Sequential use of real-time polymerase chain reaction and enzyme-linked immunosorbent assay techniques verifies adulteration of fermented sausages with chicken meat.
Detection of adulteration in processed meats is an important issue for some countries due to substitution of beef with a cheaper source of protein like poultry. In this study, the presence of chicken meat was investigated using real-time polymerase chain reaction (real-time PCR) and enzyme-linked immunosorbent assay (ELISA) techniques to verify adulteration of fermented sausage samples. A total of 60 commercial samples were collected from 20 establishments in three replicates including 10 fermented sausage manufacturers and 10 butchers to investigate the presence of chicken meat with the sequential use of real-time PCR and ELISA techniques. In addition, pH, moisture content, water activity and color values of the samples were determined. Both real-time PCR and ELISA showed agreement on the presence or absence of chicken meat in 55 out of 60 fermented sausage samples and chicken meat was identified with both methods in 16 samples. Five samples produced inconsistent results for the presence of chicken meat in the first run. Nevertheless, the presence of chicken meat was verified with both methods when these samples were analyzed for the second time. In addition, the average physico-chemical values of the fermented sausage samples tested positive for chicken meat were not significantly different from some of those fermented sausage samples tested negative for the chicken meat. The sequential use of real-time PCR and ELISA techniques in fermented sausages could be beneficial for the government testing programs to eliminate false negatives for detection of adulteration with chicken meat. Furthermore, consumers should not rely on some of the quality cues including color to predict the adulteration of fermented sausages with chicken meat since there were no statistical differences among some of the samples tested positive and negative for chicken meat.


The radiosensitizing effect of Paeonol on lung adenocarcinoma by augmentation of radiation-induced apoptosis and inhibition of the PI3K/Akt pathway.
To investigate the radiosensitizing effect and mechanism of action by the natural product Paeonol on lung adenocarcinoma both in vitro and in vivo. Two lung adenocarcinoma cell lines (human lung adenocarcinoma cell line A549 and mouse Lewis lung carcinoma (LLC) cell line) were chosen for this research. In order to select the experimental concentrations of Paeonol, cytotoxicity was determined using a MTT (3-[4,5-dimethylthiazol-2-yl]-2,5- diphenyltetrazolium bromide) assay. A clonogenic assay was performed to measure the radiosensitizing effects. Apoptosis was determined by the Tunel (terminal deoxynucleotidyl transferase-mediated dUTP nick and labeling) assay and flow cytometry. Protein expression was analyzed by Western blotting. To test the radiosensitizing effect in vivo, a transplanted tumor model was established. The MTT assay showed that Paeonol inhibited proliferation of cells. Paeonol concentration ranged from an IC5 (5% inhibiting concentration) to an IC20 and was used at non-toxic concentrations for subsequent experiments. The clonogenic assay showed that Paeonol enhanced the radiosensitivity of cells. Data from the Tunel assay and flow cytometry verified that Paeonol enhanced radiation-induced apoptosis. Paeonol inhibited the activation of the PI3K/AKT (Phosphatidylinositol 3-kinase/ Protein Kinase B) pathway and down-regulated the expression of COX-2 (Cyclooxygenase-2) and Survivin. Paeonol (1718 mg/kg) combined with 10 Gy irradiation inhibited the growth of a transplanted tumor model in vivo, resulting in the longest tumor growth time, tumor growth delay and the highest inhibition ratio when compared with the radiotherapy alone group. It is reported for the first time that Paeonol has a radiosensitizing effect on lung adenocarcinoma both in vitro and in vivo. This effect could be related to the augmentation of radiation-induced apoptosis and the inhibition of the PI3K/Akt signalling pathway and its downstream proteins: COX-2 and Survivin.


Surveillance systems and methods for monitoring the post-marketing safety of influenza vaccines at the Centers for Disease Control and Prevention.
Annual influenza vaccine safety monitoring is an important component of the influenza vaccination program in the United States to ensure that vaccines are safe, which is important for maintaining public trust in the national vaccination program. This is specially the case for influenza vaccines since the antigen composition of the viruses of which the vaccine is made often changes from one season to the next, based on the circulating strain of influenza virus. This review describes the two surveillance systems used by the Centers for Disease Control and Prevention (CDC) to monitor the safety of influenza vaccines: 1) the Vaccine Adverse Event Reporting System (VAERS); and 2) the Vaccine Safety datalink (VSD). VAERS and VSD are used routinely to monitor the safety of influenza vaccines in the United States, and over the years they have demonstrated their value in monitoring vaccine safety since their implementation in 1990. Both systems, although different, complemented each other well to study febrile seizures in young children following influenza vaccination during the 2010-2011 influenza season. Other examples of potential safety concerns after influenza vaccines are also presented and discussed.


Cross-sectional analysis of factors associated with medication adherence in western Kenya.
Poor medication adherence in low-income and middle-income countries is a major cause of suboptimal hypertension and diabetes control. We aimed to identify key factors associated with medication adherence in western Kenya, with a focus on cost-related and economic wealth factors. We conducted a cross-sectional analysis of baseline data of participants enrolled in the Bridging Income Generation with Group Integrated Care study in western Kenya. All participants were ≥35 years old with either diabetes or hypertension who had been prescribed medications in the past 3 months. Baseline data included sociodemographic characteristics, wealth and economic status and medication adherence information. Predictors of medication adherence were separated into the five WHO dimensions of medication adherence: condition-related factors (comorbidities), patient-related factors (psychological factors, alcohol use), therapy-related factors (number of prescription medications), economic-related factors (monthly income, cost of transportation, monthly cost of medications) and health system-related factors (health insurance, time to travel to the health facility). A multivariable analysis, controlling for age and sex, was conducted to determine drivers of suboptimal medication adherence in each overarching category. The analysis included 1496 participants (73.7% women) with a mean age of 60 years (range 35-97). The majority of participants had hypertension (69.2%), 8.8% had diabetes and 22.1% had both hypertension and diabetes. Suboptimal medication adherence was reported by 71.2% of participants. Economic factors were associated with medication adherence. In multivariable analysis that investigated specific subtypes of costs, transportation costs were found to be associated with worse medication adherence. In contrast, we found no evidence of association between monthly medication costs and medication adherence. Suboptimal medication adherence is highly prevalent in Kenya, and primary-associated factors include costs, particularly indirect costs of transportation. Addressing all economic factors associated with medication adherence will be important to improve outcomes for non-communicable diseases. NCT02501746.


Development and validation of a CT-3D rotational angiography registration method for AVM radiosurgery.
In this paper a novel technique is proposed and validated for radiosurgery treatment planning of arteriovenous malformations (AVMs). The technique was developed for frameless radiosurgery by means of the CyberKnife, a nonisocentric, linac-based system which allows highly conformed isodose surfaces to be obtained, while also being valid for other treatment strategies. The technique is based on registration between computed tomography (CT) and three-dimensional rotational angiography (3DRA). Tests were initially performed on the effectiveness of the correction method for distortion offered by the angiographic system. These results determined the registration technique that was ultimately chosen. For CT-3DRA registration, a twelve-parameter affine transformation was selected, based on a mutual information maximization algorithm. The robustness of the algorithm was tested by attempting to register data sets increasingly distant from each other, both in translation and rotation. Registration accuracy was estimated by means of the "full circle consistency test." A registration quality index (expressed in millimeters) based on these results was also defined. A hybrid subtraction between CT and 3DRA is proposed in order to improve 3D reconstruction. Preprocessing improved the ability of the algorithm to find an acceptable solution to the registration process. The robustness tests showed that data sets must be manually prealigned within approximately 15 mm and 20 degrees with respect to all three directions simultaneously. Results of the consistency test showed agreement between the quality index and registration accuracy stated by visual inspection in 20 good and 10 artificially worsened registration processes. The quality index showed values smaller than the maximum voxel size (mean 0.8 mm compared to 2 mm) for all successful registrations, while it resulted in much greater values (mean 20 mm) for unsuccessful registrations. Once registered, the two data sets can be used for CyberKnife treatment planning. Target delineation is performed on 3DRA while dose calculation and DRR generation are performed on CT. In conclusion, a method was developed for using 3DRA images for AVM frameless radiosurgery treatment planning. The method proved to be feasible, robust, and accurate for clinical use. 3DRA can be performed at different times or locations compared to standard, frame based stereotactic angiography. Unlike two-dimensional angiography, 3DRA allows examination of the shape of the AVM and of the surrounding target from any arbitrary point of view during treatment planning. The method can be applied to any case of intermodality registration, is operator-independent, and allows estimation of registration quality. Further research is desirable to improve time resolution in order to distinguish between feeding and draining vessels.


RAPD Fingerprinting and Genetic Diversity of Salmonella Spp. Isolated from Broiler and Layer Flocks in Karbala, Iraq.
Salmonellosis in poultry is one of the most significant bacterial infections causing mortality, reduced production, and serious economic losses. This study aimed to study the molecular diversity among Salmonella isolates and investigate the epidemiological spread of these bacteria in broiler and layer chicken flocks in five different farms in Karbala, Iraq, using random amplified polymorphic DNA (RAPD) polymerase chain reaction (PCR). In total, 217 cloac a swabs were collected from the farms, out of which 129 and 88 swabs were taken from broiler and layer chickens. The samples were screened by PCR for S. enterica subsp. enterica using primers specific for the invA gene. Afterward, RAPD-PCR with uniplex or multiplex octamer primers was applied to genotype the isolates. The incidence rate of Salmonella infections in broilers and layers was estimated to be 27.9% and 12.5%. The uniplex primers P2 and P3, along with the multiplex primers yielded discriminatory patterns. Moreover, the RAPD typing showed a diverse range of banding patterns of Salmonella spp. Dendrograms created through GelJ software revealed various Salmonella genotypes in broilers and layers. The RAPD-PCR could be used as an accurate and fast tool to identify genetic relatedness among Salmonella spp. The obtained results would assist researchers in epidemiological studies and controlling salmonellosis in poultry fields.


Natural transformation and availability of transforming DNA to Acinetobacter calcoaceticus in soil microcosms.
A small microcosm, based on optimized in vitro transformation conditions, was used to study the ecological factors affecting the transformation of Acinetobacter calcoaceticus BD413 in soil. The transforming DNA used was A. calcoaceticus homologous chromosomal DNA with an inserted gene cassette containing a kanamycin resistance gene, nptII. The effects of soil type (silt loam or loamy sand), bacterial cell density, time of residence of A. calcoaceticus or of DNA in soil before transformation, transformation period, and nutrient input were investigated. There were clear inhibitory effects of the soil matrix on transformation and DNA availability. A. calcoaceticus cells reached stationary phase and lost the ability to be transformed shortly after introduction into sterile soil. The use of an initially small number of A. calcoaceticus cells and nutrients, resulting in bacterial growth, enhanced transformation frequencies within a limited period. The availability of introduced DNA for transformation of A. calcoaceticus cells disappeared within a few hours in soil. Differences in transformation frequencies between soils were found; A. calcoaceticus cells were transformed at a higher rate and for a longer period in a silt loam than in a loamy sand. Physical separation of DNA and A. calcoaceticus cells had a negative effect on transformation. Transformation was also detected in nonsterile soil microcosms, albeit only in the presence of added nutrients and at a reduced frequency. These results suggest that chromosomal DNA released into soil rapidly becomes unavailable for transformation of A. calcoaceticus. In addition, strain BD413 quickly loses the ability to receive, stabilize, and/or express exogenous DNA after introduction into soil.


Structure-activity relationships among 9-N-alkyl derivatives of erythromycylamine and their effect on the oxidative burst of human neutrophils in vitro.
Macrolide antibiotics have recently triggered much interest owing to the immunomodulatory potential of some derivatives, particularly in the field of inflammatory diseases. Among the possible mechanisms underlying these anti-inflammatory effects, macrolide-induced inhibition of oxidant production by phagocytes has attracted much attention. We and others have previously reported that erythromycin A-derived macrolides impair the phagocyte oxidative burst, a property linked to the presence of L-cladinose. However, we have also demonstrated that other substituents can be involved in the modulation of phagocyte function. Here we have extended the analysis of structure-activity relationships by studying the effects of five 9-N-alkyl derivatives of erythromycylamine on oxidant production by human neutrophils in vitro. LY211397 (2-methoxyethyl derivative) neither altered cell viability nor superoxide anion production. LY281389 (n-propyl derivative) did not alter cell viability and was slightly more inhibitory than erythromycylamine for the production of superoxide anion; its IC50 (concentration that inhibits 50% of the neutrophil response) was about 18 and 24 microM (versus 72 and 74 pM for erythromycylamine) after 60 min of incubation following fMLP and PMA stimulation, respectively. LY80576 (N-phenyl-3-indolylmethyl derivative), LY281981 (3-phenyl-n-propyl derivative) and LY57843 (benzyl derivative) all displayed cellular toxicity at high pharmacological concentrations after 30 to 60 min of incubation. Interestingly, these latter three drugs exhibited a rapid (5 min incubation) and strong inhibitory effect on the neutrophil oxidative burst from either stimulus, with IC50 values of 3 to 10 pM. Further in-vitro and in-vivo investigations are required to analyze the anti-inflammatory potential of these three derivatives.


Natural pregnancies in HIV-serodiscordant couples receiving successful antiretroviral therapy.
Increasing numbers of HIV-serodiscordant heterosexual couples are concerned about the chances for pregnancy. We reviewed all natural pregnancies attained by HIV-serodiscordant couples seen in 3 clinics in Spain, in which the infected partner had undetectable plasma viremia while receiving highly active antiretroviral therapy (HAART). In the case of HIV-infected mothers, only those with undetectable viremia during pregnancy and at delivery were chosen. A total of 62 HIV-serodiscordant couples, 22 HIV-infected women (mean CD4 count of 522 cells/microL, 55% hepatitis C virus [HCV]-seropositive) and 40 HIV-infected men (mean CD4 count of 629 cells/microL, 75% HCV-seropositive), were recorded. Overall, 76 natural pregnancies occurred, and 68 children were born. There were 9 fetal deaths, 1 twin pregnancy, 6 couples with 2 consecutive babies, and 4 couples with 3 consecutive newborns. There were no cases of HIV seroconversion in uninfected sexual partners. One case of vertical HIV transmission occurred, however. Serodiscordant couples attaining natural pregnancy are exposed to a negligible risk of sexual transmission of HIV when the infected partner presents with complete suppression of plasma viremia while receiving HAART.


Parietal lobe epilepsy: surgical treatment and outcome.
Parietal lobe epilepsy (PLE) is neither common nor easily diagnosed because of its variable clinical features. To elucidate its characteristics and surgical outcome, the authors reviewed their surgical experiences. Between September 1994 and August 2001, 38 patients with PLE received surgical treatment at the Seoul National University Hospital. All patients underwent resection, mainly involving the parietal lobe. Preoperatively, over 60% of the cases were not considered to be PLE, even though PLE was the most common diagnosis (15/38, 39.8%). An invasive study was performed in 37 of the 38 patients. Awake operations under regional anesthesia were performed in 20 patients (52.6%). Seizure disappeared in 15 (Engel's classification I, 39.5%), and rare seizure remained in 5 (Engel II, 13.2%). Thirteen patients showed a worthwhile improvement (Engel III, 34.2%), whereas 5 exhibited no worthwhile improvement (Engel IV, 13.2%). Pathologies were diverse, the most common being cortical dysplasia (94.3%). Since PLE is difficult to diagnose preoperatively, an invasive study covering the parietal lobe is mandatory, if PLE is suspected. Cortical dysplasia was the most common etiology, thus awake operation under regional anesthesia and intraoperative brain mapping is helpful during extensive resection in order to spare the eloquent cortex.


Liver as a tumor-cell-killing organ.
Lymphoma cells (Eb and ESb, the metastasizing variant) were injected via a mesenteric vein. 85% to 95% of these cells were trapped in the liver. Most of the Eb cells (81%) were destroyed within 18 hours, ESb cells prove to be more resistant: only 28% of these cells were destroyed within this time. 51-Chromium release assay (4 hours) revealed a similar sensitivity of these two tumor cell strains.


[Optimized diabetes therapy in type 2 diabetics].
With the prevalence of type 2 diabetes mellitus having increased to approximately 8% during recent years and a further rise likely, type 2 diabetes will develop into a major health care problem in Europe. There are roughly 8 million diabetics in Germany, with another 4 million estimated unknown case. Diabetes is an accepted risk factor in the development of micro- and macrovascular complications. These complications generate enormous costs in our health care system. The optimal treatment of diabetic complications will minimize the cost to the health care system in the long run. Therefore, it is necessary to relay current therapeutic guidelines to medical personnel on a widespread basis. This publication summarizes current therapeutic options in glycemic control of type 2 diabetics which correspond to 95% of all diabetics. Recently, a national guideline has been developed by the "Arzneimittelkommission der deutschen Arzteschaft", the "Deutsche Diabetes- Gesellschaft", the "Fachkommission Diabetes Sachsen", the "Deutsche Gesellschaft für Innere Medizin e. V.", and the "Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften". In this guideline, treatment recommendations are made according to the criteria of evidence-based medicine. It is the basis of this review. In addition, the significance of the modern option of functional insulin therapy (FIT) in the treatment of type 2 diabetes will be explained. In closing, innovative alternatives of applying insulin will be discussed. Unquestionably, all other risk factors such as hypertension and/or hyperlipidemia also have to be treated optimally. These risk factors will not be discussed in this publication.


Internet research: an opportunity to revisit classic ethical problems in behavioral research.
The Internet offers many new opportunities for behavioral researchers to conduct quantitative and qualitative research. Although the ethical guidelines of the American Psychological Association generalize, in part, to research conducted through the Internet, several matters related to Internet research require further analysis. This article reviews several fundamental ethical issues related to Internet research, namely the preservation of privacy, the issuance of informed consent, the use of deception and false feedback, and research methods. In essence, the Internet offers unique challenges to behavioral researchers. Among these are the need to better define the distinction between private and public behavior performed through the Internet, ensure mechanisms for obtaining valid informed consent from participants and performing debriefing exercises, and verify the validity of data collected through the Internet.


Agenesis of the lung--a rare congenital anomaly of the lung.
Pulmonary agenesis is a very rare condition and many of them are associated with a variety of cardiac and non-cardiac malformations. We report an eight-month old girl with chronic lung infection due to right sided pulmonary agenesis without any associated major cardiac or non-cardiac abnormalities. The case brings in forth the importance of investigating any infant presenting with features of chronic lung infection for any congenital abnormality of the lung including aplasia of the lung. This case also emphasizes that mildness of the attack does not exclude right sided aplasia of the lung.


Medical Infrared Thermography assistance in the surgical treatment of axillary Hidradenitis Suppurativa: A case report.
The purpose of this case report is to highlight for the first time the way Medical Infrared Thermography can be a helpful tool to assist the surgeon in the surgical treatment of Hidradenitis Suppurativa inflammatory disease. A 36-year-old man with a 7-year history of Hidradenitis Suppurativa presented inflammatory nodules in the left axilla area corresponding to Hurley stage II. Choice is made to surgically treat this patient using a wide excision protocol combined with a postoperative second intention healing. For the study purpose, an IR FLIR SC620 camera (FLIR Systems, Wilsonville, OR), having a high resolution pixel detector of 640×480 pixels for greater accuracy and higher resolution, has been used. For the first time in the literature, this case report on HS disease supports the idea that real-time medical infrared thermography may be helpful in establishing the true extent of disease preoperatively in the surgical room and in a similar manner, that this technique allows the surgeon to ensure all diseased lesions are removed during surgery. At least, medical infrared thermography seems to be a powerful tool to control the final wide surgical wound, in order to minimize recurrence risk of such a disease.


Fetal substance exposure and cumulative environmental risk in an African American cohort.
Two models of vulnerability to socioenvironmental risk were examined in 337 African American children (M = 7.8 years) recruited to overrepresent prenatal alcohol or cocaine exposure: The cumulative risk model predicted synergistic effects from exposure to multiple risk factors, and the fetal patterning of disease model predicted that prenatal insult will increase vulnerability to environmental risk. Four or more risks emerged as a threshold for poorer cognitive and behavioral outcome among the non-substance-exposed children, whereas substance-exposed children showed greater vulnerability to lower levels of environmental risk. Cumulative risk was associated with increased delinquent and internalizing behaviors only for the substance-exposed group. Results support the cumulative risk model for non-substance-exposed children and increased vulnerability to environmental risk among the substance-exposed group.


A case of myelodysplasia with eosinophilia having a translocation t(5;12) (q31;q13) restricted to myeloid cells but not involving eosinophils.
A chromosomally abnormal clone characterized by a translocation, t(5;12)(q31;q13), was detected in the marrow of a child with myelodysplasia and associated eosinophilia which included a generalized skin infiltration. Combined immunophenotyping and fluorescence in situ hybridization on interphase bone marrow cells showed that the chromosomal rearrangement was restricted to the granulocyte lineage but was not present in the eosinophils. If the chromosome rearrangement is important in the overproduction of eosinophils in this case, the lineage restriction found suggests that its effect must be indirect.


Intraocular straylight and corneal morphology six months after LASIK.
To assess the relationship between changes in human corneal morphology and intraocular straylight produced over time after laser in situ keratomileusis (LASIK). Thirty subjects who underwent LASIK surgery were enrolled in this single-center, prospective and longitudinal trial. Twenty-five eyes were included in the study. A scanning, slit white light confocal microscope using a ConfoScan 4 equipped with 40x front lenses and a sensor called "z-ring" was used to examine structural changes in a cornea. Endothelial and stromal cellular count was randomized and masked at observer. Straylight was determined using the van den Berg straylight meter (third generation). All measurements were obtained over time and compared. No significant differences were detected in the endothelial layer. Anterior keratocyte density was lower at the time points of 15 days and 6 months after refractive surgery (p < 0.01, analysis of variance) than the presurgery value, although densities at 6 months failed to differ with Wilcoxon matched-pairs signed rank test. Posterior keratocyte density was reduced at 15 days post-surgery but had recovered slightly at 6 months (p < 0.05) with analysis of variance and Wilcoxon matched-pairs signed rank test. Intraocular straylight measurements improved after surgery with significant differences observed when presurgery values were compared to those recorded 15 days or 6 months after LASIK (p < 0.01) with analysis of variance being adjusted by the Kruskal-Wallis test. However, straylight value at 6 months failed to differ with Wilcoxon matched-pairs signed rank test. Correlation was detected between diminished anterior keratocyte density and increased intraocular straylight both at 15 days (r = -0.50, p < 0.05) and 6 months (r = -0.53, p < 0.05). Patients with anterior corneal cell density reduced as a consequence of LASIK, showed augmented intraocular straylight. This correlation warrants further research with larger samples.


Cross-platform analysis of HIV-1 RNA data generated by a multicenter assay validation study with wide geographic representation.
HIV-1 RNA quantitation continues to be extremely important for monitoring patients infected with HIV-1, and a number of assays have been utilized for this purpose. Differences in assay performance with respect to log(10) recovery and HIV-1 subtype specificity have been well documented for commercially available assays, although comparisons are usually limited to one or two assay platforms. Two new FDA-approved assays, the Roche Cobas AmpliPrep/Cobas TaqMan HIV-1 test (RT) and the Abbott RealTime HIV-1 assay (AR), that utilize real-time PCR have replaced previous HIV-1 RNA platforms. Inadequate detection of some strains of HIV-1 resulted in the addition of a new primer/probe set and the introduction of a second version of the RT assay. In this study, comparisons of assay performance between the different FDA-approved HIV-1 RNA assay platforms (both new and existing) were performed by using validation data that included both well-characterized virus stock and locally collected clinical samples. Laboratories across diverse geographical regions performed the validation testing and submitted data to the Virology Quality Assurance program (VQA) for analysis. Correlation values for clinical sample testing varied across the assay platforms (r = 0.832 to 0.986), and average log(10) recoveries for HIV-1 RNA controls (compared to the nominal value) ranged from -0.215 to 0.181. These data demonstrate the need for use of one assay platform for longitudinal patient monitoring, but the data also reinforce the notion that no one assay is superior and that testing across platforms may be required for discordance reconciliation.


The contribution of thermally labile sugar lesions to DNA double-strand break formation in cells grown in the presence of BrdU.
Radiosensitization by bromodeoxyuridine (BrdU) is commonly attributed to an increase in the yield of double-strand breaks (DSB) in the DNA and an associated decrease in the reparability of these lesions. Radiation chemistry provides a mechanism for the increased yield of DSB through the generation, after bromine loss, of a highly reactive uracilyl radical that attacks the sugar moiety of the nucleotide to produce a single-strand break (SSB). The effects underpinning DSB repair inhibition remain, in contrast, incompletely characterized. A possible source of reduced reparability is a change in the nature or complexity of the DSB in BrdU-substituted DNA. Recent studies show that DSB-complexity or DSB-nature may also be affected by the presence within the cluster of thermally labile sugar lesions (TLSL) that break the DNA backbone only if they chemically evolve to SSB, a process thought to occur within the first hour post-irradiation. Since BrdU radiosensitization might be associated with increased yields and reduced reparability of DSB, we investigated whether BrdU underpins these effects by shifting the balance in the generation of TLSL. We employed asymmetric-field-inversion gel electrophoresis (AFIGE), a pulsed-field gel electrophoresis (PFGE) method to quantitate DSB in a battery of five cells lines grown in the presence of different concentrations of BrdU. We measured specifically the yields of promptly forming DSB (prDSB) using low temperature lysis protocols, and the yields of total DSB (tDSB = prDSB + tlDSB; tlDSB form after evolution to SSB of TLSL) using high temperature lysis protocols. We report that incorporation of BrdU generates similar increases in the formation of tlDSB and prDSB, but variations are noted among the different cell lines tested. The similar increase in the yields of tlDSB and prDSB in BrdU substituted DNA showed that shifts in the yields of these forms of lesions could not be invoked to explain BrdU radiosensitization.


Age-associated remodeling of the intestinal epithelial barrier.
Disorders of the gastrointestinal tract are common in the elderly people; however, the precise trait(s) of aging that contribute to the vulnerability of the gastrointestinal tract are poorly understood. Recent evidence suggests that patients with gastrointestinal disorders have increased intestinal permeability. Here, we address the hypothesis that disruption of the intestinal barrier is associated with aging. Our results demonstrated that permeability was significantly higher in colonic biopsies collected from old baboons compared with young baboons. Additionally, colonic tissue from the older animals had decreased zonula occluden-1, occludin, and junctional adhesion molecule-A tight junction protein expression and increased claudin-2 expression. Upregulation of miR-29a and inflammatory cytokines IFN-γ, IL-6, and IL-1β was also found in colonic biopsies from old baboons relative to young baboons. These results show for the first time that a pivotal contributing factor to geriatric vulnerability to gastrointestinal dysfunction may be increased colonic permeability via age-associated remodeling of intestinal epithelial tight junction proteins.


Alcohol Dependence Modulates Amygdalar mTORC2 and PKCε Expression in a Rodent Model.
Multiple alcohol use disorder (AUD)-related behavioral alterations are governed by protein kinase C epsilon (PKCε), particularly in the amygdala. Protein kinase C (PKC) is readily phosphorylated at Ser729 before activation by the mTORC2 protein complex. In keeping with this, the current study was conducted to assess the variations in mTORC2 and PKCε during different ethanol exposure stages. The following groups of rats were employed: control, acute, chronic, ethanol withdrawal (EW), and EW + ethanol (EtOH). Ethanol-containing and non-ethanol-containing modified liquid diets (MLDs) were administered for 27 days. On day 28, either saline or ethanol (2.5 g/kg, 20% v/v) was intraperitoneally administered, followed by bilateral amygdala extraction. PKCε mRNA levels were noticeably increased in the amygdala of the EW + EtOH and EW groups. Following chronic ethanol consumption, the stress-activated map kinase-interacting protein 1 (Sin1) gene expression was markedly decreased. In the EW, EW + EtOH, and chronic ethanol groups, there was a profound increase in the protein expression of mTOR, Sin1, PKCε, and phosphorylated PKCε (Ser729). The PKCε gene and protein expressions showed a statistically significant moderate association, according to a correlation analysis. Our results suggest that an elevated PKCε protein expression in the amygdala during EW and EW + EtOH occurred at the transcriptional level. However, an elevation in the PKCε protein expression, but not its mRNA, after chronic ethanol intake warrants further investigation to fully understand the signaling pathways during different episodes of AUD.


Chemical sympathectomy decreases alveolar hypoxic vasoconstriction in lambs but not in sheep.
We studied the role of the sympathetic nervous system in the augmented vasoconstrictor response of the newborn lamb, compared with the adult sheep, by producing a chemical sympathectomy with 6-hydroxydopamine (6-OHDA). Seven lambs, age 4-16 days, and five sheep, age 2 yr, were anesthetized and intubated with a double-lumen endotracheal tube, allowing ventilation of one lung with O2 to maintain systemic oxygenation while the contralateral lung was ventilated with N2 as a hypoxic challenge. Distribution of perfusion to each lung was evaluated using positron scintigraphy after inferior vena caval injections of 13N, a positron-emitting isotope. In the lambs, prior to 6-OHDA, distribution of perfusion to the test lung was 43 +/- 3% of total lung perfusion during bilateral O2 ventilation and fell with hypoxia to 24 +/- 2%, a reduction of 44 +/- 3% during N2 ventilation as compared with O2 ventilation. After 6-OHDA, hypoxic challenge reduced perfusion by only 22 +/- 2% (P less than 0.01 compared with pre-6-OHDA). In the adult sheep, hypoxic vasoconstriction reduced perfusion to the test lung by 28 +/- 2% but was unaffected by 6-OHDA. Absence of rise in pulmonary vascular resistance (PVR) or femoral artery pressure (Pfa) in response to Tyramine infusions after 6-OHDA confirmed complete sympathectomy in lambs and sheep. Persistent increases in PVR and Pfa to infusions of prostaglandin F2 alpha before and after 6-OHDA showed that the loss of alveolar hypoxic vasoconstriction in the lamb was specific. Thus sympathetic innervation may contribute to the greater strength of alveolar hypoxic vasoconstriction found in lambs than in sheep.


Exploring the future of GM technology in sustainable local food systems in Colombia.
The security of Earth's food systems is challenged by shifting regional climates. While agricultural processes are disrupted by climate change, they also play a large role in contributing to destabilizing greenhouse gases. Finding new strategies to increase yields while decreasing agricultural environmental impacts is essential. Tropical agriculture is particularly susceptible to climate change: local, smallholder farming, which provides a majority of the food supply, is high risk and has limited adaptation capacity. Rapid, inexpensive, intuitive solutions are needed, like the implementation of genetically modified (GM) crops. In the Latin American tropics, high awareness and acceptance of GM technologies, opportunities to test GM crops as part of local agricultural educations, and their known economic benefits, support their use. However, this is not all that is needed for the future of GM technologies in these areas: GM implementation must also consider environmental and social sustainability, which can be unique to a locality. Primarily from the perspective of its educators, the potential of a rural Colombian university in driving GM implementation is explored, including the role of this type of university in producing agricultural engineers who can innovate with GM to meet regionally-dependent environmental and cultural needs that could increase their sustainability.


The importance of heart rate recovery in patients with heart failure or left ventricular systolic dysfunction.
The ability to better predict outcome with exercise testing in patients with heart failure (HF) and left ventricular systolic dysfunction (LVSD) may prove extremely valuable in determining which patients are at increased risk. This study evaluated the ability of heart rate recovery (HRR) to predict outcome in patients with HF and validate previous findings in LVSD. HRR was measured at 1-, 2-, 3-, and 5-minute time points after treadmill testing in 2,193 males being evaluated for chest pain at the Palo Alto and Long Beach VA Hospitals. Left ventricular ejection fraction (LVEF) was calculated using biplane ventriculography and patients were considered to have LVSD if they had an LVEF <50%. Angiographic and clinical data was available for all patients. Of the 2,193 patients, 314 patients had LVSD and 109 had a history of HF. Both HF patients and patients with LVSD with a normal HRR at 2 minutes had improved survival compared with patients that had an abnormal HRR at 2 minutes when adjusted for age and beta-blocker use (HF adjusted odds ratio 0.25, 95% CI 0.10-0.66, P < .006; LVSD alone adjusted odds ratio 0.25, 95% CI 0.13-0.47, P < .0001). Stepwise proportional hazard regression analysis revealed that only 2-minute HRR, age, LVEF, and chronic obstructive pulmonary disorder were significant predictors of mortality in patients with LVSD and only HRR at 2 minutes and LV hypertrophy were significant predictors of mortality in patients with HF. HRR is a significant predictor of mortality in patients with HF and patients with LVSD and may be useful in better determining prognosis.


Isolation and characterization of marine bioluminescent bacteria for toxicity bioassays and biotechnological applications.
Toxic heavy metals pollution posed severe health hazards to the environment and biodiversity. Therefore, the development of rapid and non-invasive bioassays is in the race to monitor toxic chemicals using novel approaches. This study isolated and characterized an intense blue luminescence-producing marine bacteria, Vibrio campbellii STF1, for biosensing applications. Species-level identification of this strain was confirmed based on various phenotypic tests and multilocus sequence approach using 16s rRNA, toxR, and luxA gene sequence analysis. Fatty acid methyl ester analysis revealed the presence of three predominant fatty acids C15:0 anteiso (21.73%), C17:0 anteiso (11.27%), and C19:0 anteiso (9.08%) in STF1. Luciferase enzyme from V. campbellii STF1 was extracted, partially purified, and molecular masses (alpha subunit 40 kDa and beta subunit 37 kDa) were determined by SDS-PAGE gel for in vivo assays. MALDI-TOF-MS analysis of V. campbellii cells' protein extracts showed distinct mass spectral peaks at m/z of 2615, 3948, and 4232 da. V. campbellii STF1 is resistant to heavy metal lead, while other metals such as cadmium, copper, and mercury inhibited its growth and luminescence. Crude ethyl acetate extraction of V. campbellii demonstrated antibacterial activity against Shigella dysenteriae type 5 with a maximum inhibition zone of 27.0±1.0 mm.


Aldosterone-stimulated endothelial epithelial sodium channel (EnNaC) plays a role in cold exposure-induced hypertension in rats.
Background: Previous studies have demonstrated that activated endothelial epithelial sodium channel (EnNaC) impairs vasodilatation, which contributes to salt-sensitive hypertension. Here, we investigate whether mesenteric artery (MA) EnNaC is involved in cold exposure-induced hypertension (CIH) and identify the underlying mechanisms in SD rats. Methods: One group of rats was housed at room temperature and served as control. Three groups of rats were kept in a 4°C cold incubator for 10 h/day; among which two groups were administrated with either benzamil (EnNaC blocker) or eplerenone (mineralocorticoid receptor antagonist, MR). Blood pressure (BP), vasodilatation, and endothelial function were measured with tail-cuff plethysmography, isometric myograph, and Total Nitric Oxide (NO) Assay kit, respectively. A cell-attached patch-clamp technique, in split-open MA, was used to determine the role of EnNaC in CIH rats. Furthermore, the plasma aldosterone levels were detected using an ELISA kit; and Western blot analysis was used to examine the relative expression levels of Sgk1 and Nedd4-2 proteins in the MA of SD rats. Results: We demonstrated that cold exposure increased BP, impaired vasodilatation, and caused endothelial dysfunction in rats. The activity of EnNaC significantly increased, concomitant with an increased level of plasma aldosterone and activation of Sgk1/Nedd4-2 signaling. Importantly, CIH was inhibited by either eplerenone or benzamil. It appeared that cold-induced decrease in NO production and impairment of endothelium-dependent relaxation (EDR) were significantly ameliorated by either eplerenone or benzamil in MA of CIH rats. Moreover, treatment of MAs with aldosterone resulted in an activation of EnNaC, a reduction of NO, and an impairment of EDR, which were significantly inhibited by either eplerenone or GSK650394 (Sgk1 inhibitor) or benzamil. Conclusion: Activation of EnNaC contributes to CIH; we suggest that pharmacological inhibition of the MR/Sgk1/Nedd4-2/EnNaC axis may be a potential therapeutic strategy for CIH.


Early postoperative monocyte deactivation predicts systemic inflammation and prolonged stay in pediatric cardiac intensive care.
Sepsis and systemic inflammatory response syndrome (SIRS) are major causes of morbidity and mortality after cardiopulmonary bypass. Attempts to suppress proinflammatory mediators have failed to improve outcomes in sepsis or in patients undergoing cardiopulmonary bypass. Recent work in adult patients has suggested that the balance between pro- and anti-inflammatory mediators is more important than the level of proinflammatory response alone. This balance may be reflected by the expression of monocyte human lymphocyte antigen (HLA)-DR, with low concentrations indicating an excess of anti-inflammatory stimuli and relative immunodeficiency. We investigated the relationship between monocyte HLA-DR expression and the subsequent development of sepsis/SIRS in children undergoing cardiopulmonary bypass. A prospective, observational, clinical study. A tertiary pediatric cardiac center. Eighty-two infants and children undergoing elective cardiac surgery between March and December 1999. Monocyte HLA-DR expression was assessed before and after surgery and was found to be related to the length of hospital stay and the development of complications including sepsis/SIRS. The inflammatory insult of cardiopulmonary bypass decreased monocyte HLA-DR expression in all children. Lowest concentrations were seen within 72 hrs of surgery and were significantly lower in cases that subsequently required prolonged intensive care support (p <.0001, Mann-Whitney). HLA-DR expression on <60% of circulating monocytes was associated with a greatly increased risk of later (minimum 4 days) development of sepsis/SIRS (odds ratio, 12.9; 95% confidence interval, 3.4-47.5). Low HLA-DR was an independent predictor for the development of sepsis/SIRS after correction for age, bypass time, complexity of surgery, Paediatric Index of Mortality, and surgeon on multiple logistic regression analysis. Patients with decreased HLA-DR in the early postoperative period represent a subpopulation at greatly increased risk of later sepsis/SIRS. Such patients may benefit from strategies aimed to reduce this risk.


The efficacy and safety of tigecycline for the treatment of complicated intra-abdominal infections - the European experience.
The polymicrobial nature of complicated intra-abdominal infections makes these infections particularly challenging to treat. The initial selection of antimicrobial therapy is therefore extremely important. Inappropriate empiric antimicrobial therapy has been shown to delay clinical resolution, increase length of hospital stay, and increase the risk of mortality. In addition, the increasing frequency with which resistant isolates (e.g., extended spectrum beta-lactamases [ESBLs]) are recovered from patients mandates that empiric antimicrobial therapy covers these difficult-to-treat organisms. Here, we assessed the efficacy of a new antimicrobial agent, tigecycline. This is a combined analysis of data from the European sites that participated in two Phase III, double-blind trials to evaluate the efficacy and safety of tigecycline, versus that of imipenem/cilastatin, in adults with complicated intra-abdominal infections. Patients received either tigecycline (initial dose of 100 mg, followed by 50 mg intravenously every 12 hours) or imipenem/cilastatin (500/500 mg intravenously every 6 hours) for 5-14 days. The primary end point was the clinical response at the test-of-cure visit (12-44 days after therapy) in the co-primary microbiologically evaluable (ME) and microbiological modified intent-to-treat (m-mITT) populations. For the ME group, clinical cure rates at the test-of-cure visit were 92.4% (219/237) for tigecycline versus 88.8% (198/223) for imipenem/cilastatin (95% CI = -2.2, 9.4). Clinical cure rates for the mmITT populations were 87.3% (247/283) for tigecycline versus 83.5% (228/273) for imipenem/cilastatin (95% CI = -2.5, 10.0) at the test-of-cure visit. Pretherapy in vitro activity against baseline isolates for tigecycline and imipenem/cilastatin were also determined. The mean MIC(90) for tigecycline against the most commonly isolated aerobes and anaerobes was < or =2.0 microg/mL. No pretherapy isolates displayed resistance to tigecycline based on the breakpoints used. Bacterial susceptibilities to tigecycline appeared to be consistent with clinical responses. Most commonly reported treatment emergent adverse events for tigecycline and imipenem/cilastatin were nausea (14.7% and 11.8%, respectively, p = 0.267) and vomiting (10.7% and 7.3%, respectively p = 0.146). This combined analysis demonstrates that tigecycline is safe and effective for the treatment of complicated intra-abdominal infections, and reflects the findings of the global population.


The responsibility of the pharmaceutical industry.
The pharmaceutical industry plays an active role in policy surrounding the research, discovery and development of new medicines. Along with this commitment, the pharmaceutical industry must also take an active role in helping to ensure that appropriate patients receive access to state-of-the-art scientific advancements. The various players involved in drug development and introduction, including the pharmaceutical industry, clinicians, advocacy groups and regulatory bodies, need to work together to ensure patient access to quality care. While issues such as drug acquisition costs and marketing are often given a high profile, this may cloud perceptions of the industry's commitment to deliver important new medicines to the patients and healthcare systems that need them.


Relationship quality and relationship context as antecedents of person- and task-focused interpersonal citizenship behavior.
A model hypothesizing relationship quality and relationship context as antecedents of two complementary forms of interpersonal citizenship behavior (ICB) was tested. Measures with coworkers as the frame of reference were used to collect data from 273 individuals working in 2 service-oriented organizations. As hypothesized, variables reflecting relationship quality were associated with person-focused ICB, as mediated by empathic concern. Also as hypothesized, a relationship context variable, network centrality, exhibited a direct relationship with task-focused ICB. Unexpectedly, network centrality was directly associated with person-focused ICB. and empathic concern was associated with task-focused ICB. The results are discussed, and implications for research and practice are offered.


Degradation of nuclear factor kappa B during foot-and-mouth disease virus infection.
We have previously shown that the leader proteinase (L(pro)) of foot-and-mouth disease virus (FMDV) interferes with the innate immune response by blocking the translation of interferon (IFN) protein and by reducing the immediate-early induction of beta IFN mRNA and IFN-stimulated genes. Here, we report that L(pro) regulates the activity of nuclear factor kappaB (NF-kappaB). Analysis of NF-kappaB-dependent reporter gene expression in BHK-21 cells demonstrated that infection with wild-type (WT) virus has an inhibitory effect compared to infection with a genetically engineered mutant lacking the leader coding region. The expression of endogenous NF-kappaB-dependent genes tumor necrosis factor alpha and RANTES is also reduced in WT virus-infected primary porcine cells. This inhibitory effect is neither the result of a decrease in the level of the mRNA of p65/RelA, a subunit of NF-kappaB, nor a block on the nuclear translocation of p65/RelA, but instead appears to be a consequence of the degradation of accumulated p65/RelA. Viral L(pro) is localized to the nucleus of infected cells, and there is a correlation between the translocation of L(pro) and the decrease in the amount of nuclear p65/RelA. By using a recombinant cardiovirus expressing L(pro), we demonstrate that the disappearance of p65/RelA takes place in the absence of any other FMDV product. The observation that L(pro) disrupts the integrity of NF-kappaB suggests a global mechanism by which FMDV antagonizes the cellular innate immune and inflammatory responses to viral infection.


A telemedicine distributed system for cooperative medical diagnosis.
Telemedicine is changing the classical form of health care delivery, dramatically increasing the number of new applications in which some type of distributed synchronous cooperation between health care professionals is required. This paper presents the design and development of a telemedicine distributed system for cooperative medical diagnosis based on two new approaches: 1) a distributed layered architecture specially designed to add synchronous computer supported cooperative work features either to new or existing medical applications; 2) the definition of a methodological procedure to design graphical user interfaces for telemedicine cooperative working scenarios. The cooperative work is supported by a collaborative toolkit that provides telepointing, window sharing, coordination and synchronization. Finally, we have implemented and installed the telemedicine system in clinical practice between two hospitals, providing teleconferencing facilities for cooperative decision support in haemodynamics studies. This specific implementation and a preliminary evaluation were accomplished under the Research Project FEST "Framework for European Services in Telemedicine" funded by the EU AIM Programme.


Survival after sequential mechanical complications of acute myocardial infarction, complicated with heparin-induced thrombocytopenia and multiple organ failure: report of a case.
Ventricular wall rupture and acute mitral regurgitation due to papillary muscle rupture post-acute myocardial infarction are rare and dramatic mechanical complications. The operative mortality of both complications remains extremely high but this is the only treatment which has greatly improved the prognosis. We describe the course of a patient, who survived after left ventricular free wall rupture two days post-acute myocardial infarction. He underwent left ventricular rupture repair plus two coronary artery bypass grafting. On the fifth postoperative day he developed papillary muscle rupture and acute mitral valve regurgitation. He was reoperated as an emergency case for mitral valve replacement. The patient sustained numerous complications, such as renal failure, heparin-induced thrombocytopenia, sepsis, acute respiratory distress syndrome, and multiple organ failure. He was on continuous venous-venous hemofiltration for one week and underwent a tracheostomy on the ninth postoperative day. He remained on a ventilator for three weeks. The patient survived, was discharged home after six weeks, and remains in very good condition on follow-up so far. The operative mortality of both complications remains high but this is the only treatment which improves the prognosis. Surviving both events is rare and few cases have been reported in the literature. This case highlights the necessity of careful echocardiographic examination in any patient presented with post-myocardial infarction new onset of hemodynamic instability. Identification of a single site of rupture does not eliminate the possibility of additional ruptures in the papillary muscle and intraventricular septum, and transesophageal echocardiography should be used to search for these entities. Although repair of each of these complications carries a high mortality, failure to address them will almost certainly result in death. Using standard surgical techniques, including preoperative intraaortic balloon pump insertion and careful postoperative management, successful outcome is possible.


The Top 100 Most-Cited Articles in Stroke Imaging: A Bibliometric Analysis.
The goal of our study was to compile a list of the top 100 most-cited articles in stroke imaging literature across all peer-reviewed scientific journals. These articles were then analyzed to identify current trends in stroke imaging research and determine the characteristics of highly-cited articles. A database of the top 100 most-cited articles was created using Scopus and Web of Science. Articles were reviewed for applicability by 2 fellowship-trained radiologists with over 10 years of combined experience in neuroimaging. The following information was collected from each article: Article Title, Scopus Citations, Year of Publication, Journal, Journal Impact Factor, Authors, Number of Institutions, Country of Origin, Study Topic, Study Design, and Sample Size. Citations for the top 100 most-cited articles ranged from 159-810, and citations per year ranged from 5.7-516.0. Most of articles were published between 1996 and 2000 (n = 43). Articles were published across 18 journals, most commonly in Stroke (n = 40). Magnetic resonance imaging was the focus in 46 articles, computed tomogrphy in 16, and functional magnetic resonance imaging in 10. The most common study topic is prognostic use of an imaging modality (n = 27). Our study helps to characterize the field and identify the characteristics of most-cited articles.


Hemoglobin a1c is positively correlated with framingham risk score in older, apparently healthy nondiabetic korean adults.
Several studies have suggested that elevated levels of hemoglobin A1c (HbA1c) are associated with cardiovascular disease (CVD) in nondiabetic individuals. However, it is unclear whether HbA1c levels can serve as a simple screening marker for increased CVD risk in nondiabetic individuals. Our objective was to evaluate the relationship between HbA1c levels and CVD risk using the Framingham risk score (FRS) in older, apparently healthy nondiabetic Korean adults. We retrospectively studied 2,879 Korean adults between the ages of 40 and 79 who underwent voluntary health check-ups at the Health Promotion Center of our hospital from July 2009 to June 2011. Subjects were subdivided based on their HbA1c levels into four groups: tertiles within the HbA1c normal tolerance range and a group for subjects with an increased risk for diabetes (IRD). The mean FRS for the upper tertile (9.6±3.8) group was significantly higher than that of the middle tertile (8.4±4.0) and lower tertile (7.6±3.8) groups. In addition, FRS was highest in the IRD group (10.5±3.7). Multiple linear regression analysis demonstrated that HbA1c levels exhibited a significant positive correlation with FRS when adjusted for confounding variables in all subjects (β±standard error [SE], 0.018±0.002; R (2), 0.131), women (β±SE, 0.023±0.003; R (2), 0.170), and men (β±SE, 0.016±0.004; R (2), 0.109). HbA1c levels were positively correlated with FRS in older, apparently healthy nondiabetic Korean adults. We propose that HbA1c levels may reflect CVD risk in nondiabetic individuals.


Orthognathic surgery: is there a future?
Despite significant clinical advances in orthognathic surgery, a perceived decrease in recent years in the number of orthognathic cases was noted at the authors' institution. Word of mouth suggested that this phenomenon was region-wide. To explore this possible dichotomy, a one-page questionnaire was designed and sent to all plastic surgeons in the American Society of Maxillofacial Surgeons and to all active practicing oral surgeons and orthodontists in the state of Ohio. The questionnaire was designed to estimate both the surgeons' and the orthodontists' perception of whether the number of orthognathic cases was increasing, decreasing, or remaining the same over a 5-year period (from 1996 to 2000). A second questionnaire was then sent only to plastic surgeons and oral surgeons to further evaluate reasons for this possible increase or decrease. The overall response to the first survey was 39 percent (236 of 601 surveys sent); 87 responses (32 percent) were from plastic and oral surgeons, and 132 (40 percent) were from orthodontists. Seventy-five percent of responders perceived a decrease in the number of orthognathic operations. Of those, more than 80 percent claimed that reimbursement was the major reason for the reduction in the number of surgical procedures. The degree of reduction in reimbursement over this 5-year period was documented at the authors' institution, and the perceived reduction over this 5-year period was estimated by the respondents. Finally, reimbursement per hour was calculated for orthognathic cases and compared with three other standard plastic surgery procedures. Implications of this reduction in orthognathic surgery in Ohio are discussed, and suggestions for better documentation of this health care issue are suggested.


Cortisol during human fetal life: Characterization of a method for processing small quantities of newborn hair from 26 to 42 weeks gestation.
Fetal cortisol may be reflected in hair collected shortly after birth. The objective of this study was to determine the range of human fetal hair cortisol concentrations (HCC) in live-born neonates using an approach for processing small quantities of hair. Hair was cut on the day of birth from neonates and their mothers, born between 26 and 42 weeks gestational age (GA). HCC was determined by enzyme immunoassay. Maternal sociodemographics and birth data were collected. T-tests, ANOVA, Pearson correlation, and Wilcoxon Signed Rank test were used as appropriate. Ninety maternal and neonatal hair samples were cut from 79 term (T) and 11 preterm (PT) delivered pregnancies. All samples weighed ≥2.5 mg. Fetal HCC correlated with GA (r = .25, p = .02) and birth weight (r = .25, p = .03) and was lower in PT (4.3 ± .3 LN pg/mg) than T (5.3 ± .1, LN pg/mg, p < .001) neonates. No significant relationships were seen between fetal HCC and maternal characteristics or maternal HCC. Fetal HCC was significantly higher than maternal HCC. Fetal cortisol exposure was determined using this approach for processing small amounts of hair. Preterm neonates have significantly lower HCC than term neonates and fetal HCC is associated with GA at delivery and birth weight. Fetal HCC is significantly higher than maternal HCC cut on the same day. These data provide novel information on the intrauterine fetal cortisol environment.


A new species of Mollitrichosiphum Suenaga from Taiwan Island (Hemiptera, Aphididae), based on morphological characteristics and DNA sequences.
A new species of Mollitrichosiphum Suenaga, Mollitrichosiphum tumorisiphum Qiao & Jiang, sp. n., from Fagus longipetiolata in Taiwan island is described. Siphunculi of Mollitrichosiphum tumorisiphum in alatae are distinctly swollen on the distal part, unlike those of the other known species in the genus. Updated keys to apterous and alate viviparous females of all known Chinese species of Mollitrichosiphum are provided. The specimens studied are deposited in the National Zoological Museum of China, Institute of Zoology, Chinese Academy of Sciences, Beijing, China and the Natural History Museum, London, United Kingdom.


Relationships between plasma levels of type-II phospholipase A2, PAF-acetylhydrolase, leukotriene B4, complements, endothelin-1, and thrombomodulin in patients with sepsis.
We determined the plasma levels of type-II phospholipase A2 (type II PLA2), platelet-activating factor acetylhydrolase (PAFAH) leukotriene B4 (LTB4) and of several complements (C3a, C4a, and C5a), which are considered to be among the cytokines and eicosanoids involved in vascular endothelial disorders and that vary in concentration during sepsis. We investigated the relationship between those levels and those of ET-1 and TM levels in plasma. Plasma levels of type II PLA2, PAFAH, LTB4, C3a, C4a, ET-1, and TM at the time that sepsis was diagnosed in 30 patients were 218.3 +/- 179.9 ng/ml, 23.92 +/- 9.66 nmol/min/ml, 90.35 +/- 31.49 pg/ml, 838.73 +/- 2.30 pg/ml, 1951.46 +/- 1697.78 pg/ml, 6.98 +/- 4.08 pg/ml and 7.80 +/- 3.34 ng/ml, respectively. The C5a plasma level was below the limit of detection in all cases. There were significant correlations between type II PLA2 and ET-1 plasma levels (r = 0.39, p = 0.032) and C3a and ET-1 plasma levels (r = 0.60, p = 0.03). There were also significant correlations between type II PLA2 and TM levels in plasma (r = 0.76, p = 0.0017), PAFAH and TM plasma levels (r = 0.53, p = 0.037), LTB4 and TM plasma levels (r = 0.46, p = 0.016) and C4a and TM plasma levels (r = 0.58, p = 0.037). Results suggest that the elevation of type II PLA2, PAFAH, LTB4 and complement in plasma is involved in vascular endothelial disorders in patients with sepsis.


Stroke management and outcomes in low-income and lower-middle-income countries: a meta-analysis of 8535 patients.
Strokes affect almost 13 million new people each year, and whereas the outcomes of stroke have improved over the past several decades in high-income countries, the same cannot be seen in low-income and lower-middle-income countries. This is the first study to identify the availability of diagnostic tools along with the rates of stroke mortality and other poststroke complications in low-income and lower-middle-income countries. A review of the literature was completed with a search of the MEDLINE, Embase, and Scopus databases, with adherence to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they reported any outcomes of stroke in low-income and lower-middle-income countries as designated by the World Bank classification. A meta-analysis calculating pooled prevalence rates of diagnostic characteristics and stroke outcomes was completed for all endpoint variables. A total of 19 studies were included, of which 6 came from Ethiopia, 3 from Zambia, and 2 each from Tanzania and Iran. Single studies from Zimbabwe, Botswana, Senegal, Cameroon, Uganda, and Sierra Leone were included. A total of 5265 (61.7%) patients had an ischemic stroke, 2124 (24.9%) had hemorrhagic stroke, with the remaining 1146 (13.4%) having an unknown type. Among 6 studies the pooled percentage of patients presenting to hospital within 1 day was 48.37% (95% CI 38.59%-58.27%; I2 = 97.0%, p < 0.01). The pooled in-hospital mortality rate was 19.81% (95% CI 15.26%-25.31%; I2 = 91%, p < 0.01), but was higher in a hemorrhagic subgroup (27.07% [95% CI 22.52%-32.15%; I2 = 54%, p = 0.05]) when compared to an ischemic group (13.16% [95% CI 8.60%-19.62%; I2 = 87%, p < 0.01]). The 30-day pooled mortality rate was 23.24% (95% CI 14.17%-35.70%; I2 = 93%, p < 0.01). At 30 days, the functional independence (modified Rankin Scale score 0-2) pooled rate was 13.10% (95% CI 7.50%-21.89%; I2 = 82%, p < 0.01). A severe healthcare disparity is present in low-income and lower-middle-income countries, where there is delayed diagnosis of strokes and increased rates of poor clinical outcomes for these patients.


[Acute cholecystitis and laparoscopic cholecystectomy. Comparison with non-complicated cholelithiasis].
Laparoscopic cholecystectomy has become the treatment of choice for symptomatic cholelithiasis. However, the indication of the laparoscopic approach for acute inflammation of the gallbladder in unclear and further analysis of the results is required. The aim of our study was to compare the results of laparoscopic cholecystectomy after uncomplicated cholelithiasis and after acute cholecystitis. Data from 201 patients who underwent laparoscopic cholecystectomy were collected prospectively. Uncomplicated cholelithiasis was present in 149 patients and 52 individuals had acute cholecystitis. No differences in age, sex distribution or associated diseases were observed between groups. The mean operative time was significantly higher in patients with acute cholecystitis. However, no difference was observed regarding conversion rate (7.3%-7.6%) and morbidity rate (8.7%-9.6%). No mortality has occurred in any group. The average hospital stay after laparoscopic cholecystectomy was greater when acute cholecystitis was present (2.6 days-4.9 days; p < 0.01). But in this case hospitalization was shorter than after elective conversion (8 days; p < 0.001 and p < 0.05). We conclude that patients with acute cholecystitis can undergo laparoscopic cholecystectomy safely, with low morbidity and mortality rates and reduced hospital stay.


[Differences in individual sensitivity to the antimutagenic effect of retinol in lymphocytes from workers in contact with nickel compounds].
Individual sensitivity to nickel compounds was studied in workers employed in nickel industry. The mutagen sensitivity was inferred from the number of sister chromatid exchanges (SCEs), which was used to characterize the structural alterations of the chromosomes in workers' lymphocytes before and after administration of retinol for a month. The SCE number decreased after retinol administration in nine out of eleven workers.


X-Ray fluorescence as a method of characterizing inorganic pigment patterns in the work of Julian Onderdonk.
This study utilized portable X-Ray fluorescence to analyze pigment patterns in 33 paintings by Julian Onderdonk, a 19th-20th century Texas impressionist. This analysis led to the identification of distinctive pigment preferences for Onderdonk at different periods of his career. Using the pigment preference patterns identified in the paintings that were dated by the artist, undated works were analyzed and assigned to different periods in the artists career based on their pigment patterns. This study represents a non-destructive method for organizing the artist's work without solely relying on stylistic changes.


Generation and Neuronal Differentiation of hiPSCs From Patients With Myotonic Dystrophy Type 2.
Human induced pluripotent stem cells (hiPSCs)-patient specific are an innovative tool to reproduce a model of disease in vitro and summarize the pathological phenotype and the disease etiopathology. Myotonic dystrophy type 2 (DM2) is caused by an unstable (CCTG)n expansion in intron 1 of the CNBP gene, leading to a progressive multisystemic disease with muscle, heart and central nervous dysfunctions. The pathogenesis of CNS involvement in DM2 is poorly understood since no cellular or animal models fully recapitulate the molecular and clinical neurodegenerative phenotype of patients. In this study, we generated for the first time, two DM2 and two wild type hiPSC lines from dermal fibroblasts by polycistronic lentiviral vector (hSTEMCCA-loxP) expressing OCT4, SOX2, KLF4, and cMYC genes and containing loxP-sites, excisable by Cre recombinase. Specific morphological, molecular and immunocytochemical markers have confirmed the stemness of DM2 and wild type-derived hiPSCs. These cells are able to differentiate into neuronal population (NP) expressing tissue specific markers. hiPSCs-derived NP cells maintain (CCTG)n repeat expansion and intranuclear RNA foci exhibiting sequestration of MBNL1 protein, which are pathognomonic of the disease. DM2 hiPSCs represent an important tool for the study of CNS pathogenesis in patients, opening new perspectives for the development of cell-based therapies in the field of personalized medicine and drug screening.


Should fear of malpractice dissuade dentists from caring for children?
Little information is available on malpractice related to dentistry for children. The purpose of this report was to examine characteristics of malpractice allegations related to dentistry for children from the National Practitioner Databank (NPDB) from February 1, 2004 to November 22, 2006. The public use file of the NPDB was obtained and transformed into a searchable database and allegations involving children were sorted and characterized by payment size, reason, practitioner type, and location. During the roughly 34-month study period, 571,172 total cases were evaluated. 51,691 (9%) of these involved dentists; 367 reports were identified using age-based variable reporting. The majority of cases (275; 75%) involved 10- to 19-year-old children and 92 (25%) of the cases involved 0- to 9-year-old children. One case was an infant younger than one year old. No cases were found with the provider citation of dental resident. The geographic distribution of cases was consistent with relation to practitioner (dentist) density and mean age. The allegation of malpractice related to dentistry for children is a very small portion of both dental and general health malpractice in the United States.


Comparison of bronchodilator effects of fenoterol/ipratropium bromide and salbutamol in patients with chronic obstructive lung disease.
A double-blind, randomized cross-over trial was carried out in 24 patients with chronic airflow obstruction. The patients were required to demonstrate a minimum 15% absolute increase in forced expiratory volume (FEV1) after a standard dose (0.4 mg) of fenoterol (F). On a separate occasion the effect of ipratropium bromide (IB; 0.04 mg) on FEV1 was tested also; according to the increase in FEV1 the patients were grouped into IB responders (delta FEV1 > 15%) and IB nonresponders (delta FEV1 < 15%). Two puffs of F/IB (0.1 mg/0.04 mg), salbutamol (S; 0.2 mg) and placebo (P) were given by metered-dose inhaler at the same time of the day on three different occasions. FEV1 and specific airway resistance (sRaw) were assessed before and at specific intervals following inhalation. The results showed that F/IB and S produced similar maximal increases in FEV1 (delta FEV1 32% for F/IB and 31% for S) and decreases in sRaw (delta sRaw 24% for F/IB and 21% for S). These effects were significantly different both from baseline values and from P. FEV1 was still significantly different 8 h after inhalation from P in the F/IB group, but not in the group that received S. The effect of IB on FEV1 in the pretest was compared with the subsequent response to F/IB. In IB responders F/IB seemed to produce slightly more effective bronchodilation. Side effects were minimal and clinically insignificant. In conclusion, F/IB, with its ability to effect sustained bronchodilation without adverse side effects, is a viable alternative to a monotherapy in chronic obstructive pulmonary disease.


Antiarrhythmic properties of some aroxyethylamine derivatives with adrenolytic activity.
A series of aroxyethylamines (1-10) have been previously evaluated for antihypertensive and adrenolytic properties. Of the derivatives tested, four (compounds 4, 7, 8 and 10) displayed significant antihypertensive activity and binding affinities for alpha- and beta-adrenergic receptors. As a continuation of our study, we present here the in vivo and in vitro antiarrhythmic activity of compounds 1-10, as well as their electrocardiographic properties. Only compounds 4, 7, 8 and 10 demonstrated strong antiarrhythmic activity in adrenaline induced arrhythmia after intravenous and oral administration. In addition, compounds 4 and 7 significantly decreased heart rhythm disturbances in arrhythmia induced by coronary artery occlusion and reperfusion. The pharmacological results and receptor binding studies suggest that the antiarrhythmic activity of the compounds tested may be related to their adrenolytic properties. Moreover, the presence of a methoxyphenylpiperazine moiety seems to be required for their pharmacological activity.


[Biopsy of the rectal mucosa in pediatric surgery. Technic--diagnostic value. Apropos of 193 biopsies].
193 series of punch biopsy of the rectal mucosa for the diagnosis of Hirschsprung's disease using the histochemical method are reported. These biopsies concern 176 children from 4 days to twelve years old. The authors insist on the simplicity of the method which requires few equipment: nasal speculum and biopsy forceps. The pieces are carried fresh to the laboratory and treated immediately. The method uses the medium described by Karnovsky and Roots but enzymatic inhibitor of the non selective esterase activity is not used. This shortens the time of the manipulation to about 1 h 30 and limits its cost and toxicity. Three histologists have studied the slides without knowing the clinical facts. Of 36 children suffering from a Hirschsprung's disease all presented a mucosal AChE increased activity, 28 times at once, 8 times after further biopsies. In four patients there was an inadequate biopsy at the beginning of the experience, the other four were very young (less than 1 month). The biopsy was negative at the beginning but it became positive when the patients were about aged 3 months. In the 138 children not suffering of a Hirschsprung's disease, 2 had a AChE increased activity, One is a children suffering from a severe ganglionic displasia obvious on the surgical piece, the other is a colonic mucosal neuromatosis. So, the authors confirm the reliability of the simplified method which required an unsophisticated equipment and whose technique is faster looking for mucosal AChE increased activity and not for the ganglionic cells of the sub-mucosa.(ABSTRACT TRUNCATED AT 250 WORDS)


Rare multiple variations in brachial plexus and related structures in the left upper limb of a Dravidian male cadaver.
Anatomical variations of the nerves, muscles, and vessels in the upper limb have been described in many anatomical studies; however, the occurrence of 6 variations in an ipsilateral limb is very rare. These variations occur in the following structures: the pectoralis minimus muscle, the communication between the external jugular vein and cephalic vein, axillary arch, the Struthers ligament, the medial, lateral, and posterior cords of the brachial plexus, and the common arterial trunk from the third part of the axillary artery. The relationship of these variations to each other and their probable clinical presentation is discussed.


Fatal Complications after Pediatric Surgical Interventions: Lessons Learned.
Placement of catheters, drains, shunts, and tubes in children can lead to serious or even fatal complications at the moment of placement, such as hemorrhage at insertion, or in the longterm, such as infections and migration into adjacent organs. The clinician should always be aware of these potential complications, especially if the child is unwell. For postmortem diagnostic evaluation, either with a computed tomography scan or an invasive autopsy, all tubes, drains, shunts, and/or catheters should be left in situ. We present three cases with fatal complications after the placement of a chest drain, ventriculoperitoneal shunt, and gastrostomy tube.


Two inositol 1,4,5-trisphosphate binding sites in rat basophilic leukemia cells: relationship between receptor occupancy and calcium release.
Quantal calcium release is a novel paradigm for second messenger signal transduction which provides spatial and temporal control of calcium release from intracellular stores by inositol 1,4,5-trisphosphate (InsP3). We have proposed a mechanism to account for this phenomenon [Kindman, L. A., & Meyer, T. (1993) Biochemistry 32, 1270-1277], which hypothesized the existence of five channels, each with a different affinity for InsP3. As a direct test of this hypothesis, InsP3 binding to microsomes from RBL cells was examined under conditions similar to those used for calcium release. Scatchard analyses performed under a variety of conditions indicates the presence of high affinity (KD = 0.9 +/- 0.3 nM) and low affinity (KD = 47 +/- 5 nM) InsP3 binding sites. The low affinity sites are more prevalent, constituting 82 +/- 5% of the total. Both sites are identified in the presence and absence of MgATP. Moreover, both sites are selective for InsP3 over InsP4, through high concentrations of InsP4 displace InsP3 from each site (with inhibition constants of 16 and 267 nM InsP4, respectively). The relative abundance of the two InsP3 binding sites is Ca2+ dependent. An increase in Ca2+ from 0.1 to 0.5 microM results in the apparent conversion of a portion of the low affinity sites into high affinity sites into high affinity sites. Ca2+ (0.5 microM) also increased the KD of the low affinity InsP3 binding site. Given the presence of both high and low affinity InsP3 binding sites, two simple mathematical models describing both the kinetics of calcium release and quantal calcium release from RBL cells were developed.(ABSTRACT TRUNCATED AT 250 WORDS)


Acute changes in endothelin after hemodialysis in children.
The purpose of this study was to investigate the acute changes in endothelin (ET) levels immediately after hemodialysis and to determine whether these changes vary with the use of different membranes and hemodialysis solutions. Ten children were included in the study. Three different hemodialysis sessions were performed on all patients: session 1, acetate-based dialysate and polycarbonate membrane; session 2, bicarbonate-based dialysate and polycarbonate membrane; session 3, acetate-based dialysate and polysulfone membrane. In all cases blood samples were obtained before and after dialysis. Pre- and post-hemodialysis ET levels of the patients with acetate-based dialysate and polycarbonate membrane were 33.68 +/- 11.51 pg/ml and 28.27 +/- 12.85 pg/ml, respectively. The fall in ET levels after this session was statistically significant (P = 0.015). We did not observe a statistically significant change in ET levels in the other sessions. Post-dialysis mean arterial pressure values were significantly lower than the pre-dialysis values in all three dialysis sessions (P < 0.01). A positive correlation was observed between plasma ET levels and blood urea nitrogen and serum potassium; a negative correlation was observed between plasma ET levels and hematocrit.


Aggression, suicide, and serotonin: relationships to CSF amine metabolites.
In an earlier, separate study, the authors found that human aggression and suicide (a specific aggression-related behavior) were associated with lower levels of CSF 5-hydroxyindoleacetic acid (5-HIAA), a serotonin metabolite. That study focused on subjects with personality disorders without affective illness. In the present study they examine the life history of aggression and history of suicidal behavior in 12 subjects with borderline personality disorders without major affective disorder. Histories of aggressive behaviors and of suicide attempts were significantly associated with each other, and each was significantly associated with lower 5-HIAA levels. Altered serotonin metabolism may be a highly significant contributing factor to these behaviors in whatever diagnostic group they occur.


Efficacy of fresh-frozen plasma and cryoprecipitate in dogs with von Willebrand's disease or hemophilia A.
Here we report the comparative efficacy of fresh-frozen plasma (FFP) and cryoprecipitate in the treatment of 2 inherited bleeding disorders in dogs. The dogs were divided into 3 groups, consisting of 4 Doberman Pinschers with type I von Willebrand's disease (vWD) (group 1), 1 Scottish Terrier with type III vWD (group 2), and 4 German Shepherd Dogs with hemophilia A (group 3). In vWD, therapeutic efficacy was determined by the ability of the products to increase von Willebrand factor antigen (vWf:Ag) concentrations above 35 canine units (CU)/dL and to correct the prolonged buccal mucosal bleeding time. Therapeutic efficacy in hemophilia A was assessed by the ability of the products to increase the factor VIII coagulant (FVIII:C) activity above 30 CU/dL. In both groups 1 and 2, higher increases in vWf:Ag were achieved with cryoprecipitate than with FFP, despite a significantly smaller total amount of vWf:Ag (in CU) being infused with cryoprecipitate. The maximum vWf:Ag attained after infusion in group 1 was dependent on both the baseline vWf:Ag concentration and on the type of infusion product. The dogs with vWD in both groups also displayed a delayed increase in FVIII:C activity after infusion of both plasma products, which is characteristic of the disease. In group 3, cryoprecipitate achieved similar increases in FVIII:C activity compared to FFP, although a significantly lesser amount of FVIII:C (in CU) was delivered with cryoprecipitate. Six of the 9 dogs treated with FFP experienced adverse effects ranging from mild pruritus to pallor and weakness, whereas none of the 9 dogs treated with cryoprecipitate had any observable adverse reactions (P = .009). Based on its efficacy and safety, we recommend cryoprecipitate over FFP for treatment or prophylaxis of hemorrhagic episodes in dogs with vWD or hemophilia A.


Use of 100 kV versus 120 kV in computed tomography pulmonary angiography in the detection of pulmonary embolism: effect on radiation dose and image quality.
To determine the effective radiation dose and image quality resulting from 100 versus 120 kilovoltage (kV) protocols among patients referred for computed tomography pulmonary angiography (CTPA). Sixty-six patients with clinical suspicion of pulmonary embolism (PE) were prospectively enrolled. Two CTPA protocols (group A: n=33, 100 kV/115 mAs; group B: n=33, 120 kV/90 mAs) were compared. Two experienced radiologists assessed image quality in terms of diagnostic performance and effect of artefacts. Image quality parameters [CT attenuation, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)] and effective radiation dose between the two protocols were compared. The contrast enhancement in central and peripheral pulmonary arteries was significantly higher in group A than in group B (P<0.001) with the identical SNR (P=0.26), whereas the CNR was significantly higher in group A than in group B (P<0.001). The effective radiation dose for the 100 and 120 kV scans was 3.2 and 6.8 mSv, respectively. Reducing the tube voltage from 120 to 100 kV in CTPA allows a significant reduction of radiation dose without significant loss of diagnostic image quality.


Stacked Gold Nanodisks for Bimodal Photoacoustic and Optical Coherence Imaging.
Herein, we report on biological imaging nanoprobes: physically synthesized gold nanodisks that have inherent optical advantages-a wide range of resonant wavelengths, tunable ratio of light absorption-to-scattering, and responsiveness to random incident light-due to their two-dimensional circular nanostructure. Based on our proposed physical synthesis where gold is vacuum deposited onto a prepatterned polymer template and released from the substrate in the form of a nanodisk, monodisperse two-dimensional gold nanodisks were prepared with independent control of their diameter and thickness. The optical benefits of the Au nanodisk were successfully demonstrated by the measurement of light absorbance of the nanodisks and the application of stacked nanodisks, where a smaller sized Au nanodisk was laid atop a larger nanodisk, as bimodal contrast agents for photoacoustic microscopy and optical coherence tomography.


Modulation of the immunophenotype of ovarian cancer cells by N,N-dimethylformamide and transforming growth factor-beta 1.
Exposure of HOC-7 ovarian adenocarcinoma cells to regulators of cell differentiation caused inducer-dependent alterations of the antigenic pattern of the cells. Immunocytochemistry revealed that N,N-dimethylformamide (DMF) elevated the membrane staining for epidermal growth factor (EGF)-receptor and for desmoplakins I and II. DMF also stimulated cytoplasmic and surface labeling for CA 125 and the deposition of fibronectin into the extracellular matrix. Stimulation of fibronectin was also seen after addition of transforming growth factor (TGF)-beta 1. These responses were quantified using a fixed-cell, enzyme-linked immunosorbent assay (ELISA) and revealed that DMF dose-dependently induced expression of EGF-receptor, CA 125, fibronectin, and desmoplakins I and II. TGF-beta 1 stimulated fibronectin and desmoplakins I and II only. Production of EGF and TGF-alpha was not affected by these inducers. Immunocytochemistry, ELISA and Western blotting showed that both inducers caused down-regulation of myc oncoproteins. DMF was more effective in changing the immunophenotype of HOC-7 cells than TGF-beta 1. Desmoplakins I and II demonstrated elevated epithelial differentiation, whereas fibronectin indicated stimulation of extracellular matrix formation. Elevated EGF-receptor could not compensate for the growth inhibition induced by DMF. The expression of myc oncoproteins was inversely related to cell proliferation. CA 125, however, seems to be unrelated to cell growth.


Peptide ligation by a reversible and reusable C-terminal thiol handle.
[reaction: see text] Peptide ligation of noncysteinyl residues can be achieved conveniently by a reversible C-terminal thiol handle together with a Ag(+) ion-assisted S,N-acyl migration. The regenerated C-terminal handle permits tandem ligation of multiple segment.


Health of cows, calves and young stock on 26 organic dairy herds in Sweden.
The health and housing of the stock on 26 organic dairy herds in four counties in eastern Sweden were studied for one year. The herds ranged in size from 12 to 64 cows, and their milk production from 3772 to 10,334 kg per cow per year. A large-animal practitioner visited the farms three times during the year, and a random sample of a third of the cows in each herd were examined. The calves and young stock and their housing were also studied. The calves were in good condition in all but four herds; their serum immunoglobulins varied from almost none to high levels. The young stock were in good condition and in good housing in 20 herds. No cows with clinical signs of metabolic disorders were found. Body condition scores were adequate or good except in two herds. Acetone was analysed in milk samples from individual cows three to six weeks postpartum, and only sporadic cases with high levels were found. The incidence of diseases treated by a veterinarian was lower in the organic herds than the average for the conventional herds in the local dairy association. The findings at the farm visits supported these data, and it is evident that a good standard of health and welfare can be achieved in organic dairy herds.


Redefining public health and sustainable economy: Covid-19 from pandemic to endemic.
With the recent claim that the maintenance of population immunity will not depend on continued vaccinations but on the endemic presence of the virus, the proper understanding of the value of public health allows us to configure human living conditions as it thrives in a world where the novel Corona Virus Disease in 2019 (Covid-19) becomes endemic. World leaders and economic managers need to redefine public health not just as a means that enables economic productivity but as a substantially primordial goal-an end that every functional society must achieve via living an economically sustainable lifestyle. This paper argues that economic and societal sustainability thus must be framed and delimited within the human ecological boundary-a crucial viewpoint that could sustain public health amid a Covid-19 endemic world while preventing another viral pandemic from occurring.


Low Vitamin D Levels and Genetic Polymorphism in the Vitamin D Receptor are Associated with Increased Risk of Statin-Induced Myopathy.
The main aim of this study was to test the hypothesis whether 25-hydroxyvitamin D (25OHD) levels <50 nmol/L at baseline could predict statin-induced myopathy during the course of treatment. In addition, we analysed the association between a genetic polymorphism in the vitamin D receptor (VDR) and the risk of statin-induced myopathy. We used serum samples from a prospective, observational study in statin-treated patients in Sweden who were thoroughly followed with interviews and questionnaires regarding muscular symptoms (n = 127). In this cohort, 16 developed muscular symptoms and 111 had no muscular symptoms associated with statin treatment during the first year of follow-up. Patients with 25OHD levels <50 nmol/L before starting on statin treatment had four times higher risk of developing muscular symptoms compared with individuals having 25OHD levels >50 nmol/L (RR 4.2; 95% CI 1.7-10.2; p < 0.01). The mean levels of 25OHD at baseline were 50 ± 4 nmol/L among patients developing myopathy and 60 ± 2 nmol/L among patients without myopathy (p < 0.01). Individuals homozygous for the C allele in the VDR polymorphism TaqI (rs731236) had a four times higher risk of developing muscular symptoms; (RR 4.37, 95% CI 1.9-10.1, p < 0.01). In conclusion, 25OHD levels <50 nmol/L might be a useful marker to predict muscular adverse events during statin treatment. In addition, the finding that the VDR polymorphism TaqI was associated with myopathy may indicate a causal relationship between vitamin D function and myopathy, but larger studies are needed before firm conclusions can be drawn.


Accelerated endothelialization and suppressed thrombus formation of acellular vascular grafts by modifying with neointima-inducing peptide: A time-dependent analysis of graft patency in rat-abdominal transplantation model.
Acellular blood vessels have clinical potential as tissue-engineered vascular grafts. However, neointima is hard to form on their luminal surface. We recently reported the integrin α4β1 ligand peptide (Arg-Glu-Asp-Val) conjugated with a repetitive Pro-Hyp-Gly sequence as luminal surface modifier. By using this peptide, excellent patency of tissue-engineered small-caliber long-bypass grafts in minipig transplantation model was achieved. Here, the time-dependent change of the graft patency is investigated by using rat abdominal transplantation model. In vitro test showed that 86% of the endothelial cells were adhered to the peptide-modified graft surface, while cells were scarcely adhered on the unmodified and random peptide-modified surfaces. After transplantation in the abdominal aorta, the patency of unmodified and random peptide-modified grafts gradually decreased during two to three weeks and reached 20-40% in four weeks. In contrast, 80% of the modified grafts were patent without any thrombus formation at four weeks. These results suggest that the luminal surface modifier was bound to acellular surface through (Pro-Hyp-Gly)7 sequence and improved the in vivo graft patency by endothelialization and thrombus formation suppression.


Comparison of Repeatability and Agreement between Swept-Source Optical Biometry and Dual-Scheimpflug Topography.
To assess the repeatability and agreement of parameters obtained with two biometers and to compare the predictability. Biometry was performed on 101 eyes with cataract using the IOLMaster 700 and the Galilei G6. Three measurements were obtained per eye with each device, and repeatability was evaluated. The axial length (AL), anterior chamber depth (ACD), keratometry (K), white-to-white (WTW) corneal diameter, central corneal thickness (CCT), and lens thickness (LT) were measured and postoperative predictability was compared. Measurements could not be obtained with the IOLMaster 700 in one eye and in seven eyes with the Galilei G6 due to dense cataract. Both the IOLMaster 700 and Galilei G6 showed good repeatability, although the IOLMaster 700 showed better repeatability than the Galilei G6. There were no statistically significant differences in AL, ACD, steepest K, WTW, and LT (P > 0.050), although flattest K, mean K, and CCT differed (P < 0.050). The proportion of eyes with an absolute prediction error within 0.5 D was 85.0% for the IOLMaster 700 and was 80.0% for the Galilei G6 based on the SRK/T formula. Two biometers showed high repeatability and relatively good agreements. The swept-source optical biometer demonstrated better repeatability, penetration, and an overall lower prediction error.


A basic tool to determine exercise capacity in COPD: 4-meter gait speed.
Determination of exercise capacity is crucial for chronic obstructive pulmonary disease (COPD) management since it is an indicator of life quality and mortality. Various previously defined tests, including the cardiopulmonary exercise test (CPET), the 6-minute walking test (6MWT), and the incremental shuttle walk test, are used to determine COPD patients' exercise capacity. However, they all have some disadvantages, such as time, personnel, and equipment requirements, limiting their daily practice use. Here, it was aimed to investigate the role of 4-meter gait speed (4mGS) in evaluating exercise capacity in COPD. We included 40-to-70-year-old COPD patients with no contraindications for exercise testing. We performed the tests at standard intervals without affecting each other's results. We also performed spirometry. We used the modified Medical Research Council Scale, COPD Assessment Test, and BODE index to determine the current status of individuals. Twenty-three (female/male= 2/21) subjects aged 58.1 ± 7.3 were included in the study. A statistically significant correlation was observed between 4mGS and peak VO2 values. There was also a statistically significant relationship between 4mGS and 6MWT distance. 4mGS correlated with CAT and BODE scores to represent the general medical status of patients. Considering its easy applicability and reproducibility, 4mGS seems to be a strong candidate for daily clinical use in monitoring the exercise capacity of COPD patients. Further studies in larger patient groups are needed to support these results.


The Value of Big Endothelin-1 in the Assessment of the Severity of Coronary Artery Calcification.
Progression of coronary artery calcification (CAC) was significantly associated with all-cause mortality, and high coronary artery calcium score (CACS) portends a particularly high risk of cardiovascular events. But how often one should rescan is still an unanswered question. Preliminary screening by testing circulating biomarker may be an alternative before repeat computed tomography (CT) scan. The aim of this study was to investigate the value of big endothelin-1 (bigET-1), the precursor of endothelin-1 (ET-1), in predicting the severity of CAC. A total of 428 consecutively patients who performed coronary computed tomography angiography (CCTA) due to chest pain in Fuwai Hospital were included in the study. The clinical characteristics, CACS, and laboratory data were collected, and plasma bigET-1 was detected by enzyme-linked immunosorbent assay (ELISA). The bigET-1 was positively correlated with the CACS ( r = .232, P < .001), and the prevalence of CACS >400 increased significantly in the highest bigET-1 tertile than the lowest tertile. Multivariate analysis showed that bigET-1was the independent predictor of the presence of CACS >400 (odds ratio [OR] = 1.721, 95% confidence interval [CI], 1.002-2.956, P = .049). The receiver operating characteristic (ROC) curve analysis showed that the optimal cutoff value of bigET-1 for predicting CACS >400 was 0.38 pmol/L, with a sensitivity of 59% and specificity of 68% (area under curve [AUC] = 0.65, 95% CI, 0.58-0.72, P < .001). The present study demonstrated that the circulating bigET-1 was valuable in the assessment of the severity of CAC.


Differentiating Between Donald Trump and Hillary Clinton Voters Using Facets of Right-Wing Authoritarianism and Social-Dominance Orientation.
Historically, much of the research on right-wing authoritarianism and social dominance orientation has proceeded from the assumption that they are unidimensional. Recently, researchers have begun to seriously consider the possibility that they are multidimensional in nature and should be measured as such. Several studies have examined the unique relationships between right-wing authoritarianism and social dominance orientation facets and social and political outcome measures of interest. However, there have been no efforts to include the full slate of right-wing authoritarianism and social dominance orientation facets as predictors in the same model. This is problematic when investigating the discriminant validity of these facets, given the potential empirical overlap among the facets both within and across scales. We included facets of right-wing authoritarianism and social dominance orientation as predictors of U.S. voters' intentions to vote for Hillary Clinton versus Donald Trump in the 2016 Presidential Election. Data were collected in September 2016. We found evidence for the discriminant validity of several of the right-wing authoritarianism and social dominance orientation facets.