Body surface isopotential maps of normal Japanese children.
Body surface isopotential maps were compared between 52 normal children and 47 normal adults. While sequential changes in body surface potential distribution were similar, 4 significant differences in body surface maps were observed between them: 1) Surface maps of normal children showed less smooth contour of isopotential lines than did those of normal adults. For example, breakthrough minimum was recognized more frequently in children (100%) than adults (65%). 2) Breakthrough minimum appeared earlier in normal children (23.2 +/- 5.0 msec) than in normal adults (29.2 +/- 4.3 msec), and more leftwards on the chest. 3) Forty-seven percent of the children showed positive potentials on the upper and right portions of the anterior chest in the terminal phase of QRS, but this pattern was not observed in normal adults. 4) The maximum at the time of the peak of the T wave appeared more leftward in normal children than normal adults.


Inverse scattering and acousto-optic imaging.
We propose a tomographic method to reconstruct the optical properties of a highly scattering medium from incoherent acousto-optic measurements. The method is based on the solution to an inverse problem for the diffusion equation and makes use of the principle of interior control of boundary measurements by an external wave field.


Main issues addressed in the 2014-2015 revisions to the OECD Genetic Toxicology Test Guidelines.
The Organization for Economic Cooperation and Development (OECD) recently revised the test guidelines (TGs) for genetic toxicology. This article describes the main issues addressed during the revision process, and the new and consistent recommendations made in the revised TGs for: (1) demonstration of laboratory proficiency; (2) generation and use of robust historical control data; (3) improvement of the statistical power of the tests; (4) selection of top concentration for in vitro assays; (5) consistent data interpretation and determination of whether the result is clearly positive, clearly negative or needs closer consideration; and, (6) consideration of 3R's for in vivo assay design. The revision process resulted in improved consistency among OECD TGs (including the newly developed ones) and more comprehensive recommendations for the conduct and the interpretation of the assays. Altogether, the recommendations made during the revision process should improve the efficiency, by which the data are generated, and the quality and reliability of test results. Environ. Mol. Mutagen. 58:284-295, 2017. © 2017 Wiley Periodicals, Inc.


[Visceral leishmaniasis. Pediatric case report].
Leishmaniasis is a disease caused by obligate intracellular parasites of the genus Leishmania. There are three main clinical forms of leishmaniasis: cutaneous, visceral and mucocutaneous. It belongs to the diverse group of the tropical "neglected diseases" and is the only tropical vector-borne disease that has remained endemic to southern Europe for decades. Visceral leishmaniasis represents the most serious clinical syndrome. It is characterized by fever, weight loss, anemia and enlargement of the spleen and liver. Incubation period is usually from 2 weeks to 18 months. Leishmaniasis is considered a worldwide reemerging disease. Some of the factors that favor this situation are the changes in the climatic conditions, migrations and urbanizations deficient in environmental sanitation. We report an interesting case of an European child who was spending holidays in Cordoba and presented to our hospital with fever and pancytopenia, motivating a multidisciplinary approach with favorable clinical outcome.


Mutagenic evaluation of the pesticides captan, folpet, captafol, dichlofluanid and related compounds with the mutants TA102 and TA104 of Salmonella typhimurium.
A mutagenic evaluation of captan, folpet, captafol, dichlofluanid and related compounds was carried out using the Salmonella/mammalian microsome test using strains TA102 and TA104. These strains contain A-T base pairs at the site of the mutation in contrast to the other Salmonella tester strains that detect mutagens damaging G-C base pairs. In addition, the excision repair system of the TA102 strain is still intact. Captan and folpet were mutagenic in strain TA104, captafol was mutagenic in strain TA102, whereas the remaining test compounds (dichlofluanid, tetrahydrophthalimide and thiozolidine-4-carboxylic acid) were not mutagenic in either strain. In conclusion, we consider it of value to add these two strains to those already used in the Ames test in order to increase confidence in our ability to detect mutagens and to shed further light on their mechanism of action.


Effects of depleting ionic strength on 31P nuclear magnetic resonance spectra of micellar casein during membrane separation and diafiltration of skim milk.
Membrane separation processes used in the concentration and isolation of micellar casein-based milk proteins from skim milk rely on extensive permeation of its soluble serum constituents, especially lactose and minerals. Whereas extensive literature exists on how these processes influence the gross composition of milk proteins, we have little understanding of the effects of such ionic depletion on the core structural unit of micellar casein [i.e., the casein phosphate nanocluster (CPN)]. The 31P nuclear magnetic resonance (NMR) is an analytical technique that is capable of identifying soluble and organic forms of phosphate in milk. Thus, our objective was to investigate changes to the 31P NMR spectra of skim milk during microfiltration (MF) and diafiltration (DF) by tracking movements in different species of phosphate. In particular, we examined the peak at 1.11 ppm corresponding to inorganic phosphate in the serum, as well as the low-intensity broad signal between 1.5 and 3.0 ppm attributed to casein-associated phosphate in the retentate. The MF concentration and DF using water caused a shift in the relevant 31P NMR peak that could be minimized if orthophosphate was added to the DF water. However, this did not resolve the simultaneous change in retentate pH and increased solubilization of micellar casein protein. The addition of calcium in combination with orthophosphate prevented micellar casein solubilization and simultaneously contributed to preservation of the CPN structure, except for overcorrection of retentate pH in the acidic direction. A more complex DF solution, involving a combination of phosphate, calcium, and citrate, succeeded in both CPN and micellar casein structure preservation while maintaining retentate pH in the region of the original milk pH. The combination of 31P NMR as an analytical technique and experimental probe during MF/DF processes provided useful insights into changes occurring to CPN while retaining the micellar state of casein.


Psychopathological considerations on the semantic confusion between mood and affect.
The discussion is anchored in the transcultural, organismic pervasive character of psychopathologically relevant depressive and manic reality construction; it attacks, however, the exclusion of these mood states from the normal behavior repertory. The hypothesis is advanced that both phenomena represent inborn dialectical logical instruments of evolution-like human identity creation and maintenance. Therefore, from a psychotechnical viewpoint, mood is a meta-concept in regard to all experiential, communicative, self-defining facets of human polythematic existence to which emotion-related linguistic labels can be affixed.


Terrorist Attacks against Sports Venues: Emerging Trends and Characteristics Spanning 50 Years.
Sports venues foster community and support local economies. Due to their capacity to host hundreds to thousands of spectators, sports venues are vulnerable to becoming targets of terrorism. Types of venues targeted, regional trends, and methods of attack employed world-wide have not been well-described. A search of the Global Terrorism Database (GTD) was conducted from 1970 through the end of 2019. Pre-coded variables for target type "business" and target subtype "entertainment/cultural/stadium/casino" were used to identify attacks involving venues where sports events might be viewed by spectators as part of an audience. Sports venues were specifically identified using the search terms "sport," "stadium," "arena," and "ring," as well as mention of any specific sport. Two authors then manually reviewed each entry for specific information to confirm appropriateness for inclusion, selecting preferentially for attacks against venues where watching a sports event was the primary focus for the majority of the attendees. Descriptive statistics were performed using R (3.6.1). Seventy-four (74) terrorist attacks targeting sports venues were identified from January 1, 1970 through December 31, 2019. Thirty-three (33) attacks, or 44.6% of attacks, involved soccer stadiums or soccer venues, while 33.8% of attacks (25 attacks) involved unspecified sports venues. A bombing or explosion was the most frequent method of attack employed, comprising 87.8% of attacks. The highest number of attacks occurred in the Middle East & North Africa. In total, 213 persons died and 699 more were wounded in attacks against sports venues. Although terrorist attacks against sports venues are uncommon, they carry the risk of mass casualties, especially when explosives are used. A greater understanding of the threat posed by terrorist attacks against sports venues can aid emergency preparedness planning and future medical responses.


Caging and Photoactivation in Single-Molecule Förster Resonance Energy Transfer Experiments.
Caged organic fluorophores are established tools for localization-based super-resolution imaging. Their use relies on reversible deactivation of standard organic fluorophores by chemical reduction or commercially available caged dyes with ON switching of the fluorescent signal by ultraviolet (UV) light. Here, we establish caging of cyanine fluorophores and caged rhodamine dyes, i.e., chemical deactivation of fluorescence, for single-molecule Förster resonance energy transfer (smFRET) experiments with freely diffusing molecules. They allow temporal separation and sorting of multiple intramolecular donor-acceptor pairs during solution-based smFRET. We use this "caged FRET" methodology for the study of complex biochemical species such as multisubunit proteins or nucleic acids containing more than two fluorescent labels. Proof-of-principle experiments and a characterization of the uncaging process in the confocal volume are presented. These reveal that chemical caging and UV reactivation allow temporal uncoupling of convoluted fluorescence signals from, e.g., multiple spectrally similar donor or acceptor molecules on nucleic acids. We also use caging without UV reactivation to remove unwanted overlabeled species in experiments with the homotrimeric membrane transporter BetP. We finally outline further possible applications of the caged FRET methodology, such as the study of weak biochemical interactions, which are otherwise impossible with diffusion-based smFRET techniques because of the required low concentrations of fluorescently labeled biomolecules.


EVOLUTIONARY SIGNIFICANCE OF THE LOSS OF THE CHLOROPLAST-DNA INVERTED REPEAT IN THE LEGUMINOSAE SUBFAMILY PAPILIONOIDEAE.
The distribution of a rare chloroplast-DNA structural mutation, the loss of a large inverted repeat, has been determined for 95 species representing 77 genera and 25 of the 31 tribes in the legume subfamily Papilionoideae. This mutation, which is regarded as a derived feature of singular origin within the subfamily, marks a group comprising six temperate tribes, the Galegeae, Hedysareae, Carmichaelieae, Vicieae, Cicereae, and Trifolieae, an assemblage traditionally considered to be monophyletic. This mutation also occurs in the chloroplast genome of Wisteria, a member of the tropical tribe Millettieae whose other members so far surveyed lack the mutation. These new DNA data, together with traditional evidence, support the hypothesis that Wisteria is an unspecialized member of a lineage that gave rise to the temperate tribes marked by the chloroplast-DNA mutation; the probable paraphylesis of Millettieae is revealed. Two other tribes, Loteae and Coronilleae (traditionally regarded as a derived element of the aforesaid temperate tribes) do not possess this chloroplast-DNA structural mutation and, therefore, presumably represent a distinct temperate lineage. This hypothesis is supported by additional evidence from pollen, inflorescence, and root-nodule morphology that suggests that the Loteae and Coronilleae share a more recent ancestry with tropical tribes such as Phaseoleae and Millettieae than with other temperate tribes.


Strong fluorescence of poly(N-vinylpyrrolidone) and its oxidized hydrolyzate.
Discovering fluorescence of existing compounds, which are generally regarded as non-fluorescent, is of important academic and technical significance. This article reports the fluorescence of common compounds containing pyrrolidone ring(s) and their oxidized hydrolyzates. Poly(N-vinylpyrrolidone) (PVP), polymerized from a very weak fluorescent monomer N-vinyl-2-pyrrolidone (NVP), exhibits strong intrinsic fluorescence. Moreover, the fluorescence of its "hydrolyzate" is dramatically enhanced by about 1000 times. The "hydrolyzate" of N-methyl-pyrrolidone (NMP) also exhibits significantly enhanced fluorescence. By studying the chemical structures and fluorescence of the hydrolyzates, the enhanced fluorescence is attributed to the formation of secondary amine oxide. The much stronger fluorescence of the polymers compared to the corresponding small molecular compounds is ascribed to the "aggregation-induced emission" (AIE) effect of the luminophores. PVP and its oxidized hydrolyzate also show some phenomena different to the common AIE effect. The fluorescence of PVP and its oxidized hydrolyzate shows stimuli response to metal ions and pH values. This study introduces novel fluorescent materials for various potential applications.


Targeting prevention programs for young and new healthcare workers: what is the association of age and job tenure with occupational injury in healthcare?
previous evidence suggests young and new workers experience an increased risk of occupational injury. We sought to confirm this observation for healthcare workers. a retrospective cohort of 42,771 healthcare workers (88.2% women) was constructed from an active injury surveillance database. Over 2 years, incidence rates and crude and adjusted relative risks for occupational injury were compared between age groups and job tenures. there were opposite trends in the two main types of injuries which cancelled each other: new workers and young workers had a decreased (not increased) risk of musculoskeletal sprain and strain injuries (adjusted RR [95% CI] for new hires was 0.60 [0.48, 0.73], and 0.85 [0.73, 0.98] for workers <25 years old); but an increased risk of cut and puncture injuries (1.25 [1.07, 1.45] for new hires, 1.28 [0.99, 1.67] for workers <25 years old). contrary to studies of other sectors, younger age and shorter tenure were not universal risk factors for occupational injuries in the female dominated healthcare sector. Young and new workers had increased risk of cuts and punctures, but a decreased risk of musculoskeletal injuries.


Intestinal Parasitic Infections in Human Immunodeficiency Virus-Infected and Noninfected Persons in a High Human Immunodeficiency Virus Prevalence Region of Cameroon.
The problem of intestinal parasitic infection in human immunodeficiency virus (HIV)-infected people requires careful consideration in the developing world where poor nutrition is associated with poor hygiene and several coinfecting diseases. Studies have addressed this issue in Cameroon, especially in the low HIV prevalence area. The current study was conducted to determine the prevalence of intestinal parasitosis in people living with HIV (PLHIV) in Adamaoua and to identify associated risk factors. Stool and blood specimens from study participants were screened for intestinal parasites and anti-HIV antibodies, respectively. Of 235 participants, 68 (28.9%) were HIV positive, 38 of them on antiretroviral treatment (ART). The overall prevalence of intestinal parasites was 32.3%. Of 68 PLHIV, 32.3% (22/68) were infected with intestinal parasites, compared with 32.3% (54/167) of the HIV-negative patients. Univariate analysis showed no difference between the prevalence of intestinal parasites among PLHIV and HIV-negative patients (P = 0.69). ART was not associated with the prevalence of intestinal parasites. Multivariate analysis showed that the quality of water and the personal hygiene were the major risk factors associated to intestinal parasitosis. The level of education was associated with HIV serostatus: the higher the level of education, the lower the risk of being infected with HIV (P = 0.00). PLHIV and the general population should be screened routinely for intestinal parasites and treated if infected.


Epidemiology and outcome of acute kidney injury due to venomous animals from a subtropical region of India.
To study the epidemiology and outcome of acute kidney injury (AKI) caused by venomous animals. A retrospective study of patients admitted at Indira Gandhi Medical College Hospital, Shimla, with AKI due to venomous animals over a period of 15 years (January 2003-December 2017). Medical records were evaluated for patient information on demographic factors, clinical characteristics, complications, and outcome. Outcomes of requirement for intensive care unit (ICU) support, treatment with dialysis, survival, and mortality were analyzed. The survival and non-survival groups were compared to see the difference in the demographic factors, laboratory results, clinical characteristics, and complications. One hundred and eighty-one patients were diagnosed with AKI caused by venomous creatures. Mean age was 44 ± 15.4 years, and the majority (54.1%) was women. Snakebite (77.9%) and wasp stings (19.9%) were the leading causes of AKI. Clinical details were available in 148 patients. The median duration of arrival at hospital was two days. 81.8% had oliguria, and 54.7% had a history of hematuria or having passed red or brown colored urine. The hematological and biochemical laboratory abnormalities were as follows: anemia (75%), leukocytosis (75.7%), hyperkalemia (35.8%), severe metabolic acidosis (46.6%), hepatic dysfunction (54.7%), hemolysis (85.8%), and rhabdomyolysis (65.5%). Main complications were as follows: gastrointestinal bleed (9.5%), seizure/encephalopathy (10.8%), and pneumonia/acute respiratory distress syndrome (ARDS) (11.5%). 82.3% of the patients required dialysis. 154 (85.1%) patient survived, and 27 (14.9%) patients died. As compared to the survival group, the white blood cell count, serum bilirubin, aspartate aminotransferase, alanine aminotransferase, creatine kinase, and lactate dehydrogenase were significantly higher, and serum albumin levels were significantly lower in patients who died. The proportion of patients with leukocytosis, hyperkalemia, metabolic acidosis, pneumonia/ARDS, seizure/encephalopathy, need for ICU support, and dialysis was significantly higher in patients who died. Snakebite and multiple Hymenoptera stings (bees and wasps) were the leading causes of AKI due to venomous animals. AKI was severe, a high proportion required dialysis, and the mortality was high.


A retest of MMPI prediction of admission to a psychiatric hospital.
In a previous study, Jones, Kahn, and Langsley (1965) investigated the hypothesis that the MMPI would prove clinically useful in the prediction of admission to a psychiatric hospital. They found that the MMPI had negligible predictive validity for such an application. However, several methodological flaws left the conclusion of that study in doubt. This paper retested the hypothesis that the MMPI can be predictive of the admission decision when a sophisticated multivariate classification technique and adequate sample size are used. Given our results, the hypothesis again must be rejected. Possible problems associated with testing an hypothesis such as this are discussed.


Estimation of scavenging activity of phenolic compounds using the ABTS(*+) assay.
Observations on the applicability of the ABTS(*+) assay to define structure-activity relationships (SARs) among phenols (AH) were based on experimental data and theoretical calculations. All AH examined (hydroxycinnamic derivatives, simple polyphenols, polyhydroxybenzoates, and flavonoids) were found to be active toward ABTS(*+). Moreover, known weak radical scavengers (i.e., coumaric and isoferulic acids) were found to be efficient or comparatively active to caffeic or rosmarinic acids in contradiction to the AH classification based on 1,1-diphenyl-2-picrylhydrazyl (DPPH) data or the bond dissociation enthalpy values. This behavior was observed both in ethanol and in buffered (pH 7.4) environment. Resorcinol and phloroglucin were found to be more active than catechol and hydroquinone, whereas, among polyhydroxybenzoates, 2,4-dihydroxybenzoic acid was the least active, in line with the DPPH and theoretical data. Therefore, it can be argued that the ABTS(*+) assay may give an indication for the presence of antioxidants in a certain system but SARs cannot be readily inferred.


A comparative study of the analgesic and respiratory effects of N-allylnorcodeine (nalodeine), nalorphine, codeine and morphine.
In this comparative study, the abdominal constriction test was used to determine analgesia in mice, and the body plethysmograph was used to study respiratory effects of nalodeine, nalorphine, naloxone, codeine, morphine and various agonist-antagonist combinations in rats. The analgesia dose-response curves for the surrogate pairs, nalodeine-nalorphine and codeine-morphine, were parallel but had significantly different slopes. Naloxone was a more potent antagonist of morphine and codeine than of nalorphine and nalodeine. In antagonizing morphine and codeine analgesia, naloxone was the most potent antagonist, nalorphine had a biphasic effect with decreasing activity at higher doses and nalodeine was not an antagonist. Moderate doses of nalorphrine depressed minute volume largely by their effect on tidal volume, but high doses stimulated respiratory rate and therefore had less effect on minute volume. Nalodeine depressed minute volume by depressing tidal volume, since all doses initially stimulated and then variably affected respiratory rate. Metabolic rate was not increased by either drug short of convulsant doses. Nalodeine depresses the ventilatory response to CO2 and weakly antagonizes the respiratory depressant actions of morphine.


Understanding abortion via different scholarly methodologies: book review essay.
Erde review three works that in his opinion have made important contributions to the abortion debate: Abortion Policy: An Evaluation of the Consequences For Maternal and Infant Health, by Jerome S. Legge, Jr. (Albany: State University of New York Press; 1985); Abortion and the Politics of Motherhood, by Kristen Luker (Berkeley: University of California Press; 1984); and Abortion: Moral and Legal Perspective, edited by J.L. Garfield and P. Hennessey (Amherst: University of Massachusetts Press; 1984). A later issue of the Journal of Medical Humanities and Bioethics will carry Erde's review of two additional scholarly books on abortion: Abortion: Understanding the Differences, edited by Sidney Callahan and Daniel Callahan (New York: Plenum Press; 1984), and Abortion and the Status of the Fetus, edited by William B. Bondeson, H.T. Engelhardt, Jr., S.F. Spicker, and D.H. Winship (Boston: D. Reidel; 1983).


Preliminary results on the inventory of therapeutic strategies.
The qualities of a new measure of therapists' interventions, the Inventory of Therapeutic Strategies (ITS), were examined in cognitive and brief dynamic psychotherapy. In contrast to other inventories, the ITS focuses on three types of therapist intentions (exploratory, supportive, and work-enhancing), and it also takes into account the content and object of exploratory strategies. In this preliminary study, ITS categories were found 1) to be reliably rated, 2) to be unrelated to the therapist's contribution to the alliance, 3) to differentiate cognitive and dynamic psychotherapy, and 4) to predict outcome, alone or in interaction with the alliance.


Versatile use of vacuum-assisted healing in fifty patients.
Wound management can often be a challenging experience, especially in the presence of diabetes mellitus, vascular or immunological compromise. While no single technique can be considered by itself to be ideal, vacuum-assisted healing, which is a recent innovation, is fast becoming a necessary addition as adjuvant therapy to hasten wound healing. To determine the efficacy of vacuum-assisted healing. Plastic surgery centre. Ministry of Health Hospital, Kuwait. PATIENTS FROM KUWAIT IN A WIDE VARIETY OF CLINICAL SITUATIONS WERE CHOSEN FOR STUDY: Patients (n=50) were classified by diagnosis: Group 1: pressure sore- sacral (n= 3), trochanteric (n=6), ischial (n= 2); Group 2: ulcers (n= 11); Group 3: traumatic soft tissue wounds (n =15); Group 4: extensive tissue loss from the abdominal wall perineum, thigh and axilla (n =5); Group 5: sternal dehiscence wounds (n =4) and Group 6: wounds from flap necrosis (n =4). All wounds were subjected to vacuum by wall unit or portable unit, using pressure of 100-125 mm - continuous or intermittent. Closure of wounds, significant reduction in size and refusal by patient for continuation of vacuum-assisted closure therapy were end points of vacuum application. Sixteen per cent of patients showed complete healing of the wound. Seventy per cent of patients showed 20-78% reduction in wound size. In 14% of patients treatment had to be discontinued. All patients showed improvement in granulation tissue and reduction in bacterial isolates and tissue oedema. The application of subatmospheric pressure or negative pressure promotes healing in a wide range of clinical settings and is an advanced wound healing therapy that can optimize patient care, promote rapid wound healing and help manage costs. It may be used in most instances in both hospital and community settings.


Ambulatory motor activity monitoring to study the timecourse of hypnotic action.
A solid state activity monitor worn on the wrist was used to study the effect of flunitrazepam, flurazepam, temazepam, triazolam and midazolam. All compounds reduced motor activity in the first half, but only flunitrazepam and flurazepam had an effect during the second half of the bed rest period. Ambulatory activity monitoring is an unobtrusive and simple method for investigating timecourse of action.


Maturation of rabbit reticulocytes: strong decline of the turnover of polyphosphoinositides.
The [32P]phosphate labelling of ATP and polyphosphoinositides (PI) of intact rabbit reticulocytes and mature erythrocytes was compared. Despite the fact that reticulocytes have a 30-fold higher turnover of ATP than mature erythrocytes, the 32P-labelling of the cellular ATP pool was identical. The 32P-Pi entry into the cells is the rate-limiting step for 32P-phosphate isotopic equilibration of the ATP-pool and is independent of maturation. The rates of 32P-phosphate incorporation into PI-4,5-P2 and into PI-4-P, respectively, were 17-fold and 8-fold higher in reticulocyte-rich cell suspensions than in erythrocytes. The specific radioactivity of PI-4,5-P2 labelling reaches 55% and that of PI-4-P 40% of the ATP specific activity. However, a rapid isotopic equilibration of the polyphosphoinositides, was found. These findings indicate the existence of a heterogeneity of polyphosphoinositide pools. Reticulocyte membranes lose about 30% of their polyphosphoinositides during maturation proportional to the total loss of phospholipids.


A neuropathologic diagnosis of Alzheimer's disease in an older adult with HIV-associated neurocognitive disorder.
We discuss the challenges associated with diagnosing neurodegenerative disorders in older adults living with HIV, illustrated through a case report where neurologic co-diagnosis of Alzheimer's disease (AD) and HIV-associated Neurocognitive Disorder (HAND) are considered. The patient was followed and evaluated for over 4 years and underwent post-mortem neuropathologic evaluation. Further work is needed to identify diagnostic tests that can adequately distinguish HAND from early stage neurodegenerative disorders among older adults living with HIV and cognitive changes.


Dispersion aided tenside disintegration of seagrass Syringodium isoetifolium: Towards biomethanation, kinetics, energy exploration and evaluation.
In this study, an attempt was made to enhance the biomethanation potential of seagrass (Syringodium isoetifolium) by the aid of disperser-tenside (polysorbate 80) disintegration for the first time in literature. A disperser rpm of 10,000 for 20 min and PS 80 dose of 0.000864 g/g TS were selected as ideal parameters for effectual seagrass biomass disintegration. Dispersion aided tenside disintegration (DTD) with a disperser energy consumption of 349 kJ/kg TS, was observed to be efficacious with a biomass lysis rate of 25.6%. The impact of DTD on bioacidification and biomethanation assay with respect to volatile fatty acids concentration (1100 mg/L) and methane generation (0.256 g/g COD), was greater than dispersion disintegration (DD) (800 mg/L; 0.198 g/g COD). Thus, S. isoetifolium is considered as a promising substrate to attain the third generation biofuel goals in the near future.


Planning and structuring spinal cord injury rehabilitation: the needs assessment checklist.
The study aimed to evaluate the Needs Assessment Checklist (NAC) as a clinically appropriate assessment tool for use during spinal cord injury (SCI) rehabilitation. Data were obtained during routine clinical assessments from 193 patients admitted to the National Spinal Injuries Centre, UK, from September 2007 to November 2009. Reliability analyses yielded high internal consistency coefficients (mean α = .889, SD .051), and the mean item internal validity correlation was .534 (SD .136). All subscales of the NAC were found to be highly significant to change between administrations (mean P <.001). Several differences were found on the NAC subscales with respect to gender, age, and mobility. Pain and psychological issues were associated with poorer rehabilitation outcomes. The NAC is demonstrated to be a clinically reliable assessment tool that can be used to structure rehabilitation progress by the generation of person-centered goals. The results highlight the importance of assessing psychological issues and pain during SCI rehabilitation.


Reproductive Plasticity in the Nematode Gyrinicola batrachiensis: Does an Intermediate Reproductive Strategy Exist in Sexually Reproducing, Didelphic Pinworms?
Phenotypic plasticity is a process in which multiple phenotypes arise from 1 genotype because of environmental selection pressures. Gyrinicola batrachiensis has a heterogeneous reproductive strategy such that females reproduce either via parthogenesis with thick-shelled eggs in a single uterus or sexual reproduction with thick- and thin-shelled eggs in separate uterine horns. No evidence exists that strains of G. batrachiensis are able to switch between parthenogenetic and sexual reproduction. Thin-shelled eggs are autoinfective, and thick-shelled eggs act as transmission agents once shed into the aquatic environment. Our primary goal was to determine whether dioecious, didelphic pinworms that infect Rana sphenocephala, a slow-developing tadpole, and Osteopilus septentrionalis, a quick-developing tadpole, display reproductive plasticity with concern to thick- and thin-egg development. We performed experimental cross-infections in aquatic mesocosms to determine if dioecious, didelphic worms vary (based on tadpole host) in their ability to produce thin-shelled eggs: O. septentrionalis (hylid) egg masses were exposed to infected R. sphenocephala (ranid) tadpoles, ranid egg masses to infected hylid tadpoles, and a fully crossed infection that exposed ranid and hylid egg masses to infected tadpoles of both anuran families. Results indicated that worms reproduced via didelphic haplodiploidy in experimental ranid and hylid hosts, but that worms from hylids produced only thick-shelled eggs, which supports an intermediate reproductive strategy in O. septentrionalis. There was a significant difference in the mean intensities of ranid and hylid hosts, supporting our assertion that females infecting ranids are capable of producing autoinfective, thin-shelled eggs, and females infecting hylids do not produce such thin-shelled, autoinfective eggs because of the host microenvironment.


Tradable permits without legislative targets: a review of the potential for a permit scheme for sterilized clinical waste in the UK.
Tradable-permit schemes are becoming an increasingly popular technique for encouraging materials recovery and the diversion of waste from landfill. Such schemes operate using various forms of market-based trading of waste permits between polluters but usually rely on mandatory recycling targets to provide an incentive for trading. Using the UK's Packaging Recovery Note (PRN) scheme as a template, this paper examines the potential for permit trading where mandatory targets are absent and schemes must be driven solely by the financial benefits of reduced landfill costs and permit/material sales. The case examined is sterilized clinical waste, which has considerable recycling potential but suffers from health concerns and a poor public image. Interviews with healthcare and waste-management representatives indicate that although elements of the PRN scheme might prove appropriate for encouraging materials recovery, the absence of government targets and uncertain end markets for sterilized clinical waste present major obstacles to trading. Alternative incentives would therefore be required to catalyse schemes and develop recycling infrastructure. In the final analysis, thermal processing may be a more practical alternative to landfill than materials recovery for this particular waste stream.


Cell-mediated immunity to pancreatic islet cells in the non-obese diabetic (NOD) mouse: in vitro characterization and time course study.
The non-obese diabetic (NOD) mouse is an animal model of insulin-dependent diabetes mellitus (IDDM), in which 80% of the females become diabetic after the age of 12 weeks. Using an in vitro assay we investigated the capacity of spleen lymphocytes from NOD mice to inhibit the insulin secretion of normal islet cells after stimulation by theophylline plus arginine. Spleen cells from diabetic NOD mice inhibited the insulin release of DBA/2 islet cells. Depletion experiments using monoclonal antibodies demonstrated that inhibitory cells belonged to the Lyt2 positive T lymphocyte subset. The phenomenon was not restricted by the MHC class I K region, shared by NOD and DBA/2 mice, since lymphocytes from diabetic NOD mice also inhibited the insulin secretion of normal Wistar rat islet cells. Inhibitory T cells were detected in overtly diabetic mice but also in non-diabetic females aged 5-11 weeks indicating that they are not secondary to metabolic disturbances and might contribute to their onset. Conversely they were not found in male NOD mice although some of these mice show insulitis. The presence of these inhibitory T cells might thus represent an early and sensitive marker of anti-islet cell-mediated autoimmunity.


"An ecological perspective": the value of species comparisons.
George Collier is known for promoting the incorporation of an ecological framework into the study of feeding behavior. He has tirelessly reminded psychologists and physiologists that the animals they study are members of species designed by evolution to solve problems of acquiring, handling and storing energy in particular ways. A less-appreciated contribution is the comparative approach within his laboratory. George and his students used laboratory simulations of foraging, but ranged far beyond the laboratory rat to examine the responses of a variety of species representing different dietary needs and foraging strategies. Species comparisons enhance our ability to test the generality of responses to challenges, apply ecological theory to the explanation of behavior, and incorporate the feeding strategy of a species in the study of its ingestive behavior.


Oxidative stress and cardiovascular disease in dialyzed patients.
Oxidative damage has been suggested to play a key role in accelerated atherosclerosis and to be involved in cardiovascular disease (CVD) of dialyzed patients who are at risk of increased oxidative stress. The purpose of the present study was to examine the relationship between the severity of CVD and some markers of oxidative stress and antioxidant activity in our hemodialyzed (HD) and peritoneal dialysis (PD) patients. Plasma reactive oxygen metabolites, malondialdehyde and 4-hydroxynonenal (MDA-4HNE), thiols, alpha-tocopherol, and total antioxidant status (TAS) were measured in 55 HD and in 16 PD patients. CVD was considered as the result of variably combined cardiac, cerebral, and vascular pathologies which were scored and grouped in a single CVD index and analyzed with respect to the markers of the oxidative status. 16 normal subjects served as controls. All patients showed evidence of increased oxidative stress which was more severe in HD than in PD patients and which was exacerbated by HD. When cardiac, cerebral, and vascular diseases were analyzed separately, plasma MDA-4HNE and TAS were significantly higher in more severely affected HD patients, but not in PD patients. In HD patients the CVD index was directly correlated with both MDA-4HNE and TAS (r = 0.42, p < 0.01; r = 0.39, p < 0.01) and inversely correlated with alpha-tocopherol (r = -0.32, p < 0.05). MDA-4HNE and TAS were directly correlated in HD patients and inversely correlated in control subjects. Our data show that, in spite of increased antioxidant defense, there is a relationship between the degree of lipid peroxidation and the severity of CVD in HD patients. Moreover, these data underscore the utility of MDA-4HNE, alpha-tocopherol, and TAS in the evaluation of cardiovascular disease.


High-directivity and compact microstrip coupler for RF power applications.
A microstrip coupler was designed, fabricated, and tested to monitor the power of the 500 MHz kW-level amplifier modules currently installed in an 80-kW solid-state transmitter. The proposed coupler consists of multi-section coupled lines and employs a reverse-coupling scheme, achieving a very compact structure. The dual-side configuration with good termination enables the coupler to have high directivity and wide bandwidth without using any lump components for better temperature stability. Under a low-power test, the measured coupling is 37.69 dB with high directivity from 82 to 700 MHz. The coupling is almost independent of the power at 499.65 MHz, while the directivity slightly decreases to 33.85 dB at the input power of 1 kW. The maximal insertion loss of 0.08 dB was observed at 1-kW input power. The proposed directional coupler suits many high-power applications, especially in low-frequency regimes.


Time Out-of-Home and Cognitive, Physical, and Emotional Wellbeing of Older Adults: A Longitudinal Mixed Effects Model.
Time out-of-home has been linked with numerous health outcomes, including cognitive decline, poor physical ability and low emotional state. Comprehensive characterization of this important health metric would potentially enable objective monitoring of key health outcomes. The objective of this study is to determine the relationship between time out-of-home and cognitive status, physical ability and emotional state. Participants included 85 independent older adults, age 65-96 years (M = 86.36; SD = 6.79) who lived alone, from the Intelligent Systems for Assessing Aging Changes (ISAAC) and the ORCATECH Life Laboratory cohorts. Factors hypothesized to affect time out-of-home were assessed on three different temporal levels: yearly (cognitive status, loneliness, clinical walking speed), weekly (pain and mood) or daily (time out-of-home, in-home walking speed, weather, and season). Subject characteristics including age, race, and gender were assessed at baseline. Total daily time out-of-home in hours was assessed objectively and unobtrusively for up to one year using an in-home activity sensor platform. A longitudinal tobit mixed effects regression model was used to relate daily time out-of-home to cognitive status, physical ability and emotional state. More hours spend outside the home was associated with better cognitive function as assessed using the Clinical Dementia Rating (CDR) Scale, where higher scores indicate lower cognitive function (βCDR = -1.69, p<0.001). More hours outside the home was also associated with superior physical ability (βPain = -0.123, p<0.001) and improved emotional state (βLonely = -0.046, p<0.001; βLow mood = -0.520, p<0.001). Weather, season, and weekday also affected the daily time out-of-home. These results suggest that objective longitudinal monitoring of time out-of-home may enable unobtrusive assessment of cognitive, physical and emotional state. In addition, these results indicate that the factors affecting out-of-home behavior are complex, with factors such as living environment, weather and season significantly affecting time out-of-home. Studies investigating the relationship between time out-of-home and health outcomes may be optimized by taking into account the environment and life factors presented here.


Vitrification of a small number of spermatozoa in normozoospermic and severely oligozoospermic samples.
Despite broad utilization of sperm cryopreservation, little progress has been made to modify freezing protocols or to improve rates of sperm survival. Vitrification is an alternative method for freezing human spermatozoa without toxic permeable cryoprotectants (CPAs). The purpose of our study was to optimize the vitrification and post thaw recovery of a small number of spermatozoa using only nonpermeating CPAs in a closed straw system in normozoospermic and severely oligozoospermic samples. Individual motile spermatozoa (n = 295) were selected from semen samples of 15 normozoospermic and 10 severe oligozoospermia patients. Overall sperm recovery after vitrification was 80% (n = 236) with 80% (n = 189) viability and 41.5% (n = 98) retained post-warming motility. Two different loading techniques were compared to transfer selected spermatozoa into straws in preparation for vitrification: by spontaneous capillary action (CA) and with the aid of a polar body biopsy (PBB) pipette. There was evidence that the PBB loading technique increases the odds of spermatozoa recovery in both subsets (p = 0.01 and p = 0.04) in the normal and abnormal subsamples, respectively.


CD14 facilitates invasive respiratory tract infection by Streptococcus pneumoniae.
CD14 is a pattern recognition receptor that can interact with a variety of bacterial ligands. During gram-negative infection, CD14 plays an important role in the induction of a protective immune response by virtue of its capacity to recognize lipopolysaccharide in the bacterial cell wall. Knowledge of the contribution of CD14 to host defense against gram-positive infections is limited. To study the role of CD14 in gram-positive bacterial pneumonia. CD14 knockout (KO) and normal wild-type (WT) mice were intranasally infected with Streptococcus pneumoniae. CD14 KO mice demonstrated a strongly reduced lethality, which was accompanied by a more than 10-fold lower bacterial load in lung homogenates but not in bronchoalveolar lavage fluid at 48 hours after infection. Strikingly, CD14 KO mice failed to develop positive blood cultures, whereas WT mice had positive blood cultures from 24 hours onward and eventually invariably had evidence of systemic infection. Lung inflammation was attenuated in CD14 KO mice at 48 hours after infection, as evaluated by histopathology and cytokine and chemokine levels. Intrapulmonary delivery of recombinant soluble CD14 to CD14 KO mice rendered them equally susceptible to S. pneumoniae as WT mice, resulting in enhanced bacterial growth in lung homogenates and bacteremia, indicating that the presence of soluble CD14 in the bronchoalveolar compartment is sufficient to cause invasive pneumococcal disease. These data suggest that S. pneumoniae uses (soluble) CD14 present in the bronchoalveolar space to cause invasive respiratory tract infection.


The use of FK-506 for small intestine allotransplantation. Inhibition of acute rejection and prevention of fatal graft-versus-host disease.
Small intestine allotransplantation in humans is not yet feasible due to the failure of the current methods of immunosuppression. FK-506, a powerful new immunosuppressive agent that is synergistic with cyclosporine, allows long-term survival of recipients of cardiac, renal, and hepatic allografts. This study compares the effects of FK-506 and cyclosporine on host survival, graft rejection, and graft-versus-host-disease in a rat small intestine transplantation model. Transplants between strongly histoincompatible ACI and Lewis (LEW) strain rats, and their F1 progeny are performed so that graft rejection alone is genetically permitted (F1----LEW) or GVHD alone permitted (LEW----F1) or that both immunologic processes are allowed to occur simultaneously (ACI----LEW). Specific doses of FK-506 result in prolonged graft and host survival in all genetic combinations tested. Furthermore, graft rejection is prevented (ACI----LEW model) or inhibited (rejection only model) and lethal acute GVHD is eliminated. Even at very high doses, cyclosporine did not prevent graft rejection or lethal GVHD, nor did it allow long-term survival of the intestinal graft or the host. Animals receiving low doses of cyclosporine have outcomes similar to the untreated control groups. No toxicity specific to FK-506 is noted, but earlier studies by other investigators suggest otherwise.


Pair-correlated stereodynamics for diatom-diatom rotational energy transfer: NO(A2Σ+) + N2.
We have performed a crossed molecular beam velocity-map ion imaging study of state-to-state rotational energy transfer of NO(A2Σ+, v = 0, N = 0, j = 0.5) in collisions with N2 and have measured rotational angular momentum polarization dependent images of product NO(A) rotational levels N' = 3 and 5-11 for collisions at an average energy of 797 cm-1. We present an extension of our previously published [T. F. M. Luxford et al., J. Chem. Phys. 145, 174 304 (2016)] image analysis which includes the effect of rotational excitation of the unobserved collision partner and critically evaluate this methodology. We report differential cross sections and angle-resolved angular momentum alignment moments for NO(A) levels N' = 3 and 5-11 as a function of the rotational excitation of the coincident N2 partner. The scattering dynamics of NO(A) + N2 share similarities with those previously reported for NO(A) + Ne and Ar, although with detailed differences. We use comparison of the measurements reported here to the scattering of NO(A) with Ne, and the known NO(A)-Ne potential energy surface, to draw conclusions about the previously unknown NO(A)-N2 potential.


Signal transduction and co-stimulatory pathways.
Using specific cell surface receptors lymphocytes continuously sample their environment. Maturation of the immune system and initiation of a specific immune response rely on an array of extracellular cues that elicit complex intracellular biochemical signals. Essential molecules involved in signal transduction from immunoreceptors have emerged. After immunoreceptor engagement a core signaling complex is assembled comprising cytoplasmic immunoreceptor chains, kinases of the Src and ZAP70 families and various cytoplasmic and transmembrane adaptor molecules. Further effectors nucleate onto this complex evoking the characteristic responses of lymphocyte activation. Successful maturation of T cells into effector cells relies on the presence of a persistent stimulus presented in an appropriate extracellular environment. Encounter of MHC presented antigenic peptides and their cognate T cell receptors (TCRs) results in the formation of a nanometer intercellular gap between T cells and antigen presenting cells, which is now commonly referred to as the immunological synapse. The synapse is believed to sustain persistent TCR engagement. Its formation requires massive changes in T cell cytoskeletal architecture which essentially relies on signals provided by costimulatory molecules. The well orchestrated interplay between TCR and costimulatory signals decides about successful immune response and tolerance induction or immune failure and autoimmunity.


Multispectral, Fluorescent and Photoplethysmographic Imaging for Remote Skin Assessment.
Optical tissue imaging has several advantages over the routine clinical imaging methods, including non-invasiveness (it does not change the structure of tissues), remote operation (it avoids infections) and the ability to quantify the tissue condition by means of specific image parameters. Dermatologists and other skin experts need compact (preferably pocket-size), self-sustaining and easy-to-use imaging devices. The operational principles and designs of ten portable in-vivo skin imaging prototypes developed at the Biophotonics Laboratory of Institute of Atomic Physics and Spectroscopy, University of Latvia during the recent five years are presented in this paper. Four groups of imaging devices are considered. Multi-spectral imagers offer possibilities for distant mapping of specific skin parameters, thus facilitating better diagnostics of skin malformations. Autofluorescence intensity and photobleaching rate imagers show a promising potential for skin tumor identification and margin delineation. Photoplethysmography video-imagers ensure remote detection of cutaneous blood pulsations and can provide real-time information on cardiovascular parameters and anesthesia efficiency. Multimodal skin imagers perform several of the abovementioned functions by taking a number of spectral and video images with the same image sensor. Design details of the developed prototypes and results of clinical tests illustrating their functionality are presented and discussed.


Classification of ADHD and non-ADHD using AR models.
Accurate and confident diagnosis of ADHD is highly dependent on subjective observations. Several quantitative methods have been proposed, posing it as a two-class classification problem (ADHD and non-ADHD). However, the results have not made it past the research stage yet, as misclassification rates must be close to 0%. This study aims to discriminate ADHD and non-ADHD subjects using autoregressive models, with a high level of accuracy (85-95%). In addition, a confidence metric is proposed, expressing with how much confidence the classification of ADHD and non-ADHD subjects is made.


The relationship between executive attention and dissociation in children.
Dissociation involves disruption in the usually integrated functions of consciousness, memory, identity, and perception. Recent research with adults suggests that dissociation is associated with alterations in attention. Little work, however, has examined the attentional correlates of dissociation in childhood. This study is the first to investigate the specificity of cognitive functions related to dissociation in children. Twenty-four 5- to 8-year-old foster children completed several subtests of the NEPSY: A Developmental Neuropsychological Assessment (Korkman, Kirk, & Kemp, 1998) in the Executive Functioning/ Attention domain. Foster caregivers completed the Child Dissociative Checklist (Bernstein & Putnam, 1986). Consistent with the adult literature, higher levels of childhood dissociation were associated with deficits in tasks requiring inhibition, but not with tasks requiring primarily planning, strategy, or multiple rule sets.


Leonardo da Vinci (1452-1519) and his depictions of the human spine.
Few individuals in history have exerted so great an influence and made such extensive contributions to so many disciplines as Leonardo da Vinci. Da Vinci's inquisitive, experimental mentality led him to many discoveries, such as spinal cord function and the proper anatomy of several organ systems. Respected not only as an artist but also as an anatomist, he made many significant contributions to the field. This article explores da Vinci's drawings, in relation to the anatomy of the human spine.


Asymptomatic renal cell carcinoma with metastasis to the skin and duodenum: a case report and review of the literature.
Renal cell carcinoma is known to have blood-borne metastasis. This is usually to the bone, lungs and brain. Other unusual metastatic presentations such as skin and bowel metastasis have also been described. In most cases, the metastasis occurs as a late manifestation in a patient with known primary renal cell carcinoma. A rare synchronous presentation of skin and duodenal metastasis in an otherwise asymptomatic patient is reported here. This patient presented with a skin lesion that, on excision, brought up the diagnosis of metastatic renal cell carcinoma. While the patient was waiting for surgery, she also developed melena that, on gastroscopy, confirmed a duodenal metastasis. This case highlights the importance of early recognition of otherwise unrelated lesions as presentations for an advanced renal malignancy.


EHR query language (EQL)--a query language for archetype-based health records.
OpenEHR specifications have been developed to standardise the representation of an international electronic health record (EHR). The language used for querying EHR data is not as yet part of the specification. To fill in this gap, Ocean Informatics has developed a query language currently known as EHR Query Language (EQL), a declarative language supporting queries on EHR data. EQL is neutral to EHR systems, programming languages and system environments and depends only on the openEHR archetype model and semantics. Thus, in principle, EQL can be used in any archetype-based computational context. In the EHR context described here, particular queries mention concepts from the openEHR EHR Reference Model (RM). EQL can be used as a common query language for disparate archetype-based applications. The use of a common RM, archetypes, and a companion query language, such as EQL, semantic interoperability of EHR information is much closer. This paper introduces the EQL syntax and provides example clinical queries to illustrate the syntax. Finally, current implementations and future directions are outlined.


Propensity-Score Matched Comparison of the Cera PFO Occluder With the Amplatzer PFO Occluder for Percutaneous Closure of Patent Foramen Ovale Without Echocardiographic Guidance.
Percutaneous patent foramen ovale (PFO) closure has become a routine procedure and was proven to be safe and feasible. In a recently published pooled analysis of randomized trials, percutaneous PFO closure was shown to more effectively reduce recurrent stroke when compared with medical therapy in patients with cryptogenic strokes. However, procedural safety and closure rate are device dependent. We performed a propensity-score matched comparison of 28 patients undergoing percutaneous PFO closure using the Cera PFO occluder (CPO) with 28 patients who received the Amplatzer PFO occluder (APO). The main endpoints were procedural complications and closure rate at 6 months verified by transesophageal echocardiography. The implantation procedure using the CPO was successful and without complications in all cases. After propensity-score matching, there was no significant difference between groups for the primary endpoint of residual shunt at 6 months (7% in the CPO group vs 4% in the APO group; log-rank test P=.15). With regard to procedural safety and closure rate at 6 months, the performance of the CPO is comparable with the APO in this small patient cohort.


The effect of dentin on the pulp tissue dissolution capacity of sodium hypochlorite and calcium hydroxide.
Sodium hypochlorite (NaOCl) and calcium hydroxide (Ca[OH]2) have tissue dissolution capacity. The aim of this study was to evaluate the potential effect of dentin on their tissue dissolution capacity in a novel dentin model. Dentin models were prepared from 25 freshly extracted human molar teeth; the crowns were separated from the roots, and a rectangular inner shape was prepared. Pulp tissue samples adjusted to similar weights of 6.5 ± 0.2 mg were randomly divided into 6 groups: NaOCl groups in test tubes or dentin models for 1 hour, Ca(OH)2 groups in test tubes or dentin models for 1 week, and control groups saline in test tubes or dentin models for 1 week. The final weights after the experimental period were checked and compared with the initial weights. The differences were statistically analyzed. The tissue dissolution capacity of Ca(OH)2 was affected by the presence of dentin. Similarly, NaOCl lost its effect on the pulp tissue after incubation in dentin. Comparison between all test groups showed highly significant differences (P < .001). Dentin has a detrimental effect on the ability of NaOCl and Ca(OH)2 to dissolve pulp tissue. The dentin model appears to be an efficient tool for the study of interactions between local endodontic medicaments, dentin, and pulp tissue.


Retrograde, antegrade, and laparoscopic approaches for the management of large, proximal ureteral stones: a randomized clinical trial.
Multiple procedures have been introduced for the management of urinary stones in the upper ureter. In this randomized clinical trial, we compared three surgical options in this regard. From September 2004 to May 2006, we enrolled in the study 150 patients with upper ureteral stones who were referred to our center. We included patients with a stone size >or= 1.5 cm in the greatest diameter. Using the random table, patients were divided into three 50-patient groups by treatment: Group A, retrograde ureteroscopic lithotripsy using a semirigid ureteroscope; group B, transperitoneal laparoscopic ureterolithotomy; and group C, percutaneous nephrolithotripsy. All procedures were performed in a training program. The stone-free rates for patients in groups A, B, and C, at discharge and 3 weeks later, were 56%, 88% and 64% and 76%, 90% and 86%, respectively. Conversion to open surgery and repeated laparoscopy was necessary for two and one patients in group B. Urinary leakage continued more than 3 days in eight (16%) and nine (18%) patients in groups B and C after operation, respectively (P = 0.7). Although the success rate of ureteroscopy was not significantly lower than the two other options, the complications seen with this technique were negligible. Consequently, the procedure of choice for large proximal ureteral stones seems to depend on surgeon expertise and availability of equipment.


Higher Precision in Pointing Movements of the Preferred vs. Non-Preferred Hand Is Associated with an Earlier Occurrence of Anticipatory Postural Adjustments.
It is a common experience to exhibit a greater dexterity when performing a pointing movement with the preferred limb (PREF) vs. the non-preferred (NON-PREF) one. Here we provide evidence that the higher precision in pointing movements of the PREF vs. NON-PREF hand is associated with an earlier occurrence of the anticipatory postural adjustments (APAs). In this aim, we compared the APAs which stabilize the left or the right arm when performing a pen-pointing movement (prime mover flexor carpi radialis (FCR)). Moreover, we analyzed the elbow and wrist kinematics as well as the precision of the pointing movement. The mean kinematics of wrist movement and its latency, with respect to prime mover recruitment, were similar in the two sides, while APAs in triceps brachii (TB), biceps brachii (BB) and anterior deltoid (AD) were more anticipated when movements were performed with the PREF than with the NON-PREF hand (60-70 vs. 20-30 ms). APAs amplitudes were comparable in the muscles of the two sides. Earlier APAs in the preferred limb were associated with a better fixation of the elbow, which showed a lower excursion, and with a less scattered pointing error (PREF: 10.1 ± 0.8 mm; NON-PREF: 16.3 ± 1.7). Present results suggest that, by securing the more proximal joints dynamics, an appropriate timing of the intra-limb APAs is necessary for refining the voluntary movement precision, which is known to be scarce on the NON-PREF side.


Electroconvulsive therapy for major depressive disorder in a patient with a permanent skull defect: a case report.
Electroconvulsive therapy (ECT) is an effective and safe treatment method for a variety of psychiatric disorders, including major depressive disorder. Although there is no absolute contraindication to ECT, clinicians often hesitate to apply this method to patients with a skull defect. We report a case of ECT performed on a major depressive disorder patient with an open wound after craniectomy. We summarize successful ECT cases of patients with a permanent skull defect and discuss various factors that may influence ECT outcomes in patients with a skull defect, including electrode placement, benzodiazepines, and anticonvulsants.


Substitutional boron in nanodiamond, bucky-diamond, and nanocrystalline diamond grain boundaries.
Although boron has been known for many years to be a successful dopant in bulk diamond, efficient doping of nanocrystalline diamond with boron is still being developed. In general, the location, configuration, and bonding structure of boron in nanodiamond is still unknown, including the fundamental question of whether it is located within grains or grain boundaries of thin films and whether it is within the core or at the surface of nanoparticles. Presented here are density functional tight-binding simulations examining the configuration, potential energy surface, and electronic charge of substitutional boron in various types of nanocrystalline diamond. The results predict that boron is likely to be positioned at the surface of isolated particles and at the grain boundary of thin-film samples.


Intratumoral Heterogeneity in Breast Cancer: A Comparison of Primary and Metastatic Breast Cancers.
Intratumoral heterogeneity presents challenges in the management of cancer. To gain deeper insight in intratumoral heterogeneity at different levels and tumor sites for common biomarkers in breast cancers, this report examines seven cases of invasive breast cancer with multiple axillary nodal metastases and/or recurrences for immunohistochemical expression of estrogen receptors, progesterone receptors, human epidermal growth receptor 2, and Ki67 on all tissue blocks in both primary and metastatic tumors. The Oncologist 2017;22:487-490.


Liquid chromatographic determination of lipophilicity with application to a homologous series of barbiturates.
A graphical method for determining the lipophilicity of the members of a homologous series of barbituric acids, from a consideration of their reverse-phase HPLC retention data, is described. The HPLC parameter used as the index of lipophilicity, RQ, is shown not only to form excellent correlations with the more commonly employed indices of lipophilicity, Rm and log P, but also to have a predictive capability for those log P values that had not previously been determined experimentally.


Cu-Mediated Tandem 2,3-Disubstituted Indole Synthesis from Simple Anilines and Internal Alkynes via C-H Annulation.
A simple, cost-effective, and straightforward method for the synthesis of 2,3-disubstituted indole scaffolds has been developed. The present protocol involves copper-mediated tandem hydroamination followed by C-H annulation of unprotected anilines with a wide range of internal alkynes. In the presence of Cu(OAc)2·H2O and trifluoroacetic acid (TFA), the reaction proceeds well to afford a variety of substituted indole derivatives in moderate to good yields. This process was found to be compatible with both primary and secondary anilines coupled with aromatic/aliphatic alkynes. High-purity copper nanoparticles can be recovered after the reaction, revealing the cost-effectiveness and environmentally benign feature of the current protocol.


Role of genomics in eliminating health disparities.
The Texas Center for Health Disparities, a National Institute on Minority Health and Health Disparities Center of Excellence, presents an annual conference to discuss prevention, awareness education, and ongoing research about health disparities both in Texas and among the national population. The 2014 Annual Texas Conference on Health Disparities brought together experts in research, patient care, and community outreach on the "Role of Genomics in Eliminating Health Disparities." Rapid advances in genomics and pharmacogenomics are leading the field of medicine to use genetics and genetic risk to build personalized or individualized medicine strategies. We are at a critical juncture of ensuring such rapid advances benefit diverse populations. Relatively few forums have been organized around the theme of the role of genomics in eliminating health disparities. The conference consisted of three sessions addressing "Gene-Environment Interactions and Health Disparities," "Personalized Medicine and Elimination of Health Disparities," and "Ethics and Public Policy in the Genomic Era." This article summarizes the basic science, clinical correlates, and public health data presented by the speakers.


Vibrio vulnificus septicemia and leg ulcer.
Vibrio vulnificus is a gram-negative bacteria that can cause septicemia, wound infection, or a self-limiting diarrhea. This infection typically presents as an extremely virulent infection in patients with underlying liver disease 1 to 2 days after exposure. We report a case of V vulnificus septicemia, cellulitis, and leg ulceration in a patient who had symptoms develop after exposure to brackish water (19 days before admission) or after ingestion of raw oysters (10 days before admission). The longest incubation period previously reported is 6 days. The diagnosis was made from identification of the bacteria from blood cultures. No organisms were seen or grown in culture from the skin biopsy specimen, which showed epidermal necrosis and dermal and subcutaneous neutrophilic abscess. We review 13 cases of V vulnificus septicemia and leg ulcers and their approximate incubation time.


Predictors of short-term intra-hospital case fatality following first-ever acute ischaemic stroke in Nigerians.
To determine the predictors of 30-day intra-hospital case fatality rate in patients with first-ever acute ischaemic stroke, attending a tertiary care hospital in Western Nigeria. A cross-sectional observational study. This study was conducted at the Lagos University Teaching Hospital, Lagos, Nigeria between February 2003 and May 2004 (16 months). One hundred consecutively consenting patients admitted within 72 hours of onset of first-ever acute ischaemic stroke were studied. Uniform information was obtained using a standard format documenting demographic information, stroke-related symptoms and signs, risk factor profile, admission Glasgow Coma Score (GCS), stroke severity, admission Random Blood Glucose (RBG) and presence of complications. All patients were closely followed-up to monitor progress and document any complications. The end point was mortality or survival at 30 days from stroke onset. The 30-day case fatality rate was 28%. In univariate analysis, the factors predicting mortality were admission stroke severity, admission hyperglycaemia, admission level of consciousness, and presence of any complication during the hospitalization period. Of these factors, presence of complications had the strongest correlation with 30-day case fatality (r = 0.52; p = 0.001). Presence of complications was the most important predictor of short-term mortality in Nigerians with firstever acute ischaemic stroke. Prevention, early detection, and aggressive intervention to treat complications may reduce the unacceptably high mortality rate of ischaemic stroke in our environment.


When gene therapy meets adoptive cell therapy: better days ahead for cancer immunotherapy?
Evaluation of: Johnson LA, Morgan RA, Dudley ME et al. Gene therapy with human and mouse T-cell receptors mediates cancer regression and targets normal tissues expressing cognate antigen. Blood 114(3), 535-546 (2009). Effective cancer immunotherapy requires large numbers of antitumor lymphocytes with effective homing and effector functions over a prolonged time. Adoptive cell therapy (ACT) has proven a promising immunotherapy approach by achieving clinical responses in patients bearing metastatic melanoma. ACT expands a cancer patient's own cytotoxic lymphocytes in vitro and reinfuses them in vivo. Identifying cytotoxic T lymphocytes directed against cancer cells can, however, be a tedious endeavor. The paper under evaluation overcomes this hurdle and proposes a highly effective gene therapy approach to transduce a patient's lymphocytes with a high-avidity T-cell receptor, thus turning reinfused lymphocytes into strong effector cells directed against cancer. Furthermore, transgenic mice were used to broaden the repertoire of human transduced T-cell receptor to evasive tumor-associated antigens. Patients bearing metastatic melanoma were successfully treated with ACT using peripheral blood lymphocytes transduced with Mart-1 and gp100 tumor-associated epitopes. Objective clinical response rates of 30 and 19% were obtained in patients treated with the human and mouse T-cell receptors, respectively. Gene-engineered cells persisted in all patients at high level for 1 month after treatment. These findings have two major implications: first, transgenic mice can be used to obtain high-avidity T-cell receptors specific for elusive tumor-associated antigens, bypassing the need for frustrating immunizations attempts. Second, a gene therapy approach to ACT allows for an efficient transduction of patient's lymphocytes into highly avid tumor-specific cytotoxic cells, eliminating the requirement for identification and selection of tumor-specific lymphocytes in individual patients. Taken together, these results mark a step towards standardized immunotherapy protocols open to all patients and that will be able to deliver consistent clinical results.


Bilateral Renal Oncocytoma: Active Surveillance Versus Partial Nephrectomy.
Renal oncocytomas (ROs) are benign tumors comprising 16% of renal masses. Due to the overlapping phenotypes seen in RO and chromophobe renal cell carcinoma (RCC) and lack of specific clinical and laboratory characteristics of RO, physicians face a challenge when arriving at a definitive diagnosis of RO. ROs additionally appear indistinct from RCCs on CT scan, contributing further to the difficulty of arriving at a clear diagnosis of RO. This is a case report of a 66-year-old man who presented with flank pain found to be related to bilateral ROs and underwent bilateral partial nephrectomies. ROs are benign small renal masses that often pose a diagnostic challenge since preoperative diagnosis can be difficult to achieve. Given advancements in technology, active surveillance with core renal biopsy is a promising approach to accurately diagnose and manage ROs conservatively. The application of these techniques has wide-reaching implications for patients and physicians by reducing the need for a potentially harmful surgery and creating a cost-effective way to manage a diagnosis.


Sensitive detection of the endocrine effects of the estrogen analogue ethinylestradiol using a modified enhanced subacute rat study protocol (OECD Test Guideline no. 407).
Groups of five male and female Wistar rats were treated by gavage with 0, 0.01, 0.05 or 0.2 mg/kg body weight of the known synthetic estrogen ethinylestradiol for 28-32 days according to a modified enhanced OECD Test Guideline no. 407 in order to investigate which of the current and/or additional parameters would detect effects on the endocrine system reliably and sensitively and to provide data on intra-laboratory variability. Two identical studies (A and B) were run concurrently. The modified enhanced protocol requests the additional determination of triiodothyronine, thyroxine and thyroid-stimulating hormone (TSH), of the stage of the estrous cycle to ensure necropsy of all females in diestrus, of the number and morphology of cauda epididymal spermatozoa, and of additional organ weights (ovaries, uterus, thyroid, and male accessory reproductive organs), and histopathology of additional organs (pituitary, epididymides, coagulation glands, pancreas, and vagina). There were no treatment-related mortalities, clinical signs or changes in behavioral parameters. In male rats, 0.2 mg/kg was the maximum tolerated dose (MTD) resulting in reduced body weight gain. The only treatment-related alteration in hematological parameter was prolonged blood clotting time in high-dose females of both studies. Changes in clinical chemistry observed in study A were elevated alkaline phosphatase activity (high-dose females) and triglyceride levels (mid- and high-dose females and high-dose males). Changes in thyroid hormones and TSH of treated animals showed high variability with no clear dose-dependency, and could not be clearly related to estrogenic activity. In accordance to a suppression of the hypothalamic-pituitary-gonadal axis, decreased relative organ weights of the male accessory reproductive organs were obtained in both studies at the high dose. Corresponding histological changes were degeneration of the testicular germinal epithelium and atrophy of Leydig cells and of all accessory sex glands. Atrophy of the coagulating gland (study A) and seminal vesicles (study B) was also seen at 0.05 mg/kg. A marked increase in relative adrenal weight in male rats, accompanied by decreased vacuolization of zona fasciculata cells observed in both studies at the high dose seems to reflect an activation of the hypothalamic-pituitary-adrenal axis. The male mammary gland was sensitively affected. Increased numbers of small basophilic over large acidophilic cells indicated an estrogen-mediated feminisation and were detected at the low (study A) or mid dose (study B). Co-mitogenic properties of estrogens in rat liver were reflected by increased relative liver weights in females at the mid and high dose of study A and also at the high dose in study B. No treatment-related changes in endocrine organ weights were observed in treated females. Histological changes in the ovaries were increased numbers of apoptotic corpora lutea (from mid dose, study B) and of early stage follicles at the high dose in both studies. Classical direct estrogenic effects on the uterus, i.e. an increased height of luminal and glandular epithelium and increased granulocytic infiltration of the endometrium, were observed even at the low dose in both studies. Uterine findings occurring with a greater variability were dilation, squamous metaplasia of glands and thickened walls. Although females were necropsied in diestrus, as diagnosed by vaginal cytology, typical signs of estrogenic action in the vagina such as keratinization (indicative of estrus in normally cycling rats), mucification (indicative of proestrus), or thickened epithelia were observed in both studies even at the lowest dose. This unexpected discrepancy between vaginal cytology and vaginal and uterine morphology of treated females was considered to be treatment-related as it was not observed in the controls. Studies on liver enzymes that were performed outside the scope of the enhanced protocol showed that ethinylestradiol at 0.2 mg/kg decreased the activity of the sex-specific testosterone-dependent liver enzyme CYP2C11 in male rats. A simulation of doubling group size (to ten animals) by combining both studies did not increase the sensitivity of detection of endocrine-mediated effects above the level already obtained by histopathological examination of groups containing five animals. Only some of the enhancements to the current OECD Test Guideline no. 407 evaluated in this study (additional organs weights and additional histopathological investigations) were helpful in detecting the endocrine-mediated effects of ethinylestradiol, while other enhancements did not contribute towards this aim. Spermatology was completely insensitive at the MTD and measurement of thyroid hormones and TSH did not contribute to increased sensitivity. Vaginal cytology appeared to be an unreliable procedure for estrous cycle staging in estrogen-treated animals. Ongoing investigations, according to the modified version of the enhanced OECD Test Guideline no. 407 protocol, into the interference of ten compounds with the endocrine system by different mechanisms will result in the identification of the most appropriate enhancements.


Germ tube and chlamydospore formation by Candida albicans on a new medium.
A new medium composed of "cream of rice" infusion, oxgall, Tween 80, and agar is described for the sequential development of germ tubes and chlamydospores by Candida albicans. The procedure used (Dalmau's technique) is an improvement over the fluid substrate procedures previously advocated for germ tube formation. That the same preparation is then used for chlamydospore production is of practical importance for the clinical mycology laboratory.


Virtual Quartz Crystal Microbalance: Bioinspired Resonant Frequency Tracking.
The reference acoustic properties of the quartz crystal used as a resonator are ensured by its high-quality factor (Q-factor). The microbalance of the quartz crystal (QCM) exploits the bulk acoustic properties of the quartz crystal. Turning a network analyzer or impedance analyzer into a QCM with a decent measurement rate is a challenge. The use of a virtual instrument to implement an impedance analyzer (VIA) provides greater flexibility to the virtual QCM. In this paper, VIA's flexibility is exploited for the experimental evaluation of conventional scanning procedures and the influence of associated parameters, in order to identify elements that can lead to a limitation of the performance of a virtual QCM. The results of the experimental investigation justify the use of an innovative and optimized bioinspired scanning procedure to effectively track the serial resonance frequency of the QCM sensor. Variable-resolution spatial sampling of the human retina and the ability of the eye to refocus on the area of interest is the source of bioinspiration for achieving an adaptive virtual QCM. The design methodology and physics are described in detail, and the experimental investigations demonstrate the effectiveness of the proposed bioinspired scanning procedure.


The Effects of Prognostic Factors in Idiopathic Sudden Hearing Loss.
Introduction Sudden hearing loss is one of the otologic emergencies. The treatment of this disease is affected negatively by some prognostic factors. Objective In this study, the effects of early treatment initiation in patients with idiopathic sudden hearing loss and of prognostic factors in early treated patients were investigated. Methods Out of the 216 patients admitted between September 2007 and September 2015, 154 were identified as having idiopathic sudden hearing loss; they were followed-up for a mean time of 7.4 months, and evaluated retrospectively. The effects of several parameters on the success of the treatment were statistically evaluated, such as the time the treatment was initiated, being of the female gender, the severity of the hearing loss, having descending type audiogram patterns, being older than 60 years old, and the co-presence of vertigo. Results Success rates were found to be significantly higher in idiopathic hearing loss patients that were admitted within the first week ( p < 0.05) of the onset of the hearing loss. However, the outcomes were found to be similar when patients admitted within the first 3 days and 4-7 days after the occurrence of the hearing loss were compared ( p > 0.05). Parameters such as female gender, severe hearing loss, descending type audiogram, being older than 60 years old, and co-presence of vertigo didn't reveal statistically significant effects on the outcome ( p >0.05). Conclusion The aforementioned prognostic factors, which are well-known in the literature, did not have significant effects when the idiopathic sudden hearing loss treatment was initiated within the first 7 days of the onset of the hearing loss.


mRNA structure, in situ, as assessed by microscopic techniques.
The secondary and tertiary structure of RNA, in situ, is thought to be involved in distinct functions such as directing association of the RNA with the cytoskeleton, enzymatic activity of some RNAs, and the control of translation. In situ transcription (IST), a procedure by which cDNA is synthesized in situ, has been used to assess mRNA structure in situ using fixed cells or tissues. Distinct banding patterns were noted for mouse and rat POMC. Unique IST banding patterns were observed when an oligonucleotide complementary to a putative POMC stem-loop structure was used to prime IST. Indeed local changes in banding patterns could be elicited by pharmacological agents which modulate POMC translation. Inhibition of POMC synthesis with NaF or dexamethasone decreased the number of POMC mRNAs in the polysome fractions and increased the intensity of high molecular weight IST-derived bands. Forskolin, a stimulator of POMC synthesis, had the opposite effect. One mechanism by which translational control is thought to occur is by regulation of ribosome movement down the mRNA by specific binding of cytosolic proteins to RNA structure. Cytosolic protein fractions from AtT20 pituitary cells have been shown to specifically bind to the IST-predicted RNA structure. These findings suggest that 1) mRNA structure can be assessed in situ, 2) translation may be altered by the secondary and tertiary structure of mRNAs, and 3) a predicted stem-loop structure exists in situ in the 5'-end of POMC mRNA.


Attentional selectivity for emotional faces: evidence from human electrophysiology.
This study investigated the temporal course of attentional biases for threat-related (angry) and positive (happy) facial expressions. Electrophysiological (event-related potential) and behavioral (reaction time [RT]) data were recorded while participants viewed pairs of faces (e.g., angry face paired with neutral face) shown for 500 ms and followed by a probe. Behavioral results indicated that RTs were faster to probes replacing emotional versus neutral faces, consistent with an attentional bias for emotional information. Electrophysiological results revealed that attentional orienting to threatening faces emerged earlier (early N2pc time window; 180-250 ms) than orienting to positive faces (after 250 ms), and that attention was sustained toward emotional faces during the 250-500-ms time window (late N2pc and SPCN components). These findings are consistent with models of attention and emotion that posit rapid attentional prioritization of threat.


Nutritional composition, health benefits and bio-active compounds of chickpea (Cicer arietinum L.).
Chickpea (Cicer arietinum L.), an annual plant of the family Fabaceae is mainly grown in semiarid and temperate regions. Among pulses, cultivated worldwide chickpeas are considered an inexpensive and rich source of protein. Chickpea is a good source of protein and carbohydrate, fiber, and important source of essential minerals and vitamins. The quality of protein is better among other pulses. Consumption of chickpeas is related to beneficial health outcomes. Dietary peptides from the protein of chickpeas gaining more attention. Peptides can be obtained through acid, alkali, and enzymatic hydrolysis. Among all these, enzymatic hydrolysis is considered safe. Various enzymes are used for the production of peptides, i.e., flavorzyme, chymotrypsin, pepsin, alcalase, papain, and trypsin either alone or in combinations. Chickpea hydrolysate and peptides have various bioactivity including angiotensin 1-converting enzyme inhibition, digestive diseases, hypocholesterolemic, CVD, antioxidant activity, type 2 diabetes, anti-inflammatory, antimicrobial, and anticarcinogenic activity. This review summarizes the nutritional composition and bioactivity of hydrolysate and peptides obtained from chickpea protein. The literature shows that chickpea peptides and hydrolysate have various functional activities. But due to the limited research and technology, the sequences of peptides are unknown, due to which it is difficult to conduct the mechanism studies that how these peptides interact. Therefore, emphasis must be given to the optimization of the production of chickpea bioactive peptides, in vivo studies of chickpea bioactivity, and conducting human study trials to check the bioactivity of these peptides and hydrolysate.


A novel splice site mutation in the noncoding region of BRCA2: implications for Fanconi anemia and familial breast cancer diagnostics.
Fanconi anemia (FA) is a rare recessive disorder with chromosomal instability, congenital abnormalities, and a high cancer risk. The breast cancer susceptibility gene BRCA2 (FANCD1) is one of the 16 genes involved in this recessive disease. We have identified a novel mutation of the splice donor site of intron 1 in the noncoding region of BRCA2 in a Japanese FA family. This mutation may account for the FA phenotype in a patient originally reported to have biallelic mutations in BRCA2. Subsequent functional studies revealed that one of the mutations, K2729N, was a neutral change. As reported here, a more careful analysis resulted in the identification of a novel splice site mutation. Functional analysis using a mouse embryonic stem cell-based assay revealed that it causes aberrant splicing, reduced transcript levels and hypersensitivity to DNA damaging agents, suggesting that it is likely to be pathogenic. Although similar pathogenic variants in the noncoding region of BRCA1 and 2 were not identified in a cohort of 752 familial breast cancer cases, we still think this finding is relevant for mutation analysis in Hereditary Breast and Ovarian Cancer Syndrome families in a diagnostic setting.


Skin temperature changes in patients with unilateral lumbosacral radiculopathy.
To clarify the relationship of skin temperature changes to clinical, radiologic, and electrophysiological findings in unilateral lumbosacral radiculopathy and to delineate the possible temperature-change mechanisms involved. One hundred and one patients who had clinical symptoms and for whom there were physical findings suggestive or indicative of unilateral lumbosacral radiculopathy, along with 27 normal controls, were selected for the study, and the thermal-pattern results of digital infrared thermographic imaging (DITI) performed on the back and lower extremities were analyzed. Local temperatures were assessed by comparing the mean temperature differences (ΔT) in 30 regions of interest (ROIs), and abnormal thermal patterns were divided into seven regions. To aid the diagnosis of radiculopathy, magnetic resonance imaging (MRI) and electrophysiological tests were also carried out. The incidence of disc herniation on MRI was 86%; 43% of patients showed electrophysiological abnormalities. On DITI, 97% of the patients showed abnormal ΔT in at least one of the 30 ROIs, and 79% showed hypothermia on the involved side. Seventy-eight percent of the patients also showed abnormal thermal patterns in at least one of the seven regions. Patients who had motor weakness or lateral-type disc herniation showed some correlations with abnormal DITI findings. However, neither pain severity nor other physical or electrophysiological findings were related to the DITI findings. Skin temperature change following lumbosacral radiculopathy was related to some clinical and MRI findings, suggesting muscle atrophy. DITI, despite its limitations, might be useful as a complementary tool in the diagnosis of unilateral lumbosacral radiculopathy.


[Clinical and genetic profile of patients with medullary thyroid cancer treated in the Cancer Centre--Institute of Oncology in Warsaw].
The aim of this study was to analyse the distribution and frequency of mutations and their correlations with clinical phenotypes of patients with MTC, to reveal the differences between sporadic and familial type of MTC, and to describe the phenotypes of patients. 212 patients with medullary thyroid cancer (MTC) were treated in Cancer Centre in Warsaw between 1997 and 2005. In most patients, DNA isolated from peripheral blood leukocytes was tested for RET gene mutations by sequencing and accordingly MTC form was assessed. Genetic testing was performed in the relatives of patients with familial MTC in order to distinguish asymptomatic mutation carriers from noncarriers. RET gene mutations were identified in 46 patients (22%). The others were found noncarriers and sporadic MTC was diagnosed. MEN 2A/FMTC syndrome (multiple endocrine neoplasia type 2A/ familial type of MTC) was diagnosed in 44 patients, MEN 2B syndrome (multiple endocrine neoplasia type 2B) in 2 patients. In patients with sporadic and familial MTC, age at diagnosis and multifocal occurrence was analysed, and the results were found to be in accordance with those of other research centres. However, the distribution and frequency of mutations, as well as some clinical data, such as the frequency of pheochromocytoma occurrence as the first manifestation of MEN syndrome, differed from the published data, and further studies are necessary to reveal the reasons of these differences. DNA testing for RET gene mutations is reliable as a diagnostic tool and therefore it should be performed for screening of all patients with MTC or other diseases of MEN syndrome.


An artificial intelligence tool to predict fluid requirement in the intensive care unit: a proof-of-concept study.
The goal of personalised medicine in the intensive care unit (ICU) is to predict which diagnostic tests, monitoring interventions and treatments translate to improved outcomes given the variation between patients. Unfortunately, processes such as gene transcription and drug metabolism are dynamic in the critically ill; that is, information obtained during static non-diseased conditions may have limited applicability. We propose an alternative way of personalising medicine in the ICU on a real-time basis using information derived from the application of artificial intelligence on a high-resolution database. Calculation of maintenance fluid requirement at the height of systemic inflammatory response was selected to investigate the feasibility of this approach. The Multi-parameter Intelligent Monitoring for Intensive Care II (MIMIC II) is a database of patients admitted to the Beth Israel Deaconess Medical Center ICU in Boston. Patients who were on vasopressors for more than six hours during the first 24 hours of admission were identified from the database. Demographic and physiological variables that might affect fluid requirement or reflect the intravascular volume during the first 24 hours in the ICU were extracted from the database. The outcome to be predicted is the total amount of fluid given during the second 24 hours in the ICU, including all the fluid boluses administered. We represented the variables by learning a Bayesian network from the underlying data. Using 10-fold cross-validation repeated 100 times, the accuracy of the model in predicting the outcome is 77.8%. The network generated has a threshold Bayes factor of seven representing the posterior probability of the model given the observed data. This Bayes factor translates into p < 0.05 assuming a Gaussian distribution of the variables. Based on the model, the probability that a patient would require a certain range of fluid on day two can be predicted. In the presence of a larger database, analysis may be limited to patients with identical clinical presentation, demographic factors, co-morbidities, current physiological data and those who did not develop complications as a result of fluid administration. By better predicting maintenance fluid requirements based on the previous day's physiological variables, one might be able to prevent hypotensive episodes requiring fluid boluses during the course of the following day.


Associations between constructs related to social relationships and mental health conditions and symptoms: an umbrella review.
Loneliness and social isolation are increasingly recognised as prevalent among people with mental health problems, and as potential targets for interventions to improve quality of life and outcomes, as well as for preventive strategies. Understanding the relationship between quality and quantity of social relationships and a range of mental health conditions is a helpful step towards development of such interventions. Our aim was to give an overview of associations between constructs related to social relationships (including loneliness and social isolation) and diagnosed mental conditions and mental health symptoms, as reported in systematic reviews of observational studies. For this umbrella review (systematic review of systematic reviews) we searched five databases (PsycINFO, MEDLINE, EMBASE, CINAHL, Web of Science) and relevant online resources (PROSPERO, Campbell Collaboration, Joanna Briggs Institute Evidence Synthesis Journal). We included systematic reviews of studies of associations between constructs related to social relationships and mental health diagnoses or psychiatric symptom severity, in clinical or general population samples. We also included reviews of general population studies investigating the relationship between loneliness and risk of onset of mental health problems. We identified 53 relevant systematic reviews, including them in a narrative synthesis. We found evidence regarding associations between (i) loneliness, social isolation, social support, social network size and composition, and individual-level social capital and (ii) diagnoses of mental health conditions and severity of various mental health symptoms. Depression (including post-natal) and psychosis were most often reported on, with few systematic reviews on eating disorders or post-traumatic stress disorder (PTSD), and only four related to anxiety. Social support was the most commonly included social construct. Our findings were limited by low quality of reviews and their inclusion of mainly cross-sectional evidence. Good quality evidence is needed on a wider range of social constructs, on conditions other than depression, and on longitudinal relationships between social constructs and mental health symptoms and conditions.


The Food and Drug Administration and the regulation of clinical trials for endosseous implants.
The Office of Device Evaluation (ODE), within the Center for Devices and Radiological Health of the Food and Drug Administration is the primary component responsible for the premarket review of medical devices. Dental devices are reviewed by the Dental Devices Branch within ODE. Premarket submissions to FDA for dental endosseous implants should include complete characterization of the device and often may necessitate the inclusion of mechanical and other bench testing and clinical data. FDA guidance documents are available which outline the information that should be included in the submissions. The guidance document for premarket approval submissions for dental endosseous implants also provides guidance on clinical trials for dental implants. This guidance document addresses such issues as the number of patients and study sites, length of follow-up, post-implant assessment, and pooling of data. The review of dental endosseous implants involves many challenging issues, including success/failure criteria, new designs and new indicated uses. The Dental Branch continues to gather information to address these issues.


Divide and Control: Comparison of Split and Switch Hybridization Sensors.
Hybridization probes have been intensively used for nucleic acid analysis in medicine, forensics and fundamental research. Instantaneous hybridization probes (IHPs) enable signalling immediately after binding to a targeted DNA or RNA sequences without the need to isolate the probe-target complex (e. g. by gel electrophoresis). The two most common strategies for IHP design are conformational switches and split approach. A conformational switch changes its conformation and produces signal upon hybridization to a target. Split approach uses two (or more) strands that independently or semi independently bind the target and produce an output signal only if all components associate. Here, we compared the performance of split vs switch designs for deoxyribozyme (Dz) hybridization probes under optimal conditions for each of them. The split design was represented by binary Dz (BiDz) probes; while catalytic molecular beacon (CMB) probes represented the switch design. It was found that BiDz were significantly more selective than CMBs in recognition of single base substitution. CMBs produced high background signal when operated at 55°C. An important advantage of BiDz over CMB is more straightforward design and simplicity of assay optimization.