Emphysema in chronic bronchitis and asthma; a practical therapeutic approach.
Asthma and chronic bronchitis are characterized by bronchial occlusion in expiration. Acute spasmodic asthma, if prolonged, may bring about changes in thoracic structure and diaphragm position which can result in permanent pulmonary inefficiency unless this tendency is corrected by breathing exercises. As expiratory obstruction becomes more chronic, irreversible emphysema develops. Thereafter therapy for bronchopulmonary insufficiency is necessary. The approaches to such therapy have been outlined and briefly evaluated, with emphasis upon the value of intermittent positive-pressure therapy.


Characterization of peptides resulting from digestion of human skin elastin with elastase.
Several pathological disorders are associated with abnormalities in elastic fibers, which are mainly composed of elastin. Understanding the biochemical basis of such disorders requires information about the primary structure of elastin. Since the acquisition of structural information for elastin is hampered by its extreme insolubility in water or any organic solvent, in this study, human skin elastin was digested with elastase to produce water-soluble peptides. Tandem mass spectrometry (MS/MS) experiments were performed using conventional electrospray ionization (ESI) and nano-ESI techniques coupled with ion trap and quadrupole time-of-flight (qTOF) mass analyzers, respectively. The peptides were identified from the fragment spectra using database searching and/or de novo sequencing. The cleavage sites of the enzyme and, for the first time, the extent and location of proline hydroxylation in human skin elastin were determined. A total of 117 peptides were identified with sequence coverage of 58.8%. It has been observed that 25% of proline residues in the sequenced region are hydroxylated. Elastase cleaves predominantly at the C-terminals of the amino acids Gly, Val, Leu, Ala, and Ile, and to a lesser extent at Phe, Pro, Glu, and Arg. Our results confirm a previous report that human skin elastin lacks amino acid sequences expressed by exon 26A.


A Case of Disseminated Histoplasmosis Presenting As Adrenal Insufficiency With Granulomatous Hepatitis.
Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the United States, histoplasmosis is endemic in the Mississippi River Valley and Ohio. Histoplasmosis is often asymptomatic in immunocompetent individuals, and severe disseminated cases are more often seen in immunosuppressed patients. Disseminated histoplasmosis often affects the reticuloendothelial system, invading specific visceral organs such as the liver, spleen, and pancreas. The current study presents a unique case of disseminated histoplasmosis in a 64-year-old immunocompetent male. The patient's presentation included a 40-lb weight loss over a year, bilateral adrenal nodules, abnormal liver enzymes, and granulomatous hepatitis, which initially raised suspicion of a malignant etiology. An adrenal mass biopsy showed fungal morphology that confirmed an H. capsulatum infection. Further history showed that the patient recently traveled to Bangladesh, which is thought to be a region endemic to histoplasmosis. This case is noteworthy because disseminated histoplasmosis rarely affects immunocompetent individuals, and an infectious etiology for adrenal insufficiency is exceedingly rare, especially in the United States. The treatment regimen included a 14-day induction therapy of IV amphotericin B followed by outpatient itraconazole, leading to symptom resolution. This case highlights the need to consider an infectious etiology for adrenal insufficiency, especially among immunocompetent individuals who may be at risk after traveling to endemic areas.


Steroid Receptor Coactivator-3 (SRC-3/AIB1) as a Novel Therapeutic Target in Triple Negative Breast Cancer and Its Inhibition with a Phospho-Bufalin Prodrug.
Triple negative breast cancer (TNBC) has the poorest prognosis of all types of breast cancer and currently lacks efficient targeted therapy. Chemotherapy is the traditional standard-of-care for TNBC, but is frequently accompanied by severe side effects. Despite the fact that high expression of steroid receptor coactivator 3 (SRC-3) is correlated with poor survival in estrogen receptor positive breast cancer patients, its role in TNBC has not been extensively investigated. Here, we show that high expression of SRC-3 correlates with both poor overall survival and post progression survival in TNBC patients, suggesting that SRC-3 can serve as a prognostic marker for TNBC. Furthermore, we demonstrated that bufalin, a SRC-3 small molecule inhibitor, when introduced even at nM concentrations, can significantly reduce TNBC cell viability and motility. However, because bufalin has minimal water solubility, its in vivo application is limited. Therefore, we developed a water soluble prodrug, 3-phospho-bufalin, to facilitate its in vivo administration. In addition, we demonstrated that 3-phospho-bufalin can effectively inhibit tumor growth in an orthotopic TNBC mouse model, suggesting its potential application as a targeted therapy for TNBC treatment.


Colonic anastomoses and non-steroidal anti-inflammatory drugs.
Nonsteroidal anti-inflammatory drugs (NSAID) play an important role in the treatment of post-operative pain, particularly in the context of enhanced recovery after colorectal surgery. Several recent articles have suggested that NSAID may have a deleterious effect on colo-colic or colo-rectal anastomoses. The aim of this review is to analyze the evidence based on meta-analyses and cohort studies in the literature. A systematic review of clinical studies identified twelve studies including two meta-analyses and ten comparative cohort studies that included a large number of patients. The data in these studies are heterogeneous, often biased, and do not permit a formal recommendation based on a high level of evidence. The main conclusion of this review is that the balance of benefit vs. risk (analgesic effect/risk of anastomotic disruption) is acceptable; it appears (with a low level of evidence) that a prescription of NSAID for 48h after surgery may be recommended for elective colon surgery. Nevertheless, it is important to respect the specific contra-indications of NSAID and avoid post-operative NSAID use if there are risk factors for anastomotic leakage: advanced age, malnutrition, severe co-morbidities, intra-operative difficulties.


[Three-chamber pacemakers (ventricular resynchronization therapy)].
The medical treatment of patients with Congestive Heart Failure, functional class III-IV, has improved the quality of life, but have not reduced mortality. One group of these patients courses with intraventricular conduction delay and interventricular asynchrony, which worsens ventricular function. Resynchronization therapy is a novel alternative for the management of these individuals.


Nasal airflow after septorhinoplasty.
The changes in nasal function which occur after septorhinoplasty for obstruction were investigated by anterior rhinomanometry in 15 subjects. Objective and subjective measures of outcome were compared. Anterior rhinomanometry was performed after nasal decongestion. These data were mathematically transformed to determine the amount of airflow asymmetry through the nostrils and the stiffness of the nasal valve. The results suggested that the presence of gross airflow asymmetry (> +/- 80%) in patients prior to surgery was a bad prognostic indicator for post-operative satisfaction with the airway. Patient satisfaction with function and cosmetic appearance post-operatively was correlated with the presence of symmetrical nasal airflow. Nasal valve stiffness did not seem to be affected by septorhinoplasty.


Automatic measurement of prosody in behavioral variant FTD.
To help understand speech changes in behavioral variant frontotemporal dementia (bvFTD), we developed and implemented automatic methods of speech analysis for quantification of prosody, and evaluated clinical and anatomical correlations. We analyzed semi-structured, digitized speech samples from 32 patients with bvFTD (21 male, mean age 63 ± 8.5, mean disease duration 4 ± 3.1 years) and 17 matched healthy controls (HC). We automatically extracted fundamental frequency (f0, the physical property of sound most closely correlating with perceived pitch) and computed pitch range on a logarithmic scale (semitone) that controls for individual and sex differences. We correlated f0 range with neuropsychiatric tests, and related f0 range to gray matter (GM) atrophy using 3T T1 MRI. We found significantly reduced f0 range in patients with bvFTD (mean 4.3 ± 1.8 ST) compared to HC (5.8 ± 2.1 ST; p = 0.03). Regression related reduced f0 range in bvFTD to GM atrophy in bilateral inferior and dorsomedial frontal as well as left anterior cingulate and anterior insular regions. Reduced f0 range reflects impaired prosody in bvFTD. This is associated with neuroanatomic networks implicated in language production and social disorders centered in the frontal lobe. These findings support the feasibility of automated speech analysis in frontotemporal dementia and other disorders.


Clinical decision making associated with an undetected odontoid fracture in an older individual referred to physical therapy for the treatment of neck pain.
Resident's case problem. The purpose of this paper is to provide the examination of and decision-making process for a patient referred to physical therapy for the treatment of neck pain following trauma. She was found to have an underlying odontoid fracture that precluded physical therapy intervention. This case involved a 73-year-old woman who had a sudden onset of neck and left upper extremity pain after a fall 15 days prior to her initial physical therapy visit. Conventional cervical spine radiographs completed 1 day prior to her initial physical therapy visit were negative for a fracture. However, several components of this patient's history and physical examination were consistent with a condition for which physical therapy intervention would not be indicated until more definitive cervical spine diagnostic imaging had been completed; more specifically, the physical therapist was primarily concerned about the possibility of an undetected fracture. The referring physician was contacted and immediate magnetic resonance imaging was requested, which revealed a type II fracture of the odontoid. Thirty-four days after her fall, the patient underwent a C1-C2 fusion. When evaluating patients with neck pain who have a history of cervical spine trauma, it is important that physical therapists understand the clinical findings associated with cervical spine fractures, as these findings provide guidance for the use of cervical spine diagnostic imaging and medical referral prior to implementing physical therapy interventions. Diagnosis, level 4.


MicroRNAs in cancer metastasis: biological and therapeutic implications.
Cancer metastasis is the primary cause of cancer-related deaths. The seeding of primary tumours at a secondary site is a highly inefficient process requiring substantial alterations in the genetic architecture of cancer cells. These alterations include significant changes in global gene expression patterns. MicroRNAs are small, non-protein coding RNAs which play a central role in regulating gene expression. Here, we focus on microRNA determinants of cancer metastasis and examine microRNA dysregulation in metastatic cancer cells. We dissect the metastatic process in a step-wise manner and summarise the involvement of microRNAs at each step. We also discuss the advantages and limitations of different microRNA-based strategies that have been used to target metastasis in pre-clinical models. Finally, we highlight current clinical trials that use microRNA-based therapies to target advanced or metastatic tumours.


Ischemia-induced ST-segment elevation: classification, prognosis, and therapy.
The standard 12-lead electrocardiogram (ECG) remains the most useful tool for the diagnosis, early risk stratification, triage, and guidance of therapy in patients with acute coronary syndromes. However, the initial and the terminal part of the QRS complex, the ST segments, and the T waves are influenced by anatomical and metabolic factors such as the "myocardium at risk" and "severity" and "duration" of ischemia. Moreover, there are complex interactions between all these factors. The ECG can identify potential candidates for reperfusion therapy as well as the completeness and success of reperfusion, whereas it can also identify those patients who will have no benefit from reperfusion because of either late arrival or nonischemic etiologies of ECG changes. These patients may have a "pseudo" ST-elevation acute myocardial infarction (STEAMI) or "pseudo-pseudo" STEAMI. The presence of Q waves and additional ST-segment depression and T-wave inversion on the admission ECG in patients with STEAMI may provide us information regarding the potential myocardial reserves, and various ECG scoring systems are in current use for that purpose. The pattern and timing of changes in Q waves, ST segment, and T waves may all be markers of the patency status of the infarct-related artery. We review and discuss each of the dynamic ECG variables during ischemia and reperfusion: the initial QRS (Q and R waves), the terminal QRS (Sclarovsky-Birnbaum score), the ST segment, and the T waves.


Mitochondrial genomes and comparative analyses of Culex camposi, Culex coronator, Culex usquatus and Culex usquatissimus (Diptera:Culicidae), members of the coronator group.
The Coronator Group currently encompasses six morphologically similar species (Culex camposi Dyar, Culex coronator Dyar and Knab, Culex covagarciai Forattini, Culex usquatus Dyar, Culex usquatissimus Dyar, and Culex ousqua Dyar). Culex coronator has been incriminated as a potential vector of West Nile Virus (WNV), Saint Louis Encephalitis Virus (SLEV), and Venezuelan Equine Encephalitis Virus (VEEV). The complete mitochondrial genome of Cx. coronator, Cx. usquatus, Cx.usquatissimus, and Cx. camposi was sequenced, annotated, and analyzed to provide genetic information about these species. The mitochondrial genomes of Cx. coronator, Cx. usquatus, Cx.usquatissimus, and Cx. camposi varied from 15,573 base pairs in Cx. usquatus to 15,576 in Cx. coronator. They contained 37 genes (13 protein-encoding genes, 2 rRNA genes, and 22 tRNA genes) and the AT-rich control region. Comparative analyses of the 37 genes demonstrated the mitochondrial genomes to be composed of variable and conserved genes. Despite the small size, the ATP8, ATP6 plus NADH5 protein-encoding genes were polymorphic, whereas tRNAs and rRNAs were conserved. The control region contained some poly-T stretch. The Bayesian phylogenetic tree corroborated that both the Coronator Group and the Culex pipens complex are monophyletic taxa. The mitochondrial genomes of Cx. coronator, Cx. usquatus, Cx. usquatissimus and Cx. camposi share the same gene composition and arrangement features that match to those reported for most Culicidae species. They are composed of the same 37 genes and the AT-rich control region, which contains poly-T stretches that may be involved in the functional role of the mitochondrial genome. Taken together, results of the dN/dS ratios, the sliding window analyses and the Bayesian phylogenetic analyses suggest that ATP6, ATP8 and NADH5 are promising genes to be employed in phylogenetic studies involving species of the Coronator Group, and probably other species groups of the subgenus Culex. Bayesian topology corroborated the morphological hypothesis of the Coronator Group as monophyletic lineage within the subgenus Culex.


Continent cutaneous diversion.
Continent urinary diversion requires the creation of a reservoir, ureteric implantation and establishment of a continence mechanism in the efferent segment. This review is a short overview on the history of different techniques in current use. Reservoirs with high volume and low pressure can be fashioned by antimesenteric opening and spherical reconfiguration of the bowel. Previously, techniques for ureteric implantation were simply transferred to continent urinary diversion. Currently the need for antirefluxive ureteric implantation techniques is questioned and there is a trend towards refluxive implantation. To create a continence mechanism, simple and reproducible procedures. e.g. the incorporation of the efferent segment into the pouch wall (e.g. appendix stoma, flap valve T mechanism, serosal-lined extramural tunnel) have been developed. Long-term data for different surgical techniques show excellent continence and acceptable complication rates.


[Efficacy of commercially available vaccines against HPV infection in women: a systematic review and meta-analysis].
Persistent HPV infection is a necessary condition for the occurrence of cervical cancer. Prophylactic HPV vaccines have been developed to reduce the incidence of cervical cancer. Two vaccines are commercially available: bivalent (types 16, 18) and quadrivalent (6, 11, 16 and 18). This study aimed to perform a systematic review and metaanalysis of the HPV vaccines' efficacy in women, focusing its performance stratified by clinical outcomes. Randomized controlled trials (RCT) published between 2000 and 2009 were identified from searches of MEDLINE, LILACS and Cochrane Library, and evaluated by two independent reviewers. Six RCT were selected. The vaccines reduced the risk of precursor lesions of cervical cancer, presenting efficacy of 97% (95%CI: 90-99) for CIN 2 and 96% (95%CI: 89-99) for CIN 3, in the per protocol analysis. The efficacies in the analysis by intention to treat were smaller: 63% (95%CI: 52-71) and 42% (95%CI: 26-55), respectively. In order to evaluate its effectiveness on the incidence and mortality rates for cervical cancer, longer-term studies will be needed.


Mdivi-1 Protects CD4+ T Cells against Apoptosis via Balancing Mitochondrial Fusion-Fission and Preventing the Induction of Endoplasmic Reticulum Stress in Sepsis.
Apoptosis of CD4+ T cells plays a central role in the progression of sepsis because it is associated with subsequent immunosuppression and the lack of specific treatment. Thus, developing therapeutic strategies to attenuate the apoptosis of CD4+ T cells in sepsis is critical. Several studies have demonstrated that Mdivi-1, which is a selective inhibitor of the dynamin-related protein 1 (Drp1), attenuates apoptosis of myocardial cells and neurons during various pathologic states. The present study revealed the impact of Mdivi-1 on the apoptosis of CD4+ T cells in sepsis and the potential underlying mechanisms. We used lipopolysaccharide (LPS) stimulation and cecal ligation and puncture (CLP) surgery as sepsis models in vitro and in vivo, respectively. Our results showed that Mdivi-1 attenuated the apoptosis of CD4+ T cells both in vitro and in vivo. The potential mechanism underlying the protective effect of Mdivi-1 involved Mdivi-1 reestablishing mitochondrial fusion-fission balance in sepsis, as reflected by the expression of the mitofusin 2 (MFN2) and optic atrophy 1 (OPA1) , Drp1 translocation, and mitochondrial morphology, as observed by electron microscopy. Moreover, Mdivi-1 treatment reduced reactive oxygen species (ROS) production and prevented the induction of endoplasmic reticulum stress (ERS) and associated apoptosis. After using tunicamycin to activate ER stress, the protective effect of Mdivi-1 on CD4+ T cells was reversed. Our results suggested that Mdivi-1 ameliorated apoptosis in CD4+ T cells by reestablishing mitochondrial fusion-fission balance and preventing the induction of endoplasmic reticulum stress in experimental sepsis.


Pathophysiological consideration of medullary streaks on FLAIR imaging in pediatric moyamoya disease.
OBJECTIVE Medullary streaks detected on fluid-attenuated inversion recovery (FLAIR) imaging have been considered to be reflected ischemic regions in pediatric moyamoya disease. The purpose of this study was to evaluate these medullary streaks both clinically and radiologically and to discuss associated pathophysiological concerns. METHODS The authors retrospectively reviewed data from 14 consecutive pediatric patients with moyamoya disease treated between April 2009 and June 2016. Clinical and radiological features and postoperative imaging changes were analyzed. In 4 patients, hyperintense medullary streaks on FLAIR imaging (HMSF) at the level of the centrum semiovale were detected. RESULTS The HMSF were coincident with hyperintense medullary streaks on a T2-weighted image, though they were not completely coincident with the vasculature on either a T2*-weighted image or contrast-enhanced CT. Analysis revealed significantly higher values in terms of MR angiography scores, number of flow voids of the basal ganglia, and the presence of the medullary artery in the group with HMSF than in those without. In contrast, the presence of white matter damage was significantly less frequent in the HMSF group. All HMSF disappeared after surgery, and the mean apparent diffusion coefficient at the same level was significantly reduced postoperatively. CONCLUSIONS Although HMSF should be associated with collateral circulation in moyamoya disease, other factors may be involved, including stagnated cerebrospinal fluid or vasogenic edema that is relevant to the impaired state of the white matter. Findings in this study provide insight into the pathophysiological basis of the perivascular space in moyamoya disease.


Psychological network analysis of the relations between beliefs about smoking for smokers with and without a recent quit attempt.
Psychological network analysis was used to evaluate the relations between beliefs about cigarette smoking in current smokers with and without a recent quit attempt and determine if these networks differed in global strength (how strongly beliefs are related) or global structure (which beliefs are related). Using two publicly available datasets, the California Smokers' Cohort (CSC; N = 933) and Wave 1 of the Population Assessment of Tobacco and Health (PATH; N = 7855), we evaluated differences in global strength and global structure of the beliefs held by current smokers with and without a recent quit attempt. Strength and structure of networks generated for current smokers with and without a recent quit attempt. In the CSC dataset there were differences between smokers with and without a recent quit attempt in global structure and marginal differences in global strength; the PATH dataset suggested small differences in global strength and structure. The present study suggests that consideration of relations among smoking beliefs may be a valuable contribution to characterizing smoking beliefs when assessing smoking quit attempts.


Polymerase chain reaction-based methods for detection of Listeria monocytogenes: toward real-time screening for food and environmental samples.
A review is presented of nucleic acid amplification-based methodology, specifically polymerase chain reaction (PCR)-based assays, for the detection of Listeria monocytogenes in food and environmental samples. Until recently, developmental challenges including poor sensitivity, due in part to reaction inhibition by components of the sample matrix, and the potential for false-positive reactions have limited routine application of PCR-based screening assays. Commercial assays address these challenges while offering convenient, standardized protocols, a high level of automation, and results within 2 days after the sampling date. Although sample enrichment is necessary to achieve desired detection limits, continued efforts toward template purification will facilitate the development of assays offering real-time, quantitative results. The development of ribonucleic acid (RNA) amplification-based assays may increase in importance, particularly if end-product testing is prioritized by regulatory agencies, as messenger RNA appears to serve as an accurate indicator of cell viability. Further, the increase in target copy number may improve assay sensitivity. PCR-based screening methods offer efficient, reliable results and are ideal for monitoring the presence of L. monocytogenes in foods and in the food processing environment.


Parrots eat nutritious foods despite toxins.
Generalist herbivores are challenged not only by the low nitrogen and high indigestibility of their plant foods, but also by physical and chemical defenses of plants. This study investigated the foods of wild parrots in the Peruvian Amazon and asked whether these foods contain dietary components that are limiting for generalist herbivores (protein, lipids, minerals) and in what quantity; whether parrots chose foods based on nutrient content; and whether parrots avoid plants that are chemically defended. We made 224 field observations of free-ranging parrots of 17 species in 8 genera foraging on 102 species of trees in an undisturbed tropical rainforest, in two dry seasons (July-August 1992-1993) and one wet season (January-February1994). We performed laboratory analyses of parts of plants eaten and not eaten by parrots and brine shrimp assays of toxicity as a proxy for vertebrates. Parrots ate seeds, fruits, flowers, leaves, bark, and insect larvae, but up to 70% of their diet comprised seeds of many species of tropical trees, in various stages of ripeness. Plant parts eaten by parrots were rich in protein, lipid, and essential minerals, as well as potentially toxic chemicals. Seeds were higher than other plant materials in protein and lipid and lower in fiber. Large macaws of three species ate foods higher in protein and lipids and lower in fiber compared to plant parts available but not eaten. Macaws ate foods that were lower in phenolic compounds than foods they avoided. Nevertheless, foods eaten by macaws contained measurable levels of toxicity. Macaws did not appear to make dietary selections based on mineral content. Parrots represent a remarkable example of a generalist herbivore that consumes seeds destructively despite plant chemical defenses. With the ability to eat toxic foods, rainforest-dwelling parrots exploited a diversity of nutritious foods, even in the dry season when food was scarce for other frugivores and granivores.


Diabetes medication incidents in the care home setting.
This article analyses data received from a Freedom of Information Act 2000 request made to the National Patient Safety Agency in June 2010. Information was requested about adverse drug event reports in relation to insulin therapy and oral glucose-lowering agents in the care home setting. Data identified were reported to the National Patient Safety Agency between January 12005 and December 312009 and were processed through the National Reporting and Learning Service. There were 684 reports related to insulin and 84 incidents related to oral glucose-lowering agents. The most common error involved wrong or unclear dose: 173 reports for insulin, including one death, and 20 reports for oral glucose-lowering agents. Evidence shows that residents with diabetes in care homes are at risk of harm from adverse drug events involving insulin and oral glucose-lowering agents.


How to cope with Alzheimer's disease?
Alzheimer's disease (AD) is the most common causative brain disease of primary dementia in the elderly. The incidence of AD rises exponentially with age. Many countries, where the aging population is a national problem, have to face how to cope with AD. The main strategies against AD include the estimation of the exact size of the problem, the elucidation of etiology of AD, the development of effective treatment, and the establishment of the caring system for AD sufferers in the community. A recent fruit of the research is the new cholinomimetic agent E2020 (Donepezil), which is a highly selective acetylcholinesterase inhibitor. As a result of clinical trials, statistically significant improvements were seen in cognitive function of AD patients. However, E2020 is one of the neurotransmitter substitution therapies and is not specifically linked to the etiological treatment. We have to make efforts to establish a definitive therapy for AD and this depends on basic research, such as the molecular biology of AD. Many AD patients and their families expect fruitful result from this symposium, which will be a big milestone for the research of AD toward the 21st Century.


Age-dependent therapeutic effect of memantine in a mouse model of juvenile Batten disease.
Currently there is no treatment for juvenile Batten disease, a fatal childhood neurodegenerative disorder caused by mutations in the CLN3 gene. The Cln3-knockout (Cln3(Δex1-6)) mouse model recapitulates several features of the human disorder. Cln3(Δex1-6) mice, similarly to juvenile Batten disease patients, have a motor coordination deficit detectable as early as postnatal day 14. Previous studies demonstrated that acute attenuation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA)-type glutamate receptor activity by the non-competitive AMPA antagonist, EGIS-8332, in both 1- and 6-7-month-old Cln3(Δex1-6) mice results in improvement in motor coordination. Here we show that acute inhibition of N-methyl-D-aspartate (NMDA)-type glutamate receptors by memantine (1 and 5 mg/kg i.p.) had no effect on the impaired motor coordination of one-month-old Cln3(Δex1-6) mice. At a later stage of the disease, in 6-7-month-old Cln3(Δex1-6) mice, memantine induced a delayed but extended (8 days) improvement of motor skills similarly to that observed previously with EGIS-8332 treatment. An age-dependent therapeutic effect of memantine implies that the pathomechanism in juvenile Batten disease changes during disease progression. In contrast to acute treatment, repeated administration of memantine or EGIS-8332 (1 mg/kg, once a week for 4 weeks) to 6-month-old Cln3(Δex1-6) mice had no beneficial effect on motor coordination. Moreover, repeated treatments did not impact microglial activation or the survival of vulnerable neuron populations. Memantine did not affect astrocytosis in the cortex. EGIS-8332, however, decreased astrocytic activation in the somatosensory barrelfield cortex. Acute inhibition of NMDA receptors can induce a prolonged therapeutic effect, identifying NMDA receptors as a new therapeutic target for juvenile Batten disease.


Association of urinary organophosphate metabolites with adult asthma patients: a cross-sectional population-based study.
Human health is adversely affected by exposure to organophosphate (OP) pesticides. This study aims to investigate the correlation between urinary OP metabolites and the prevalence of asthma. In cross-sectional studies, data from the National Health and Nutrition Examination Survey (NHANES) projects conducted between 2003-2008, 2011-2012, and 2015-2018 were analyzed. Multiple logistic regressions and restricted cubic spline (RCS) regressions were utilized to examine the relationship between four urinary OP metabolites, namely dimethyl phosphate (DMP), diethyl phosphate (DEP), dimethyl phosphorothioate (DMTP), and diethyl phosphorothioate (DETP), and the prevalence of asthma. Additionally, quantile g-computation (QG-C) regression was employed to evaluate the association between urinary OP metabolites (both individual and combined exposures) and asthma prevalence. The results showed that a total of 9316 adults, including 1298 participants with asthma, were included in the analysis. The median age of the participants was 47.37 years, and 50.27% were female. In the comprehensive model, the third tertile of DMP and DEP exhibited a positive association with asthma prevalence compared to the first tertile (odds ratio [95% confidence interval]: 1.26 [1.01-1.57], Ptrend = 0.036; and 1.25 [1.07-1.51], Ptrend = 0.008, respectively). Moreover, a linear relationship was observed between DMP, DEP, and asthma prevalence (P for nonlinearity = 0.320 and 0.553, respectively). The QG-C regression revealed a positive association between the mixture of urinary OP metabolites and asthma prevalence (OR = 1.04 [1.01-1.07], P = 0.025), with DEP contributing the most substantial effect (weight = 0.564). Our findings suggest that exposure to OP pesticides is associated with an increased prevalence of asthma, with DEP demonstrating the strongest impact.


Generation-specific incentives and disincentives for nurse faculty to remain employed.
The aims of this paper are to: (1) describe work characteristics that nurse faculty report encourage them to remain in or leave their academic positions; and (2) determine if there are generational differences in work characteristics selected. Nurse faculty play key roles in preparing new nurses and graduate nurses. However, educational institutions are challenged to maintain full employment in faculty positions. A cross-sectional, descriptive survey design was employed. Ontario nurse faculty were asked to select, from a list, work characteristics that entice them to remain in or leave their faculty positions. Respondent data (n = 650) were collected using mailed surveys over four months in 2011. While preferred work characteristics differed across generations, the most frequently selected incentives enticing nurse faculty to stay were having: a supportive director/dean, reasonable workloads, supportive colleagues, adequate resources, manageable class sizes and work/life balance. The most frequently selected disincentives included: unmanageable workloads, unsupportive organizations, poor work environments, exposure to bullying, belittling and other types of incivility in the workplace and having an unsupportive director/dean. This research yields new and important knowledge about work characteristics that nurse faculty report shape their decisions to remain in or leave their current employment. Certain work characteristics were rated as important among all generations. Where similarities exist, broad strategies addressing work characteristics may effectively promote nurse faculty retention. However, where generational differences exist, retention-promoting strategies should target generation-specific preferences.


Preferential use of the ipsilateral pedicle in TRAM flap breast reconstruction.
Breast reconstruction utilizing the ipsilateral transverse rectus abdominis musculocutaneous (TRAM) flap provides superior results when compared with contralaterally based reconstructions by preserving the medial inframammary fold and eliminating the perixiphoid bulge. Additionally, a longer pedicle can be obtained using the ipsilateral TRAM, thereby allowing greater mobility and flexibility during flap transposition. These findings are based on a retrospective review of 50 consecutive ipsilateral TRAM flap reconstructions in 38 patients. The mean patient age was 45.4 years and mean follow-up was 8.6 months. Thirty-two flaps were performed as immediate reconstructions and 18 flaps were delayed. No patient suffered total flap loss, whereas partial flap loss was observed in three flaps. One patient required suture removal to alleviate venous congestion of the flap. No patient developed a postoperative hernia, but 1 patient required removal of a polytetrafluoroethylene onlay patch following graft exposure. This technique achieves aesthetically pleasing results with acceptable morbidity, allows greater flap mobility without disruption of the medial inframammary fold or creation of a perixiphoid bulge, and is our method of choice for TRAM flap breast reconstruction.


Atypical presentation of syphilis in an HTLV-I infected patient.
We report the case of a 44 year-old female, who presented a long-lasting, clinically atypical, secondary syphilis ("malignant syphilis") in the right foot, which started six months before medical evaluation. The patient had a serological diagnosis of HTLV-I infection and syphilis two years before the onset of the skin lesions, following a blood donation. As she believed she was allergic to penicillin, she initially received sulfamethoxazole + trimethoprim, without any improvement of the clinical picture. After failure of this first treatment regimen, she was given penicillin, which promoted complete healing of the lesion. We found evidence that infection by HTLV-I is capable of modifying the clinical course of secondary syphilis.


Nationwide survey of pediatric septic arthritis in the United States.
The epidemiology of pediatric septic arthritis, such as annual hospitalization rates and disparities by age, gender, race/ethnicity, and socioeconomic status, remains unclear. We obtained hospital discharge records of patients under the age of 20 years with septic arthritis from the kids inpatient database for 2006, 2009 and 2012. We weighted the records to estimate the number of hospitalizations in the US and calculated the annual rates of hospitalization due to septic arthritis. We used multivariable logistic regression to assess risk factors associated with comorbidities of osteomyelitis and bacteremia/septicemia. Overall annual hospitalization rates showed a decreasing trend (4.23, 3.64, and 3.28 per 100,000 children in 2006, 2009, and 2012, respectively). Children who were male, white or black, and between the ages of 0-4 years were more likely to have higher hospitalization rates than others. The proportions of hospitalizations were high among children living in lower-income areas. Large joints at the lower limbs were the most frequently affected sites of infection. Infections of large joints and age category of 10-14 years were the factors that were significantly associated with comorbidities of osteomyelitis and bacteremia/septicemia. We demonstrated a change in the epidemiological patterns of pediatric septic arthritis and identified risk factors associated with comorbidities of osteomyelitis and bacteremia/septicemia.


Cytotoxic T lymphocytes generated across and I-Ab mutant difference are directed against a molecule bearing Ia antigens.
The recently discovered B6.C-H-2bm12 (bm12) histocompatibility mutant bears a mutation of the I-A subregion of the H-2b haplotype. We have studied cytotoxic T lymphocytes (CTL) generated in secondary mixed lymphocyte culture (MLC) between the bm12 mutant and the strain of origin C57BL/6 (B6). In both directions, strong CTL responses were generated against lipopolysaccharide-stimulated, but not against concanavalin A-stimulated target cells. Studies of the specificity of the bm12 anti-B6 CTL response, using target cells from a panel of H-2 recombinants, showed that the CTL were directed against specificities of the I-Ab subregion. This conclusion was confirmed by the observation that the bm12 anti-B6 CTL could be specifically blocked by anti-Iab, but not by anti-Kb antisera. EL4 tumor cells, which express Kb and Db but not Iab antigens, were not lysed by the CTL. The combined data confirm that bm12 is an I-A subregion mutant and indicate that the I-A subregion antigens, recognized by antibody and those recognized by CTL, are probably present on the same molecules. The CTL effector cells generated in secondary MLC across the I-Ab mutant difference had the surface phenotype Lyt 1- 2+.


Influence of preterm delivery on ghrelin and obestatin concentrations in maternal plasm, milk and their expression in mammary epithelial cells.
Ghrelin and obestatin are gastrointestinal peptides with a potential role in the programming of metabolism in newborns. The present study aimed to investigate the influence of preterm delivery on ghrelin and obestatin concentrations in the maternal blood plasma and breast milk as well as their gene expressions in the mammary epithelial cells (MECs). On the 3rd day after delivery, milk and plasma samples were collected from mothers that carried to term or gave birth prematurely (< 36 weeks of gestation) and analyzed for ghrelin and obestatin concentrations. MECs isolated from the milk were analyzed for the relative expression of GHRL splice variants. In both groups ghrelin concentrations were significantly lower in milk than in blood plasma. In the preterm group obestatin concentrations were significantly higher in milk than in blood plasma but significantly lower in comparison to that of the control mothers. The expression of GHRL mRNAs was higher (P < 0.05) in MECs isolated from the preterm group as compared to those isolated from control mothers. The concentration of obestatin (but not ghrelin) in the breast milk is dependent on the term of pregnancy. Moreover, the lactating mammary gland is one of the sources of ghrelin and obestatin.


Permanganate Oxidation of Organic Contaminants and Model Compounds.
Permanganate oxidation is an attractive environmental remediation strategy due to its low cost, ease of use, and wide range in reactivity. Here, permanganate reactivity trends are investigated for model organic compounds and organic contaminants. Second-order permanganate reaction rate constants were compiled for 215 compounds from 82 references (journal articles, conference proceedings, master's theses, and dissertations). Additionally, we validated some phenol rate constants and contribute a few additional phenol rate constants. Commonalities between contaminant oxidation products are also discussed, and we tentatively identify several model compound oxidation products. Aromatic rings, alcohols, and ether groups had low reaction rate constants with permanganate. Alkene reaction sites had the highest reaction rate constants, followed by phenols, anilines, and benzylic carbon-hydrogen bonds. Generally, permanganate reactivity follows electrophilic substitution trends at the reaction site where electron donating groups increase the rate of reaction, while electron withdrawing groups decrease the rate of reaction. Solution conditions, specifically, buffer type and concentration, may impact the rate of reaction, which could be due to either an ionic strength effect or the buffer ions acting as ligands. The impact of these solution conditions, unfortunately, precludes the development of a quantitative structure-activity relationship for permanganate reaction rate constants with the currently available data. We note that critical experimental details are often missing in the literature, which posed a challenge when comparing rate constants between studies. Future research directions on permanganate oxidation should seek to improve our understanding of buffer effects and to identify oxidation products for model compounds so that extrapolations can be made to more complex contaminant structures.


Chemical component separation: a systematic review and meta-analysis of botulinum toxin for management of ventral hernia.
Ventral hernia represents a surgical challenge plagued by high morbidity and recurrence rates. Primary closure of challenging hernias is often prohibited by severe lateral retraction and tension of the abdominal wall musculature. Botulinum toxin injections have recently been identified as a potential pre-operative means to counteract abdominal wall tension, reduce hernia size, and facilitate fascial closure during hernia repair. This systematic review and meta-analysis reviews outcomes associated with botulinum toxin injections in the setting of ventral hernia, and demonstrates an opportunity to leverage this mainstream aesthetic product for use in abdominal wall reconstruction. A literature review was conducted according to PRISMA guidelines using MeSH terms 'ventral hernia', 'herniorrhaphy', 'hernia repair', and 'botulinum toxins'. Relevant studies reporting pre- and postinjection data were included. Outcomes of interest included changes in hernia defect width and lateral abdominal muscle length, recurrence, complications, and patient follow-up. Qualitative findings were also considered to help demonstrate valuable themes across the literature. Of 133 results, 12 were included for qualitative review and three for quantitative analysis. Meta-analysis revealed significant hernia width reduction (mean = 5.79 cm; n = 29; p < 0.001) and lateral abdominal wall muscular lengthening (mean = 3.33 cm; n = 44; p < 0.001) following botulinum injections. Mean length of follow-up was 24.7 months (range = 9-49). Botulinum toxin injections offer tremendous potential in ventral hernia management by reducing hernia width and lengthening abdominal wall muscles prior to repair. Although further studies are needed, there is a significant opportunity to bridge the knowledge gap in preoperative practice measures for ventral hernia risk reduction.


OKT3 muromonab as second-line and subsequent treatment in recipients of stem cell allografts with steroid-resistant acute graft-versus-host disease.
We retrospectively evaluated response to monoclonal antibody directed against CD3 (OKT3) treatment in 43 patients with steroid-resistant acute graft-versus-host disease (aGvHD) following allogeneic hematopoietic cell transplantation. Median duration of OKT3 therapy was 9 (range, 1-20) days. In all, 20 cycles were administered as second-line and 28 as third-plus line treatment. Side effects were mild to moderate. Overall response rate was 69 with 12% complete remissions and best response in skin involvement. Proportional reduction of concomitant steroids was higher in responding patients. Five patients (12%) achieved durable responses. Pharmacokinetic studies of OKT3 showed adequate plasma levels (> or = 1000 ng/ml) in 13 of 17 evaluable patients after a median of 6 (1-11) days on treatment. OKT3 became undetectable shortly after discontinuation of therapy. Median survival for all patients was 80 (2 to 2474+) days. There was a trend for better survival for patients on second-line vs third-plus line treatment (146 vs 46 days; P=0.07) and significant longer survival for patients with grade II when compared to those with grade III/IV aGvHD (206 vs 47 days; P=0.039). We conclude that salvage treatment with OKT3 shows considerable efficiency, however, sometimes of transient nature, and is well tolerated in patients with corticosteroid-resistant aGvHD.


Patients selection for awake neurosurgery.
Based upon the surgical location and indication, including redundant regions, eloquent areas, deep brain stimulation, and epilepsy foci, some patients will benefit from an awake craniotomy, which allows completion of neurocognitive testing during the intra-operative period. This paper suggests patient selection criteria through a new decision algorithm. We completed a retrospective chart review at Tampa General Hospital after IRB approval; data were obtained concerning total number of craniotomies, indications, and problems experienced for selection of awake vs. general anesthetic techniques. A total of 397 craniotomies were performed during the two years 2005 and 2006: among those 79 patients received an awake craniotomy (20%). We have utilized a sedation sequence which includes dexmedetomidine, propofol and LMA placement. A skull block is then performed to anesthetize pin placement, and desflurane and remifentanil are used for maintenance until the dural incision. At this time the inhalation agent is stopped and the LMA is removed while breathing spontaneously: the patient remains sedated on dexmedetomidine and remifentanil for the duration of the operation and can communicate effectively if closely coached. Analysis of all patient data led us to a decision tree to guide the surgeon and anesthesiologist in selecting the awake patients. We describe the sequence of steps and anesthetic agents which has proved successful for our group. Finally, the use of the proposed decision algorithm simplifies preoperative anesthetic selection and prevents erroneous assignment of inappropriate patients to an awake technique.


Role of FDFT1 polymorphism for fibrosis progression in patients with chronic hepatitis C.
In chronic hepatitis C (CHC), steatosis is associated with fibrosis and impaired response to antiviral therapy. Recently, a polymorphism of single nucleotide polymorphism SNP rs2645424 of farnesyl diphosphate farnesyl transferase 1 (FDFT1) was identified in NAFLD/NASH as a possible causal link to steatosis and fibrosis progression. SNP rs738409 in the adiponutrin gene (PNPLA3) is a well described factor for steatosis. This study evaluated the relation of these SNPs on steatosis, fibrosis and treatment response in CHC. The SNPs rs738409478 and rs2645424 were determined by real-time PCR in 478 patients with CHC (m/f: 314/164; mean age: 44.9 ± 10.7; GT1: 387, GT4: 91) who completed treatment with peg-IFN-α-2a/ribavirin. All had a pretreatment liver biopsy. Steatosis and fibrosis were graded by board-certified pathologists according to Brunt and METAVIR respectively. The distribution of FDFT1 rs2645424 was GG: 186 (38.9%), AG: 222 (46.4%) and AA: 70 (14.6%) and of the rs738409 PNPLA3 allele: CC: 269 (56.3%), CG: 177 (37.0%) and GG: 32 (6.7%). Overall, FDTF1 polymorphism was not linked to the extent of steatosis or fibrosis. However, in patients without steatosis the AA genotype was associated with advanced fibrosis [AA: 8/20 (40.0%), AG: 6/70 (8.5%), GG: 9/57 (16.1%), P = 0.003]. In contrast, the minor PNPLA3 allele was associated with both steatosis and advanced fibrosis (P < 0.001). Both SNPs did not influence treatment response. The minor allele in FDFT1 was associated with advanced fibrosis in the non-steatotic but not in the steatotic subgroup. This may reflect different metabolic pathways in fibrosis progression for steatotic and non-steatotic patients with CHC.


Homogeneous apoenzyme reactivation immunoassay for thyroxin-binding globulin in serum.
In this automated apoenzyme reactivation immunoassay system (Ames Optimate) for thyroxin-binding globulin (TBG), the sample and N6-aminohexylflavin adenine dinucleotide-labeled TBG react sequentially with antiserum. Then apoglucose oxidase is added to combine with the free fraction and generate glucose oxidase activity, which is measured colorimetrically. The assay requires 100 microL of sample and covers the clinically significant range for TBG (less than 2.5 to 55 mg/L). The first result is obtained in 16 min; assay of 29 samples and their blanks is completed in less than 1 h. The lower limit of detection is about 2.5 mg/L. Between-assay CVs (n = 9) were less than 9%, within-assay CVs (n = 5) were less than 6%, and analytical recovery of TBG was 103-112%. Reagents are stable at 4 degrees C for at least five months. Results by this method for serum TBG (y) compared well with those determined by radioimmunoassay (x): y = 1.029x--0.352 (r = 0.990, n = 49, Syx = 1.165 mg/L). In addition, with 39 other sera the ratio of total thyroxin (by RIA) to TBG compared well with free thyroxin measured by equilibrium dialysis (r = 0.930) and the free thyroxin index (r = 0.970).


Contributing to the ICNP: validating the term 'informal settlement'.
The specific aims of this study were to propose a definition of the term informal settlement, validate the term informal settlement, and submit a term and definition for international utilization to the International Council of Nurses (ICN) for consideration for inclusion in the International Classification of Nursing Practice (ICNP). South Africa was one of four African countries (Botswana, South Africa, Swaziland and Zimbabwe) funded by the WK Kellogg Foundation to participate in the ICNP project. South Africa had two research groups. One of the research groups identified the term informal settlement to define. This was a qualitative study where a philosophical perspective was used to explore, explain and describe nursing practice. The combined method proposed by the ICN was utilized to define and validate the term informal settlement. Validation and literature review provided sufficient support for the defined characteristics and the term was finally defined and submitted to ICN on 12 April 2001 as informal settlement is a type of residential development with the specific characteristics--temporary residential structures, erected with limited or no formal infrastructure, densely populated, no secure tenure for occupants, no property demarcations, often associated with overcrowding/limited or no privacy, and low standard of living, being situated in high risk areas with an increased risk for disease and disasters. The ICNP Evaluation Committee recommended inclusion in the ICNP with minor changes in February 2003.


Adoption studies of schizophrenia.
The understanding and treatment of schizophrenia have been greatly hampered by uncertainty about etiological factors and controversy about diagnostic boundaries. Adoption studies have helped clarify both of these problems. First, the adoptees study method, the index offspring of adopting-away schizophrenic biological parents are compared with control adoptees whose adopting-away parents were non-schizophrenic. Earlier studies have found increased illness in the index adoptees, thus supporting a genetic hypothesis. Additionally, in this approach the comparison of index versus control adoptive rearing families permits the assessment of environmental joint or interaction effects. An on-going Finnish study appears to provide evidence supporting both genetic and environmental main effects, as well as joint effects. Secondly, in the adoptees' relatives method, the biological relatives of schizophrenic index adoptees are compared with the biological relatives of non-schizophrenic control adoptees. A Danish study found that the relatives not only have more frequent typical, narrowly defined schizophrenia but also have more 'latent', non-psychotic forms of the illness. Thus, the adoption studies of schizophrenia are proving valuable in establishing the significance of both genetic and environmental contributions to the illness and in clarifying the diagnostic criteria for a genetically relevant syndrome.


Cytogenetics and sperm ultrastructure of Atelopus spumarius (Anura, Bufonidae) from the Brazilian Amazon.
The current taxonomy of most Atelopus species is based on morphological and color data only. Recent studies suggest that A. spumarius may represent a species complex assigned under the same name. Karyotypic data and description of sperm ultrastructure for 13 specimens of A. spumarius are presented here for the first time. A chromosomal analysis revealed 2n = 22 chromosomes, with centromeric heterochromatin in all pairs and a nucleolar organizer region (NOR) on the telomere of pair 7. The sperm was of the bufonoid type, presenting a filiform nucleus covered by an acrosomal complex and a mitochondrial collar in the neck region. The tail was composed of an axoneme, an undulating membrane and an axial rod. A karyotype analysis of A. spumarius showed the same chromosome number and similar chromosomal morphology as described for congeneric species, with slight differences probably resulting from pericentric inversions. The NOR location (on pair 7) was the same as that observed for species belonging to the genus Rhinella. The spermatological findings indicate a close relationship between Atelopus and the bufonoid lineage. The present data are useful for reference in future studies to determine whether more than one species are assigned to A. spumarius.


Involvement of efflux pumps in the resistance to peptidoglycan synthesis inhibitors in Mycobacterium tuberculosis.
We evaluated the contributions of Mycobacterium tuberculosis efflux pumps towards intrinsic resistance to different classes of peptidoglycan synthesis inhibitors (PSI). Our study indicates that the efflux pump knockout strains are more susceptible to PSI than the wild type. Vancomycin and ceftriaxone exhibited up to 3 log increased kill on efflux pump mutants compared to the wild-type strain, strongly suggesting an important role for efflux pumps in the intrinsic resistance of M. tuberculosis to PSI.


Some reflections on postgraduate medical ethics education.
Three goals of teaching medical ethics to physicians are reviewed. Components of a basic course in medical ethics are described with special attention to the roles of case conferences, ethics rounds, and role modeling. Obstacles to teaching ethics are also addressed.


[Effects of S-alpha-chlorohydrin on male ICR mice fertility].
To study the effects of S-alpha-chlorohydrin on male ICR mice mating index, fertility index and the histopathologic changes of testis and epididymis. 64 sexually mature male ICR mice were randomly divided into four groups, each group contained 16 mice. At the doses of 1/40, 1/20 and 1/10LD50 (mice oral, LD50 117.54 mg/kg) S-alpha-chlorohydrin (ACH) were administrated consecutively by oral gavage to male ICR mice, while equal volume redistilled water was given to the controls. At the 5th day mating tests were started, and four male mice from each group were mated with females at a ratio of 1:1. The mating test was carried out every other day until 2 months, and the mating index and the male fertility index induced by S-alpha-chlorohydrin were observed. 6 male mice from each group were exposed with S-alpha-chlorohydrin for another 6 months, and then epididymal cauda sperm counts and histopathological changes in the testes and epididymides were evaluated. (1) In Comparison with control groups, the mating index and male fertility index in male mice exposed to S-alpha-chlorohydrin for two months at any dose level were not changed; (2) There were no significant changes in cauda sperm count between treated and control groups, and no obvious histopathological injuries were observed in testes and epididymides of treated mice. Long term exposure to S-alpha-chlorohydrin less than 1/40LD50 did not induce antifertility effects in male ICR mice.


Catalytic Properties of Amylolytic Enzymes Produced by Gongronella butleri Using Agroindustrial Residues on Solid-State Fermentation.
Amylases catalyze the hydrolysis of starch, a vegetable polysaccharide abundant in nature. These enzymes can be utilized in the production of syrups, alcohol, detergent, pharmaceutical products, and animal feed formulations. The aim of this study was to optimize the production of amylases by the filamentous fungus Gongronella butleri by solid-state fermentation and to evaluate the catalytic properties of the obtained enzymatic extract. The highest amylase production, 63.25 U g-1 (or 6.32 U mL-1), was obtained by culturing the fungus in wheat bran with 55% of initial moisture, cultivated for 96 h at 25°C. The enzyme presented optimum activity at pH 5.0 and 55°C. The amylase produced was stable in a wide pH range (3.5-9.5) and maintained its catalytic activity for 1 h at 40°C. Furthermore, the enzymatic extract hydrolyzed starches from different vegetable sources, presenting predominant dextrinizing activity for all substrates evaluated. However, the presence of glucose was observed in a higher concentration during hydrolysis of corn starch, indicating the synergistic action of endo- and exoamylases, which enables the application of this enzymatic extract to produce syrups from different starch sources.


[The possible pathways of IL-2 stimulation of colony formation by bone marrow cells irradiated in vitro].
The authors have made an attempt to find out the reasons of IL-2 stimulation of spleen colony growth by in vitro (1 Gy) irradiated bone marrow cells. It was shown that the effect of IL on haemopoiesis manifests itself with merely small radiation doses implying that the influence of the preparation makes the process of haemopoietic organ repopulation start at a higher level of cell survival, which is presumably related to a more active repair of radiation-induced CFUs damages: this leads, with other things being equal (e.g. proliferation rate and f factor), to a higher yield of colonies than it is observed with the recipients protected with the exposed bone marrow only.


Global Efforts against HIV Epidemic and HIV Vaccine Development.
Although the tremendous effort has been paid by scientists for creating HIV vaccine over the past three decades since the discovery of HIV-1, the HIV vaccine development still has a long way to go. Only one HIV vaccine, RV144, has been proved to be moderately effective by the clinical trials, but there has been much debate about its usefulness. The difficulties of HIV vaccine development includes the attacks to host's immune system by HIV and the emergence of various escape mutants. The necessity of large clinical trials for the proof of efficacy also makes HIV vaccine development difficult. One the other hand, Treatment as Prevention (TasP) or Preexposure Prophylaxis (PrEP) has revealed to be highly effective for HIV prevention. Those preventive strategies using antiretroviral therapy is one of the recent main stream of HIV policy worldwide. However, it is believed that a sustained end of the HIV pandemic is guaranteed by the combination of nonvaccine prevention and the development of a safe and effective HIV vaccine. The continuous efforts are needed for the HIV vaccine development.


Use of 3-dimensional computed tomography reconstruction studies in the preoperative assessment of patients undergoing balloon dilatation for tracheobronchial stenosis.
Balloon dilatation (BD) is a useful method of treating tracheobronchial stenosis (TBS); however, accurate preoperative identification of the lesion is difficult. Three-dimensional computed tomography (3D-CT) is an imaging method that may allow more accurate definition of the lesion(s) preoperatively. It is the aim of this study to present our finding using 3D-CT as a part of the preoperative evaluation of patients with TBS undergoing BD. We studied a prospective case series of 17 consecutive patients who underwent 29 BDs for TBS from a variety of benign and malignant causes at a tertiary care hospital. All patients had a preoperative spiral CT; these data were processed by a software program, VIDA, which was developed at this institution, and 3D-CT reconstruction images of the TBS were created. This enabled accurate preoperative anatomic definition of the lesion. The patients subsequently underwent BD. All 17 patients had lesions identified with 3D-CT. Six patients had tracheal lesions and 12 patients had main stem lesions. One patient had combined tracheal and main stem lesions and 2 other patients had bilateral main stem lesions. Nine out of 17 patients required only one BD. One patient had a failed BD. The remaining 6 patients required more than one BD for optimal results (up to a maximum of 4). The follow-up period ranged from 1 to 34 months. 3D-CT offers accurate definition of TBS, including anatomic location, number of lesions present and status of airway distal to lesion. In this study, all preoperative lesions were correctly identified prior to BD.


Characterization of the components of urban particulate matter mediating impairment of nitric oxide-dependent relaxation in intrapulmonary arteries.
We have previously shown that exposure to urban particulate matter (UPM) impairs endothelial nitric oxide (NO) bioactivity in intrapulmonary arteries. As UPM is composed of heterogeneous constituents, the aim of this study was to clarify the class of pollutants responsible for such effect. Extracts (aqueous, acidic or organic) were prepared from SRM1648, an UPM sample collected in St. Louis (MO, USA). The metal composition of extracts as well as endotoxin content was determined. The effects of each extract, metal mixture and endotoxin were evaluated on endothelium-dependent relaxation to acetylcholine (reflecting endothelial NO production) in rat isolated intrapulmonary arteries. Aqueous or organic SRM1648 pretreatment altered acetylcholine-induced relaxation, similar to that induced by native SRM1648. Organic extract induced similar attenuation of acetylcholine relaxation than organic-treated SRM1648, whereas aqueous extract had no effect. Acidic pretreatment, which impoverished metal and endotoxin content of SRM1648, prevented the impairment of acetylcholine-induced relaxation. However, neither the acidic extract enriched in metals, nor a metal mixture representative of SRM1648 content, modified acetylcholine relaxation, while endotoxin impaired it. Polymyxin B, which chelates endotoxin, prevented SRM1648-induced decrease in relaxation to acetylcholine. It is concluded that SRM1648-induced impairment of endothelial NO-dependent relaxation in intrapulmonary arteries unlikely involved a soluble factor released by vascular cells during UPM exposure, but rather an organic extractible and acidic-sensitive constituents of UPM. Endotoxin, but not metals, may be responsible for UPM-induced impairment of endothelial NO-dependent relaxation.


Antibacterial Compounds from Marine Bacteria, 2010-2015.
This review summarizes the reports on antibacterial compounds that have been obtained from marine-derived bacteria during the period 2010-2015. Over 50 active compounds were isolated during this period, most of which (69%) were obtained from Actinobacteria. Several compounds were already known, such as etamycin A (11) and nosiheptide (65), and new experiments with them showed some previously undetected antibacterial activities, highlighting the fact that known natural products may be an important source of new antibacterial leads. New broad-spectrum antibacterial compounds were reported with activity against antibiotic resistant Gram-positive and Gram-negative bacteria. Anthracimycin (33), kocurin (66), gageotetrins A-C (72-74), and gageomacrolactins 1-3 (86-88) are examples of compounds that display promising properties and could be leads to new antibiotics. A number of microbes produced mixtures of metabolites sharing similar chemical scaffolds, and structure-activity relationships are discussed.


Terbinafine resistance conferred by multiple copies of the salicylate 1-monooxygenase gene in Trichophyton rubrum.
Resistance to antifungals is a leading concern in the treatment of human mycoses. We demonstrate that the salA gene, encoding salicylate 1-monooxygenase, is involved in resistance of the dermatophyte Trichophyton rubrum to terbinafine, one of the most effective antifungal drugs against dermatophytes. A strain with multiple copies of salA was constructed and exhibited elevated expression of salA and increased terbinafine resistance. This reflects a mechanism not yet reported in a pathogenic fungus.


Gender-sensitive school environment and bullying victimization among adolescent girls: A multilevel study in Nepal.
Bullying is an understudied global social problem. While school-level factors are a recognized influence on bullying victimization, the elements of a 'girl-friendly' school that may reduce the risk of bullying victimization among girls and prevent dropout is understudied in lower- and middle-income countries (LMICs). This study used baseline data from the evaluation of the Room-to-Read (RtR) Girls' Education Program (GEP) in Nepal to assess the relationship of a conceptually grounded gender-equitable school (GES) index with girls' risk of direct and relational bullying victimization, adjusted for potential confounders at the individual and school levels. The school sample included all 24 RtR GEP schools and 25 community schools attended by girls in a comparison cohort, representing 729 grade six girls with complete outcome data. We employed multilevel negative binomial regression to assess the relationship between the GES score (higher scores indicate greater support for girls), and girls' risk of peer victimization, controlling for individual- and school-level covariates. On average, girls reported 2.84 direct victimizations and 0.27 relational victimizations in the prior week. The first component of the GES index, a generalized measure of school-level support for girls, showed a significant negative relationship with weekly relational bullying victimization in models with all school- and individual-level covariates. In the full model, a one-point higher score on the generalized GES component accounted for a 26% lower risk of relational bullying victimization in the prior week. School-level policies, practices, and pedagogy designed to support girls may reduce their exposure to relational aggression, a form of bullying that girls most often perpetrate. In LMICs, the school may be an ideal place to raise awareness about the types and effects of peer bullying and to promote prosocial bystander behavior. Further research is needed to identify factors related to other forms of bullying.


[Study on etiology of nongonococcal urethritis].
One thousand one hundred and fifty-seven samples from urogenital tract were detected by isolating culture and immunofluorescence. The positive rates of Chlamydia trachomatis (CT), Ureaplasma Urealyticum (UU), Mycoplasma hominis (Mh), Candida (Cd), Staphylococcus aureus were 27.8%, 33.5%, 25.6%, 11.5%, 23% respectively. The rate of mixed infection caused by at least two pathogens was 19.8%. About 90% of the infected patients were from 20 to 40 years old. The related factors of pathogen detection were also studied.


Patient Satisfaction as a Moderator of Risky Alcohol Consumers' Attitude Towards Screening and Brief Intervention: A Cross Sectional Survey.
Although shown to be effective, General Practitioners (GPs) tend to refuse the implementation of Screening and Brief Intervention (SBI). Their expectation of negative response by patients seems to contrast with the positive attitude towards SBI of these patients. This discrepancy may be resolved by regarding moderators such as drinking status and patient satisfaction. We hypothesized that the attitude towards SBI will be more positive for abstainers or low-level consumers in comparison to high risk consumers especially in case of low patient satisfaction. Ten GP offices in Germany received the questionnaires for a recruitment maximum of 30 patients each. Patient satisfaction was measured by the Koelner Questionnaire of Patient Satisfaction and drinking status was evaluated using the AUDIT-C. To assess the SBI attitude a pretested 8-item Likert scale was used. Questionnaires of 257 patients could be analyzed. Almost a third of patients were risky consumers (N = 78, 29.9%). They showed a more negative attitude towards SBI (M = 3.99, SD = 0.71) than abstainers or low-level consumers (M = 4.20, SD = 0.55). The main analysis revealed main effects for alcohol consumption, F(1, 252) = 4.31, P < 0.05, and patient satisfaction, F(1, 252) = 22.15, P < 0.001, as well as an interaction effect, F(1, 252) = 5.01, P < 0.05, showing that the SBI attitude of risky consumers was more negative than the SBI attitude of abstainers or low-level consumers only in case of low satisfaction. Risky consumers show a more positive attitude towards SBI when they are satisfied with their GP. Our results thus suggest the use of a supportive consultation style for the intervention of risky consumers. SBI attitude of general practice patients depends on their drinking status: abstainers or low-level consumers revealed a more positive attitude towards SBI than risky consumers. This effect is moderated by the patient's satisfaction. Risky consumers show a more positive attitude towards SBI if they are satisfied with their GP.


Quality of education predicts performance on the Wide Range Achievement Test-4th Edition Word Reading subtest.
The current study examined whether self-rated education quality predicts Wide Range Achievement Test-4th Edition (WRAT-4) Word Reading subtest and neurocognitive performance, and aimed to establish this subtest's construct validity as an educational quality measure. In a community-based adult sample (N = 106), we tested whether education quality both increased the prediction of Word Reading scores beyond demographic variables and predicted global neurocognitive functioning after adjusting for WRAT-4. As expected, race/ethnicity and education predicted WRAT-4 reading performance. Hierarchical regression revealed that when including education quality, the amount of WRAT-4's explained variance increased significantly, with race/ethnicity and both education quality and years as significant predictors. Finally, WRAT-4 scores, but not education quality, predicted neurocognitive performance. Results support WRAT-4 Word Reading as a valid proxy measure for education quality and a key predictor of neurocognitive performance. Future research should examine these findings in larger, more diverse samples to determine their robust nature.


[Advance in signal analysis of auditory evoked potential].
Signal analysis of the auditory evoked potential (AEP) has been the interesting field in biomedicine and signal processing for a long time. Recent advances in the analytic method of AEP are summed up in this paper. Seven methods, including spectral analysis, adaptive filtering, wavelet transform, chaos theory, artificial neutral network, regularization, and independent component analysis are mainly introduced. All of them are promising for extracting the signal with less stimulation and adequate quality, and for displaying their efficient application in the analysis of AEP.


Risk of falls in the rheumatic patient at geriatric age.
Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in the case of patients after joint arthroplasty surgeries. The specificity of rheumatic patient's falls is determined by numerous factors. It is not always possible to avoid them. However, it becomes vital to include fall prevention in the rehabilitation process as well as to prepare the house for the needs of an elderly person so that they are safe and as self-dependent as possible.


Absence of L-histidine lyase and histidine imidazole metabolites in human adenomatous prostate.
The histidine metabolism in homogenates of human tissues of nontreated benign prostatic hyperplasia has been examined by means of the determination of L-histidine ammonia lyase activity (EC 220.127.116.11;histidine alpha-deaminase, histidase) and the histidine imidazole metabolites which were separated by means of ion exchange chromatography. Neither enzymatic activity nor metabolites of histidine could be detected. It is concluded that non-treated benign prostatic hyperplasia lacks L-histidine ammonia lyase activity and subsequently the metabolic pathway of histidine.


Morphology, ecophysiology and germination of seeds of the neotropical tree Alibertia patinoi (Rubiaceae).
Alibertia patinoi (Rubiaceae) is of economic and cultural importance for communities in the Colombian Pacific and Amazon regions, where it is cultivated and mature fruits are highly appreciated and consumed. Since there is a lack of knowledge of the seed physiology of this species, we describe here the germination behavior and morphometry of seeds of Alibertia patinoi, and relate them to its habitat. Fruits were collected from a mixed food crop and a commercial plantation in Guaimía village, Buenaventura, Colombia, a tropical rain forest area. We measured length, width, thickness, mass (n = 1 400), and moisture content of seeds (n = 252). Primary dormancy tests were conducted (n = 200), followed by imbibition (n=252) and germination dynamics, under different conditions of light and temperature specific to understory and forest clearings (n = 300 seeds). Finally, seed storage behavior was established (n = 100 seeds). We observed that size and mass of seeds had a narrow range of values that did not differ within or among fruits and that the species did not exhibit primary dormancy. The seeds are recalcitrant, and recently harvested seeds exhibited higher seed moisture content (ca. 44%) and continuous metabolism. The seed germination percentage was observed to be higher under the specific dense canopy forest light and temperature conditions; furthermore, neither enriched far-red light nor darkness conditions inhibited germination. We concluded that rapid germination could be the establishment strategy of this species. Also, the physiological traits (i.e., rapid germination rate, low germination requirements, absence of primary dormancy, and recalcitrant behavior) and seed size and mass, suggest that A. patinoi is adapted to conditions of mature tropical rain forests.


Nyssorhynchus darlingi genome-wide studies related to microgeographic dispersion and blood-seeking behavior.
In Brazil, malaria is concentrated in the Amazon Basin, where more than 99% of the annual cases are reported. The main goal of this study was to investigate the population structure and genetic association of the biting behavior of Nyssorhynchus (also known as Anopheles) darlingi, the major malaria vector in the Amazon region of Brazil, using low-coverage genomic sequencing data. Samples were collected in the municipality of Mâncio Lima, Acre state, Brazil between 2016 and 2017. Different approaches using genotype imputation and no gene imputation for data treatment and low-coverage sequencing genotyping were performed. After the samples were genotyped, population stratification analysis was performed. Weak but statistically significant stratification signatures were identified between subpopulations separated by distances of approximately 2-3 km. Genome-wide association studies (GWAS) were performed to compare indoor/outdoor biting behavior and blood-seeking at dusk/dawn. A statistically significant association was observed between biting behavior and single nucleotide polymorphism (SNP) markers adjacent to the gene associated with cytochrome P450 (CYP) 4H14, which is associated with insecticide resistance. A statistically significant association between blood-seeking periodicity and SNP markers adjacent to genes associated with the circadian cycle was also observed. The data presented here suggest that low-coverage whole-genome sequencing with adequate processing is a powerful tool to genetically characterize vector populations at a microgeographic scale in malaria transmission areas, as well as for use in GWAS. Female mosquitoes entering houses to take a blood meal may be related to a specific CYP4H14 allele, and female timing of blood-seeking is related to circadian rhythm genes.


Transthyretin Antisense Oligonucleotides Lower Circulating RBP4 Levels and Improve Insulin Sensitivity in Obese Mice.
Circulating transthyretin (TTR) is a critical determinant of plasma retinol-binding protein 4 (RBP4) levels. Elevated RBP4 levels cause insulin resistance, and the lowering of RBP4 levels improves glucose homeostasis. Since lowering TTR levels increases renal clearance of RBP4, we determined whether decreasing TTR levels with antisense oligonucleotides (ASOs) improves glucose metabolism and insulin sensitivity in obesity. TTR-ASO treatment of mice with genetic or diet-induced obesity resulted in an 80-95% decrease in circulating levels of TTR and RBP4. Treatment with TTR-ASOs, but not control ASOs, decreased insulin levels by 30-60% and improved insulin sensitivity in ob/ob mice and high-fat diet-fed mice as early as after 2 weeks of treatment. The reduced insulin levels were sustained for up to 9 weeks of treatment and were associated with reduced adipose tissue inflammation. Body weight was not changed. TTR-ASO treatment decreased LDL cholesterol in high-fat diet-fed mice. The glucose infusion rate during a hyperinsulinemic-euglycemic clamp was increased by 50% in high-fat diet-fed mice treated with TTR-ASOs, demonstrating improved insulin sensitivity. This was also demonstrated by 20% greater inhibition of hepatic glucose production, a 45-60% increase of glucose uptake into skeletal and cardiac muscle, and a twofold increase in insulin signaling in muscle. These data show that decreasing circulating TTR levels or altering TTR-RBP4 binding could be a potential therapeutic approach for the treatment of type 2 diabetes.


PubMed searches: overview and strategies for clinicians.
PubMed is a biomedical and life sciences database maintained by a division of the National Library of Medicine known as the National Center for Biotechnology Information (NCBI). It is a large resource with more than 5600 journals indexed and greater than 22 million total citations. Searches conducted in PubMed provide references that are more specific for the intended topic compared with other popular search engines. Effective PubMed searches allow the clinician to remain current on the latest clinical trials, systematic reviews, and practice guidelines. PubMed continues to evolve by allowing users to create a customized experience through the My NCBI portal, new arrangements and options in search filters, and supporting scholarly projects through exportation of citations to reference managing software. Prepackaged search options available in the Clinical Queries feature also allow users to efficiently search for clinical literature. PubMed also provides information regarding the source journals themselves through the Journals in NCBI Databases link. This article provides an overview of the PubMed database's structure and features as well as strategies for conducting an effective search.


The effect of diet on the spontaneous insulin dependent diabetic syndrome in the rat.
We have fed rats prone to developing spontaneous insulin dependent diabetes mellitus (IDDM) defined diets in which casein was the sole source of protein and the fat content was either menhaden oil, safflower oil, or corn oil. The incidence of IDDM was compared to that in litter mates fed rat chow. Animals receiving the defined diets had a lower frequency of overt IDDM than did animals receiving rat chow. The effect was seen only when the diet was introduced before the animals had reached the age of 30 days. The defined diets did not affect the distribution of peripheral blood T lymphocytes. Rats fed defined diets had decreased intensity of expression of Class I major histocompatibility complex (MHC) products on the endocrine cells of the pancreas compared to animals receiving rat chow.


The effect of auditory stressors on cognitive flexibility.
Stress is known to activate the noradrenergic system which may have a modulatory influence on cognitive flexibility. We investigated whether an auditory stressor would thus affect performance on cognitive flexibility. A task utilizing cognitive flexibility and two memory tasks were presented in both stressful and non-stressful condition. In the stressful condition performance was impaired for the cognitive flexibility task but not for the memory tasks, arguing against the stressor serving as a general distracter. These findings suggest that stress caused by an auditory stressor may negatively impact performance on more complex tasks requiring a rapid search of the semantic and lexical associative networks.


Efficient "total" extraction of perfluorooctanoate from polytetrafluoroethylene fluoropolymer.
To determine the optimum conditions for the complete extraction of perfluorooctanoate (PFO) from polytetrafluoroethylene fluoropolymers, sample preparation and pressurized solvent extraction (PSE) conditions were investigated. Solvent extraction temperature, solvent residence time, relaxation time between extractions, and the effects of heating before PSE showed that methanol at 150 degrees C extraction temperature and a 12 min solvent residence time were the most efficient conditions. Preheating the polymer before extraction at 150 degrees C for 24 h significantly enhanced the quantity of PFO removed. Heating above 150 degrees C resulted in loss of PFO. PFO was determined by liquid chromatography with tandem mass spectrometry.


Precise identification and manipulation of adsorption geometry of donor-π-acceptor dye on nanocrystalline TiO₂ films for improved photovoltaics.
Adsorption geometry of dye molecules on nanocrystalline TiO2 plays a central role in dye-sensitized solar cells, enabling effective sunlight absorption, fast electron injection, optimized interface band offsets, and stable photovoltaic performance. However, precise determination of dye binding geometry and proportion has been challenging due to complexity and sensitivity at interfaces. Here employing combined vibrational spectrometry and density functional calculations, we identify typical adsorption configurations of widely adopted cyanoacrylic donor-π bridge-acceptor dyes on nanocrystalline TiO2. Binding mode switching from bidentate bridging to hydrogen-bonded monodentate configuration with Ti-N bonding has been observed when dye-sensitizing solution becomes more basic. Raman and infrared spectroscopy measurements confirm this configuration switch and determine quantitatively the proportion of competing binding geometries, with vibration peaks assigned using density functional theory calculations. We further found that the proportion of dye-binding configurations can be manipulated by adjusting pH value of dye-sensitizing solutions. Controlling molecular adsorption density and configurations led to enhanced energy conversion efficiency from 2.4% to 6.1% for the fabricated dye-sensitized solar cells, providing a simple method to improve photovoltaic performance by suppressing unfavorable binding configurations in solar cell applications.


On the scaling properties of oscillatory modes with balanced energy.
Animal bodies maintain themselves with the help of networks of physiological processes operating over a wide range of timescales. Many physiological signals are characterized by 1/f scaling where the amplitude is inversely proportional to frequency, presumably reflecting the multi-scale nature of the underlying network. Although there are many general theories of such scaling, it is less clear how they are grounded on the specific constraints faced by biological systems. To help understand the nature of this phenomenon, we propose to pay attention not only to the geometry of scaling processes but also to their energy. The first key assumption is that physiological action modes constitute thermodynamic work cycles. This is formalized in terms of a theoretically defined oscillator with dissipation and energy-pumping terms. The second assumption is that the energy levels of the physiological action modes are balanced on average to enable flexible switching among them. These ideas were addressed with a modelling study. An ensemble of dissipative oscillators exhibited inverse scaling of amplitude and frequency when the individual oscillators' energies are held equal. Furthermore, such ensembles behaved like the Weierstrass function and reproduced the scaling phenomenon. Finally, the question is raised whether this kind of constraint applies both to broadband aperiodic signals and periodic, narrow-band oscillations such as those found in electrical cortical activity.


Safety and effectiveness of an aggressive and individualized bath-PUVA regimen in the treatment of psoriasis.
The optimal therapeutic regimen of bath-PUVA therapy of psoriasis is still under debate. We investigated the safety and efficacy of an aggressive and individualized bath-PUVA regimen. Two closely matched groups of 22 psoriatic patients were treated either with 30-min baths in 0.0003% 8-methoxypsoralen (8-MOP) aqueous solution or oral administration of the drug. According to the standard European regimen, treatments were delivered 4 times a week starting with the minimal phototoxic dose. Complete clearing or marked improvement was observed in all the patients. However, with bath-PUVA, the same therapeutic effect required smaller cumulative UVA doses (39.3 +/- 15.8 vs. 123.8 +/- 39.9 J/cm2) and lower numbers of exposures (15.2 +/- 4.4 vs. 20.6 +/- 4.2). Both differences were significant at the 0.01 level (Student's t test). Gastro-intestinal side-effects were of course restricted to oral 8-MOP. The incidences of burns and pruritus were similar. Using an aggressive and individualized schedule, bath-PUVA therapy showed a greater efficacy than oral PUVA therapy while being just as safe.


Adolescent varicocele: is it a unilateral disease?
To evaluate the incidence of left and right varicocele in adolescents. The study group consisted of 28 adolescents who underwent evaluation for varicocele at our clinic. In 19 patients, varicocele was detected on routine physical examination, and 9 patients presented with scrotal pain or discomfort. All patients were evaluated by three methods. Physical examination was followed in all cases by contact thermography and venography studies of both testes. The rate of left and right retrograde flow in the spermatic veins by the three methods used was as follows: physical examination 92.8% and 10.7%; contact thermography 100% and 89%; and venography 100% and 85.7%, respectively. Varicocele was not detected by physical examination in 2 (7.2%) of the 28 patients on the left side and in 21 (87.5%) of 24 on the right side. The main finding of this study was that varicocele is a bilateral disease in 85.7% of adolescents. The high percentage of bilateral varicocele in our sample may explain the pathophysiologic mechanism whereby what has traditionally been considered a unilateral disease can produce bilateral testicular dysfunction. The high incidence of subclinical bilateral varicocele may indicate that we should consider varicocele a bilateral disease. The second finding was that only 10% of patients with right varicocele were diagnosed by physical examination and more than 85% were diagnosed by thermography, with confirmation by venography. Therefore, we suggest that thermography and venography should play a major role in the diagnosis of varicocele.


[A comparative study between real time monitor KH-3000 and conventional Durham sampler measuring airborne pollen].
Real time monitoring of airborne pollen has gradually increased because monitoring is laborsaving and provides better real-time information. A problem arose, however, due to differences between the KH3000 (Yamato Co. Ltd) monitor and the conventional Durham sampler pointed out in results of airborne pollen monitoring in Wakayama in 2004. We compared the two monitors for airborne pollen in Wakayama in 2004, which less dispersed than usual. The peak monitored by the KH-3000 monitor was not consistent with the prime period of Japanese cedar and cypress pollen dispersion, especially in February and April, although they correlated highly in March. The inconsistency in February is thought to be caused by snow, and that in April by falsely monitoring beech-tree airborne pollen-which is similar in size-in addition to Japanese cedar and cypress pollen. This report points out the need to take these conditions (snow and other plants pollen) into account when a real time monitor is used for collecting pollen information.


Evaluation of genetic diversity of Fusarium head blight resistance in European winter wheat.
Genetic diversity in relation to Fusarium head blight (FHB) resistance was investigated among 295 European winter wheat cultivars and advanced breeding lines using 47 wheat SSR markers. Twelve additional wheat lines with known FHB resistance were included as reference material. At least one SSR marker per chromosome arm, including SSR markers reported in the literature with putative associations with QTLs for FHB resistance, were assayed to give an even distribution of SSR markers across the wheat genome. A total of 404 SSR alleles were detected. The number of alleles per locus ranged from 2 to 21, with an average of 8.6 alleles. The polymorphism information content of the SSR markers ranged from 0.13 (Xwmc483) to 0.87 (Xwmc607), with an average of 0.54. Cluster analysis was performed by both genetic distance-based and model-based methods. In general, the dendrogram based on unweighted pair-group method with arithmetic averages showed similar groupings to the model-based analysis. Seven clusters were identified by the model-based method, which did not strictly correspond to geographical origin. The FHB resistance level of the wheat lines was evaluated in field trials conducted over multiple years or locations by assessing the following traits: % FHB severity, % FHB incidence, % diseased kernels, in spray inoculation trials, and % FHB spread and % wilted tips, in point inoculation trials. Association analysis between SSR markers and the FHB disease traits detected markers significantly associated with FHB resistance, including some that have not been previously reported. The percentage of variance explained by each individual marker was, however, rather low. Haplotype analysis revealed that the FHB-resistant European wheat lines do not contain the 3BS locus derived from Sumai 3. The information generated in this study will assist in the selection of parental lines in order to increase the efficiency of breeding efforts for FHB resistance.


Endoscope reprocessing: Retrospective analysis of 90,311 samples.
Background and study aims The contamination level of ready-to-use endoscopes published in the literature varies from 0.4 % to 49.0 %. Unfortunately, the comparison and the interpretation of these results are quite impossible, given the limited number of samples and sites included and the differences observed between sampling, culturing methods, and interpretation criteria. Methods The objective of this retrospective study was to analyze the results of 90,311 endoscope samples collected between 2004 and 2021 in 490 private or public hospitals in France. Results Through the full test period, the mean ratio of endoscopes at the action level was 12.6 % (19.5 % including alert level). Of the endoscopy units, 23.0 % had a ratio of compliant endoscopes ≤ 70.0 %. The overall microbial quality of gastroscopes, duodenoscopes, and colonoscopes is improving year by year, whereas an opposite trend is observed for ultrasound endoscopes and bronchoscopes. In 2021, following French guidelines, 13.0 % of the endoscopes should have been quarantined and 8.1 % were at the alert level, meaning that the contamination level of 21.1 % of the endoscopes exceeded what was defined as a maximum acceptable value. Conclusions This study demonstrates that additional efforts, including implementation of microbial surveillance strategies using a standardized sampling method and periodic observational audits, must be made to improve the overall microbiological quality of endoscopes and reduce the risk associated with their use.


A family based model of Hispanic adolescent substance use.
While adolescent substance use has been the focus of extensive research over the last few decades, Hispanic adolescent substance use has received only limited attention. Studies exploring predictors of Hispanic adolescent substance use have failed to adequately explore the contribution of the family on substance use. The present study examined the relative influence of family, school and peer influences, perceived student substance use, family substance use, and acculturation on a sample of Mexican-American early adolescents using structural equations modeling. The findings varied for males and females. Family functioning and family use directly influenced substance use for males. Family functioning influenced school and peer variables, however, these were unrelated to use. For females, family use and student use directly influenced substance use. Family functioning influenced family use and school and peer attachments. School and peer attachment predicted perceived student use. These findings suggest that family functioning has a primary role in Hispanic adolescent substance use.


Guideline Compliance in Surgery for Thyroid Nodules - A Retrospective Study.
Diagnostic guidelines for thyroid nodules focus on malignancy risk assessment to avoid unnecessary diagnostic operations. These guidelines recommend a combination of tests in form of a diagnostic algorithm. The present study analyzed the recommended algorithm and its implementation by different medical professionals. Preoperative diagnostic procedures, laboratory tests and histopathological findings of patients who underwent thyroid surgery between 2006 and 2013 were analyzed. The results were stratified by the assignation by specialized endocrinologists (ENP), general practitioners (GP) or Goethe-University Hospital Frankfurt (UKF). 677 patients were enrolled, of these 62% were assigned by UKF, 18.5% by an ENP and 19.5% by a GP. Ultrasonography rate was significantly higher in UKF (97.6%) compared to patients assigned by GP (90.9%, p<0.0001). Rates for fine-needle aspiration cytology ranged between 47.6% in UKF and 23.2% in ENP (p<0.0001). In over 93% of the patients an analysis of thyroid-stimulating hormone and triiodothyronine/thyroxin was realized. The overall malignancy rate was 11.82%. The malignancy rate was significantly higher if a FNA biopsy was performed (16.35 vs. 8.94%; p=0.0048). A higher malignancy rate could only be seen if the preoperative diagnostic workup included FNA. Besides this, the grade of algorithm adherence showed no effect on the malignancy rate.


Dinuclear zinc complexes using pentadentate phenolate ligands.
The synthesis and characterization of 15 dinuclear zinc complexes are reported, including the X-ray crystal structures of 5 complexes. The ligand motif utilizing p-cresol as a bridging unit between the two zinc centers and a set of three related ligands has been synthesized; 2,6-bis(R)-p-cresol (where R is CH(2)NMe(CH(2))(2)NMe(2) = L(1), CH=N(CH(2))(2)NMe(2) = L(2), and CH(2)NH(CH(2))(2)NMe(2) = L(3)). Dizinc trihalide complexes [L(n)Zn(2)(mu-X)X(2)] (where X = Cl, Br, I) have been prepared. The trihalide complexes were treated with potassium ethoxide, resulting in quantitative substitution of the bridging halide group to give [L(n)Zn(2)(mu-OEt)X(2)]. The dizinc ethoxide complexes were tested in situ as initiators for lactide ring opening polymerization. Dizinc triacetate complexes have also been synthesized [L(n)Zn(2)(OAc)(3)], as well as cationic diacetate species containing two bridging acetate groups, [L(n)Zn(2)(mu-OAc)(2)][BPh(4)]. Structural differences between complexes of the three ligands are discussed.