Chance-type fractures of the thoracolumbar spine: imaging analysis in 53 patients.
Chance-type fractures are subtle unstable injuries that are often associated with intraabdominal injuries. CT-based observations made during routine interpretations revealed involvement of a burst component to this fracture pattern and a clue on the transaxial images to its presence. The purpose of this review was to determine how often these features occurred in a retrospective study of a large sample because these findings influence diagnosis and management. A retrospective review of all patients identified from the University of Maryland Shock Trauma Center trauma registry and IDXRad system diagnosed with flexion-distraction injuries of the thoracolumbar spine over an 8-year period was performed. Three trauma radiologists assessed the admission spinal radiographs, CT studies with multiplanar images, and available MRI examinations. Imaging findings were confirmed by consensus. Abdominopelvic CT studies and surgical reports were reviewed for evidence and type of intraabdominal injury. A literature review of previous similar series was performed. Fifty-three patients were identified for inclusion in the study. Associated intraabdominal injury occurred in 40% and most commonly involved the bowel and mesentery. A close examination of the fracture patterns on CT revealed that a burst-type fracture with posterior cortex buckling or retropulsion was a common finding (48%). Also, serial transaxial CT images often (76%) showed a gradual loss of definition of the pedicles that we refer to as the "dissolving pedicle" sign. The study showed that the horizontally oriented fracture planes through the posterior elements can often be recognized radiographically, but these fractures can be very subtle. Intraabdominal injuries occurred in 40% of flexion-distraction thoracolumbar fractures in our study cohort, which is slightly lower than previously reported. About half of the patients with this injury displayed a burst-type component that could have a significant influence on surgical management. The dissolving pedicle sign can assist in recognition of this often subtle injury on transaxial CT.


Protein kinase Cepsilon overexpression alters myofilament properties and composition during the progression of heart failure.
We report characterization of a transgenic mouse that overexpresses constitutively active protein kinase Cepsilon in the heart and slowly develops a dilated cardiomyopathy with failure. The hemodynamic, mechanical, and biochemical properties of these hearts demonstrate a series of temporal events that mark the progression of the disease. In the 3-month transgenic (TG) animals, contractile properties and gene expression measurements are normal, but an increase in myofibrillar Ca2+ sensitivity and thin filament protein phosphorylation is noted. At 6 months, there is a decrease in the myofibrillar Ca2+ sensitivity, a significant increase in beta-myosin heavy chain mRNA and protein, normal cardiac function, but a blunted response to an inotropic challenge. The transition at 9 months is especially interesting because age-related changes appear to contribute to the decline in function seen in the TG heart. At this point, there is a decline in baseline function and maximum tension produced by the myofibrils, which is coincident with the onset of atrial myosin light chain isoform re-expression in the ventricles. In the 12-month TG mice, there is clear hemodynamic and geometric evidence of failure. Alterations in the composition of the myofibrils persist but the phosphorylation of myosin light chain 2v is dramatically different at this age compared with all others. We interpret these data to implicate the disruption of the myofibrillar proteins and their interactions in the propagation of dilated cardiac disease.


Blind source separation of concurrent disease-related patterns from EEG in Creutzfeldt-Jakob disease for assisting early diagnosis.
Creutzfeldt-Jakob disease (CJD) is a rare, transmissible and fatal prion disorder of brain. Typical electroencephalography (EEG) patterns, such as the periodic sharp wave complexes (PSWCs), do not clearly emerge until the middle stage of CJD. To reduce transmission risks and avoid unnecessary treatments, the recognition of the hidden PSWCs forerunners from the contaminated EEG signals in the early stage is imperative. In this study, independent component analysis (ICA) was employed on the raw EEG signals recorded at the first admissions of five patients to segregate the co-occurrence of multiple disease-related features, which were difficult to be detected from the smeared EEG. Clear CJD-related waveforms, i.e., frontal intermittent rhythmical delta activity (FIRDA), fore PSWCs (triphasic waves) and periodic lateralized epileptiform discharges (PLEDs), have been successfully and simultaneously resolved from all patients. The ICA results elucidate the concurrent appearance of FIRDA and PLEDs or triphasic waves within the same EEG epoch, which has not been reported in the previous literature. Results show that ICA is an objective and effective means to extract the disease-related patterns for facilitating the early diagnosis of CJD.


Cryptic telomere imbalance: a 15-year update.
It has been 15 years since we proposed that assays of telomere integrity might reveal cryptic translocations and deletions as a significant cause of mental retardation (MR) in patients with normal G-banded karyotypes. Development of unique genomic probes adjacent to the subtelomeric repeats of each chromosome arm allowed multiplex FISH analyses that confirmed such cryptic telomeric imbalances in 3-6% of all unexplained MR. Although such "telomere FISH" analysis quickly became standard of care, limitations of this technology platform included a lack of information on the size and gene content of the deleted/duplicated segments and the failure to detect interstitial deletions not involving the most distal unique clone. The development of "molecular ruler" clone sets for every human telomere provided the foundation for accurate determination of size and gene content of each imbalance, as well as the detection of interstitial deletions within these regions. Array comparative genomic hybridization (aCGH) has emerged as a powerful technology to assess single copy changes (monosomy or trisomy) at targeted loci such as telomeres or across the whole genome. This technology now replaces multiplex FISH for the assessment of telomere integrity in unexplained MR and has the advantage of efficiently determining the size and gene content of the imbalance, as well as detecting interstitial deletions near telomeres or anywhere else in the genome covered by the array design. The application of aCGH in several studies of unexplained MR has confirmed that telomere imbalances are overrepresented compared to "average" chromosomal regions, although this is likely due to random chromosome breakage rather than specific molecular mechanisms associated with the genomic architecture of human telomeres. Telomere imbalances are significantly larger than initially envisioned ( approximately 40% are >5 Mb in size), and indicate the analytic sensitivity of the G-banded karyotype is much lower than previously thought. Finally, experience with smaller benign variants compared to larger pathogenic imbalances at telomeres serves as a model for approaching whole-genome aCGH in a clinical setting.


[Exercise test under catheterization in mitral stenosis].
The sensitivity of basal hemodynamic data and the value of those observed during exercise in the diagnosis of severe mitral stenosis (MS) were investigated by comparing the results under basal conditions and during dynamic exercise with the operative findings in 55 patients with pure MS, aged between 18 and 73 years (average, 43 years), 29 with mild stenosis (Group I) and 26 with severe stenosis (Group II). Under basal conditions, mean pulmonary capillary pressure (PCP) was significantly higher in Group II than in Group I (15.7 +/- 4.4 mm Hg compared to 12.2 +/- 3.5 mm Hg, p less than 0.01). The same difference was observed in mean pulmonary arterial pressure: Group I, 18.2 +/- 5.4 mm Hg; Group II: 23.0 +/- 6.1 mm Hg, p less than 0.01; but cardiac and systolic indices were comparable in the two groups. On exercise, only PCP (Group I: 29.6 +/- 6.8; Group II: 34.7 +/- 4.9 mm Hg) and systolic index (Group I: 39.9 +/- 10.0; Group II: 33.4 +/- 8.2 ml/m2) were significantly different (p less than 0.01). Pulmonary capillary and arterial pressures rose in the same proportion in the two groups on exercise but systolic index fell in severe MS (-4 p. 100) and rose in mild MS (+30 p. 100) (p less than 0.001). The formulae for calculating mitral valve surface area only give discriminating results between the two groups when the hemodynamic data on exercise are used.(ABSTRACT TRUNCATED AT 250 WORDS)


Intravenous flurbiprofen axetil accelerates restoration of bowel function after colorectal surgery.
Flurbiprofen axetil (FA) is a potent non-steroidal anti-inflammatory drug (NSAID). We examined the effects that peri-operative intravenous administration of FA, combined with thoracic epidural anesthesia and postoperative patient-controlled epidural analgesia (PCEA), have on bowel function, postoperative pain, and cytokine release, after open colorectal surgery. This was a prospective, randomized, double-blind, placebo-controlled study. Forty patients were randomly assigned to one of two groups (n = 20 in each group). The FA group patients received FA 1 mg.kg(-1) iv, 30 min before and six hours after skin incision; whereas the control group patients received an equal volume of intralipid. Blood cytokine levels were measured before FA administration, at the end of surgery, and six hours and 24 hr postoperatively. All patients received postoperative PCEA for pain control. Analgesic efficacy was evaluated for 72 hr postoperatively using visual analogue scale (VAS) pain scores both at rest and during coughing. Gastrointestinal motility was recorded. Temperature and leukocyte count were measured preoperatively, and 24 hr postoperatively. The times to first bowel movement (87 +/- 23 vs 105 +/- 19 hr, P = 0.008) and first flatus (63 +/- 16 vs 75 +/- 11 hr, P = 0.01) were earlier in the FA group compared to the control group. For the first 24 hr, the pain scores in the FA group were also lower during coughing (P < 0.001 compared to control). The plasma concentrations of interleukin (IL)-6 and IL-8 in the FA group were lower, postoperatively (P < 0.01 and P < 0.05, respectively, compared to control). In contrast, the IL-10 levels were significantly increased at six hours, postoperatively, in the FA group (P = 0.009). The total leukocyte count and the incidence of pyrexia were also lower in patients of the FA group (P = 0.001 and P = 0.006, respectively, compared to control). Flurbiprofen axetil may have an anti-inflammatory effect in major abdominal surgery. The combination of perioperative intravenous FA, intraoperative thoracic epidural anesthesia, and postoperative PCEA facilitated recovery of bowel function, enhanced analgesia, and attenuated the cytokine response.


New insights into two-photon absorption properties of functionalized aza-BODIPY dyes at telecommunication wavelengths: a theoretical study.
Special attention has been paid to understanding the structural effect on electronic structure and absorption spectra for an extensive series of functionalized aza-BODIPY molecules. We have employed the quadratic response theory as well as a sum-over-states approach involving few intermediate states to calculate the two-photon cross section (δmax). The results suggest that chemical modifications on the aza-BODIPY core and peripheral moieties using various substituents can finely tune their linear and nonlinear optical properties. Therefore, some new fluorophores absorbing in the near infrared region and featuring considerably high δmax at telecommunication wavelengths are proposed, which are excellent candidates for nonlinear transmission and fluorescent labeling materials. The investigation contributes a useful starting point for further design of more effective aza-BODIPY dyes and can be valuable as a foundation for future experimental research and development.


[Experimental study on the in vitro osteogenic differentiation of dental pulp stem cells encapsulated in Pluronic F-127 hydrogel].
To evaluate the biocompatibility and viability of nonionic triblock copolymer Pluronic F-127 as a cell scaffold for osteogenic differentiation of dental pulp stem cells(DPSC). DPSC were obtained via enzymatic digestion method and purified bylimited dilution method. The freeze dried hydrogel of 20% Pluronic F-127 was prepared and itsstructurewas observed usingscanning electron microscopy(SEM). After the encapsulation of cells of passage 3 in Pluronic F-127, the effects of hydrogel on the proliferations of DPSC were assessed with methyl thiazolyl terazolium(MTT) after one day and 3, 5, 7 days of incubations, respectively. On day 14, osteogenic abilities of DPSC encapsulated in the hydrogel were estimated by means of alizarin red S, immunocytochemical staining and real-time quantitative PCR(RT-qPCR). DPSC were isolated and cultured successfully in the present study. SEM observations showed that porous structures which might be suitable for cell culture. A570 values of MTT were then normalized. A570 values of the cells in 2D cultures were 0.30±0.06, 0.30±0.17, 0.35±0.04 and 0.25±0.06 and A570 values of DPSC in 3D cultures were 0.36±0.06, 0.54±0.18, 0.70±0.10 and 0.32±0.10 on day 1, 3, 5 and 7, respectively. A570 value peaks were found on day 5 in both groups. The proliferation of 3D cultured DPSC was higher than that of 2D cultured cells(P<0.05). After 14 days of osteogenic induction, there were no calcium nodules observed in the control group and the numbers of calcium nodulesin the 2D and 3D groups had no significant difference(P>0.05). Inmmunocytochemical staining demonstrated strong expression of osteoblast marker Runt-related transcription factor 2(RUNX2), type Ⅰ collagen(Col-Ⅰ) and relatively low expression of osteocalcin(OCN). Moreover, RT-qPCR showed no differences between the relative expression of ALP, RUNX-2, OCN in the 2D and 3D groups (P>0.05), but a higher relative expression of Col-Ⅰ was observed in the 3D group(P=0.023). Pluronic F-127 is a promising cell scaffold or cell carrier for the osteobalst differentiation of dental pulp stem cells.


Lithium-Induced Hyperparathyroidism: An Ill-defined Territory.
Lithium is the gold standard treatment for bipolar disorder. Studies have shown an association between lithium and hyperparathyroidism. However, there is limited data regarding the management of lithium-induced hyperparathyroidism. We present a clinical conundrum which physicians frequently encounter-an excellent lithium responder refractory to other treatments who developed lithium-induced hyperparathyroidism. Medical treatment with cinacalcet was successful in management of hyperparathyroidism without discontinuing lithium maintenance therapy.


Gender-related differences in morbidity and mortality during combined valve and coronary surgery.
Gender-related differences in morbidity and mortality are well described for coronary artery bypass grafting but are not well understood for combined valve and bypass surgery. We reviewed retrospectively the morbidity and mortality of 1570 consecutive patients who underwent combined valve and bypass procedures at the Toronto General Hospital between January 1990 and October 2000. There were 1073 men (68%) and 497 women (32%). The mean ages (+/- 1 SD) of women and men were 69 +/- 9 and 68 +/- 9 years, respectively (P =.02). Of the 1570 total patients, 973 patients (62%) underwent aortic valve and coronary bypass surgery, 481 patients (31%) had mitral valve and coronary bypass operations, and 116 (7%) patients had double or triple valve and coronary bypass operations. Preoperative hypertension (P =.002), diabetes (P =.001), and atrial fibrillation (P =.001) were seen more frequently in women. Body surface area was significantly lower in women (P =.0001). At presentation, more women were in congestive heart failure (69% vs 58%, P =.001) and in New York Heart Association functional class III or IV (25% vs 19%, P =.001). Although there was no difference in the number of women with three or more diseased vessels (32% vs 38%), only 35% of women received three or more grafts compared with 44% of men (P =.001). The use of left internal thoracic grafts, although uncommon in the whole study population (36%), was less common in women than in men (26% vs 41%, P =.001). Multivariable logistic analyses for morbidity and mortality showed female gender to be an independent risk factor. Mitral valve replacement, age, left ventricular dysfunction, New York Heart Association classes III and IV, and association of tricuspid valve disease, diabetes, peripheral vascular disease, and preoperative renal failure were found to be independent risk factors for mortality. Female gender is an independent risk factor for combined morbidity and mortality during and after combined valve and coronary bypass surgery. As with isolated coronary artery bypass grafting, women undergoing combined procedures have more premorbid conditions, are more often in heart failure, had an equal incidence of triple vessel disease but received fewer grafts than men, and, therefore, were more frequently incompletely revascularized.


Physiological meaning and potential for application of reductive dechlorination by anaerobic bacteria.
The physiological meaning of reductive dechlorination reactions catalyzed by anaerobic bacteria can be explained as a co-metabolic activity or as a novel type of respiration. Co-metabolic activities have been found mainly with alkyl halides. They are non-specific reactions catalyzed by various enzyme systems of facultative as well as obligate anaerobic bacteria. In contrast, the reductive dechlorinations involved in metabolic respiration processes are very specific reactions. Only a limited number of alkyl and aryl chlorinated compounds is presently known to function as a terminal electron acceptor in a few, recently isolated bacteria. Metabolic dechlorination rates are in general several orders of magnitude higher than co-metabolic ones. Both reaction types are suitable for the anaerobic treatment of waste streams.


Phenotypic and functional consequences of different isolation protocols on skin mononuclear phagocytes.
Mononuclear phagocytes are present in skin and mucosa and represent one of the first lines of defense against invading pathogens, which they detect via an array of pathogen-binding receptors expressed on their surface. However, their extraction from tissue is difficult, and the isolation technique used has functional consequences on the cells obtained. Here, we compare mononuclear phagocytes isolated from human skin using either enzymatic digestion or spontaneous migration. Cells isolated via enzymatic digestion are in an immature state, and all subsets are easily defined. However, cells isolated by spontaneous migration are in a mature state, and CD141 cross-presenting DCs (cDC1) are more difficult to define. Different pathogen-binding receptors are susceptible to cleavage by blends of collagenase, demonstrating that great care must be taken in choosing the correct enzyme blend to digest tissue if carrying out pathogen-interaction assays. Finally, we have optimized mononuclear phagocyte culture conditions to enhance their survival after liberation from the tissue.


Vaginoperitoneal fistula after ovariohysterectomy in three bitches.
Vaginoperitoneal fistulation was detected in three neutered bitches undergoing retrograde positive contrast vaginourethrography. This is a rarely detected complication of ovariohysterectomy and appears to result in no clinical signs.


Emergence of multidrug resistance in leukemia cells during chemotherapy: mechanisms and prevention.
Multifactorial resistance to extracellular stimuli is one of the major factors of tumor progression. Cells can acquire a multidrug resistant (MDR) phenotype in response to a wide variety of stress-inducing agents including chemotherapeutic drugs. In addition to the mechanisms expressed in the tumor prior to chemotherapy (presumably these mechanisms allowed tumor cells to escape the control of growth and differentiation), a complex phenotype of pleiotropic resistance is presented in the residual or recurrent tumor. This review analyzes the molecular mechanisms of MDR acquisition with the focus on hematopoietic malignancies. In particular, the chemotherapy-induced up-regulation of P-glycoprotein, a broad-specificity transmembrane efflux pump, is considered a major event in establishment of MDR in leukemia cells that were sensitive before drug exposure. The pharmacological and genetic approaches to prevent the acquisition of Pgp-mediated MDR during chemotherapy are discussed.


Habitat Preference of German Mantis religiosa Populations (Mantodea: Mantidae) and Implications for Conservation.
In Germany, the thermophilic European mantid (Mantis religiosa L.) is endangered. Here, we study habitat requirements during its life, and discuss the applicability of the two conservation measures grazing and mowing to this insect species. At two study sites in south-western Germany, which were each subject to one of these measures, we recorded structural and climatic conditions within different microhabitats. We also conducted capture-mark-recapture studies for adult M. religiosa, and mapped adult roosting, oothecae deposition, egg hatching, and imaginal molting in microhabitats over two vegetation periods. In order to assess microhabitat preference of M. religiosa during its life, and identify climatic conditions driving preferences, we applied the Lille habitat preference index and conducted logistic regression analysis for life phases. Our results suggest that temperature is important for egg and nymph development. For egg deposition, females preferred solid substrates with high heat-storing capacities, as those attenuate the negative influence of cold weather periods on egg development. Being ambush predators, males and females preferred roosting sites with sufficient shelter and high prey abundance. Contrary to our expectation, the conservation measures reduced adult population sizes, and presumably reproduction rates. We thus suggest that mowing during the adult phase should reduce vegetation height to a moderate level to keep prey abundance high. Mowing with a clearing saw or grazing over a short period in small fenced areas should be preferred over prolonged grazing, as grazers collaterally stamp down the vegetation. Grazers indirectly reduce prey availability by deteriorating prevailing microclimatic conditions.


Genetic isolation of transport signals directing cell surface expression.
Membrane proteins represent approximately 30% of the proteome in both prokaryotes and eukaryotes. The spatial localization of membrane-bound proteins is often determined by specific sequence motifs that may be regulated in response to physiological changes, such as protein interactions and receptor signalling. Identification of signalling motifs is therefore important for understanding membrane protein expression, function and transport mechanisms. We report a genetic isolation of novel motifs that confer surface expression. Further characterization showed that SWTY, one class of these isolated motifs with homology to previously reported forward transport motifs, has the ability to both override the RKR endoplasmic reticulum localization signal and potentiate steady-state surface expression. The genetically isolated SWTY motif is functionally interchangeable with a known motif in cardiac potassium channels and an identified motif in an HIV coreceptor, and operates by recruiting 14-3-3 proteins. This study expands the repertoire of and enables a screening method for membrane trafficking signals.


Diagnosis of neuroparacoccidioidomycosis by detection of circulating antigen and antibody in cerebrospinal fluid.
Neuroparacoccidioidomycosis (neuroPCM) is the central nervous system infection by the fungus Paracoccidioides brasiliensis. Its diagnosis is a difficult task that depends on neuroimaging techniques such as computed tomography and magnetic resonance imaging. However, the detection of circulating P. brasiliensis antigens in body fluids by inhibition enzyme-linked immunosorbent assay (inh-ELISA) has provided encouraging results. In this study, 14 cerebrospinal fluid (CSF) and 11 serum samples of patients with neuroPCM were analyzed by inh-ELISA for detection of circulating glycoprotein antigens of 43 kDa (gp43) and 70 kDa (gp70). Circulating gp43 and gp70 antigens were detected in all CSF samples from patients with neuroPCM at mean concentrations of 19.3 and 6.8 mug/ml, respectively. In addition, both gp43 and gp70 antigens were detected in 10 of 11 serum samples analyzed at mean concentrations of 4.6 and 4.0 mug/ml, respectively. By immunodiffusion test, CSF samples were determined to be negative in 13 of 14 samples. The detection of anti-gp43 and anti-gp70 antibodies by conventional ELISA showed positive results for all CSF samples, with titers ranging from 1:50 to 1:51,200. Therefore, the high sensitivity of the inh-ELISA technique in detecting gp43 and gp70 antigens in the CSF of neuroPCM patients strongly indicates that this assay can be considered as a powerful diagnostic tool. In addition, the finding of anti-gp43 and anti-gp70 antibodies in CSF samples by conventional ELISA also seems to be a promising diagnostic method for this special modality of PCM.


Familiar Voices Are More Intelligible, Even if They Are Not Recognized as Familiar.
We can recognize familiar people by their voices, and familiar talkers are more intelligible than unfamiliar talkers when competing talkers are present. However, whether the acoustic voice characteristics that permit recognition and those that benefit intelligibility are the same or different is unknown. Here, we recruited pairs of participants who had known each other for 6 months or longer and manipulated the acoustic correlates of two voice characteristics (vocal tract length and glottal pulse rate). These had different effects on explicit recognition of and the speech-intelligibility benefit realized from familiar voices. Furthermore, even when explicit recognition of familiar voices was eliminated, they were still more intelligible than unfamiliar voices-demonstrating that familiar voices do not need to be explicitly recognized to benefit intelligibility. Processing familiar-voice information appears therefore to depend on multiple, at least partially independent, systems that are recruited depending on the perceptual goal of the listener.


Three-Dimensional Radiomics Features of Magnetic Resonance T2-Weighted Imaging Combined With Clinical Characteristics to Predict the Recurrence of Acute Pancreatitis.
To explore the diagnostic value of radiomics model based on magnetic resonance T2-weighted imaging for predicting the recurrence of acute pancreatitis. We retrospectively collected 190 patients with acute pancreatitis (AP), including 122 patients with initial acute pancreatitis (IAP) and 68 patients with recurrent acute pancreatitis (RAP). At the same time, the clinical characteristics of the two groups were collected. They were randomly divided into training group and validation group in the ratio of 7:3. One hundred thirty-four cases in the training group, including 86 cases of IAP and 48 cases of RAP. There were 56 cases in the validation group, including 36 cases of IAP and 20 cases of RAP. Least absolute shrinkage and selection operator (LASSO) were used for feature screening. Logistic regression was used to establish the radiomics model, clinical model and combined model for predicting AP recurrence. The predictive ability of the three models was evaluated by the area under the curve (AUC). The recurrence risk in patients with AP was assessed using the nomogram. The AUCs of radiomics model in training group and validation group were 0.804 and 0.788, respectively. The AUCs of the combined model in the training group and the validation group were 0.833 and 0.799, respectively. The AUCs of the clinical model in training group and validation group were 0.677 and 0.572, respectively. The sensitivities of the radiomics model, combined model, and clinical model were 0.646, 0.691, and 0.765, respectively. The specificities of the radiomics model, combined model, and clinical model were 0.791, 0.828, and 0.590, respectively. There was no significant difference in AUC between the radiomics model and the combined model for predicting RAP (p = 0.067). The AUCs of the radiomics model and combined model were greater than those of the clinical model (p = 0.008 and p = 0.007, respectively). Radiomics features based on magnetic resonance T2WI could be used as biomarkers to predict the recurrence of AP, and radiomics model and combined model can provide new directions for predicting recurrence of acute pancreatitis.


Spectral Super-Resolution Network Guided by Intrinsic Properties of Hyperspectral Imagery.
Hyperspectral imagery (HSI) contains rich spectral information, which is beneficial to many tasks. However, acquiring HSI is difficult because of the limitations of current imaging technology. As an alternative method, spectral super-resolution aims at reconstructing HSI from its corresponding RGB image. Recently, deep learning has shown its power to this task, but most of the used networks are transferred from other domains, such as spatial super-resolution. In this paper, we attempt to design a spectral super-resolution network by taking advantage of two intrinsic properties of HSI. The first one is the spectral correlation. Based on this property, a decomposition subnetwork is designed to reconstruct HSI. The other one is the projection property, i.e., RGB image can be regarded as a three-dimensional projection of HSI. Inspired from it, a self-supervised subnetwork is constructed as a constraint to the decomposition subnetwork. These two subnetworks constitute our end-to-end super-resolution network. In order to test the effectiveness of it, we conduct experiments on three widely used HSI datasets (i.e., CAVE, NUS, and NTIRE2018). Experimental results show that our proposed network can achieve competitive reconstruction performance in comparison with several state-of-the-art networks.


Clinical Knowledge, Perceptions, and Communication Confidence Regarding the Development of Thyroid Cancer --A Cross-Sectional Study of Clinical Medical Students in Chongqing, Southwest China.
Medical students play an essential role in providing disease consultation for patients. Despite the rapid increase in thyroid disease, there are few data on how well Chinese medical students master the knowledge of thyroid diseases. This study aims to evaluate the clinical knowledge, perception, and clinical communication confidence of medical students on thyroid cancer (TC). This cross-sectional study was carried out among medical students of Chongqing Medical University. An anonymous, self-administered questionnaire distributed from December 2022 to February 2023 included items on demographics and other information, the warning signs of cancer, perception regarding a person's chance of developing cancer, and clinical communication confidence. Descriptive analysis, difference analysis, and correlation analysis were carried out. A total of 226 medical students participated in the survey. Most students (n=191, 84.5%) had heard of TC, while only a few (n=10, 4.4%) regularly performed thyroid self-examination. One hundred and eighty-four students (81.4%) agreed that an unexplained lump or swelling could be a sign of cancer. There were significant differences in thyroid clinical knowledge in relation to gender (P<0.001), major (P=0.026), and thyroid disease (P=0.030). Clinical communication confidence showed significant differences in year of study (P=0.002), major (P=0.048), and graduate major (P<0.001). There was a correlation between clinical confidence and year of study (r=0.261, P<0.001). Most medical students have sufficient clinical knowledge on TC prevention, but there are still misconceptions related to TC screening. In addition, medical students lack confidence in communicating with patients. Comprehensive communication training should be integrated into the medical curriculum and clinical activities should be initiated earlier.


Association study of 15 novel single-nucleotide polymorphisms of the T-bet locus among Finnish asthma families.
T-box expressed in T cells (T-bet) is a transcription factor regulating the commitment of T helper (Th) cells by driving the cells into the Th1 direction. Abnormal Th1/Th2 balance may lead to complex disorders like asthma or autoimmune diseases. Recent studies have suggested that T-bet might be a candidate gene for asthma. This led us to screen 23 Finnish individuals for single-nucleotide polymorphisms (SNPs) in the T-bet locus and study the association between the SNPs and high serum IgE level and asthma. We screened all six exons, adjacent intronic areas and 2 kb of the 5'-flanking region from 23 individuals utilizing WAVE trade mark technology. To explore whether T-bet is associated in serum IgE regulation or asthma we genotyped the SNPs in a Finnish asthmatic founder population. The association analyses were made using haplotype pattern mining. Fifteen novel SNPs were found in the T-bet gene. Within the Finnish asthmatic founder population, there was no association between T-bet SNPs and high serum IgE level or asthma. The genetic variability in the T-bet gene does not play a role in the pathogenesis of human asthma. Our results provide a novel panel of SNPs in T-bet and will help determine whether the SNPs have a functional role in other T cell-mediated diseases.


Cryosurgical treatment of the eyelids and lacrimal drainage ducts of the rhesus monkey. Course of injury and repair.
Freezing injuries were produced on the eyelids and lacrimal drainage systems in ten rhesus monkeys. The instrumentation produced both single and double freezing cycles at tissue temperatures of -30 and -60 degrees C. The extent of injury and the course of repair were evaluated by clinical observation and by histologic examination of tissue specimens removed at intervals up to three months after freezing. Both cryosurgical techniques produced necrosis of the tissues, but injury was less with single freezing cycles at -30 degrees C. The course of repair was favorable. Even at the three-month observation period, when healing was complete, there was minimal-clinical or histologic evidence of canalicular obstruction or other periocular complications.


Functional foods in pediatrics.
The philosophy that food can be health promoting beyond its nutritional value is gaining acceptance. Known disease preventive aspects of nutrition have led to a new science, the 'functional food science'. Functional foods, first introduced in Japan, have no universally accepted definition but can be described as foods or food ingredients that may provide health benefits and prevent diseases. Currently, there is a growing interest in these products. However, not all regulatory issues have been settled yet. Five categories of foods can be classified as functional foods: dietary fibers, vitamins and minerals, bioactive substances, fatty acids and pro-, pre- and symbiotics. The latter are currently the main focus of research. Functional foods can be applied in pediatrics: during pregnancy, nutrition is 'functional' since it has prenatal influences on the intra-uterine development of the baby, after birth, 'functional' human milk supports adequate growth of infants and pro- and prebiotics can modulate the flora composition and as such confer certain health advantages. Functional foods have also been studied in pediatric diseases. The severity of necrotising enterocolitis (NEC), diarrhea, irritable bowel syndrome, intestinal allergy and lactose intolerance may be reduced by using functional foods. Functional foods have proven to be valuable contributors to the improvement of health and the prevention of diseases in pediatric populations.


Impostor phenomenon, self-compassion, and campus connectedness in Black female undergraduates.
Aim: This study explored the relationship between impostor phenomenon (IP), campus connectedness, self-compassion, and mental health among Black female undergraduate students attending an HBCU. Methods: Participants completed study measures via an online survey platform. Results: Linear regression analyses identified statistically significant relationships between campus connectedness, self-compassion, feelings of IP, and symptoms of depression, anxiety, and stress. Hierarchical regression analyses revealed that both self-compassion and campus connectedness explained statistically significant variance in mental health after controlling for the influence of IP on students' anxiety and depressive symptoms. Conclusion: Implications of this finding suggest student support services could develop and utilize programs that educate students about self-compassion interventions in order to decrease IP, which is directly linked with depression and anxiety.


The assessment of fetal behavior in early pregnancy: comparison between 2D and 4D sonographic scanning.
To determine the accuracy of 4D sonography in the assessment of embryonic and early fetal motor activity in the first trimester of normal pregnancy, in comparison to the 2D sonography. Fifty pregnant women between 6-14 weeks of gestation with singleton pregnancy were assigned for the investigation. Two dimensional and four dimensional recordings were displayed on the screen and recorded on the videotape during the 15 minutes observation period. General body, head and limb movements recorded by 2D sonography were notable by 4D technique in the same gestational age. These movements were presented collectively with maximum, minimum, and median frequencies during 15 minutes observation period. Spearman rank order correlation reached statistical significance (P<0.05) between the frequencies of all observed movement patterns assessed by two different techniques. Several movement patterns, such as sideway bending, hiccup, breathing movements, mouth opening and facial movements could be observed only by 2D sonographic technique in this period of gestation. Presently, both 2D and 4D methods are required for the assessment of early fetal motor development and motor behavior. It is reasonable to expect that such technological improvement may provide some new information about the intrauterine motor activity and facilitate the prenatal detection of some neurological disorders.


Potassium preserves endothelial function and enhances aortic compliance in Dahl rats.
It has recently been proposed that in rat models of genetic hypertension, supplemental dietary potassium preserves release of endothelium-derived relaxing factor independently of its capacity to either attenuate hypertension or increase plasma potassium. To test this hypothesis in Dahl salt-sensitive rats given sodium chloride (4%) for 3 weeks, we supplemented dietary potassium (2.1%) with either KCl (n = 16) or KHCO3 (n = 16). Compared with unsupplemented rats (n = 16), rats supplemented with either potassium salt had a lower mean arterial pressure and a greater release of endothelium-derived relaxing factor, as assessed from acetylcholine-induced relaxation of precontracted aortic rings. However, the maximum relaxation response to acetylcholine correlated inversely with blood pressure (r = -.82, P < .001), not only in the KCl (r = -.68, P < .002) and KHCO3 (r = -.77, P < .001) groups but also in unsupplemented rats (r = -.86, P < .001). With potassium supplementation, plasma potassium concentrations measured between 4 and 6 PM did not increase, but those measured between 4 and 6 AM did increase (P < .05). In isolated ring segments, aortic compliance was greater in both the KCl and KHCO3 groups than in unsupplemented rats (0.015 and 0.017 vs 0.009 mm2/mm Hg) (P < .01). This greater compliance could not be related to differences in blood pressure, plasma potassium, or collagen or elastin content of the aortic wall.(ABSTRACT TRUNCATED AT 250 WORDS)


Associations of Breast Arterial Calcifications with Cardiovascular Disease.
Cardiovascular diseases (CVD), including coronary artery disease (CAD), continue to be the leading cause of global mortality among women. While traditional CVD/CAD prevention tools play a significant role in reducing morbidity and mortality among both men and women, current tools for preventing CVD/CAD rely on traditional risk factor-based algorithms that often underestimate CVD/CAD risk in women compared with men. In recent years, some studies have suggested that breast arterial calcifications (BAC), which are benign calcifications seen in mammograms, may be linked to CVD/CAD. Considering that millions of women older than 40 years undergo annual screening mammography for breast cancer as a regular activity, innovative risk prediction factors for CVD/CAD involving mammographic data could offer a gender-specific and convenient solution. Such factors that may be independent of, or complementary to, current risk models without extra cost or radiation exposure are worthy of detailed investigation. This review aims to discuss relevant studies examining the association between BAC and CVD/CAD and highlights some of the issues related to previous studies' design such as sample size, population types, method of assessing BAC and CVD/CAD, definition of cardiovascular events, and other confounding factors. The work may also offer insights for future CVD risk prediction research directions using routine mammograms and radiomic features other than BAC such as breast density and macrocalcifications.


[Focal nodular hyperplasia involving portal cavernoma].
Focal nodular hyperplasia is a rare hepatic tumor in children representing only 2% of all pediatric hepatic tumors. We report a case in teen-ager who had a symptomatic portal cavernoma at 9 years of age, and had been treated by porto-mesenteric surgical shunt. At 16 years, liver ultrasounds revealed multiple hepatic nodules. Focal nodular hyperplasia was suggested by CT scan and magnetic resonance imaging. Given the symptoms and the unusual and multiple lesions, diagnosis was confirmed by surgical biopsy. FNH pathogeny is discussed in this context.


[Bone mineral density in children before and after completion of cancer treatment].
This study was performed to determine the degree of osteopenia in children with malignancy before and after completion of treatment. Twenty six subjects (17 male, 9 female) treated for acute lymphoblastic leukemia (n=15), lymphogranulomatosis maligna (n=7) or solid tumor (n=4) at a mean age 9.34 (range 3-17.41 years) before and 15.85 (range 9.66-23) after treatment participated in this longitudinal study. Mean follow up period after discontinuation of therapy was 5.5 years (range 2.6-8.3 years). Interview (estimation of physical activity, other chronic disease, and fractures), anthropometric measurements of body mass and height, body mass index (BMI), bone mineral density total (BMD Total) and spine (BMD Spine) were obtained from every child. Gained findings were compared to the same parameters in the group of 473 healthy children, comparable in age and gender with examined group and showed as SD score. There were no differences in BMI and BMD Total and Spine between patients and controls. No correlation was found between the BMD values and the diagnosis, age at diagnosis, gender and cranial irradiation and duration of follow-up. BMD Spine SD score was significantly increased in a subgroup of patients in pubertal stage at diagnosis as compared to patients in prepubertal stage. Further studies are needed to evaluate the long-term effect on BMD in patients with cancer and how to prevent a decrease of BMD.


Residual tumor following radiotherapy for locally advanced carcinomas of the uterine cervix. Prognostic significance.
Over a five-year period from 1977 to 1982, 120 patients with locally advanced carcinomas of the uterine cervix were surgically staged by lymphadenectomy and laparotomy. Radiotherapy was then administered according to the pelvic extent of disease, and all patients underwent extrafascial total hysterectomy with adnexectomy at ten weeks after completing radiation therapy. The presence or absence of residual tumor in the hysterectomy specimen appeared to be an important prognostic factor in treatment success or failure. Patients with no residual tumor were found to have an excellent prognosis. Those with residual tumor clear of the resection margins were at risk for distant metastases. Only one survivor was noted in the group of patients in whom the margins of resection were involved with tumor, nearly all of these patients dying from local recurrences. Major operative morbidity in the series was minimal, and consisted of a single ureterovaginal fistula, which required urinary diversion.


Diagnostic and prognostic value of galactose-deficient IgA1 in patients with IgA nephropathy: an updated systematic review with meta-analysis.
Galactose-deficient IgA1 (Gd-IgA1) is a critical effector molecule in the pathogenesis of IgA nephropathy (IgAN), a leading renal disease without noninvasive assessment options. This updated systematic review aimed to determine the diagnostic and prognostic value of Gd-IgA1 assessment in biological fluids in patients with IgAN. PRISMA guidelines were followed in this review. We searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine disc, VIP Information/China Science and Technology Journal Database, and WANFANG for studies published between database inception and January 31, 2023. Eligible studies that evaluated aberrant IgA1 glycosylation in IgAN patients relative to controls were identified, and random effects meta-analyses were used to compare Gd-IgA1 levels in different groups. The quality of the evidence was assessed using the Newcastle-Ottawa Scale. This study was registered on PROSPERO (CRD42022375246). Of the 2727 records identified, 50 were eligible and had available data. The mean Newcastle-Ottawa Scale score was 7.1 (range, 6-8). Data synthesis suggested that IgAN patients had higher levels of blood and/or urine Gd-IgA1 compared with healthy controls (standard mean difference [SMD]=1.43, 95% confidence interval [CI]=1.19-1.68, P<0.00001), IgA vasculitis patients (SMD=0.58, 95% CI=0.22-0.94, P=0.002), and other kidney disease patients (SMD=1.06, 95% CI=0.79-1.33, P<0.00001). Moreover, patients with IgAN had similar levels of serum Gd-IgA1 compared to first-degree relatives (SMD=0.38, 95% CI= -0.04-0.81, P=0.08) and IgA vasculitis with nephritis patients (SMD=0.12, 95% CI= -0.04-0.29, P=0.14). In addition, ten studies demonstrated significant differences in serum Gd-IgA1 levels in patients with mild and severe IgAN (SMD= -0.37, 95% CI= -0.64--0.09, P=0.009). High serum and urine Gd-IgA1 levels suggest a diagnosis of IgAN and a poor prognosis for patients with this immunological disorder. Future studies should use more reliable and reproducible methods to determine Gd-IgA1 levels. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022375246, identifier CRD42022375246.


Radiation D10-values on thawed and frozen catfish and tilapia for finfish isolates of Listeria monocytogenes.
With the popularity of catfish and tilapia in the healthy diet, the consumption and harvesting of farm-raised finfish have increased. Since 1987 the pathogenic bacterium Listeria monocytogenes has been isolated from seafood, particularly farm-raised catfish in the United States. Seafood isolates of L. monocytogenes are now available. In order to maintain the raw finfish product, nonthermal interventions to remove bacterial pathogens need to be evaluated using these isolates. A nonthermal intervention process, irradiation, was used to determine the destruct values of the L. monocytogenes seafood isolates along with a nonpathogenic Listeria strain and an L. monocytogenes strain previously studied. The irradiation destruct values were obtained for each individual isolate inoculated on raw and frozen catfish or tilapia irradiated at 4 or -10 degrees C. The Dradiation values obtained for L. monocytogenes inoculated on raw or frozen catfish did not differ (P > 0.05) from the values obtained for strains inoculated on the raw or frozen tilapia. The Dradiation-values ranged from 0.48 to 0.85 kGy, with an average of 0.62 +/- 0.09 kGy, which is typical for Listeria. The data obtained have identified a multi-isolate cocktail that can be used for future radiation inactivation studies for L. monocytogenes inoculated on finfish.


Cell-mediated anti-embryo cytotoxicity in human pregnancy.
The microcytotoxicity assay has been used to study human maternal cell-mediated immunity against foetal lung cells derived from foetal autopsies and amnion cells from full-term deliveries. Cytotoxicity against semi-allogeneic foetal lung cells but not against adult skin fibroblasts was detected in fourteen cases. No cytotoxicity was detected in six mothers tested during the first 15 weeks of gestation whereas 58% of mothers in the 15-17 weeks of gestation (twelve cases) and 88% with more advanced pregnancies (eight cases) were specifically cytotoxic. Cross-reactions against allogeneic foetal lung cells were mainly produced by effector cells from patients with 16-17-week-old pregnancies. No cytotoxicity was detected against semi-allogeneic amnion cells by effector cells from mothers after full-term deliveries. Cytotoxicity was blocked by autologous post-abortum sera in two out of seven cases. The effect of autologous post-abortum sera on non-cytotoxic effector cells was nonspecifically arming in four out of ten cases.


Prevalence, correlates, comorbidity and treatment of electronic nicotine delivery system use in the United States.
This study presents nationally representative data on the prevalence, correlates, psychiatric comorbidity and treatment (including pharmacological and nonpharmacological) among electronic nicotine delivery system (ENDS) users. Face-to-face interviews in the National Epidemiologic Survey on Alcohol and Related Conditions-III. Prevalences of 12-month and lifetime ENDS use were 3.8% (SE=0.14) and 5.4% (SE=0.17). Odds of ENDS use were greater among men than women, regardless of timeframe. Rates were lower among Blacks, Hispanics and Asians/Pacific Islanders relative to Whites. Odds of 12-month and lifetime ENDS use was also higher among younger (<65years) than older (≥65years) individuals and higher among individuals with high school education relative to these with some college education. Odds of 12-month and lifetime ENDS use was also higher among individuals with incomes <$70,000.00 compared with those with incomes≥$70,000.00 and higher among the previously married relative to those who were currently married. Associations between 12-month ENDS use and severe nicotine use disorder were strong, whereas associations with other substance use disorders and borderline and antisocial personality disorders were modest (AORs=1.3-2.6). Rates of treatment seeking to cut down or quit tobacco or nicotine use (12-month, 25.0% (SE=1.6); lifetime, 24.4% (SE=1.4)) were low. ENDS use is substantially comorbid, especially with nicotine use disorder. Virtually all ENDS users smoked cigarettes. Research is needed to understand their role in smoking cessation, adverse effects on bodily systems and their potential for addiction and comorbidity.


Niemann-Pick Type C 1 (NPC1) and NPC2 Gene Variability in Demented Patients with Evidence of Brain Amyloid Deposition.
Variants in Niemann-Pick Type C genes (NPC1 and NPC2) have been suggested to play a role as risk or disease modifying factors for Alzheimer's disease (AD). The aim of this study was to analyze NPC1 and NPC2 variability in demented patients with evidence of brain amyloid-β 1-42 (Aβ) deposition and to correlate genetic data with clinical phenotypes. A targeted Next Generation Sequencing panel was customized to screen NPC1, NPC2, and main genes related to neurodegenerative dementias in a cohort of 136 demented patients with cerebrospinal fluid (CSF) low Aβ levels or positive PET with Aβ tracer and 200 non-demented geriatric subjects. Seven patients were carriers of NPC variants in heterozygosis. Four of them displayed pathogenic variants previously found in NPC patients and one AD patient had a novel variant. The latter was absent in 200 non-demented elderly subjects. Five of seven patients (70%) exhibited psychiatric symptoms at onset or later as compared with 43%in non-carriers (p > 0.05). The frequency of NPC1 and NPC2 heterozygous variants in patients with CSF evidence of Aβ deposition is higher than in the general population.


Fostering traditional health systems and ethnomedicine practices through a holistic approach: a pioneering community strategy from Southern India.
The ever-presence of traditional medicine and of medical practitioners in remote areas of the world is well documented by anthropological studies. However, the social, cultural, and environmental factors influencing health and traditional health systems have been analyzed separately, ignoring the interlinkages existing between them and the resulting synergies as well as the impact these will have on the multiple aspects of local communities. This case study attempts to overcome this shortcoming, by investigating the interrelationships between biodiversity conservation and the practice of ethnomedicine in Southern India as a basis to implement primary health care, enhance local livelihoods, and contribute to poverty alleviation through community-based entrepreneurial activities.


Patient Characteristics and Preferences Regarding Anticoagulant Treatment in Venous Thromboembolic Disease.
Background: Anticoagulants are the recommended treatment for venous thromboembolic disease (VTE). The mode of anticoagulant administration may influence compliance, and therefore the effectiveness of the treatment. Unlike in atrial fibrillation or cancer-associated thrombosis, there is only limited data on patient preferences regarding the choice of anticoagulation in VTE. This study aims to evaluate patient preferences regarding anticoagulants in terms of administration: types (oral or injectable treatment) and number of doses or injections per day. Patients and Methods: This is a national survey through a questionnaire sent by e-mail to 1936 French vascular physicians between February and April 2019. They recorded the responses for each patient admitted for VTE. Results: Three hundred and eleven (response rate of 16%) of the 1936 contacted physicians responded for 364 patients. Among these, there were 167 fully completed questionnaires. Most patients (63%) express concerns about VTE and prefer oral treatment (81.5%), justified by the ease of administration (74%) and a fear of the injections (22%). When patients were taking more than three oral treatments they statistically chose injectable treatment more often (54%) than oral treatment (25%, p = 0.002). Patients who chose injectable treatment were also older (70 ± 16 vs. 58 ± 17 years old, p = 0.001). There was no statistically difference in anticoagulation preference according to gender or to the expected duration of treatment (6 weeks, 3 months, 6 months or unlimited). When oral treatment was preferred (81%), most chose oral treatment without dose adjustment and biomonitoring (74.3%). Among them, very few (5.8%) preferred a twice-daily intake. Conclusion: Patient preference in terms of anticoagulant treatment in VTE disease is in favor of oral treatment without adjustment or biomonitoring and with once-daily intake. When an injectable treatment is chosen, a prolonged duration of treatment does not seem to be a constraint for the patient. Clinical Trial Registration: ClinicalTrials.gov, identifier [NCT03889457].


Selenium added unripe carica papaya pulp extracts enhance wound repair through TGF-β1 and VEGF-a signalling pathway.
Increased wound healing efficiency by Se(2+) added Carica papaya L. (Caricaceae) fruit extract was linked to increased antioxidant and anti-inflammatory responses during healing. We investigated the impact of Se(2+) or Zn(2+) added papaya water (WE) and phosphate-buffered saline (PE) extracts on cells recruitment and bio-molecular alterations on days 4 and 10 post wounding in an in vivo excision wound. Excision wounds were created on the dorsum of Sprague Dawley rats and treated topically twice/day with 20 μL of PE and WE (5 mg extract/mL), 0.5 μgSe(2+) added PE and WE (PES and WES), or 100 μMZn(2+) added PE and WE (PEZ and WEZ). Deionised water (negative) and Solcoseryl (positive) were applied on the control groups. Histochemical and biochemical assays were used to evaluate cellular and bio-molecular changes in the wound. PES (PE + 0.5 μg Se(2+)) only increased significantly (p < 0.05) wound total protein content (95.14 ± 1.15 mg/g tissue vs positive control; 80.42 ± 0.86 mg/g tissue) on day 10 post wounding. PES increased significantly (p < 0.05) the number of fibroblasts/high power field (HPF) (75.60 ± 9.66) but decreased significantly (p < 0.05) the number of polymorphonuclear leukocytes/HPF (59.20 ± 12.64) in the wound compared to positive control (50.60 ± 12.58 fibroblasts/HPF, 101.00 ± 27.99 polymorphonuclear leukocytes/HPF) on day 4. Similar results were recorded for WES. PES demonstrated increased neovascularization, TGF-β1 and VEGFA expressions at day 4 and increased collagen at day 10. Papaya extract improved wound repair by increasing fibroblasts recruitment and reducing polymorphonuclear leukocytes infiltration through early transient expressions of TGF-β1 and VEGFA at the wound area. The processes were amplified with Se(2+) addition.


Gonadoblastoma with tubal pregnancy.
A case of unilateral gonadoblastoma in association with a ruptured ectopic tubal pregnancy is presented. The patient had normal menstrual history prior to a missed period followed by abdominal pain and the passage of clots. The surgical specimens, in addition to the ruptured tubal pregnancy, showed nodular foci of typical gonadoblastoma in the right ovary, the remainder of the ovarian tissue being normal. The left ovary was subsequently removed and examination revealed normal constituents without evidence of tumor. Cytogenetic evaluation of peripheral leukocytes showed cells with a normal female sex chromatin complement, 46-XX, as well as cells with 45 chromosomes in which one of the X chromosomes was missing.


Rapid extraction of layer relative humidity, geopotential thickness, and atmospheric stability from satellite sounding radiometer data.
Layer moisture and temperature are important variables for forecasting local weather phenomena. The purpose of ths paper is to present a method to rapidly compute layer average relative humidities and geopotential thicknesses from satellite measurements of atmospheric water vapor and oxygen radiation emission to space. Both polar-orbiting and geostationary satellite data are considered. Analyses show that the relative humidity and geopotential thickness patterns from satellite data are consistent with radiosonde data. The relative humidity calculation is insensitive to the assumed temperature profile condition. It is shown that time variations of the atmospheric moisture can be monitored from a GOES-4 VAS sequential image. Also an attempt is made to derive the atmospheric stability index, total-totals, by use of satellite derived relative humidities and geopotential thicknesses. The results show good correspondence between the derived stability patterns and subsequent convective weather.


Intrapancreatic axonal hyperbranching of dorsal root ganglia neurons in chronic pancreatitis model rats and its relation to pancreatic pain.
Increase in number of intrapancreatic nerve bundles has been implicated in the generation of persistent pain in chronic pancreatitis. To examine the origin of these nerve fibers and the mechanisms linking neural morphological change to pain generation, we used neuronal tracing techniques in combination with immunohistochemistry in spontaneous chronic pancreatitis in the Wistar Bonn/Kobori (WBN/Kob) rats. For retrograde tracing, horseradish peroxidase was injected into the pancreas, and labeled neurons in the sensory ganglia were counted. For anterograde tracing, biotinylated dextran amine was injected into the dorsal root ganglia (DRGs), and labeled intrapancreatic sensory fibers were histochemically assessed. For assessment of pain generation, we evaluated c-Fos-positive neurons in the spinal dorsal horn and behavioral changes of the animals. In WBN/Kob rats, the numbers of horseradish peroxidase-labeled neurons were decreased in the DRGs, and the numbers of biotinylated dextran amine-labeled intrapancreatic nerve fibers and terminals were increased. Biotinylated dextran amine-labeled nerve fibers contained growth-associated protein 43. The number of c-Fos-positive neurons in the dorsal horn was also increased and was correlated with intrapancreatic growth-associated protein 43 immunoreactivity. Grooming behavior was reduced in WBN/Kob rats, and this reduction was facilitated by exocrine stimulation. Axonal branching in DRG neurons innervating the pancreas increases in WBN/Kob rats, and these morphological changes are likely involved in pain generation in chronic pancreatitis.


Chronic pneumonias.
Some patients present in the outpatient setting with persistent respiratory and constitutional symptoms in association with unresolving parenchymal infiltrates on the chest radiograph. Clinicians must entertain a wide differential diagnosis as many infectious and noninfectious conditions can lead to this chronic pneumonia syndrome. The clinical presentation and radiographic abnormalities are often nonspecific. A significant proportion of patients have no underlying predisposing illness, and most of the bacterial pathogens are often considered constituents of the "normal respiratory flora." Accurate diagnosis generally requires bronchoscopic evaluation. Prolonged therapy is essential. This article reviews the epidemiology and the predominant bacterial, mycobacterial, and fungal pathogens associated with this syndrome. A brief discussion of some of the noninfectious processes is also included.


Enhanced procoagulant activity of platelets after chemotherapy in non-small cell lung cancer.
The procoagulant status of patients with non-small cell lung cancer (NSCLC) after chemotherapy is poorly characterized and the role of platelets in hypercoagulative state of NSCLC is unknown. The aim of this study was to evaluate the procoagulant activity (PCA) of platelets in NSCLC before and after chemotherapy. The subjects were 52 patients newly diagnosed with NSCLC. The patients had decreased clotting time compared with healthy subjects, and the thrombin-antithrombin complex increased 2.5-fold after chemotherapy. Platelets in the patients after chemotherapy had enhanced phosphatidylserine (PS) exposure, and shortened coagulation time as well as increased thrombin and fibrin formation of platelets compared with those before chemotherapy. Platelet-derived microparticles increased 2-fold at day 1 and peaked at day 2 post-chemotherapy. Treatment of cisplatin in vitro also resulted in upregulated intrinsic FXa and thrombin formation on platelets with a dose-dependent manner. Platelets treated with aspirin significantly decreased PCA. However, lactadherin blocked PS and inhibited the PCA approximately by 70%. Seven days after chemotherapy, PCA of platelets restored to the baseline as that before chemotherapy, indicating that within a week of chemotherapy patient platelets are highly procoagulant and effective intervention should be taken in case of thrombosis. Our results suggested that platelets after chemotherapy had elevated PCA and may contribute to the hypercoagulative state of NSCLC. Prophylactic anti-coagulant combined with anti-platelet therapy may play an inhibitory role in thrombotic complications in NSCLC.


Developing a compassionate community: a Canadian conceptual model for community capacity development.
The purpose of this article is to share a Canadian model called Developing a Compassionate Community (DCC) in which aging, dying, caregiving, and grieving are everyone's responsibility. The model provides a research-informed practice guide for people who choose to adopt a community capacity development approach to developing a compassioante community. Based on 30 years of Canadian research by the author in rural, urban, First Nations communities, and long-term care homes, the DCC model offers a practice theory and practical tool. The model incorporates the principles of community capacity development which are as follows: change is incremental and in phases, but nonlinear and dynamic; the change process takes time; development is essentially about developing people; development builds on existing resources (assets); development cannot be imposed from the outside; and development is ongoing (never-ending). Community capacity development starts with citizens who want to make positive changes in their lives and their community. They become empowered by gaining the knowledge, skills, and resources they need. The community mobilizes around finding solutions rather than discussing problems. Passion propels their action and commitment drives the process. The strategy for change is engaging, empowering, and educating community members to act on their own behalf. It requires mobilizing networks of families, friends, and neighbors across the community, wherever people live, work, or play. Community networks are encouraged to prepare for later life, and for giving and getting help among themselves. This Canadian model offers communities one approach to developing a compassionate community and is a resource for implementing a public health approach to end-of-life care in Canada. The model is also available to be evaluated for its applicability beyond Canada and is designed to be adapted to new contexts if desired.


The effect of visualizing the flow of multimedia content among and inside devices.
This study introduces a user interface, referred to as the flow interface, which provides a graphical representation of the movement of content among and inside audio/video devices. The proposed interface provides a different frame of reference with content-oriented visualization of the generation, manipulation, storage, and display of content as well as input and output. The flow interface was applied to a VCR/DVD recorder combo, one of the most complicated consumer products. A between-group experiment was performed to determine whether the flow interface helps users to perform various tasks and to examine the learning effect of the flow interface, particularly in regard to hooking up and recording tasks. The results showed that participants with access to the flow interface performed better in terms of success rate and elapsed time. In addition, the participants indicated that they could easily understand the flow interface. The potential of the flow interface for application to other audio video devices, and design issues requiring further consideration, are discussed.


The importance of Toll-like receptor 2 polymorphisms in severe infections.
Toll-like receptor 2 (TLR2) is a member of the TLR family, which plays a central role in the innate immune response to a wide variety of microorganisms. Animal studies have shown that TLR2-knockout mice are more susceptible to septicemia due to Staphylococcus aureus and Listeria monocytogenes, meningitis due to Streptococcus pneumoniae, and infection with Mycobacterium tuberculosis, suggesting that functional TLR2 polymorphisms may impair host response to a certain spectrum of microbial pathogens. In humans, 2 polymorphisms in the exon part of TLR2, which attenuate receptor signaling, enhance the risk of acute severe infections, tuberculosis, and leprosy. Because gram-positive bacteria have became the first cause of severe infections, including septic shock, knowledge of the role that alteration or lack of TLR2 function plays in the pathogenesis of infectious diseases could contribute to the design of new therapeutic strategies, including prevention, pharmacological intervention, and vaccine development.


Role of K+ATP channels in coronary vasodilation during exercise.
The mechanism of metabolic regulation of coronary vascular tone is still unclear. Therefore, we examined the role of vascular smooth muscle K+ATP channels in regulating coronary blood flow under resting conditions, during increments in myocardial metabolic demand produced by treadmill exercise, and in response to a brief ischemic stimulus. Ten chronically instrumented dogs were studied at rest and during a four-stage exercise protocol under control conditions and during intracoronary infusion of the K+ATP channel blocker glibenclamide at rates of 10 and 50 micrograms.kg-1 x min-1. Glibenclamide (50 micrograms.kg-1 x min-1) decreased coronary blood flow at rest from 51 +/- 4 to 42 +/- 6 mL/min (P < .05), decreased myocardial oxygen consumption from 5.70 +/- 0.31 to 4.11 +/- 0.56 mL O2/min (P < .05), and decreased systolic wall thickening from 21 +/- 3% to 12 +/- 3% (P < .05). The depression of systolic wall thickening produced by glibenclamide was reversed when coronary blood flow was restored to the control level with intracoronary nitroprusside, indicating a primary effect of glibenclamide on coronary flow during resting conditions. However, glibenclamide did not impair the increases of coronary blood flow, myocardial oxygen consumption, and systolic wall thickening that occurred during exercise. In eight resting awake dogs, 50 micrograms.kg-1 x min-1 glibenclamide decreased the peak reactive hyperemia blood flow rate following a 20-second coronary occlusion from 149 +/- 14 mL/min during control conditions to 111 +/- 15 mL/min (P < .05), decreased the duration of reactive hyperemia from 49 +/- 6 to 33 +/- 3 seconds (P < .05), and decreased reactive hyperemia excess flow from 33 +/- 5 to 20 +/- 4 mL (P < .05). These data demonstrate that K+ATP channels modulate coronary vasomotor tone under resting conditions and contribute to coronary vasodilation during ischemia. However, the coronary vasculature retains the capacity to dilate in response to increases in oxygen demand produced by exercise when K+ATP channels are blocked.


Active Tracking of Temporally Changing Gas-Phase Odor Mixture Using an Array of Cells Expressing Olfactory Receptors.
A cell expressing an olfactory receptor (OR) exhibits excellent odorant detection ability and thus is widely applied in odor biosensors. Most of those biosensors, however, could detect only liquid-phase nonchanging single-component odorants. In this paper, we raised up an odor biosensor for the active tracking of temporally changing gas-phase odor mixture by an array of cells expressing ORs. A thin stable liquid film covered the cell, thus allowing gas-phase odorants to penetrate. The online image processing generated individual cell brightness data which were used to compute the biosensor response. Based on the obtained responses, we adjusted the known odor components to be similar with the unknown odor. The function of our biosensor was validated by tracking the variable single-component odorant or the binary odor mixture. The influence from the sensor drift could be overcome by comparing the adjacent unknown and known odor responses. In the odor mixture quantification, adding the OR label to mixed cells and then quantifying separately (named as the pre-label method) was more efficient, while directly using the cell response pattern (named as the label-free method) was still capable even if the OR odor had cross-sensitivity.


The interlaminar and the narrowest distances at the L3/4 and L4/5 interspinous spaces and location of the intercrestal line in Thai cadavers.
Data on the L3/4 andL4/5 interspinous distances are important in performing a lumbar puncture. This has not been studied in Thais. To study the interlaminar and the narrowest distances at theL3/4 and L4/5 interspinous spaces and location ofthe intercrestal line in Thai cadavers. The interlaminar and the narrowest distances at the L3/4 and L4/5 interspinous spaces and location of the intercrestal line were measured in 87 cadavers. Mean age of cadavers was 66.7±10.6 years (range 40-80 years). Measurements were statistically analyzed using unpaired t-tests. The intercrestal line most often intersected at the lower halfofthe L4spinousprocess (32/87, 36.8%), rangingfrom the lower half ofL3 spinous process to the upper half of Si. Mean interlaminar and the narrowest distances at the L3/4 interspinous space were not significantly different from the L4/5 interspinous space: 7.32±2.7 mm vs. 7.05±3.0 mm and 5.27±2.1 mm vs. 5.38±2.4 mm, respectively (p> 0. 05). These interspinous process distances in 71-80year old cadavers were significantly shorter than 40-60 and 61-70 year age groups (p<0.05). The present study confirms that the intercrestal line is most commonly at the lower half of the L4 spinous process. Mean interlaminar and the narrowest distances at the L3/4 and L4/5 interspinous spaces were unrelated to gender or body type. The elderly had more narrow interspinous process distances which may be benefitfrom having lumbar puncture done in the sitting andfeet supported position.


Congenital hemangiopericytoma: report of a case.
A congenital hemangiopericytoma of the lower lip, first detected by prenatal ultrasound, was only partially resected and involuted over the next 20 months.


Neurosarcoidosis mimicry of multiple sclerosis: clinical, laboratory, and imaging characteristics.
To characterize the clinical and laboratory features of neurosarcoidosis (NS), presenting with findings consistent with multiple sclerosis (MS). Retrospective chart review of our entire NS database was undertaken. Patients initially diagnosed with MS but who were subsequently diagnosed as having both systemic and neurologic sarcoidosis years later were selected for more detailed review. Seven patients were identified who were diagnosed with MS (although only 4 of these met McDonald criteria for MS during chart review) and 1 patient with optic neuritis who had a diagnosis of likely MS. These patients maintained the diagnosis of MS for a mean of 107 months (median 50 mo, range 23 to 262 mo) before the diagnosis was changed to NS, concomitant with the discovery of biopsy-proven systemic sarcoidosis in 4 cases. Neurologic manifestations included relapsing-remitting optic neuritis, myelopathy, dystonic spasms, sensory abnormalities, paraparesis, and hemiparesis. Patients appeared to improve or stabilize by treatment with corticosteroids or alternative immunosuppressants. MRIs demonstrated rounded or ovoid periventricular white matter changes typical for MS. Patients with NS are frequently diagnosed initially with MS because of a considerable overlap of clinical and laboratory features. However, due to the relative rarity of NS, a misdiagnosis of NS as MS occurred only infrequently in our MS clinic.


Virulence, transmission, and heterologous protection of four isolates of Haemophilus parasuis.
Haemophilus parasuis causes Glässer's disease, a syndrome of polyserositis, meningitis, and arthritis in swine. Previous studies with H. parasuis have revealed virulence disparity among isolates and inconsistent heterologous protection. In this study, virulence, direct transmission, and heterologous protection of 4 isolates of H. parasuis (SW114, 12939, MN-H, and 29755) were evaluated using a highly susceptible pig model. In an initial experiment, isolates 12939, MN-H, and 29755 caused Glässer's disease, while strain SW114 failed to cause any clinical signs of disease. One pig from each group challenged with MN-H or 29755 failed to develop clinical disease but was able to transmit H. parasuis to noninfected pigs, which subsequently developed Glässer's disease. Pigs colonized with SW114, 29755, or MN-H that were free of clinical disease were protected from a subsequent challenge with isolate 12939. In a following experiment, pigs vaccinated with strain SW114 given as either a bacterin intramuscularly or a live intranasal vaccine were protected from subsequent challenge with isolate 12939; however, some pigs given live SW114 developed arthritis. Overall these studies demonstrated that pigs infected with virulent isolates of H. parasuis can remain healthy and serve as reservoirs for transmission to naive pigs and that heterologous protection among H. parasuis isolates is possible. In addition, further attenuation of strain SW114 is necessary if it is to be used as a live vaccine.


Association of frailty status with acute kidney injury and mortality after transcatheter aortic valve replacement: A systematic review and meta-analysis.
Frailty is a common condition in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). The aim of this systematic review was to assess the impact of frailty status on acute kidney injury (AKI) and mortality after TAVR. A systematic literature search was conducted using MEDLINE, EMBASE, and Cochrane databases from the inception through November 2016. The protocol for this study is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42016052350). Studies that reported odds ratios, relative risks or hazard ratios comparing the risk of AKI after TAVR in frail vs. non-frail patients were included. Mortality risk was evaluated among the studies that reported AKI-related outcomes. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Eight cohort studies with a total of 10,498 patients were identified and included in the meta-analysis. The pooled RR of AKI after TAVR among the frail patients was 1.19 (95% CI 0.97-1.46, I2 = 0), compared with non-frail patients. When the meta-analysis was restricted only to studies with standardized AKI diagnosis according to Valve Academic Research Consortium (VARC)-2 criteria, the pooled RRs of AKI in frail patients was 1.16 (95% CI 0.91-1.47, I2 = 0). Within the selected studies, frailty status was significantly associated with increased mortality (RR 2.01; 95% CI 1.44-2.80, I2 = 58). The findings from our study suggest no significant association between frailty status and AKI after TAVR. However, frailty status is associated with mortality after TAVR and may aid appropriate patient selection for TAVR.


Peripheral tear of the triangular fibrocartilage: depiction with MR arthrography of the distal radioulnar joint.
Although central tears of the triangular fibrocartilage are easily seen on imaging, peripheral tears of the ulnar attachment are frequently missed. The aim of this study was to evaluate the accuracy of MR arthrography of the distal radioulnar joint in depiction of peripheral tears of the triangular fibrocartilage. Forty-one patients (18 women, 23 men; mean age, 38 years; age range, 18-60 years) underwent MR arthrography and wrist arthroscopy. For MR arthrography, iopamidol (300 mg I/mL) and gadopentetate dimeglumine (4 mmol/L) were injected into the distal radioulnar joint. Consensus review of both MR arthrograms and conventional arthrograms was performed by two experienced musculoskeletal radiologists. Presence or absence of communicating and noncommunicating tears of the ulnar attachment of the triangular fibrocartilage was recorded. Arthroscopy was used as the standard of reference for determining sensitivity, specificity, and accuracy in detection of tears of the ulnar attachment. At MR arthrography, communicating tear of the ulnar attachment was diagnosed in three patients, noncommunicating tear in 19 patients, and normal attachment in 19 patients. Arthroscopy revealed peripheral tear of the triangular fibrocartilage in all three patients with communicating tear, in 14 of 19 patients with noncommunicating tear, and in three of 19 patients with normal attachment. The sensitivity was 85% (17/20), specificity was 76% (16/21), and accuracy was 80% (33/41). MR arthrography of the distal radioulnar joint is accurate in depiction of peripheral tears of the ulnar attachment of the triangular fibrocartilage. These tears often appear as noncommunicating tears extending from the distal radioulnar joint into the triangular fibrocartilage.


Setting research priorities for maternal, newborn, child health and nutrition in India by engaging experts from 256 indigenous institutions contributing over 4000 research ideas: a CHNRI exercise by ICMR and INCLEN.
Health research in low- and middle- income countries (LMICs) is often driven by donor priorities rather than by the needs of the countries where the research takes place. This lack of alignment of donor's priorities with local research need may be one of the reasons why countries fail to achieve set goals for population health and nutrition. India has a high burden of morbidity and mortality in women, children and infants. In order to look forward toward the Sustainable Development Goals, the Indian Council of Medical Research (ICMR) and the INCLEN Trust International (INCLEN) employed the Child Health and Nutrition Research Initiative's (CHNRI) research priority setting method for maternal, neonatal, child health and nutrition with the timeline of 2016-2025. The exercise was the largest to-date use of the CHNRI methodology, both in terms of participants and ideas generated and also expanded on the methodology. CHNRI is a crowdsourcing-based exercise that involves using the collective intelligence of a group of stakeholders, usually researchers, to generate and score research options against a set of criteria. This paper reports on a large umbrella CHNRI that was divided into four theme-specific CHNRIs (maternal, newborn, child health and nutrition). A National Steering Group oversaw the exercise and four theme-specific Research Sub-Committees technically supported finalizing the scoring criteria and refinement of research ideas for the respective thematic areas. The exercise engaged participants from 256 institutions across India - 4003 research ideas were generated from 498 experts which were consolidated into 373 research options (maternal health: 122; newborn health: 56; child health: 101; nutrition: 94); 893 experts scored these against five criteria (answerability, relevance, equity, innovation and out-of-box thinking, investment on research). Relative weights to the criteria were assigned by 79 members from the Larger Reference Group. Given India's diversity, priorities were identified at national and three regional levels: (i) the Empowered Action Group (EAG) and North-Eastern States; (ii) States and Union territories in Northern India (including West Bengal); and (iii) States and Union territories in Southern and Western parts of India. The exercise leveraged the inherent flexibility of the CHNRI method in multiple ways. It expanded on the CHNRI methodology enabling analyses for identification of research priorities at national and regional levels. However, prioritization of research options are only valuable if they are put to use, and we hope that donors will take advantage of this prioritized list of research options.


Reverse redistribution on exercise-redistribution (201)Tl SPECT in chronic ischemic dysfunction: predictive of functional outcome after revascularization?
This study analyzed the incidence and clinical significance of reverse redistribution (RR) on stress-redistribution (201)Tl SPECT studies in patients with poor left ventricular function and tested the hypothesis that the RR phenomenon could be caused by artifacts. Seventy-three consecutive patients with chronic coronary artery disease and left ventricular dysfunction (ejection fraction, 36% +/- 12%) who underwent exercise-redistribution-reinjection (201)Tl SPECT before myocardial revascularization were included. Recovery of left ventricular systolic function was assessed with 2-dimensional echocardiography performed before and 5.5 +/- 2.5 mo after revascularization. RR was determined visually and confirmed quantitatively as a > or = 10% decrease in (201)Tl uptake on the circumferential profiles. The left ventricle was divided in 16 segments for (201)Tl uptake and wall motion analyses. RR was present in 39 of 1,168 segments (3.3%) and in 18 of 73 patients (25%). Before revascularization, regional wall motion was normal in 26 of 39 RR segments (67%), hypokinetic in 7 of 39 (18%), and akinetic in 6 of 39 (15%). Eight percent of all dysfunctional segments (13/167) of RR patients presented RR. After revascularization, 60 of 167 dysfunctional segments (36%) improved function by > or = 1 grade, among which 8 (13%) displayed RR on (201)Tl SPECT before revascularization. Segments with RR improved function more frequently than those without RR (62% vs. 34%; P = 0.05). Using a threshold for segmental (201)Tl uptake of >54%, the accuracy of (201)Tl reinjection to detect functional improvement in RR segments after revascularization was 77% (10/13). Artifactually induced RR was also excluded in all but 1 case because no increased activity of the pixel used for normalization could be found on redistribution images relative to that of the stress images. These data suggest that in patients with chronic left ventricular ischemic dysfunction, RR on exercise-redistribution (201)Tl SPECT is not an artifact and occurs rarely in normally functioning and in dysfunctional myocardium. In the latter, RR is frequently associated with myocardial viability as shown by functional recovery after revascularization. However, the presence or absence of RR in dysfunctional segments seems to be of little clinical relevance.


Quantum continuum mechanics made simple.
In this paper we further explore and develop the quantum continuum mechanics (QCM) of Tao et al. [Phys. Rev. Lett. 103, 086401 (2009)] with the aim of making it simpler to use in practice. Our simplifications relate to the non-interacting part of the QCM equations, and primarily refer to practical implementations in which the groundstate stress tensor is approximated by its Kohn-Sham (KS) version. We use the simplified approach to directly prove the exactness of QCM for one-electron systems via an orthonormal formulation. This proof sheds light on certain physical considerations contained in the QCM theory and their implication on QCM-based approximations. The one-electron proof then motivates an approximation to the QCM (exact under certain conditions) expanded on the wavefunctions of the KS equations. Particular attention is paid to the relationships between transitions from occupied to unoccupied KS orbitals and their approximations under the QCM. We also demonstrate the simplified QCM semianalytically on an example system.


The Effects of Blood Flow Restriction in Patients Undergoing Knee Surgery: A Systematic Review and Meta-analysis.
Blood flow restriction (BFR) training has been shown to have beneficial effects in reducing quadriceps muscle atrophy and improving strength in patients with various knee pathologies. Furthermore, the effectiveness of BFR training in patients undergoing knee surgery has been investigated to determine if its use can improve clinical outcomes. The purpose of this study was to conduct a systematic review and meta-analysis to examine the effectiveness of BFR training in patients undergoing knee surgery. We hypothesized that BFR, before or after surgery, would improve clinical outcomes as well as muscle strength and volume. Systematic review and meta-analysis; Level of evidence, 4. This systematic review and meta-analysis of peer-reviewed literature was conducted using PubMed, Embase, and Cochrane databases from 1980 to present. Search results were limited to those assessing BFR training in patients undergoing knee surgery published in a scientific peer-reviewed journal in English. Selected studies subsequently underwent data extraction, methodological quality assessment, and data analysis. Eleven studies were eligible, including anterior cruciate ligament reconstruction (n = 10) and knee arthroscopy (n = 1). Two studies specifically assessed BFR use in the preoperative time frame. For the meta-analysis, including 4 studies, the primary outcome variables included the cross-sectional area of the quadratus femoris muscle group assessed with magnetic resonance imaging or ultrasonography, and patient-reported outcome measure scores. The results demonstrated that BFR use in the postoperative time period can lead to a significant improvement in the cross-sectional area when quantifying muscle atrophy. However, there were no significant differences found for patient-reported outcome measures between the included studies. It should be noted that 4 of the included papers in this review reported increases in clinical strength when using BFR in the postoperative setting. Last, preoperative BFR training did not show any significant clinical benefit between the 2 studies. This is the first systematic review and meta-analysis to study the effects of BFR in patients undergoing knee surgery. The results of this analysis show that BFR in the postoperative period after knee surgery can improve quadriceps muscle bulk compared with a control group. However, future research should examine the effects of preconditioning with BFR before surgery. Lastly, BFR protocols need to be further investigated to determine which provide the best patient outcomes. This will help standardize this type of treatment modality for future studies.


Neonatal hypoglycemia and hyperglycemia: two unique perinatal metabolic problems.
Hypoglycemia is a frequent, potentially morbid disease in the newborn. Most infants who are at risk can be identified either prior to or immediately after birth. A knowledge of those factors that cause or potentiate the development of hypoglycemia can alert the physician as to which infants require close observation and frequent monitoring of blood glucose. Care in interpretation of laboratory data is important in establishing the diagnosis. Prompt treatment can prevent permanent damage and promote intact survival in these infants. Hyperglycemia has been reported with the use of parenteral glucose in infants of very low birth weight. Rate of glucose infusion appears to be a critical factor in the development of hyperglycemia in these infants. The hazards of allowing fasting hypoglycemia to develop by inappropriate withholding of early calories and of causing hyperglycemia by injudicious use of parenteral glucose infusions in the tiny neonate show the critical need for constant monitoring of blood glucose both by screening techniques and by laboratory determinations.


Pyrotinib Plus Vinorelbine Versus Lapatinib Plus Capecitabine in Patients With Previously Treated HER2-Positive Metastatic Breast Cancer: A Multicenter, Retrospective Study.
Pyrotinib is a newly-developed irreversible pan-ErbB (erythroblastic leukemia viral oncogene homolog) receptor oral tyrosine kinase inhibitor (TKI) with promising efficacy in the human epidermal growth factor receptor-2 (HER2) positive breast cancer. The phase III PHOEBE study proved that pyrotinib plus capecitabine exceeded lapatinib plus capecitabine (LX) in PFS (p < 0.001). Oral vinorelbine is commonly used in combination with anti-HER2 treatment. However, no evidence was reported in terms of the real-world pattern, safety, and efficacy of pyrotinib plus vinorelbine (NP) compared with LX. Medical records were retrospectively evaluated for all HER2-positive metastatic breast cancer (MBC) patients who experienced progression on prior trastuzumab-containing regimens (advanced setting) and taxane (any setting) and received NP or LX therapy from 2015 to 2021 in five institutions. A total of 224 patients were enrolled and evaluated, of which 132 (58.9%) patients received LX and 92 (41.1%) patients received NP. The median progression-free survival (mPFS) of NP group was significantly longer than that in LX group (8.3 vs 5.0 months, HR = 0.47 95% CI 0.34-0.65, p < 0.001). The advantage of NP over LX was seen both in patients with trastuzumab resistance (p < 0.001) and refractoriness (p = 0.004). The NP group had more diarrhea cases (23.9%) compared to the LX group (8.3%). Discontinuation rates in the two groups were similar. This trial revealed the clinical practice of NP and LX treatment among HER2+ MBC patients pretreated with trastuzumab in China. More patients received LX than NP in real-world while the efficacy of NP exceeded LX in terms of PFS regardless of resistant status of trastuzumab. Although the NP group had more diarrhea cases, toxicities in both groups were acceptable.


Traumatic injury rates in meatpacking plant workers.
This was a 3-year retrospective cohort study of traumatic injuries in a midwestern pork meatpacking plant. Based on n = 5410 workers, this was a diverse workforce: Caucasian (56.6%), Hispanic (38.9%), African American (2.7%), Asian (1.1%) and Native American (0.8%). There were n = 1655 employees with traumatic injuries during this period. At 6 months of employment, the probability of injury was 33% in the harvest workers who were responsible for slaughter operations. The overall incidence injury rate was 22.76 per 100 full-time employees per year. Women experienced a higher incidence for injury than men. The risk ratio (RR) for traumatic injury was significantly lower in Hispanic workers compared to Caucasians (RR = 0.54, 95% CI = 0.49-0.60) and nonsignificantly higher in African American and Native American workers after adjusting for age, gender, work section assignment, and experience (RR = 1.33, 95% CI = 1.21-1.47). These findings suggest that either Hispanics are very safe employees or they underreport injuries. We make the case for the latter in the discussion.


A human opsin-related gene that encodes a retinaldehyde-binding protein.
The ligand-binding property of a cytoplasmic membrane-bound protein from bovine retinal pigment epithelium (RPE) has been demonstrated. The putative RPE-retinal G protein coupled receptor (RGR) covalently binds both all-trans- and 11-cis-retinal after reduction by sodium borohydride. The 32-kDa receptor binds all-trans-retinal preferentially, rather than the 11-cis isomer. The amino acid sequence of the opsin-related protein in humans is 86% identical to that of bovine RGR, and a lysine residue, analogous to the retinaldehyde attachment site of rhodopsin, is conserved in the seventh transmembrane domain of RGR in both species. The human gene that encodes the novel retinaldehyde receptor spans 14.8 kb and is split into seven exons. The structure of the gene is distinct from that of the visual pigment genes. These findings support the notion that the rgr gene represents the earliest independent branch of the vertebrate opsin gene family. A second form of human RGR in retina is predicted by alternative splicing of its precursor mRNA. This RGR variant results from the alternative use of an internal acceptor splice site in the second intron of the human gene, and it contains an insertion of four amino acids in the connecting loop between the second and thrid transmembrane domains. Since RGR binds all-trans-retinal preferentially, one of its functions may be to catalyze isomerization of the chromophore by a retinochrome-like mechanism.


ADAPTIVE PHENOTYPIC PLASTICITY AND ITS DIFFERENCE BETWEEN UNIVOLTINE AND MULTIVOLTINE POPULATIONS IN A BRUCHID BEETLE, KYTORHINUS SHARPIANUS.
The multivoltine bruchid Kytorhinus sharpianus shows seasonal phenotypic plasticity in adult longevity, the preoviposition period, and the number of eggs laid without feeding between the diapausing and nondiapausing generations. This study compared the norms of reaction in three life-history traits between the univoltine Aomori and multivoltine Mitsuma populations. The directions of response in the norms of reaction were similar in both populations, although their response curves differed between populations. This result indicated a potential for variation in seasonal phenotypic plasticity in the univoltine population. However, the variation in the norms of reaction was small in both populations, suggesting strong selection pressure on the plasticity in the multivoltine population. These results also suggest that the univoltine Aomori population may have originated from a multivoltine population.


Congenital scoliosis: a review and update.
Vertebral anomalies causing congenital scoliosis are classified on the basis of failures of formation, segmentation, or both. The natural history depends on the type of anomaly and the location of anomaly. Patient evaluation focuses on the history and physical examination, followed by appropriate imaging modalities. The hallmark of surgical treatment is early intervention before the development of large curvatures. The surgical treatment of a congenital deformity mandates the use of neurological monitoring to minimize the risk of perioperative neurological deficit. Modern surgical techniques have evolved to include the routine use of spinal instrumentation. Patients with associated chest wall deformities or large compensatory curves may be candidates for vertical expansion prosthetic titanium rib placement or growing rods insertion to maximize growth.


Putting the nutrient-rich foods index into practice.
With approximately 2 out of 3 Americans currently overweight or obese, many continue to come up short on recommendations for certain nutrients such as calcium, magnesium, potassium, vitamin A, vitamin C, vitamin E, and fiber in their diet. Numerous attempts have been made to provide consumers with nutrient-profiling tools, such as manufacturer-specific symbols, to improve dietary selections, but many of the tools have focused on assisting consumers in making single food selections and do not provide guidance about planning total diets. In response to the 2005 Dietary Guidelines Advisory Committee's recommendation for research to define nutrient density, the Nutrient Rich Foods Coalition (NRFC) embarked on the development of a scientifically valid definition of nutrient density and consumer-driven educational tools to communicate the concept of nutrient-rich foods (NRF) to consumers. The science-based, consumer-driven NRF approach to eating may help Americans make multiple small changes in their diet that ultimately lead to better diet quality and significant improvements in public health.