in Hydra and other cnidarians, bioactive compounds are secreted both as localized point sources (nematocyte discharges) and across extensive body surfaces, likely combining to create complex "chemical landscapes". We speculate that these cnidarian-derived chemical landscapes may affect the surrounding community on scales from microns to, in the case of coral reefs, hundreds of kilometers.


Differentiation between Thalassemia Trait and Iron Deficiency Anemia Based on Low Hemoglobin Density and Microcytic Anemia Factor.
The most common causes of microcytic hypochromic anemia are thalassemia trait (TT) and iron deficiency anemia (IDA). Clinically, the differential diagnosis of TT and IDA is crucial, but it is typically challenging. Thus, in order to differentiate between TT and IDA, we seek to develop a new discriminative index on an automatic hematology analyzer utilizing the two new RBC characteristics of low hemoglobin density (LHD) and microcytic anemia factor (MAF). We recruited a total of 323 subjects, including 115 healthy controls, 83 TT, and 125 IDA. An automated hematology analyzer (DxH800, Beckman Coulter) was used to determine peripheral blood parameters; LHD and MAF were calculated using the parameters of MCHC, Hb, and MCV. The receiver operating characteristic (ROC) curve was used to determine the cutoff values and evaluate the diagnostic value for TT and IDA. LHD was significantly lower in TT than IDA, whereas MAF was higher. To distinguish between TT and IDA, a new formula based on LHD and MAF was developed, with a cutoff value of 0.5, AUC of 0.9706 (95% CI: 0.9503 - 0.9909), and specificity, sensitivity, positive predictive value, and negative predictive values were 92.91%, 91.36%, 89.16%, and 94.40%, respectively. The new formula has proven advantages over conventional indices, such as RDW-SD, MCV, MCH, etc. Conclusions: The RBC parameters LHD and MAF detected by hematology analyzer could be useful for screening for TT and IDA. Our new formula outperforms other discriminant formulas in the literature with high sensitivity and specificity, is simple, rapid, and can aid in early detection and management.


Decolorization of industrial synthetic dyes using engineered Pseudomonas putida cells with surface-immobilized bacterial laccase.
Microbial laccases are highly useful in textile effluent dye biodegradation. However, the bioavailability of cellularly expressed or purified laccases in continuous operations is usually limited by mass transfer impediment or enzyme regeneration difficulty. Therefore, this study develops a regenerable bacterial surface-displaying system for industrial synthetic dye decolorization, and evaluates its effects on independent and continuous operations. A bacterial laccase (WlacD) was engineered onto the cell surface of the solvent-tolerant bacterium Pseudomonas putida to construct a whole-cell biocatalyst. Ice nucleation protein (InaQ) anchor was employed, and the ability of 1 to 3 tandemly aligned N-terminal repeats to direct WlacD display were compared. Immobilized WlacD was determined to be surface-displayed in functional form using Western blot analysis, immunofluorescence microscopy, flow cytometry, and whole-cell enzymatic activity assay. Engineered P. putida cells were then applied to decolorize the anthraquinone dye Acid Green (AG) 25 and diazo-dye Acid Red (AR) 18. The results showed that decolorization of both dyes is Cu(2+)- and mediator-independent, with an optimum temperature of 35°C and pH of 3.0, and can be stably performed across a temperature range of 15°C to 45°C. A high activity toward AG25 (1 g/l) with relative decolorization values of 91.2% (3 h) and 97.1% (18 h), as well as high activity to AR18 (1 g/l) by 80.5% (3 h) and 89.0% (18 h), was recorded. The engineered system exhibited a comparably high activity compared with those of separate dyes in a continuous three-round shake-flask decolorization of AG25/AR18 mixed dye (each 1 g/l). No significant decline in decolorization efficacy was noted during first two-rounds but reaction equilibriums were elongated, and the residual laccase activity eventually decreased to low levels. However, the decolorizing capacity of the system was easily retrieved via a subsequent 4-h cell culturing. This study demonstrates, for the first time, the methodology by which the engineered P. putida with surface-immobilized laccase was successfully used as regenerable biocatalyst for biodegrading synthetic dyes, thereby opening new perspectives in the use of biocatalysis in industrial dye biotreatment.


[SEEDS OF MINDFULNESS IN THE DESERT: PRELIMINARY RESULTS FROM A CLINICAL TRIAL IN THE MINDFULNESS CLINIC MENTAL HEALTH CENTER, BEER SHEVA].
Mindfulness-based therapies are rooted in the Buddhist tradition, and promote cultivation of qualities such as open awareness, acceptance and compassion. While various studies have demonstrated the efficacy of integrating mindfulness in therapeutic practice for people suffering from clinical conditions such as depression and anxiety as well as the non-clinical population, this was rarely replicated in Israel. In the Mindfulness Clinic, located in the Mental Health Center, Beer Sheva, mindfulness workshops are now available for diverse populations dealing with various challenges such as daily stress, chronic pain, and depression. This article aims to describe the effects of mindfulnessbased workshops in a mixed sample, via the examination of various outcome variables such as quality of life, depression and anxiety symptoms, mindfulness, self-compassion and self-criticism. Self-report questionnaires provided before and after the workshop. Results: Preliminary results demonstrated that among 18 participants in mindfulness workshops during the period November 2013 till March 2014, a significant improvement was observed for most of the variables. In addition, effect sizes were measured, demonstrating medium to large effects, with the largest effect size for self-compassion. These preliminary results demonstrate the time limited efficacy of Mindfulness Workshops in a mixed sample. In addition, it is conceivable that mindfulness-based workshop may provide an effective preventive and/or therapeutic approach for people living in the south of Israel, who were facing an ongoing rackets' threat in recent years. In the future, this hypothesis should be examined empirically.


The detection matrix as a model-agnostic tool to estimate the number of degrees of freedom in mechanical systems and engineering structures.
Estimating the number of degrees of freedom of a mechanical system or an engineering structure from the time-series of a small set of sensors is a basic problem in diagnostics, which, however, is often overlooked when monitoring health and integrity. In this work, we demonstrate the applicability of the network-theoretic concept of detection matrix as a tool to solve this problem. From this estimation, we illustrate the possibility to identify damage. The detection matrix, recently introduced by Haehne et al. [Phys. Rev. Lett. 122, 158301 (2019)] in the context of network theory, is assembled from the transient response of a few nodes as a result of non-zero initial conditions: its rank offers an estimate of the number of nodes in the network itself. The use of the detection matrix is completely model-agnostic, whereby it does not require any knowledge of the system dynamics. Here, we show that, with a few modifications, this same principle applies to discrete systems, such as spring-mass lattices and trusses. Moreover, we discuss how damage in one or more members causes the appearance of distinct jumps in the singular values of this matrix, thereby opening the door to structural health monitoring applications, without the need for a complete model reconstruction.


MR imaging of hepatic focal nodular hyperplasia: characterization and distinction from primary malignant hepatic tumors.
Spin-echo MR imaging at 0.35 T was used to image hepatic focal nodular hyperplasia (FNH) and to attempt to distinguish it from primary malignant hepatic tumors. There were six FNH and 10 malignant tumors including seven hepatocellular carcinomas, two cholangiocarcinomas, and one hepatoblastoma. Our results show that FNH has a fairly consistent appearance, dissimilar from that of malignant primary hepatic tumors. Four of six FNH lesions were isointense (except for a central scar in three) and indistinguishable from normal hepatic parenchyma on all pulse sequences, whereas two of six were homogeneous but slightly hyperintense on T2-weighted sequences. Furthermore, a central hyperintense scar was seen in three of six lesions on T2-weighted sequences. In contrast, each of the malignant primary hepatic tumors was hyperintense on T2-weighted sequences and seven of 10 were hypointense on T1-weighted sequences; in nine of 10, heterogeneous areas of intensity were noted. In two fibrolamellar hepatocellular carcinomas a central scar was seen that was hypointense on all pulse sequences. By using quantitative data, the best characterization was obtained by using lesion/normal-liver intensity ratios from a T2-weighted sequence; all FNH had a ratio less than 1.33, while in nine of 10 primary malignant tumors it was greater than 1.41. We conclude that focal nodular hyperplasia may have a consistent appearance on spin-echo MR imaging and probably can be distinguished from primary malignant lesions in most instances.


In vivo detection of carotid plaque thrombus by ultrasonic tissue characterization.
The purpose of the study was to determine whether ultrasonic tissue characterization could detect carotid plaque thrombus in vivo. Patients undergoing carotid endarterectomy were examined preoperatively and the ultrasonic tissue characterization findings were compared to those of optical microscopy of the removed plaque specimens. Ten of 15 patients studied had plaque thrombus. Ultra-ultrasonic tissue characterization entailed an analysis of parameters obtained from the power spectrum of backscattered ultrasound signals. Data were obtained with a nominal 10 MHz sector scanning transducer with an effective bandwidth of 3 to 13 MHz. The parameters were the slope and intercept derived from the linear regression of the normalized spectrum and total power (log of the integrated power of the normalized spectrum over the effective bandwidth). The combined effect of the three parameters was determined by discriminant function analysis and showed a significant difference (P < 0.05) between nonthrombus and plaque thrombus in a small sample of patients with advance carotid atherosclerosis. These parameters applied singly could not provide such a distinction. Correct classification of carotid plaque thrombus using the multiple-parameter analysis revealed a sensitivity of 90%, specificity of 80%, and accuracy of 86.7%. This study demonstrates that analysis utilizing a combination of multiple spectral parameters was able to detect carotid plaque thrombus in vivo.


Integrating self-efficacy and aging theories to promote behavior change and reduce stroke risk.
The increasing incidence of stroke has resulted in the establishment of secondary stroke prevention clinics. Such clinics have successfully reduced wait-to-treatment times for individuals diagnosed with transient ischemic attack or minor stroke. In addition to improving access to consultation, diagnosis, and treatment, healthcare clinics need to implement behavioral risk-reduction programs tailored to older adults to help them better adhere to treatment regimens. The integration of two social-psychological theories--(a) self-efficacy and (b) selection, optimization, and compensation-provide the foundation for an approach that could lead to the development of evidence-based behavioral risk-reduction programs for older adults at high risk of stroke.


Photonic doping of epsilon-near-zero media.
Doping a semiconductor with foreign atoms enables the control of its electrical and optical properties. We transplant the concept of doping to macroscopic photonics, demonstrating that two-dimensional dielectric particles immersed in a two-dimensional epsilon-near-zero medium act as dopants that modify the medium's effective permeability while keeping its effective permittivity near zero, independently of their positions within the host. The response of a large body can be tuned with a single impurity, including cases such as engineering perfect magnetic conductor and epsilon-and-mu-near-zero media with nonmagnetic constituents. This effect is experimentally demonstrated at microwave frequencies via the observation of geometry-independent tunneling. This methodology might provide a new pathway for engineering electromagnetic metamaterials and reconfigurable optical systems.


A home-treatment program for the cerebral-palsied child.
The process and results of a two-month intensive home-treatment program for a two-year-old athetoid cerebral-palsied boy are described in this article. The exploratory program was designed to develop methods and procedures for the mother to use to promote the child's normal postural tone and movement during daily handling and care. The foundation for the intervention program was based on a collation of the child's history, a one-day assessment of the child's activities and time schedule in the home, and a physical evaluation. Postevaluation identified changes in the child's feeding, playing, and sleep patterns that suggested more normal movement and muscle tone. Also, the mother established new physical handling patterns and the therapist gained skill and a new awareness in home intervention programs.


Experimental anion affinities for the air/water interface.
Anion affinities, gammaX-, for the aerial interface of aqueous (Br- + NO3- + I- + SCN- + BF4- + ClO4-) solutions are determined by electrospray ionization mass spectrometry. The composition of the ions ejected from the surface of fissioning nanodroplets shows that gammaX- increase (decrease) exponentially with anionic radii, aX-(dehydration free energies, dGX-), and selectively respond to the presence of surfactants. BF4-, the least hydrated and polarizable anion of the set, has one of the largest gammaX- values. Non-ionic surfactants decrease gammaI- and gammaSCN- but increase gammaBF4-. Cetyltrimethyl ammonium markedly enhances the gammaX- of smaller anions. A similar but weaker effect is observed upon lowering the pH of the bulk solutions from 8.2 to 3.0. Dodecyl sulfate has a negligible effect on gammaX-. Considering that (i) universal many-body electrodynamic interactions will progressively stabilize the interfacial layer as its dielectric permittivity falls relative to that of the bulk solution and (ii) water permittivity is uniformly depressed by increasing concentrations of these anions, we infer that the observed Hofmeister correlation, ln gammaX- infinity - dGX-, is consistent with the optimal depression of the permittivity of the drier interfacial layer by the least hydrated ions. Interfacial ion-ion interactions can significantly influence gammaX- in environmental aqueous media.


[Evaluation of intraperitoneal chemotherapy using CDDP combined with MMC in gastric carcinomatous peritonitis].
Based on the experimental studies using Meth A and L 1210 transplantable mouse, which indicated that simultaneous combined administration of MMC and CDDP prolonged life span more significantly than individual administration, clinical application was performed on 14 cases with carcinomatous peritonitis in gastric cancer. One hundred mg of CDDP was administered before the closure of abdomen and drainage tubes were opened 2 hours later. Then, repeated administration of 10 mg/body of MMC and 40-50 mg/body of CDDP was continued once a month via the drug delivery system. Negative change of cytology was observed in seven out of 14 cases, and the prognosis of these patients was better than in the unchanged cytology group. Side effects such as severe gastro-intestinal symptoms and bone marrow toxicities were not recognized. Further studies should be done to confirm the efficacy of the intraperitoneal chemotherapy for carcinomatous peritonitis.


Patterns of transfer for patients with non-ST-segment elevation acute coronary syndrome from community to tertiary care hospitals.
Practice guidelines for non-ST-segment elevation acute coronary syndromes (NSTE ACS) recommend early invasive management (cardiac catheterization and revascularization within 48 hours of hospital presentation) for high-risk patients, but interhospital transfer is necessary to provide rapid access to revascularization procedures for patients who present to community hospitals without revascularization capabilities. We analyzed patterns and factors associated with interhospital transfer among 19,238 patients with NSTE ACS (positive cardiac markers and/or ischemic ST-segment changes) from 124 community hospitals without revascularization capabilities in the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines quality improvement initiative from January 2001 through June 2004. Less than half of the patients (46.3%) admitted to community hospitals were transferred to tertiary hospitals, and fewer (20%) were transferred early (within 48 hours of presentation). Early transfer rates increased by 16% over 10 quarters in patients with a predicted low or moderate risk of inhospital mortality, compared with 5% in high-risk patients. By the last quarter of the analysis, 41.4% of low-risk patients were transferred early versus 12.5% of high-risk patients. Factors significantly associated with early transfer included younger age, lack of prior heart failure, cardiology inpatient care, and ischemic ST-segment electrocardiographic changes. Among patients who were not transferred, 29% had no further risk stratification performed with stress testing, ejection fraction measurement, or diagnostic cardiac catheterization (at hospitals with catheterization laboratories). Most patients with NSTE ACS presenting to community hospitals without revascularization capabilities are not rapidly transferred to tertiary hospitals, and lower-risk patients appear to be preferentially transferred early. Further investigation is needed to determine if improved risk-based triage at community hospitals can optimize transfer decision making for high-risk patients with NSTE ACS.


Pelvic organ prolapse in a woman with previous mitrofanoff operation: Management of a case.
Mitrofanoff operation or vesico-appendicostmy is a continent conduit operation performed for intractable incontinence. The long-term complications reported in the literature are related to the stoma. Pelvic organ prolapse among women who have undergone this surgery is not reported earlier. A woman of 27 years of age presented with uterovaginal prolapse. She had sustained bladder neck transection following a road traffic accident at 16 years of age. The same was primarily repaired but incontinence had remained. Many standard operations for incontinence were performed. Finally, Mitrofanoff operation was carried out 9 years back because of persisting intractable incontinence. She got married and had two uneventful vaginal deliveries 5 and 2 years back. There was supravaginal elongation of the cervix with a rectocele. After counseling Fothergills operation with laparoscopic ligation was performed. The challenges and details of the management of the case are highlighted.


Transport processes in tumours.
The characteristic features of transport systems controlling influx into tumour cells of nutrients and other chemicals are briefly described. Two notable features of transport of amino acids into tumour cells have been observed: extensive accumulation against a concentration gradient and equal accumulations, whether conditions are aerobic or anaerobic, provided glucose is present. This combination of features has not been observed in the majority of normal mammalian tissues so far examined. Important for considerations of chemotherapy is the ability of tumour transport carriers to transfer substances related in structure to amino acids and other nutrients. Amino acid analogues, for example, can either block transport of natural amino acids or can be transported into the cell where they may interfere with various aspects of amino acid metabolism. The study of transport carriers is essential for an understanding of tumour-host relationships and for considerations of chemotherapy.