Extension of oxygen tolerance in man: philosophy and significance.
The respiration of oxygen over a range of partial pressures higher than in the natural environment has expanding usefulness in health and disease. It provides for denitrogenation of the astronaut to prevent aerospace decompression sickness, it facilitates diving of many forms and improves safety in decompression after diving, and it is the key to therapy of diving and iatrogenic gas embolic diseases. In the continuum of general and hyperbaric medicine, it is essential for sustaining viability of damaged or diseased tissues not adequately oxygenated at natural oxygen pressures. Over the entire range of its clinical and operational usefulness, the pressure and duration of tolerable exposure to oxygen is limited by adverse effects on multiple chemical targets, cells, tissues, and organ functions. The rates of development and the qualitative expressions of these effects are different at different respired oxygen pressures. Successful extension of oxygen tolerance, as by slowing the rate of development of adverse effects, will further expand the medical and operational usefulness and safety of oxygen in normal, hypobaric, and hyperbaric environments. A prerequisite baseline for overall extension of oxygen tolerance is the quantitative investigation of early stages of toxic oxygen effects upon specific chemical and composite functions of multiple organ systems, including rates of development and rates of recovery. The practicality of limited oxygen tolerance extension by systematic interruption of oxygen exposure has been demonstrated and the procedure widely used. Broad present goals are both to establish oxygen tolerance for specific tissues and to optimize tolerance extension over the full range of useful oxygen pressures.


The effect of repeated periods of speed endurance training on performance, running economy, and muscle adaptations.
The effect of repeated intense training interventions was investigated in eight trained male runners (maximum oxygen uptake [VO2 -max]: 59.3±3.2 mL/kg/min, mean±SD) who performed 10 speed endurance training (SET; repeated 30-seconds "all-out" bouts) and 10 aerobic moderate-intensity training sessions during two 40-day periods (P1 and P2) separated by ~80 days of habitual training. Before and after both P1 and P2, subjects completed an incremental test to exhaustion to determine VO2 -max and a repeated running test at 90% vVO2 -max to exhaustion (RRT) to determine short-term endurance capacity. In addition, running economy (RE) was measured at 60% vVO2 -max (11.9±0.5 km/h) and v10-km (14.3±0.9 km/h), a 10-km track-running test was performed, and a biopsy from m. vastus lateralis was collected. 10-km performance and VO2 -max (mL/min) were the same prior to P1 and P2, whereas RE was better (P<.05) before P2 than before P1. During P1 and P2, 10-km performance (2.9% and 2.3%), VO2 -max (2.1% and 2.6%), and RE (1.9% and 1.8% at 60% vVO2 -max; 1.6% and 2.0% at v10-km) improved (P<.05) to the same extent, respectively. Performance in RRT was 20% better (P<.05) after compared to before P2, with no change in P1. No changes in muscle expression of Na+ ,K+ -ATPase α1, α2 and β1, NHE1, SERCA1 and SERCA2, actin, and CaMKII were found during neither P1 nor P2. Thus, the present study demonstrates that a second period of intense training leads to improved short-term performance and further improved RE, whereas 10-km performance and VO2 -max improve to the same extent as during the first period.


Altholactone, a novel styryl-lactone induces apoptosis via oxidative stress in human HL-60 leukemia cells.
Plant styryl-lactone derivatives isolated from Goniothalamus sp. are potential compounds for cancer chemotherapy. In this study, we have examined the mechanisms of apoptosis induced by altholactone, a stryl-lactone isolated from the Malaysian plant G. malayanus on human HL-60 promyelocytic leukemia cells. Flow cytometric analysis of the externalization of phosphatidylserine (PS) using the annexin V/PI method on altholactone treated HL-60 cells showed a concentration-dependent increase of apoptosis from concentrations ranging from 10.8 (2.5 microg/ml) to 172.4 microM (40 microg/ml). Pre-treatment with the antioxidant N-acetylcysteine (1 mM) completely abrogated apoptosis induced by altholactone, suggesting for the involvement of oxidative stress. Further flow cytometric assessment of the level of intracellular peroxides using the fluorescent probe 2',7'-dichlorofluorescein diacetate (DCFH-DA) confirmed that altholactone induced an increase in cellular oxidative stress in HL-60 cells which was suppressed by N-acetylcysteine. In summary, our results demonstrate for the first time that altholactone induced apoptosis in HL-60 cells occurs via oxidative stress.


The ageing male reproductive tract.
Ageing of the male reproductive system is characterized by changes in the endocrine system, hypogonadism, erectile dysfunction and proliferative disorders of the prostate gland. Stochastic damage accumulating within ageing leads to progressive dysregulation at each level of the hypothalamic-pituitary-gonadal (HPG) axis and in local auto/paracrine interactions, thereby inducing morphological changes in reproductive target organs, such as the prostate, testis and penis. Despite age-related changes in the HPG axis, endocrine functions are generally sufficient to maintain fertility in elderly men. Ageing of the male reproductive system can give rise to clinically relevant manifestations, such as benign prostatic hyperplasia (BPH), prostate cancer (PCa) and erectile dysfunction (ED). In this review, we discuss morphological/histological changes occurring in these organs and current views and concepts of the underlying pathology. Moreover, we emphasize the molecular/cellular pathways leading to reduced testicular/penile function and proliferative disorders of the prostate gland.


Intensity-interrogated hot-wire anemometer based on chirp effect of a fiber Bragg grating.
An intensity-interrogated optical fiber hot-wire anemometer based on the chirp effect of fiber Bragg grating (FBG) is presented. The FBG is coated with a silver film and heated optically by a 1480 nm laser beam, which is coupled into the fiber cladding by a long-period grating (LPG) and absorbed by the silver film to convert to thermal heat. Due to the gradual decrease of laser power along the length of the FBG, a temperature gradient is formed that induces a chirp effect to the FBG. Bandwidth of the FBG's reflection spectrum is therefore broadened that increases its reflected light power. The chirp rate of the FBG reduces with airflow velocity since the temperature gradient is weakened under the cooling effect of the airflow, resulting in a certain relationship between the reflected power of the FBG and airflow velocity. In the experiment, by detecting the reflected power of the FBG, airflow velocity measurement is achieved successfully with a high sensitivity up to -28.60 µW/(m·s-1) at airflow velocity of 0.1 m/s and a dynamic response time of under one second. The measurement range is up to 0 to 11 m/s. The intensity interrogation scheme of the FBG hot-wire anemometer reduces its cost greatly and makes it a promising solution for airflow velocity measurement in practical applications.


Effects of timing of signal indicating jump directions on knee biomechanics in jump-landing-jump tasks.
A variety of the available time to react (ATR) has been utilised to study knee biomechanics during reactive jump-landing tasks. The purpose was to quantify knee kinematics and kinetics during a jump-land-jump task of three possible directions as the ATR was reduced. Thirty-four recreational athletes performed 45 trials of a jump-land-jump task, during which the direction of the second jump (lateral, medial or vertical) was indicated before they initiated the first jump, the instant they initiated the first jump, 300 ms before landing, 150 ms before landing or at the instant of landing. Knee joint angles and moments close to the instant of landing were significantly different when the ATR was equal to or more than 300 ms before landing, but became similar when the ATR was 150 ms or 0 ms before landing. As the ATR was decreased, knee moments decreased for the medial jump direction, but increased for the lateral jump direction. When the ATR is shorter than an individual's reaction time, the movement pattern cannot be pre-planned before landing. Knee biomechanics are dependent on the timing of the signal and the subsequent jump direction. Precise control of timing and screening athletes with low ATR are suggested.


Surgical approach to the thyroarytenoid branch of the inferior laryngeal nerve through the thyroid cartilage.
To describe the anatomical course of the intralaryngeal portion of the inferior laryngeal nerve (ILN) and to standardize the surgical access to its thyroarytenoid branch (TAb) through the thyroid cartilage. Under surgical microscopy, 33 adult human excised larynges were dissected, to expose the intralaryngeal portion of ILN. The point of entry of TAb, ILN's terminal branch, in the thyroarytenoid (TA) muscle was determined and correlated with thyroid cartilage dimensions. After entering the larynx, the ILN consistently traveled between the thyroid cartilage and the lateral cricoarytenoid muscle in an anterior and slightly cranial course. The distance from the point of entry of the TAb in the TA muscle to the midline (TAb-H) and to the inferior border (TAb-V) of the thyroid cartilage differed according to gender. In females, mean distances of TAb-H and TAb-V were 20.5mm and 5.2mm and in males, 22.3mm and 5.9mm, respectively. The intralaryngeal course of the inferior laryngeal nerve presents low variability and measures from landmarks in the thyroid cartilage help to estimate the point of entry of thyroarytenoid branch in thyroarytenoid muscle.


Laryngeal chondrometaplasia: a great mimic of chondrosarcoma.
Chondrometaplasia of larynx is a rare entity with an unknown etiopathogenesis. The lesion remains asymptomatic unless it reaches a large size and a history of trauma is usually elicited. It is a known pitfall in diagnostic evaluation and a clinically significant differential considered in evaluation of cartilaginous tumors of the larynx. A 66-year-old man presented with a nodular mass of right side of neck, progressive hoarseness of voice and pain, and a suspicious growth in the right glottic region. A CT followed by an MRI one month later revealed a slow growing ill defined thickening and enhancement of the supraglottic soft tissues, predominantly involving the submucosa, along the greater cornu on the left side of the thyroid cartilage, with extra-chondral enhancement and was suggested to be of infectious etiology. On neck exploration a lesion clinically suspected to be a chondrosarcoma was excised along with the right ala of the thyroid cartilage. The tissue processed entirely, revealed features consistent with chondrometaplasia of larynx. The importance of distinguishing this lesion from cartilaginous tumors is emphasized.


Synthesis and the absolute configuration of both enantiomers of 4,5-dihydroxy-3-(formyl)cyclopent-2-enone acetonide as a new chiral building block for prostanoid synthesis.
The synthesis of both enantiomers of 4,5-dihydroxy-3-(formyl)cyclopent-2-enone acetonide (5) was accomplished in five steps starting from meso-tartaric acid (6). The key steps involved are preparation of the isopropylidene protected 3-[(dimethoxyphosphoryl)methyl]-4,5-dihydroxycyclopent-2-enone (9), resolution of the diastereoisomeric products 10 of the Horner reaction of racemic 9 with (R)-glyceraldehyde acetonide and the final regioselective ozonolysis of the exocyclic carbon–carbon double bond of the separated dienones 10 leading to both enantiomeric title compounds 5. The absolute configuration of both enantiomers was initially assigned based on the comparison of the chiroptical properties obtained from the DFT calculations with the experimental data and finally confirmed by X-ray analysis.


End-loop ileocolostomy for massive trauma to the right side of the colon.
In patients with severe trauma to the right side of the colon, who might have intraoperative contraindications to primary ileocolostomy, we use a new technique called end-loop ileocolostomy, which allows for complete diversion of the fecal stream with the distinct advantage that it precludes the need for formal laparotomy at the time of subsequent closure. This has been used successfully in eight patients.


Therapeutic Monoclonal Antibodies in Clinical Practice against Cancer.
The importance of monoclonal antibodies in oncology has increased drastically following the discovery of Milstein and Kohler. Since the first approval of the monoclonal antibody, i.e. Rituximab in 1997 by the FDA, there was a decline in further applications but this number has significantly increased over the last three decades for various therapeutic applications due to the lesser side effects in comparison to the traditional chemotherapy methods. Presently, numerous monoclonal antibodies have been approved and many are in queue for approval as a strong therapeutic agent for treating hematologic malignancies and solid tumors. The main target checkpoints for the monoclonal antibodies against cancer cells include EGFR, VEGF, CD and tyrosine kinase which are overexpressed in malignant cells. Other immune checkpoints like CTLA-4, PD-1 and PD-1 receptors targeted by the recently developed antibodies increase the capability of the immune system in destroying the cancerous cells. Here, in this review, the mechanism of action, uses and target points of the approved mAbs against cancer have been summarized.


Keeping complaints in perspective.
A while ago, a team of colleagues received a complaint. They are an efficient bunch: thoughtful, caring, the kind of people who are constantly praised by patients for their good practice. So the complaint came as a surprise.


Extracellular matrix of the developing ovarian follicle.
Ovaries can be considered tissues in which endocrine organs--follicles and corpora lutea--continually grow and regress. Follicles have both epithelial and stromal layers in which cell migration or movement, cell division, specialization and differentiation, and death occur. A fluid-filled antrum develops and at ovulation the epithelial cells undergo an epithelial to mesenchymal transition into luteal cells. Although growth factors and hormones are very important in some of these processes, the extracellular matrix participates in all of them. Importantly, the matrix is diverse in composition and cells rarely behave without reference to the composition and structure of the matrix. When follicles commence growing, the follicular basal lamina changes in its composition from containing all six alpha chains of collagen type IV to only alpha 1 and alpha 2. Perlecan and nidogen 1 subsequently become components of the follicular basal lamina, and there is an increase in the amount of laminin chains alpha 1, beta 2 and gamma 1, at least in cows. Late in follicular development and on atresia some follicles contain laminin alpha 2. On atresia the follicular basal lamina is not degraded as occurs at ovulation, but can be breached by cells from the thecal layer if granulosa cells no longer align it. Other matrix components are present and also change during follicular development. Versican was identified in all the follicular layers and has been found to play a key role together with inter-alpha-trypsin inhibitor, tumour necrosis factor alpha-stimulated gene 6 (TSG-6) and hyaluronan in cumulus oocyte expansion and fertility. Recent studies are directed at investigating the regulation of the matrix and its function in the ovary.


Support Detection for SAR Tomographic Reconstructions from Compressive Measurements.
The problem of detecting and locating multiple scatterers in multibaseline Synthetic Aperture Radar (SAR) tomography, starting from compressive measurements and applying support detection techniques, is addressed. Different approaches based on the detection of the support set of the unknown sparse vector, that is, of the position of the nonzero elements in the unknown sparse vector, are analyzed. Support detection techniques have already proved to allow a reduction in the number of measurements required for obtaining a reliable solution. In this paper, a support detection method, based on a Generalized Likelihood Ratio Test (Sup-GLRT), is proposed and compared with the SequOMP method, in terms of probability of detection achievable with a given probability of false alarm and for different numbers of measurements.


The new reinforcement sensitivity theory: implications for personality measurement.
In this article, we review recent modifications to Jeffrey Gray's (1973, 1991) reinforcement sensitivity theory (RST), and attempt to draw implications for psychometric measurement of personality traits. First, we consider Gray and McNaughton's (2000) functional revisions to the biobehavioral systems of RST. Second, we evaluate recent clarifications relating to interdependent effects that these systems may have on behavior, in addition to or in place of separable effects (e.g., Corr, 2001; Pickering, 1997). Finally, we consider ambiguities regarding the exact trait dimension to which Gray's "reward system" corresponds. From this review, we suggest that future work is needed to distinguish psychometric measures of (a) fear from anxiety and (b) reward-reactivity from trait impulsivity. We also suggest, on the basis of interdependent system views of RST and associated exploration using formal models, that traits that are based upon RST are likely to have substantial intercorrelations. Finally, we advise that more substantive work is required to define relevant constructs and behaviors in RST before we can be confident in our psychometric measures of them.


Effectiveness of Shorter Treatment Regimen in Multidrug-Resistant Tuberculosis Patients in Pakistan: A Multicenter Retrospective Record Review.
In Pakistan, the treatment of multidrug-resistant tuberculosis (MDR-TB) with a shorter treatment regimen (STR), that is, 4-6 months of amikacin, moxifloxacin (Mfx), ethionamide, clofazimine (Cfz), pyrazinamide (Z), ethambutol (E), and high-dose isoniazid, followed by 5 months of Mfx, Cfz, Z, and E, was initiated in 2018. However, there is a lack of information about its effectiveness in Pakistani healthcare settings. Therefore, this retrospective record review of MDR-TB patients treated with STR at eight treatment sites in Pakistan aimed to fill this gap. Data were analyzed using SPSS 23. Multivariate binary logistic regression (MVBLR) analysis was conducted to find factors associated with death and treatment failure, and lost to follow-up (LTFU). A P-value < 0.05 was considered statistically significant. Of 912 MDR-TB patients enrolled at the study sites, only 313 (34.3%) eligible patients were treated with STR and included in the current study. Of them, a total of 250 (79.9%) were cured, 12 (3.8%) completed treated, 31 (9.9%) died, 16 (5.1%) were LTFU, and four (1.3%) were declared as treatment failures. The overall treatment success rate was 83.7%. In MVBLR analysis, patients' age of 41-60 (odds ratio [OR] = 4.9, P-value = 0.020) and > 60 years (OR = 3.6, P-value = 0.035), being underweight (OR = 2.7, P-value = 0.042), and previous TB treatment (OR = 0.4, P-value = 0.042) had statistically significant association with death and treatment failure, whereas patients' age of > 60 years (OR = 5.4, P-value = 0.040) and previous TB treatment (OR = 0.2, P-value = 0.008) had statistically significant association with LTFU. The treatment success rate of STR was encouraging. However, to further improve the treatment outcomes, special attention should be paid to the patients with identified risk factors.


Origin of the magnetoelectric coupling effect in Pb(Zr0.2Ti0.8)O{3}/La{0.8}Sr{0.2}MnO{3} Multiferroic heterostructures.
The electronic valence state of Mn in Pb(Zr0.2Ti0.8)O{3}/La{0.8}Sr{0.2}MnO{3} multiferroic heterostructures is probed by near edge x-ray absorption spectroscopy as a function of the ferroelectric polarization. We observe a temperature independent shift in the absorption edge of Mn associated with a change in valency induced by charge carrier modulation in the La0.8Sr0.2MnO3, demonstrating the electronic origin of the magnetoelectric effect. Spectroscopic, magnetic, and electric characterization shows that the large magnetoelectric response originates from a modified interfacial spin configuration, opening a new pathway to the electronic control of spin in complex oxide materials.


Wear resistance of nanofilled composite resin and feldspathic ceramic artificial teeth.
The wear resistance of nanofilled composite resin and feldspathic ceramic artificial teeth may vary according to the material type and physical characteristics of the antagonist. The purpose of this study was to evaluate the wear resistance of nanofilled composite resin and feldspathic ceramic artificial teeth after simulated mastication against steatite, zirconia, and alumina antagonists. The study evaluated 6 groups of artificial teeth: 3 groups of 8 nanofilled composite resin teeth (Condyloform II NFC) and 3 groups of 8 feldspathic ceramic teeth (Bonartic CT). Three sets of 16 steatite, 16 zirconia, and 16 alumina cusp-shaped antagonist surfaces were fabricated and used to test wear resistance. Each group was loaded for 600,000 cycles. The wear resistance was analyzed by measuring vertical and volume substance lost (microm and mm(3), respectively), determined with a laser scanner. Data were statistically analyzed using 2-way ANOVA and Games-Howell test (alpha=.05). The influence of the materials tested and antagonists was statistically significant. The composite resin teeth showed significantly higher vertical and volume substance loss than ceramic teeth opposing steatite cusps (P<.001; P=.04, respectively), while composite resin teeth opposing alumina and zirconia cusps demonstrated less wear than ceramic teeth. However, the latter differences were not statistically significant. The wear behavior of nanofilled composite resin and feldspathic ceramic teeth varies according to the type of antagonistic material. However, alumina and zirconia ceramics caused less wear in antagonists than steatite ceramic.


The impact of ZnO and TiO2 on the stability of clotrimazole under UVA irradiation: Identification of photocatalytic degradation products and in vitro cytotoxicity assessment.
In order to ensure the safe and effective use of pharmaceutical products especially for topical administration photostability testing is necessary. The current paper presents an in-depth analysis of the stability of one of the most common antifungal agents, namely clotrimazole. Clotrimazole has proven to be stable under UVA irradiation in applied experimental conditions, but the presence of catalysts such as ZnO and TiO2 has contributed significantly to the degradation of this compound. The findings indicate that its photocatalytic degradation reactions followed the pseudo first-order kinetics with rate constant depending on the pH and the used solvent. Using LC-MS/MS, 14 presumable degradation products of clotrimazole were identified and the plausible transformation pathways were proposed. The in vitro cytotoxicity risk evaluation based on photostability of clotrimazole was also performed using the Human skin fibroblast cell line (BJ) ATCC™ CRL-2522. There was no statistically significant difference between cells viability in all analyzed combinations of clotrimazole, TiO2/ZnO, and UVA irradiation (p<0.05).


Life story resources in dementia care: a review.
Life story work has a relatively long tradition in the caring sciences and is recognised as an important component of dementia care and practice. However, to date, there has not been a review of accessible life story resources. The paper aims to discuss these issues. Following a systematic approach to identification and inclusion, 11 life story resources were reviewed to ascertain areas of commonality and divergence between the materials. The authors were able to group the analysis under eight areas and at the end of this process, it was uncertain if life story work is a formal staff intervention or an informal activity that people with dementia and their families could engage in. Resources also varied in terms of whether the life story information was organised in a chronological way, or with topics of interest/discussion or with a combination of both. Life story evaluation and its impact on the life of the person with dementia is in need of development. Across the resources the authors identified four reasons to do life story work which the authors have named as: emotional connections; interactional connections; building new connections and practical care connections. There was limited guidance aimed at helping people with dementia to develop and compile their own life story. This paper provides new insights into the usefulness, future directions and content of life story resources in dementia care. It will be of interest to those in health and social care as well as people living with dementia.


Hijacking of the AP-1 Signaling Pathway during Development of ATL.
Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of a fatal malignancy known as adult T-cell leukemia (ATL). One way to address the pathology of the disease lies on conducting research with a molecular approach. In addition to the analysis of ATL-relevant signaling pathways, understanding the regulation of important and relevant transcription factors allows researchers to reach this fundamental objective. HTLV-1 encodes for two oncoproteins, Tax and HTLV-1 basic leucine-zipper factor, which play significant roles in the cellular transformation and the activation of the host's immune responses. Activating protein-1 (AP-1) transcription factor has been linked to cancer and neoplastic transformation ever since the first representative members of the Jun and Fos gene family were cloned and shown to be cellular homologs of viral oncogenes. AP-1 is a dimeric transcription factor composed of proteins belonging to the Jun (c-Jun, JunB, and JunD), Fos (c-Fos, FosB, Fra1, and Fra2), and activating transcription factor protein families. Activation of AP-1 transcription factor family by different stimuli, such as inflammatory cytokines, stress inducers, or pathogens, results in innate and adaptive immunity. AP-1 is also involved in various cellular events including differentiation, proliferation, survival, and apoptosis. Deregulated expression of AP-1 transcription factors is implicated in various lymphomas such as classical Hodgkin lymphomas, anaplastic large cell lymphomas, diffuse large B-cell lymphomas, and adult T-cell leukemia. Here, we review the current thinking behind deregulation of the AP-1 pathway and its contribution to HTLV-induced cellular transformation.


Effect of plano-valgus foot posture on midfoot kinematics during barefoot walking in an adolescent population.
Plano-valgus is a common alteration of the paediatric foot, characterized by valgus hindfoot, foot pronation and drop of the medial longitudinal arch. Despite their importance in the diagnosis and classification of plano-valgus foot condition, little information is available on functional alterations of the major joints spanning the medial longitudinal arch - i.e. midtarsal and tarso-metatarsal. Aim of the study was to provide objective description of the alterations in plano-valgus midfoot joints with respect to those in an age-matched normally-developed feet population. Twenty adolescents (13.3 ± 0.8 years) with bilateral plano-valgus feet underwent clinical examination and were gait-analysed via a validated 4-segment foot model. This allowed to measure static foot posture, kinematics of the main foot joints, and medial longitudinal arch deformation during walking at comfortable speed. Range of motion and temporal profiles of joint rotations were compared to those from a control population of age-matched adolescents with normally-developed feet. The plano-valgus midtarsal joint was more dorsiflexed, everted and abducted than that in the control group, and showed reduced sagittal-plane RoM (plano-valgus = 15.9 degrees; control = 22.2 degrees; P < 0.01). The tarso-metarsal joint was more plantarflexed and adducted, and showed larger frontal-plane RoM. The MLA showed larger RoM and was lower throughout the stance phase of the gait cycle. Significant postural and kinematic alterations are present at the midtarsal and tarso-metarsal joints of adolescents with plano-valgus feet. Objective identification and quantification of plano-valgus foot alterations, via non-invasive gait-analysis, is relevant to improving the diagnosis of this condition and to evaluating the effect of conservative treatments and of surgical corrections by different techniques.


Ductal carcinoma in situ: a brief review of treatment variation and impacts on patients and society.
Nearly 20% of all breast cancer cases are ductal carcinoma in situ (DCIS), with over 60,000 cases diagnosed each year. Many of these cases would never cause clinical symptoms or threaten the life of the woman; however, it is currently impossible to distinguish which lesions will progress to invasive disease from those that will not. DCIS is generally associated with an excellent prognosis regardless of the treatment pathway, but there is variation in treatment aggressiveness that seems to exceed the medical uncertainty associated with DCIS management. Therefore, it would seem that a significant proportion of women with DCIS receive more extensive treatment than is needed. This overtreatment of DCIS is a growing concern among the breast cancer community and has implications for both the patient (via adverse treatment-related effects, as well as out-of-pocket costs) and society (via economic costs and the public health and environmental harm resulting from health care delivery). This article discusses DCIS treatment pathways and their implications for patients and society and calls for further research to examine the factors that are leading to such wide variation in treatment decisions.


Cleavage of the peptide bond of beta-alanyl-L-histidine (carnosine) induced by a Co(III)-amine complexes: reaction, structure and mechanism.
Cleavage of the peptide bond occurs when beta]-alanyl-L-histidine (carnosine) reacts with [Co(tren)Cl2]+ (tren = tris(2-aminoethyl)amine) to give [Co(tren)(histidine)](2+) 1 and [Co(tren)(beta-alanine)](2+) 2. [Co(tren)(histidine)](2+) 1 crystallizes in the enantiomorphic space group P2(1)2(1)2(1) and 2 crystallizes in the P2(1)/c space group. The mechanism of the cleavage reactions were studied in detail for the precursor [Co(tren)Cl2]+ and [Co(trien)Cl2]+, which convert into [Co(tren)(OH)2]+/[Co(tren)(OH)(OH2)]2+ and [Co(trien)(OH)2]+/[Co(trien)(OH)(OH2)]2+ in water at basic pH (trien = 1,4,7,10-tetraazadecane). At a slightly basic pH, the initial coordination of the substrate (beta-alanyl-L-histidine) is by the carboxylate group for the reaction with [Co(tren)Cl2]+. This is followed by a rate-limiting nucleophilic attack of the hydroxide group at the beta-alanyl-L-histidine carbonyl group. In a strongly basic reaction medium substrate, binding of the metal was through carboxylate and amine terminals. On the other hand, for the reaction between [cis-beta-Co(trien)Cl2]+ and beta-alanyl-L-histidine, the initial coordination of the substrate takes place via an imidazole ring nitrogen, independently, and followed by a nucleophilic attack of the hydroxide group at the beta-alanyl-L-histidine carbonyl group. The circular dichroism spectrum for 1 suggests that a very small extent of racemization of the amino acid (L-histidine) takes place during the cleavage reaction between [Co(tren)Cl2]+ and beta-alanyl-L-histidine. Reaction between [cis-beta-Co(trien)Cl2]+ and beta-alanyl-L-histidine also causes cleavage of the peptide bond, producing a free beta-alanyl molecule and a cationic fragment [cis-alpha-Co(trien)(histidine)](2+) 3 that crystallizes in the optically active space group P2(1)2(1)2(1). Unlike the previous case an appreciable degree of racemization of the L-histidine takes place during the reaction between [cis-beta-Co(trien)Cl2]+ and beta-alanyl-L-histidine. Crystals containing L-histidine and D-histidine fragments in the [cis-alpha-Co(trien)(histidine)]2+ moiety were crystallographically documented by mounting a number of randomly selected crystals.


Source-specific oppositional defiant disorder: comorbidity and risk factors in referred elementary schoolboys.
To examine differences in risk factors and comorbid conditions for oppositional defiant disorder (ODD) symptom groups in a sample of 248 elementary schoolboys (ages 6-10) recruited from 1994 to 1996. The boys and their mothers received multiple assessments of cognitive, behavioral, academic, and family functioning, including a clinic-based evaluation in Stony Brook, NY. ODD was defined using four different strategies for aggregating data from mother and teacher reports of DSM-IV symptoms. Source-specific ODD symptom groups had better internal validity and were more differentiated than groups defined using the other strategies. The mother-defined ODD symptom group (ODD/M) had higher levels of maternal detachment than the teacher-defined symptom group (ODD/T), and the ODD/T group had more social problems than the ODD/M group. The classification agreement group (ODD/M + T) evidenced higher levels of sensation-seeking, maternal control, and comorbid symptoms than the ODD/M and ODD/T groups. Controlling for co-occurring attention-deficit/hyperactivity disorder and conduct disorder symptoms altered some of the relationships among ODD, comorbid symptoms, and psychosocial correlates. Patterns of co-occurring psychiatric symptoms and psychosocial correlates of ODD symptom groups varied depending on the rater(s) used to determine group membership. Results support continued research into source specificity for conceptualizing ODD.


Atrial Septal Defect in a Very Old Woman.
Atrial Septal Defect (ASD) is one of the most frequently congenital heart diseases in adults and it is often asymptomatic until adulthood. We report a case of a 90-year-old woman admitted to hospital with dyspnea and orthopnea insidiously progressing over the preceding 5 years and becoming severe with dyspnea on minimal activities, orthopnea and paroxysmal nocturnal dyspnea, in the last 2 weeks. The transthoracic echocardiogram revealed an atrial septal defect ostium secundum type, with left-to-right shunt, moderate to severe tricuspid insufficiency, severe pulmonary hypertension (72 mmHg) and preserved biventricular function. With diuretic therapy optimization the patient showed symptomatic improvement. This present case represents and unusual and very late presentation of an atrial septal defect ostium secundum type, which is usually diagnosed at the mild adult age. Our patient lived symptom-free for over 80 years.


[Activity of cathepsin B and collagenase in urine and excretion of fibronectin and TGF-beta 1 in urine of patients with membranous glomerulonephritis].
In 30% cases nephrotic syndrome is due to membranous glomerulonephritis (MG). Fifty percent of patients reveal end stage renal disease in 15 years follow-up. The another 50% gain persistent remission. The pathogenesis of disease is not known. Protein accumulation in glomeruli leads to progressive loss of kidney structure and function in MG. Also the role of tissue proteolytic systems and growth factors in this process is not known. We aimed to estimate urine cathepsin B, collagenase activity and urine excretion of TGF-beta 1 and fibronectin in MG. MG patients revealed increased urine cathepsin B activity (10.58 +/- 8.73 pmol AMC/mg creatinine/min. vs. control 7.11 +/- 2.05 pmol AMC/mg creatinine/min. [p < 0.05]), urine collagenase activity (8.59 +/- 4.26 pmol AMC/mg creatinine/min. vs. control 3.84 +/- 2.09 pmol AMC/mg creatinine/min. [p > 0.02]) and increased urine excretion of fibronectin (214 +/- 335 ng/mg creatinine vs. control 12.7 +/- 6.7 ng/mg creatinine [p < 0.05]) and increased urine excretion of TGF-beta 1 (283.55 +/- 248.13 pg/ml vs. control 36.11 +/- 48.01 pg/ml [p < 0.05]). The results indicates on glomerular overproduction of TGF-beta 1 and urinary leak of proteolytic enzymes which may exacerbate glomerular proteolytic activity in MG. This may lead to glomerular protein accumulation and progressive loss of kidney function and structure in MG. Increased urine fibronectin excretion in MG patients seems to confirm the hypothesis.


Hydrolysis and speciation of Al bound to pectin and plant cell wall material and its reaction with the dye chrome azurol S.
Hydrolysis of aluminum (Al) in solution increases at pH >or= 4 and with an Al concentration. Pectin, an important anionic polysaccharide of plant cell walls, adsorbs Al, but this phenomenon is poorly understood. This study showed that Al(3+) hydrolysis results in binding of Al to pectin in excess of the stoichiometric equivalent, leading to oversaturation of the pectin with Al. However, the degree of pectin methyl-esterification did not affect the extent of Al hydrolysis. Binding of Al to purified cell wall material also resulted in Al hydrolysis in a pH- and soluble Al concentration-dependent manner, but the source of cell wall material had no effect at fixed pH. Staining of Al-treated pectin and cell wall material from wheat ( Triticum aestivum L.) and sunflower ( Helianthus annuus L.) with the Al-specific dye, chrome azurol S (CAS), resulted in the formation of a purple color, with the intensity related to the extent of Al hydrolysis.


A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials.
Ultrahigh molecular weight polyethylene (UHMWPE) is widely used in total joint arthroplasties as a load-bearing surface. Periprosthetic joint infections, the majority of which occur shortly after joint replacement, constitute almost 25% of total knee revision surgeries, and the complete eradication of bacterial infection poses a major challenge. A promising way to tackle this problem is to ensure the local sustained delivery of antibiotic concentrations sufficient to inhibit the bacteria to support routine systemic antibiotic prophylaxis. There is increased research into the development of efficient local drug delivery devices. Although established antibacterial testing methods for drugs can be used to test the antibacterial efficacy of drug-eluting materials, they are lacking in terms of providing real-time and longitudinal antibacterial efficacy data that can be correlated to the elution profiles of antibiotics from these devices. Here, we report a direct and versatile methodology to determine the antibacterial efficacy of antibiotic-eluting UHMWPE implants. This methodology can be used as a platform to avoid bacterial culture at each time point of a lengthy experiment and can also be adapted to other local drug delivery devices.


Polymorphism in a Neotropical toad species: ontogenetic, populational and geographic approaches to chromatic variation in Proceratophrys cristiceps (Müller, 1883) (Amphibia, Anura, Odontophrynidae).
Quantifying variability is important for understanding how evolution operates in polymorphic species such as those of the genus Proceratophrys Miranda-Ribeiro, 1920, which is widely distributed in South America. P. cristiceps distribution is limited to the Caatinga biome in Brazil. We examined its chromatic variation from a populational perspective, looking at different phenetic polymorphism levels and probable chromotypic association by applying statistical and GIS tools that could facilitate future taxonomic research regarding this and other species. We characterized P. cristiceps colour patterns and re-evaluated its geographic variation, highlighting potential consequences for the taxonomy of the genus. Our results revealed six principle chromotypes whose frequencies varied among sex and ontogenetic classes. Phenotypic expression appeared to respect defined proportions and evidenced selective value for the species. We conclude that individual variation, together with typological traditionalism may overestimate the polymorphic magnitude at the population level and cause taxonomic inflation. Our data support the usefulness of P. cristiceps as a model for microevolutionary studies.


Engineering Topological Superlattices and Phase Diagrams.
The search for new topological materials and states of matter is presently at the forefront of quantum materials research. One powerful approach to novel topological phases beyond the thermodynamic space is to combine different topological/functional materials into a single materials platform in the form of superlattices. However, despite some previous efforts there has been a significant gap between theories and experiments in this direction. Here, we provide the first detailed set of experimentally verifiable phase diagrams of topological superlattices composed of archetypal topological insulator, Bi2Se3, and normal insulator, In2Se3, by combining molecular-level materials control, low-temperature magnetotransport measurements, and field theoretical calculations. We show how the electronic properties of topological superlattices evolve with unit-layer thicknesses and utilize the weak antilocalization effect as a tool to gain quantitative insights into the evolution of conducting channels within each set of heterostructures. This orchestrated study opens the door to the possibility of creating a variety of artificial-topological-phases by combining topological materials with various other functional building blocks such as superconductors and magnetic materials.


Susceptibilities of 55 strains of Neisseria meningitidis isolated in Spain in 1993 and 1994.
The in vitro susceptibility of 55 strains of Neisseria meningitidis isolated in 1993 and 1994 at the Valme and Macarena Hospitals, Sevilla, Spain to penicillin, ampicillin, cefotaxime, cefpodoxime, imipenem, rifampin, ciprofloxacin, chloramphenicol, tetracycline, erythromycin and trimethoprim-sulfamethoxazole were determined by a microdilution method in Mueller-Hinton broth. Among our N. meningitidis isolates, 36.4% were found to be moderately resistant to penicillin, 43.6% were resistant to trimethoprim/sulfamethoxazole. All the strains were susceptible to tetracycline, ciprofloxacin, cefotaxime and rifampin.


Immediate hemodynamic changes produced by urapidil in normotensive and spontaneously hypertensive rats.
The immediate effects on regional and systemic hemodynamics of urapidil (1 mg/kg IV), a recently synthesized vasodilator with a possible combined central and peripheral action, were studied in spontaneously hypertensive (SHR) and normotensive (WKY) rats. Maximal decrease in mean arterial pressure was achieved within the first minute after injection (154 +/- 4 vs 113 +/- 6 mm Hg in SHR and 111 +/- 4 vs 82 +/- 4 mm Hg in WKY, p less than 0.01). This effect was accompanied by a transient (10 min) significant increase in heart rate in both strains. There was a significant fall in total peripheral resistance (0.43 +/- 0.02 vs 0.30 +/- 0.02 U/kg in WKY and 0.62 +/- 0.03 vs 0.43 +/- 0.03 U/kg in SHR, p less than 0.01) and rise in cardiac index 15 min after drug injection (371 +/- 9 vs 425 +/- 12 ml/min/kg in WKY and 395 +/- 8 vs 432 +/- 112 ml/min/kg in SHR, p less than 0.01). Organ vascular resistance decreased significantly in all the organs of /KY and most of the organs of SHR rats. However, a significant increase in blood flow was observed only in skeletal muscle. The data indicate that urapidil is a potent hypotensive agent. The pressure fall is mediated through a decreased total peripheral resistance that is distributed through all circulations. The increased cardiac output and heart rate are most likely reflexly induced.


[Effect of recasting on the elastic modulus of metal-ceramic systems from nickel-chromium and cobalt-chromium alloys].
Elastic modulus of metal-ceramic systems determines their flexural strenght and prevents damages on ceramics during mastication. Recycling of basic alloys is often a clinical practice, despite the possible effects on the quality of the future metal-ceramic dentures. This research was done to establish recasting effects of nickel-chromium and cobalt-chromium alloys on the elastic modulus of metal-ceramic systems in making fixed partial dentures. The research was performed as an experimental study. Six metal-ceramic samples of nickel-chromium alloy (Wiron 99) and cobalt-chromium alloy (Wirobond C) were made. Alloy residues were recycled through twelve casting generations with the addition of 50% of new alloy on the occasion of every recasting. Three- point bending test was used to determine elastic modulus, recommended by the standard ISO 9693:1999. Fracture load for damaging ceramic layer was recorded on the universal testing machine (Zwick, type 1464), with the speed of 0,05 mm/min. The results of this research revealed significant differences between elasticity modules of metal-ceramic samples in every examined recycle generation. Recasting had negative effect on the elastic modulus of the examined alloys. This research showed the slight linear reduction of elastic modulus up to the 6th generation of recycling. After the 6th recycling there was a sudden fall of elastic modulus. Recasting of nickel-chromium and cobalt-chromium alloys is not recommended because of the reduced elastic modulus of these alloys. Instead of reusing previously recasted alloys, the alloy residues should be returned to the manufacturer.


Oseltamivir resistance in swine influenza: a brief discussion.
Swine flu, an atypical H1N1 influenza virus infection, is a new emerging infectious disease starting from Mexico in 2009, and is presently pandemic around the world. For treatment of this infection, oseltamivir is recommended as drug of choice. Generally, a big problem for using oseltamivir in treatment of classical H1NI influenza virus infection is drug resistance. In this brief paper, the author discusses on the situation of oseltamivir resistance in swine influenza. Briefly, the oseltamivir resistance of swine flu is expected to be possible due to many underlying factors. It is needed to perform surveillance on oseltamivir resistance in swine flu. Planning for management of case of emerging oseltamivir drug resistance is needed.


Feeding and filtration rates of zooplankton (rotifers and cladocerans) fed toxic cyanobacterium (Microcystis aeruginosa).
Microcystis aeruginosa is generally dominant in many Mexican freshwater ecosystems interacting with zooplankton species. Hence, feeding and filtration rates were quantified for three cladoceran (Daphnia pulex, Moina micrura and Ceriodaphnia dubia) and three rotifer species (Brachionus calyciflorus, Brachionus rubens and Plationus patulus) using sonicated M. aeruginosa alone or mixed with Scenedesmus acutus in different proportions (25, 50 and 75%, based on cell density), offering a combined initial density of 100,000 cells·ml(-1). All the three cladoceran species ingested M. aeruginosa (100-300 cells ind(-1) min(-1)) when fed exclusively with cyanobacterium. When green alga offered as exclusive diet, the number of cells ingested by the tested cladocerans varied from 80 to 400 cells ind(-1) min(-1). Compared to cladocerans, rotifers in general consumed much lower quantity (< 200 cells ind(-1) min(-1)) of M. aeruginosa and S. acutus. The filtration rate for Daphnia pulex was inversely related to the proportion of green alga in the diet. For other tested cladocerans, no such clear trend was evident. In mixed treatments containing M. aeruginosa, the filtration rate of Daphnia was highest (about 220 μl ind(-1) min(-1)) when the medium contained 75% of S. acutus. Among the rotifer species, P. patulus filtered highest volume (100 μl ind(-1) min(-1) from mixed diets containing higher proportions (50 or 75%) of M. aeruginosa. Thus, there were species-specific differences in the filtration and feeding rates of zooplankton when offered mixed diets of green algae and toxic cyanobacteria. These probably explain the coexistence of different zooplankton species in Microcystis-dominant waterbodies.


Ethionamide-induced goitrous hypothyroidism.
A 42-year-old woman developed goitrous hypothyroidism while receiving ethionamide for treatment of an atypical mycobacterial infection. Five weeks after discontinuation of ethionamide therapy, thyroid function had returned to normal. The goitrogenic effect was studied in vitro by incubating ethionamide in various concentrations (10(-3) to 10(-7) mol/L) with ovine thyroid cells in tissue cultures. Ethionamide inhibited the trapping of technetium and organification of iodine at concentrations seen clinically (10(-5) mol/L). Ethionamide appears to be a potential goitrogen in susceptible persons.


Post-operative Opioid, Benzodiazepine and Sedative Usage in Medicare versus Commercial Insurance Hand Surgery Patients.
Opioid usage has increased in recent years. The purpose of this study is to assess post-operative opioid, sedative, and benzodiazepine usage in a Medicare population. Consecutive patients undergoing elbow, wrist, and hand surgery by hand surgeons at one academic outpatient surgical center were prospectively enrolled. Patients were excluded if they were minors or if they underwent more than one surgical procedure during the study period. There were 269 patients enrolled, and this group was divided by insurance type into younger commercial insurance (CI) and older Medicare (MC) groups. The Pennsylvania Physician Drug Monitoring Program website was used to document all prescriptions of controlled substances filled six months prior to and after the surgical procedure. The mean age in the CI group was 45.8 years (range: 16-88) and 69.2 years (range: 43-91) in the MC group. Postoperatively, the CI patients filled significantly less opioid prescriptions than the MC group, 1.10 vs. 1.79. Patients in the CI group were given an average of 0.3 benzodiazepine prescriptions before surgery and 0.2 after surgery. Patients in the MC group were given 0.6 prescriptions before and 0.5 prescriptions of benzodiazepines after surgery. The CI group was given an average of 0.1 sedative/hypnotic prescriptions before surgery and 0.1 after surgery. The MC group was given 0.7 prescriptions before and 0.4 prescriptions of sedative/hypnotics after surgery.There were 0.17 prescriptions per patient in the CI group and 0.75 per patient in the MC group (P <.05). Twenty-two of 208 (10.6%) of CI and 16/61 (26.2%) of MC patients filled a prescription between 3-8 months post-operatively. Prolonged use of opioid, benzodiazepine and sedative medications is common after upper extremity surgical procedures. Older patients are also at risk, and may be even more likely than younger patients to use these medications post-operatively.


Approaches to teach evidence-based practice among health professionals: an overview of the existing evidence.
Health care professionals' adoption of evidence-based practice (EBP) remains limited, although most health care professionals are familiar with EBP and believe in its value. This systematic review aimed to bring together the best methods used to teach EBP to health professionals. The authors conducted a systematic search for the period 2005-2015 (an update of the search took place in October 2016) using PubMed interface (Medline). MeSH terms as well as free-text keywords were used. Studies were analyzed and evaluated by title and abstract. Those studies which fulfilled the inclusion criteria were assessed by full text. References of articles were also taken into consideration for identifying relevant studies not found through algorithm search. Twenty articles were found to be relevant. The majority of the studies were conducted among nurses (n=7) and physicians (n=6), and only a few among professionals from mixed disciplines (n=5). Two studies were conducted among chiropractors (n=1) and faculty members from a naturopathic and classical Chinese medicine institution (n=1). Researchers used a variety of different approaches, which varied with respect to duration and organization. We divided interventions into two categories. Single interventions included either a workshop, or a journal club, or a conference, or a lecture, or online learning tools, whereas multiple interventions included a combination of these approaches. An increase in EBP competencies and attitudes was reported in nine studies. Teaching methods for optimizing EBP among health professionals could become a robust standardized procedure of the medical educational curricula and lifelong learning of health care professionals.


Construction of DNAzyme-Encapsulated Fibermats Using the Precursor Network Polymer of Poly(γ-glutamate) and 4-Glycidyloxypropyltrimethoxysilane.
Here, we developed functional nucleic acid (FNA)-encapsulated electrospun fibermats. To facilitate stable FNA encapsulation in the γ-PGA/GPTMS fibermats, we used the FNA as an FNA/streptavidin complex, and as a representative FNA, we selected a DNAzyme, the DNA/hemin complex, which is composed of G-quadraplex-forming single-stranded DNA and hemin and exhibits oxidation activity with the aid of a cocatalyst, H2O2. Scanning electron microscopy and Fourier-transform infrared spectroscopy measurements revealed that encapsulation of the DNA/hemin complex (∼1 wt % against the γ-PGA/GPTMS hybrid) in the nanofibers of the γ-PGA/GPTMS fibermats did not affect the structure of the original nanofibers. However, because a unique MW-dependent molecular permeability originated from the 3D network structure of the γ-PGA/GPTMS hybrid, low-MW substrates such as 4-aminoantipyrine, N-ethyl-N-(2-hydroxy-3-sulfopropyl)-3-methylaniline, and luminol were able to reach the encapsulated DNA/hemin complex by permeating to the inside of the nanofibers from an immersion buffer and then underwent catalytic oxidation. Conversely, nucleases, which are proteins featuring high MWs (>5 kDa), could not penetrate the γ-PGA/GPTMS nanofibers, and the encapsulated DNA/hemin complex was therefore effectively protected against nuclease digestion. Thus, encapsulating FNAs on the inside of the nanofibers of fibermats offers clear advantages for the practical application of FNAs in sensors and drugs, particularly for use in the in vivo circumstances.


3D electrode configurations for spectral induced polarization surveys of landfills.
There is growing interest in the use of spectral induced polarization (SIP) surveys to characterize the near-surface environment. Few attempts have been made to perform field SIP surveys in a 3D configuration; when done, they are typically conducted using a series of parallel 2D electrode lines with collinear measurements. However, such measurements are limited in the resolution between the lines which is critical in the case of heterogeneous subsurface conditions, such as in landfills. To overcome this, we investigate here the enhanced resolution in SIP measurements through true 3D measurements, i.e., the resolving capabilities of different electrode configurations distributed across measuring planes. First, we investigate, through a synthetic study, the difference between results from using 2D parallel collinear electrode arrays and true 3D configurations. Second, we collected SIP data (in the frequency range between 1 and 240 Hz) using 2D and 3D configurations in two landfills to evaluate the application of our results in real field conditions. Both the synthetic and the field experiments demonstrate that measurements of parallel 2D collinear arrays result in the creation of artifacts and the loss of resolution in the 3D structure, especially of polarizable features. In contrast, the 3D configurations are able to resolve polarizable anomalies in synthetic and field measurements, resulting in a better delineation of the geometry of waste units. Our results also demonstrate that 3D configurations are better suited to recover the frequency-dependence of the electrical properties; thus, permitting an improved interpretation of waste composition and the quantification of waste volume.


Empyema caused by transdiaphragmatic extension of pyogenic liver abscess.
Empyema caused by transdiaphragmatic extension of pyogenic liver abscess is a very rare complication of liver abscess. Empyema patients with unclear respiratory symptoms should be evaluated for the presence of underlying liver abscess. Effective drainage with appropriate antibiotic use is an essential part of successful treatment.


Laser heterodyne interferometer for simultaneous measuring displacement and angle based on the Faraday effect.
A laser heterodyne interferometer for simultaneous measuring displacement and angle based on the Faraday effect is proposed. The optical configuration of the proposed interferometer is designed and the mathematic model for measuring displacement and angle is established. The influences of the translational, lateral and rotational movements of the measuring reflector on displacement and angle measurement are analyzed in detail. The experimental setup based on the proposed interferometer was constructed and a series of experiments of angle comparison and simultaneous measuring displacement and angle were performed to verify the feasibility of the proposed interferometer for precision displacement and angle measurement.


Ex-vivo cellular MRI with b-SSFP: quantitative benefits of 3T over 1.5 T.
The use of MRI with iron-based magnetic nanoparticles for imaging cells is a rapidly growing field of research. We have recently reported that single iron-labeled cells could be detected, as signal voids, in vivo in mouse brains using a balanced steady-state free precession imaging sequence (b-SSFP) and a customized microimaging system at 1.5 T. In the current study we assess the benefits, and challenges, of using a higher magnetic field strength for imaging iron-labeled cells with b-SSFP, using ex vivo mouse brain specimens imaged with near identical systems at 1.5 and 3.0 T. The substantial banding artifact that appears in 3 T b-SSFP images was readily minimized with RF phase cycling, allowing for banding-free b-SSFP images to be compared between the two field strengths. This study revealed that with an optimal 3 T b-SSFP imaging protocol, more than twice as many signal voids were detected as with 1.5 T. There are several factors that contributed to this important result. First, a greater-than-linear SNR gain was achieved in mouse brain images at 3 T. Second, a reduction in the bandwidth, and the associated increase in repetition time and SNR, produced a dramatic increase in the contrast generated by iron-labeled cells.


The prevalence of oesophageal eosinophilia and eosinophilic oesophagitis: a prospective study in unselected patients presenting to endoscopy.
Oesophageal eosinophilia (EE) is encountered in clinical practice as oesophageal biopsies are being obtained in patients with GI symptoms other than classical symptoms of eosinophilic oesophagitis (EoE). The prevalence, determinants and clinical relevance of EE identified irrespective of symptoms are unclear. To determine the prevalence and risk factors of EE with or without EoE in a nonselected group of patients undergoing endoscopy and in primary care patients. A cross-sectional study in a single VA centre in which we obtained at least one oesophageal biopsy from patients presenting to elective endoscopy, as well as a sample of patients eligible for screening colonoscopy recruited from primary care clinics. EE was defined by >15 eosinophils in a single HPF; and EoE was defined as definite, probable or none depending on the presence of EE, acid-suppressive therapy and oesophageal symptoms. EE was identified in 33 of 1357 patients (2.4%, 95% CI: 1.7-3.4); of whom 9 had definite EoE (0.66%, 95% CI: 0.23-1.10), 17 had probable EoE (1.25%), and the only 7 patients had EE without EoE. The prevalence of EE was 2.3% among patients undergoing elective endoscopy and 0.1% among patients eligible for screening colonoscopy. Seasonal allergies (adjusted OR: 2.78; 95% CI: 1.26-6.11) and oesophageal strictures (4.50; 0.90-22.40) were associated with EE. The prevalence of EE was 2.3% among unselected patients presenting to endoscopy most of whom have EoE. EE was present in 0.1% in primary care patients none of whom had EoE.


Ab initio correlation functionals from second-order perturbation theory.
Orbital-dependent exchange-correlation functionals are not limited by the explicit dependence on the density and present an attractive alternative to conventional functionals. With the successful implementation of the exact orbital-dependent exchange functional, the challenge lies in developing orbital-dependent approximations for the correlation functional. Ab initio many-body methods can provide such approximations. In particular, perturbation theory with the Kohn-Sham model as the reference [Görling and Levy, Phys. Rev. A 50, 196 (1994)] defines the exact correlation functional via an infinite perturbation series. The second-order term of these series gives the lowest-order approximation to the correlation functional. However, it has been suggested [Bartlett et al., J. Chem. Phys. 122, 034104 (2005)] that the Kohn-Sham Hamiltonian is not the optimal choice for the perturbation expansion and a different reference Hamiltonian may lead to an improved perturbation series and more accurate second-order approximation. Here, we demonstrate explicitly that the modified series can be used to define superior functional and potential. We present results of atomic and molecular calculations with both second-order functionals. Our results demonstrate that the modified functional offers a significantly improved description of the correlation effects as it does not suffer from convergence problems and results in energies and densities that are more accurate than those obtained with second-order Møller-Plesset perturbation theory or generalized-gradient approximation functionals.


[Gastroesophageal reflux disease and connective tissue dysplasia in aspect of premorbid and comorbid disorders].
To investigate the phenotypic and visceral signs of connective tissue dysplasia (CTD) and comorbid diseases of the digestive system in gastroesophageal reflux disease (GERD) patients with different types of esophageal reflux as the predictors of its variants. In 124 patients with GERD the clinical features, phenotypic and visceral signs of undifferentiated CTD were studied in details. In 82.0% of patients with GERD associated with gastroesophageal type of reflux (GER) phenotypic and especially visceral signs of STD were detected, mainly in the form of cardiochalasia and hiatal hernia. In patients with duodenogastroesophageal reflux symptoms (DGER) the signs of STD were marked in 42.0% of cases, mostly in the form of biliary tract structure abnormalities. The risk of GERD associated with prevalence of GER, was 11.9 times higher in the presence of diagnostically meaningful combination of 6 or more signs of STD than in patients with DGER. Realization of predictor options in GER occurs in the preference of sharp, acidic foods, spices, taking medications that reduce lower esophageal sphincter tone. GERD, associated with DGER, is formed in patients with family history of diseases of the biliary tract and in the preference of food rich of calories. Study of STD symptoms as predictors of structural development of GERD and its variants is prospective to predict disease, choice of profession and eating behavior, primarily in young adults.


Mental health research in The Lancet: a case study.
The Lancet recently declared that it intends to "make mental health one of its campaign focal points". However, it has been silent on the role it might play in disseminating mental health research. To examine The Lancet's track record in publishing mental health research relative to its disease burden. Research articles (n = 733) published in The Lancet over a 2.5 year period (2003-2005) were coded according to the Global Burden of Disease (GBD) classification system and compared with data from the 2002 GBD study. A range of other characteristics including whether consumers were involved in the research process were coded. Mental health articles (excluding neurological and substance abuse) accounted for 1.8% of articles but are responsible for a worldwide YLD of 22.8% (25.4% high income countries) and DALYs of 9.0% (14.7% in high income countries). Despite its commendable mental health advocacy work, mental health research is under-represented in The Lancet. The journal should take steps to ensure that the dissemination of mental health research is not a neglected aspect of their advocacy activities.


Antiherpetic flavones from the heartwood of Artocarpus gomezianus.
The heartwood of Artocarpus gomezianus was investigated for anti-herpetic principles. During the course of the separation, a new compound, artogomezianone (1), was isolated, along with the known compounds cycloartocarpin (2), isocyclomorusin (3), artocarpin (4), norcycloartocarpin (5), norartocarpetin (6), and oxyresveratrol (7). Evaluation of these isolates for inhibitory effects against herpes simplex virus (HSV) types 1 and 2 was carried out using the inactivation method. Compounds 2, 3, 6 and 7 showed moderate activities against both types of HSV, while 1, 4 and 5 were basically inactive.


The Efficacy of Color-Mapped Diffusion-Weighted Images Combined With CT in the Diagnosis and Treatment of Cholesteatoma Using Transcanal Endoscopic Ear Surgery.
To assess the efficacy of a color-mapped diffusion-weighted image combined with a computed tomography scan (CMDWI-CT) in preoperatively evaluating the anatomical location of cholesteatomas and determining whether a patient is indicated for transcanal endoscopic ear surgery (TEES) to reduce intraoperative switching to microscopic ear surgery (MES). Prospective case study. A single university hospital. Fifty-five patients scheduled for middle ear cholesteatoma surgery. The CMDWI-CT is produced in a multistep process. A color-mapped fusion image (CMFI) is created by performing MR cisternography on a 1-mm thin-slice nonecho planar diffusion-weighted imaging (non-EPI DWI) and then by performing color mapping on the resulting image to enhance cholesteatoma visualization. False positives are reduced by taking a T1-weighted image (T1WI), whereas false negatives are further reduced by preoperative endoscopic examination. As cholesteatomas are difficult to locate on a CMFI in the temporal bone region, we stripped out the MR cisternography data from the CMFI and then fused the CMFI to the initial computer tomography (CT) scan to create a CMDWI-CT. This CMDWI-CT better clarifies the cholesteatoma position within temporal bone. CMDWI-CT preoperative findings were compared with intraoperative findings. The positive predictive value and negative predictive value were also evaluated depending on the cholesteatoma location. CMDWI-CT facilitated accurate detection of the cholesteatoma anatomical location in the temporal bone region which was reflected in positive predictive and negative predictive values of over 90% for all areas of the middle ear. CMDWI-CT is a reliable diagnostic modality for evaluating the anatomical location of cholesteatomas that seem as high-signal regions on a CMFI and for determining whether TEES is indicated for treatment in such patients.


RNA interference-mediated hookworm control by gut-dwelling lactic acid bacteria.
The complex life cycle of geohelminth parasites make it difficult to manage repeated infections that occur in endemic areas, that requires the development of new therapeutic strategies. Human hookworm Ancylostoma sp. and Necator sp. are a serious problem in many areas of the world where the old age anti-helminthics are ineffective. To address this, we have tried a non-traditional therapeutic approach for a sustainable solution to manage parasite infections. In this study, we attempted to develop a new type of therapy using value-added probiotics-producing antiparasitic RNA interference (RNAi) molecules against a vital hookworm (Ancylostoma sp.) enzyme, astacin-like metalloprotease Ac-MTP-1. A new gut delivery RNAi vector was designed to produce double-stranded RNA (dsRNA) against the target to be delivered by feeding with a probiotic Lactococcus lactis that when administered in endemic areas can potentially be used to control the spread of infection by interrupting the life cycle of hookworm. The engineered probiotics colonizing the gut, when consumed by the parasite released the dsRNA that which knocked down the target by RNAi interfering with their moulting and tissue migration. The initial penetration of the larvae into the gut lining was reduced by 70%, followed by a reduction of up to 50% in migration to the critical organs. The damage caused to the liver (30%-40%) and the kidneys (50%-60%) by the hookworm in mouse models as quantitated by enzymes released in the blood was totally reversed when the worms were pre fed with the engineered L. lactis before the parasite challenge. We believe that this is the first demonstrated knockdown of a target gene in hookworms using probiotics genetically engineered to stimulate RNAi (RNAi food), administered through the oral route. This novel method of parasite control when extended to other hookworms, A. duodenalis and A. ceylanicum can augment the efficacy of the existing anthelminthics if combined with them.


Prevalence of Diffuse Idiopathic Skeletal Hyperostosis Diagnosed by Whole Spine Computed Tomography: A Preliminary Study.
Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by ossification of the enthesis. The diagnosis has been mainly based on the chest or whole spine lateral plain film. Recently, chest or thoracolumbar computed tomography (CT) has been reported to be more reliable for the diagnosis of DISH. The purposes of this study were to investigate the prevalence and location of DISH and evaluate the prevalence of comorbidities, such as ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF), using whole spine CT. Whole spine CT scans of patients over 16 years of age who were examined at Cheju Halla General Hospital between February 2011 and December 2016 were reviewed for this study. The diagnosis of DISH was made according to the modified Resnick criteria. The prevalence of DISH in each age decade and its location were evaluated. Also, the prevalence of OPLL and OLF in DISH patients was investigated. The overall incidence of DISH was 24.4% (40 of 164 cases). There was no case of DISH in patients in their 40s and younger. The percentile incidences of DISH in patients in their fifth, sixth, seventh, eighth, and ninth decades were 20.0% (4 of 20 cases), 32.3% (10 of 31 cases), 40.0% (10 of 25 cases), 34.5% (10 of 29 cases), and 27.3% (6 of 22 cases), respectively. A strong positive correlation between the age decade and the incidence of DISH was noted (r = 0.853, p = 0.007). DISH patients had higher incidences of OLF (22.5%) and OPLL (37.5%). The most common location of DISH was the middle thoracic spine (90.0%) followed by the lower thoracic spine (87.5%). There was one case of DISH involving only the cervical spine. The incidence of DISH diagnosed by CT was higher than we expected. Whole spine CT can be a valuable modality to evaluate the location of DISH in the cervical and lumbar spine and the comorbidity rates of OLF and OPLL.


Carbon nanotube radio-frequency electronics.
Carbon nanotube (CNT) is considered a promising material for radio-frequency (RF) applications, owing to its high carrier mobility and saturated drift velocity, as well as ultra-small intrinsic gate capacitance. Here, we review progress on CNT-based devices and integrated circuits for RF applications, including theoretical projection of RF performance of CNT-based devices, preparation of CNT materials, fabrication, optimization of RF field-effect transistors (FETs) structures, and ambipolar FET-based RF applications, and we outline challenges and prospects of CNT-based RF applications.


Women's experience of internal radiation treatment for uterine cervical cancer.
This paper is a report of a study to explore the experiences of women undergoing internal radiation for cervical cancer. Cervical cancer continues to be one of the most common cancers and one of the leading causes of cancer deaths globally. Women's experiences of undergoing internal radiation for cervical cancer remain relatively unexplored, in particular in Hong Kong. Better understanding of the experiences of this specific group could inform the provision of supportive care services and provide useful information to be included in education programmes for them. A phenomenological approach was adopted and unstructured telephone interviews were carried out with eight participants between July and October 2004. The interviews were audio-taped and analysed using the procedures described by Giorgi, 1985. Three themes were identified from the data: (1) isolation versus social intercourse, (2) unbearable symptom distress versus endurance and coping and (3) growth from the experience. The most distressing aspects of undergoing internal cervical irradiation reported by the patients were the experience of isolation and various physical and psychological symptoms. Specific provisions in the physical environment, psychological support provided by healthcare professionals, family and fellow patients and a positive attitude helped them to cope. They also felt that they became stronger through their hardship and suffering. The findings highlight the importance of adequate preparation of patients, carers and friends before the procedure, more sensitive support during the procedure and debriefing afterwards. There might also be benefits in delivering therapy to two women in adjacent beds to enable them to support each other.


Balance and limits: modeling graduate medical education reform based on recommendations of the Council on Graduate Medical Education.
National commissions, medical philanthropies, scholars, and policy analysts agree that the key to improved health care access and cost containment is a physician workforce built on a generalist foundation. They propose a national system to allocate a specific and limited number of graduate medical education (GME) positions. The Council on Graduate Medical Education recommended that training positions be limited to 110 percent of the graduates of U.S. allopathic and osteopathic medical schools and that the system graduate 50 percent into primary care practice (50/50-110 proposal). The 50/50-110 option would significantly modify GME training: surgical and support specialty positions would be reduced, and increased numbers of medical and pediatric residents would enter general practice. This workforce composition would facilitate provision of universal health care access and help control costs--the basic tenets of reform.


Study of nasal cycles in children by acoustic rhinometry.
Studies concerning nasal cycle physiology in children are still rare, and controversies exist about its existence. This study was ascertained to evaluate the dynamic behavior of inferior turbinates in children by acoustic rhinometry. Sixteen volunteer patients, aged 2-11 years old (mean, 6.25 years), were evaluated between April and July 2003. The patients submitted to periodic acoustic rhinometry, with triplicate measurements (each 30 minutes) for 3 hours. All evaluated children presented nasal cycles, with five children presenting a classic pattern (31.25%), three children presenting a concert pattern (18.75%), and eight children presenting an irregular pattern (50%). This study suggests that children present nasal cycles, as well as adults. Nevertheless, the most prevalent pattern in children was the irregular pattern, whereas in adults the most frequently detected is the classic pattern.


A case of epidermoid median raphe cyst traversing the corpora cavernosa.
Median raphe cysts are congenital lesions that typically have a superficial appearance. We present a very unusual case of a deep perineal mass in a six-year-old boy. The lesion extends into the corpus cavernosum, suggesting that the anomaly was an early embryological event. Histopathological features are consistent with an epidermoid type of median raphe cyst.


Structure-activity studies on antidepressant 2,2-diarylethylamines.
A series of 2,2-diarylethylamine derivatives has been examined for potential antidepressant activity in the tetrabenazine (TBZ) test. Diethanolamine 4 (McN-4187) was one of the more potent compounds despite its polar alcohol functionalities [ED50 values of 15 mg/kg (exploratory activity) and 1.5 mg/kg (ptosis)]. Structure-activity relationships are described. Minor structural modifications of 4 were sufficient to strongly attenuate activity. For example, changing one phenyl group to a 2-thienyl, cyclohexyl, or 3,4-dimethoxyphenyl group greatly reduced activity. Replacing both phenyl groups by 4-chlorophenyl groups also dissipated activity. The bisethanol functionality was not essential for activity (q.v. 17-19 in Table I). Although 17-19 compared well with 4 in the TBZ assay, only 19 (like 4) showed a satisfactory profile in the maximal electroshock seizure threshold test.


Evaluation of the diagnostic accuracy of CEUS in children with benign and malignant liver lesions and portal vein anomalies.
Comparison of the diagnostic findings of MRI, CT and CEUS in children with benign and malignant and portal venous anomalies of the liver. Retrospective analysis of the diagnostic findings of CEUS, MRI and CT scans in 56 children (age 0-17 years) with a total of 60 benign and malignant liver lesions and anomalies of the portal vein/perfusion. All patients underwent CEUS using sulphur hexafluoride microbubbles and a multi-frequency probe (1-5 MHz, 6-9 MHz). Cine-loops were stored up to 3 minutes. MRI was performed in 38 lesions. CT was performed in 8 lesions. Out of the 56 patients 49 liver lesions (48 benign, 1 malignant), 9 anomalies of the portal vein/perfusion and 2 of the biliary system were detected. 16/49 lesions were analyzed histopathologically. Using CEUS, the characterization of the lesions was possible in 45 out of 49 cases. In 32 cases, CEUS provided the exact diagnosis. Only two benign lesions were falsely categorized as malignant.Findings of MRI and CEUS were concordant in 84% of cases (n = 32/38). CEUS considered 1 benign lesion to be malignant. 2 lesions were not detectable and in 3 lesions no definite diagnosis was established using MRI.Findings of CT and CEUS were concordant in 5 of 8 cases. In 21 lesions CEUS as the only imaging modality was found to be sufficient for diagnostics. Despite the restricted indications for using CEUS in children, it offers a high diagnostic detection rate (93%) for characterization of liver lesions and portal vein anomalies.


[Electroacupuncture of "Tianshu" (ST 25) Suppresses Visceral Pain Possibly by Down-regulating Mast Cell Activation, and Tryptase and SP Expression in Rats with Post-infectious Irritable Bowel Syndrome].
To observe the effect of electroacupuncture (EA) at "Tianshu" (ST 25) on visceral pain and colonic mast cell (MCs) number and tryptase and SP expression in post-infectious irritable bowel syndrome (PI-IBS) rats, so as to reveal its mechanisms underlying improvement of PI-IBS. Forty-five female Wistar rats were randomly divided into control, model and EA groups (15 rats/ group, 3 rats/group used for H. E. staining, and 12 rats/group for immunohistochemistry). The PI-IBS model was established by intra-anal injection of mixed liquor of 50% ethyl alcohol and trinitro-benzene-sulfonic acid (TNBS). EA (2 Hz/15 Hz, 0.5-1.0 mA) was applied to bilateral "Tianshu" (ST 25) for 30 min, once every day for 14 days. The visceral pain was measured by abdominal withdrawal reflex (AWR), for which the rectal implanted air balloon was dilated by infusion of normal saline. The histopathological changes of the colon tissue were observed after H. E. staining, and the colonic MCs were displayed by Toluidine blue staining. The expression of tryptase and SP proteins in the colon specimens were detected by immunohistochemistry. The AWR threshold was significantly lowered in the model group relevant to the control group (P<0.05) and considerably increased after EA intervention in comparison with the model group (P<0.05). The number of MCs and the expression levels of colonic tryptase and SP proteins in the colon tissues were significantly higher in the model group than in the control group (P<0.05), and obviously lower after EA intervention in the EA group than in the model group (P<0.05). EA of "Tianshu" (ST 25) can inhibit visceral pain in PI-IBS rats, which may be associated with its effects in activating MCs and down-regulating the expression of tryptase and SP proteins in the colonic tissues.


Copper supplementation of sheep.
The effect of 6 methods of copper supplementation on copper status was examined in Merino sheep at pasture. Plasma copper concentrations were not affected by any of the treatments. Liver copper concentrations in sheep given an oral dose of 3 g of oxidised copper wire particles were significantly greater than those of untreated sheep for the duration of the experiment of 80 weeks. Subcutaneous injections of 18 mg of copper as diethylamino cupro -oxyquinoline sulphonate produced small, transient increases in liver copper. Single oral doses of 150 mg of copper as copper sulphate or 30 mg of copper as copper oxychloride produced little or no detectable increase in liver copper. Liver copper concentrations of untreated sheep were lowest in winter, apparently associated with increased damage to the abomasum, as indicated by raised plasma pepsinogen activities.


The role of CKIP-1 in cell morphology depends on its interaction with actin-capping protein.
CKIP-1 is a pleckstrin homology domain-containing protein that induces alterations of the actin cytoskeleton and cell morphology when expressed in human osteosarcoma cells. CKIP-1 interacts with the heterodimeric actin-capping protein in cells, so we postulated that this interaction was responsible for the observed cytoskeletal and morphological effects of CKIP-1. To test this postulate, we used peptide "walking arrays" and alignments of CKIP-1 with CARMIL, another CP-binding protein, to identify Arg-155 and Arg-157 of CKIP-1 as residues potentially required for its interactions with CP. CKIP-1 mutants harboring Arg-155 and Arg-157 substitutions exhibited greatly decreased CP binding, while retaining wild-type localization, the ability to interact with protein kinase CK2, and self-association. To examine the phenotype associated with expression of these mutants, we generated tetracycline-inducible human osteosarcoma cells lines expressing R155E,R157E mutants of CKIP-1. Examination of these cell lines reveals that CKIP-1 R155E,R157E did not induce the distinct changes in cell morphology and the actin cytoskeleton that are characteristic of wild-type CKIP-1 demonstrating that the interaction between CKIP-1 and CP is required for these cellular effects.


Adenoid cystic carcinoma of ceruminous gland: a case report.
Adenoid cystic carcinoma of the external auditory canal (EAC) is a very rare malignant tumor and its diagnosis is frequently missed because of the superficial nature of biopsies. A 30 year old male presented with 6 months history of recurrent painful right ear discharge. On examination there was a nodule of 2 cms in diameter. The microscopic examination of the punch biopsy specimen of tumor revealed typical features of an adenoid cystic carcinoma. While reporting the biopsies of external auditory canal one should keep the adenoid cystic carcinoma as one of the possible differentials, especially if the biopsy is superficial, problem is recurrent and histopathological features suggest the granulation tissue.


Humour in nursing care.
Humour is an integral part of everyday life and therefore also a component of the care and treatment of patients in the modern health care system. This paper looks at the role of humour in practical nursing in the light of earlier research literature on the subject. It also describes some preliminary results of our studies on the meaning of humour to professional nurses. We opted to use a qualitative approach in this study because the focus of interest was on an issue that has received only little attention in earlier research. Nurses were presented with a set of unstructured, open-ended questions requiring short, essay-type answers. The data obtained were analysed using the qualitative method of content analysis. In the light of our findings here, humour can be described as a joie de vivre which is manifested in human interaction in the form of fun, jocularity and laughter. Humour is a meaningful factor, both with regard to the patient's well-being and to coping, and also with regard to the interaction of nurse and patient. Humour also allows for more job satisfaction and better motivation. Research should be continued and intensified into the role and use of humour in everyday life and particularly in nursing care.


Massive lower gastrointestinal bleeding as a presenting feature of Behcet's disease.
This reports a 27 yr old female Patient with seronegative polyarthritis who presented with lower GI bleeding and subsequently developed evidence of cutaneous vasculitis (palpable purpura) and orogenital ulcers. The cause of the GI bleeding was multiple ulcerations in the terminal ileum, cecum ascending colon and transverse colon. Continued and massive bleeding necessitated surgical resection of the involved segment of gut which on histopathological examination confirmed the presence of vasculities. This patient was thus diagnosed as having Behcet's disease. Although major GI bleeding is a rare manifestation of Behcet's disease with vasculitis of the gut, one must consider this possibility if the patient has multi-system involvement with evidence of vasculitis involving the skin in the form of palpable purpura.


Establishment of the Thai version of National Institute of Health Stroke Scale (NIHSS) and a validation study.
The National Institute of Health Stroke Scale (NIHSS) is a well validated stroke severity assessment scale. The scale is used to assess neurological deficits, progression and degree of recovery in acute stroke settings. To date, no Thai version exists. This study aimed to adapt and validate a Thai version of the NIHSS (NIHSS-T). A cross-cultural adaptation of the NIHSS was developed according to the methods recommended by the International Quality of Life Assessment Project Group. Forward and backward translations were performed. A final version of the NIHSS-T was validated against initial MRI infarction volume and modified Rankin Scale (mRS) at 3 months in a consecutive series of acute stroke patients. The patients were prospectively evaluated by 3 different types of health care providers: 2 stroke fellows, 2 internists, and 2 stroke nurses. Mean NIHSS-T scores from all raters were used in the analysis. The study included 32 acute ischemic stroke patients with a mean age (+/- SD) of 64.53 +/- 14.97 years of age. Men comprised 71.9%. Mean NIHSS-T score (+/- SD) was 7.49 +/- 7.02. Intra-observer reliability demonstrated a high agreement with an intraclass correlation (ICC) of 0.98, 0.98, 0.96, 0.98, 0.90 and 0.98 for 2 stroke fellows, 2 internists and 2 stroke nurses respectively. Inter-observer reliability between 6 raters was excellent, i.e.; ICC, 0.99 (0.98, 0.99). Spearman rank correlation coefficients between the initial NIHSS-T score versus initial MRI lesion volume and mRS at 3 months were 0.53 and 0.69 with a p-value of 0.002 and < 0.001 respectively. The Thai version of NIHSS is valid for assessing acute stroke severity. The scale is also reliable when administered in a Thai-speaking setting by trained healthcare professionals.


[Classes of crude drugs and its distribution of producing area in the attached illustrations in Ben cao tu jing (Illustrated Classic of Materia Medica)].
Ben cao tu jing (Illustrated Classic of Materia Medica) is the earliest extant atlas book of materia medica in China, with 933 attached drawings. Among them, the largest portion, amounting to 670, are herbaceous plants, mostly commonly used, with definite marks of the origin producing areas, distributed across 149 administrative divisions(prefectures and counties) of the Song Dynasty, most of them in Northern area which were distributed denser than those in Southern area. The densest ones were located in Southern Shanxi, Eastern Sichuan and Eastern Anhui. In the attached drawings, the frequency of highest occurrence appeared in this Classic are three prefectures, Chuzhou, Shizhou and Guangzhou.


Selected Immunohistochemical Assessment and Clinical Examinations in the Diagnosis of Palatine Tonsil Diseases.
The palatine tonsils are secondary lymphoid organs where immune processes occur, influencing the development of a targeted cellular and humoral response. The diseased tonsils are subject to immunological imbalances, including the activity of pro-inflammatory and anti-inflammatory factors. This leads to the development of palatine tonsil diseases, such as palatine tonsillitis and palatine tonsillar hypertrophy. The main aim of the study was to evaluate the similarities and differences in the clinical and pathomorphological pictures of patients qualified for surgical treatment due to hypertrophy or inflammation of the palatine tonsils. The aim was achieved by demonstrating the relationship between the patient's medical history and physical examination and histopathological diagnosis of a given tonsillar disease, evaluating the usefulness of basic blood tests (leukocytosis, ASO, ESR, and CRP) in differential diagnosis, and assessing the immunohistochemical assessment of palatine tonsil tissue. The tonsils were stained with the following antibodies: IL-1, IL-2, IL-6, IL-8 IL-10, and IL-37 and CD25, CD40, and CD69, taking into account the histological division of the studied lymphatic tissue (epithelial, subepithelial, follicular, follicular center, and interfollicular). Patients aged between 19 and 70 years with tonsillitis or clinical signs of tonsillar hypertrophy were qualified for tonsillectomy/UPPP. Seventy-two males (68.6%) and thirty-three females (31.4%) were enrolled in the study. Histopathological and immunohistochemical assessment was performed on 105 palatine tonsils. The diagnostic value of blood tests, including determination of ASO, ESR, CRP, and leukocyte level, proved to be a significant predictor of tonsil disease. In the pathomorphological assessment, 75% of the subjects who had simultaneously elevated ESR (>4.73) and leukocytosis (>6.96) and reduced ASO (<161.03) and CRP (<0.31) belonged to the tonsillitis group. The immunohistochemical assessment revealed a diverse profile of the markers tested depending on the diagnosed disease of the tonsils. The follicular center proved to be the region of palatine tonsil tissue for which the most statistically significant differences between the markers were found. Responses to CD-40 and IL-1 were observed in this region. The tissue of epithelial, follicular, and interfollicular regions each showed one statistically significant value for the studied chemokines and lymphokines. However, the lack of significant statistical differences for p < 0.05 between the study groups was only noted in the subepithelial region. It should be emphasized that for the data as a whole (calculated on the basis of the data for all regions together), no statistically significant differences were observed. In conclusion, the results obtained are indicative of the presence of a specific immunohistochemical profile for palatine tonsil diseases. Significant discrepancies have been found in the clinical and pathomorphological assessment of tonsils qualified for tonsillectomy. Therefore, these methods should be considered complementary. The patient's medical history and physical examination, depending on the adopted clinical or histopathological classification, show a variation in the distribution of features that are the basis for allocation to a particular group.


Discovery of the genus Pseudepione Inoue, 1943 in Taiwan, with description of a new species (Lepidoptera: Geometridae: Ennominae).
The genus Pseudepione Inoue, 1943 is a small geometrid taxon comprising only two species, the typo species P. magnaria (Wileman, 1911) and P. shiraii Inoue, 1943. They are known to distribute in Japan (Honshu, Kyushu and Shikoku), south and central Korea (Choi 2012; Choi An 2010; Jung Oh 2012), the former species was also reported in Jiangxi of China (Fang 2003). The genus seems to be univoltine since adults can only be found in the autumn season (Wileman 1911; Inoue 1943, 1982; Parsons et al. 1999; Kim Beljaev 2001; Sato 2011; Choi 2012). The combination of the absence of forewing fovea, tuft of scales of third abdominal sternite, gnathos, socii and cormata is quite unique in Ennominae. So far, the phylogenetic affinity of Pseudepione is unclear since the closely related genus has never been proposed and still no morphological or molecular phylogenetic studies, i.e. Beljaev (2006a; 2006b; 2016), Sihvonen (2011), Yamamoto Sota (2007), Jiang et al. (2017), considering the palaearctic subfamily or tribal levels sampled this genus. The dense fundamental surveys conducted in recent 7 years in the cloud forests of Taiwan acquire the opportunity to collect this genus new to Taiwan. After comparing the Taiwanese specimens with the known two species in both sexes, it's clear the Taiwanese specimens are a distinct species needed to be described in the present study.


A nurse-led service for tunnelled central venous catheter insertion.
The procedure of inserting tunnelled central venous catheters was once carried out by surgeons or radiologists at Glasgow NHS Trust. However, increased workloads meant that these health care professionals were left with less time to devote to these procedures, which resulted in unacceptable waiting times for those requiring them. After visiting several centres in England where nurses were already successfully inserting tunnelled central venous catheters with impressive audit results, we decided to set up a similar service. Following a successful bid for funding we now have a nurse-led service for the insertion of tunnelled central venous catheters with minimal waiting times and low complication rates.


Bioinformatics approaches for the functional interpretation of protein lists: from ontology term enrichment to network analysis.
The main result of a great deal of the published proteomics studies is a list of identified proteins, which then needs to be interpreted in relation to the research question and existing knowledge. In the early days of proteomics this interpretation was only based on expert insights, acquired by digesting a large amount of relevant literature. With the growing size and complexity of the experimental datasets, many computational techniques, databases, and tools have claimed a central role in this task. In this review we discuss commonly and less commonly used methods to functionally interpret experimental proteome lists and compare them with available knowledge. We first address several functional analysis and enrichment techniques based on ontologies and literature. Then we outline how various types of network and pathway information can be used. While the problem of functional interpretation of proteome data is to an extent equivalent to the interpretation of transcriptome or other ''omics'' data, this paper addresses some of the specific challenges and solutions of the proteomics field.


Treatment of blepharitis: recent clinical trials.
Blepharitis is a chronic inflammatory disease of the eyelids that is frequently encountered in clinical practice. The etiology of the disorder is complex and not fully understood, but the general consensus is that bacteria and inflammation contribute to the pathology. Blepharitis can be classified into anterior blepharitis, involving the anterior lid margin and eyelashes, and posterior blepharitis, characterized by dysfunction of the meibomian glands. Long-term management of symptoms may include daily eyelid cleansing routines and the use of therapeutic agents that reduce infection and inflammation. A cure is not possible in most cases, and subjective symptoms may persist even when a clinical assessment of signs indicates that the condition has improved. There are no established guidelines regarding therapeutic regimens, but recent clinical trials have shown that antibiotics and topical corticosteroids can produce significant improvement in signs and symptoms of blepharitis. Fixed combinations of a topical antibiotic and a corticosteroid offer an effective and convenient treatment modality that addresses both infectious and inflammatory components of the disease. Further clinical trials are needed to determine optimal therapies for managing blepharitis.


The sacrificial role of easily oxidizable sites in the protection of DNA from damage.
It has been suggested that DNA contains sacrificial nucleobase sequences that protect sensitive regions of the genome from oxidative damage. Oxidation of DNA by loss of an electron generates a radical cation that can migrate long distances by hopping. The radical cation can be trapped irreversibly at certain sites (GG steps) by reaction with H2O or O2 leading to the formation of lesions (oxidative damage). A series of DNA oligomers that contain regularly spaced GG steps and an 8-oxo-7,8-dihydroguanine (8-oxoG), which serves as a proxy for possibly sacrificial protective low oxidation potential sites, was prepared and analyzed. We find that in certain special sequences of DNA nucleobases that 8-oxoG protects remote GG steps from oxidative damage but that this is not a general phenomenon extending to normal mixed sequence DNA. This is a consequence of the change in the relative rate of charge hopping compared with trapping of the radical cation. When hopping is relatively slow, 8-oxoG exerts no protective effect. Thus, it seems unlikely that low oxidation potential sequences play a meaningful part in protecting mixed sequence DNA from damage.