Clinical spectrum of pulmonary mucormycosis.
Pulmonary mucormycosis is an uncommon, but important, opportunistic fungal pneumonia which is often diagnosed post-mortem. This review emphasizes clinical and pathologic characteristics of pulmonary mucormycosis that differentiate this infection from other fungal pneumonias. The most common clinical presentation of pulmonary mucormycosis is a rapidly progressive pneumonia with diffuse infiltrates on chest radiographic examination of a patient with an underlying hematologic malignancy treated with immunosuppressive drugs. Other immunocompromised hosts at risk for pulmonary mucormycosis include patients with diabetes mellitus who may develop a distinctive endobronchial form of this disease. Early consideration of this diagnosis, along with aggressive diagnostic evaluation, are critical to effective therapy and patient survival. While treatment with amphotericin B is the mainstay of therapy for pulmonary mucormycosis, diabetics with endobronchial disease may benefit from early, aggressive surgical resection of the involved lung tissue.


RESULTS OF THALAMOTOMY FOR PARKINSON'S DISEASE.
Surgical destruction of a portion of the ventrolateral nucleus of the thalamus is currently the procedure of choice for the treatment of incapacitating tremor and rigidity of parkinsonism. Seventy-three patients were treated by 105 thalamotomies at the University of Alberta Hospital and assessed one to four years later for improvement of function in everyday activities. Fifty-six patients were improved, 12 were unchanged, and five had died. Only two of the deaths were related to the operation. Paresis was permanent in only one patient. Twenty-five patients had bilateral operations and 22 of these showed improvement of function. Contraindications to operation include serious cardiovascular disease, mental deterioration, and those parkinsonian patients whose disability is chiefly due to akinesia, oculogyric crisis, dysphasia or dysarthria.


Kinetically Controllable Construction of Nine-Membered Carbocycles via Pd-Catalyzed Decarboxylative Cycloaddition.
A kinetically controllable strategy toward the construction of otherwise challenging nine-membered carbocycles is reported. This Pd-catalyzed decarboxylative procedure utilizes vinyl methylene cyclic carbonates as the C5-dipole and allylidenemalononitriles as C4-building blocks. The protocol features user-friendly operations with controllable regioselectivity and generates CO2 as the sole byproduct. The formation of synthetically valuable and thermodynamically favored seven-membered carbocycles was also investigated.


Sound localization precision under conditions of the precedence effect: effects of azimuth and standard stimuli.
Minimum audible angles (MAAs) were estimated for single noise bursts, and for burst pairs that satisfied the conditions of the precedence effect (that is, produced fused images). In one burst-pair condition, the bursts to be discriminated differed in lead location; in the other, they differed in lag location. Sounds were presented over loudspeakers. MAAs were lowest for single bursts, slightly higher for lead discrimination, and much higher for lag discrimination. Presence of a standard reference burst had no reliable effect on performance. The data are interpreted using a model of Shinn-Cunningham et al. [J. Acoust. Soc. Am. 93, 2923-2932 (1993)] in which discrimination of precedence-effect burst pairs is based on the lateral position of the auditory image, which is a weighted average of the positions of the leading and lagging bursts.


Antibodies from plants for bionanomaterials.
Antibodies are produced as part of the vertebrate adaptive immune response and are not naturally made by plants. However, antibody DNA sequences can be introduced into plants, and together with laboratory technologies that allow the design of antibodies recognizing any conceivable molecular structure, plants can be used as 'green factories' to produce any antibody at all. The advent of plant-based transient expression systems in particular allows the rapid, convenient, and safe production of antibodies, ranging from laboratory-scale expression to industrial-scale manufacturing. The key features of plant-based production include safety, speed, low cost, and convenience, allowing newcomers to rapidly master the technology and use it to its full advantage. Manufacturing in plants has recently achieved significant milestones and offers more than just an alternative to established microbial and mammalian cell platforms. The use of plants for product development in particular offers the power and flexibility to easily coexpress many different genes, allowing the plug-and-play construction of novel bionanomaterials, perfectly complementing existing approaches based on plant virus-like particles. As well as producing single antibodies for applications in medicine, agriculture, and industry, plants can be used to produce antibody-based supramolecular structures and scaffolds as a new generation of green bionanomaterials that promise a bright future based on clean and renewable nanotechnology applications. WIREs Nanomed Nanobiotechnol 2017, 9:e1462. doi: 10.1002/wnan.1462 For further resources related to this article, please visit the WIREs website.


A Smart Chair to Monitor Sitting Posture by Capacitive Textile Sensors.
In this paper, a smart office chair with movable textile sensors to monitor sitting position during the workday is presented. The system consists of a presence textile capacitive sensor with different levels of activation with a signal conditioning device. The proposed system was integrated into an office chair to detect postures that could provoke musculoskeletal disorders or discomfort. The microcontroller measured the capacitance by means of a cycle count method and provided the position information in real time. The information could be analysed to set up warnings to prevent incorrect postures or the necessity to move. Five participants assumed a series of postures, and the results showed the workability of the proposed smart chair. The chair can be provided as a new tool for companies, hospitals, or other institutions to detect incorrect postures and monitor the postures of people with reduced mobility. This tool can optimise control procedures or prevent occupational risks.


Comparison of Commercial Lures and Food Baits for Early Detection of Fruit Infestation Risk by Drosophila suzukii (Diptera: Drosophilidae).
Drosophila suzukii (Matsumura; Diptera: Drosophilidae) is one of the most serious invasive pests of berries and cherries worldwide. Several adult monitoring systems are available to time foliar application of insecticides with the expectation of detecting the presence of D. suzukii before they infest susceptible crops. We tested this by comparing four different trapping systems based on two homemade baits, apple cider vinegar (ACV) or fermenting dough, and two fermentation volatile-based commercial lures, Scentry and Trécé. Traps baited with dough or Scentry captured more D. suzukii than traps baited with ACV or Trécé in blueberries and traps baited with Trécé in raspberries. In blueberries, traps baited with Scentry, Trécé and dough provided 11-21 d of warning prior to first detection of fruit infestation. However, these traps were not as effective in summer floricane raspberries. The Scentry lure baited traps detected D. suzukii on the same week as the first detection of fruit infestation and other trapping systems detected the fly 4 to 11 d after the first detection, suggesting the need for an improved D. suzukii detection system in raspberries. Both synthetic lures (Scentry and Trécé) were significantly more selective for D. suzukii than dough bait, although the selectivity of all four tested lures/baits were relatively low at <20%. Our results suggest that in locations where D. suzukii adults are not trapped in late winter and spring, adult monitoring of D. suzukii using a sensitive trapping system may provide early warning of pending infestation risk thereby potentially reducing unnecessary insecticide applications.


Factors Associated with Anxiety and Depression in Korean Patients with Inactive Inflammatory Bowel Disease.
Psychological distress is highly prevalent in patients with inflammatory bowel disease (IBD). We evaluated the disease characteristics and socioeconomic factors associated with anxiety and depression in Korean patients with quiescent IBD. In total, 142 IBD patients (67 with Crohn's disease [CD] and 75 with ulcerative colitis [UC]) completed self-report questionnaires, including the Hospital Anxiety and Depression Score, the Modified Morisky Adherence Scale-8, the socioeconomic deprivation score, and the Crohn's and Colitis Knowledge Score questionnaires. In the CD group, 30 patients (44%) were anxious, and 10 patients (15%) were depressed; in the UC group, 31 patients (41%) were anxious, and 18 patients (24%) were depressed. Using multivariate analysis, in the CD group, socioeconomic deprivation was associated with anxiety (p=0.03), whereas disease duration (p=0.04) and socioeconomic deprivation (p=0.013) were associated with depression. In the UC group, there was no significant independent predictor of anxiety and/or depression; however, low income tended to be associated with depression (p=0.096). Despite clinical remission, a significant number of IBD patients present with anxiety and depression. IBD patients in remission, particularly those who are socioeconomically deprived, should be provided with appropriate psychological support.


Reduced Interhemispheric Functional Connectivity in Obsessive-Compulsive Disorder Patients.
Background: Neuroimaging studies have shown that the high synchrony of spontaneous neural activity in the homotopic regions between hemispheres is an important functional structural feature of normal human brains, and this feature is abnormal in the patients with various mental disorders. However, little is known about this feature in obsessive-compulsive disorder (OCD). This study aimed to further analyze the underlying neural mechanisms of OCD and to explore whether clinical characteristics are correlated with the alerted homotopic connectivity in patients with OCD. Methods: Using voxel-mirrored homotopic connectivity (VMHC) during resting state, we compared 46 OCD patients and 46 healthy controls (HCs) matched for age, gender, and education level. A partial correlation analysis was used to investigate the relationship between altered VMHC and clinical characteristics in patients with OCD. Results: Patients with OCD showed lower VMHC than HCs in fusiform gyrus/inferior occipital gyrus, lingual gyrus, postcentral gyrus/precentral gyrus, putamen, and orbital frontal gyrus. A significant positive correlation was observed between altered VMHC in the angular gyrus/middle occipital gyrus and illness duration in patients. Conclusions: Interhemispheric functional imbalance may be an essential aspect of the pathophysiological mechanism of OCD, which is reflected not only in the cortico-striato-thalamo-cortical (CSTC) loop but also elsewhere in the brain.


Integrating palliative care into chronic care for children with severe neurodevelopmental disabilities.
Children with severe neurodevelopmental disabilities and complex medical conditions are a growing and unique segment of the pediatric population. The increasing use of life sustaining technologies has provided the chance at an extended life and increasing inclusion within the broader community. Families work to overcome personal and professional biases, clinical uncertainties, and pragmatic obstacles to improve quality of life. Little attention, however, has been paid to the unique challenges of caring for a dying child affected with neurodevelopmental delay. In this paper we outline several specific barriers to the provision of excellent end-of-life care for these children and their families. We also outline our approach for overcoming these barriers. The benefit of comprehensive palliative care in select pediatric populations has been demonstrated. Extending and tailoring those service to meet the unique needs of children with severe disabilities is the next logical step in that continuum. Ultimately, acknowledging that the lives of children with neurodevelopmental disabilities and their families have a unique quality will permit the human face of medical care to keep pace with technologic advances. Appreciation of the value of a perhaps incomparable quality of life will allow for a better quality of dying for children with severe neurodevelopmental disabilities.


Microsporum gypseum dermatophytosis in a patient of acquired immunodeficiency syndrome: a rare case report.
Microsporum gypseum, a geophillic dermatophyte is rarely isolated from patients with acquired immunodeficiency syndrome. We report tinea corporis due to Microsporum gypseum, an uncommon aetiological agent, in a patient with acquired immunodeficiency syndrome from our region. The clinical presentation resembled psoriasis characterised by atypical, scaly and hyperkeratotic lesions.


Generalized synchronization via nonlinear control.
In this paper, the generalized synchronization problem of drive-response systems is investigated. Using the drive-response concept and the nonlinear control theory, a control law is designed to achieve the generalized synchronization of chaotic systems. Based on the Lyapunov stability theory, a generalized synchronization condition is derived. Theoretical analyses and numerical simulations further demonstrate the feasibility and effectiveness of the proposed technique.


Human movement is both diffusive and directed.
Understanding the influence of the built environment on human movement requires quantifying spatial structure in a general sense. Because of the difficulty of this task, studies of movement dynamics often ignore spatial heterogeneity and treat movement through journey lengths or distances alone. This study analyses public bicycle data from central London to reveal that, although journey distances, directions, and frequencies of occurrence are spatially variable, their relative spatial patterns remain largely constant, suggesting the influence of a fixed spatial template. A method is presented to describe this underlying space in terms of the relative orientation of movements toward, away from, and around locations of geographical or cultural significance. This produces two fields: one of convergence and one of divergence, which are able to accurately reconstruct the observed spatial variations in movement. These two fields also reveal categorical distinctions between shorter journeys merely serving diffusion away from significant locations, and longer journeys intentionally serving transport between spatially distinct centres of collective importance. Collective patterns of human movement are thus revealed to arise from a combination of both diffusive and directed movement, with aggregate statistics such as mean travel distances primarily determined by relative numbers of these two kinds of journeys.


Base-mediated cascade rearrangements of aryl-substituted diallyl ethers.
Two base-mediated cascade rearrangement reactions of diallyl ethers were developed leading to selective [2,3]-Wittig-oxy-Cope and isomerization-Claisen rearrangements. Both diaryl and arylsilyl-substituted 1,3-substituted propenyl substrates were examined, and each exhibits unique reactivity and different reaction pathways. Detailed mechanistic and computational analysis was conducted, which demonstrated that the role of the base and solvent was key to the reactivity and selectivity observed. Crossover experiments also suggest that these reactions proceed with a certain degree of dissociation, and the mechanistic pathway is highly complex with multiple competing routes.


Ectothermic philosophy of acid-base balance to prevent fibrillation during hypothermia.
In the ectotherms, or cold-blooded animals, carbon dioxide pressure decreases (PCO2) and pH increases as body temperature falls. This tends to increase coronary blood flow and prevent fibrillation. This concept was investigated in 181 consecutive patients undergoing open heart surgery of all types. In 121 cases, endothermic (warm-blooded) temperature-corrected normal values of pH, PCO2, and oxygen pressure were maintained during extracorporeal circulation as the perfusate temperature was lowered to 24 degrees C prior to aortic cross-clamping and administration of blood cardioplegia solution. In 49 patients (40%), ventricular fibrillation occurred prior to cross-clamping. In the other 60 consecutive cases, in which the ectothermic principle of cooling was applied, the PCO2 was allowed to decrease from 50 to 40 mm Hg and the non-temperature-corrected pH rose from 7.28 to 7.42. Fibrillation occurred in only 12 (20%) of these 60 patients.


3D semiconducting Co-MOFs based on 5-(hydroxymethyl)isophthalic acid and imidazole derivatives: syntheses and crystal structures.
Two three-dimensional cobalt-based metal-organic frameworks with 5-(hydroxymethyl)isophthalic acid (H2HIPA), namely poly[[μ2-1,4-bis(2-methyl-1H-imidazol-1-yl)benzene-κ2N3:N3'][μ2-5-(hydroxymethyl)isophthalato-κ2O1:O3]cobalt(II)], [Co(C9H6O5)(C14H14N4)]n (1), and poly[tris[μ2-1,4-bis(1H-imidazol-1-yl)benzene-κ2N3:N3']bis[μ3-5-(hydroxymethyl)isophthalato-κ2O1:O3:O5]dicobalt(II)], [Co2(C9H6O5)2(C12H10N4)3]n (2), were synthesized under similar hydrothermal conditions. Single-crystal X-ray diffraction analyses revealed that 5-(hydroxymethyl)isophthalate (HIPA2-) and 1,4-bis(2-methyl-1H-imidazol-1-yl)benzene (1,4-BMIB) are simple linkers connecting cobalt centres to build a fourfold interpenetration dia framework in complex 1. However, complex 2 is a pillared-layer framework with a (3,6)-connected network constructed by 1,4-bis(1H-imidazol-1-yl)benzene (1,4-DIB) linkers, 3-connected HIPA2- ligands and 6-connected CoII centres. The above significant structural differences can be ascribed to the introduction of the different auxiliary N-donor ligands. Moreover, UV-Vis spectroscopy and Mott-Schottky measurements confirmed that complexes 1 and 2 are typical n-type semiconductors.


Vitamin B12 neuropathy in a 6 year old.
Gross neuropathy consequent upon selective malabsorption of vitamin B12 was diagnosed in a 6 year old Bangladeshi girl brought to Great Britain for further investigation of an unexplained illness of three years' duration. The initial peripheral blood count was normal. Treatment with vitamin B12 has led to substantial recovery.


Enhancement of maximal bilirubin excretion by bile salts in the anaesthetized rabbit.
The influence of glycodeoxycholate, taurocholate and dehydrocholate on the maximal hepatic excretion of bilirubin was investigated in rabbits anaesthetized with sodium pentobarbitone. Biliary secretion of dehydrocholate was much less than that of the other two bile salts, which could be explained by its metabolism in the hepatocytes. Glycodeoxycholate and dehydrocholate had a greater choleretic effect than taurocholate. Only glycodeoxycholate and taurocholate increased the secretion of biliary lipids, suggesting that dehydrocholate or its metabolites were unable to form micelles. All three bile salts, however, increased maximal bilirubin excretion to a similar extent. These results indicate that the action of bile salts on the excretion of bilirubin cannot be fully explained in terms of binding to mixed micelles.


Diurnal variability of glucose tetrasaccharide (Glc4) excretion in patients with glycogen storage disease type III.
The urinary glucose tetrasaccharide, Glcα1-6Glcα1-4Glcα1-4Glc (Glc4), is a glycogen limit dextrin that is elevated in patients with glycogen storage disease (GSD) type III. We evaluated the potential of uncooked cornstarch therapy to interfere with Glc4 monitoring, by measuring the diurnal variability of Glc4 excretion in patients with GSD III. Voids were collected at home over 24 hours, stored at 4°C and frozen within 48 hours. Glc4 was analyzed using liquid chromatography-tandem mass spectrometry and normalized to creatinine. Subjects with GSD III (median age: 13.5 years, range: 3.7-62; n = 18) completed one or more 24-hour urine collection, and 28/36 collections were accepted for analysis. Glc4 was elevated in 16/18 subjects (median: 13 mmol/mol creatinine, range: 2-75, reference range: <3). In collections with elevated Glc4 (23/28), two-thirds (15/23) had low diurnal variability in Glc4 excretion (coefficient of variation [CV%] <25). The diurnal variability was significantly correlated with the Glc4 concentration (Pearson R = .644, P < .05), but not with the dose of uncooked cornstarch. High intraday variability (>25%) was not consistently observed in repeat collections by the same subject. The extent and variability of Glc4 excretion relative to creatinine was not correlated with cornstarch dose. A majority of collections showed low variability over 24 hours. These findings support the use of single time-point collections to evaluate Glc4 in patients with GSD III treated with cornstarch. However, repeat sampling over short time-periods will provide the most accurate assessment of Glc4 excretion, as intraday variability may be increased in patients with high Glc4 excretion.


[Determination of four amino acids in tea by capillary zone electrophoresis and direct ultraviolet detection without derivatization].
Abstract: Four important amino acids, arginine (Arg), tryptophane (Trp), phenylalanine (Phe) and tyrosine (Tyr) in tea samples with different fermentation processes were simultaneously determined by capillary zone electrophoresis (CZE) using direct ultraviolet detection (UV) at 190 nm. Under the conditions of 20 kV of separation voltage and 25 degrees C of temperature, Arg, Trp, Phe and Tyr were separated successfully within 8 min in 25 mmol/L sodium borate-boric acid (pH 10.0) with the detection limits of 5.0, 1.0, 0.3 and 0.5 mg/L for Arg, Trp, Phe and Tyr, respectively. The relative standard deviations (RSDs) of migration time (n = 7) were all lower than 2.8% and the RSDs of peak electric current (n = 7) were lower than 4.0%. The method was applied in the determination of Arg, Trp, Phe and Tyr in eleven tea samples. The results were satisfactory. This method can provide beneficial reference to evaluation quality of tea.


GillesPy2: A Biochemical Modeling Framework for Simulation Driven Biological Discovery.
Stochastic modeling has become an essential tool for studying biochemical reaction networks. There is a growing need for user-friendly and feature-complete software for model design and simulation. To address this need, we present GillesPy2, an open-source framework for building and simulating mathematical and biochemical models. GillesPy2, a major upgrade from the original GillesPy package, is now a stand-alone Python 3 package. GillesPy2 offers an intuitive interface for robust and reproducible model creation, facilitating rapid and iterative development. In addition to expediting the model creation process, GillesPy2 offers efficient algorithms to simulate stochastic, deterministic, and hybrid stochastic-deterministic models.


Local delivery of interleukin 4 by retrovirus-transduced T lymphocytes ameliorates experimental autoimmune encephalomyelitis.
Experimental autoimmune encephalomyelitis (EAE) is an inflammatory autoimmune disease of the central nervous system which serves as a model for the human disease multiple sclerosis. We demonstrate here that encephalitogenic T cells, transduced with a retroviral gene, construct to express interleukin 4, and can delay the onset and reduce the severity of EAE when adoptively transferred to myelin basic protein-immunized mice. Thus, T lymphocytes transduced with retroviral vectors can deliver "regulatory cytokines" in a site-specific manner and may represent a viable therapeutic strategy for the treatment of autoimmune disease.


Fast-to-slow conversion following chronic low-frequency activation of medial gastrocnemius muscle in cats. II. Motoneuron properties.
Chronic stimulation (for 2-3 mo) of the medial gastrocnemius (MG) muscle nerve by indwelling electrodes renders the normally heterogeneous MG muscle mechanically and histochemically slow (type SO). We tested the hypothesis that motoneurons of MG muscle thus made type SO by chronic stimulation would also convert to slow phenotype. Properties of all single muscle units became homogeneously type SO (slowly contracting, nonfatiguing, nonsagging contraction during tetanic activation). Motoneuron electrical properties were also modified in the direction of type S, fatigue-resistant motor units. Two separate populations were identified (on the basis of afterhyperpolarization, rheobase, and input resistance) that likely correspond to motoneurons that had been fast (type F) or type S before stimulation. Type F motoneurons, although modified by chronic stimulation, were not converted to the type S phenotype, despite apparent complete conversion of their muscle units to the slow oxidative type (type SO). Muscle units of the former type F motor units were faster and/or more powerful than those of the former type S motor units, indicating some intrinsic regulation of motor unit properties. Experiments in which chronic stimulation was applied to the MG nerve cross-regenerated into skin yielded changes in motoneuron properties similar to those above, suggesting that muscle was not essential for the effects observed. Modulation of group Ia excitatory postsynaptic potential (EPSP) amplitude during high-frequency trains, which in normal MG motoneurons can be either positive or negative, was negative in 48 of 49 chronically stimulated motoneurons. Negative modulation is characteristic of EPSPs in motoneurons of most fatigue-resistant motor units. The general hypothesis of a periphery-to-motoneuron retrograde mechanism was supported, although the degree of control exerted by the periphery may vary: natural type SO muscle appears especially competent to modify motoneuron properties. We speculate that activity-dependent regulation of the neurotrophin-(NT) 4/5 in muscle plays an important role in controlling muscle and motoneuron properties.


Multimodal imaging characteristics of hydroxychloroquine retinopathy.
Hydroxychloroquine (HCQ) is known to cause retinal toxicity. Early detection of the toxicity is necessary to stop the drug in time. Multicolor imaging (MC) is a new noninvasive retinal imaging modality that simultaneously acquires three reflectance images of the retina using three individual lasers producing a composite image, thereby allowing analysis of changes at various levels within the retina. It is a new and promising addition to the retinal imaging armory. MC characteristics of HCQ toxicity are hitherto unreported. A 61-year-old female presented with history of HCQ intake (400 mg/day) for the last 6 years. She had retinopathy in both eyes. Multicolor composite image showed circumscribed perifoveal arcuate area of darkening, and infrared reflectance showed speckled hyperreflecetance in both eyes. MC imaging shows definite changes in HCQ toxicity, and it might emerge as a possible screening tool in future.


Diverse pathways for nuclear signaling by G protein-coupled receptors and their ligands.
Recent realization that plasma membrane G protein-coupled receptors (GPCRs) may translocate and establish ligand-responsive signaling complexes in other cellular structures has motivated studies of site-specific differences in transductional pathways. GPCRs and their ligands may signal transcription and other nuclear events by two basic mechanisms. The first consists of GPCR-complex activation of messengers that enter the nucleus and there initiate cell-modifying processes without the GPCR leaving the plasma membrane. The second encompasses entry into the nuclear membranes or matrix of either GPCR ligands, which bind to non-GPCR nuclear signaling proteins, proteolytic fragments of GPCRs capable of ligand-independent signaling, or intact GPCRs with transduction-competent factors that directly initiate or regulate transcriptional events. With the second mechanism, often concurrent down-regulation of plasma membrane GPCRs terminates signaling from the cell-surface and moves it into the nuclear domain. Site-dependent differences in signals from the same GPCR provide potentials for unique cellular abnormalities attributable to defective intracellular movement and distribution of a GPCR, site-specific alterations in ligand concentration, and limited intracellular bioavailability of pharmacological agents that can interact specifically with both nuclear and plasma membrane forms of a GPCR.


AN ADULT CASE OF ANAPHYLAXIS CAUSED BY ALLERGY TO JELLYFISH.
A 35-year-old female, professional diver, reported nausea, vomiting, and systemic hives 20 to 30 minutes after ingestion of antipasto made with jellyfish. Patient reported prior episodes of swelling after stings from several different creatures, including jelly fish. She also developed a systemic allergic reaction after sting from an unknown creature while diving. On the initial visit to our hospital, serum total IgE level was 545IU/ml. We extracted crude allergen from jellyfish and evaluated allergen specific IgE antibody levels using ELISA. Patient samples showed higher levels of jellyfish-derived allergen specific IgE than healthy control samples. Basophils were isolated from the peripheral blood of patient. Stimulation with jellyfish-derived allergen showed expression of surface antigens on basophils increased in a concentration-dependent manner. Methods using sodium dodecyl sulfate poly acrylamide gel electrophoresis and immunoblotting showed acid-soluble collagen fraction from jellyfish contained above 250kDa weighed protein that may have caused this current event. A provocation test using jellyfish samples was not performed due to risk of anaphylactic shock. The patient was diagnosed with a jellyfish allergy due to IgE mediated anaphylaxis after ingestion. She was asked to refrain from consuming any food containing jellyfish. IgE-mediated food allergy caused by jellyfish is rare worldwide. Collagen was speculated to be an allergen in this study. Additional study to detect specific allergens related to jellyfish allergy would be particularly useful to specify disease phenotypes and individual care in future.


Immunoglobulin classes of antibody to hepatitis B core antigen.
Antibody to hepatitis B core antigen in the sera of 10 patients with acute viral hepatitis B, 20 patients with chronic hepatitis B, and 30 carriers of chronic hepatitis B surface antigen was assayed by the indirect immunofluorescence test. The activity of antibody to hepatitis B core antigen in the sera of these three groups of patients was identified as belonging to immunoglobulin classes G, M, A, and D. Antibody to hepatitis B core antigen was predominantly of IgG and IgM classes in all three groups of patients.


Milling Microchannels in Monel 400 Alloy by Wire EDM: An Experimental Analysis.
This paper presents the results of an investigation on the capacity of wire electrical discharge machining (WEDM) to produce microchannels in the Nickel-based alloy, Monel 400. The main objective of the current study is to produce microchannels with desired/target geometry and acceptable surface quality. Square cross-sectional microchannels with dimensions of 500 × 500 µm were investigated. Experiments were conducted based on the one-factor-at-a-time approach for the key input WEDM process parameters, namely pulse-on time (TON), pulse-off time (TOFF), average gap voltage (VGAP), wire feed (WF), and dielectric flow rate (FR). Dimensional accuracy, machining speed, surface roughness, surface morphology, microhardness, and microstructure were analyzed to evaluate the microchannels. The minimum errors of 6% and 3% were observed in the width and depth of the microchannels, respectively. Furthermore, microchannels with enhanced surface integrity could be produced exhibiting smooth surface morphology and shallow recast layer (~0-2.55 µm).


Primary hyperparathyroidism in the elderly.
Primary hyperparathyroidism is a relatively common disease in elderly women. Many of its clinical presentations may be confused with normal aging. Among the elderly, renal dysfunction and skeletal disease, particularly osteoporosis, are the two aspects of the disease likely to cause the most morbidity. It is increasingly apparent, however, that a large group of patients with hyperparathyroidism are asymptomatic or only mildly symptomatic. When symptoms are present, or repeated serum calcium levels all exceed 11.0 mg/dL, surgery is considered the treatment of choice. Success of surgery and of postoperative recovery are not affected by the age of the patient, but are enhanced by the experience of the surgeon performing the parathyroidectomy. There are difficult management decisions to be made concerning the elderly asymptomatic patient with mild hypercalcemia. A conservative approach to therapy for these individuals would include maintenance of adequate hydration, and involvement in physical activity. Dietary restriction of calcium should be recommended only as long as there is no evidence that it is exacerbating negative calcium balance. Drugs likely to worsen hypercalcemia, such as thiazides, must be avoided, and blood chemistries should be monitored at regular intervals. Because the bone loss of hyperparathyroidism may develop insidiously, serial bone density measurements are probably reasonable in older women already at risk for osteoporosis. Accelerated bone loss is an indication for surgical intervention. A wide variety of medications have been proposed for the treatment of primary hyperparathyroidism, but none stands out as a particularly desirable therapeutic alternative. Future research in this area, particularly with the use of estrogens in postmenopausal women with hyperparathyroidism, may eventually lead to greater acceptance of this alternative to surgery.


Serum samples from patients with mycobacterial infections cross-react with HIV structural proteins Gp41, p55 and p18.
Infection with Mycobacterium leprae is associated with a high frequency of false positive results in a variety of serological assays. Our studies have found cross-reactivity to HIV structural proteins in serum samples from leprosy patients, irrespective of the type of disease, treatment duration, age and gender and from a few patients with active TB disease. Western blot (WB) analysis revealed that sera from HIV negative leprosy patients across the spectrum showed high reactivity with p18, Gp41 and p55 and lower reactivity with other HIV proteins. The reactivity appeared to be specific; western blot-positive samples were negative in ELISA and in several rapid tests for HIV. Cross-reactivity was not found in sera from patients with leishmaniasis or from normal healthy individuals. None of the WB reactive leprosy patients seroconverted to HIV positivity within 6 months to 1 year after Western blot testing. BLAST analysis revealed that envelope antigens of HIV (Gp41, Gp120 and Gp160) contained amino acid sequences similar to M. leprae ML0470, putative integral membrane protein, Rv0740, mmpL9 (M. tuberculosis). Core (gag) antigens (p18) had similarities to ML0406, but polymerase antigens (p52) had similarities to PE_PGRS (M. tuberculosis, H37Rv). Nucleotide sequence analysis, on the other hand, did not reveal any significant homology between M. leprae or M. tuberculosis and HIV. The occurrence of these high false-positive rates in M. leprae-infected individuals suggests a possible complication of serodiagnosis of HIV in regions where mycobacterial infections are endemic. There is a need for caution in reporting HIV infection among leprosy patients. Our observations emphasise the value of the various rapid assay kits for HIV, where this false positivity is not observed.


Conservative management of a traumatic common iliac venous pseudoaneurysm: a case report.
Limited evidence-based protocols exist regarding the management of venous pseudoaneurysms. Cases reports have documented surgical treatments including endovascular coil embolization or suture ligation in the setting of hemodynamic stability. Depending on the location of the venous injury, a more conservative approach to a stable pseudoaneurysm may be advantageous. This report describes a case of a patient who sustained a blunt traumatic common iliac vein pseudoaneurysm who was successfully managed non-operatively.


Human detection thresholds of DC, AC, and hybrid electric fields: a double-blind study.
In the course of the ongoing transition of electric energy systems, transmission corridors are often upgraded to higher voltages and other technologies leading to another quality of human exposure. The study aims to determine human detection thresholds for direct current (DC), alternating current (AC), and hybrid electric fields (various DC; constant AC). A total of 203 participants were exposed to DC, AC, and hybrid electric fields (EFs) in a highly specialized whole-body exposure laboratory using a double-blind experimental setting. Additionally, the participants were exposed to ion currents in part of the DC and hybrid sessions. To investigate environmental influences, relative humidity was changed in two subgroups during EF perception. Methods derived from the signal detection theory and the adaptive staircase procedure based on the single interval adjustment matrix were used to assess individual sensitivity and detection thresholds, respectively. The results indicated that detection thresholds of hybrid EF were lower compared to single EF presentation of DC or AC. Ion current exposure enhanced EF perception. High relative humidity facilitated DC EF perception, whereas low relative humidity reinforced the perception of AC EFs. With this systematic investigation of human perception of DC, AC, and hybrid EFs, detection thresholds were provided, which can help improve the construction processes of energy transmission systems and the prevention of unwanted sensory perception by contributing to the determination of limit values.


Role of Brain NUCB2/nesfatin-1 in the Stress-induced Modulation of Gastrointestinal Functions.
Nucleobindin2 (NUCB2)/nesfatin-1 plays a well-established role in homeostatic functions associated with food intake and stress integration. This review focusses on NUCB2/nesfatin-1's central effects on gastrointestinal functions and will summarize the effects on food intake, motility and secretion with focus on the upper gastrointestinal tract. We will highlight the stressors that influence brain NUCB2/nesfatin-1 expression and discuss functional implications. In addition to traditional acute psychological and physical stressors such as restraint stress and abdominal surgery we will look at immunological, visceral and metabolic stressors as well as a chronic combination stress model that have been shown to affect NUCB2/nesfatin-1 signaling and describe associated functional consequences.


Dynamic Phosphorus: Thiolate Exchange Cascades with Higher Phosphorothioates.
In this study, we introduce phosphorus, a pnictogen, as an exchange center for dynamic covalent chemistry. Cascade exchange of neutral phosphorotri- and -tetrathioates with thiolates is demonstrated in organic solvents, aqueous micellar systems, and in living cells. Exchange rates increase with the pH value, electrophilicity of the exchange center, and nucleophilicity of the exchangers. Molecular walking of the dynamic phosphorus center along Hammett gradients is simulated by the sequential addition of thiolate exchangers. Compared to phosphorotrithioates, tetrathioates are better electrophiles with higher exchange rates. Dynamic phosphorotri- and -tetrathioates are non-toxic to HeLa Kyoto cells and participate in the dynamic networks that account for thiol-mediated uptake into living cells.


Four Principles to Consider Before Advising Women on Screening Mammography.
This article reviews four important screening principles applicable to screening mammography in order to facilitate informed choice. The first principle is that screening may help, hurt, or have no effect. In order to reduce mortality and mastectomy rates, screening must reduce the rate of advanced disease, which likely has not happened. Through overdiagnosis, screening produces substantial harm by increasing both lumpectomy and mastectomy rates, which offsets the often-promised benefit of less invasive therapy. Next, all-cause mortality is the most reliable way to measure the efficacy of a screening intervention. Disease-specific mortality is biased due to difficulties in attribution of cause of death and to increased mortality due to overdiagnosis and the resulting overtreatment with radiotherapy and chemotherapy. To enhance participation, the benefit from screening is often presented in relative instead of absolute terms. Third, some screening statistics must be interpreted with caution. Increased survival time and the percentage of early-stage tumors at detection sound plausible, but are affected by lead-time and length biases. In addition, analyses that only include women who attend screening cannot reliably correct for selection bias. The final principle is that accounting for tumor biology is important for accurate estimates of lead time, and the potential benefit from screening. Since "early detection" is actually late in a tumor's lifetime, the time window when screen detection might extend a woman's life is narrow, as many tumors that can form metastases will already have done so. Instead of encouraging screening mammography, physicians should help women make an informed decision as with any medical intervention.


Design Principles for Compartmentalization and Spatial Organization of Synthetic Genetic Circuits.
Compartmentalization is a hallmark of cellular systems and an ingredient actively exploited in evolution. It is also being engineered and exploited in synthetic biology, in multiple ways. While these have demonstrated important experimental capabilities, understanding design principles underpinning compartmentalization of genetic circuits has been elusive. We develop a systems framework to elucidate the interplay between the nature of the genetic circuit, the spatial organization of compartments, and their operational state (well-mixed or otherwise). In so doing, we reveal a number of unexpected features associated with compartmentalizing synthetic and template-based circuits. These include (i) the consequences of distributing circuits including trade-offs and how they may be circumvented, (ii) hidden constraints in realizing a distributed circuit, and (iii) appealing new features of compartmentalized circuits. We build on this to examine exemplar applications, which consolidate and extend the design principles we have obtained. Our insights, which emerge from the most basic and general considerations of compartmentalizing genetic circuits, are relevant in a broad range of settings.


Spatial summation and visual adaptation in the inner part of the frog retina.
The spatial summation of the proximal negative response (PNR) of frog retina was analyzed during different states of adaptation induced by repetitive light stimulation with either 15 sec or 1 min interstimulus interval. The spatial summation area of the PNR was found to be wider during relatively more dark adapted conditions compared to relatively more light adapted ones. This finding indicates that lateral mechanisms in the inner network of the retina seem to be activated by adapting stimuli. Secondly, the results suggest that the activity of the amacrines, as reflected by the PNR, may initiate the series of neuronal events which underlie the oscillatory potentials (OPs) of the electroretinogram (ERG).


[The broad bean's syndrome in ancient Egypt].
The problem of broad bean's syndrome and lathyrism in ancient Greece has been deeply studied, with particular referrement to the hypothetic medica and mystical reasons of the Pythagoric order not to eat broad beans. It is impossible to prove Egyptian influence of Phythagora's precept, but we can, however, consider the hypothesis that they had noticed the potential deadly effect of broad beans' use, too, and wonder if their interduction had the same motivations.


Predictors of Burnout, Job Satisfaction, and Turnover Among CRNAs During COVID-19 Surging.
This study examined the relationship between demographic factors, job characteristics, relations between Certified Registered Nurse Anesthetists (CRNAs) and administration, and conflict between work and personal responsibilities using structural equation modeling to determine levels of burnout, job satisfaction, and turnover intention among CRNAs during COVID-19 surges. Survey data were collected from CRNAs practicing in Massachusetts and Texas through an email link distributed by their respective state associations of nurse anesthetists. Results of the structural equation modeling showed a decrease in feedback, low CRNA-administration relations scores, and prioritizing work over personal responsibilities were predictive of CRNA burnout. In addition, burnout levels were correlated with job satisfaction and turnover intention. Based on these findings, employers could decrease CRNA burnout and turnover by creating organizational strategies focused on improving job feedback, relationships between CRNAs and administrators, and work-life integration. Through these approaches, healthcare managers and leaders may support CRNA resiliency and retention, particularly during times of professional change, such as the COVID-19 pandemic.


Predictors of In-Hospital Ambulatory Status Following Low-Energy Hip Fracture Surgery.
Twenty-five percent to seventy-five percent of independent patients do not walk independently after hip fracture (HF), and many patients experience functional loss. Early rehabilitation of functional status is associated with better long-term outcomes; however, predictors of early ambulation after HF have not been well described. To assess the impact of perioperative and patient-specific variables on in-hospital ambulatory status following low-energy HF surgery. This is a retrospective analysis of 463 geriatric patients who required HF surgery at a metropolitan level-1 trauma center. The outcomes were time to transfer (out of bed to chair) and time to walk. Three hundred ninety-two (84.7%) patients were able to transfer after surgery with a median time of 43.8 hours (quartile range: 24.7-53.69 hours), while 244 (52.7%) patients were able to walk with a median time of 50.86 hours (quartile range: 40.72-74.56 hours). Preinjury ambulators with aids (hazard ratio [HR]: 0.70, confidence interval [CI]: 0.50-0.99), age >80 years (HR: 0.66, CI: 0.52-0.84), peptic ulcer disease (HR: 0.57, CI: 0.57-0.82), depression (HR: 0.66, CI: 0.49- 0.89), time to surgery >24 hours (HR: 0.77, CI: 0.61-0.98), and surgery on Friday (HR: 0.73, CI: 0.56-0.95) were associated with delayed time to transfer. Delayed time to walk was observed in patients over 80 years old (HR: 0.74, CI: 0.56-0.98), females (HR: 0.67, CI: 0.48-0.94), peptic ulcer disease (HR: 0.23, CI: 0.84-0.66), and depression (HR: 0.51, CI: 0.33-0.77). Operative predictors of delayed time to transfer were surgery on Friday and time to surgery >24 hours after admission. Depression is associated with delayed time to transfer and time to walk. These data suggest that is important to perform surgeries within 24 hours of admission identify deficiencies in care during the weekends, and create rehabilitation programs specific for patient with depression. Improving functional rehabilitation after surgery may facilitate faster patient discharge, decrease inpatient care costs, and better long-term functional outcomes.


Development and characterization of an experimental model of diet-induced metabolic syndrome in rabbit.
Metabolic syndrome (MetS) has become one of the main concerns for public health because of its link to cardiovascular disease. Murine models have been used to study the effect of MetS on the cardiovascular system, but they have limitations for studying cardiac electrophysiology. In contrast, the rabbit cardiac electrophysiology is similar to human, but a detailed characterization of the different components of MetS in this animal is still needed. Our objective was to develop and characterize a diet-induced experimental model of MetS that allows the study of cardiovascular remodeling and arrhythmogenesis. Male NZW rabbits were assigned to control (n = 15) or MetS group (n = 16), fed during 28 weeks with high-fat, high-sucrose diet. We measured weight, morphological characteristics, blood pressure, glycaemia, standard plasma biochemistry and the metabolomic profile at weeks 14 and 28. Liver histological changes were evaluated using hematoxylin-eosin staining. A mixed model ANOVA or unpaired t-test were used for statistical analysis (P<0.05). Weight, abdominal contour, body mass index, systolic, diastolic and mean arterial pressure increased in the MetS group at weeks 14 and 28. Glucose, triglycerides, LDL, GOT-AST, GOT/GPT, bilirubin and bile acid increased, whereas HDL decreased in the MetS group at weeks 14 and 28. We found a 40% increase in hepatocyte area and lipid vacuoles infiltration in the liver from MetS rabbits. Metabolomic analysis revealed differences in metabolites related to fatty acids, energetic metabolism and microbiota, compounds linked with cardiovascular disease. Administration of high-fat and high-sucrose diet during 28 weeks induced obesity, glucose intolerance, hypertension, non-alcoholic hepatic steatosis and metabolic alterations, thus reproducing the main clinical manifestations of the metabolic syndrome in humans. This experimental model should provide a valuable tool for studies into the mechanisms of cardiovascular problems related to MetS, with special relevance in the study of cardiovascular remodeling, arrhythmias and SCD.


Symposium review: Progesterone effects on early embryo development in cattle.
The causes of low fertility in dairy cattle are complex and multifactorial and may be due to compromised follicle development affecting oocyte quality, a suboptimal reproductive tract environment incapable of supporting normal embryo development, or a combination of both. Progesterone (P4) plays a key role in reproductive events associated with establishment and maintenance of pregnancy, through its effects on oocyte quality and its action on the uterine endometrium. Reduced P4 concentrations during growth of the ovulatory follicle are associated with lower fertility, and low concentrations of circulating P4 after ovulation have been associated with reductions in conceptus growth and elongation, decreased interferon-τ (IFNT) production, and lower pregnancy rates in cattle. In contrast, elevated concentrations of circulating P4 in the period immediately following conception have been associated with advancement of conceptus elongation, increased IFNT production, and, in some cases, higher pregnancy rates in cattle. Despite the potential beneficial effects of exogenous P4 supplementation on fertility, results of supplementation studies have been inconsistent. As part of the 2019 ADSA Reproduction Symposium, focusing on the etiology of pregnancy losses in dairy cattle, the aim of this review is to highlight recent findings from our group and others in relation to embryo-maternal interaction during bovine pregnancy establishment and the role of P4 in uterine biology and embryo development.


Neonatal bone marrow transplantation prevents bone pathology in a mouse model of mucopolysaccharidosis type I.
Neonatal bone marrow transplantation (BMT) could offer a novel therapeutic opportunity for genetic disorders by providing sustainable levels of the missing protein at birth, thus preventing tissue damage. We tested this concept in mucopolysaccharidosis type I (MPS IH; Hurler syndrome), a lysosomal storage disorder caused by deficiency of α-l-iduronidase. MPS IH is characterized by a broad spectrum of clinical manifestations, including severe progressive skeletal abnormalities. Although BMT increases the life span of patients with MPS IH, musculoskeletal manifestations are only minimally responsive if the timing of BMT delays, suggesting already irreversible bone damage. In this study, we tested the hypothesis that transplanting normal BM into newborn MPS I mice soon after birth can prevent skeletal dysplasia. We observed that neonatal BMT was effective at restoring α-l-iduronidase activity and clearing elevated glycosaminoglycans in blood and multiple organs. At 37 weeks of age, we observed an almost complete normalization of all bone tissue parameters, using radiographic, microcomputed tomography, biochemical, and histological analyses. Overall, the magnitude of improvements correlated with the extent of hematopoietic engraftment. We conclude that BMT at a very early stage in life markedly reduces signs and symptoms of MPS I before they appear.


Running speed in mammals increases with muscle n-6 polyunsaturated fatty acid content.
Polyunsaturated fatty acids (PUFAs) are important dietary components that mammals cannot synthesize de novo. Beneficial effects of PUFAs, in particular of the n-3 class, for certain aspects of animal and human health (e.g., cardiovascular function) are well known. Several observations suggest, however, that PUFAs may also affect the performance of skeletal muscles in vertebrates. For instance, it has been shown that experimentally n-6 PUFA-enriched diets increase the maximum swimming speed in salmon. Also, we recently found that the proportion of PUFAs in the muscle phospholipids of an extremely fast runner, the brown hare (Lepus europaeus), are very high compared to other mammals. Therefore, we predicted that locomotor performance, namely running speed, should be associated with differences in muscle fatty acid profiles. To test this hypothesis, we determined phospholipid fatty acid profiles in skeletal muscles of 36 mammalian species ranging from shrews to elephants. We found that there is indeed a general positive, surprisingly strong relation between the n-6 PUFAs content in muscle phospholipids and maximum running speed of mammals. This finding suggests that muscle fatty acid composition directly affects a highly fitness-relevant trait, which may be decisive for the ability of animals to escape from predators or catch prey.


Erroneous laboratory results: what clinicians need to know.
Laboratory tests such as 'conventional biochemistry' are analytically robust and trusted, however, some common tests performed by immunoassays, eg thyroid function tests, are inherently more prone to analytical interference, giving rise to incorrect results. Interfering antibodies capable of causing potentially misleading results in immunoassay varied from about 0.4% to 4%. Furthermore, this form of interference cannot be predicted a priori and cannot be detected even by most stringent laboratory quality control assurance schemes because it is unique to an individual sample. Since more than 10 million immunoassay tests are carried out yearly in the UK alone, the impact of this problem on delivering appropriate patient care can no longer be ignored. Clinicians tend to perceive all laboratory data in the same light. Because of this, increased awareness of the inherent limitations of these laboratory tests should trigger a more measured and thoughtful approach, thus ensuring patients receive appropriate investigations and treatment.


Apnoeic oxygenation in paediatric anaesthesia: a narrative review.
Apnoeic oxygenation refers to oxygenation in the absence of any patient or ventilator effort to move the lungs. This phenomenon was first described in humans in the mid-20th century but has seen renewed interest in the last decade following the demonstration of apnoeic oxygenation with low-flow, and subsequently high-flow, nasal oxygen. This narrative review summarises our understanding of apnoeic oxygenation in the paediatric population. We examine the evidence supporting oxygenation via tracheal tube, modified laryngoscopes and nasal cannulae. The evidence for prolongation of safe apnoea time at induction of anaesthesia is also appraised. We explore the capacity for carbon dioxide clearance, flow rate selection with high-flow nasal oxygen and complications associated with the technique. It remains uncertain whether apnoeic oxygenation in paediatric patients results in a meaningful clinical benefit compared with standard care for outcomes such as the number of tracheal intubation attempts or the incidence of hypoxaemia. In particular, the role of apnoeic oxygenation in paediatric difficult airway management is unclear as this has not been the targeted focus of any published research to date.


Avenues of investigation for the role of catecholamines in anxiety.
Many of the cardinal somatic symptoms associated with anxiety states are produced by the sympathoadrenal medullary discharge of catecholamines (CA) described over 50 years ago as 'fight or flight' responses. During the last decade, development of sensitive convenient assays for CA and their metabolites in tissues, cerebrospinal fluid, plasma and urine has made possible assessment of brain and peripheral adrenergic activity during stress, in neuropsychiatric disorders, and after administration of drugs. Studies in animal models of stress and anxiety parallel studies in humans. In rats, there are genetic differences in the graded adrenergic alerting responses to administered or anticipated stress, analogous to trait anxiety in humans. Behavioral responses to stress may be attenuated in rats by pharmacological blockade of peripheral CA release, suggesting a positive feedback process in which released CA augment behavioral responses, possibly analogous to use of clonidine or beta-adrenergic blocking agents to diminish somatic symptoms attending anxiety-provoking situations in humans. The biochemical evaluation of adrenergic responses by examination of CA and their metabolites in body fluids of humans with various levels of sympathetic activation will be discussed.


Asymmetric band profile of the Soret band of deoxymyoglobin is caused by electronic and vibronic perturbations of the heme group rather than by a doming deformation.
We measured the Soret band of deoxymyoglobin (deoxyMb), myoglobin cyanide (MbCN), and aquo-metmyoglobin (all from horse heart) with absorption and circular dichroism (CD) spectroscopies. A clear non-coincidence was observed between the absorption and CD profiles of deoxyMb and MbCN, with the CD profiles red- and blueshifted with respect to the absorption band position, respectively. On the contrary, the CD and absorption profiles of aquametMb were nearly identical. The observed noncoincidence indicates a splitting of the excited B state due to heme-protein interactions. CD and absorption profiles of deoxyMb and MbCN were self-consistently analyzed by employing a perturbation approach for weak vibronic coupling as well as the relative intensities and depolarization ratios of seven bands in the respective resonance Raman spectra measured with B-band excitation. The respective B(y) component was found to dominate the observed Cotton effect of both myoglobin derivatives. The different signs of the noncoincidences between CD and absorption bands observed for deoxyMb and MbCN are due to different signs of the respective matrix elements of A(1g) electronic interstate coupling, which reflects an imbalance of Gouterman's 50:50 states. The splitting of the B band reflects contributions from electronic and vibronic perturbations of B(1g) symmetry. The results of our analysis suggest that the broad and asymmetric absorption band of deoxyMb results from this band splitting rather than from its dependence on heme doming. Thus, we are able to explain recent findings that the temperature dependences of CO rebinding to myoglobin and the Soret band profile are uncorrelated[Ormos et al., Proc. Natl. Acad. Sci U.S.A. 95, 6762 (1998)].


Molecular Computing and Bioinformatics.
Molecular computing and bioinformatics are two important interdisciplinary sciences that study molecules and computers. Molecular computing is a branch of computing that uses DNA, biochemistry, and molecular biology hardware, instead of traditional silicon-based computer technologies. Research and development in this area concerns theory, experiments, and applications of molecular computing. The core advantage of molecular computing is its potential to pack vastly more circuitry onto a microchip than silicon will ever be capable of-and to do it cheaply. Molecules are only a few nanometers in size, making it possible to manufacture chips that contain billions-even trillions-of switches and components. To develop molecular computers, computer scientists must draw on expertise in subjects not usually associated with their field, including organic chemistry, molecular biology, bioengineering, and smart materials. Bioinformatics works on the contrary; bioinformatics researchers develop novel algorithms or software tools for computing or predicting the molecular structure or function. Molecular computing and bioinformatics pay attention to the same object, and have close relationships, but work toward different orientations.


Effects of vaginal versus oral misoprostol to terminate second-trimester pregnancy.
Using surgical methods compared to medical methods, such as misoprostol for termination of pregnancy, has several side effects. This study was performed in order to compare the effect of vaginal and oral misoprostol in second-trimester pregnancy termination (14-24 weeks). The authors performed a clinical trial study in 40 pregnant women at 14 to 24 weeks of gestation and candidates for medical interruption of pregnancy. All patients received 600 microg of vaginal misoprostol as primary dosage and then, were placed randomly in two groups consisting of 20 patients that received 400 microg of vaginal or oral misoprostol, every four hours, up to three doses. If the abortion was incomplete, oxytocin was used. Twenty-four hours after the procedure, uterine sonography was performed in all patients and if residue was found, the patients were then candidates for curettage. Seventeen patients (85%) in the vaginal group and 17 patients (85%) in the oral group had successful pregnancy interruption. The mean interval until the discharge of pregnancy products in the vaginal group (15/42 +/- 10/84) showed no significant difference compared to the oral group (12/65 +/- 7/8) and no significant differences in side-effects were found between the two groups. Oral misoprostol is as effective as vaginal misoprostol in performing second-trimester abortion. It appears that the vaginal misoprostol primary dose together with the continuation of oral dose is not more effective compared to the vaginal misoprostol method alone.


Accuracy of a Smartphone-Based Artificial Intelligence Application for Classification of Melanomas, Melanocytic Nevi, and Seborrheic Keratoses.
Current artificial intelligence algorithms can classify melanomas at a level equivalent to that of experienced dermatologists. The objective of this study was to assess the accuracy of a smartphone-based "You Only Look Once" neural network model for the classification of melanomas, melanocytic nevi, and seborrheic keratoses. The algorithm was trained using 59,090 dermatoscopic images. Testing was performed on histologically confirmed lesions: 32 melanomas, 35 melanocytic nevi, and 33 seborrheic keratoses. The results of the algorithm's decisions were compared with those of two skilled dermatologists and five beginners in dermatoscopy. The algorithm's sensitivity and specificity for melanomas were 0.88 (0.71-0.96) and 0.87 (0.76-0.94), respectively. The algorithm surpassed the beginner dermatologists, who achieved a sensitivity of 0.83 (0.77-0.87). For melanocytic nevi, the algorithm outclassed each group of dermatologists, attaining a sensitivity of 0.77 (0.60-0.90). The algorithm's sensitivity for seborrheic keratoses was 0.52 (0.34-0.69). The smartphone-based "You Only Look Once" neural network model achieved a high sensitivity and specificity in the classification of melanomas and melanocytic nevi with an accuracy similar to that of skilled dermatologists. However, a bigger dataset is required in order to increase the algorithm's sensitivity for seborrheic keratoses.


Thermal nucleation of kink-antikink pairs in the presence of impurities: the case of a Remoissenet-Peyrard substrate potential.
Thermal nucleation of kink-antikink pairs in a nonlinear Klein-Gordon (NKG) model with a Remoissenet-Peyrard (RP) substrate potential in the presence of impurities and coupled to an applied field is analyzed in the limits of moderate temperature and strong damping. Using the Kolmogorov method, the average velocity of particles of the lattice is calculated and its dependence on the intensity of impurities is discussed in connection with the deformability parameter or the shape of the RP substrate potential. Numerical values are carried out by making use of parameters of the hydrogen atom adsorbed in the tungsten and ruthenium substrates. We show that, for large values of the applied field, the presence of impurities in the system makes the nucleation process of kink-antikink pairs more favorable in the high-temperature regime while they contribute to make it less favorable in the low-temperature regime.


Patient selection for upper airway stimulation: is concentric collapse in sleep endoscopy predictable?
Upper airway stimulation is an effective treatment option for obstructive sleep apnea after failure of positive airway pressure (PAP) therapy. To ensure a therapeutic effect, closed-loop hypoglossal nerve implants require the absence of palatal complete concentric collapse during sleep endoscopy. The frequency and potential predictors of this exclusion criterion are unknown. Over a 2-year period, 74 consecutive patients with sleep apnea who sought PAP alternatives were evaluated with sleep endoscopy using propofol. The influence of sleep apnea severity and anthropometric characteristics as predictors of sleep endoscopy results was investigated. One-fifth of all patients showed a concentric collapse. Gender and age did not predict the presence of concentric collapse, but higher body mass and apnea hypopnea index values were predictive (p = 0.011; e.g., 0.026). The most commonly used body mass index values for upper airway stimulation indications demonstrated acceptable specificity (BMI 32 kg/m(2) 0.71, 95 % confidence interval = 0.57, 0.82; e.g., 35 kg/m(2) 0.81, 95 % confidence interval = 0.69, 0.90). Despite the association with overweight, a significant number of severely overweight patients had no concentric palatal collapse. Concentric collapse is a somewhat common condition encountered in sleep endoscopy evaluations of PAP alternatives, and cannot be sustainably predicted with anthropometric or sleep assessments. Sleep surgeons should be aware of the possibility of concentric collapse, especially in candidates who are more overweight and have severe sleep apnea. Sleep endoscopy can be useful for providing information about continuous positive airway pressure (CPAP) alternatives or to motivate patient adherence to treatment.


The role of endoscopic ultrasonography in the evaluation of pancreatico-biliary cancer.
Accurate staging of pancreatico-biliary cancer is essential for surgical planning and for identification of locally advanced and metastatic disease that is incurable by surgery. The complex regional anatomy of the pancreatico-biliary system makes histologic diagnosis of malignancy at this region difficult. The ability to position the endoscopic ultrasound transducer at endoscopy in direct proximity to the pancreas and the bile duct, combined with the use of fine-needle aspiration, enables accurate preoperative staging of cancer, especially cancer too small to be characterized by CT or MRI. Endoscopic ultrasonography (EUS) identifies patients unlikely to be cured by surgery due to vascular invasion or regional nodal metastasis, thereby limiting procedure-related morbidity and mortality. This article focuses on the utility and recent advances of EUS in the evaluation of pancreatico-biliary cancer.


First record of Lutzomyia evansi (Nuñez-Tovar 1924) in Mexico (Diptera: Psychodidae, Phlebotominae).
The phlebotomine sand fly Lutzomyia evansi is recorded in Mexico for the first time. This species is a suspected vector of Leishmania infantum in other parts of its geographical range and was captured in a focus of American visceral leishmaniasis where the principal vector, Lu. longipalpis sensu lato, was also found. The relative public health importance of the two species in the study area (Chiapas state, Southern Mexico) is discussed.


An exploratory, randomized, parallel-group, open-label, relative bioavailability study with an additional two-period crossover food-effect study exploring the pharmacokinetics of two novel formulations of pexmetinib (ARRY-614).
Pexmetinib (ARRY-614) is a dual inhibitor of p38 mitogen-activated protein kinase and Tie2 signaling pathways implicated in the pathogenesis of myelodysplastic syndromes. Previous clinical experience in a Phase I dose-escalation study of myelodysplastic syndrome patients using pexmetinib administered as neat powder-in-capsule (PIC) exhibited high variability in pharmacokinetics and excessive pill burden, prompting an effort to improve the formulation of pexmetinib. A relative bioavailability assessment encompassed three parallel treatment cohorts of unique subjects comparing the two new formulations (12 subjects per cohort), a liquid oral suspension (LOS) and liquid-filled capsule (LFC) and the current clinical PIC formulation (six subjects) in a fasted state. The food-effect assessment was conducted as a crossover of the LOS and LFC formulations administered under fed and fasted conditions. Subjects were divided into two groups of equal size to evaluate potential period effects on the food-effect assessment. The geometric mean values of the total plasma exposures based upon area-under-the-curve to the last quantifiable sample (AUClast) of pexmetinib were approximately four- and twofold higher after administration of the LFC and LOS formulations, respectively, than after the PIC formulation, when the formulations were administered in the fasted state. When the LFC formulation was administered in the fed state, pexmetinib AUClast decreased by <5% compared with the fasted state. After administration of the LOS formulation in the fed state, pexmetinib AUClast was 34% greater than observed in the fasted state. These results suggest that the LFC formulation of pexmetinib may achieve greater exposures with lower doses due to the greater bioavailability compared to the PIC, and remain unaffected by coadministration with food.


Perfusion reversed-phase high-performance liquid chromatography/mass spectrometry analysis of intact soybean proteins for the characterization of soybean cultivars.
Perfusion reversed-phase HPLC (RP-HPLC)-electrospray mass spectrometry (ESI-MS) was employed for the characterization of soybean cultivars through the analysis of intact soybean proteins. The similarities and differences between yellow soybeans (the most usual soybeans) and other beans with different pigmentation (green, red, and black) commercialized as soybean were investigated. Red beans commercialized as azuki that are frequently sold as red soybean were also analyzed. Separation was carried out using a perfusion column at a flow-rate of 0.5 mL/min and a gradient elution. A step-by-step procedure was used for the optimization of the mass spectrometry parameters enabling the most sensitive detection. The method was applied to the analysis of the above-mentioned beans and the main soybean proteins (11S and 7S globulins) obtained by a fractionation procedure. MS spectra obtained from every peak in the beans and in their fractions were compared observing clear differences between yellow soybeans and the other beans with different pigmentation. The identification of some soybean proteins in yellow soybeans was also possible.


Frequency and duration of ambulance officer exposure to nitrous oxide and methoxyflurane in New Zealand.
Nitrous oxide (Entonox®) and methoxyflurane (Penthrox®) are inhaled analgesics administered in paramedicine. Occupational exposure to nitrous oxide has been associated with negative health effects, and may inhibit professional capability. The effect of occupational exposure to methoxyflurane has not yet been clearly determined. This study identifies the frequency and duration of ambulance officer (AO) occupational exposure to nitrous oxide and methoxyflurane to provide a foundation for future assessments of occupational toxicity risk. A retrospective database review of Patient Report Forms (PRFs) in 11 months between February 2016 and February 2018 was conducted. Nitrous oxide was available for the first 5 months studied, followed by 6 months methoxyflurane availability. AO-specific measures of attendance, rate of inhaled analgesic use, and duration of analgesic use were determined. Subgroup analysis by AO qualification and rostered work hours was undertaken. A total of 46,759 PRFs were examined, identifying 1,033 cases of nitrous oxide administration and 1456 cases of methoxyflurane was administration. There was a significant increase in the proportion of cases where inhaled analgesia was administered following the replacement of nitrous oxide with methoxyflurane. Relative risk of exposure to methoxyflurane compared with nitrous oxide was 1.22, while median duration of each exposure remained unchanged (32 vs. 33 min). Methoxyflurane via the Penthrox® inhaler was more likely to be administered than nitrous oxide. Most AOs are infrequently exposed to inhaled analgesics and are exposed for durations slightly greater than previously reported. Relative risk of exposure was greatest for lower-qualified AOs. Peak number of exposures and duration values suggest a subset of AOs with higher occupational health risk.


Collisions of localized patterns in a nonvariational Swift-Hohenberg equation.
The cubic-quintic Swift-Hohenberg equation (SH35) has been proposed as an order parameter description of several convective systems with reflection symmetry in the layer midplane, including binary fluid convection. We use numerical continuation, together with extensive direct numerical simulations (DNSs), to study SH35 with an additional nonvariational quadratic term to model the effects of breaking the midplane reflection symmetry. The nonvariational structure of the model leads to the propagation of asymmetric spatially localized structures (LSs). An asymptotic prediction for the drift velocity of such structures, derived in the limit of weak symmetry breaking, is validated numerically. Next, we present an extensive study of possible collision scenarios between identical and nonidentical traveling structures, varying a temperaturelike control parameter. These collisions are inelastic and result in stationary or traveling structures. Depending on system parameters and the types of structures colliding, the final state may be a simple bound state of the initial LSs, but it can also be longer or shorter than the sum of the two initial states as a result of nonlinear interactions. The Maxwell point of the variational system, where the free energy of the global pattern state equals that of the trivial state, is shown to have no bearing on which of these scenarios is realized. Instead, we argue that the stability properties of bound states are key. While individual LSs lie on a modified snakes-and-ladders structure in the nonvariational SH35, the multipulse bound states resulting from collisions lie on isolas in parameter space, disconnected from the trivial solution. In the gradient SH35, such isolas are always of figure-eight shape, but in the present nongradient case they are generically more complex, although the figure-eight shape is preserved in a small subset of cases. Some of these complex isolas are shown to terminate in T-point bifurcations. A reduced model is proposed to describe the interactions between the tails of the LSs. The model consists of two coupled ordinary differential equations (ODEs) capturing the oscillatory nature of SH35 profiles at the linear level. It contains three parameters: two interaction amplitudes and a phase, whose values are deduced from high-resolution DNSs using gradient descent optimization. For collisions leading to the formation of simple bound states, the reduced model reproduces the trajectories of LSs with high quantitative accuracy. When nonlinear interactions lead to the creation or deletion of wavelengths, the model performs less well. Finally, we propose an effective signature of a given interaction in terms of net attraction or repulsion relative to free propagation. It is found that interactions can be attractive or repulsive in the net, irrespective of whether the two closest interacting extrema are of the same or opposite signs. Our findings highlight the rich temporal dynamics described by this bistable nonvariational SH35, and show that the interactions in this system can be quantitatively captured, to a significant extent, by a highly reduced ODE model.


Detection of transforming sequences in human melanomas and leukemias.
DNA extracted from fresh solid human melanoma tumors and untreated acute myeloid leukemic cells was used in two assays designed to detect oncogenes, based on the transfection of murine NIH 3T3 fibroblasts followed by selection of transformed cells in low serum concentration or induction of tumors in athymic mice. Ras and non-ras oncogenes were detected.


[Franco-Mexican medical action and the Mexican Expedition (1864-1867)].
In the days when French expeditionary troops were fighting in Mexico, Napoleon the Third founded a "Mexican Scientific Committee" in the same wave length as his uncle, General Bonaparte in Egypt. The Committee was headquartered in Paris and since April 1864, a "Franco-Mexican Committee" took place at Mexico-City. The medical branch was led, in Paris, by the Baron Hippolyte Larrey and chaired on the spot by Dr Ehrmann; it will become the "Academia de Medicina de Mexico" and published the "Gaceta Medica". Numerous researchs were undertaken and most of them printed in the "Gaceta Medica" with some regards to many diseases, particuliarly Yellow Fever and Typhus. The Academia and Gaceta will last long after war ending and, in 1970, a special session was hallowed to their foundation, more than one century before.


Gamma delta + T cells from patients with psoriatic and rheumatoid arthritis respond to streptococcal antigen.
To investigate cellular immune responses to streptococcal antigens in patients with psoriatic arthritis (PsA). To specifically examine responses of the gamma delta + T cell subset. Proliferation of PsA synovial fluid lymphocytes (SFL) and peripheral blood lymphocytes (PBL) cultured with streptococcal antigen was measured using a 3H thymidine (3HTdr) uptake assay system. gamma delta + T cells from PsA PBL and SFL were phenotyped by flow cytometry. Following culture with streptococcal antigen, gamma delta + enriched SFL were sorted by automated flow cytometry and 3HTdr uptake measured. Patients with PsA and the control group did not differ significantly in their PBL responses to 2 strains of streptococci, one of which was isolated from a patient with guttate psoriasis (Strep 1) and the other from a patient with rheumatic fever (Strep 2). There was also no difference in their responses to a cell wall preparation derived from the former strain. SFL from 8 of 9 patients with PsA responded to both streptococcal strains as did SFL from 3 patients with rheumatoid arthritis (RA). gamma delta + SFL from 7 patients with PsA 3 patients with RA responded only to the psoriasis associated strain. PsA PBL and SFL responded to stimulation by streptococcal antigen but this reactivity was not disease specific. We have demonstrated that gamma delta + T cells from PsA SF proliferated when cultured with a psoriasis associated strain of streptococcus (Strep 1). However, RA gamma delta + SFL responded similarly suggesting that gamma delta + T cell reactivity to streptococcal antigen may be a feature of inflammatory arthritis.


Exploring negative evaluations of health care by Polish patients: an attempt at cross-cultural comparison.
Understanding patient dissatisfaction is essential as it provides information on how to improve the relationship between healthcare users and medical professionals. The aim of this paper is to determine how Polish patients verbally express negative opinions of their healthcare services, and to compare the patterns of opinion-giving behaviour between patients in Poland and Western Europe. A qualitative approach employing in-depth interviews was used. Nine primary healthcare centres were chosen in various regions of Poland, taking into account both type of practice, i.e. small and large, and location of residence, i.e. urban (small and large towns) and rural. In every centre, interviews were performed with four patients coming consecutively to their family physician. Thirty-six patients aged 20-78 years were interviewed. Their views could be categorised into eight reasons for avoiding expressing negative opinions: unpleasant emotions induced by giving a negative evaluation; avoiding offending healthcare providers; fear that their utterances could have a negative effect on their further medical care; fear of giving a hasty evaluation based on their own inexpert medical knowledge; determinants from recent Polish history; prestige of the medical profession; entrusting the most important aspect of life, i.e. health, to a doctor; and lack of faith that their opinions could cause change for the better. The respondents used certain rhetorical tricks to soften their criticisms. Patients face cultural barriers to expressing dissatisfaction about their health care. In the Polish context, these are the high social status of the physician and the low position of the patient. In their spontaneous utterances, the respondents gave detailed suggestions for raising the level of patient satisfaction with health care.


Association of Melatonin Production with Seasonal Changes, Low Temperature, and Immuno-Responses in Hamsters.
Seasonal changes impact the melatonin production and immuno-activities in vertebrates. This is believed due to the photoperiodic alterations of the different seasons which impact the functions of pineal gland. The short photoperiod promotes pineal melatonin production. As a result, during the winter, animals have significantly higher levels of melatonin than in summer. However, the seasonal changes also include temperature changes. This factor has never been systemically investigated in animals. In the current study, we observed that increased temperature had limited influence on melatonin production. In contrast, cold temperature is the major factor to induce melatonin production in hamsters. Cold temperature per se can upregulate the expressions of melatonin synthetic gene AANAT and ASMT, which are the important enzymes for melatonin biosynthesis. The elevated melatonin levels induced by the cold exposure in hamster in turn, improve the immuno-responses of the animals with increased levels of IL1, 6, and 10 as well CD3. In addition, melatonin as a potent antioxidant and thermogenic agent would improve the survival chance of animals during cold weather.


Status and trend analysis of prophylactic usage of recombinant factor VIII in Chinese pediatric patients with hemophilia A: ReCare - a retrospective, phase IV, non-interventional study.
No study has reported the status and chronological trend of prophylactic recombinant factor VIII (rFVIII) use in Chinese pediatric patients with hemophilia A (HA). We aimed to analyze the status and trend of rFVIII-containing prophylaxis in Chinese pediatric patients with HA. ReCARE (Retrospective study in Chinese pediatric hemophilia A patients with rFVIII contained REgular prophylaxis) was a retrospective study conducted in 12 hemophilia treatment centers across China. The trend of prophylaxis was evaluated by determining the mean duration of prophylaxis, mean injection frequency (per week), mean dose of each injection (IU/kg), mean total dose injected/week (IU) and proportion of rFVIII consumption relative to factor VIII (FVIII) consumption over the study period. We analyzed 183 male pediatric patients with HA (mean age, 7.1 ± 4.23 years), who received intermittent prophylaxis between 1 November 2007 and 31 May 2013. The mean duration of prophylaxis with rFVIII increased from 16.72 weeks in 2008 to 32.77 in 2012. Per injection dose of rFVIII increased significantly from 2008 to 2013 (25.89 to 28.31 IU/kg, p < .001). An increase was also reported in the mean total FVIII consumed (699.97 ± 173.25 IU in 2008 and 891.30 ± 730.341 in 2013) and mean proportion of rFVIII used (33.33 ± 57.73% in 2008 to 85.50 ± 29.077% in 2013). Our data revealed an overall improvement in treatment dosage and duration with an increase in the number of patients receiving prophylaxis. The total proportion of rFVIII also increased gradually indicating the development of economy and safety awareness. The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT02263066).


Post-cardiac Arrest Syndrome in Children.
Although sustained return of spontaneous circulation (ROSC) can be initially established after resuscitation in children, many of the children do not survive to discharge because they developped a post cardiac arrest syndrome. The post-cardiac arrest syndrome includes systemic ischaemia/reperfusion response, post-cardiac arrest brain injury, postcardiac arrest myocardial dysfunction, and persistent precipitating pathology. The main cause of death after ROSC in children is brain injury. Physiopathology and management are reviewed in regards of pediatric specificities. Management according to ABCDE includes airway and ventilation management, oxygen therapy, hemodynamic management with early goal directed therapy and protection of the brain against secondary injury by therapeutic hypothermia, management of seizures and control of glycemia.


Achieving value in mobile health applications for cancer survivors.
This study aimed to identify appropriate development and testing strategies for mobile health applications for cancer survivors. In January of 2016, we conducted a PubMed search for mobile applications for cancer survivors. A total of 32 articles were selected for inclusion, including 13 review articles, and 19 articles describing an mHealth application or intervention. We assessed mobile app development and testing strategies and standards as described in these articles. We identified seven elements of patient empowerment applications for cancer survivors, strategies for application development that take advantage of smartphone capabilities, issues for consideration in developing new applications, and steps for creating user-centered mobile health applications that provide meaningful value for cancer survivors. However, few mobile health apps implemented empowerment elements, underwent rigorous design approaches, or included assessment of use in the cancer survivor population. There is tremendous potential for mobile health apps to benefit cancer survivors. However, there are specific issues for consideration in developing new applications and steps for creating user-centered applications which are not routinely used. This diminishes the value for the cancer survivor population but could be easily addressed through standardized development and testing procedures. Smartphone applications have the potential to improve the cancer survivorship experience, but users should look for evidence that the application was appropriately developed and tested.


[« Doctor, I have a little erection problem ! »].
Erectile dysfunction (ED) is a common condition that affects nearly one in three men age 50 and more than one in two after 70 years. It is often multifactorial and shares risk factors with coronary heart disease, which is an early marker. Its management involves an etiological research, a modifiable risk factors correction and often a treatment with phosphodiesterase type 5 inhibitors (IPDE-5). Follow-up should ensure the effectiveness of treatment and the presence of side effects that could affect medication compliance. Specialized expertise (mainly the urologist, psychiatrist, endocrinologist and cardiologist) is required on a case by case depending on comorbidities, the need for further investigations or no satisfactory IPDE-5 treatment response.


Stimulus-responsive nonclose-packed photonic crystals: fabrications and applications.
Stimulus-responsive photonic crystals (PCs) possessing unconventional nonclosely packed structures have received growing attention due to their unique capability of mimicking the active structural colors of natural organisms (for example, chameleons' mechanochromic properties). However, there is rarely any systematic review regarding the progress of nonclose-packed photonic crystals (NPCs), involving their fabrication, working mechanisms, and applications. Herein, a comprehensive review of the fundamental principles and practical fabrication strategies of one/two/three-dimensional NPCs is summarized from the perspective of designing nonclose-packed structures. Subsequently, responsive NPCs with exciting functions and working mechanisms are sorted and delineated according to their diverse responses to physical (force, temperature, magnetic, and electric fields), chemical (ions, pH, vapors, and solvents), and biological (glucose, organophosphate, creatinine, and bacteria) stimuli. We then systematically introduced and discussed the applications of NPCs in sensors, printing, anticounterfeiting, display, optical devices, etc. Finally, the current challenges and development prospects for NPCs are presented. This review not only concludes the design principle for NPCs but also provides a significant basis for the exploration of next-generation NPCs.


[Ectopic adrenal cortex tissue in the spermatic cord: clinico-surgical implications].
Ectopic corticoadrenal tissue is not a very uncommon finding during orchiopexy in children. The causes can be found in the period of organ development and gonadal migration (spermatic cord). From 1986 to 1990, we have performed 88 orchiopexy procedures in the Urology Service of "San Antonio Abad de Gallarate" Hospital. Only one case (1.13%) of juxta-funicular corticoadrenal ectopia has been observed. The aim of the present study is to determine the correct surgical approach to this incidental finding during surgery of the inguinal canal in pediatric patients.


Porous silicon-based rugate filters.
We report an experimental study of porous silicon-based rugate filters. We performed filter apodization, following a half-apodization approach, which successfully attenuated the sidelobes at both sides of the photonic stop band. We achieved successful reduction of interference ripples through the insertion of index-matching layers on the first and last interfaces. An apodized dielectric mirror and a rugate filter are compared: Appreciable differences in the harmonic presence and stop-band performance were observed and are commented on. Bandwidth control when index contrast is modified is also demonstrated. Finally, the possibility of combining different rugate filter designs to attain more complex responses is demonstrated by the achievement of a multi-stop-band filter. Numerical calculations for design optimization and comparison with experimental data are reported too.


Contrasting female-male mortality ratios after routine vaccinations with pentavalent vaccine versus measles and yellow fever vaccine. A cohort study from urban Guinea-Bissau.
In addition to protection against the target diseases, vaccines may have non-specific effects (NSEs). Measles vaccine (MV) has beneficial NSEs, providing protection against non-measles deaths, most so for girls. By contrast, though protecting against diphtheria, tetanus and pertussis, DTP vaccine is associated with increased female mortality relative to male mortality. In 2008, Guinea-Bissau replaced DTP with the DTP-containing pentavalent vaccine (Penta; DTP-H. influenza type B-Hepatitis B) at 6, 10 and 14weeks and yellow fever vaccine (YF) was to be given with MV. We investigated possible sex-differential mortality rates following Penta and MV+YF vaccination. Bandim Health Project (BHP) registers vaccines given by the three government health centres in the study area and vital status through demographic surveillance. We assessed the association between sex and mortality by vaccination status in Cox proportional hazards models with age as underlying timescale. Follow-up was censored at a subsequent vaccination contact or after 6months of follow-up. Between September 2008 and April 2011, we registered 23,448 vaccination contacts for children aged 42-365days; 17,313 were for Penta and 3028 for MV (2907 co-administered with YF). During follow-up 112 children died. The female/male mortality rate ratio was 1.73 (1.11-2.70) following Penta and 0.38 (0.12-1.19) after MV (p=0.02 for same effect). Adjusting for maternal education or weight-for-age at the time of vaccination did not change the estimates. Penta appears to have the same negative effects on mortality as those seen for DTP. Assessing post-vaccination mortality for boys and girls is necessary to improve the vaccination programme.


Factors influencing psoriasis: an analysis based upon the extent of involvement and clinical type.
A variety of external stimuli are accepted as important in modifying the severity of psoriasis. We sought to determine whether there is any difference in the influence of external factors on psoriasis in relation to extent of involvement or clinical type. A total of 870 psoriasis patients seen between 1982 and 1995 were categorized as mild, moderate, or severe on the basis of extent of the disease, and as guttate, nummular/plaque, or exfoliative/generalized pustular according to clinical type. We then performed a questionnaire survey concerning the influence of external factors such as seasonal changes, sunlight, stress, and pregnancy. These data sets were combined and analysed. The majority of patients stated favorable effects of summer, sunlight, and pregnancy and adverse effects of winter and stress. A statistically significant correlation was noted between the extent of psoriasis and the proportion of patients stating that their disease worsened at times of psychological stress (p < 0.01). We confirmed that psoriasis patients with more extensive involvement experience greater fluctuations in their condition, notice these changes, and therefore relate them to psychological stress.


Effect of bromelain on kaolin-induced inflammation in rats.
The effects of stem bromelain on the plasma kallikrein system, bradykinin levels and plasma exudation at the inflammatory site were examined in rats with a kaolin-induced inflammation of an air pouch. Bromelain (5, 7.5 mg/kg) caused a dose-dependent decrease of bradykinin levels at the inflammatory site and a parallel decrease of the prekallikrein levels in sera. Plasma exudation was also reduced dose dependently. Bradykinin-degrading activity in sera was elevated after treatment with bromelain, although it was unchanged in the pouch fluid. These data indicate that bromelain inhibits plasma exudation through inhibiting the generation of bradykinin at the inflammatory site via depletion of the plasma kallikrein system.


ZnO Nanocrystal Networks Near the Insulator-Metal Transition: Tuning Contact Radius and Electron Density with Intense Pulsed Light.
Networks of ligand-free semiconductor nanocrystals (NCs) offer a valuable combination of high carrier mobility and optoelectronic properties tunable via quantum confinement. In principle, maximizing carrier mobility entails crossing the insulator-metal transition (IMT), where carriers become delocalized. A recent theoretical study predicted that this transition occurs at nρ3 ≈ 0.3, where n is the carrier density and ρ is the interparticle contact radius. In this work, we satisfy this criterion in networks of plasma-synthesized ZnO NCs by using intense pulsed light (IPL) annealing to tune n and ρ independently. IPL applied to as-deposited NCs increases ρ by inducing sintering, and IPL applied after the NCs are coated with Al2O3 by atomic layer deposition increases n by removing electron-trapping surface hydroxyls. This procedure does not substantially alter NC size or composition and is potentially applicable to a wide variety of nanomaterials. As we increase nρ3 to at least twice the predicted critical value, we observe conductivity scaling consistent with arrival at the critical region of a continuous quantum phase transition. This allows us to determine the critical behavior of the dielectric constant and electron localization length at the IMT. However, our samples remain on the insulating side of the critical region, which suggests that the critical value of nρ3 may in fact be significantly higher than 0.3.


Impact of high-fat diet and hypoxia on the serum levels of main vasoconstrictors in male rabbits.
Introduction: During atherosclerosis process, vasoconstriction phenomenon occurs which in turn leads to tissue hypoxia. A few studies have been performed on the combination of atherosclerosis and hypoxia as stressors that may accelerate secretion of constrictors. The aim of present study was to evaluate the effects of atherosclerosis and hypoxia on serum levels of main vasoconstrictors (epinephrine, norepinephrine and renin). Methods: In this interventional study, 32 New Zealand white rabbits were randomly divided into four groups (n = 8): normal diet (control group), normal diet exposed to hypoxia (11%, 10 days), high-fat diet (cholesterol-2%, 8 weeks), and high-fat diet with hypoxia. Later, serum levels of renin, epinephrine and norepinephrine were measured on second, 56th and 66th days. Results: High-fat diet and hypoxia caused significant increase in epinephrine and norepinephrine concentrations on days 56 and 66 compared to the control group (P < 0.05). Also, renin showed significance increase in high-fat diet and high-fat diet+ hypoxia groups compared to the control group (P < 0.05). Conclusion: Both high-fat diet and hypoxia increase renin levels in male rabbits. Furthermore, the combination of high-fat diet and hypoxia immensely increases renin levels. Both hypoxia and combined of high-fat diet and hypoxia increase norepinephrine levels. However epinephrine is only increased in the combination of high-fat diet and hypoxia. So the presence of hypoxia in combination with high-fat diet, cause accelerated and aggravated atherosclerosis.