Emergency surgery during the COVID-19 pandemic: what you need to know for practice.
Several articles have been published about the reorganisation of surgical activity during the COVID-19 pandemic but few, if any, have focused on the impact that this has had on emergency and trauma surgery. Our aim was to review the most current data on COVID-19 to provide essential suggestions on how to manage the acute abdomen during the pandemic. A systematic review was conducted of the most relevant English language articles on COVID-19 and surgery published between 15 December 2019 and 30 March 2020. Access to the operating theatre is almost exclusively restricted to emergencies and oncological procedures. The use of laparoscopy in COVID-19 positive patients should be cautiously considered. The main risk lies in the presence of the virus in the pneumoperitoneum: the aerosol released in the operating theatre could contaminate both staff and the environment. During the COVID-19 pandemic, all efforts should be deployed in order to evaluate the feasibility of postponing surgery until the patient is no longer considered potentially infectious or at risk of perioperative complications. If surgery is deemed necessary, the emergency surgeon must minimise the risk of exposure to the virus by involving a minimal number of healthcare staff and shortening the occupation of the operating theatre. In case of a lack of security measures to enable safe laparoscopy, open surgery should be considered.


A delicate balance: maintaining mutualism to prevent disease.
The intestinal microbial ecosystem is complex, and few of the principles that contribute to homeostasis in health are well understood. Pham et al. (2014) show that a network including the epithelial interleukin-22 receptor protects against infection with the opportunistic pathogen Enterococcus faecalis through promotion of host-microbiota mutualism.


A qualitative approach to understand antiretroviral therapy (ART) adherence for refugees living in Nakivale Refugee Settlement in Uganda.
Refugees living with HIV in sub-Saharan Africa suffer unique hardships that may increase their vulnerability to interruptions in antiretroviral therapy (ART). To investigate refugees' experiences adhering to ART, we conducted inperson interviews with refugees on ART (n = 73) and HIV clinic staff (n = 4) in Nakivale Refugee Settlement in southwest Uganda from March to July 2011. Three analysts used a conventional content analysis approach to evaluate these data. Refugees described profound motivation to adhere to ART and employed adherence strategies to facilitate success despite the austere setting. However, refugees spoke of specific hardships living in Nakivale that served as barriers to ART adherence, including difficulty accessing clinic when ill, food insecurity, drug stockouts, and violence and unrest in the settlement. For some refugees, need for ART inextricably linked them to the HIV clinic and prevented them from transitioning permanently away from the settlement. By learning about refugees' experiences we can design informed interventions to enhance ART adherence, thus minimizing morbidity and mortality, preventing transmission of HIV, and supporting refugees' abilities to move freely toward repatriation, resettlement or integration in their host country.


Issues in mapping genes for eating disorders.
Recent twin studies show that both genetic and environmental factors contribute to the development of eating disorders. As in many other fields, there is much enthusiasm regarding the possibility of locating the specific genes that influence the risk of eating disorders. Advances in molecular and statistical technology have made this task more feasible than it was in the past, and continued enhancements in new technology are expected in the future. Despite these advances, the resources required to map a gene for traits as complex as eating disorders are likely to be enormous. Researchers considering such an undertaking may wish to look for ways to reduce this demand, such as (1) using multivariate analyses, (2) studying intermediate quantitative phenotypes, (3) using large sibships, (4) analytic enhancements (e.g., multipoint analyses), (5) reconceptualizing power, (6) data pooling, and (7) disequilibrium mapping.


Synthetic peptides of Goodpasture's antigen in antiglomerular basement membrane nephritis in rats.
Goodpasture's syndrome (GPS) is an autoimmune disease characterized by pulmonary hemorrhage, glomerulonephritis and anti-glomerular basement membrane (GBM) antibodies. The alpha(3) noncollagenous domain (NC1) of type IV collagen [alpha(3)(IV)] is the pathogen. The disease is T-cell-dependent; thus linear peptides initiate the autoimmune process. Studies in a rat model of GPS, experimental autoimmune glomerulonephritis (EAG), have shown that the carboxy-terminal 36 amino acids (purportedly the pathogenic epitope) are not responsible for disease induction. More recent studies implicate the amino terminus of alpha(3)(IV)NC1. Finding the nephritogenic epitope(s) is crucial in the understanding of the disease and for treatment. Because alpha(3)(IV)NC1 contains the antigens that induce GN in rats and human beings, we hypothesized that regions of the alpha(3)(IV)NC1 other than the carboxy terminus were responsible for disease. We investigated overlapping peptides spanning the entire NC1 domain of the alpha(3)(IV) chain N-terminal to the 36-mer (Goodpasture epitope) using the EAG rat model. Most peptides elicited antibody responses exclusively to themselves but not to native GBM. T-cells from GBM-immunized rats proliferated in vitro after stimulation with peptides 6, 8, 14, and 15, 24-mer and 23-mer. Fifteen percent of peptide 8 and peptide 14 rats had mild glomerulonephritis. In none of the animals immunized with other peptides did glomerulonephritis develop. These data suggest that conformation-dependent sites, posttranslational modification, multiple epitopes, concomitant antibody formation, or other disturbances are important in the ability of alpha(3)(IV)NC1 to induce EAG in rats and may also be important in the induction of GPS in human beings.


Antiemetic efficacy of nabilone and dexamethasone: a randomized study of patients with lung cancer receiving chemotherapy.
In a previous study on the antiemetic effect of nabilone (N) in patients with lung cancer receiving chemotherapy (CT), we found that N was only moderately effective and that its side effects limited its use, especially in elderly outpatients. We, therefore, performed a new study of N in combination with dexamethasone (DXM), a potent antiemetic in itself, to evaluate whether the addition of DXM to N would improve the antiemetic effect and/or reduce the side effects. Forty patients with lung cancer were enrolled in the study. A randomized, third-party-blinded, crossover design was used. Study drugs were given during two consecutive, identical CT cycles. N was given at a fixed dosage regimen of 2 mg b.i.d. The initial dose was administered the evening before CT, the second dose at 0.5 h before CT, and the third dose in the evening 12 h after CT. DXM, 8 mg, or placebo was given orally with the first dose of N. The subsequent doses (either 10 mg DXM or saline) were given intravenously 0.5 h before CT and at 2 and 6 h after the start of CT. The CT regimens given included the following drugs in various combinations: cisplatin, cyclophosphamide, adriamycin, etoposide (VP-16), vincristine, and vindesine. The combination of N and DXM was significantly superior to N alone in the reduction of vomiting episodes, both in subgroups of patients receiving cisplatin and in those receiving other CT combinations. There was no statistically significant difference between the treatments with regard to the patients' assessments of the severity of nausea or effects on appetite. Approximately half the patients (63% with N plus DXM versus 47% with N) reported no side effects. The frequency and severity of central nervous system adverse reactions, mainly vertigo, were similar in both treatment groups. The fall in blood pressure was significantly greater after N alone. Two thirds of the patients preferred N plus DXM. Thus, the addition of DXM to N enhanced the therapeutic yield of N, and we recommend DXM as an adjunct to N, when the use of steroids is not contraindicated. The optimal dose and schedule of DXM was not investigated in our study; a higher dose of DXM might increase the clinical benefit of the drug combination tested.


Optimizing shelf life conditions for anthocyanin-rich tomatoes.
Shelf life is the time a product can be stored without losing its qualitative characteristics. It represents one of the most critical quality traits for food products, particularly for fleshy fruits, including tomatoes. Tomatoes' shelf life is usually shortened due to fast over-ripening caused by several different factors, among which changes in temperature, respiration and pathogen exposure. Although tomatoes usually do not contain anthocyanins, varieties enriched in these antioxidant compounds have been recently developed. The anthocyanin-rich tomatoes have been shown to possess a significantly extended shelf life by delayed over-ripening and reduction of the susceptibility to certain pathogens. In the present work, we compared different conditions of postharvest storage of anthocyanin-rich tomato fruits with the aim to understand if the added value represented by the presence of the anthocyanins in the fruit peel can be affected in postharvest. For this purpose we used an anthocyanin-enriched tomato line derived from conventional breeding and took into consideration different light and temperature conditions, known to affect fruit physiology during postharvest as well as anthocyanin production. Several quality traits related to the fruit ripening were measured, including anthocyanin and carotenoid content, pH, titratable acidity and total soluble solids. In this way we identified that the most suitable fruit storage and postharvest anthocyanin accumulation were obtained through exposure to cool temperature (12° C), particularly in the presence of light. Under these parameters, tomato fruits showed increased anthocyanin content and unchanged flavour-related features up to three weeks after harvesting.


Monocilia on chicken embryonic endocardium in low shear stress areas.
During cardiovascular development, fluid shear stress patterns change dramatically due to extensive remodeling. This biomechanical force has been shown to drive gene expression in endothelial cells and, consequently, is considered to play a role in cardiovascular development. The mechanism by which endothelial cells sense shear stress is still unidentified. In this study, we postulate that primary cilia function as fluid shear stress sensors of endothelial cells. Such a function already has been attributed to primary cilia on epithelial cells of the adult kidney and of Hensen's node in the embryo where they transduce mechanical signals into an intracellular Ca2+ signaling response. Recently, primary cilia were observed on human umbilical vein endothelial cells. These primary cilia disassembled when subjected to high shear stress levels. Whereas endocardial-endothelial cells have been reported to be more shear responsive than endothelial cells, cilia are not detected, thus far, on endocardial cells. In the present study, we use field emission scanning electron microscopy to show shear stress-related regional differences in cell protrusions within the cardiovasculature of the developing chicken. Furthermore, we identify one of these cell protrusions as a monocilium with monoclonal antibodies against acetylated and detyrosinated alpha-tubulin. The distribution pattern of the monocilia was compared to the chicken embryonic expression pattern of the high shear stress marker Krüppel-like factor-2. We demonstrate the presence of monocilia on endocardial-endothelial cells in areas of low shear stress and postulate that they are immotile primary cilia, which function as fluid shear stress sensors.


Human immunodeficiency virus-associated cytomegalovirus infection with multiple small vessel cerebral infarcts in the setting of early immune reconstitution.
Cytomegalovirus (CMV) infection is an important cause of neurologic disease in the context of advanced human immunodeficiency virus (HIV) infection and is recognized as a cause of immune reconstitution inflammatory syndrome (IRIS) after initiation of highly active antiretroviral therapy (HAART). Central nervous system vasculitis secondary to CMV has only rarely been described in the context of HIV, despite the established ability of CMV to infect microvascular endothelial cells in the brain. However, we report a case that demonstrates the association between CMV and multiple small vessel cerebral infarct lesions after initiation of HAART.


The effect of alpha4 beta1-integrin binding sequences of fibronectin on growth of cells from human hematopoietic progenitors.
Highly regulated interactions between adhesion receptors on progenitor cells and their extracellular matrix ligands are essential for the control of hematopoiesis in bone marrow stroma. We have examined the relationship between alpha4beta1-integrin-mediated adhesion and growth of CD34(+) cells by assessing their adhesive and migratory patterns of proliferation in a mixture of hematopoietic growth factors in the presence of different recombinant fragments of the HepII/IIICS region of fibronectin. CD34(+) cells were isolated from cord blood and placed in culture wells containing serum-free medium and growth factors. Wells were precoated with either the H120 fragment of fibronectin, which contains three alpha4beta1-integrin binding sites, or the H0 fragment, which lacks the two highest affinity alpha4beta1 binding sequences. Proliferation of single cells of CD34(+)38(+)DR+ and CD34(+)38(-)DR+ phenotypes occurred in contact with the H120 substrate and was associated with migration. Larger numbers of cells were used to quantitate proliferative responses. Cells growing in wells coated with H120 formed attachments to the base of the wells throughout the culture period. Higher total cell counts were consistently found in wells coated with H120 compared with H0 and bovine serum albumin controls. The difference was first apparent at day 8 of culture and reached a maximum at days 11 through 13, when expansion with H120 was a mean of 1.8-fold higher than that seen with H0 (P</= .0001). The greatest expansion (2.25-fold) with H120 compared with H0 was seen when the growth factor concentrations were reduced to 1/16 of the standard levels (P </= .001). The increase in total cell numbers was not at the expense of CD34(+) cells as numbers of these were similar in H120 and control cultures. These results provide evidence for synergy between growth factors and integrins that may be relevant to understanding hematopoiesis in marrow stroma.


Sodium butyrate induces neuroendocrine cytodifferentiation in the insulinoma cell line RINm5F.
The differentiating agent sodium butyrate inhibits proliferation and stimulates cell-specific hormone expression in rat insulinoma cells. In this study, we investigated the effect of sodium butyrate on neuroendocrine cytodifferentiation in the rat insulinoma subclone, RINm5F. The cells were cultured with 0.5, 1, or 1.5 mM sodium butyrate for up to 72 h. Ultrastructurally, cells cultured with 1 mM sodium butyrate revealed a more differentiated appearance with an induction of cellular compartments involved in regulated insulin secretion. Morphometric analysis showed a significant elevation of neuroendocrine granule density. The total area of the specific granules was increased after incubation with 1 mM sodium butyrate for 48 and 72 h. Proliferation of RINm5F cells was inhibited by sodium butyrate in a dose-dependent manner. DNA production ceased completely within 24 h at 1.5 mM sodium butyrate. This concentration of sodium butyrate increased the cellular insulin content 8.9-fold and the insulin production 2-fold after 72 h. The insulin release was reduced from 79 +/- 3.5% in controls to 37 +/- 5.6% of total in a 24-h incubation period after 3 days of culture with 1.5 mM sodium butyrate. Insulin mRNA levels increased to a maximum of 324% compared with controls after 48 h of culture with 1.5 mM sodium butyrate. Chromogranin A mRNA levels increased to a similar extent (368 +/- 26%), whereas sodium butyrate did not stimulate the expression of synaptophysin, a major membrane component of small neuroendocrine vesicles. In conclusion, our data suggest the selective induction of neuroendocrine cytodifferentiation by sodium butyrate in RINm5F cells.(ABSTRACT TRUNCATED AT 250 WORDS)


Real-time and wearable functional electrical stimulation system for volitional hand motor function control using the electromyography bridge method.
Voluntary participation of hemiplegic patients is crucial for functional electrical stimulation therapy. A wearable functional electrical stimulation system has been proposed for real-time volitional hand motor function control using the electromyography bridge method. Through a series of novel design concepts, including the integration of a detecting circuit and an analog-to-digital converter, a miniaturized functional electrical stimulation circuit technique, a low-power super-regeneration chip for wireless receiving, and two wearable armbands, a prototype system has been established with reduced size, power, and overall cost. Based on wrist joint torque reproduction and classification experiments performed on six healthy subjects, the optimized surface electromyography thresholds and trained logistic regression classifier parameters were statistically chosen to establish wrist and hand motion control with high accuracy. Test results showed that wrist flexion/extension, hand grasp, and finger extension could be reproduced with high accuracy and low latency. This system can build a bridge of information transmission between healthy limbs and paralyzed limbs, effectively improve voluntary participation of hemiplegic patients, and elevate efficiency of rehabilitation training.


Comparison of pigment cell ultrastructure and organisation in the dermis of marble trout and brown trout, and first description of erythrophore ultrastructure in salmonids.
Skin pigmentation in animals is an important trait with many functions. The present study focused on two closely related salmonid species, marble trout (Salmo marmoratus) and brown trout (S. trutta), which display an uncommon labyrinthine (marble-like) and spot skin pattern, respectively. To determine the role of chromatophore type in the different formation of skin pigment patterns in the two species, the distribution and ultrastructure of chromatophores was examined with light microscopy and transmission electron microscopy. The presence of three types of chromatophores in trout skin was confirmed: melanophores; xanthophores; and iridophores. In addition, using correlative microscopy, erythrophore ultrastructure in salmonids was described for the first time. Two types of erythrophores are distinguished, both located exclusively in the skin of brown trout: type 1 in black spot skin sections similar to xanthophores; and type 2 with a unique ultrastructure, located only in red spot skin sections. Morphologically, the difference between the light and dark pigmentation of trout skin depends primarily on the position and density of melanophores, in the dark region covering other chromatophores, and in the light region with the iridophores and xanthophores usually exposed. With larger amounts of melanophores, absence of xanthophores and presence of erythrophores type 1 and type L iridophores in the black spot compared with the light regions and the presence of erythrophores type 2 in the red spot, a higher level of pigment cell organisation in the skin of brown trout compared with that of marble trout was demonstrated. Even though the skin regions with chromatophores were well defined, not all the chromatophores were in direct contact, either homophilically or heterophilically, with each other. In addition to short-range interactions, an important role of the cellular environment and long-range interactions between chromatophores in promoting adult pigment pattern formation of trout are proposed.


Effect of body condition and season on yield and quality of in vitro produced bovine embryos.
The aim of our study was to examine the effects of cow's body condition score (BCS; scale 1-5) and season on the quality of bovine in vitro produced embryos. The proportion of good quality oocytes (Q1 and Q2) was higher (P < 0.05) in the BCS 2 (57.60%) and BCS 3 (60.90%) groups compared with the BCS 1 (43.60%) group. There were no statistical differences in embryo cleavage and blastocyst rate among the BCS groups. The highest total cell number (TCN, DAPI stain) of blastocysts (P < 0.05), recorded in BCS 1 (122.27 ± 6.90) in comparison with BCS 2 (101.8 ± 3.60) or BCS 3 (105.44 ± 3.70) groups, was related to higher dead cell (DCI, TUNEL) index in this group (7.07%) when compared with BCS 2 (6.54%) or BCS 3 (6.06%), respectively. The yield of good quality oocytes during spring was lower (P < 0.05) compared with the summer season. There were significant differences (P < 0.05) in maturation and cleavage rates between autumn and summer (73.42%, 76.2% vs. 85.0%, 41.8%, respectively). The highest (P < 0.01) blastocyst rate was noted during spring and summer months. Significant difference (P < 0.05) in the TCN among spring (99.38 ± 3.90), autumn (110.1 ± 4.58) or summer (108.96 ± 3.52) was observed. The highest proportion of embryos with the best (grade I) actin cytoskeleton (phalloidin-TRITC) quality was noted during the summer months. Our results indicate that body condition affects the initial quality of oocytes, but does not affect embryo cleavage, blastocyst rate and actin quality. This finding may suggest that development in vitro can mask the influence of BCS. The season affects yield and quality of blastocysts in the way that the autumn period is more favorable for embryo development.


Curative endoscopic resection of early esophageal adenocarcinomas (Barrett's cancer).
In view of the increasing incidence of adenocarcinoma in Barrett's esophagus and the mortality and high morbidity rates associated with surgical therapy for this condition, safe and effective but less invasive methods of treatment are needed. To evaluate efficacy and safety of endoscopic resection in these patients. Single-center prospective study. Teaching hospital, conducted between October 1996 and September 2003. A total of 100 consecutive patients (mean age, 62.1 +/- 10.9 years; range, 31-86 years) with low-risk adenocarcinoma of the esophagus (macroscopic types I, IIa, IIb, and IIc; lesion diameter up to 20 mm; mucosal lesion without invasion into lymph vessels and veins; and histologic grades G1 and G2) arising in Barrett's metaplasia. Endoscopic resection with the suck-and-cut technique. Complete local remission. A total of 144 resections (1.47 per patient) were performed without technical problems. No major complications and only 11 minor ones (bleedings without decrease of Hb >2 g/dL; treated with injection therapy) occurred. Complete local remission was achieved in 99 of the 100 patients after 1.9 months (range, 1-18 months) and a maximum of 3 resections. During a mean follow-up period of 36.7 months, recurrent or metachronous carcinomas were found in 11% of the patients, but successful repeat treatment with endoscopic resection was possible in all of these cases. The calculated 5-year survival rate was 98%. Two patients died of other causes. Nonblinded, nonrandomized study. Endoscopic resection is associated with favorable outcomes for low-risk patients with early esophageal adenocarcinoma (Barrett's carcinoma).


Bacterial colonization in neonates with sibling visitation.
The effect of postpartum sibling visitation on the incidence of bacterial colonization in neonates was investigated in a 25-bed ob/gyn unit at a military hospital. The visitation policy allowed siblings to visit with the infant at the mother's bedside, and siblings were allowed unrestricted contact with the infant after handwashing with an iodine scrub preparation. Data comparison revealed bacterial colonization on discharge in 70% of 214 control infants (admitted prior to sibling visitation program) and 67% of 182 study infants. It was concluded that postpartum sibling visitation did not increase the incidence of bacterial colonization in neonates.


Efficacy of Intravenous and Endotracheal Epinephrine during Neonatal Cardiopulmonary Resuscitation in the Delivery Room.
A retrospective examination is presented of intravenous vs a lower (0.03?mg/kg) and higher (0.05?mg/kg) dose of endotracheal epinephrine during delivery room cardiopulmonary resuscitation. Repeated dosing of intravenous and endotracheal epinephrine is needed frequently for successful resuscitation. Research regarding optimal dosing for both routes is needed critically.


A cryptic type I polyketide synthase (cpk) gene cluster in Streptomyces coelicolor A3(2).
The chromosome of Streptomyces coelicolor A3(2), a model organism for the genus Streptomyces, contains a cryptic type I polyketide synthase (PKS) gene cluster which was revealed when the genome was sequenced. The ca. 54-kb cluster contains three large genes, cpkA, cpkB and cpkC, encoding the PKS subunits. In silico analysis showed that the synthase consists of a loading module, five extension modules and a unique reductase as a terminal domain instead of a typical thioesterase. All acyltransferase domains are specific for a malonyl extender, and have a B-type ketoreductase. Tailoring and regulatory genes were also identified within the gene cluster. Surprisingly, some genes show high similarity to primary metabolite genes not commonly identified in any antibiotic biosynthesis cluster. Using western blot analysis with a PKS subunit (CpkC) antibody, CpkC was shown to be expressed in S. coelicolor at transition phase. Disruption of cpkC gave no obvious phenotype.


Revisiting Postoperative Vision Loss following Non-Ocular Surgery: A Short Review of Etiology and Legal Considerations.
Postoperative vision loss (POVL) following non-ocular surgery is a serious complication where the causes are not fully understood. Studies have identified several causes of POVL as well as risk factors and prevention strategies. POVL research is made difficult by the fact that cases are often subject to malpractice claims, resulting in a lack of public access to case reports. This literature review was conducted in order to identify legal issues as a major barrier to studying POVL and address how this affects current knowledge. Informed consent provides an opportunity to overcome legal challenges by reducing malpractice litigation through educating the patient on this outcome. Providing pertinent information regarding POVL during the informed consent process has potential to reduce malpractice claims and increase available clinical information.


Outer membrane protein profiles of Edwardsiella ictaluri from fish.
Outer membrane proteins (OMP) prepared with sodium N-lauroyl sarcocinate (SLS) from 33 Edwardsiella ictaluri isolates from fish were examined by electrophoresis. Twenty-eight isolates from channel catfish (Ictalurus punctatus) had similar OMP profiles. Ten bands (71 kilodaltons [kD] to 19.5 kD) were identified in all isolates from channel catfish. One major 35-kD protein comprised most of the protein content of the outer membrane of isolates from channel catfish. Differences existed among isolates in the amount of protein within minor OMP bands. Edwardsiella ictaluri ATCC 33202 contained larger quantities of the 38.5- and 37-kD proteins than did the other isolates. Outer membrane protein profiles of E ictaluri derived from Bengal danio (Danio devario) and walking catfish (Clarias batrachus) were identical to OMP profiles of isolates from channel catfish. In contrast, OMP profiles from single isolates from green knife fish (Eigemannia virescens) and white catfish (Ictalurus catus) were different. Variations in incubation time, SLS extraction time, SLS extraction number, and in vivo and in vitro passage had no effect on the OMP profile of E ictaluri ATCC 33202. An increase in duration of sample solubilization did affect the OMP profile of E ictaluri ATCC 33202 by decreasing the amount of protein in 52-, 46-, and 43.5-kD bands. Accompanying the decrease were increased staining intensity in the 31.5- and 28.5-kD bands and the appearance of 4 new bands (34, 33, 25.5, and 22.5 kD). Edwardsiella ictaluri, a gram-negative bacterium in the family Enterobacteriaceae, is the cause of enteric septicemia of catfish.(ABSTRACT TRUNCATED AT 250 WORDS)


The role of endoscopic therapy in obesity management: intragastric balloons and aspiration therapy.
Weight management is increasingly incorporating endoscopic bariatric therapy (EBT). As the global burden of obesity and its comorbidities has increased, it is evident that novel therapeutic approaches will be necessary to address the obesity epidemic. EBTs offer greater efficacy than diet and lifestyle modification and lower invasiveness than bariatric surgery. The US Food and Drug Administration has approved two intragastric balloons and aspiration therapy for the treatment of obesity: Apollo Orbera is indicated for the treatment of Class I and Class II obesity, Re Shape Integrated Dual Balloon system is indicated for the same range with a comorbidity, and Aspire Bariatrics AspireAssist is approved for patients with a body mass index of 35-55 kg/m2. These devices have proven safe and effective in clinical trials and are gaining commercial acceptance in the USA; the Orbera has been used extensively outside the USA for over 20 years. These devices will need to be delivered in the context of a multidisciplinary weight loss program, integrating comprehensive care of obesity. Patient selection is important, and ensuring appropriate patient expectations and understanding of alternatives such as pharmacologic therapy and surgery is essential. With several EBTs on the horizon, patients with obesity will have an even broader array of safe and effective options for weight management in the future.


In-vitro and in-vivo evaluation of enteric-coated starch-based pellets prepared via extrusion/spheronisation.
Pellet cores containing modified starch (high-amylose, crystalline and resistant starch) as the main excipient were enteric-coated with an Eudragit L30 D-55 based dispersion. The polymer weight gain was from 15% to 30% (w/w). Pellet cores were prepared using piroxicam (2.5% w/w, poor water solubility) and anhydrous theophylline (2.5% and 25% w/w, coarse and micronised powder, medium water solubility) as model drugs. Next to the water solubility, particle size and concentration of the model drugs, the influence of sorbitol (0% and 10%, w/w) and drying method (oven and fluid-bed) on pellet yield, size (Feret mean diameter), sphericity (aspect ratio, AR and two-dimensional shape factor, e(R)), friability, surface morphology and drug release were evaluated. Binder (HPMC) and granulation liquid (water) concentration were optimised to obtain maximum yield (size fraction between 900 and 1400 microm) and acceptable sphericity (AR<1.2). Pellet friability was <0.01% for all formulations, while the mean pellet diameter was lower for pellets with sorbitol and the ones dried in an oven. Mercury intrusion porosimetry combined with scanning electron microscopy revealed an influence of drying method and sorbitol level on the surface structure: the surface of fluid-bed dried pellets without sorbitol and with 2.5% of model drug was cracked, which correlated with a Hg-intrusion peak at the 6-80 microm pore size range. Due to improved mechanical properties of the wet mass, sorbitol addition smoothened the pellets as the main peak of Hg-intrusion shifted to a smaller pore size range. Using a higher drug concentration and micronised theophylline shifted the main peak of Hg-intrusion further towards the smaller pore size range. Oven-dried pellets showed no Hg-intrusion and no cracks were observed. When applying the highest coating thickness (30% weight gain), all theophylline pellet formulations were successfully coated (<10% drug release after 2h in acid dissolution medium), while pellets with the lowest coating thickness (15% weight gain) released from 5% to about 30% theophylline. The extent of drug release depended on the pellet composition and drying method as these factors determined the surface properties. Piroxicam release in acid medium was less than 1% irrespective of the surface characteristics, due to its poor water solubility. In basic medium (phosphate buffer, pH 6.8) all pellets released the drug in less than 45 min. The bioavailability of coated and uncoated piroxicam pellets was determined after oral administration to six dogs. Values of AUC(0-->72h), C(max) and t(max) after oral administration of piroxicam pellets to dogs were not significantly different from the values obtained for immediate release capsules (P>0.05).


A domino reaction of 2-isocyanophenyloxyacrylate and aryne to synthesize arenes with vicinal olefin and benzoxazole.
An unusual domino reaction of 2-isocyanophenyloxyacrylate and aryne has been disclosed. The present strategy experiences nucleophilic addition, Michael addition, carbon-oxygen cleavage, and cyclization, thus enabling the quick aryne vicinal difunctionalization by the installation of a benzoxazole and an olefin.


Pressure-volume curve of lung and lobes in kittens.
In the neonatal period, the incomplete aeration of the lung parenchyma and the presence of some pulmonary fluid could determine inequalities in the mechanical behavior of lung regions, favoring unevenness of ventilation distribution. We studied the pressure-volume (PV) curve of excised lungs of kittens in the 1st wk of life 1) by changing the volume a known amount and measuring the corresponding changes in transpulmonary pressure (PL) and 2) by ventilating them at a fixed PL at a rate of 20 cycles/min. An expiratory load equal to the value of PL at the resting volume of the respiratory system was added to avoid the collapse of the lung. A lobar bronchus was then tied, and the measurements were repeated. The difference in PV curves before and after ligature therefore represented the PV curve of the lobe. This was done for all the lobes (upper and middle right, lower right, lower left, upper left) in a random order. A total of 20 lungs and 61 lobes have been studied. Individual lobes were not different in terms of dry-to-wet weight ratio, compliance per unit weight, or per maximal volume and shape of the PV curve, indicating a similar mechanical behavior. Dynamic lung compliance averaged 76% +/- 15 SD of the static value, suggesting some degree of asynchronous behavior of lung regions or viscoelastic properties of the tissue.


The effects of earthworm inoculation on cadmium-contaminated rice field in Southern China: a pot experiment and a field test.
Currently, the effects of earthworm inoculation on cadmium-contaminated rice field remain unclear. In this study, four treatments were tested, including rice monoculture (CK), earthworm inoculation with low density (L, 30 g/m2), middle density (M, 60 g/m2), and high density (H, 90 g/m2). The pot and field experiment were conducted in Hunan Province, China. In the pot experiment, the H treatment significantly decreased the available cadmium concentration in 0 ~ 20 cm soil by 5.21% ~ 16.51%, and the M treatment significantly decreased in 0 ~ 10 cm soil by 7.29% ~ 8.96%. The H treatment significantly decreased the total cadmium concentration in 0 ~ 5 cm soil by 10.36%. Moreover, the earthworm inoculation treatments significantly reduced cadmium accumulation in rice organs. In the field experiment, the M and H treatment decreased the available cadmium concentration in 0 ~ 20 cm soil by 14.05% ~ 47.52% and the H treatment decreased the total cadmium concentration in 0 ~ 20 cm soil by 0.78% ~ 5.75% although there was no significant difference. Furthermore, the earthworm inoculation treatments significantly decreased cadmium accumulation in part of rice organs. In conclusion, this study recommends that earthworm inoculation is an effective method of controlling cadmium contamination for rice production.


Fragrances Categorized According to Relative Human Skin Sensitization Potency.
The development of non-animal alternatives for skin sensitization potency prediction is dependent upon the availability of a sufficient dataset whose human potency is well characterized. Previously, establishment of basic categorization criteria for 6 defined potency categories, allowed 131 substances to be allocated into them entirely on the basis of human information. To supplement the original dataset with an extended range of fragrance substances. A more fully described version of the original criteria was used to assess 89 fragrance chemicals, allowing their allocation into one of the 6 potency categories. None of the fragrance substances were assigned to the most potent group, category 1, whereas 11 were category 2, 22 were category 3, 37 were category 4, and 19 were category 5. Although none were identified as non-sensitizing, note that substances in category 5 also do not pass the threshold for regulatory classification. The combined datasets of >200 substances placed into potency categories solely on the basis of human data provides an essential resource for the elaboration and evaluation of predictive non-animal methods.


Red Blood Cell-Mimicking Micromotor for Active Photodynamic Cancer Therapy.
Photodynamic therapy (PDT) is a promising cancer therapeutic strategy, which typically kills cancer cells through converting nontoxic oxygen into reactive oxygen species using photosensitizers (PSs). However, the existing PDTs are still limited by the tumor hypoxia and poor targeted accumulation of PSs. To address these challenges, we here report an acoustically powered and magnetically navigated red blood cell-mimicking (RBCM) micromotor capable of actively transporting oxygen and PS for enhanced PDT. The RBCM micromotors consist of biconcave RBC-shaped magnetic hemoglobin cores encapsulating PSs and natural RBC membrane shells. Upon exposure to an acoustic field, they are able to move in biological media at a speed of up to 56.5 μm s-1 (28.2 body lengths s-1). The direction of these RBCM micromotors can be navigated using an external magnetic field. Moreover, RBCM micromotors can not only avoid the serum fouling during the movement toward the targeted cancer cells but also possess considerable oxygen- and PS-carrying capacity. Such fuel-free RBCM micromotors provide a new approach for efficient and rapid active delivery of oxygen and PSs in a biofriendly manner for future PDT.


[Chemotherapy of non-small cell bronchial cancer with mitomycin C, vindesine and cisplatin. Results of a phase II study].
Forty-five patients (39 male, 6 female) with inoperable non-small-cell lung cancer were treated with combined mitomycin C, vindesine and cisplatin. All patients had measurable disease and had no previously received chemotherapy. The performance status of all patients was over 60%. Twenty-one patients had limited, 24 extensive disease. The overall remission rate was 53.3% (3 complete and 21 partial remissions) with a median remission duration of 9 months. Adeno- and squamous cell carcinoma responded to the chemotherapy with a remission rate of 63% (7 out of 11 patients) and 58% (14 out of 24 patients), but there were only 30% responders in large cell carcinoma (3 out of 10 patients). The median survival time for responders was 12 months, for those with no change and for patients with progressive disease 6 months. Myelosuppression and renal toxicity of the combination was generally not a treatment problem; subjective tolerance, however, (gastrointestinal upset) was poor.


Separating medical and ethical: helping families determine the best interests of loved ones.
Critical care nurses are often confronted with situations where the wishes of an incompetent patient on life support are undocumented and the family is struggling with the decision to either continue or withdraw life support. It is important that critical care nurses are able to identify their values in this and similar situations. With a better understanding of personal values, nurses are better able to provide medical information families need to make decisions about life support, without their ethical opinions being confused with medical knowledge. This article presents a framework using 2 values that are essential to decisions about life support, the sanctity of life, and quality of life to assist critical care nurses to identify values.


Oral Administration of Piperine as Curative and Prophylaxis Reduces Parasitaemia in Plasmodium berghei ANKA-Infected Mice.
Malaria remains a public health problem and a leading cause of death worldwide. Consequently, the discovery of novel agents, including substances from medicinal plants, is urgently needed. Piper nigrum has long been used by the community in the treatment of the symptoms of malaria. In a previous study, Piper nigrum was demonstrated to exhibit promising antiplasmodial activity against Plasmodium falciparum 3D7 and INDO strains. The aim of this study was to further investigate the antimalarial activity (curative and prophylactic) of piperine (a major isolated constituent of Piper nigrum) in Plasmodium berghei ANKA-infected mice. Piperine 10, 20, and 40 mg/kg body weight (bw), artesunate 5 mg/kg bw, and DMSO were administered orally for four days to different groups of Swiss Webster mice. Then, mice were monitored for parasitaemia, body weight, rectal temperature, survival rate, and clinical parameters. Piperine 40 mg/kg bw in curative and prophylactic tests had the maximum parasitaemia chemosuppression of 79.21% and 58.8% (p < 0.05), respectively, with a significant effect on the survival rate compared with control animals. In the curative test, piperine 40 mg/kg bw reduced the mean clinical score compared with the control group. Additionally, piperine showed an ability to protect organs (lungs, liver, spleen, and kidneys) from some damage in a dose-dependent manner. This study can be used as a basis for further discovery of novel chemotherapeutic or chemoprophylactic compounds.


IMC9 Edinburgh Nomenclature Sessions.
The proceedings of the 3-5 August 2010, IMC9 Edinburgh Nomenclature Sessions are briefly summarized. The final resolution approved by the General Assembly endorses the recommendations by the Nomenclature Sessions regarding transfer of the governance of fungal nomenclature from botanical to mycological congresses, mandatory pre-publication deposit of nomenclatural information for valid publication of new fungal names, and the acceptability of English as an alternative to Latin in the valid publication of fungal names. Complete results from the IMC9 nomenclature questionnaire are also provided.


Reversible dementia in patients with chronic subdural hematomas.
Neuropsychiatric changes following surgery for chronic subdural hematomas (CSDHs) were analyzed in 26 patients (21 men and five women) by using the Mini-Mental State Examination (MMSE) and the Hasegawa Dementia Scale-Revised (HDS-R) to determine factors that potentially contribute to neuropsychiatric recovery. Burr hole irrigation was performed in every patient to treat the CSDH. The patients' profiles, including age and sex, neuroimaging findings (such as hematoma volume and thickness, as well as midline shift), and preoperative and postoperative scores on the MMSE, HDS-R, and activities of daily living (ADL) scale were recorded. According to preoperative MMSE scores, eight patients (30.8%) were classified as mentally healthy and 18 (69.2%) as suffering from dementia before surgery. Nine of the 18 patients with dementia recovered to a normal psychological state following surgery. Surgery improved not only the patients' independence in ADL (p = 0.0026), but also their neuropsychiatric functions such as orientation and calculation, as estimated by scores on the MMSE (p = 0.0002) and the HDS-R (p = 0.0008). Factors affecting neuropsychiatric status on admission were midline shift (p = 0.0398) and ADL score (p = 0.0124); factors that could be used to predict neuropsychiatric recovery after surgery were patient age (p = 0.0027) and ADL score (p = 0.0193). The results of a logistic regression analysis demonstrated that significant predictors of neuropsychiatric recovery after surgery include the following: patient age (p = 0.0049, odds ratio [OR] = 0.842) and preoperative ADL (p = 0.0056, OR = 0.471), MMSE (p < 0.0001, OR = 1.895), and HDS-R (p = 0.0073, OR = 1.303) scores. Results of subgroup analyses demonstrated that patients younger than 74 years of age and those who had preoperative scores lower than 5 on the converted ADL scale, higher than 10 on the MMSE, or higher than 9 on the HDS-R on admission were found to have a significantly better recovery of neuropsychiatric functions after surgery. Dementia is reversible in many patients with CSDH, and surgery can improve not only independence in ADL, but also neuropsychiatric functions. Patients who are younger and/or those who have lower preoperative ADL scores and/or higher preoperative MMSE or HDS-R scores will achieve a good recovery with regard to neuropsychiatric functions after surgery. Estimations of neuropsychiatric function based on MMSE and HDS-R scores were found to be useful in predicting functional outcomes in patients with CSDH.


Synthesis and biological activity of raltitrexed-carrier conjugates.
Drugs used in chemotherapy give undesirable side effects, e.g., cardiotoxicity, leucopenia, hair loss and others. Covalent binding of a drug with a carrier may change its biodistribution, elimination and/or rate of transformation in the organism. The aim of this work was to synthesize conjugates of anticancer drug - raltitrexed (RTX) with lysozyme, bovine serum albumin (BSA), and dextran T40 and to investigate their cytotoxicity and influence on the cell cycle in comparison with the free drug. Before conjugation RTX was transformed into anhydride by treatment with dicyclohexylcarbodiimide in dimethylformamide. Activated RTX was added into aqueous solution of carriers at different pH (from 8.5 to 10.5) for 3 to 15 min. The reaction was stopped by reducing the pH to 7.0. Maximum yield of the reaction was obtained at pH 10 for BSA as well as for dextran. The highest level of substitution was obtained after 5 min of the reaction. In in vitro experiments on three cell lines: SW707, LoVo and A549, all conjugates tested had up to a few hundred times higher IC(50) than the free drug. Interestingly, it was noticed that the conjugates based on dextran and albumin were more cytotoxic than the free drug in the highest concentrations tested (1000 and 10000 ng/ml). The influence of RTX and the conjugates on SW707 cell cycle was studied. RTX blocked the cell cycle mostly in the G(0)-G(1) and S phase and increased the percentage of apoptotic cells. Cells in the G(2)-M phase were not observed. The conjugates blocked the cell cycle in the S phase and decreased the percentage of cells in the G(0)-G(1) phase.


Potential Blood-based Biomarkers for Concussion.
Mounting research in the field of sports concussion biomarkers has led to a greater understanding of the effects of brain injury from sports. A recent systematic review of clinical studies examining biomarkers of brain injury following sports-related concussion established that almost all studies have been published either in or after the year 2000. In an effort to prevent chronic traumatic encephalopathy and long-term consequences of concussion, early diagnostic and prognostic tools are becoming increasingly important; particularly in sports and in military personnel, where concussions are common occurrences. Early and tailored management of athletes following a concussion with biomarkers could provide them with the best opportunity to avoid further injury. Should blood-based biomarkers for concussion be validated and become widely available, they could have many roles. For instance, a point-of-care test could be used on the field by trained sport medicine professionals to help detect a concussion. In the clinic or hospital setting, it could be used by clinicians to determine the severity of concussion and be used to screen players for neuroimaging (computed tomography and/or magnetic resonance imaging) and further neuropsychological testing. Furthermore, biomarkers could have a role in monitoring progression of injury and recovery and in managing patients at high risk of repeated injury by being incorporated into guidelines for return to duty, work, or sports activities. There may even be a role for biomarkers as surrogate measures of efficacy in the assessment of new treatments and therapies for concussion.


The PHD finger protein VRN5 functions in the epigenetic silencing of Arabidopsis FLC.
Vernalization, the acceleration of flowering by the prolonged cold of winter, ensures that plants flower in favorable spring conditions. During vernalization in Arabidopsis, cold temperatures repress FLOWERING LOCUS C (FLC) expression in a mechanism involving VERNALIZATION INSENSITIVE 3 (VIN3), and this repression is epigenetically maintained by a Polycomb-like chromatin regulation involving VERNALIZATION 2 (VRN2), a Su(z)12 homolog, VERNALIZATION 1 (VRN1), and LIKE-HETEROCHROMATIN PROTEIN 1. In order to further elaborate how cold repression triggers epigenetic silencing, we have targeted mutations that result in FLC misexpression both at the end of the prolonged cold and after subsequent development. This identified VERNALIZATION 5 (VRN5), a PHD finger protein and homolog of VIN3. Our results suggest that during the prolonged cold, VRN5 and VIN3 form a heterodimer necessary for establishing the vernalization-induced chromatin modifications, histone deacetylation, and H3 lysine 27 trimethylation required for the epigenetic silencing of FLC. Double mutant and FLC misexpression analyses reveal additional VRN5 functions, both FLC-dependent and -independent, and indicate a spatial complexity to FLC epigenetic silencing with VRN5 acting as a common component in multiple pathways.


Alcohol's effect on fatality risk from a physical insult.
Although alcohol's effect on the risk of being involved in a traffic crash is well known, its influence on the risk of death, given that a crash has occurred, is more uncertain. One study published a few years ago finds that alcohol increases such risk. The present study examines alcohol's effect on fatality risk in a crash using data and methods independent of the previous study, and provides estimates as a function of blood alcohol concentration (BAC). Data for drivers with measured BAC who were fatally injured in a two-car crash were selected from the Fatal Accident Reporting System (FARS). The study uses two sets of fatal crashes. For one, the probability that a BAC = 0 driver was killed is low, so that if alcohol increased fatality risk, this would generate additional fatalities at higher BAC levels. For the other set of crashes, fatality risk was sufficiently close to 100% that other factors had little opportunity to influence it. Dividing the fatalities that can be affected by alcohol by those that cannot measures alcohol's influence on fatality risk, and gives that a driver with BAC = 0.1% is 1.9 +/- 0.2 times as likely as is a BAC = 0 driver to be killed in the same crash. The corresponding ratio for a BAC = 0.25% driver is 3.3 +/- 0.5. While derived using the "laboratory" of traffic, there does not appear to be any obvious reason why the results should not apply to physical trauma in general, so a BAC of 0.1% doubles the risk of death from a given impact, and a BAC of 0.25% triples the risk.


Isoacridone dyes with parallel reactivity from both singlet and triplet excited states for biphotonic catalysis and upconversion.
Metal-based photosensitizers commonly undergo quantitative intersystem crossing into photoactive triplet excited states. In contrast, organic photosensitizers often feature weak spin-orbit coupling and low intersystem crossing efficiencies, leading to photoactive singlet excited states. By modifying the well-known acridinium dyes, we obtained a new family of organic photocatalysts, the isoacridones, in which both singlet- and triplet-excited states are simultaneously photoactive. These new isoacridone dyes are synthetically readily accessible and show intersystem crossing efficiencies of up to 52%, forming microsecond-lived triplet excited states (T1), storing approximately 1.9 eV of energy. Their photoactive singlet excited states (S1) populated in parallel have only nanosecond lifetimes, but store ∼0.4 eV more energy and act as strong oxidants. Consequently, the new isoacridone dyes are well suited for applications requiring parallel triplet-triplet energy transfer and photoinduced electron transfer elementary steps, which have become increasingly important in modern photocatalysis. In proof-of-principle experiments, the isoacridone dyes were employed for Birch-type arene reductions and C-C couplings via sensitization-initiated electron transfer, substituting the commonly used iridium or ruthenium based photocatalysts. Further, in combination with a pyrene-based annihilator, sensitized triplet-triplet annihilation upconversion was achieved in an all-organic system, where the upconversion quantum yield correlated with the intersystem crossing quantum yield of the photosensitizer. This work seems relevant in the greater contexts of developing new applications that utilize biphotonic photophysical and photochemical behavior within metal-free systems.


Extracellular vesicles are the main contributor to the non-viral protected extracellular sequence space.
Environmental virus metagenomes, commonly referred to as "viromes", are typically generated by physically separating virus-like particles (VLPs) from the microbial fraction based on their size and mass. However, most methods used to purify VLPs, enrich extracellular vesicles (EVs) and gene transfer agents (GTAs) simultaneously. Consequently, the sequence space traditionally referred to as a "virome" contains host-associated sequences, transported via EVs or GTAs. We therefore propose to call the genetic material isolated from size-fractionated (0.22 µm) and DNase-treated samples protected environmental DNA (peDNA). This sequence space contains viral genomes, DNA transduced by viruses and DNA transported in EVs and GTAs. Since there is no genetic signature for peDNA transported in EVs, GTAs and virus particles, we rely on the successful removal of contaminating remaining cellular and free DNA when analyzing peDNA. Using marine samples collected from the North Sea, we generated a thoroughly purified peDNA dataset and developed a bioinformatic pipeline to determine the potential origin of the purified DNA. This pipeline was applied to our dataset as well as existing global marine "viromes". Through this pipeline, we identified known GTA and EV producers, as well as organisms with actively transducing proviruses as the source of the peDNA, thus confirming the reliability of our approach. Additionally, we identified novel and widespread EV producers, and found quantitative evidence suggesting that EV-mediated gene transfer plays a significant role in driving horizontal gene transfer (HGT) in the world's oceans.


[A case of Takotsubo Syndrome complicated by not embolic cerebral].
The Takotsubo syndrome is characterized by transient left ventricular dysfunction with ST segment elevation in all or some leads, T-wave inversion in anterior and inferior leads and elevate cardiac biomarkers (HS troponin), which can mimic an acute coronary syndrome (STEMI) in the absence of obstructive coronary disease. The echocardiography shows transient alterations in the kinetics of the anterior, intermediate and apical segments of the left ventricle which tends to disappear within 4-8 weeks. A particular variant of Takotsubo Syndrome is reported in a 73-year-old man.


Cuboid Edema Syndrome Following Fixation of Proximal Fifth Metatarsal Fractures in Professional Athletes.
Stress fractures of the proximal fifth metatarsal are common injuries in elite athletes. Fixation using an intramedullary screw represents the most popular surgery performed for treating these injuries, with excellent results in most cases. However, multiple reports in the literature highlight the possibility of painful hardware, usually related to the presence of the screw head, following intramedullary fixation In this case report, we outline 4 cases of professional athletes who developed lateral-based foot symptoms following complete healing of their surgically treated proximal fifth metatarsal fractures and were found to have significant cuboid edema on magnetic resonance images. We also outline recommendations regarding specific surgical technique considerations aiming to minimize this possible complication. Level of Evidence: Level V: Case report.


Galectin-1 sensitizes resting human T lymphocytes to Fas (CD95)-mediated cell death via mitochondrial hyperpolarization, budding, and fission.
Galectins have emerged as a novel family of immunoregulatory proteins implicated in T cell homeostasis. Recent studies showed that galectin-1 (Gal-1) plays a key role in tumor-immune escape by killing antitumor effector T cells. Here we found that Gal-1 sensitizes human resting T cells to Fas (CD95)/caspase-8-mediated cell death. Furthermore, this protein triggers an apoptotic program involving an increase of mitochondrial membrane potential and participation of the ceramide pathway. In addition, Gal-1 induces mitochondrial coalescence, budding, and fission accompanied by an increase and/or redistribution of fission-associated molecules h-Fis and DRP-1. Importantly, these changes are detected in both resting and activated human T cells, suggesting that Gal-1-induced cell death might become an excellent model to analyze the morphogenetic changes of mitochondria during the execution of cell death. This is the first association among Gal-1, Fas/Fas ligand-mediated cell death, and the mitochondrial pathway, providing a rational basis for the immunoregulatory properties of Gal-1 in experimental models of chronic inflammation and cancer.


[Traumatology in the elderly. Treatment concept in per- and subtrochanteric fractures in the elderly].
The aim of treatment of trochanteric fractures in the elderly patient is a prompt procedure, which allows early load bearing. Between 1986 and 1988 272 patients were treated with per- and subtrochanteric fractures: pertrochanteric fractures were stabilised by means of the dynamic hip screw (DHS), subtrochanteric fractures via the 95 degree condylar plate. With both methods an early mobilisation of the patients is possible. In 70 per cent of cases treated with DHS, early load bearing could be achieved within one week. 80 per cent of the patients were operated on within the first 24 hours after trauma. Complications of the methods (incorrect position of the lag screw, plate protrusion) were seen in one case in each group. The overall infection rate was 2.2 per cent. Hospital mortality was 10 per cent. On reviewing the results obtained, we approved of the concept of treatment.


Biomechanical design of escalading lower limb exoskeleton with novel linkage joints.
In this paper, an obstacle-surmounting-enabled lower limb exoskeleton with novel linkage joints that perfectly mimicked human motions was proposed. Currently, most lower exoskeletons that use linear actuators have a direct connection between the wearer and the controlled part. Compared to the existing joints, the novel linkage joint not only fitted better into compact chasis, but also provided greater torque when the joint was at a large bend angle. As a result, it extended the angle range of joint peak torque output. With any given power, torque was prioritized over rotational speed, because instead of rotational speed, sufficiency of torque is the premise for most joint actions. With insufficient torque, the exoskeleton will be a burden instead of enhancement to its wearer. With optimized distribution of torque among the joints, the novel linkage method may contribute to easier exoskeleton movements.


Immune-mediated keratoconjunctivitis sicca in dogs: current perspectives on management.
Keratoconjunctivitis sicca (KCS) is a frequent canine ophthalmic disease, resulting from the deficiency of one or more elements in the precorneal tear film. There are different known causes of KCS in dogs, including congenital, metabolic, infectious, drug induced, neurogenic, radiation, iatrogenic, idiopathic, and immune mediated, though the last one is the most prevalent form in dogs. Initially, clinical signs of KCS include blepharospasm caused by ocular pain, mucoid to mucopurulent ocular discharge, and conjunctival hyperemia; secondary bacterial infection may also occur, with chronicity, corneal epithelial hyperplasia, pigmentation, neovascularization, and corneal ulceration. The diagnosis of KCS is based on the presence of consistent clinical signs and measurement of decreased aqueous tear production using the Schirmer tear test. Therapy is based on administering the following topical drugs: ocular lubricant, mucolytics, antibiotics, corticosteroids, pilocarpine, and immunomodulators. These last drugs (eg, cyclosporine, pimecrolimus, and tacrolimus) have immunosuppressive activity and stimulate tear production. Furthermore, the nerve growth factor is a new subject matter of the research. Although these therapies are advantageous, stimulation of natural tear production seems to provide the highest recovery in clinical signs and prevention of vision loss. The goal of the following article is to describe the recent developments about KCS in dogs emphasizing the use of new therapies.


Palladium-catalyzed addition of arylboronic acids to aldehydes.
[reaction: see text] Arylboronic acids react with aldehydes in the presence of a base and a catalytic amount of a palladium(0) complex with chloroform, affording the corresponding secondary alcohols in good yields. General palladium complexes have no catalytic activity without chloroform. Chloroform is essential for this reaction, and palladium complex that was prepared from Pd(PPh3)4 with CHCl3 showed good catalytic acitivity as well.


A systems toxicology approach to elucidate the mechanisms involved in RDX species-specific sensitivity.
Interspecies uncertainty factors in ecological risk assessment provide conservative estimates of risk where limited or no toxicity data is available. We quantitatively examined the validity of interspecies uncertainty factors by comparing the responses of zebrafish (Danio rerio) and fathead minnow (Pimephales promelas) to the energetic compound 1,3,5-trinitroperhydro-1,3,5-triazine (RDX), a known neurotoxicant. Relative toxicity was measured through transcriptional, morphological, and behavioral end points in zebrafish and fathead minnow fry exposed for 96 h to RDX concentrations ranging from 0.9 to 27.7 mg/L. Spinal deformities and lethality occurred at 1.8 and 3.5 mg/L RDX respectively for fathead minnow and at 13.8 and 27.7 mg/L for zebrafish, indicating that zebrafish have an 8-fold greater tolerance for RDX than fathead minnow fry. The number and magnitude of differentially expressed transcripts increased with increasing RDX concentration for both species. Differentially expressed genes were enriched in functions related to neurological disease, oxidative-stress, acute-phase response, vitamin/mineral metabolism and skeletal/muscular disorders. Decreased expression of collagen-coding transcripts were associated with spinal deformity and likely involved in sensitivity to RDX. Our work provides a mechanistic explanation for species-specific sensitivity to RDX where zebrafish responded at lower concentrations with greater numbers of functions related to RDX tolerance than fathead minnow. While the 10-fold interspecies uncertainty factor does provide a reasonable cross-species estimate of toxicity in the present study, the observation that the responses between ZF and FHM are markedly different does initiate a call for concern regarding establishment of broad ecotoxicological conclusions based on model species such as zebrafish.


Reversible photoinduced change in molecular ordering of diarylethene derivatives at a solution-HOPG interface.
A diarylethene-pyrene diad and a diarylethene-pyrene-diarylethene triad were synthesized to investigate the photoinduced two-dimensional ordering change at a solution-HOPG interface. The molecular arrangements were detected by STM. The different photochromic isomers showed different orderings reflecting the differences in their molecular structures. For the diarylethene-pyrene-diarylethene triad, a new ordering appeared upon irradiation with UV light and returned to the original ordering upon subsequent irradiation with visible light. The new arrangement was assigned to the ordering of the closed-closed isomers based on the images of the isolated open- and closed-isomers. The relationship between the nature of the two-dimensional ordering and the molecular structure is discussed.


Novel rearrangements of 4-silyl-3-buten-2-ones.
Two 4-silyl-3-buten-2-ones, 2a and 2c, underwent an interesting rearrangement involving migration of the allyl or phenyl group on the silicon atom to the adjacent enone carbon when treated with various bases.


[Neuroradiological investigations in mild brain injuries: state of the art and practical recommendations].
To clarify the contribution of each technique of neuroradiological and nuclear medicine investigations after mild brain injuries. To analyze the pathophysiological mechanisms of the lesions. To update indications for imaging techniques in the short or long term management. To define the practical recommendations. The international databases were consulted for each neuroradiological technique; the most valuable articles were retained for study (PubMed, ). Standard skull X-rays are obsolete. Craniofacial (bony windows) and brain CT-scan (parenchymal windows) is the most efficient diagnosis tool in the acute phase because of its accessibility. Brain MRI is less accessible in the emergency setting but is feasible in some centers. It is the best choice in the first weeks following mild brain injury but may be normal. Taking into account the limitations of morphological imaging, functional imaging techniques (SPECT, fMRI, PET-scan) are necessary as they may show axonal damage or brain atrophy. There is however the problem of availability. SPECT is the most accessible. Spectro-MRI is promising. In spite of progress in neuroradiological investigation methods, the neuropsychological evaluation and multi-disciplinary treatment of these patients by a skilled team remains of utmost importance.


Macrophage migration inhibitory factor: A promising oncogenic serological biomarker for oral squamous cell carcinoma.
There are few reports in oral squamous cell carcinoma (OSCC) that indicate the expression of macrophage migration inhibitory factor (MIF) in tissues, serum, or saliva of patients with OSCC. The aim of this study was to evaluate the mRNA expression and protein of MIF in tissues and serum, respectively, in OSCC patients and its association with the TNM stage. A cross-sectional study was performed. Serum and tissues of 25 patients with OSCC and 25 healthy control subjects (HCS) were included to evaluate the MIF mRNA expression and protein serum levels by real-time PCR and ELISA, respectively. Serum MIF levels were significantly higher in OSCC compared with control subjects. Furthermore, in the OSCC group, MIF was significantly increased in accordance with tumor disease stage (TNM III-IV), as well as in poorly differentiated tumors. The mRNA showed significantly higher levels in HCS, as well as in more differentiated tumors. The results of this study suggest that MIF could be an indicator of severity and progression of OSCC. Further studies are required to explore the role of MIF as a serological biomarker for OSCC.


ALDH1A1 Deficiency in Gorlin Syndrome Suggests a Central Role for Retinoic Acid and ATM Deficits in Radiation Carcinogenesis.
We hypothesize that aldehyde dehydrogenase 1A1 (ALDH1A1) deficiency will result in impaired ataxia-telangiectasia mutated (ATM) activation in a retinoic acid-sensitive fashion. Data supporting this hypothesis include (1) reduced ATM activation in irradiated primary dermal fibroblasts from ALDH1A1-deficient Gorlin syndrome patients (GDFs), relative to ALDH1A1-positive normal human dermal fibroblasts (NHDFs) and (2) increased ATM activation by X-radiation in GDFs pretreated with retinoic acid, however, the impact of donor variability on ATM activation in fibroblasts was not assessed and is a prudent consideration in future studies. Clonogenic survival of irradiated cells showed differential responses to retinoic acid as a function of treatment time. Long-term (5 Day) retinoic acid treatment functioned as a radiosensitizer and was associated with downregulation of ATM protein levels. Short-term (7 h) retinoic acid treatment showed a trend toward increased survival of irradiated cells and did not downregulate ATM protein levels. Using a newly developed IncubATR technology, which defines changes in bulk chemical bond patterns in live cells, we can discriminate between the NHDF and GDF phenotypes, but treatment of GDFs with retinoic acid does not induce reversion of bulk chemical bond patterns associated with GDFs toward the NHDF phenotype. Collectively, our preliminary investigation of the Gorlin phenotype has identified deficient ALDH1A1 expression associated with deficient ATM activation as a possible susceptibility factor that is consistent with the high incidence of spontaneous and radiation-induced carcinogenesis in these patients. The IncubATR technology exhibits sufficient sensitivity to detect phenotypic differences in live cells that may be relevant to radiation health effects.


Protein lipidation.
Proteins are covalently modified with a variety of lipids, including fatty acids, isoprenoids, and cholesterol. Lipid modifications play important roles in the localization and function of proteins. The focus of this review is S-palmitoylation, the reversible addition of palmitate and other long-chain fatty acids to proteins at cysteine residues in a variety of sequence contexts. The functional consequences of palmitoylation are diverse. Palmitoylation facilitates the association of proteins with membranes, mediates protein trafficking, and more recently has been appreciated as a regulator of protein stability. Members of a family of integral membrane proteins that harbor a DHHC cysteine-rich domain mediate most cellular palmitoylation events. Here we focus on DHHC proteins that modify Ras proteins in yeast and mammalian cells.


Review of the Literature on Determinants of Chemical Hazard Information Recall among Workers and Consumers.
In many low and middle income countries (LMIC), workers' and consumers' only access to risk and hazard information in relation to the chemicals they use or work with is on the chemical label and safety data sheet. Recall of chemical hazard information is vital in order for label warnings and precautionary information to promote effective safety behaviors. A literature review, therefore, was conducted on determinants of chemical hazard information recall among workers and consumers globally. Since comprehension and recall are closely linked, the determinants of both were reviewed. Literature was reviewed from both online and print peer reviewed journals for all study designs and countries. This review indicated that the level of education, previous training and the inclusion of pictograms on the hazard communication material are all factors that contribute to the recall of hazard information. The influence of gender and age on recall is incongruent and remains to be explored. More research is required on the demographic predictors of the recall of hazard information, the effect of design and non-design factors on recall, the effect of training on the recall among low literate populations and the examining of different regions or contexts.


How listening to music affects reading: Evidence from eye tracking.
The current research looked at how listening to music affects eye movements when college students read natural passages for comprehension. Two studies found that effects of music depend on both frequency of the word and dynamics of the music. Study 1 showed that lexical and linguistic features of the text remained highly robust predictors of looking times, even in the music condition. However, under music exposure, (a) readers produced more rereading, and (b) gaze duration on words with very low frequency were less predicted by word length, suggesting disrupted sublexical processing. Study 2 showed that these effects were exacerbated for a short period as soon as a new song came into play. Our results suggested that word recognition generally stayed on track despite music exposure and that extensive rereading can, to some extent, compensate for disruption. However, an irrelevant auditory signal may impair sublexical processing of low-frequency words during first-pass reading, especially when the auditory signal changes dramatically. These eye movement patterns are different from those observed in some other scenarios in which reading comprehension is impaired, including mindless reading. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


A xenograft nude mouse model for perineural invasion and recurrence in pancreatic cancer.
Pancreatic cancer recurrence after initially "curative" resection is an unresolved clinical problem in the management of patients with this disease. Perineural invasion correlates with and might be partially responsible for tumor recurrence and poor survival. However, no adequate preclinical animal model is yet available to study this aspect of pancreatic cancer biology. We modified our orthotopic xenograft model of pancreatic cancer in nude mice to develop a model for pancreatic cancer perineural invasion and recurrence. After initial orthotopic transplantation, complete surgical resection of MIA PaCa-2 (undifferentiated) and Capan-2 (well-differentiated) tumors at 4, 6, and 8 weeks was attempted. All animals that had undergone tumor resection survived the operation. Animals that had the MIA PaCa-2 tumor resected after 6 weeks developed recurrent pancreatic cancer with local invasion and distant metastasis. Histological evaluation revealed extensive invasion of retroperitoneal nerves by the cancer cells. Complete resection of orthotopically transplanted pancreatic cancer in nude mice leads to local tumor recurrence. This model may eventually prove valuable for studying the mechanisms of pancreatic cancer perineural invasion and recurrence.


[Association of vitamin D receptor gene polymorphisms with susceptibility to bone and joint tuberculosis in Chinese Han population].
To investigate the association between vitamin D receptor (VDR) gene Apa I polymorphism and the susceptibility to bone and joint tuberculosis in Chinese Han population. Between May, 2015 and June, 2016, 100 patients with bone and joint tuberculosis and 100 healthy volunteers were recruited concomitantly in Heyuan Hospital of Traditional Chinese Medicine. Vitamin D receptor gene Apa I polymorphisms in these subjects were analyzed using SNaPshot. The genotype frequencies of Apa I-AA, Apa I-Aa and Apa I-aa were 51%, 41%, and 8% in the case group and 33%, 55%, and 12% in the control group, respectively, showing significant differences between the two groups (P<0.05). The genotype of Apa I-AA was significantly higher in the case group with an odds ratio (OR) of 2.073 (95% CI: 1.142-3.763). The Apa I polymorphisms of the VDR gene are associated with the susceptibility to bone and joint tuberculosis in Chinese Han population, and individuals with a Apa I-AA genotype are at greater risks to develop bone and joint tuberculosis.


Preliminary analysis of patients with progressive renal cell carcinoma vaccinated with CA9-peptide-pulsed mature dendritic cells.
Carbonic anhydrase-IXG250/MN (CA9) is a renal cell carcinoma (RCC)-associated antigen ubiquitously expressed in the clear-cell subtype of RCC. Two CA9-derived peptides have been identified defining a cytotoxic T-lymphocyte epitope and human leukocyte antigen (HLA)-DR epitope, able to induce T-cell responses in vitro. A phase I clinical trial was performed with CA9-peptide-loaded dendritic cells (DCs) in patients with progressive, cytokine-refractory metastatic RCC to assess the safety, toxicity, and induction of CA9-specific immunity. Patients with objective progressive metastatic RCC received 5 vaccinations of mature DCs pulsed with the CA9-derived peptides and keyhole limpet hemocyanine (KLH). Peripheral blood was collected at regular intervals, delayed-type hypersensitivity (DTH) was tested at baseline and after the last vaccination, and skin biopsies of positive DTH sites were collected for immunomonitoring purposes. Patients were also monitored for clinical responses. No significant toxicity was observed. All patients developed humoral responses against KLH, and demonstrated DTH conversion. Evaluation of biopsy material suggested an increased influx of T-helper cells. In none of the immunomonitoring assays was evidence for the induction of CA9-peptide-specific immunity observed. No clinical responses were observed. The vaccination of DCs pulsed with KLH and 2 CA9-derived peptides was well tolerated. The lack of induction of CA9-peptide-specific immune responses indicates that this particular vaccine regimen is poor in inducing CA9-peptide-specific immune responses.


Epidemiology of pediatric critically-ill patients presenting to the pediatric emergency department.
This study aimed to analyze the epidemiologic patterns of pediatric critically-ill patients presenting to the emergency department (ED) and the etiologies of intensive care unit (ICU) admission of different age groups.This retrospective study of all children aged less than 18 years presenting with critical illnesses to the ED was conducted in a tertiary medical center in Taiwan from 2003 to 2007. All patients transferred to the ICU from the ED were included without distinction. Demographic data of critically-ill children admitted to the ED and ICU were analyzed. Etiologies of the ICU admissions were analyzed by various age groups.There were 2978 critically-ill children admitted to the ICU from the ED. In 120 pediatric patients with out-of-hospital cardiac arrest, cases with pulseless electrical activity or ventricular fibrillation had higher successful CPR rates than patients with asystole (both p<0.05). In patients admitted to ICUs, complications from the perinatal period, respiratory system diseases, accidental injuries and poisoning were the predominant etiologies respectively in young children (42.5%), school-aged children (38.5%), and adolescents (47.9%). Moreover, the most common of which was respiratory distress syndrome in neonates followed by bacterial pneumonia and status epilepticus.Epidemiologic analysis may provide primary clinicians to identify significant differences in admission rates based on different etiologies of various age groups.


Caseating granulomas on the glans penis as a complication of bacille calmette-guérin intravesical therapy.
Intravesical instillation of bacille Calmette-Guérin (BCG) in patients with superficial bladder cancer or with carcinoma in situ of the bladder is a frequently used therapeutic option. As with other cancer therapies, BCG instillation has its share of side effects and complications. This case report highlights an uncommon complication.


Epstein-Barr virus lytic cycle involvement in diffuse large B cell lymphoma.
Epstein-Barr virus (EBV)-mediated B cell transformation is achieved predominantly through the action of latent proteins, but recent evidence suggests that lytic EBV replication has also a certain pathogenic role in lymphomagenesis, at least in the early phases of cell transformation. Particularly, in diffuse large B cell lymphoma (DLBCL), the EBV lytic cycle is by and large unexplored, so to disclose lytic cell contribution to lymphomagenesis, our aim was to evaluate viral early and late lytic gene expression in relation to several immune response markers in a series of EBV+ DLBCL from Argentina. An unexpected number of cells expressed lytic transcripts, being transcribed at the BZLF1, BHRF1, and BLLF1 locus, by real-time quantitative polymerase chain reaction. This lytic antigen expression was confirmed by immunohistochemical staining for BMRF1 early lytic protein, and a positive correlation between lytic and latent genes was confirmed, revealing a close link between their expressions in EBV+ DLBCL pathogenesis. Remarkably, BZLF1 displayed a negative correlation with CD4 cell counts, and this could be in part justified by the restriction of antigen presentation previously reported. The direct correlation for the late lytic gene BLLF1 and IFNγ in this series could represent a specific response directed towards this antigen. Interleukin 10 transcripts also displayed a positive correlation with lytic expression, indicating that regulatory mechanisms could be also involved on EBV-associated DLBCL pathogenesis in our series. Complete lytic reactivation in EBV-positive tumours could potentially kill EBV-positive malignant cells, providing a tool to promote tumour cell killing mediated by EBV as a complementary treatment strategy.


Life cycle GHG evaluation of organic rice production in northern Thailand.
Greenhouse gas (GHG) emission is one of the serious international environmental issues that can lead to severe damages such as climate change, sea level rise, emerging disease and many other impacts. Rice cultivation is associated with emissions of potent GHGs such as methane and nitrous oxide. Thai rice has been massively exported worldwide however the markets are becoming more competitive than ever since the green market has been hugely promoted. In order to maintain the same level or enhance of competitiveness, Thai rice needs to be considered for environmentally conscious products to meet the international environmental standards. Therefore, it is necessary to evaluate the greenhouse gas emissions throughout the life cycle of rice production in order to identify the major emission sources and possible reduction strategies. In this research, the rice variety considered is Khao Dawk Mali 105 (KDML 105) cultivated by organic practices. The data sources were Don-Chiang Organic Agricultural Cooperative (DCOAC), Mae-teang district, Chiang Mai province, Thailand and the Office of Agricultural Economics (OAE) of Thailand with onsite records and interviews of farmers in 2013. The GHG emissions were calculated from cradle-to-farm by using the Life Cycle Assessment (LCA) approach and the 2006 IPCC Guideline for National Greenhouse Gas Inventories. The functional unit is defined as 1 kg of paddy rice at farm gate. Results showed that the total GHG emissions of organic rice production were 0.58 kg CO2-eq per kg of paddy rice. The major source of GHG emission was from the field emissions accounting for 0.48 kg CO2-eq per kg of paddy rice, about 83% of total, followed by land preparation, harvesting and other stages (planting, cultivation and transport of raw materials) were 9, 5 and 3% of total, respectively. The comparative results clearly showed that the GHG emissions of organic paddy rice were considerably lower than conventional rice production due to the advantages of using organic fertilisers.


Cytomorphological features of cervical small cell neuroendocrine carcinoma in SurePath™ liquid-based cervical samples.
Small cell neuroendocrine carcinoma (SCNEC) of the cervix is a rare, highly aggressive tumour with poor prognosis and high propensity for distant metastases. The cytological features of SCNEC have rarely been described in cervical samples, and to the best of our knowledge, there are no previous reports using SurePath™ liquid-based cytology. In the present report we present the cytomorphological features of histopathologically confirmed cases of cervical SCNEC in SurePath preparations. On cytological examination, all three cases demonstrated variable numbers of tumour cells, ranging from a few dispersed cells and tiny micro-biopsies to large aggregates of small tumour cells with a high nucleus-to-cytoplasmic ratio, stippled chromatin, inconspicuous nucleoli, and scant cytoplasm. Immunocytochemistry for CD56 on the cervical preparation confirmed the diagnosis in one case. The presence of small tumour cells with characteristic stippled/salt-and-pepper type nuclear chromatin were the most consistent cytological features in these cases. Knowledge of these characteristic cytological features can help in suggesting a diagnosis of SCNEC in cervical samples which can then be confirmed by immunocytochemistry.


Stability and energy criteria in healthy and paraplegic subject gait.
The functional electrical stimulation (FES) assisted gait of paraplegic patients is inferior to that of healthy subjects. The difference can be observed in terms of speed, upright balance, biomechanical energy consumption, and generation of propulsion forces in the direction of walking. The biomechanical structure of paraplegic subjects is the same as that of normal ones; however, the mode of walking differs significantly because of the reduced number of activated muscles and primitive control. The healthy subject is utilizing a 2-point dynamically stable gait. The paraplegic patient is using 4-channel FES and utilizing a 4-point statically stable gait. We believe that the FES gait can be improved if converted into a semidynamically or dynamically stable gait. The gait is considered statically stable if the center of gravity (COG) projection on the ground (PCOG) is inside the supporting area. For a quadruped, this is only possible if it is utilizing a creeping crawl gait. In this paper, the relationship between PCOG and the supporting area are discussed as a criterion for dynamic stability assessment. Results are shown for 3 different modes of 2-point and 4-point gaits.


[Results of single-stage repair of distal hypospadias using the King modification].
From 1975 to 1986 34 patients undergoing repair of distal hypospadias between the age of 2 and 11 were explored. Standard method of the one-stage correction of distal hypospadias without or with moderate chordee was the operative technique according to the modification of King. After rolling the urethral groove into a tube the neourethra is covered with an asymmetrical part of dorsal hood. Thus the operative aims such as nonproblematic micturition, normal cohabitation and ejaculation and a good cosmetic result, avoiding psychological problems, can be obtained. The total complication rate was 23.4%; the correction of urethral fistulas in two layers as ambulatory operations was nonproblematic. By using Silastic foam the incidence of postoperative edema could be reduced significantly.


Sex Difference in Comorbid Depression in First-Episode and Drug-Naive Patients With Schizophrenia: Baseline Results From the Depression in Schizophrenia in China Study.
Comorbid depression is common in schizophrenia, and sex differences are prominent in many aspects of schizophrenia. However, few studies have investigated sex difference in comorbid depression in schizophrenia. This large sample study aimed to investigate sex differences in first-episode drug-naive (FEDN) patients with schizophrenia comorbid major depressive episode (SZ-MDE). A total of 996 FEDN patients with schizophrenia (472 males/524 females) were recruited. The 17-item Hamilton Depression Rating Scale and Positive and Negative Syndrome Scale (PANSS) were applied. There was no difference in the prevalence of comorbid MDE between male and female patients with schizophrenia. Among SZ-MDE patients, men had more severe psychotic symptoms (scores of PANSS total scale, negative scale, and general psychopathology scale), more severe depressive symptoms, and higher proportion of severe depression than women (all p < .001). The early onset age of schizophrenia, smoking, and PANSS positive score were the risk factors for comorbid MDE only in female patients with schizophrenia (all p < .05). Furthermore, in female patients with SZ-MDE, smoking was associated with the severity category of depression (p = .001, odds ratio = 2.70). Multiple variable regression demonstrated that the Hamilton Depression Rating Scale score correlated with PANSS general psychopathology (p = .01) and total scores (p = .04) in female SZ-MDE. Our results indicate sex differences in proportion of severe depression, clinical symptoms, and factors of comorbid MDE in FEDN patients with schizophrenia. These sex differences have clinical implications for the treatment of depression as related to the nature and severity of psychopathological symptoms in patients with schizophrenia.


A novel coumarin derivative, 8-methoxy chromen-2-one alleviates collagen induced arthritis by down regulating nitric oxide, NFκB and proinflammatory cytokines.
Ruta graveolens (Rue) is a well-known medicinal plant having anti-inflammatory and other healing properties. This contains many active phytochemicals such as coumarins which possess anti-inflammatory and anti-cancer activities. The present study was carried out to evaluate the therapeutic potential of a newly isolated coumarin derivative from rue plant, 8-methoxy-chromen-2-one (MCO) in the collagen induced arthritic (CIA) rat model. MCO showed inhibition of cytokines and NF-κB in LPS stimulated J774 cells which prompted its possible use in animal. In CIA, arthritic index and arthritic score reduced markedly within 15days of MCO treatment at doses of 2mg and 20mg per kg body weight. Alleviation of joint damage in CIA animals on treatment with MCO was evident from radiographic and histological data. Behavioral studies by open field tests also showed convalescence in the MCO treated CIA rats. Further, escalated plasma levels of pro-inflammatory cytokines TNF-α, IL-1β and IL-6, and also nitric oxide reduced significantly with the treatment. All these results indicate the therapeutic efficacy of MCO and its possible use as an anti-arthritic drug.


Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD.
FEV(1) is regarded as the most significant correlate of survival in COPD and is used as a measure of disease severity in the staging of COPD. Recently, however, the categorization of patients with COPD on the basis of the level of dyspnea has similarly been reported to be useful in the prediction of health-related quality of life and improvement in exercise performance after pulmonary rehabilitation. We compared the effects of the level of dyspnea and disease severity, as evaluated by airway obstruction, on the 5-year survival rate of patients with COPD. A total of 227 patients with COPD were enrolled in a 5-year, prospective, multicenter study in the Kansai area of Japan, involving 20 divisions of respiratory medicine from various university and city hospitals. After 5 years, 183 patients were available for the follow-up examination (follow-up rate, 81%). The 5-year cumulative survival rate among patients with COPD was 73%. The effect of disease staging, based on the American Thoracic Society (ATS) guideline as evaluated by the percentage of predicted FEV(1), on the 5-year survival rate was not significant (p = 0.08). However, the level of dyspnea was significantly correlated to the 5-year survival rate (p < 0.001). The Cox proportional hazards model revealed that the level of dyspnea had a more significant effect on survival than disease severity based on FEV(1). The categorization of patients with COPD on the basis of the level of dyspnea was more discriminating than staging of disease severity using the ATS guideline with respect to 5-year survival. Dyspnea should be included as one of the variables, in addition to airway obstruction, for evaluating patients with COPD in terms of mortality.


Expression of the MT1 melatonin receptor in ovarian cancer cells.
Ovarian cancer (OC) is the leading cause of death among women with genital tract disorders. Melatonin exhibits oncostatic properties which it may effect through binding to its membrane receptor, MT1. The aim of this study was to determine the expression of MT1 in OC cells and to correlate this with clinical and pathological data. Immunohistochemistry was performed on 84 cases of OC. Normal ovarian epithelial (IOSE 364) and OC (SK-OV-3, OVCAR-3) cell lines were used to examine the MT1 expression at protein level using the western blot and immunofluorescence technique. The expression of MT1 was observed as cytoplasmic-membrane (MT1(CM)) and membrane (MT1(M)) reactions. A positive correlation between MT1(CM) and MT1(M) was found in all the studied cases. There were no significant differences between the expression of MT1(CM), MT1(M), and histological type, staging, grading, presence of residual disease, or overall survival time. Immunofluorescence showed both MT1(M) and MT1(CM) expression in all the tested cell lines. Western blot illustrated the highest protein level of MT1 in IOSE 364 and the lowest in the OVCAR-3. The results indicate the limited prognostic significance of MT1 in OC cells.


The Association between Frailty and Cognition in Elderly Women.
Frailty refers to the loss of physiologic complexity and the associated decline in ability to withstand stressors as one gets older. It is defined as unintentional weight loss, exhaustion, weakness, slow walking speed, and low physical activity. According to several western studies, frailty is associated with cognitive impairment, but there have been few studies about the relationship between frailty and cognitive impairment in Korea. Thus, the purpose of this study is to analyze the relationship between cognition and factors related to frailty such as grip strength, walking speed, physical activity, and depression, among female patients older than 65 in Korea. A total of 121 subjects among the outpatients of the department of family medicine at Kangbuk Samsung Hospital who did not meet the exclusion criteria were included in this study. We divided the participants into 2 groups, according to the Korean version of the Montreal Cognitive Assessment (MoCA) score: 1 group with subjects that had normal cognition and the other group with patients that had impaired cognition. A comparison was made between the 2 groups in regards to the factors related to frailty, and we completed equation that predicting cognition from the frailty related factors. Compared with the impaired cognition group, the subjects in the normal cognition group had higher hand strength, and walked faster (P<0.001). There was no statistically significant difference in physical activity between the 2 groups (P=0.19). When multiple linear regression analysis was performed using age, grip strength, and walking speed as the predictor variables and MoCA score as the dependent variable, the regression coefficients were calculated to be: -0.2015, 0.2294, 1.2372, and -0.1436, respectively (P<0.05). In Korean female patients who are older than 65 years of age, cognition tends to decline as grip strength decreases, walking speed gets slower, depression becomes more severe, and as age increases.


Symptomatic Internal Carotid Agenesis in Children.
Carotid artery agenesis is a rare congenital anomaly, and there are controversies in the leading cause for it. We present a 6-year-old girl with resolved focal neurological ischemic stroke that showed bilateral internal carotid artery (ICA) agenesis. Through this paper, we highlight the carotid canal congenital obliteration hypothesis as it may be a risk for such finding.


Luminescent Mechanism and Anti-Counterfeiting Application of Hydrophilic, Undoped Room-Temperature Phosphorescent Silicon Nanocrystals.
Silicon nanocrystals (SiNCs) have attracted extensive attention in many advanced applications due to silicon's high natural abundance, low toxicity, and impressive optical properties. However, these applications are mainly focused on fluorescent SiNCs, little attention is paid to SiNCs with room-temperature phosphorescence (RTP) and their relative applications, especially water-dispersed ones. Herein, this work presents water-dispersible RTP SiNCs (UA-SiNCs) and their optical applications. The UA-SiNCs with a uniform particle size of 2.8 nm are prepared by thermal hydrosilylation between hydrogen-terminated SiNCs (H-SiNCs) and 10-undecenoic acid (UA). Interestingly, the resultant UA-SiNCs can exhibit tunable long-lived RTP with an average lifetime of 0.85 s. The RTP feature of the UA-SiNCs is confirmed to the n-π* transitions of their surface C═O groups. Subsequently, new dual-modal emissive UA-SiNCs-based ink is fabricated by blending with sodium alginate (SA) as the binder. The customized anticounterfeiting labels are also prepared on cellulosic substrates by screen-printing technique. As expected, UA-SiNCs/SA ink exhibits excellent practicability in anticounterfeiting applications. These findings will trigger the rapid development of RTP SiNCs, envisioning enormous potential in future advanced applications such as high-level anti-counterfeiting, information encryption, and so forth.