Systemic Type 2 Inflammation-Associated Atopic Dermatitis Exacerbates Periodontitis.
Atopic dermatitis (AD) is a prevalent and chronic inflammatory skin disease characterized by Th2 cell-mediated type 2 inflammation. Emerging evidence indicated that AD patients exhibit an increased incidence of oral disorders. In the present study, we sought mechanistic insights into how AD affects periodontitis. Onset of AD was induced by 2,4-dinitrochlorobenzene (DNCB). Furthermore, we induced periodontitis (P) in AD mice. The effect of AD in promoting inflammation and bone resorption in gingiva was evaluated. Hematoxylin and eosin staining, tartrate-resistant acid phosphatase staining, immunofluorescence assay, and flow cytometry were used to investigate histomorphology and cytology analysis, respectively. RNA sequencing of oral mucosa is used tissues to further understand the dynamic transcriptome changes. 16S rRNA microbial analysis is used to profile oral microbial composition. Compared to control group, mice in AD group showed inflammatory signatures and infiltration of a proallergic Th2 (Th2A)-like subset in oral mucosa but not periodontitis, as identified by not substantial changes in mucosa swelling, alveolar bone loss, and TRAP+ osteoclasts infiltration. Similarly, more Th2A-like cell infiltration and interleukin-4 levels were significantly elevated in the oral mucosa of DNCB-P mice compared to P mice. More importantly, AD exacerbates periodontitis when periodontitis has occurred and the severity of periodontitis increased with aggravation of dermatitis. Transcriptional analysis revealed that aggravated periodontitis was positively correlated with more macrophage infiltration and abundant CCL3 secreted. AD also altered oral microbiota, indicating the re-organization of extracellular matrix. These data provide solid evidence about exacerbation of periodontitis caused by type 2 dermatitis, advancing our understanding in cellular and microbial changes during AD-periodontitis progression.


Disturbed feto-maternal cell traffic in preeclampsia.
To investigate whether the transfer of fetal blood cells to the maternal circulation is perturbed in pregnancies affected by preeclampsia. Fetal erythroblasts were isolated from eight women with clinically diagnosed preeclampsia (blood pressure values of at least 140/90 mmHg and associated proteinuria) and an equal number of matched corresponding controls. All patients in both groups were pregnant with male singleton fetuses. The presence of fetal cells was evaluated histologically and by fluorescence in situ hybridization for X and Y chromosomes. The number of fetal cells was higher in preeclamptic patients than in controls, with respect to both nucleated red blood cells (median per 200 cells 38 versus 7; P < .001) and the proportion of these cells that were of fetal origin (median per 2000 cells 9 versus 2; P = .001). These results suggest that the trafficking of fetal cells into the maternal periphery is disturbed in patients with preeclampsia. Because it is unlikely that such an altered flow of cells is restricted to the erythroblasts examined in this study, these findings also may lead to interesting new concepts regarding the development of preeclampsia and possibly the associated syndrome of hemolysis, elevated liver enzymes, and low platelets.


A comparison of fixed prostheses generated from conventional vs digitally scanned dental impressions.
For many years, mechanical and laser-based scanning technology has been used with computer-aided design and computer-aided manufacturing applications in the field of dentistry, but most have been limited to the dental laboratory. For the past 20 years, only 1 intraoral scanning device has been available to the dentist for in-office use. Recently, a new kind of intraoral scanning technology was introduced to the dental market. This technology, based on a laser scanning protocol called "parallel confocal," allows the dentist to take electronic impressions intraorally. This technology is coupled with traditional laboratory protocol for the construction of fixed dental restorations, providing the dentist with an accurate and efficient system to produce high-quality fixed dental restorations of all types. In a blind study, crowns developed using this technology were preferred over crowns generated using conventional impressions and criteria of marginal fit, contacts, occlusion, and time of adjustment in nearly 70% of cases. This article introduces scanning technology including a discussion of its clinical applications and an overview of the benefits.


PLEIOTROPIC EFFECTS OF INDIVIDUAL GENE LOCI ON MANDIBULAR MORPHOLOGY.
The genotypic basis of morphological variation is largely unknown. In this study we examine patterns of pleiotropic effects on mandibular morphology at individual gene loci to determine whether the pleiotropic effects of individual genes are restricted to functionally and developmentally related traits. Mandibular measurements were obtained from 480 mice from the F2 generation of an intercross between the LG/J and SM/J mouse strains. DNA was also extracted from these animals, and 76 microsatellite loci covering the autosomes were scored. Interval mapping was used to detect chromosomal locations with significant effects on various mandibular measurements. Sets of traits mapping to a common chromosomal region were considered as being affected by a single quantitative trait locus (QTL) for mandibular morphology. Thirty-seven such chromosomal regions were identified spread throughout the autosomes. Gene effects were small to moderate with the allele derived from the LG/J strain typically leading to larger size. When dominance was present, the LG/J allele was typically dominant to the SM/J allele. Most loci affected restricted functional and developmental regions of the mandible. Of the 26 chromosomal regions affecting more than two traits, 50% affect the muscular processes of the ascending ramus, 27% affect the alveolar processes carrying the teeth, and 23% affect the whole mandible. Four additional locations affecting two traits had effects significantly associated with alveolar regions. Pleiotropic effects are typically restricted to morphologically integrated complexes.


Patient data from Philips IntelliVue monitors may appear on wrong XDS remote display.
Under certain circumstances, when a Philips IntelliVue physiologic monitor is disconnected from an IntelliVue XDS remote display and reconnected to a different XDS remote display, monitored patient information will not be automatically transferred to the new display, but instead will reappear on the original display. As a result, the data on the original display may be associated with the wrong patient. This problem is limited to IntelliVue XDS software version H.00.xx or earlier. A software upgrade is available that permits automatic data transfer when a monitor is moved from one XDS remote display to another.


Proliferative, infiltrative, and metastatic activities in colorectal tumors assessed by MIB-1 antibody.
MIB-1 antibody staining discriminates the cells in phases other than G0 of the cell cycle. The current study examined the proliferative activity assessed by MIB-1 antibody in colorectal adenoma, primary lesions of colorectal carcinoma (CRC) to investigate the relation between the histologic atypia, the proliferative, infiltrative, and metastatic activities. The MIB-1 antibody positive rate was immunohistologically determined in primary lesions in 311 patients, 22 having adenoma or carcinoma in situ, 207 invasive CRC without distant metastasis, and 82 invasive CRC with distant metastasis. The MIB-1 antibody positive rate was significantly higher in cases of adenoma with severe atypia and carcinoma in situ, showing a close relation between histologic atypia and proliferative activity. Among invasive CRC, the positive rate in poorly differentiated adenocarcinoma and mucinous carcinoma is significantly lower than in well differentiated and moderately differentiated adenocarcinomas. The positive rate was significantly lower in carcinomas with subserosa or deeper invasion than in carcinomas with submucosa or muscularis propria invasion, showing no distinct relation between the proliferative activity and the infiltrative activity. The positive rate of primary lesion was significantly lower in cases with metachronous liver or lung metastasis than in synchronous cases, indicating that metachronous hematogenous metastasis occurs even in cancers with low proliferative activity. The MIB-1 antibody positive rate showed a close relation between histologic atypia and proliferative activity in mucosal colorectal tumors although its relation with infiltrative activity was unclear in invasive CRC. It was apparent that metachronous hematogenous cancer metastasis might take place even in cases with low proliferative activity.


Pterin-based pigmentation in animals.
Pterins are one of the major sources of bright coloration in animals. They are produced endogenously, participate in vital physiological processes and serve a variety of signalling functions. Despite their ubiquity in nature, pterin-based pigmentation has received little attention when compared to other major pigment classes. Here, we summarize major aspects relating to pterin pigmentation in animals, from its long history of research to recent genomic studies on the molecular mechanisms underlying its evolution. We argue that pterins have intermediate characteristics (endogenously produced, typically bright) between two well-studied pigment types, melanins (endogenously produced, typically cryptic) and carotenoids (dietary uptake, typically bright), providing unique opportunities to address general questions about the biology of coloration, from the mechanisms that determine how different types of pigmentation evolve to discussions on honest signalling hypotheses. Crucial gaps persist in our knowledge on the molecular basis underlying the production and deposition of pterins. We thus highlight the need for functional studies on systems amenable for laboratory manipulation, but also on systems that exhibit natural variation in pterin pigmentation. The wealth of potential model species, coupled with recent technological and analytical advances, make this a promising time to advance research on pterin-based pigmentation in animals.


Correlation between HRCT findings, pulmonary function tests and bronchoalveolar lavage cytology in interstitial lung disease associated with rheumatoid arthritis.
A prospective study correlating high-resolution computed tomography (HRCT), lung function tests (PFT) and bronchoalveolar lavage (BAL) cytology in patients with interstitial lung disease (ILD) associated with rheumatoid arthritis (RA). Fifty-three RA patients with suspected ILD (19 men, 34 women) underwent 71 HRCT (14 of 53 with sequential HRCT, mean follow-up 24.3 months). The HRCT evaluation by two observers on consensus included a semi-quantitative characterisation of lesion pattern and profusion on representative anatomical levels. Fifty-two HRCT were followed by PFT and BAL. Agreement or discordance of HRCT-, PFT- and BAL findings were analysed with Pearson's correlation, kappa score and McNemar's test. Tobacco-fume exposure was estimated in pack years. Smoking/non-smoking groups were compared with Student's t test. In 49 of 53 patients, HRCT was suggestive of ILD associated with RA (66 of 71 HRCT). Reticular lesions were found in 40 of 53 patients, in 15 of 40 presenting as mixed pattern with ground-glass opacities (GGO). Pure reticular patterns predominated in patients with long duration of ILD (p>0.01). Pure GGO were not observed. Lesion profusion was highly variable and correlated moderately negative with diffusion capacity (mean 88.2% (SD +/- 20.9%); r=-0.54; p<0.001) and very weak with vital capacity and FEV1 (mean values 92.2% (SD +/- 18.3%); r=-0.27; p<0.05 and 89.8% (SD +/- 17.5%); r=-0.31; p<0.01). In patients with GGO, BAL differentials tended towards neutrophilia (kappa=0.39; p=0.04; McNemar test p>0.2), but not towards lymphocytosis (kappa=0.10; p=0.23; McNemar test p>0.2). Differences in smoking history were not significant (p>0.1). The HRCT appears most appropriate for the detection and follow-up of ILD associated with RA. The PFT and BAL correlate only partially with lesion profusion or grading on HRCT, but they contribute valuable information about dynamic lung function and differential diagnoses (pneumonia, medication side effects).


Maternal weight characteristics influence recurrence of fetal macrosomia in women with normal glucose tolerance.
This study examines the relationship between maternal weight characteristics and recurrence of macrosomia in 111 non-diabetic women who delivered a second baby following primiparous delivery of a macrosomic infant (> 4500 g). Recurrence of fetal macrosomia was associated with greater maternal body mass index (P = 0.032), greater initial pregnancy weight (P < 0.05) and total weight gain during second pregnancy (P < 0.01). Women delivering a first macrosomic infant should avoid excessive weight gain before and during a subsequent pregnancy.


Haptic tracking permits bimanual independence.
This study shows that in a novel task-bimanual haptic tracking-neurologically normal human adults can move their 2 hands independently for extended periods of time with little or no training. Participants lightly touched buttons whose positions were moved either quasi-randomly in the horizontal plane by 1 or 2 human drivers (Experiment 1), in circle and square patterns in the vertical plane by 2 human drivers (Experiment 2), or at different frequencies in the horizontal plane by 2 human drivers (Experiment 3). Bimanual contact was maintained equally well in all conditions even though in Experiment 1 the left- and right-hand motions were uncorrelated (in the 2-driver condition), in Experiment 2 the left- and right-hand motions were spatially incongruous when circles and squares were tracked at the same time, and in Experiment 3 the left- and right-hand motions maintained different frequency ratios. Because haptic tracking has revealed that humans can in fact move their 2 hands independently, it may have potential as a new behavioral tool for revealing other perceptual-motor capabilities.


Bilateral tibial metaphyseal stress fractures associated with physitis in a foal.
A 7-month-old Appaloosa foal had bilateral hind limb lameness and was unable to rise from recumbency without assistance. Lameness could be exacerbated by tarsal flexion and a firm swelling at the distomedial aspect of the tibias was associated with a marked pain response when palpated. Radiography revealed enlargement of the distal tibial metaphysis physis (compared with normal), and radiolucent fissure lines extending proximally from the physis into the metaphysis at its medial aspect. Treatment included rest and dietary adjustment. Although clinical signs initially resolved following treatment, the problem recurred when the foal was 14 months old. Further treatment included 7 months of pasture rest without forced exercise, after which the foal was reported to be clinically normal.


[Assessment of the impact of a palliative care support team in a tertiary hospital].
This study aimed to measure the effectiveness of the interventions of a palliative care support team in a tertiary hospital. It used a pre-post design and included 41 patients. The results show a significant improvement of the quality of palliative care as well as a significant reduction in the intensity and in the number of moderate to severe symptoms. The importance of a palliative care support team in a tertiary hospital is confirmed by our results. Its interventions appear to respond to the growing need for specialized palliative care, particularly in patients with complex clinical problems.


[Clinical use of meniscus sonography].
We report on the sonography of the meniscus as a new non-invasive imaging technique for diagnosis of traumatic lesions of the menisci of the knee joint. Using an efficient ultrasound equipment with a 7.5 MHz sectorscanner, the sonographic imaging of all parts of the medial and the lateral meniscus is regularly successful. During 10 months more than 200 patients with symptoms of a traumatic meniscal lesion got a sonographic examination in our hospital. The results show that in 86% there is an identity with the operative findings. By sonographic imaging there can be seen longitudinal and transversal ruptures, 'fishmouth' - and 'bucket - handle' lesions and complete detachment of the meniscus. Decisive for the diagnosis is a hyperechogenic zone running through the homogeneous gray meniscus. With ultrasound, it is regularly possible to get information about the locality and the extension, but not about the kind of lesion.


Improved Charge Balance in Green Perovskite Light-Emitting Diodes with Atomic-Layer-Deposited Al2O3.
Perovskite light-emitting diodes (LEDs) have experienced a rapid increase in efficiency over the last several years and are now regarded as promising low-cost devices for displays and communication systems. However, it is often challenging to employ ZnO, a well-studied electron transport material, in perovskite LEDs due to chemical instability at the ZnO/perovskite interface and charge injection imbalance caused by the relatively high conductivity of ZnO. In this work, we address these problems by depositing an ultrathin Al2O3 interlayer at the ZnO/perovskite interface, allowing the fabrication of green-emitting perovskite LEDs with a maximum luminance of 21 815 cd/m2. Using atomic layer deposition, we can precisely control the Al2O3 thickness and thus fine-tune the electron injection from ZnO, allowing us to enhance the efficiency and operational stability of our LEDs.


Five-year experience with intraoperative extracorporeal membrane oxygenation in lung transplantation: Indications and midterm results.
Since April 2010, extracorporeal membrane oxygenation (ECMO) has replaced cardiopulmonary bypass for intraoperative support during lung transplantation at our institution. The aim of this study was to present our 5-year experience with this technique. Records of patients who underwent transplantation between April 2010 and January 2015 were retrospectively reviewed. Patients who underwent transplantation without ECMO formed Group A. Patients in whom the indication for ECMO support was set a priori before the beginning of the operation formed Group B. The remaining patients in whom the indication for ECMO support was set during transplantation formed Group C. Among 595 patients, 425 (71%) patients (Group A) did not require intraoperative ECMO; the remaining 170 (29%) patients did. Among these patients, 95 (56%) patients formed Group B, and the remaining 75 (44%) patients comprised Group C. Pulmonary fibrosis and pre-operative dilated or hypertrophied right ventricle emerged as risk factors for the indication of non-a priori intraoperative ECMO. Patients in Groups B and C showed a higher pre-operative risk profile and higher prevalence of post-operative complications than patients in Group A. Overall survival at 1 year was 93%, 83%, and 82% and at 4 years was 73%, 68%, and 69% in Groups A, B, and C (p = 0.11). The intraoperative use of ECMO did not emerge as a risk factor for in-hospital mortality or mortality after hospital discharge. Intraoperative ECMO filled the gap between pre-operative and post-operative ECMO in lung transplantation. Although complications and in-hospital mortality were higher in patients who received ECMO, survival was similar among patients who underwent transplantation with or without ECMO.


Cobalt(III)-Catalyzed C-H Alkynylation with Bromoalkynes under Mild Conditions.
Expedient cobalt-catalyzed C-H alkynylation was achieved under exceedingly mild reaction conditions. Thus, chelation-assisted direct alkynylations of heteroarenes occurred with 1-bromoalkynes and ample substrate scope. The optimized catalytic system allowed for step-economical C-H functionalizations with a mild base K2CO3 at reaction temperatures as low as 25 °C.


Splashes in isotropic media.
The response of a weakly absorbing isotropic medium to a sudden localized perturbation (a "splash") is explained within the framework of linear response theory. In this theory splashes result from the interference of the collective excitations of the medium, with the outcome determined by the interplay between their phase and group velocities as well as the sign of the latter. The salient features of splashes are controlled by the existence of extremal values of the phase and the group velocities: the group velocity gives the expansion rate of the locus of the points where new wave fronts nucleate or existing ones disappear, while the phase velocity determines the large-time expansion rate of a group of wave fronts. If the group velocity is negative in a spectral range and takes on a minimal value within it, then converging wave fronts will be present in the splash. These results are relevant to the studies of several experimentally viable setups, such as a splash on the surface of deep water due to a small pebble or a raindrop, a splash in the two-dimensional electron gas caused by a short voltage pulse applied with the tip of a scanning tunneling microscope, or a bulk splash in superfluid ^{4}He due to formation of an electron bubble. Specifically, the gross features of a splash in superfluid ^{4}He are determined by five extremal velocities. Additionally, due to the existence of a negative group-velocity spectral range, some of the wave fronts in the superfluid splash are converging.


Antibiofilm activity and mode of action of DMSO alone and its combination with afatinib against Gram-negative pathogens.
Biofilms are complex microbial communities that tend to attach to either biotic or abiotic surface. Enclosed in a self-produced extracellular polymeric substance (EPS) matrix, the biofilms often cause persistent infections. The objective of this study was to investigate the antibiofilm activity of dimethyl sulfoxide (DMSO) and afatinib against Gram-negative pathogens. Test microorganisms used in this study were Escherichia coli ATCC 1299, Pseudomonas aeruginosa ATCC 10145, and Salmonella typhimurium ATCC 14028. Biofilms were developed in 96-well microplate at 37°C for 24 h. Following removal of non-adherent cells, analysis of biofilm viability, biofilm biomass, and extracellular polymeric substances (EPS) matrix were performed using resazurin assay, crystal violet assay, and attenuated total reflectance fourier transform infrared (ATR-FTIR) spectroscopy, respectively. Bradford protein assay was conducted to determine the total amount of EPS proteins. The results demonstrated that both 32% DMSO alone and its combination with 3.2 μg/mL afatinib were effective in killing biofilm cells and reducing biofilm biomass. IR spectral variations of EPS matrix of biofilms in the range between 1700 and 900 cm-1 were also observed. Reduction in EPS proteins verified the chemical modifications of EPS matrix. In conclusion, 32% DMSO alone and its combination with 3.2 μg/mL afatinib showed remarkable antibiofilm activities against Gram-negative pathogens. It was suggested that the biofilm inhibition was mediated by the chemical modification of EPS matrix.


Mapping the Architecture of Ferret Brains at Single-Cell Resolution.
Mapping the cytoarchitecture of the whole brain can reveal the organizational logic of neural systems. However, this remains a significant challenge, especially for gyrencephalic brains with a large volume. Here we propose an integrated pipeline for generating a cytoarchitectonic atlas with single-cell resolution of the whole brain. To analyze a large-volume brain, we used a modified en-bloc Nissl staining protocol to achieve uniform staining of large-scale brain specimens from ferret (Mustela putorius furo). By combining whole-brain imaging and big data processing, we established strategies for parsing cytoarchitectural information at a voxel resolution of 0.33 μm × 0.33 μm × 1 μm and terabyte-scale data analysis. Using the cytoarchitectonic datasets for adult ferret brain, we identified giant pyramidal neurons in ferret brains and provide the first report of their morphological diversity, neurochemical phenotype, and distribution patterns in the whole brain in three dimensions. This pipeline will facilitate studies on the organization and development of the mammalian brains, from that of rodents to the gyrencephalic brains of ferret and even primates.


Left main coronary artery stenosis after aortic valve replacement.
We describe two cases with iatrogenic left main coronary artery stenosis where a symptomatology of unstable angina appeared within three months of aortic valve replacement surgery. One patient was treated with aortocoronary bypass and the other with angioplasty and stenting.


Achondroplasia: Really rhizomelic?
Achondroplasia is the most common form of short limb dwarfism in humans. The shortening of the limb lengths in achondroplasia is widely described as "rhizomelic." While this appearance may be convincing clinically, the description is not necessarily true or helpful radiologically. The aims of this study, were therefore, to determine whether rhizomelic shortening is a true feature of achondroplasia at diagnosis in infancy. Humeral, radial, femoral, and tibial diaphyseal lengths were recorded by two independent observers from 22 skeletal surveys of infants with achondroplasia and compared with 150 normal age-matched control subjects. Upper and lower limb bone length ratios (radial/humeral and tibial/femoral lengths, respectively) in both groups were compared using an unpaired t-test. Mean upper limb length ratios were statistically higher within the achondroplasia group at 0.87 ± 0.04 (n = 22, mean age 70 ± 94 days) compared to normal controls at 0.79 ± 0.02 (n = 150, mean age 113 days ± 88 days; P < 0.0001). Lower limb length ratios were not significantly different between groups (0.84 ± 0.04 vs. 0.83 ± 0.02, P = 0.46). There was good inter-observer agreement of limb length measurements, with an average measurement difference of 0.1 ± 1.4 mm. In conclusion, infants with achondroplasia demonstrate statistically significant rhizomelic shortening within the upper limbs, but not lower limbs at diagnosis, compared to normal controls. The term "rhizomelic shortening" in relation to achondroplasia should be reserved when describing upper limb proportions. © 2016 Wiley Periodicals, Inc.


Influences of culture on sexuality.
Religion is a cultured phenomenon, a subculture within our larger cultural system. Different religions have different teachings about what constitutes sexual morality, while members within a specific religious denomination may also have different beliefs and practices. Religiosity, or acceptance of the teachings of a particular religion, is more important as a determinant of sexual behavior than a specific religion per se. Orthodox Judaism, traditional Catholicism and traditional Protestantism are alike in their condemnation of masturbation, abortion, homosexuality, and premarital and extramarital coitus. More liberal members of these religions may not tolerate these activities, but may espouse them as necessary means to maintain or attain health. Nurses assess the beliefs that clients hold in regard to sexual morality and also identify if the client is experiencing guilt about past sexual practices. Interventions are planned with the client within the framework of the client's religious and spiritual beliefs and practices. To do otherwise is to invite distrust and distress in the client. Nurses intervene with sensitivity, compassion, and respect for beliefs and values that may be different from their own.


No Postoperative Adrenal Insufficiency in a Patient with Unilateral Cortisol-Secreting Adenomas Treated with Mifepristone Before Surgery.
Glucocorticoid replacement is commonly required to treat secondary adrenal insufficiency after surgical resection of unilateral cortisol-secreting adrenocortical adenomas. Here, we describe a patient with unilateral cortisol-secreting adenomas in which the preoperative use of mifepristone therapy was associated with recovery of the hypothalamic-pituitary-adrenal (HPA) axis, eliminating the need for postoperative glucocorticoid replacement. A 66-year-old Caucasian man with type 2 diabetes mellitus, hyperlipidemia, hypertension, and obesity was hospitalized for Fournier's gangrene and methicillin-resistant Staphylococcus aureus sepsis. Abdominal computed tomography scan revealed three left adrenal adenomas measuring 1.4, 2.1, and 1.2 cm and an atrophic right adrenal gland. Twenty-four-hour urinary free cortisol level was elevated (237 µg/24 hours, reference range 0-50 µg/24 hours). Hormonal evaluation after resolution of the infection showed an abnormal 8 mg overnight dexamethasone suppression test (cortisol postdexamethasone 14.5 µg/dL), suppressed adrenocorticotropic hormone (ACTH; <5 pg/mL, reference range 7.2-63.3 pg/mL), and low-normal dehydroepiandrosterone sulfate (50.5 µg/dL, male reference range 30.9-295.6 µg/dL). Because of his poor medical condition and uncontrolled diabetes, his Cushing's syndrome was treated with medical therapy before surgery. Mifepristone therapy was started and, within five months, his diabetes was controlled and insulin discontinued. The previously suppressed ACTH increased to above normal range accompanied by an increase in dehydroepiandrosterone sulfate levels, indicating recovery of the HPA axis and atrophic contralateral adrenal gland. The patient received one precautionary intraoperative dose of hydrocortisone and none thereafter. Two days postoperatively, ACTH (843 pg/mL) and cortisol levels (44.8 µg/dL) were significantly elevated, reflecting an appropriate HPA axis response to the stress of surgery, and two weeks postoperatively, ACTH was within normal range and a repeat dexamethasone suppression test was normal. Six months postoperatively, ACTH was within normal limits and cortisol was approaching normal. The patient has exhibited no postoperative signs or symptoms of adrenal insufficiency in 12 months. Preoperative mifepristone therapy was associated with apparent recovery of the HPA axis prior to unilateral adrenalectomy in a patient with unilateral adrenal adenomas. Postoperatively, the patient experienced no signs or symptoms of adrenal insufficiency and no glucocorticoid replacement was required.


The correlation between human leucocyte antigen amino acid residue matching before keratoplasty and postoperative rejection: a systematic review and meta-analysis.
At present, corneal transplantation has become the main surgical method for infectious keratitis. However, the rejection of corneal graft after operation leads to graft opacity, which is an important reason for the failure of transplantation. There is no unified conclusion whether the rejection can be reduced by matching human leucocyte antigen (HLA) before operation. The purpose of this meta-analysis is to explore the correlation between HLA locus matching and corneal transplantation rejection, so as to provide evidence-based medical evidence for clinical corneal transplantation in the treatment of infectious keratitis. Search English databases, such as PubMed, Medline, Embase and Evidence-based Medicine Library by computer; Chinese databases, such as China Biomedical Literature Database, China Knowledge Network (CNKI) database, Wanfang database, Weipu database, and Google Academic database. According to Cochrane Handbook 5.0 risk assessment table, two researchers made random sequence random allocation method, blind method, allocation scheme hiding, integrity of data results and quality score of research results. The bias risk evaluation of Rev Man 5.3 software was used to evaluate the risk bias of the references. A total of 5 literatures were included, and 725 eyes underwent penetrating keratoplasty, all of which were randomized controlled trials (RCTs). The quality of the included articles was medium to high quality. A meta-analysis of four HLA-A matching articles showed odds ratio (OR) =0.28, 95% confidential interval (CI): (0.15, 0.51), significance test Z=4.08, P<0.0001, and the difference was statistically significant. Meta-analysis was performed on four HLA-B matching articles and showed OR =0.50, 95% CI: (0.27, 0.89), significance test Z=2.33, P=0.02, and the difference was statistically significant. Meta-analysis of four HLA-DR matching articles showed OR =0.69, 95% CI: (0.41, 1.17), significance test Z=1.39, P=0.17, and the difference was not statistically significant. In patients with infectious keratitis undergoing corneal transplantation, preoperative matching of HLA-A, HLA-B, and HLA-DR sites played an important role in corneal transplantation. Preoperative HLA matching is of clinical significance.


Flexing the Spectrum: Advancements and Prospects of Flexible Electrochromic Materials.
The application potential of flexible electrochromic materials for wearable devices, smart textiles, flexible displays, electronic paper, and implantable biomedical devices is enormous. These materials offer the advantages of conformability and mechanical robustness, making them highly desirable for these applications. In this review, we comprehensively examine the field of flexible electrochromic materials, covering topics such as synthesis methods, structure design, electrochromic mechanisms, and current applications. We also address the challenges associated with achieving flexibility in electrochromic materials and discuss strategies to overcome them. By shedding light on these challenges and proposing solutions, we aim to advance the development of flexible electrochromic materials. We also highlight recent advances in the field and present promising directions for future research. We intend to stimulate further innovation and development in this rapidly evolving field and encourage researchers to explore new opportunities and applications for flexible electrochromic materials. Through this review, readers can gain a comprehensive understanding of the synthesis, design, mechanisms, and applications of flexible electrochromic materials. It serves as a valuable resource for researchers and industry professionals looking to harness the potential of these materials for various technological applications.


Desensitizing agent efficacy during whitening in an at-risk population.
Nightguard vital bleaching (NGVB) has gained acceptance among dentists and patients as a simple and effective procedure to lighten discolored teeth. Although the efficacy and predictability of NGVB have been well established, it has been documented that patients undergoing the procedure may experience side effects such as tooth sensitivity (TS) and gingival irritation (GI). A previous NGVB study suggested that selected participants might benefit from a regimen of a desensitizing agent (DSA) to decrease or prevent TS during whitening. The purpose of this study was to determine whether the daily use of an active DSA (UltraEZ, Ultradent Products Inc., South Jordan, UT, USA) during NGVB would decrease TS in a population at risk for TS when compared with a placebo. Forty subjects participated in this single-blind randomized clinical trial. All participants had indicated that they had preexisting TS or other risk factors for TS during NGVB. To evaluate TS caused by the tray alone, participants wore custom-fitted maxillary whitening trays containing no DSA or whitening solution during week 1. Next, participants were randomly assigned to apply either the active DSA or placebo daily for 14 days in the trays for 30 minutes prior to whitening. The placebo was the same formulation as UltraEZ but without the desensitizing agents (3% potassium nitrate and 0.11% by weight fluoride ion). The bleaching solution was a 10% carbamide peroxide whitening solution (Opalescence, Ultradent Inc.). Post treatment, participants were followed up for 1 week, during which time they used neither trays nor solutions. Throughout the study, participants completed a daily diary to record their perceptions of TS and the time spent wearing the tray with the whitening solution. Forty-one percent of the active group had at least 1 day of TS during treatment compared with 78% of the placebo group. The difference was statistically significant (p = .027) using the two-tailed Fisher exact test. This study suggests that the use of an active 3% potassium nitrate and 0.11% fluoride desensitizing agent for 30 minutes prior to whitening may decrease tooth sensitivity when compared with a placebo in a population at risk for tooth sensitivity.


Sexually transmitted diseases and children: there is good news, but....
A review is provided of a series of federal agency reports on sexually transmitted diseases among children and young adults. While there have been marked decreases in the number of reports of disease, continued infection of youngsters less than fifteen years of age is a continuing reality.


[Monitoring of the Blood Concentrations of Antiepileptic Drugs (TDM)].
The incidence of epilepsy is high in infants/children and elderly persons. Patients with epilepsy account for approximately 1% of the population. This chronic cerebral disorder is characterized by repeated epileptic seizures related to excessive excitation of the brain, and it is important to reduce such seizures in life. Therapeutic drug monitoring (TDM) is useful for evaluating the treatment response and checking for adverse effects. When interpreting the results of measurement of the blood concentrations of antiepileptic drugs, the duplication of various factors must be understood. In this article, matters that clinical technologists face in routine work are presented/arranged so that the results of TDM may be adequately interpreted. In 270% of patients with epilepsy, as a nervous disease, seizures may be reduced by administering adequate therapy with antiepileptic drugs; the response rate is high. If measurements deviate from the reference range, clini- cal technologists should utilize their specialized knowledge and adequately evaluate the values obtained, con- tributing to drug therapy. [Review].


'We don't need another Scottish vet school'.
Will McLean argues that the SRUC's plans to open its own vet school is not an appropriate solution to the problems the profession faces with regards to a shortage of vets working in rural and public health roles.


An uncommon case of chronic leg ulcers in an 80-year-old woman.
Ulcers of the lower extremities, particularly in individuals older than 65, are a common cause for visits to the dermatologist, primary-care physician, or vascular surgeon. There are many different causes of leg ulcers, among which vascular causes are the most frequent. Less commonly, other pathological processes result in leg ulcers. Unfortunately some of them are malignant. Large B-cell lymphoma, leg type, is a malignant lymphoma of intermediate behavior, occurring mostly on the legs in elderly patients. Usually it presents as erythematous or bluish-red nodules or tumors, but ulcerations are not uncommon. When faced with unusual and non-healing ulcers, the physician should also have in mind rarer but more lethal causes.


Rickettsia conorii subsp. israelensis infection: a case report from southeast Iran.
Mediterranean spotted fever (MSF) is a zoonotic and vector-borne disease caused by Rickettsia conorii. We report a case (36 year-old-woman) of MSF caused by Rickettsia conorii from Iran. In September 2019, the patient was admitted to the hospital in Kerman province with flu-like symptoms and maculopapular lesions. According to the laboratory results, thrombocytopenia, elevated liver enzymes, and cardiac enzymes were observed. Skin biopsy was examined for Crimean-Congo Hemorrhagic Fever (CCHF) and MSF using the Real-Time-PCR and ELISA method. Finally, the sample was positive for Rickettsia conorii subsp. israelensis and treated with doxycycline and completely recovered. This study showed that MSF could be present in Iran. Therefore, identifying endemic areas in Iran for this disease should be on the agenda.


[A case of pseudocyst of the spleen].
The authors report a case of pseudocyst of the spleen in a five years old girls whose only complaint was a slight pain in the left upper quadrant. A palpable globular mass was confirmed to be a splenic cyst by instrumental procedures regarded as the first ones to employ in such cases, ultrasonography and CT scan. The diagnosis of pseudocyst was possible only after the surgical spleen removal when the absence of an epithelial lining was histologically found. A short excurses on splenic cysts, from etiology to therapy, follows. Moreover the after splenectomy management of paediatric patients is discussed.


H-F bond insertions into α-diazo carbonyl compounds.
A reaction for H-F bond insertion into α-diazo carbonyl compounds is reported. The protocol describes a simple reaction setup employing commercially available HF·pyr (Olah reagent) as the fluorine source. The method is rapid and practical, and allows access to a broad range of α-fluorinated carbonyl compounds in generally good yields.


Prostaglandin E1 diluted solution: preparation technique and stability evaluation.
The authors describe their prostaglandin E1 dilution method for the treatment of male erectile dysfunction. Preparation stability was investigated. Results suggest that PGE1 diluted solution can last as long as 90 days, while decreased concentrations of PGE1 are detected after three months.


Prevalence of anxiety and depression during pregnancy in a private setting sample.
To estimate the prevalence and risk factors for antenatal anxiety (AA) and antenatal depression (AD). We performed a cross sectional study of 432 women attending a private clinic in the city of Osasco, São Paulo, from 5/27/1998 to 5/13/2002. The following instruments were used: Spielberger state-trait anxiety inventory (STAI), Beck depression inventory (BDI), and a questionnaire for socio-demographic and obstetric data. Inclusion criteria were: pregnant women with no past or present history of depression, psychiatric treatment, alcohol or drug abuse and no clinical and obstetric complications. The prevalence of AA, according to STAI, and AD, according to Beck Inventory, were estimated with 95% confidence intervals (95% CI). Odds ratios and 95% CI were used to examine the association between AA and AD and exposures variables. The prevalence of AA, state and trait were 59.5 (95 CI%: 54.8:64.1%) and 45.3% (95% CI: 40.6:50.0), respectively. The prevalence of AD was 19.6 (95% CI:15.9:23.4). In the multivariate analysis, AA-trait (OR: 5.26; 95% CI 2.17:12.5, p < 0.001), AA-state (OR: 2.27; 95% CI 1.08:4.76, p = 0.02) and AD (OR: 2.43; 95% CI 1.40:4.34, p = 0.002) were associated with lower women's educational level. AA-trait (OR: 3.43; 95% CI 1.68:7.00, p = 0.001), AA-state (OR: 2.22; CI 95% 1.09:4.53, p = 0.02) and AD (OR: 2.82; CI 95% 1.35:5.97, p = 0.005) were also associated with not being married. AA-trait was associated with lower women's income (OR: 2.22; 95% CI 0.98:5.26, p = 0.05) and not being white (OR: 1.7; 95% CI 1.00:2.91, p = 0.04), while AD was associated with lower couple's income (OR: 2.43; 95% CI 1.40:4.34, p = 0.001) and greater number of previous abortions (OR: 2.21; 95% CI 1.23:3.97, p = 0.009). Prevalence of AA and AD were high in this sample of women attending a private care setting, particularly AA state and trace. AA and AD were associated with similar socio-demographic and socio-economic risk factors, suggesting some common environmental stressors may be involved.


Pulsatile tinnitus--a review of 84 patients.
Pulsatile tinnitus can be annoying for a patient and can also be the only clue to a potentially devastating and life-threatening disease. In order to understand its clinical spectrum and management better we analysed the files of 84 patients seen at our institution over a 10-year period. Noninvasive techniques (ultrasound, computed tomography, magnetic resonance imaging) and angiography were employed as investigations tailored to the individual patient. A vascular disorder [i.e. arteriovenous fistula, dissection of the internal carotid artery (ICA), fibromuscular dysplasia, aneurysm of the ICA and sinus thrombosis] was found in 36 patients (42%), most commonly a dural arteriovenous fistula or a carotid-cavernous sinus fistula. In 26 patients with a vascular abnormality, pulsatile tinnitus was the presenting symptom. In 12 patients (14%), nonvascular disorders such as glomus tumour or intracranial hypertension with a variety of causes explained the tinnitus. We conclude that patients with pulsatile tinnitus should be investigated with noninvasive techniques. If these are negative or to clarify abnormal findings of noninvasive techniques selective angiography is needed for diagnosis and to guide treatment.


Cementless total hip arthroplasty using an autograft of the femoral head for marked acetabular dysplasia: case series.
To assess the short-term outcome of cementless total hip arthroplasty involving an autograft of the femoral head in Japanese patients. Cementless total hip arthroplasty with autogenous bone block grafting was performed on 18 hips in 15 patients with marked acetabular dysplasia. The resected femoral head was used as a graft for the superior-lateral region of the true acetabulum. Clinical outcome was correlated with the placement of the acetabular component, as revealed in radiographs. The 13 women and 2 men had a mean age of 60.2 years (range, 37.0-73.0 years) at primary surgery and a mean follow-up duration of 3.3 years (range, 2.0-5.3 years). According to the classification of Crowe, 4 hips were in group I, 3 were in group II, one in group III, and 10 in group IV. The mean Harris Hip Score preoperatively was 45.7 (range, 19-69) and that at follow-up was 82.5 (range, 44-100). All 15 cases showed a good clinical outcome. There were no major intra-operative complications in this series. The grafted bones united in all patients. Two patients need surgical revision because the lateral insertion of the acetabular component resulted in loosening of it. Medial insertion of the acetabular component provides satisfactory short-term outcomes. Lateral insertion of the acetabular component during total hip arthroplasty should be avoided in patients with marked acetabular dysplasia.


Size-dependent oxygen storage ability of nano-sized ceria.
We thermodynamically studied the size-dependent oxygen storage ability of nano-sized ceria by tracing the surface Ce/O ratio of octahedral particles with different diameters, from the viewpoint of lattice Ce and O in a CeO2 crystallographic structure. The high surface Ce/O ratio with small scale particle size has more excess surface Ce(4+) ions, which allows ceria to have an increasing oxygen storage ability in a crystalline lattice. For the perfect octahedron growth shape of ceria, the nonstoichiometric surfaces can produce excess Ce(4+) ions, Ce(4+) ions can be stabilized by bonding with lattice oxygen, leading to an enhanced oxygen storage ability of ceria. With the increasing particle size, the surface Ce/O ratio approaches to 0.5 owing to the decreased contributions of atoms located at the edges and corners. When the octahedron diameter D = 0.55 nm, the surface Ce/O ratio can reach 0.75. When D = 7.58 nm, the surface Ce/O ratio decreases down to 0.51. If D≥ 14.61 nm, the surface Ce/O ratios are equal to 0.5. The present study deepens the insight of the size-dependent oxygen storage ability of nano-sized ceria, focusing on the size-dependent excess Ce(4+) on nonstoichiometric surfaces of ceria in thermodynamics.


Nerve fibre interaction with large ganglion cells in the human spiral ganglion. A TEM study.
A TEM study was performed on freshly fixed human spiral ganglions (HSG) biopsied during skull base surgery. Well preserved tissue specimens were obtained for ultrastructural analysis. The investigation revealed that nerve fibres frequently form contacts with the large ganglion cells (type I cells). In the areas of contact, membrane specializations occurred, consisting of symmetric or asymmetric densities often alternating from one cell to the other with a reduced intercellular distance (approximately 10 nm). High power TEM showed the intercellular cleft to contain an extra dense line resulting in a pentalaminar structure. The dense line appeared on the side of the membrane protein concentration. Protein densities jutted into the cytoplasm along the intracellular face spreading into a diffuse cytoplasmic web physically related to accumulating mitochondria. This indicated a concentration of oxygen-dependent metabolic activity in these regions. It is believed that the nerve junctions are involved in electric transmission between type I ganglion cells. The neural junctions were morphologically different from synaptic contacts between small human ganglion cells (type II cells) and nerve fibres which have been suspected of sharing the olivocochlear bundle as their origin.


Short communication: use of a mechanical brush by Holstein dairy cattle around parturition.
Grooming is a normal behavior that may contribute to relief of stress. The purpose of this study was to investigate the effect of access to a mechanical brush on auto-grooming behavior in parturient cows. The hypothesis was that cows would increase the total time spent scratching using the brush if they had access to a brush around the time of calving, whereas auto-grooming would be lower for the brush group compared with the no-brush group. The use of a mechanical brush was analyzed both in a group-housed pen (72 to 48 h before calving) and in an individual maternity pen (6h before to 6h after calving) in 16 multiparous Holstein cows. In the maternity pen, cows were randomly assigned to have access to the brush or not. The provision of a mechanical brush in the individual maternity pen did not change the amount of time spent auto-grooming but cows did use the brush before calving and after the calf was removed. Despite being housed in pens containing a brush, cows failed to use it when the calf was present. However, cows with access to a brush spent more time licking their calves in the first hour postcalving (β=8.7 min; 95% confidence interval: 1.5, 15.8) than cows that did not have access to a brush. Regardless of treatment, cows increased the time spent auto-grooming and scratching following separation of their newborn calf (β=1.4 min; 95% confidence interval: 0.46, 2.3 and β=0.07 min; 95% confidence interval: 0.02, 0.12, respectively). Further research is warranted to investigate possible benefits of mechanical brush devices at the time of calving, particularly for cows that experience difficult calving and require manual or mechanical assistance.


[Morphophysiologic study of the afferent projections of the posterolateral nucleus of the thalamus in the rat].
Afferent connections of the posterolateral nucleus of the thalamus were studied in rat using retrograde axonal transport of horseradish peroxidase. It was shown that the posterolateral nucleus receives ascending projections from SC, GL, PT, VP, VL, zona incerta and hypothalamus as well as descending projections from cortical areas 18A, 20, 18, 7, 29c , 17 and 36 and from fascia dentata of rippocampus as well. In electrophysiological experiments 134 from 229 investigated neurons of the posterolateral nucleus responded to isolated or simultaneous visual, auditory and cutaneous stimulations. 53 neurons were monosensory units; they responded only to visual (41/53) or cutaneous (12/53) stimulation. Cells responding only to auditory stimulation were not found. Polysensory neurons (81/134) showed convergence of signals from two-three sensory systems and received preferential inputs from visual and somatosensory systems. The polysensory cells showed nonlinear interaction between responses during heterosensory stimulations.


Using just-in-time teaching and peer instruction in a residency program's core curriculum: enhancing satisfaction, engagement, and retention.
To assess use of the combined just-in-time teaching (JiTT) and peer instruction (PI) instructional strategy in a residency program's core curriculum. In 2010-2011, JiTT/PI was piloted in 31 core curriculum sessions taught by 22 faculty in the Northwestern University Feinberg School of Medicine's general surgery residency program. JiTT/PI required preliminary and categorical residents (n=31) to complete Web-based study questions before weekly specialty topic sessions. Responses were examined by faculty members "just in time" to tailor session content to residents' learning needs. In the sessions, residents answered multiple-choice questions (MCQs) using clickers and engaged in PI. Participants completed surveys assessing their perceptions of JiTT/PI. Videos were coded to assess resident engagement time in JiTT/PI sessions versus prior lecture-based sessions. Responses to topic session MCQs repeated in review sessions were evaluated to study retention. More than 70% of resident survey respondents indicated that JiTT/PI aided in the learning of key points. At least 90% of faculty survey respondents reported positive perceptions of aspects of the JiTT/PI strategy. Resident engagement time for JiTT/PI sessions was significantly greater than for prior lecture-based sessions (z=-2.4, P=.016). Significantly more review session MCQ responses were correct for residents who had attended corresponding JiTT/PI sessions than for residents who had not (chi-square=13.7; df=1; P<.001). JiTT/PI increased learner participation, learner retention, and the amount of learner-centered time. JiTT/PI represents an effective approach for meaningful and active learning in core curriculum sessions.


Treatment with SI000413, a new herbal formula, ameliorates murine collagen-induced arthritis.
We tested the effects of SI000413, a new formula, consisting of Pyrolae herba and Trachelospermi caulis, on type II collagen-induced arthritis (CIA). CIA was induced in DBA/1J mice by immunization with bovine type II collagen (CII) on days 1 and 21. SI000413 was orally administered 3 times per week throughout the experiment and indomethacin was served as a positive control. Clinical scores, the count of arthritic legs, levels of interleukin 6 (IL-6) and anti-CII antibody, and lymphocyte subsets in blood were examined. SI000413 suppressed CIA development in a dose dependent manner and reduced the incidence of arthritic legs in mice. Histological analysis showed administration of SI000413 reduced inflammatory signs and cartilage destruction. Serum levels of IL-6 and anti-CII antibody were significantly decreased in SI000413-treated mice and the percentages of CD4 T cell, CD8 T cell and B cell in blood were restored to normal levels. In conclusion, we demonstrate that SI000413 ameliorates CIA both clinically and histologically and inhibits the production of anti-CII antibody and pro-inflammatory cytokine in the CIA mouse. These findings suggest that SI000413 is a potential new therapeutic herbal formula for the treatment of RA.


Gaining freedom: self-responsibility in adolescents with diabetes.
This exploratory, qualitative pilot study explored the meaning of the chronic illness experience for adolescents with diabetes in relation to taking on responsibility for their own care. Four adolescents aged 15 to 17 years with insulin-dependent diabetes mellitus participated in indepth interviews. Gaining freedom was the central phenomenon that captured the process of gaining self-responsibility in diabetes management during adolescence. Three themes marked the process: (a) making it fit; (b) being ready and willing; and (c) having a safety net of friends. These adolescents described a gradual transition from dependence to independence in learning to manage their diabetes. These findings should cause advanced practice nurses to re-evaluate their frameworks for adolescents with diabetes and develop a collaborative approach. Intervention strategies must be developed that incorporate adolescent developmental needs, determine readiness and motivation to learn, and provide opportunities to practice independence in self-management.


Sound source localization using multiple circular microphone arrays based on harmonic analysis.
This paper proposes a multiple signal classification (MUSIC) framework for direction-of-arrival estimation by combining multiple circular arrays in the circular-harmonics domain. We jointly transform the received signals of all sub-arrays into the circular harmonics domain to generate a set of sound field coefficients containing the direction information of the sound sources. These coefficients are then formulated in a form in which MUSIC algorithm can be applied. Compared with the conventional circular-harmonics-domain localization methods, which are based on a single circular array, the proposed method can provide sufficient spatial resolution over different frequency ranges by adjusting the distribution of sub-arrays. Furthermore, the mean square error of the estimated sound field coefficients is derived for guiding this adjustment. Numerical simulation results indicate that a reasonable distribution of sub-arrays can effectively avoid the performance degradation caused by the zeros of Bessel functions, which is an inherent problem of the modal array signal processing. Simulation and experimental results with different configuration parameters demonstrate that the proposed method provides a better localization performance compared to the state-of-the-art methods.


Antifungal Mechanism and Efficacy of Kojic Acid for the Control of Sclerotinia sclerotiorum in Soybean.
Sclerotinia stem rot, which is caused by the fungal pathogen Sclerotinia sclerotiorum, is a soybean disease that results in enormous economic losses worldwide. The control of S. sclerotiorum is a difficult task due to the pathogen's wide host range and its persistent structures, called sclerotia. In addition, there is lack of soybean cultivars with medium to high levels of resistance to S. sclerotiorum. In this work, kojic acid (KA), a natural bioactive compound commonly used in cosmetic industry, was evaluated for the management of Sclerotinia stem rot. Interestingly, KA showed strong antifungal activity against S. sclerotiorum by inhibiting chitin and melanin syntheses and, subsequently, sclerotia formation. The antifungal activity of KA was not obviously affected by pH, but was reduced in the presence of metal ions. Treatment with KA reduced the content of virulence factor oxalic acid in S. sclerotiorum secretions. Preventive applications of 50 mM KA (7.1 mg/ml) completely inhibited S. sclerotiorum symptoms in soybean; whereas, in curative applications, the combination of KA with prochloraz and carbendazim improved the efficacy of these commercial fungicides. Taken together, the antifungal activity of KA against S. sclerotiorum was studied for the first time, revealing new insights on the potential application of KA for the control of Sclerotinia stem rot in soybean.


EEG theta and alpha oscillations in early versus late mild cognitive impairment during a semantic Go/NoGo task.
Amnestic mild cognitive impairment (aMCI) is marked by episodic memory deficits, which can be used to classify individuals into early MCI (EMCI) and late MCI (LMCI). Although mounting evidence suggests that individuals with aMCI have additional cognitive alterations including deficits in cognitive control, few have examined if EMCI and LMCI differ on processes other than episodic memory. Using a semantic Go/NoGo task, we examined differences in cognitive control between EMCI and LMCI on behavioral (accuracy and reaction time) and neural (scalp-recorded event-related oscillations in theta and alpha band) measures. Although no behavioral differences were observed between the EMCI and LMCI groups, differences in neural oscillations were observed. The LMCI group had higher theta synchronization on Go trials at central electrodes compared to the EMCI group. In addition, the EMCI group showed differences in theta power at central electrodes and alpha power at central and centro-parietal electrodes between Go and NoGo trials, while the LMCI group did not exhibit such differences. These findings suggest that while behavioral differences may not be observable, neural changes underlying cognitive control processes may differentiate EMCI and LMCI stages and may be useful to understand the trajectory of aMCI in future studies.


Volatile N-nitrosamines and their precursors in Chinese salted fish--a possible etological factor for NPC in china.
Epidemiological studies show that the consumption of Chinese salted fish is a causative factor for nasopharyngeal carcinoma (NPC) in southern China. In the present study, N-nitrosamines and their precursors were analyzed in 145 samples of cooked, salted fish collected from various areas in China. The results show that N-dimethylnitrosamine (NDMA), N-diethylnitrosamine (NDEA), N-nitrosopyrrolidine (NPYR) and N-nitrosopiperidine (NPIP) were present in the salted fish. Total volatile N-nitrosamines (TVN) in the salted fish were 0.028 to 4.54 mg/kg. The samples from areas with higher NPC risk showed a higher average level of TVN than those from areas of lower NPC risk. Positive correlations were found between the levels of NDMA, NDEA and TVN and mortality from NPC. Although neither the nitrates nor the nitrites in the salted fish were present at significantly high levels, in vitro data regarding nitrosation of salted fish showed that the N-nitrosamine content had increased substantially. The results support the conclusion that the high NPC risk in southern Chinese may be attributed to consumption of salted fish containing high levels of N-nitrosamines.


Three-component Gross-Pitaevskii equations in the spin-1 Bose-Einstein condensate: Spin-rotation symmetry, matter-wave solutions, and dynamics.
We report new matter-wave solutions of the one-dimensional spin-1 Bose-Einstein condensate system by combining global spin-rotation states and similarity transformation. Dynamical behaviors of non-stationary global spin-rotation states derived from the SU(2) spin-rotation symmetry are discussed, which exhibit temporal periodicity. We derive generalized bright-dark mixed solitons and new rogue wave solutions and reveal the relations between Euler angles in spin-rotation symmetry and parameters in ferromagnetic and polar solitons. In the modulated spin-1 Bose-Einstein condensate system, new solutions are derived and graphically illustrated for different types of modulations. Moreover, numerical simulations are performed to investigate the stability of some obtained solutions for chosen parameters.


Optimization of foot-and-mouth disease vaccination protocols by surveillance of neutralization antibodies.
An appropriate immunization program for pigs in a foot-and-mouth disease (FMD) endemic area was proposed based on data analysis obtained from serological surveillance in Taiwan, after an intensive vaccination program. To provide an adequate passive immunity for piglets, gilts that have completed two basic vaccinations must be boosted once before breeding. To achieve an efficient response to the FMD vaccine for piglets born to well vaccinated sows, vaccination need to be delayed until 10-12 weeks of ages for the first immunization, followed by a boost 4 weeks later.


Accidental entry of an implantable cardioverter defibrillator lead into the left hepatic vein detected by transesophageal echocardiography.
We report a case of accidental entry of an implantable cardioverter defibrillator lead into the hepatic vein, which was not noted on fluoroscopy but was apparent when transesophageal echocardiography (TEE) was used incidentally. The lead was depicted in the hepatic vein as strongly echogenic, accompanied by an acoustic shadow. Additional bending of the stylet was helpful for successful advancement of the lead. TEE provides additional information in such cases, although indications for its use should be explored because of its possible complications.


Electric field and mechanical stress driven structural inhomogeneity and compositionally induced relaxor phase transformation in modified BaTiO3 based lead-free ferroelectrics.
The compositionally induced ferroelectric to relaxor transformation via diffuse phase transition and structural disorder by external stimuli is explored in lead-free Ba1-x (Bi0.5Li0.5) x TiO3 (x = 0, 0.05, 0.1, 0.15, and 0.20) ferroelectric system. X-ray diffraction studies reveal the coexistence of the monoclinic phase along with the orthorhombic and tetragonal phases in BaTiO3, which could be the reason for its superior dielectric properties. The dielectric studies reveal that the x = 0.15 sample shows intrinsic dielectric relaxation due to the quenched-in random field caused by the atomic displacement. The ferroelectric to relaxor phase transformation is analysed by modified Curie-Weiss law. Furthermore, the driving forces for the relaxor behaviour in the system are attributed to the compositionally induced charge disorder, quenched-in random field, and oxygen vacancy related defects in the BBLT system. The detailed structural analysis on the relaxor ferroelectric samples displays direct evidence for the electric field and mechanical stress driven structural inhomogeneity. Notably, mechanically stressed and electrically poled x = 0.15 sample exhibits a remarkable 50% and 37% increase in orthorhombic phase fraction, respectively. Overall, the comprehensive studies on the lead-free modified BaTiO3 samples give further insight into understanding the relaxor system.


1,2,3,4-Tetrahydrobenzo[h][1,6]naphthyridines as a new family of potent peripheral-to-midgorge-site inhibitors of acetylcholinesterase: synthesis, pharmacological evaluation and mechanistic studies.
A series of 1,2,3,4-tetrahydrobenzo[h][1,6]naphthyridines differently substituted at positions 1, 5, and 9 have been designed from the pyrano[3,2-c]quinoline derivative 1, a weak inhibitor of acetylcholinesterase (AChE) with predicted ability to bind to the AChE peripheral anionic site (PAS), at the entrance of the catalytic gorge. Fourteen novel benzonaphthyridines have been synthesized through synthetic sequences involving as the key step a multicomponent Povarov reaction between an aldehyde, an aniline and an enamine or an enamide as the activated alkene. The novel compounds have been tested against Electrophorus electricus AChE (EeAChE), human recombinant AChE (hAChE), and human serum butyrylcholinesterase (hBChE), and their brain penetration has been assessed using the PAMPA-BBB assay. Also, the mechanism of AChE inhibition of the most potent compounds has been thoroughly studied by kinetic studies, a propidium displacement assay, and molecular modelling. We have found that a seemingly small structural change such as a double O → NH bioisosteric replacement from the hit 1 to 16a results in a dramatic increase of EeAChE and hAChE inhibitory activities (>217- and >154-fold, respectively), and in a notable increase in hBChE inhibitory activity (>11-fold), as well. An optimized binding at the PAS besides additional interactions with AChE midgorge residues seem to account for the high hAChE inhibitory potency of 16a (IC50 = 65 nM), which emerges as an interesting anti-Alzheimer lead compound with potent dual AChE and BChE inhibitory activities.


TCR expression of activated T cell clones in the lungs of patients with pulmonary sarcoidosis.
Sarcoidosis is a systemic granulomatous disease of unknown etiology in which CD4+ T cells seem to be critically involved. In the lungs of patients with pulmonary disease, CD4+ T cells accumulate in large numbers, and a subset of these cells is activated. By using both quantitative PCR and anti-V beta mAbs, we analyzed the TCR repertoire of total and activated bronchoalveolar lavage T cells, the latter subset being defined by the ability to proliferate in short-term culture supplemented with IL-2. Overall, there was little difference when TCR V beta expression of freshly isolated lung and peripheral blood cells was compared in individual patients. Some individuals did demonstrate a modest increase in a few V beta-expressing subsets. However, after 1 to 2 wk of in vitro growth in IL-2-supplemented media, bronchoalveolar lavage cells from most patients, but not from any healthy individuals, demonstrated a selective expansion of particular V beta-expressing subsets. Interestingly, different V beta-bearing subsets were expanded in different patients. Junctional region sequencing indicated that the proliferating T cells in culture were strikingly oligoclonal and were derived from T cell clones already selectively expanded in vivo. These results provide evidence for a disease process that involves recognition of local Ag(s) by specific subsets of CD4+ T cells. Analysis of the Ag specificity of these IL-2-expanded populations is likely to provide insight into the pathogenesis of this disease.


Epidemiology of invasive pneumococcal disease among adult patients in barcelona before and after pediatric 7-valent pneumococcal conjugate vaccine introduction, 1997-2007.
A dramatic decrease in the incidence of invasive pneumococcal disease (IPD) was observed among children and adults in the United States after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). Little is known about the incidence of IPD after PCV7 licensure in Europe. The objective of this study was to examine changes in the prevalence of IPD among adults in the PCV7 era. We undertook a prospective study involving adults with IPD who required hospital admission in the southern area of Barcelona, Spain. Three periods were studied: the pre-PCV7 period (1997-2001), the early PCV7 period (2002-2004), and the late PCV7 period (2005-2007). A total of 1007 episodes of IPD were observed. Rates of IPD among adults increased from 13.9 to 14.6 episodes per 100,000 population between the pre-PCV7 period and the early PCV7 period (P = .6) and then to 19.55 episodes per 100,000 population in the late PCV7 period (P < .001). The rates of IPD among adults due to non-PCV7 serotypes increased from 8.4 to 9.7 episodes per 100,000 population between the pre-PCV7 period and the early PCV7 period (P = .15) and then to 15.3 episodes per 100,000 population in the late PCV7 period (P < .001); IPD due to PCV7 serotypes decreased from 5.6 to 4.9 episodes per 100,000 population between the pre-PCV7 period and the early PCV7 period (P = .3), then to 4.3 episodes per 100,000 population in the late PCV7 period (P = .056). Among people aged > or = 65 years, IPD due to PCV7 serotypes decreased from 19.5 to 14.6 episodes per 100,000 population between the pre-PCV7 period and the early PCV7 period (P = .13), then to 12.3 episodes per 100,000 population in the late PCV7 period (P = .02). A decrease in the prevalence of antibioticresistant pneumococci in the late PCV7 period was associated with a decrease in the prevalence of multidrugresistant PCV7 clones (Spain(23F)-ST81, Spain(6B)-ST90, and ST88(19F)) and an increase in the prevalence of non-PCV7 antibiotic-susceptible clones (ST306(1), ST191(7F), ST989(12F), and ST433(22F)). Rates of IPD among adults increased in Barcelona in the late PCV7 period, coinciding with a clonal expansion of non-PCV7 serotypes. In contrast, rates of IPD caused by PCV7 serotypes decreased among people aged > or = 65 years, which suggests the development of a herd immunity.


Photochemically induced spinal cord ischaemia in rats: assessment of blood flow by laser Doppler flowmetry.
A photochemical technique was used to create central nervous system ischaemia in rats. Changes in blood flow in the spinal cord were assessed by laser Doppler flowmetry. The Th11 spinal cord segment was irradiated by an argon ion laser after intravenous injection of an organic dye, erythrosin B, to rats with or without a laminectomy. In the group of laminectomized rats, laser irradiation for 5 s did not influence cord blood flow, but 10 s irradiation caused a 25% decrease of blood flow, which normalized within 20 min. Decreases of 50 and 80% in spinal cord blood flow were noted after 20 s and after 1 min of laser irradiation, respectively, with no recovery observed after 20 min. In the group of rats without a laminectomy, 1 min of laser irradiation caused approximately a 25% decrease of spinal cord blood flow, which gradually recovered within 12 min, whereas 5 min of laser irradiation caused a more severe reduction of spinal cord blood flow (45%) with some recovery was observed 30 min later. We could thus confirm that the interaction between a photosensitizing dye and laser irradiation reduced the regional spinal cord blood flow and the extent of this effect could be modified by varying the duration of laser irradiation. The present results therefore provide further support for using this photochemical technique to create animal models of central nervous system ischaemia.


Scoping Review on Interventions, Actions, and Policies Affecting Return to School and Preventing School Dropout in Primary School.
Dropout is one of the most important social problems in the world and especially in low- and middle-income countries. Efforts to prevent dropouts require giving due attention to different perspectives for applying them. The present study aims to identify the policies and interventions made in previous studies because reviewing evidence-based interventions and learning from their strengths and weaknesses is likely to play an effective role in preventing students from leaving school and returning them to school. This scoping review study conducted on all available studies and documents related to students' dropout. The study population includes articles searched in electronic sources that contain information related to the subject of dropout and out-of-school in primary schools. Appropriate keywords were extracted based on Mesh term and EMTREE and their synonyms and searched by a medical librarian. scientific sources and Gray literature published in Persian and English based on PRISMA standard criteria were reviewed. A review of studies indicated that various interventions such as student interaction with school, educational interventions on students and teachers, family and local community cooperation, free nutrition, behavioral interventions, financial aid, and free education had positive effects on reducing dropout, absenteeism and encouraging students to return to schools. effect size was not reported for school dropout intervention. The findings have indicated that intervention with a combination of global and targeted strategies can affect dropout in developing countries. However, to confirm the effectiveness of this type of intervention, further research is required to be conducted in different countries and with different cultures.


Molecular cloning and characterization of the human RNase kappa, an ortholog of Cc RNase.
A novel protein family, designated hereafter as RNase kappa (kappa) family, has been recently introduced with the characterization of the specific Cc RNase, isolated from the insect Ceratitis capitata. The human ortholog of this family consists of 98 amino acids and shares > 98% identity with its mammalian counterparts. This RNase is encoded by a single-copy gene found to be expressed in a wide spectrum of normal and cancer tissues. The cDNA of the human ribonuclease has been isolated and subcloned into a variety of prokaryotic expression vectors, but most efforts to express it caused a severe toxic effect. On the other hand, the expression of the human RNase by the use of the methylotrophic yeast Pichia pastoris system resulted in the production of a highly active recombinant enzyme. Using a 30-mer 5'-end-labeled RNA probe as substrate, the purified enzyme seems to preferentially cleave ApU and ApG phosphodiester bonds, while it hydrolyzes UpU bonds at a lower rate. Based on amino acid sequence alignment and substrate specificity data, as well as the complete resistance of the recombinant protein to the placental ribonuclease inhibitor, we concluded that the human RNase kappa is a novel endoribonuclease distinct from other known ribonucleases.


Highly optimised global organisation of metabolic networks.
High-level, mathematically precise descriptions of the global organisation of complex metabolic networks are necessary for understanding the global structure of metabolic networks, the interpretation and integration of large amounts of biologic data (sequences, various -omics) and ultimately for rational design of therapies for disease processes. Metabolic networks are highly organised to execute their function efficiently while tolerating wide variation in their environment. These networks are constrained by physical requirements (e.g. conservation of energy, redox and small moieties) but are also remarkably robust and evolvable. The authors use well-known features of the stoichiometry of bacterial metabolic networks to demonstrate how network architecture facilitates such capabilities, and to develop a minimal abstract metabolism which incorporates the known features of the stoichiometry and respects the constraints on enzymes and reactions. This model shows that the essential functionality and constraints drive the tradeoffs between robustness and fragility, as well as the large-scale structure and organisation of the whole network, particularly high variability. The authors emphasise how domain-specific constraints and tradeoffs imposed by the environment are important factors in shaping stoichiometry. Importantly, the consequence of these highly organised tradeoffs and tolerances is an architecture that has a highly structured modularity that is self-dissimilar and scale-rich.


Intraplacental choriocarcinoma in a term placenta with both maternal and infantile metastases: a case report and review of the literature.
Intraplacental choriocarcinoma is rare, and usually results in maternal metastasis at the time of diagnosis. Intraplacental choriocarcinoma involves both mother and infant is extremely rare. There was only one case report of intraplacental choriocarcinoma with confirmed metastases involving both the mother and the infant. We describe a second case of intraplacental choriocarcinoma in a term placenta with both maternal and infantile metastases. Grossly, the primary lesion of the placenta resembled an old infarct. Microscopically, clusters of malignant trophoblasts arose from residual normal chorionic villi and infiltrated into the intervillous spaces. Both the mother and the infant received chemotherapy and were alive without disease after one year's follow-up. The optimal treatment for intraplacental choriocarcinoma is controversial. However, aggressive chemotherapy is suggested for patients with metastatic disease.


Histological evaluations of organ tissues reveal sublethal effects in a freshwater mussel (Villosa iris) exposed to chloride and potassium concentrations below benchmark estimates.
Salinization of freshwater ecosystems due to anthropogenic sources will increasingly impact biodiversity. An example of point-source industrial salinization has occurred from historical activities at a U.S. Environmental Protection Agency Superfund Site near Saltville, Virginia USA and its associated chemical waste ponds adjacent to the North Fork Holston River. These point source discharges are documented contributors to mussel declines, partially due to high concentrations of chloride (Cl-, ≤ 26,000 mg Cl-/L) and potassium (K+, ≤ 97 mg K+/L). During a chronic 61-day laboratory study, Rainbow mussels, Villosa iris, were exposed to concentrations of Cl- (0, 416, 831, and 1,663 mg/L) and K+ (0, 4, 8, and 17 mg/L) to determine effects on survival and organ tissues. All test mussels died by day-2 in the 1,663 mg Cl-/L exposure, and 50% of mussels died by day-13 in the 17 mg K+/L concentration. Significantly greater abundances of tissue abnormalities were observed in digestive glands and kidneys with exposures to the 4 and 8 mg/L concentrations of K+ versus the control, and significantly greater abundances of lesions in kidneys were observed in the 416 and 831 mg Cl-/L concentrations compared to the control. The sublethal effects to digestive glands and kidneys were below reported effect (EC50, 20, 10 and LOEC) concentrations. Significant histological differences between control and baseline (day-0 sample) mussels were observed, suggesting the need for further study on the effects of captivity during longer-term laboratory experiments.


Respirator use and practices in agricultural crop production establishments.
The risk of developing respiratory diseases can be reduced by either wearing respiratory protection under the guidance of an effective respiratory protection program or using controls. In 2001, the Survey of Respirator Use and Practices gathered information on the types of respirators used, respirator use practices, and the respirator program characteristics from 40,002 randomly selected US establishments. This report presents findings of the Survey of Respirator Use and Practices for the Agricultural Production-Crops industry and compares them with National Institute for Occupational Safety and Health (NIOSH) recommendations. Approximately one third of all Agricultural Production-Crops establishments required respirator use. Of the Agricultural Production-Crops establishments that required respirator use, (1) a written program to determine what type of respirator to use was not adopted by management in 73% of the establishments; (2) 21% did not know whether air sampling was conducted for substances for which employees were required to use respirators; (3) 29.5% did not provide respirator training for employees; (4) employees were not assessed for medical fitness to wear a respirator or it was not known whether the employees were assessed, in 49.4%; and (5) the program administrator had received no respirator training in 29.5%. Of the Agricultural Production-Crops establishments that required respirator use, 69.5% had at least 3 indicators of a potentially inadequate respiratory protection program. The high rates of indicators of potential inadequacies suggest widespread problems with respiratory protection programs in the Agricultural Production-Crops industry, indicating a potential for improvement.


25 Angstrom resolution structure of a cytoplasmic dynein motor reveals a seven-member planar ring.
Dyneins form one of the three major families of cytoskeleton-based motor proteins that together drive most of the visible forms of cell and organelle movement. We present here a 3D reconstruction of a cytoplasmic dynein motor domain obtained by electron microscopy, at 25 Angstrom resolution. This work demonstrates a basic motor architecture of a flat, slightly elliptical ring composed of seven densities arranged around a partially enclosed central cavity. We have used specific Fab tags to localize the microtubule-binding domain; the connecting stalk emerges at one end of the motor's long axis. Through proposed fitting of representative AAA domain structures, we show that the nucleotide catalytic P-1 domain is likely located at the opposite end of the motor. Thus mechanisms that couple nucleotide hydrolysis with microtubule binding must be propagated around a ring structure, in a manner clearly distinct from kinesin or myosin-mediated movements. Analysis of the Fab tagged datasets reveals classes of particles with stalks protruding at distinct angles from the motor. There is a approximately 40 degrees variation in microtubule-binding stalk angle that may reflect linkage to dynein's mechanochemical cycle. Overall, the work provides sufficient resolution to begin the mapping of landmark features onto a dynein motor, and provides a foundation for understanding the mechanics of dynein movement.


Analysis of household expenditure on healthcare in Argentina, as a component of universal health coverage.
The 2010 World Health Report of WHO established a conceptual framework for the analysis of the components of Universal Health Coverage; three dimensions were suggested: services coverage, financial coverage, and population coverage. Within this framework, health-related spending of argentine households for the year 2012-2013 are analyzed. The analysis was performed on data retrieved from the National Survey of Household Expenditure 2012-2013. Household healthcare expenditure indicators were built following Sherri's proposal (2012) and multivariate models were defined to identify determiners of household spending. Results indicate that catastrophic spending situations affect 2.3% of the country households, whereas impoverishment resulting from spending on healthcare was detected in 1.7% of them.


Improved flooding tolerance and carbohydrate status of flood-tolerant plant Arundinella anomala at lower water temperature.
Operation of the Three Gorges Reservoir (TGR, China) imposes a new water fluctuation regime, including a prolonged winter submergence in contrast to the natural short summer flooding of the rivers. The contrasting water temperature regimes may remarkably affect the survival of submerged plants in the TGR. Plant survival in such prolonged flooding might depend on the carbohydrate status of the plants. Therefore, we investigated the effects of water temperature on survival and carbohydrate status in a flood-tolerant plant species and predicted that both survival and carbohydrate status would be improved by lower water temperatures. A growth chamber experiment with controlled water temperature were performed with the flood-tolerant species Arundinella anomala from the TGR region. The plants were submerged (80 cm deep water above soil surface) with a constant water temperature at 30°C, 20°C or 10°C. The water temperature effects on survival, plant biomass and carbohydrate content (glucose, fructose and sucrose and starch) in the viable and dead tissues were investigated. The results showed that the survival percentage of A.anomala plants was greatly dependent on water temperature. The two-month submergence survival percentage was 100% at 10°C, 40% at 20°C and 0% at 30°C. Decreasing the water temperature led to both later leaf death and slower biomass loss. Temperature decrease also induced less reduction in glucose, fructose and sucrose in the roots and leaves (before decay, p < 0.05), but only marginally significant in the stems (p < 0.05). However, the starch content level did not differ significantly between the water temperature treatments (p > 0.05). Different water temperatures did not alter the carbon pool size in the stems, leaves and whole plants (p > 0.05), but a clear difference was found in the roots (p < 0.05), with a larger pool size at a lower temperature. We concluded that (1) A. anomala is characterized by high flooding tolerance and sustained capability to mobilize carbohydrate pool. (2) The survival percentage and carbohydrate status of submerged A. anomala plants were remarkably improved by lower water temperatures. The survival of submergence seemed to be closely associated with the sugar content and carbohydrate pool size of the roots, which contained the lowest amount of carbohydrates. Three Gorges reservoir impoundment in winter is beneficial to the survival of submerged A. anomala in riparian area of the reservoir due to the low water temperature.


Single-cell detection by gradient echo 9.4 T MRI: a parametric study.
Recent studies have shown that cell migration can be monitored in vivo by magnetic resonance imaging after intracellular contrast agent incorporation. This is due to the dephasing effect on proton magnetization of the local magnetic field created by a labelled cell. Anionic iron oxide nanoparticles (AMNP) are among the most efficient and non-toxic contrast agents to be spontaneously taken up by a wide variety of cells. Here we measured the iron load and magnetization of HeLa tumour cells labelled with AMNP, as a function of the external magnetic field. High-resolution gradient echo 9.4 T MRI detected individual labelled cells, whereas spin echo sequences were poorly sensitive. We then conducted a systematic study in order to determine the gradient echo sequence parameters (echo time, cell magnetization and resolution) most suitable for in vivo identification of single cells.


The study of the radiation environment in near-earth space.
The report contains the description of the devices used for studying the radiation environment in space. They consist of passive dosimeters, a monitoring dosimeter and a spectrometer. Data were obtained with them over a long period of time. The analysis of these data permits one to conclude that radiation dose greatly depends on the apogee altitude and inclination; increasing the shield thickness does not greatly decrease the daily dose. The daily doses in orbits with an inclination of less than 65 degrees are 7 to 45 mrad day-1; the quality factor in those orbits was 1.2-1.4.


Comparison of RECIST version 1.0 and 1.1 in assessment of tumor response by computed tomography in advanced gastric cancer.
Response Evaluation Criteria in Solid Tumors (RECIST) guideline version 1.0 (RECIST 1.0) was proposed as a new guideline for evaluating tumor response and has been widely accepted as a standardized measure. With a number of issues being raised on RECIST 1.0, however, a revised RECIST guideline version 1.1 (RECIST 1.1) was proposed by the RECIST Working Group in 2009. This study was conducted to compare CT tumor response based on RECIST 1.1 vs. RECIST 1.0 in patients with advanced gastric cancer (AGC). We reviewed 61 AGC patients with measurable diseases by RECIST 1.0 who were enrolled in other clinical trials between 2008 and 2010. These patients were retrospectively re-analyzed to determine the concordance between the two response criteria using the κ statistic. The number and sum of tumor diameters of the target lesions by RECIST 1.1 were significantly lower than those by RECIST 1.0 (P<0.0001). However, there was excellent agreement in tumor response between RECIST 1.1 and RECIST 1.0 (κ=0.844). The overall response rates (ORRs) according to RECIST 1.0 and RECIST 1.1 were 32.7% (20/61) and 34.5% (20/58), respectively. One patient with partial response (PR) based on RECIST 1.0 was reclassified as stable disease (SD) by RECIST 1.1. Of two patients with SD by RECIST 1.0, one was downgraded to progressive disease and the other was upgraded to PR by RECIST 1.1. RECIST 1.1 provided almost perfect agreement with RECIST 1.0 in the CT assessment of tumor response of AGC.


Down-regulation of miR-342-3p in hepatocellular carcinoma tissues and its prognostic significance.
The involvement of microRNAs in cancer and their potential as biomarkers of prognosis are becoming increasingly appreciated. The aim of this study was to evaluate the clinical importance and prognostic value of miR-342-3p in hepatocellular carcinoma (HCC). RT-PCR was used to detect the expression of miR-342-3p. The association with clinicopathologic features was analyzed. Kaplan-Meier survival analysis and Cox proportional hazards analysis were used to compare the overall survival between HCC patients with high miR-342-3p expression and those with low miR-342-3p expression. We found that miR-342-3p expression was significantly decreased in HCC tissues compared with paired adjacent non-tumor tissues (p < 0.001). MiR-342-3p expression was correlated with histologic grade (p = 0.008) and tumor TNM stage (p = 0.001). Kaplan-Meier survival analysis showed that patients in the high miR-342-3p expression group had better overall survival than those in the low miR-342-3p expression group (p < 0.001). Univariate analysis showed that miR-342-3p (p = 0.001), TNM stage (p = 0.002) and histologic grade (p = 0.006) were associated with poor survival rates. Multivariate analysis confirmed that miR-342-3p expression can be used as an independent predictor for HCC prognosis (p = 0.002). miR-342-3p may serve as a tumor suppressor during HCC progression, and its low expression may be a potential biomarker for poor prognosis of HCC.


Accuracy evaluation of a new stereophotogrammetry-based functional method for joint kinematic analysis in biomechanics.
The human joint kinematics is an interesting topic in biomechanics and turns to be useful for the analysis of human movement in several fields. A crucial issue regards the assessment of joint parameters, like axes and centers of rotation, due to the direct influence on human motion patterns. A proper accuracy in the estimation of these parameters is hence required. On the whole, stereophotogrammetry-based predictive methods and, as an alternative, functional ones can be used to this end. This article presents a new functional algorithm for the assessment of knee joint parameters, based on a polycentric hinge model for the knee flexion-extension. The proposed algorithm is discussed, identifying its fields of application and its limits. The techniques for estimating the joint parameters from the metrological point of view are analyzed, so as to lay the groundwork for enhancing and eventually replacing predictive methods, currently used in the laboratories of human movement analysis. This article also presents an assessment of the accuracy associated with the whole process of measurement and joint parameters estimation. To this end, the presented functional method is tested through both computer simulations and a series of experimental laboratory tests in which swing motions were imposed to a polycentric mechanical analogue and a stereophotogrammetric system was used to record them.


Post-transplant cyclophosphamide for graft-versus-host disease prophylaxis in HLA matched sibling or matched unrelated donor transplant for patients with acute leukemia, on behalf of ALWP-EBMT.
Experience using post-transplant cyclophosphamide (PT-Cy) as graft-versus-host disease (GVHD) prophylaxis in allogeneic stem cell transplantation (HSCT) from matched sibling donors (MSD) or unrelated donors (UD) is limited and with controversial results. The study aim was to evaluate PT-Cy as GVHD prophylaxis post-HSCT from MSD and UD transplants. We analyzed 423 patients with acute leukemia who received PT-Cy alone or in combination with other immunosuppressive (IS) drugs as GVHD prophylaxis. Seventy-eight patients received PT-Cy alone (group 1); 204 received PT-Cy in combination with one IS drug-cyclosporine-A (CSA) or methotrexate (MTX) or mycophenolate-mofetil (MMF) (group 2), while 141 patients received PT-Cy in combination with two IS drugs-CSA + MTX or CSA + MMF (group 3). Transplants were performed from 2007 to 2015 and median follow-up was 20 months. Probability of overall survival (OS) at 2 years was 50, 52.2, and 62.4%, for the three groups, respectively, p = 0.06. In multivariate analysis, in comparison to PT-Cy alone, the addition of two IS drugs was associated with reduced risk of extensive cGVHD (HR 0.25, p = 0.02). Use of bone marrow (BM) and anti-thymocyte globulin were independently associated with reduced risk of extensive cGVHD. Prognostic factors for non-relapse mortality (NRM) were the addition of two IS drugs to PT-Cy (HR 0.35, p = 0.04), diagnosis of AML, disease status at transplant, and patient CMV serology. Factors associated with increased OS were the use of PT-Cy with two IS drugs (HR 0.49, p = 0.02), AML, and disease status at transplant. For GVHD prophylaxis in MSD and UD HSCT, the addition of IS drugs to PT-Cy enhances its effect and reduces the risk of severe cGVHD, reducing mortality and improving survival.


Lymphaticovenous Bypass: Adaptations and Lessons Learned.
Advances in microsurgical instruments and techniques have allowed for introduction of lymphaticovenous anastomosis as a potential surgical treatment for patients with upper and lower extremity lymphedema. This article reviews the approach to lymphaticovenous anastomosis patient selection and technical modifications that improve the ease and efficiency of the procedure.


The relationship between coronary artery disease and abnormal glucose regulation in China: the China Heart Survey.
The aim of this article is to characterize the glucometabolic state of patients with coronary artery disease (CAD) in China. This multicentre study recruited 3513 patients hospitalized for CAD, of whom 35.1% were admissions for acute CAD and 64.9% were elective admissions for CAD. At entry, 1153 patients had known type 2 diabetes and 97 had newly diagnosed diabetes [fasting plasma glucose level (FPG) > or =7.0 mmol/L]. Oral glucose tolerance tests (OGTTs) performed in the remaining patients revealed that 26.9% had diabetes and 37.3% had impaired glucose regulation (IGR). The prevalence of abnormal glucose regulation (AGR) was similar in the acute and elective admissions groups. Overall, the proportion of patients with diagnosed diabetes increased from 32.8% at baseline to 52.9% post-OGTT analysis. In total, 87.4% of patients with IGR and 80.5% of patients with diabetes would have remained undiagnosed if OGTTs had not been performed. AGR is common in patients with CAD. The prevalence of AGR is underestimated by FPG testing alone. OGTTs should be routinely used to assess the glucometabolic state of patients with CAD. Individuals identified with IGR or type 2 diabetes should receive treatment to reduce the progression of AGR and associated complications.