[The nursing field in education].
"Campus Extens" is a new correspondence course/open university educational project which makes use of new technologies in communication such as the Internet or videoconferences for the diffusion of its course content. This program commenced in 1997 as a provisional experimental program at the University of the Balearic Islands; at present, after six years up and running, this program is an established program. Classes in nursing were introduced as part of this program, due to a request by the Nursing Department, in an experimental provisional format since the academic year 2001-02 hoping to integrate new educational technologies and bring these closer to students in the Balearic Isles who find it difficult to attend traditional classes which are taught on the Palma campus and at the same time to make future correspondence courses possible. Taking the pedagogical materials which correspond to the Nursing Fundamentals course as an example, the authors describe the characteristics of this system, the educational model implemented, the didactic strategies which are used in this virtual classroom environment, as well as the methodological arrangement and the didactic materials which have been developed for this program. Finally, the authors want to point out that the participation of Nursing in this program has enabled the Nursing Department to respond to the educational and professional demands of the University of the Balearic Islands, to reflect critically about teaching methodology, to bring the School of Nursing and Physiotherapy closer to our university community and to design new projects for future correspondence/open university courses.


Ultrasonographic findings of shoulders in individuals with spinal cord injury.
Objective: To investigate shoulder ultrasonography findings in spinal cord injury (SCI) and identify factors associated with ultrasongraphic abnormalities.Design: A cross-sectional descriptive studySetting: Srinagarind hospital, ThailandParticipants: Spinal cord injury patients who attended the Srinagarind Hospital rehabilitation department.Outcome Measures: Baseline characteristics, physical examination, Physical Examination of the Shoulder Scale (PESS), and the ultrasonography of both shoulders of SCI patients were prospectively evaluated.Results: Ninety-one SCI patients were enrolled in this study, (56 with paraplegia and 35 with quadriplegia). Most patients in both groups had incomplete SCI. Wheelchairs were the most commonly used assistive devices in both groups. The top three ultrasonographic abnormalities in patients with quadriplegia were unilateral subdeltoid-subacromion bursitis (65.7%), unilateral supraspinatus tendinosis (45.7%), and unilateral biceps tendon effusion (37.2%). The most common abnormalities in those with paraplegia were unilateral subdeltoid-subacromion bursitis (64.3%), unilateral biceps tendon effusion (55.4%), and unilateral supraspinatus tendinosis (53.6%).Conclusions: Abnormal shoulder US findings were prevalent in individuals with SCI. The most common ultrasonographic abnormalities in patient with SCI was unilateral subdeltoid-subacromion bursitis.


Organ donation: a significant marketing challenge.
Unlike most health care markets, the organ donation market is one where patients are the marketers, prospective donors are the customers, and no payment is allowed in the exchange process. The assumption that altruistic behavior by donors would satisfy the need for organs has proven woefully untrue. As a result, those needing organs have resorted to relying on unwilling or impoverished donors, to having to promote themselves on websites which have achieved success for only small numbers of patients, or to waiting for organs which they may never receive. This remains a still unsolved marketing challenge.


Recurrent respiratory papillomatosis: the role of cidofovir.
Recurrent respiratory papillomatosis (RRP) is a rare condition that affects the respiratory system. It is caused by human papilloma virus (HPV) infection. Usually infection and papilloma growth is limited to 6-12 months duration; however, some patients have persistent disease, resulting in long-term symptoms and the need for recurrent intervention. Predominant symptoms include shortness of breath, reduced exercise tolerance and voice deterioration during flares. Current gold-standard management is through resection via microdebrider, CO2 laser, cryotherapy, electrocoagulation, Nd: YAG laser or pulse-dye laser. However, despite these therapies, approximately 20% of patients require adjuvant therapy. We discuss the use of intralesional cidofovir in the management of tracheal papillomatosis. Cidofovir's mechanism of action involves incorporating into the virus DNA chain and therefore, inhibiting the viral DNA polymerization process and hence replication.


Variation in Genetic Diversity of Phytophthora infestans Populations in Mexico from the Center of Origin Outwards.
The Toluca valley, located in central Mexico, is thought to be the center of origin of the potato late blight pathogen Phytophthora infestans. We characterized over 500 individuals of P. infestans sampled from populations with a geographical distance of more than 400 km in six regions adjacent to the Toluca valley in three states including Michoacán, Mexico, and Tlaxcala. Our sampling occurred on a predominant east to west gradient and showed significant genetic differentiation. The most western sampling location found in Michoacán was most differentiated from the other populations. Populations from San Gerónimo, Juchitepec, and Tlaxcala clustered together and appeared to be in linkage equilibrium. This work provides a finer understanding of gradients of genetic diversity in populations of P. infestans at the center of origin.


Association between illicit drug and alcohol use and first manic episode.
In light of the established influence of substance use on the onset, course, and outcome of bipolar disorder, we performed a retrospective chart review of patients with bipolar I disorder participating in a randomized controlled trial to further investigate the relationship between alcohol and substance use and first onset of mania. A total of 59.4% (N=101) of the 170 participants were determined to have a history of substance and/or alcohol use. Among the 101 participants with SU, use was coded in 10 (9.9%) as immediately preceding, in 50 (49.5%) as preceding mania, in 7 (6.9%) as following mania, and in 34 (33.7%) as indeterminable. Of the 10 participants with immediately preceding use, 5 experienced their first manic episode immediately after discontinuing a substance. Our findings support earlier reports detailing the high prevalence of substance use among patients with bipolar disorder. Treatments targeting alcohol and substance use among individuals with bipolar disorder are clearly needed, as are prophylactic treatments targeting adolescents and young adults who are at risk for either bipolar disorder or alcohol and substance related disorders.


PU.1 (Sfpi1), a pleiotropic regulator expressed from the first embryonic stages with a crucial function in germinal progenitors.
In the adult mammalian testis, spermatogenic differentiation starts from a minute population of spermatogonial stem cells (SSCs). SSCs are generated after birth from the fetal gonocytes, themselves derived from the primordial germ cells (PGCs), which are specified during the first days after implantation. Transcriptome profiling of purified preparations evidenced the preferential accumulation in SSCs of transcripts of PU.1 (Sfpi1), a regulatory gene previously identified in hematopoietic progenitors. In situ immunolabeling and RNA determination showed a complex pattern of expression in the adult testis, first in SSCs and early spermatogonia followed by de novo expression in pachytene spermatocytes. Spermatogenesis in a null mutant (PU.1(G/G)) was arrested at the prenatal stage, with reduced numbers of gonocytes owing to a defect in proliferation already noticeable at E12.5. Transcripts of several germinal markers, including vasa (Mvh, Ddx4), Oct4 (Pou5f1), Dazl and Taf4b, were detected, whereas stella (PGC7, Dppa3) was not. Germ cells of PU.1(G/G) newborn testes grafted in nude mice did not initiate the postnatal replicative stage, whereas grafts of their wild-type littermates underwent complete spermatogenesis. During embryonic development, PU.1 transcription was initiated as early as the blastocyst stage, with a generalized expression at E6.5 in the embryonic ectoderm. PU.1 therefore appears to play a determinant role in at least two distinct lineages and, given its wide range of expression, possibly in other stem cells.


Assessment of bleomycin lung toxicity using angiotensin-converting enzyme in pulmonary lavage.
Activity of the dipeptidyl hydrolase angiotensin-converting enzyme has been observed to be altered by treatment with bleomycin. We used an animal model of bleomycin lung toxicity to study the effects on angiotensin-converting enzyme activity in various lung fractions. Serum activity of angiotensin-converting enzyme increased only 23% after a single intratracheal instillation of bleomycin. Lung tissue angiotensin-converting enzyme activity fell to 40% of control level (p < 0.05) and returned toward and eventually exceeded control values during the ensuing 6 weeks. However, angiotensin-converting enzyme activity in alveolar lavage fluid from bleomycin-treated rats was elevated 30-fold above the barely detectable levels found in control animals. Angiotensin-converting enzyme activity in lavage fluid was soluble and was not associated with the alveolar cell pellet. Maximum elevation of lavage angiotensin-converting enzyme activity occurred 3 days following bleomycin instillation. Significant transudation of serum into alveolar lavage fluid occurred in bleomycin-treated rats. Nevertheless, this phenomenon would not explain the high levels of angiotensin-converting enzyme activity found in lavage fluid. Elevated lavage angiotensin-converting enzyme levels were detected after doses of bleomycin too low to cause significant sequelae of pulmonary fibrosis. Lavage angiotensin-converting enzyme is a sensitive monitor of tissue response to bleomycin.


Interferon-induced sarcoidosis.
Sarcoidosis is a rare side effect of interferon therapy that has been reported over the last years. We present the case of a 43-year-old man presenting with systemic sarcoidosis during treatment with pegylated interferon and ribavirin. Skin lesions, which were found to be associated with asymptomatic bilateral hilar lymph nodes and pulmonary nodules, were the sole clinical manifestation of the disease. Stopping therapy resulted in clinical and radiological improvement.


The Role of Magnetic Resonance Imaging in the Investigation and Management of Invasive Lobular Carcinoma-A 3-Year Retrospective Study in Two District General Hospitals.
Invasive lobular carcinoma (ILC) accounts for 5-15% of breast cancers. In comparison to other types of breast cancer, ILC is more likely to be associated with multifocal and contralateral breast involvement as well as a tendency to a diffuse infiltrative growth pattern which can represent a diagnostic challenge. The National Institute of Clinical Excellence guidelines in 2009 recommended the use of magnetic resonance imaging (MRI) in the preoperative assessment of ILC. This study aims to assess compliance with the guidelines in two District General Hospitals and the utility of MRI in the investigation of ILC. All cases of ILC between 2011 and 2013 were retrospectively identified from the pathology database and their breast imaging findings, pathology report, and operative intervention were reviewed. A total of 126 patients were identified with ILC, of these 46 had MRI preoperatively (36.5%). MRI upgraded mammography/ultrasound diagnoses in 10 patients (21.7%). MRI showed multicentric unilateral disease in 17 patients (37.0%) occult on ultrasound/mammogram, with these patients undergoing mastectomy and 16/17 (94.1%) confirmed multifocality on pathology. MRI showed a contralateral lesion in 9 patients (19.6%), four (8.7%) of which were malignant and had bilateral surgery, and five (10.9%) were benign on further imaging/biopsy. MRI also downgraded three patients (6.5%) to unifocal disease with reported multifocal appearances on mammography/ultrasound, and these patients underwent breast-conserving surgery. MRI adds significant additional information to mammograms/ultrasound in ILC and should be undertaken in all such cases preoperatively assuming no contraindication.


Genomic differentiation and intercontinental population structure of mosquito vectors Culex pipiens pipiens and Culex pipiens molestus.
Understanding the population structure and mechanisms of taxa diversification is important for organisms responsible for the transmission of human diseases. Two vectors of West Nile virus, Culex pipiens pipiens and Cx. p. molestus, exhibit epidemiologically important behavioral and physiological differences, but the whole-genome divergence between them was unexplored. The goal of this study is to better understand the level of genomic differentiation and population structures of Cx. p. pipiens and Cx. p. molestus from different continents. We sequenced and compared the whole genomes of 40 individual mosquitoes from two locations in Eurasia and two in North America. Principal Component, ADMIXTURE, and neighbor joining analyses of the nuclear genomes identified two major intercontinental, monophyletic clusters of Cx. p. pipiens and Cx. p. molestus. The level of genomic differentiation between the subspecies was uniform along chromosomes. The ADMIXTURE analysis determined signatures of admixture in Cx. p. pipens populations but not in Cx. p. molestus populations. Comparison of mitochondrial genomes among the specimens showed a paraphyletic origin of the major haplogroups between the subspecies but a monophyletic structure between the continents. Thus, our study identified that Cx. p. molestus and Cx. p. pipiens represent different evolutionary units with monophyletic origin that have undergone incipient ecological speciation.


Pharmacological management of obsessive-compulsive disorder: a review for clinicians.
Obsessive-compulsive disorder (OCD) has been treated pharmacologically with drugs that enhance availability of the neurotransmitter serotonin. This review summarizes the available literature on the pharmacological treatments of OCD. Numerous randomized controlled trials have attested to the efficacy of serotonin-reuptake inhibitors (SRIs) in treating this disorder, although a coherent model of serotonin dysfunction in OCD has not been established. Meta-analyses of randomized controlled trials have found better results with clomipramine than with other SRIs, but comparative studies have so far not replicated this finding. Aspects of the methodology in these studies that might explain this discrepancy are considered. Tolerability, side effects, dosing, and safety during pregnancy of the SRIs are discussed. Treatment of OCD with poor insight and of OCD comorbid with a tic disorder, augmentation strategies, and management of partial response to SRIs are reviewed. Finally, the available interventions for refractory OCD are considered.


Addressing the barriers related with opioid therapy for management of chronic pain in India.
India has a high prevalence of chronic disorders which may be associated with persistent pain. Despite the availability of multiple treatment options, chronic pain is largely untreated and contributes to disability and mortality. Medical consumption of opioids remains low due to various barriers that prevent access to opioids for patients and healthcare practitioners. Stringent regulatory provisions outlined in the Narcotic Drugs and Psychotropic Substances Act (1985) have been major deterrents to adequate opioid use. Although multiple amendments to the act have ensured ease of opioid access for medicinal purposes, concerns such as lack of awareness and prescribing practices and attitudes of physicians/patients still need to be addressed. This review aims to identify these barriers and suggest recommendations to overcome them.


DETERMINATION OF THE RESPONSE TO THE ATMOSPHERIC COSMIC RADIATION OF A NEUTRON DOSIMETER ASSISTED BY MONTE CARLO SIMULATION.
A TLD-based dosimeter of polyethylene-lead-polyethylene, was developed and characterized with Monte Carlo simulations, using the MCNPX code. This passive system for the determination of the ambient dose equivalent (H*(10)) for neutrons over a wide energy range can be used for the dosimetry of neutrons from atmospheric cosmic radiation, on the ground, and onboard aircraft. A method assisted by Monte Carlo simulations that improves the calibration of fast neutron dosimeters based on moderation and thermalization of the incident fast flux and the measurement of the thermal flux by a sensor, which respond mainly to thermal neutrons, is presented in this work. The H*(10) energy response of this dosimeter was obtained from simulations for monoenergetic neutrons from 10-10 to 104 MeV. The validation of the modeling was done with irradiations for ISO standard neutron fields of 241Am-Be, 252Cf and 252Cf(D2O) at Instituto de Radioproteção e Dosimetria (IRD, Brazil) and at CERN-EU high-energy reference field (CERF).


Pharmacogenomic Advances in the Prediction and Prevention of Cutaneous Idiosyncratic Drug Reactions.
Cutaneous idiosyncratic drug reactions (CIDRs) are usually unpredictable, ranging from mild maculopapular exanthema (MPE) to severe cutaneous adverse drug reactions (SCARs) such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Increasing evidence suggests that HLA alleles are strongly associated with drug-induced-CIDRs. The pathomechanisms for CIDRs include genetic polymorphisms affecting complex immune-specific HLA/drug antigen/T-cell receptor interactions and drug metabolism. Pharmacogenomic tests to prevent CIDRs have been widely implemented in clinical practice in recent years.


Medical Education in Iran: An Exploration of Some Curriculum Issues.
Although Iran is a large and populous country, the state of medical education is poorly understood and under researched. However, it is apparent that, in recent years, calls for reform in medical education have not tended to lead to major changes. As a result, the curricula used are in danger of being perceived as dated and less effective than they should be. This exploratory study is designed to investigate the perspectives and experiences of a group of the most influential medical education course planners in Iran. Its aim is to investigate their views about the nature of the undergraduate medical curriculum in Iran and explore with them ways in which such curricula could be modernized and improved. In-depth, semi-structured interviews were used to explore the perceptions of an elite group of medical education course planners who all work in prestigious universities in Tehran. Each of these 10 individuals was interviewed twice, over a period of several months, in order that an in-depth view of their perceptions could be unraveled. A deep concern about the lack of an innovative medical education curriculum in Iran emerged as the strongest theme from the interviews. There is widespread agreement that the current curriculum is too oriented towards the students passively learning facts. There is also a perceived lack of integration between the two-year basic science courses and clinical learning. Furthermore, participants feel that poor teaching facilities and overcrowding of students has provided an unsuitable learning environment. Both positive and negative attitudes toward educational strategies in curriculum development were demonstrated. Some of the barriers to curriculum change were also discussed. There is a real need for major changes in the medical education curriculum in Iran. The results of this study suggest that a move towards a curriculum that engages students as active participants in a process of lifelong learning would be highly beneficial. As clinically qualified doctors they will face many challenges in the years ahead, and a modernized curriculum should help them to acquire the necessary knowledge and develop the clinical skills and problem solving abilities they will need.


Giant Cephalocele Case Mimicking Cystic Neoplasia in Skull Base.
Petrous apex cephalocel, also called arachnoid cyst or meningocele, is a rare cephalocele caused by protrusion of the posterolateral wall of the Meckel cave to the petrous apex. Increased intracranial pressure is thought to play a role in etiopathogenesis and is generally asymptomatic. Radiologically, they are expansile lesions with the same density or intensity as cerebrospinal fluid and may mimic cystic masses. The diagnosis is made by showing the continuity with Meckel cave on magnetic resonance imaging. No intervention is required in asymptomatic patients; surgical treatment is applied in symptomatics.


Beckwith-Wiedemann syndrome: difficulties with prenatal diagnosis.
Beckwith-Wiedemann syndrome (BWS), though a well-delineated clinical and morphological entity, can be difficult to diagnose by prenatal ultrasound examination when incomplete forms occur. We present a case with sonographic results including hydronephrosis, cardiomegalia, hepatomegalia, macroglossia, and prominent forehead. No abdominal wall defect was detected. Karyotype was normal. In spite of intensive prenatal diagnostics, BWS could not be diagnosed definitely until birth.


[Reductive dechlorination of trichloroacetic acid by bioelectrochemically catalytic method].
Direct electrochemical behaviors of hemoglobin (Hb) immobilized on carbon nanotube (CNT) modified carbon paste electrode with adsorption were investigated. Cyclic voltammetry of Hb-CNT-modified electrode showed a pair of well-defined and nearly reversible peaks for HbhemeFe(III) /Fe(II) redox couple in pH = 7 PBS buffers. The electrocatalytic behaviors of Hb-CNT-modified electrode for the reductive dechlorination of trichloroacetic acid (TCA) were studied by cyclic voltammmetry and fixed-potential electrolysis technique, and the reductive mechanism of TCA was discussed by analysis of reduction products. The results showed that Hb-CNT-modified electrode possessed good electro-catalytic activity for reduction of TCA and the dechlorination of TCA was stepwise, following the pathway of trichloroacetic--> dichloroacetic--> monochloroacetic--> acetic. The dechlorination of TCA in waster water was investigated using a two-compartment flow reactor with working electrode compartment packed with Hb-CNT-modified graphite electrode. The conversion of TCA was 40.13% with electrolysis for 180 min at - 0.60V (vs. SCE).


Effect of protein-to-fat ratio of milk on the composition, manufacturing efficiency, and yield of cheddar cheese.
Twenty-three Cheddar cheeses were prepared from milks with a protein content of 3.66% (wt/wt) and with different protein-to-fat ratio (PFR) in the range 0.70 to 1.15; the PFR of each milk differed by 0.02. For statistical analysis, the 23 cheeses were divided into 3 PFR groups: low (LPFR; 0.70 to 0.85), medium (MPFR; 0.88 to 1.00) and high (HPFR; 1.01 to 1.15), which were compared using ANOVA. The numbers of PFR values in the LPFR, MPFR, and HPFR groups were 9, 7, and 7, respectively. Data were also analyzed by linear regression analysis to establish potentially significant relationships among the PFR and response variables. Increasing PFR significantly increased the levels of cheese moisture, protein, Ca, and P, but significantly reduced the levels of moisture in nonfat substances, fat-in-DM, and salt-in-moisture. The percentage of milk fat recovered in the LPFR cheese was significantly lower than that in the MPFR or HPFR cheeses. In contrast, the recovery of water from milk to the LPFR cheese was significantly higher than that in the MPFR or HPFR cheeses. Increasing the PFR led to a significant decrease in the actual yield of cheese per 100 kg of milk but a significant increase occurred in the normalized yield of cheese per 100 kg of milk with reference values of fat plus protein (3.4 and 3.3%, wt/wt, respectively). The results demonstrate that alteration of the PFR of cheese milk in the range 0.70 to 1.15 has marked effects on cheese composition, component recoveries, and cheese yield.


Middle-ear adenoma (MEA): a report of two cases, one with predominant "plasmacytoid' features.
Middle-ear adenomas (MEAs) are rare neoplasms which can display several histological patterns and represent a diagnostic challenge. We present two cases of MEA which share some histopathological features such as medium to small cells forming solid infiltrating tumour nests as well as scattered glandular structures with Alcian blue and PAS positive material within. The second case also displayed a distinct and predominant "plasmacytoid' appearance which, in a small biopsy, might have been misleading. Both cases expressed an admixture of epithelial and neuroendocrine immunohistochemical markers, whereas ultrastructural study demonstrated electron dense granules. Taken together, these observations support a mixed epithelial and neuroendocrine nature for these neoplasms, the differential diagnosis of which includes paragangliomas and other tumours or tumour-like lesions involving less frequently the middle ear, such as meningiomas, plasmacytomas and inflammatory polyps. The existence of MEAs with plasmacytoid features should be remembered to avoid confusion with plasmacytomas, plasmacytoid myoepithelioma and plasma cell inflammatory infiltrates.


Reexamining the role of the description of problem texts in the disjunction effect.
M. Bagassi and L. Macchi (2006) demonstrated that through a pragmatic analysis and consequent reformulation of a task, the certainty vs. uncertainty condition is not a crucial factor to the disjunction effect. In addition, C. Lambdin and C. Burdsal (2007) argued that, given the defining characteristics of a disjunction effect, a between-subjects design does not allow for the conditions necessary for a disjunction effect to occur. In the present study, the authors reexamined the role of text's description in the disjunction effect using a within-subject experimental design rather than a between-subjects design across 3 conditions. The results support M. Bagassi and L. Macchi's conclusion, regardless of whether the information presentation was transparent or not.


Metabolism and nutritional support in the surgical neonate.
Various factors can influence the metabolism of surgical neonates. These include prematurity, operative stress, critical illness, and sepsis. The nutritional management of surgical infants with congenital or acquired intestinal abnormalities has improved after the introduction of parenteral nutrition. This article is focused on the energy and protein metabolism of surgical neonates with particular reference to the metabolic response to operative trauma and sepsis. The metabolic utilization of intravenous nutrients also is discussed. The metabolic response to operative trauma is different between neonates and adults. Infants have high rates of protein turnover and are avid retainers of nitrogen. Energy expenditure increases only transiently (4 to 6 hours) after major surgery in neonates. Protein turnover and catabolism seems not to be affected by major operative procedures in neonates. In neonates on parenteral nutrition, carbohydrate and fat have an equivalent effect on protein metabolism. The main determinants of fat utilization are carbohydrate intake and resting energy expenditure. Parenteral nutrition in surgical neonates is associated with increased production of oxygen-free radicals. This seems to be related to intravenous fat administration. Promoting fat utilization by reducing the carbohydrate to fat ratio in the intravenous diet reduces free radical activity to a similar extent as fat exclusion. Glutamine appears to be safe for use in neonates and infants and is "conditionally essential" in very-low birth weight infants and in septic neonates. Enteral glutamine supplementation in very-low birth weight infants reduces the risk of sepsis. The metabolism of surgical neonates is affected by operative trauma, critical illness, and sepsis. Nutritional support in surgical neonates has a profound impact on outcome. Exogenous glutamine can modulate immune, metabolic, and inflammatory responses. Further investigations are needed to clarify the clinical benefit of parenteral or enteral glutamine administration in surgical neonates.


Characterization of complete mitochondrial genome of three Horse flies of the genus Tabanus (Diptera: Tabanidae): comparative analysis.
Tabanidae (Horse-Flies or Deer-Flies) are one of the most economically important as well as medically significant haematophagous insect family within the order Diptera. Members of this group are also responsible for the mortality of substantial number of live-stock every year. Due to their pathogen transmission potential and vector competencies makes them an important insect group to study. Till now, mitochondrial genome of 18 species of tabanids were available. The complete mitogenome of three species T. diversifrons (15,809 bp), T. rubidus (15,878 bp) and T. tenens (15,872 bp) were generated by Next generation sequencing method. They consist 37 genes, with a positive AT skew and a negative GC skew. The gene order of these three species is similar to the typical gene arrangement of infra-order Tabanomorpha. Most of the tRNAs showed typical clover-leaf secondary structure except trnS1, which lacks the DHU arm. The sliding window analysis showed that the nad4L is the most conserved while atp8, and nad6 are the most variable genes. Moreover, the ratios of non-synonymous to synonymous substitution rates indicated that all PCGs under the purifying selection. Phylogeny revealed Chrysops and Haematopota are monophyletic while species of Hybomitra are nested within the polyphyletic clade of Tabanus. T. diversifrons exhibits sister relationship with Atylotus miser. Two morphologically divergent species T. rubidus and T. tenens are found to be genetically similar and indistinguishable by mitochondrial genome. The hypervariable genes like atp8 and nad6 can be used as molecular markers for the identification of recently diverged lineages of family Tabanidae. Further, to address uncertainties arising from the two morphological divergent species, it is imperative to obtain data from nuclear gene markers.


Surgical treatment of intramural hematoma of the ascending aorta.
Intramural hematoma of the aorta presents potentially fatal condition developing as a result of a vasa vasorum rupture. It is a major risk factor for developing a frank aortic dissection. A 65-year-old woman was admitted to our clinic for the second time, after her symptoms of chest pain and vertigo (with no electrocardiographic signs of myocardial infarction) hadn't disappeared after several months of medicament treatment (indicated in the first hospitalization). Computed tomography arteriography of the aorta showed no sign of acute aortic dissection, but revealed a contrast depo in the aortic wall of 8 x 14 mm dimensions, with no extravasation of contrast. Also, massive pericardial effusion was observed (10-30 mm in thickness). Transesophageal echocardiography confirmed these findings completely. The patient underwent surgery, in which plaque exulceration was detected on the convex side of the ascending aorta, 3 cm above the aortic valve, 1 cm in diameter, with no signs of intimal tear. A resection of the ascending aorta was performed, and the aorta was reconstructed with a 30 mm Dacron tube graft. The patient was discharged on the 14th postoperative day with satisfactory results. Intramural hematoma is not a common event, but it is potentially a fatal one. Open surgery in patients with an intramural hematoma is an effective treatment strategy, although percutaneous endovascular treatment options are being described.


Management of an Extensive Intraparotid and Auricular Arteriovenous Malformation.
BACKGROUND Extracranial arteriovenous malformations (AVMs) of the parotid gland and auricle are rarely encountered. Management of these AVMs depends on the Schobinger stage and their flow characteristics. We present a rare case of an AVM involving the parotid and auricle concurrently. The clinical and imaging features of these high-flow vascular malformations and their treatment options are discussed and we provide a review of the literature. CASE REPORT A 40-year-old woman presented with a large 6.4×6.0×13.0 cm high-flow Schobinger stage II high-flow AVM of the parotid gland and auricle. Diagnostic imaging included magnetic resonance imaging (MRI) and conventional catheter angiogram, which defined the vascular anatomy and flow characteristics of the AVM. She was treated with preoperative endovascular embolization followed by surgical excision and free-tissue transfer reconstruction on the next day. The results were excellent, with no recurrence over 3.5 years of follow-up. CONCLUSIONS This is the second case reported in the literature of high-flow AVM concurrently involving the parotid gland and auricle, treated with perioperative embolization followed by surgical excision and grafting. Management of AVMs requires a multidisciplinary team approach and understanding of the natural history of the lesion. Although total surgical resection is the criterion standard for these AVMs, endovascular embolization is an alternative treatment that can be used as an adjunct to surgery. Furthermore, perioperative embolization can decrease the vascularity of the lesion and effectively reduce blood loss during AVM surgery.


Surveilling the Potential for Precision Medicine-driven PD-1/PD-L1-targeted Therapy in HNSCC.
Immunotherapy is becoming an accepted treatment modality for many patients with cancer and is now approved for use in platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). Despite these successes, a minority of patients with HNSCC receiving immunotherapy respond to treatment, and few undergo a complete response. Thus, there is a critical need to identify mechanisms regulating immune checkpoints in HNSCC such that one can predict who will benefit, and so novel combination strategies can be developed for non-responders. Here, we review the immunotherapy and molecular genetics literature to describe what is known about immune checkpoints in common genetic subsets of HNSCC. We highlight several highly recurrent genetic lesions that may serve as biomarkers or targets for combination immunotherapy in HNSCC.


Correlating in Vitro and in Vivo Activities of Light-Inducible Dimers: A Cellular Optogenetics Guide.
Light-inducible dimers are powerful tools for cellular optogenetics, as they can be used to control the localization and activity of proteins with high spatial and temporal resolution. Despite the generality of the approach, application of light-inducible dimers is not always straightforward, as it is frequently necessary to test alternative dimer systems and fusion strategies before the desired biological activity is achieved. This process is further hindered by an incomplete understanding of the biophysical/biochemical mechanisms by which available dimers behave and how this correlates to in vivo function. To better inform the engineering process, we examined the biophysical and biochemical properties of three blue-light-inducible dimer variants (cryptochrome2 (CRY2)/CIB1, iLID/SspB, and LOVpep/ePDZb) and correlated these characteristics to in vivo colocalization and functional assays. We find that the switches vary dramatically in their dark and lit state binding affinities and that these affinities correlate with activity changes in a variety of in vivo assays, including transcription control, intracellular localization studies, and control of GTPase signaling. Additionally, for CRY2, we observe that light-induced changes in homo-oligomerization can have significant effects on activity that are sensitive to alternative fusion strategies.


Clonal characterization of Staphylococcus aureus by multilocus restriction fragment typing, a rapid screening approach for molecular epidemiology.
We have developed a rapid and simplified approach for the strain characterization of Staphylococcus aureus on the basis of multilocus sequence typing (MLST) in which sequence variations in the MLST housekeeping gene loci are detected by restriction fragment pattern analysis rather than sequencing; we refer to this approach as multilocus restriction fragment typing (MLRFT). Briefly, MLRFT for S. aureus involves the PCR amplification of each of the seven MLST housekeeping gene loci by using the same primer pairs used in MLST. The amplicons are then digested directly with one or two restriction enzymes and the restriction fragments are resolved by agarose gel electrophoresis. Projection from published MLST data shows that MLRFT captures about 95% of the genetic diversity detected by MLST. The MLRFT approach was validated with a set of 59 methicillin-susceptible and 44 methicillin-resistant S. aureus isolates from community-acquired and nosocomial sources which had previously been characterized by pulsed-field gel electrophoresis (PFGE). MLRFT resolved the 103 isolates into 15 restriction fragment types, giving a discrimination index of 89.0%. Clonal groupings established by MLRFT correlated well with those established by PFGE. In short, MLRFT provides a convenient alternative to MLST and PFGE because it requires minimal laboratory facilities and is relatively simple and inexpensive to perform.


[Optimization and property evaluation of gelatin microspheres for embolization].
To optimize the preparation of gelatin microspheres for embolization and to evaluate the physicochemical properties of the optimized microspheres. The gelatin microspheres were prepared using emulsification crosslink method. The response surface methodology (RSM) was used in order to achieve gelatin microspheres with satisfactory degradable time and elasticity. The response values considered in this study were degradable time and elasticity, and the factors were the concentration of formaldehyde solution and the time of cross-linking reaction. The optimized microspheres were achieved by RSM. The properties of the optimized microspheres were investigated, including degradable time, elasticity, particle size, ratio of water absorption and the swelling ratio. The elasticity of the optimized microspheres was appropriate. The degradable time of the optimized microspheres was 2-3 weeks. The average diameter for dried gelatin microsphere was 377.6 μm, and for wet gelatin microsphere was 535.6 μm. The gelatin microsphere achieved the rate of water absorption balance at 20 min, and the average swelling ratio of gelatin microsphere was 41.9%. The gelatin microspheres optimized by RSM seemed to be suitable for clinical embolization according to the physicochemical properties.


Erythrocyte membrane proteins in healthy Saudis and patients with hereditary spherocytosis and hereditary elliptocytosis.
Little is known about hereditary spherocytosis (HS) and hereditary elliptocytosis (HE) in the native population of Saudi Arabia, even though these conditions are seemingly common. The purpose of this study was to ascertain the protein make-up of the red cell membrane in healthy Saudis and in patients with HS and HE. Eighteen healthy Saudi subjects (13 males and 5 females), 11 patients with HS (6 males and 5 females) and 11 patients with HE (7 males and 4 females) were studied. All normal controls and patients underwent SDS-PAGE red cell membrane protein analysis in duplicate and the stained protein bands were identified and quantitated by densitometry. In normal, healthy Saudis, the mean values for seven membrane proteins ( I+/- spectrin, I(2) spectrin, ankyrin, band 3, protein 4.1, protein 4.2, and actin) were similar to those published for normal, healthy Americans. Of the eleven cases with HS, 7 (64%) demonstrated detectable protein abnormalities while 4 (36%) were apparently normal. The electrophoretic patterns of membrane proteins in Saudis with HS differed from those of patients with HS in other parts of the world. Of the 11 cases of HE, 7 (64%) displayed abnormalities while 4 (36%) were normal. The electrophoretic pattern of the main proteins in the membranes of red blood cells in healthy Saudis is similar to that reported from the USA. However, significant differences exist in the electrophoretic patterns between Saudi patients with HS and patients from other parts of the world.


Comparison of qSOFA and SIRS for predicting adverse outcomes of patients with suspicion of sepsis outside the intensive care unit.
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) Task Force recently introduced a new clinical score termed quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) for identification of patients at risk of sepsis outside the intensive care unit (ICU). We attempted to compare the discriminatory capacity of the qSOFA versus the Systemic Inflammatory Response Syndrome (SIRS) score for predicting mortality, ICU-free days, and organ dysfunction-free days in patients with suspicion of infection outside the ICU. The Weill Cornell Medicine Registry and Biobank of Critically Ill Patients is an ongoing cohort of critically ill patients, for whom biological samples and clinical information (including vital signs before and during ICU hospitalization) are prospectively collected. Using such information, qSOFA and SIRS scores outside the ICU (specifically, within 8 hours before ICU admission) were calculated. This study population was therefore comprised of patients in the emergency department or the hospital wards who had suspected infection, were subsequently admitted to the medical ICU and were included in the Registry and Biobank. One hundred fifty-two patients (67% from the emergency department) were included in this study. Sixty-seven percent had positive cultures and 19% died in the hospital. Discrimination of in-hospital mortality using qSOFA [area under the receiver operating characteristic curve (AUC), 0.74; 95% confidence intervals (CI), 0.66-0.81] was significantly greater compared with SIRS criteria (AUC, 0.59; 95% CI, 0.51-0.67; p = 0.03). The qSOFA performed better than SIRS regarding discrimination for ICU-free days (p = 0.04), but not for ventilator-free days (p = 0.19), any organ dysfunction-free days (p = 0.13), or renal dysfunction-free days (p = 0.17). In patients with suspected infection who eventually required admission to the ICU, qSOFA calculated before their ICU admission had greater accuracy than SIRS for predicting mortality and ICU-free days. However, it may be less clear whether qSOFA is also better than SIRS criteria for predicting ventilator free-days and organ dysfunction-free days. These findings may help clinicians gain further insight into the usefulness of qSOFA.


7-Polyacylated delphinidin 3,7-diglucosides from the blue flowers of Leschenaultia cv. Violet Lena.
The triacyl anthocyanins, Leschenaultia blue anthocyanins 1 and 2 (LBAs 1 and 2) were isolated from the blue flowers of Leschenaultia R. Br. cv. Violet Lena (Goodeniaceae), in which LBA 1 was present as a dominant pigment. The structure of LBA 1 was elucidated to be delphinidin 3-O-[6-O-(malonyl)-beta-D-glucopyranoside]-7-O-[6-O-(4-O-(6-O-(4-O-(beta-D-glucopyranosyl)-trans-caffeoyl)-beta-D-glucopyranosyl)-trans-caffeoyl)-beta-D-glucopyranoside] by application of chemical and spectroscopic methods. Since LAB 2 was isolated in small amount, its structure was tentatively assigned as either delphinidin 3-(malonylglucoside)-7-[(glucosyl-p-coumaroyl)-(glucosylcaffeoyl)-glucoside] or delphinidin 3-(malonyl-glucoside)-7-[(glucosyl-caffeoyl)(glucosyl-p-coumaroyl)-glucoside]. This is the first report of the occurrence of 7-polyacylated anthocyanins in the family of Goodeniaceae, although others have been found in the families of the Ranunculaceae, Campanulaceae, and Compositae. Moreover, delphinidin 3-glycoside-7-di-(glucosylcaffeoyl)-glucoside has been reported only in the flowers of Platycodon grandiflorum (Campanulaceae). From a chemotaxonomical viewpoint, the Goodeniaceae may be closely related to the Campanulaceae.


Second neoplasm in patients with head and neck cancer.
The improvement in locoregional control of head and neck carcinomas over the last decades does not appear to modify the final survival of these patients, mainly due to the appearance of distant metastases and second neoplasms. We ran a study to evaluate the incidence of second neoplasms and their characteristics in patients with head and neck carcinoma treated in our hospital. A retrospective study was undertaken to analyze the appearance of second neoplasm, its characteristics, and repercussion on the survival in 1845 patients with carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx diagnosed and treated in our department between 1984 and 1995. A group of 302 patients (16%) developed a second neoplasm. The incidence of second neoplasms was 4% per year and was constant during the follow-up period. Second neoplasms were mainly carcinomas located in head and neck (40%), lungs (31%), or esophagus (9%). Twenty percent of second neoplasms were tumors located outside the aerodigestive tract. The appearance of a second neoplasm significantly worsened the survival. Four percent per year of patients with carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx develop a second neoplasm, most frequently a carcinoma of the aerodigestive tract. This leads to a significant worsening of survival.


Confirmation of Plasmodium falciparum in vitro resistance to monodesethylamodiaquine and chloroquine in Dakar, Senegal, in 2015.
In response to increasing resistance to anti-malarial drugs, Senegal adopted artemisinin-based combination therapy (ACT) as the first-line treatment for uncomplicated malaria in 2006. However, resistance of Plasmodium falciparum parasites to artemisinin derivatives, characterized by delayed parasite clearance after treatment with ACT or artesunate monotherapy, has recently emerged and rapidly spread in Southeast Asia. After 10 years of stability with rates ranging from 5.6 to 11.8%, the prevalence of parasites with reduced susceptibility in vitro to monodesethylamodiaquine, the active metabolite of an ACT partner drug, increased to 30.6% in 2014 in Dakar. Additionally, after a decrease of the in vitro chloroquine resistance in Dakar in 2009-2011, the prevalence of parasites that showed in vitro chloroquine resistance increased again to approximately 50% in Dakar since 2013. The aim of this study was to follow the evolution of the susceptibility to ACT partners and other anti-malarial drugs in 2015 in Dakar. An in vitro test is the only method currently available to provide an early indication of resistance to ACT partners. Thirty-two P. falciparum isolates collected in 2015 in Dakar were analysed using a standard ex vivo assay based on an HRP2 ELISA. The prevalence of P. falciparum parasites with reduced susceptibility in vitro to monodesethylamodiaquine, chloroquine, mefloquine, doxycycline and quinine was 28.1, 46.9, 45.2, 31.2 and 9.7%, respectively. None of the parasites were resistant to lumefantrine, piperaquine, pyronaridine, dihydroartemisinin and artesunate. These results confirm an increase in the reduced susceptibility to monodesethylamodiaquine observed in 2014 in Dakar and the chloroquine resistance observed in 2013. The in vitro resistance seems to be established in Dakar. Additionally, the prevalence of parasites with reduced susceptibility to doxycycline has increased two-fold compared to 2014. The establishment of a reduced susceptibility to monodesethylamodiaquine as well as chloroquine resistance, and the emergence of a reduced susceptibility to doxycycline are disturbing. The in vitro and in vivo surveillance of anti-malarial drugs must be implemented in Senegal.


Comparison of shade matching by visual observation and an intraoral dental colorimeter.
The purpose of this study was to compare the applicability of two shade-matching approaches: Vintage Halo shade guide (visual method) and Shofu ShadeEye NCC colorimeter (instrumental method). Twenty participants' maxillary left central incisors were evaluated. Corresponding metal ceramic crowns were fabricated with each shade-matching approach. The colour distributions (L*, a* and b*) of the middle third region of each tooth and corresponding metal ceramic crowns were spectrophotometrically assessed. The colour difference (DeltaE) and colour distributions (DeltaL*, Deltaa* and Deltab*) between the tooth and the corresponding crowns were calculated. We found that the colour differences of both groups fell within the clinical unacceptable range (DeltaE > 2.75). Regarding DeltaE and the three colour distributions, no significant difference was found, expect for a* (P < 0.01). The shade matching difficulty degree was analysed through the agreements of visual shade selection. Within easy matching cases, the instrumental method achieved better results (P = 0.041). In conclusion, it is suggested that the reliability of shade matching can be ensured by neither the colorimeter nor the visual approach. However, the colorimeter can achieve better results within easy matching cases.


Universal Depression Screening to Improve Depression Outcomes in Primary Care: Sounds Good, but Where Is the Evidence?
The 2016 recommendation statement by the U.S. Preventive Services Task Force (USPSTF) endorsed screening for depression in the general adult population. The recommendation was mainly based on studies that compared enhanced depression care that included depression screening with usual care. In contrast to the USPSTF recommendation, the 2013 guidelines from the Canadian Task Force on Preventive Health Care (CTFPHC) recommended against routine depression screening. The CTFPHC could not identify any studies comparing depression outcomes of usual care with and without the addition of routine depression screening. In the absence of evidence of clinical benefit, there are concerns that wide adoption of the USPSTF recommendation for universal depression screening would lead to overdiagnosis of depression and an increase in inappropriate prescription of antidepressant medications.


Risk factors for esophagitis after hypofractionated palliative (chemo) radiotherapy for non-small cell lung cancer.
Esophagitis influences quality of life and might cause treatment interruption and hospitalization. Previous studies of risk factors focused on curative treatment for non-small cell lung cancer (NSCLC), which often involves concomitant chemoradiation (CRT). Given the uncertainty around extrapolation of dose constraints, we analyzed risk factors in patients treated with hypofractionated palliative regimens. A retrospective review of 106 patients treated with palliative radiotherapy or CRT between 2009 and 2017 was performed. prescribed total dose 30-54 Gy, dose per fraction 2.5-4 Gy, esophageal dose > 1 Gy. Uni- and multivariate analyses were performed in 97 eligible patients to identify predictive factors for acute esophagitis grade ≥ 1 (CTCAE 5.0). Forty percent of patients were treated with 15 fractions of 2.8 Gy (42 Gy) and 28% also received chemotherapy according to the CONRAD study regimen (induction and concomitant Carboplatin/Vinorelbine) published by the Norwegian Lung Cancer Group. Thirty-four percent were treated with 10 fractions of 3 Gy. Stage IV NSCLC was present in 47%. Esophagus Dmax was 39 Gy (population median) and Dmean 15 Gy. Overall 31% of patients developed esophagitis (26% grade 2-3, no grade 4-5). Several dosimetric parameters correlated with the risk of esophagitis (Dmax, Dmean, D5cc, V20, V30, V35, V40). Dmax outperformed other dosimetric variables in multivariate analysis. Furthermore, concomitant chemotherapy significantly increased the risk of esophagitis, while oral steroid medication reduced it. In patients with Dmax ≥40 Gy a reduced Dmean (≤20 Gy) was beneficial. In order to reduce esophagitis after hypofractionated palliative treatment lower doses than those recommended in curative NSCLC settings are preferable. Besides esophageal dose, CRT is the main risk factor for esophagitis. Additional work is needed to confirm that steroids are able to modify the risk (or to rule out confounding effects of baseline variables not included in our database).


Hemorrhage Enlargement Is More Frequent in the First 2 Hours: A Prehospital Mobile Stroke Unit Study.
Hematoma enlargement (HE) after intracerebral hemorrhage (ICH) is a therapeutic target for improving outcomes. Hemostatic therapies to prevent HE may be more effective the earlier they are attempted. An understanding of HE in first 1 to 2 hours specifically in the prehospital setting would help guide future treatment interventions in this time frame and setting. Patients with spontaneous ICH within 4 hours of symptom onset were prospectively evaluated between May 2014 and April 2020 as a prespecified substudy within a multicenter trial of prehospital mobile stroke unit versus standard management. Baseline computed tomography scans obtained <1, 1 to 2, and 2 to 4 hours postsymptom onset on the mobile stroke unit in the prehospital setting were compared with computed tomography scans repeated 1 hour later and at 24 hours in the hospital. HE was defined as >6 mL if baseline ICH volume was <20 mL and 33% increase if baseline volume >20 mL. The association between time from symptom onset to baseline computed tomography (hours) and HE was investigated using Wilcoxon rank-sum test when time was treated as a continuous variable and using Fisher exact test when time was categorized. Kruskal-Wallis and Wilcoxon rank-sum tests evaluated differences in baseline volumes and HE. Univariable and multivariable logistic regression analyses were conducted to identify factors associated with HE and variable selection was performed using cross-validated L1-regularized (Lasso regression). This study adhered to STROBE guidelines (Strengthening the Reporting of Observational Studies in Epidemiology) for cohort studies. One hundred thirty-nine patients were included. There was no difference between baseline ICH volumes obtained <1 hour (n=43) versus 1 to 2 hour (n=51) versus >2 hours (n=45) from symptom onset (median [interquartile range], 13 mL [6-24] versus 14 mL [6-30] versus 12 mL [4-19]; P=0.65). However, within the same 3 time epochs, initial hematoma growth (volume/time from onset) was greater with earlier baseline scanning (median [interquartile range], 17 mL/hour [9-35] versus 9 mL/hour [5-23]) versus 4 mL/hour [2-7]; P<0.001). Forty-nine patients had repeat scans 1 hour after baseline imaging (median, 2.3 hours [interquartile range. 1.9-3.1] after symptom onset). Eight patients (16%) had HE during that 1-hour interval; all of these occurred in patients with baseline imaging within 2 hours of onset (5/18=28% with baseline imaging within 1 hour, 3/18=17% within 1-2 hour, 0/13=0% >2 hours; P=0.02). HE did not occur between the scans repeated at 1 hour and 24 hours. No association between baseline variables and HE was detected in multivariable analyses. HE in the next hour occurs in 28% of ICH patients with baseline imaging within the first hour after symptom onset, and in 17% of those with baseline imaging between 1 and 2 hours. These patients would be a target for ultraearly hemostatic intervention.


Chemical composition and evaluation of antileishmanial and cytotoxic activities of the essential oil from leaves of Cryptocarya aschersoniana Mez. (Lauraceae Juss.).
Leishmaniasis is an endemic disease caused by protozoa of the genus Leishmania, which affects around two million people worldwide. One major drawback in the treatment of leishmaniasis is the emergence of resistance to current chemotherapeutics. Medicinal and aromatic plants constitute a major source of natural organic compounds. In this study, the leaf essential oil of Cryptocarya aschersoniana was obtained by hydrodistillation in a Clevenger-type apparatus, and the chemical composition was analyzed by GC-MS and GC-FID. The essential oil of these species was predominantly constituted by monoterpene hydrocarbons (48.8%). Limonene (42.3%), linalool (9.7%) and nerolidol (8.6%) were the main constituents in the oil of C. aschersoniana. The in vitro activity of the oil was evaluated against the promastigote forms of Leishmania amazonensis, the causative agent of cutaneous leishmaniasis in humans. The essential oil of C. aschersoniana showed high activity against L. amazonensis promastigote forms (IC50 = 4.46 µg/mL), however, it also demonstrated a relatively high cytotoxicity on mouse peritoneal macrophages (CC50 = 7.71 µg/mL). This is the first report of the chemical composition and the leishmanicidal and cytotoxic activities of the leaf essential oil of C. aschersoniana.


[Determination of hydroxyproline in liver tissue by hydrophilic interaction chromatography-quadrupole/electrostatic field orbitrap high resolution mass spectrometry].
A method for the determination of hydroxyproline (Hyp) in liver tissue of mice by hydrophilic interaction chromatography-quadrupole/electrostatic field orbitrap high resolution mass spectrometry (HILIC-HRMS) was developed. The liver tissue samples of normal mice and liver fibrosis mice induced by carbon tetrachloride were hydrolyzed by concentrated hydrochloric acid. After filtrated and diluted by solution, the diluent was separated on an Hypersil GOLD HILIC column (100 mm×2.1 mm, 3 μm). Water-acetonitrile (28:72, v/v)were used as the mobile phases with isocratic elution. Finally, the target analytes were detected in positive model by HRMS equipped with an electrospray ionization source. The linear range of hydroxyproline was from 0.78 to 100.00 μg/L with the correlation coefficient (R2) of 0.9983. The limit of quantification was 0.78 μg/L. By detecting the spiked samples, the recoveries were in the range of 97.4%-100.9% with the relative standard deviations (RSDs) between 1.4% and 2.0%. In addition, comparison of the measurement results by this method and the chloramine T method was proceeded. It was found that the linear correlation between the two methods was very good, and the Pearson correlation coefficient was 0.927. And this method had simpler operation procedure and higher accuracy than chloramine T method. This method can be used for the quick determination of hydroxyproline in liver tissue samples.


Antipyretic Medicinal Plants, Phytocompounds, and Green Nanoparticles: An Updated Review.
Pyrexia itself is not a terminal condition. Basically, it occurs with mild to serious diseases affecting alarge population of the world. Other than a high body temperature, pyrexia is accompanied by several sickness behaviors, changes in physiological and metabolic characteristics of the body system, and alterations in the immune responses. Various allopathic drugs are available to treat pyrexia by targeting the symptom or the pathogen itself. Drug-resistance has made control and treatment of vectors more difficult. However, many marginal people are obligated to utilize locally available medicinal plants for the treatment of various diseases due to limited access to synthetic drugs. Developments in the field of nanotechnology and phytochemical research towards the discovery of new antimicrobial agents have also drawn the interest of researchers towards the synthesis of green nanoparticles from plant extracts due to their several benefits over the other methods. Thus, the present report discusses the use of ethnomedicinal plants, phytocompounds, and the application of green nanoparticles synthesized from plant extracts to treat pyrexia.


Multi-scale hybrid models for radiopharmaceutical dosimetry with Geant4.
The accuracy of radiopharmaceutical absorbed dose distributions computed through Monte Carlo (MC) simulations is mostly limited by the low spatial resolution of 3D imaging techniques used to define the simulation geometry. This issue also persists with the implementation of realistic hybrid models built using polygonal mesh and/or NURBS as they require to be simulated in their voxel form in order to reduce computation times. The existing trade-off between voxel size and simulation speed leads on one side, in an overestimation of the size of small radiosensitive structures such as the skin or hollow organs walls and, on the other, to unnecessarily detailed voxelization of large, homogeneous structures.We developed a set of computational tools based on VTK and Geant4 in order to build multi-resolution organ models. Our aim is to use different voxel sizes to represent anatomical regions of different clinical relevance: the MC implementation of these models is expected to improve spatial resolution in specific anatomical structures without significantly affecting simulation speed. Here we present the tools developed through a proof of principle example. Our approach is validated against the standard Geant4 technique for the simulation of voxel geometries.


A network analysis of changes in molecular interactions in cellular signaling.
Multiprotein complexes play an essential role in the propagation and integration of cellular signals. However, systems level analyses of signaling-dependent changes in the pattern of molecular interactions are still missing. Signaling in T-lymphocytes is one prominent example in which multiprotein complexes orchestrate signal transduction. We implemented peptide microarrays comprising a set of interaction motifs of signaling proteins for network-based analyses of signaling-dependent changes in molecular interactions. Lysates of resting or stimulated cells were incubated on these arrays, and the binding of signaling proteins was detected by immunofluorescence. Signaling-dependent complex formation led to changes of signals on the microarrays in two ways. 1) Masking of a binding site of a signaling protein for a peptide on the array resulted in a signal decrease. 2) Interaction of a protein with a second protein, which in turn binds to a peptide on the array, resulted in a signal increase for the first protein. Dissipation of complexes led to the reverse changes. Competition with peptides corresponding to interaction motifs provided detailed information on the architecture of complexes; lack of individual signaling proteins revealed the functional interdependence of interactions in the network. We show that complex formation through phosphorylation of the scaffolding protein LAT (linker for activation of T-cells) acted as a signal amplifier. PLCgamma1 deficiency increased the resting state levels of LAT-dependent complexes and augmented the recruitment of the phosphatase SHPTP2 into complexes. For the analysis of signaling networks, the parallel detection of changes in interactions enabled the identification of functional interdependencies with minimum a priori knowledge.


Detecting association of rare and common variants by adaptive combination of P-values.
Genome-wide association studies (GWAS) can detect common variants associated with diseases. Next generation sequencing technology has made it possible to detect rare variants. Most of association tests, including burden tests and nonburden tests, mainly target rare variants by upweighting rare variant effects and downweighting common variant effects. But there is increasing evidence that complex diseases are caused by both common and rare variants. In this paper, we extend the ADA method (adaptive combination of P-values; Lin et al., 2014) for rare variants only and propose a RC-ADA method (common and rare variants by adaptive combination of P-values). Our proposed method combines the per-site P-values with the weights based on minor allele frequencies (MAFs). The RC-ADA is robust to directions of effects of causal variants and inclusion of a high proportion of neutral variants. The performance of the RC-ADA method is compared with several other association methods. Extensive simulation studies show that the RC-ADA method is more powerful than other association methods over a wide range of models.


[Asystole following synchronized DC conversion].
A case of asystole following direct current CDC cardioversion for atrial fibrillation is described and studies of the complications associated with DC cardioversion are presented. It is important to be aware of the possible severe complications of DC cardioversion.


ESTABLISHMENT OF A NATIONAL DOSE REGISTER AND A DOSIMETRY SERVICE APPROVAL SYSTEM IN IRELAND.
Until the end of 2012, the Radiological Protection Institute of Ireland (RPII) operated a personal dosimetry service for workers in the medical, industrial, education and research sectors in Ireland. The data recorded by the RPII service were used to generate national dose statistics and as such acted as a National Dose Register (NDR). In preparation for the closure of the RPII dosimetry service in 2012, a formal NDR was introduced for the first time in Ireland and data on all monitored workers are now supplied to it annually by Approved Dosimetry Services. A new system for approving dosimetry services operating in Ireland was also introduced in 2012. The criteria for approval are based on the recommendations given in the European Commission's publication, 'Radiation Protection No. 160'. This paper describes the steps involved and the operational experience gained in establishing both the NDR and the system for approval of dosimetry services.


[Estrogen biosynthesis in human female adipose tissue in vitro].
The level of androstenedione aromatase activity in 10 cases of abdominal adipose tissues of premenopausal patients with benign gynecological disease (myoma uteri 7 cases, ovarian cyst 1 case, intersex 1 case, and hydatidiform mole 1 case) was examined. The adipose tissue homogenate (500mg) was incubated with [1,2,6, 7-3H]-androstenedione (10 microCi, 110 pmol), and NADPH (0.5mg) at 37 degrees C for 2h in air. After stopping the enzyme reaction, [14C]-estrone, estradiol (1 X 10(4) dpm) and cold estrone, estradiol (250 micrograms) were added as tracers. Ethyl acetate extract was submitted to Bio-Rad AG1-X2 column chromatography, TLC, and co-crystallization to constant specific activity and 3H/14C ratio. Estrone was formed in all samples (29-65 fmol/g/h), and estradiol was formed in 7 samples. The estradiol level was extremely low compared to estrone. Control samples (no tissue blank and zero time incubated samples) were under 1 fmol/g/h for estrone and estradiol through this procedure, respectively. This result indicates that adipose tissue may contribute to estrogen formation as one of the extragonadal tissues. The enzyme activity did not differ significantly according to gynecological disease, age, and superficial area.


Exposure to Oil Spill Chemicals and Lung Function in Deepwater Horizon Disaster Response Workers.
The aim of this study was to assess the relationship between total hydrocarbon (THC) exposures attributed to oil spill clean-up work and lung function 1 to 3 years after the Deepwater Horizon (DWH) disaster. We used data from the GuLF STUDY, a large cohort of adults who worked on response to the DWH disaster and others who were safety trained but did not work. We analyzed data from 6288 workers with two acceptable spirometry tests. We estimated THC exposure levels with a job exposure matrix. We evaluated lung function using the forced expiratory volume in 1 second (FEV1; mL), the forced vital capacity (FVC; mL), and the FEV1/FVC ratio (%). Lung function measures did not differ by THC exposure levels among clean-up workers. We did not observe an association between THC exposure and lung function among clean-up workers 1 to 3 years following the DWH disaster.


Adaptogenic potential of royal jelly in liver of rats exposed to chronic stress.
Restraint and cold stress increase both corticosterone and glycemia, which lead to oxidative damages in hepatic tissue. This study assessed the effect of royal jelly (RJ) supplementation on the corticosterone level, glycemia, plasma enzymes and hepatic antioxidant system in restraint and cold stressed rats. Wistar rats were allocated into no-stress, stress, no-stress supplemented with RJ and stress supplemented with RJ groups. Initially, RJ (200mg/Kg) was administered for fourteen days and stressed groups were submitted to chronic stress from the seventh day. The results showed that RJ supplementation decreases corticosterone levels and improves glycemia control after stress induction. RJ supplementation also decreased the body weight, AST, ALP and GGT. Moreover, RJ improved total antioxidant capacity, SOD activity and reduced GSH, GR and lipoperoxidation in the liver. Thus, RJ supplementation reestablished the corticosterone levels and the hepatic antioxidant system in stressed rats, indicating an adaptogenic and hepatoprotective potential of RJ.


The Potential of Phytomelatonin as a Nutraceutical.
Phytomelatonin (plant melatonin) is chemically related to the amino acid tryptophan and has many diverse properties. Phytomelatonin is an interesting compound due to its outstanding actions at the cellular and physiological level, especially its protective effect in plants exposed to diverse stress situations, while its vegetable origin offers many opportunities because it is a natural compound. We present an overview of its origin, its action in plants in general (particularly in plant species with high levels of phytomelatonin), and its possibilities for use as a nutraceutical with particular attention paid to the beneficial effects that it may have in human health. The differences between synthetic melatonin and phytomelatonin, according to its origin and purity, are presented. Finally, the current market for phytomelatonin and its limits and potentials are discussed.


Left ventricular assist device implantation in patients after left ventricular reconstruction.
Left ventricular assist device (LVAD) implantation can be challenging in patients with a prior surgical ventricular restoration (SVR). In this case series of heart failure patients with a history of SVR, we describe the surgical technique and outcome of a customized approach for inflow cannula orientation. Seven patients with a history of SVR with end-stage chronic heart failure were accepted for long-term LVAD support. In all patients, the Dacron patch was removed through left ventriculotomy and a Hegar 22 dilator was inserted at the estimated optimal position of the LVAD inflow cannula. The left ventricle was reconstructed around the dilator from the left ventricular (LV) apex to the base. Finally, the LVAD sewing ring was sutured onto the remaining apical defect and a HeartWare® LVAD was implanted. LVAD implantation was successful in all 7 patients. Transoesophageal echocardiography ensured an adequate LVAD position and inflow and outflow cannula Doppler flow recordings. The mean intensive care unit stay was 5.8 ± 2.6 days, and the hospital stay after surgery was 32 ± 16 days. All patients follow regular visits (follow-up 20 ± 16 months) at the outpatient clinic without any remarkable event. Using the technique described, LVAD implantation in patients after SVR is feasible and safe.


Growth, processing, and optical properties of epitaxial Er2O3 on silicon.
Erbium-doped materials have been investigated for generating and amplifying light in low-power chip-scale optical networks on silicon, but several effects limit their performance in dense microphotonic applications. Stoichiometric ionic crystals are a potential alternative that achieve an Er(3+) density 100 x greater. We report the growth, processing, material characterization, and optical properties of single-crystal Er (2)O(3) epitaxially grown on silicon. A peak Er(3+) resonant absorption of 364 dB/cm at 1535 nm with minimal background loss places a high limit on potential gain. Using high-quality microdisk resonators, we conduct thorough C/L-band radiative efficiency and lifetime measurements and observe strong upconverted luminescence near 550 and 670 nm.


Potent Inhibitors of Mycobacterium tuberculosis Growth Identified by Using in-Cell NMR-based Screening.
In-cell NMR spectroscopy was used to screen for drugs that disrupt the interaction between prokaryotic ubiquitin like protein, Pup, and mycobacterial proteasome ATPase, Mpa. This interaction is critical for Mycobacterium tuberculosis resistance against nitric oxide (NO) stress; interruption of this process was proposed as a mechanism to control latent infection. Three compounds isolated from the NCI Diversity set III library rescued the physiological proteasome substrate from degradation suggesting that the proteasome degradation pathway was selectively targeted. Two of the compounds bind to Mpa with sub-micromolar to nanomolar affinity, and all three exhibit potency toward mycobacteria comparable to antibiotics currently available on the market, inhibiting growth in the low micromolar range.


Involvement of genetic factors in the response to a variable-dosing ranibizumab treatment regimen for age-related macular degeneration.
To determine whether gene polymorphisms of the major genetic risk factor for age-related macular susceptibility 2 (ARMS2 A69S) and the complement factor H Y402H influence the response to a variable-dosing treatment regimen with ranibizumab for age-related macular degeneration. This prospective cohort study included 90 patients (90 eyes) with exudative age related macular degeneration (AMD) treated with ranibizumab. Patients underwent a 1-year treatment as in the Study of Ranibizumab in Patients with Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration (Mitchell et al.). Injections were administered monthly when a patient lost five letters on the Early Treatment Diabetic Retinopathy Study chart or gained 100 μm in central subfield retinal thickness (CSRT). Genotypes (rs10490924 and rs1061170) were analyzed using gene sequence analysis. Best-corrected visual acuity (BCVA) and CSRT values were compared between ARMS2 and complement factor H genotypes. Multiple regression analysis was used to assess the statistical significance. Mean increase in visual acuity was 4.44±8.12 letters with a 103.63±94.7 µm decrease in CSRT. BCVA improvement was statistically significant in all genotype groups except in homozygous 69S in the AMRS2 gene. CSRT and BCVA changes were correlated (r=0.2521; 95% CI: 0.04746-0.4364, p=0.0165). Multiple regression analysis revealed a significant impact of 69S (p=0.015) on the change in BCVA. Visual acuity did not improve during the study in patients homozygous for ARMS2 69S, despite a decrease in CSRT. Further investigation is needed to confirm our findings and understand the mechanisms involved.


Yields of tubulin paracrystals, vinblastine-crystals, induced in unfertilized and fertilized sea urchin eggs in the presence of D2O.
The effect of D2O on the crystallization of polymerizable tubulin in sea urchin egg cytoplasm was investigated by estimating the yield of "vinblastine (VB)-crystals" by directly measuring the dimensions of the crystals produced and by protein assays of the crystal isolates. The yield of VB-crystals in mature unfertilized eggs was fairly constant; it neither increased nor decreased in the presence of D2O. On fertilization, the yield of crystals decreased markedly as compared with yields from unfertilized eggs; but, the yield was restored to the value for unfertilized eggs when an adequate concentration of D2O was present during incubation. These results are evidence that tubulin molecules in unfertilized sea urchin eggs are in the polymerizable state but become masked and partly unpolymerizable after fertilization and the D2O releases the masked state and converts unpolymerizable tubulin molecules into active and polymerizable state.


Characterization of potential probiotic starter cultures of lactic acid bacteria isolated from Ethiopian fermented cereal beverages, Naaqe, and Cheka.
To test the in vitro probiotic potential and starter culture capacity of lactic acid bacteria (LAB) isolated from Naaqe and Cheka, cereal-based Ethiopian traditional fermented beverages. A total of 44 strains were isolated from spontaneously fermented Ethiopian cereal-based beverages, Naaqe and Cheka with 24 putatively identified as LAB and 14 identified up to the species level. The species Limosilactobacillus fermentum (6/12; 50%) and Weissella confusa (5/12, 41.67%) were the predominant species identified from Naaqe, while the two Cheka isolates were L. fermentum and Pediococcus pentosaceus. Six LAB strains inhibited eight of the nine gastrointestinal indicator key pathogens in Ethiopia, including Escherichia coli, Salmonella enterica subsp. enterica var. Typhimurium, Staphylococcus aureus, Shigella flexneri, and Listeria monocytogenes. Three of the LAB isolates exhibited strain-specific immunostimulation in human monocytes. Based on these probiotic properties and growth, six strains were selected for in situ evaluation in a mock fermentation of Naaqe and Cheka. During primary fermentations, L. fermentum 73B, P. pentosaceus 74D, L. fermentum 44B, W. confusa 44D, L. fermentum 82C, and Weissella cibaria 83E and their combinations demonstrated higher pH-lowering properties and colony-forming unit counts compared to the control spontaneous fermentation. The same pattern was also observed in the secondary mock fermentation by the Naaqe LAB isolates. In this study, we selected six LAB strains with antipathogenic, immunostimulatory, and starter culture potentials that can be used as autochthonous probiotic starters for Naaqe and Cheka fermentations once their health benefit is ascertained in a clinical trial as a next step.


One-pot synthesis of substituted di-hydrofurans from Lewis base-catalyzed three-component condensation.
A one-pot synthesis of substituted dihydrofurans was developed through a Lewis base-catalyzed three-component cascade condensation between nitroalkenes, aldehydes, and 1,3-dicarbonyl compounds. The desired cyclization products were prepared with a large substrate scope (22 examples) and excellent diastereoselectivity (only trans isomers) in good to excellent yields (up to 95%).


Psychological disorders and distress after adult cardiothoracic transplantation.
This review summarizes and integrates evidence concerning mental health outcomes following heart, lung, and heart-lung transplantation. Drawing on English-language case reports and empirical studies published between January 1980 and December 2004, the goals of the review were to (a) describe the prevalence and clinical characteristics of psychological disorders, as well as the level and pattern of clinically significant distress in the years posttransplant; (b) review the major risk factors for poor posttransplant psychological outcomes; (c) consider evidence suggesting that posttransplant psychological outcomes predict physical morbidity and mortality after transplant; (d) summarize findings from intervention studies designed to improve posttransplant psychological outcomes; and (e) provide patient care recommendations for the practicing clinician and recommendations for continued clinical research. Several major conclusions can be drawn from this literature. First, depressive and anxiety-related disorders and associated distress are common posttransplant. While new onsets of disorder may decline after the first year posttransplant, the development of new medical complications in the late years posttransplant may provoke renewed distress and recurrences of disorder. Second, risk factors for posttransplant psychological disorders and elevated distress include both standard risk factors observed in other populations (eg, younger age, lifetime history of psychiatric disorder) and transplant-specific factors related to physical functional impairments, social supports, and strategies for coping with health problems. Third, while little evidence has been published to date, there is some indication that posttransplant psychological outcomes can predict subsequent physical health outcomes. Fourth, extremely few intervention studies in cardiothoracic transplant recipients have been performed. The few reports indicate that multicomponent psychosocial strategies focused on risk factor reduction and enhancement of personal coping resources may lead to reductions in psychological distress. An important caveat in considering all of the evidence reviewed is that most studies focus on heart rather than lung or heart-lung recipients. Recommendations for practicing clinicians focus on assessment and treatment options, based on the evidence to date. Research recommendations focus on the need for intervention effectiveness studies.


[Neonatal small left colon syndrome: a finding of only radiological or also clinical significance? (author's transl)].
The finding in the literature that the neonatal small left colon syndrome can be present in newborn infants of diabetic mothers without relevant clinical signs led us to perform contrast enema investigations of the colon in 20 newborn infants of insulin-dependent diabetic mothers. Among these only one infant, with signs of intestinal obstruction, had the small left colon syndrome. During the same period the neonatal small left colon syndrome was diagnosed in 4 out of 10 mature newborn infants of healthy, non-diabetic mothers who underwent contrast enema investigation because of intestinal obstruction. The concepts of the pathogenesis of the neonatal small left colon syndrome and the importance of this form of functional intestinal obstruction in the newborn are discussed together with the presumptive relationship to severe gastrointestinal complications such as e.g. necrotizing enterocolitis, seen with increasing frequency in artificially ventilated newborns.


The transformation of global value chains in the age of Covid-19 and Digitization.
Almost everyone on the globe had to adjust to new conditions as a result of Covid-19 in conjunction with digitization. Contact and entry limitations damaged global business, trade and social connections. In addition, there is an increasing impact of digitization in supply chain. Regarding these disruptions current publications emphasize that global value chains are transforming to become more resilient. This study analyzes potential factors that might increase resilience in such a dynamic environment. The research is based on a quantitative empirical study to test the formulated hypotheses. The research questions were investigated trough a survey with logistics professionals. Two hypotheses were established as significant throughout the study. These are the robustness and responsiveness of global value chains, which have a substantial impact on their resilience. Both are determined direct or indirect by digital technologies. The complexity of global value chains had no discernible effect on the resilience of the system. A structural equation model is used to analyze the data's processing. This is achieved via a hypothesis model. As a result, major implications on global value chains' resilience can be found.


US characteristics of frozen prostate.
Cryosurgery has previously been used successfully to treat prostatic carcinoma. Inability to monitor the freezing led to local complications that limited the use of this modality. In this animal study, monitoring of the freezing process was accomplished with real-time ultrasound. The margin of the frozen tissue appeared as a hyperechoic rim with posterior acoustic shadowing. The thawed cryolesions showed markedly decreased echogenicity compared with normal unfrozen prostate. These characteristic changes should allow safer and more efficacious application of prostatic cryosurgery.


Stability of BDNF in Human Samples Stored Up to 6 Months and Correlations of Serum and EDTA-Plasma Concentrations.
Brain-derived neurotrophic factor (BDNF), an important neural growth factor, has gained growing interest in neuroscience, but many influencing physiological and analytical aspects still remain unclear. In this study we assessed the impact of storage time at room temperature, repeated freeze/thaw cycles, and storage at -80 °C up to 6 months on serum and ethylenediaminetetraacetic acid (EDTA)-plasma BDNF. Furthermore, we assessed correlations of serum and plasma BDNF concentrations in two independent sets of samples. Coefficients of variations (CVs) for serum BDNF concentrations were significantly lower than CVs of plasma concentrations (n = 245, p = 0.006). Mean serum and plasma concentrations at all analyzed time points remained within the acceptable change limit of the inter-assay precision as declared by the manufacturer. Serum and plasma BDNF concentrations correlated positively in both sets of samples and at all analyzed time points of the stability assessment (r = 0.455 to rs = 0.596; p < 0.004). In summary, when considering the acceptable change limit, BDNF was stable in serum and in EDTA-plasma up to 6 months. Due to a higher reliability, we suggest favoring serum over EDTA-plasma for future experiments assessing peripheral BDNF concentrations.


Depressive symptoms and psychosocial aspects of work in bank employees.
The financial sector has seen an increase in the number of cases of violence and stress, which can result in adverse health outcomes, including depressive symptoms, but studies related to stress at work and depression for these workers are scarce. To investigate the association between exposure to psychosocial work stressors and depressive symptoms in bank employees. A self-administered questionnaire was completed by a sample of bank employees in Pará and Amapá, Brazil. The survey assessed sociodemographic characteristics, mental health (Patient Health Questionnaire-9), Demand-Control-Support and Effort-Reward Imbalance (ERI). Outcomes included two levels of depressive symptoms: major depressive symptoms (MDS) and other forms of depressive symptoms (ODS). Logistic regression models were used to estimate associations between depressive symptoms, the two job stress models and relevant covariates. Of 2806 eligible subjects, there were 1445 respondents (52% response rate) and the final analyses included 1046 participants. The overall prevalence of depressive symptoms was 32% (MDS = 18%; ODS = 14%), with no statistically significant difference between men and women. High demands, low levels of control and low social support were associated with MDS and/or ODS, adjusted for gender, age and other work-related conditions. High effort/low reward, over-commitment and ERI were also associated with MDS and ODS. Psychosocial conditions in banking activity involving high strain, low social support at work, high effort with low reward and over-commitment may represent possible risk factors for depressive symptoms in bank employees.


Clinical impact of non-lying time on hospital-associated functional decline in older patients undergoing transcatheter aortic valve implantation.
The purposes of the present study were: (1) to investigate the relationship between hospital-associated functional decline (HAFD) and non-lying time and (2) to clarify the optimal cut-off value for non-lying time associated with HAFD in older patients undergoing transcatheter aortic valve implantation (TAVI). From January 2021 to December 2022, patients admitted to a university hospital who underwent trans-femoral TAVI were consecutively recruited. We measured short physical performance battery (SPPB) pre and post-TAVI, and non-lying time from post-operative days 3-5. HAFD was defined as at least 1 point decrease in SPPB during pre and post-TAVI. Among 75 patients (47 female, mean age of 84.5 years) enrolled, 14 patients were classified as having HAFD. Non-lying time was significantly shorter in the HAFD group than in the non-HAFD group (371 min vs. 539 min, P < 0.001). Receiver-operating characteristic analysis determined an optimal cut-off value of 477 min for differentiating the patients more likely to experience HAFD (sensitivity, 75%; specificity, 92%; area under the curve, 0.798). The non-lying time could be one of the associated factors of HAFD in older patients with TAVI. Non-lying time of about 480 min (8 h) during hospitalization may be an initial target for preventing HAFD.


Parent-rated emotional-behavioral and executive functioning in childhood epilepsy.
The present study examined clinical and demographic risk factors associated with parent-rated emotional-behavioral and executive functioning in children and adolescents with epilepsy. The medical records of 152 children and adolescents with epilepsy referred for neuropsychological evaluation were reviewed. Results indicated that the sample displayed significantly elevated symptoms across the emotional-behavioral and executive domains assessed. Executive functioning and behavioral symptoms had the highest rates of clinically elevated scores, with lowest rates of elevated scores in internalizing and externalizing emotional problems. Only 34% of those participants with clinically significant emotional-behavioral or executive functioning difficulties had a history of psychological or counseling services, highlighting the underserved mental health needs of this population. In regard to clinical factors, the majority of seizure-related variables were not associated with emotional-behavioral or executive functioning. However, the frequency of seizures (i.e., seizure status) was associated with behavioral regulation aspects of executive functioning, and the age at evaluation was associated with externalizing problems and behavioral symptoms. Family psychiatric history (with the exception of ADHD) was associated with all domains of executive and emotional-behavioral functioning. In summary, emotional-behavioral and executive functioning difficulties frequently co-occur with seizures in childhood epilepsy, with both seizure-related and demographic factors contributing to the presentation of such neurobehavioral comorbidities. The present findings provide treatment providers of childhood epilepsy with important information to assist in better identifying children and adolescents who may be at risk for neurobehavioral comorbidities and may benefit from intervention.


Evaluation of aesthetics of implant-supported single-tooth replacements using different bone augmentation procedures: a prospective randomized clinical study.
The aim of this study was to evaluate the aesthetics of implant-supported single-tooth replacements using different augmentation procedures in a prospective study with the use of an objective rating index and with a subjective patient questionnaire, and to compare the results with each other. Ninety-three patients with a single-tooth gap in the anterior zone of the maxilla were selected for the study. All patients had a local bone defect that needed augmentation before placement of an endosseous implant with sufficient initial stability. Aesthetics of the implant-supported crown and adjacent mucosa was rated by a prosthodontist 1 year after placement of the porcelain crown. Aesthetics was rated using the Implant Crown Aesthetic Index. A subjective appreciation of the final result was assessed with a patient questionnaire. The Implant Crown Aesthetic Index reveals a mean overall score of 4.8, with an acceptable result in 66% of the cases. Results of the satisfaction questionnaire reveal a mean overall score of 8.5 with an acceptable result in 100% of the cases. There is no correlation between results of the Index and the questionnaire for the overall and the crown score. The patients' opinion and the professionals' opinion about the peri-implant mucosa do show a significant correlation. The peri-implant mucosa is rated as less satisfactory than the implant-supported crown by both the dental professional and patients. The dental professional was less satisfied with respect to the total result and results of the crown than the patients.


Streptomyces coelicolor SCO4226 is a nickel binding protein.
The open reading frame SCO4226 of Streptomyces coelicolor A3(2) encodes an 82-residue hypothetical protein. Biochemical assays revealed that each SCO4226 dimer binds four nickel ions. To decipher the molecular function, we solved the crystal structures of SCO4226 in both apo- and nickel-bound (Ni-SCO4226) forms at 1.30 and 2.04 Å resolution, respectively. Each subunit of SCO4226 dimer adopts a canonical ferredoxin-like fold with five β-strands flanked by two α-helices. In the structure of Ni-SCO4226, four nickel ions are coordinated at the surface of the dimer. Further biochemical assays suggested that the binding of Ni2+ triggers the self-aggregation of SCO4226 in vitro. In addition, RT-qPCR assays demonstrated that the expression of SCO4226 gene in S. coelicolor is specifically up-regulated by the addition of Ni2+, but not other divalent ions such as Cu2+, Mn2+ or Co2+. All these results suggested that SCO4226 acts as a nickel binding protein, probably required for nickel sequestration and/or detoxification.


Tunable THz polariton laser based on 1342 nm wavelength for enhanced terahertz wave extraction.
We detail the operation of a THz laser source based on non-linear stimulated polariton scattering (SPS) in Mg:LiNbO3. This system utilizes a fundamental wavelength of 1342 nm to completely avoid the negative effect of free-carrier generation within high-resistivity silicon (Si) prisms used to extract THz radiation from the Mg:LiNbO3 crystal. THz power of up to 23.6 μW (62.3 μW when chopped at 50% duty cycle) was detected at 1.33 THz, and frequency tunability across the range 1.05-2.2 THz was achieved.


Preventing child pedestrian injury: pedestrian education or traffic calming?
The traditional approach to the prevention of child pedestrian injuries in New Zealand is pedestrian education. However, none of the programs currently being implemented in New Zealand have ever been shown to reduce injury rates. The allocation of scarce resources to pedestrian education must therefore be questioned. In this paper we estimate the number of serious child pedestrian injuries which might be prevented if the resources allocated to pedestrian education were allocated instead to environmental approaches, in particular, to traffic calming. It is estimated that approximately 18 hospitalisations of child pedestrians could be prevented each year under this alternative resource allocation, disregarding any other benefits of traffic calming. These results emphasise the need to consider the potential sacrifices involved in the allocation of scarce resources to child pedestrian education.


Should Advertising by Aesthetic Surgeons be Permitted?
Cosmetic, aesthetic and cutaneous surgical procedures require qualified specialists trained in the various procedures and competent to handle complications. However, it also requires huge investments in terms of infrastructure, trained staff and equipment. To be viable advertising is essential to any establishment which provides cosmetic and aesthetic procedures. Business men with deep pockets establish beauty chains which also provide these services and advertise heavily to sway public opinion in their favour. However, these saloons and spas lack basic medical facilities in terms of staff or equipment to handle any complication or medical emergency. To have a level playing field ethical advertising should be permitted to qualified aesthetic surgeons as is permitted in the US and UK by their respective organisations.


Serotoninergic receptor 1A in the sudden infant death syndrome brainstem medulla and associations with clinical risk factors.
The immunoreactivity of the serotoninergic receptor subtype 1A (5HT(1A)R) was quantitatively analyzed in the human infant brainstem medulla (caudal and rostral levels). We hypothesized that immunoreactivity of 5HT(1A)R would be reduced in infants diagnosed with sudden infant death syndrome (SIDS). In particular that those infants with known clinical risk factors (including cigarette smoke exposure, bed sharing and sleep position) would have greater changes than those without clinical risks. Comparing SIDS (n = 67) to infants who died suddenly with another diagnosis (non-SIDS, n = 25), we found decreased 5HT(1A)R immunoreactivity in the majority of the nuclei studied at the rostral medulla level including dorsal motor nucleus of the vagus (DMNV), nucleus of the solitary tract, vestibular, and inferior olivary nucleus (ION). There was a significant relationship with all risk factors for 5HT(1A)R, especially for DMNV, suggesting that 5HT(1A)Rs are highly vulnerable to various insults within the SIDS DMNV. This study not only provides further evidence of abnormalities within the brainstem serotoninergic system of SIDS infants, but also shows that these changes may be associated with exposure to clinical risk factors.


Disruption of axonal transport by loss of huntingtin or expression of pathogenic polyQ proteins in Drosophila.
We tested whether proteins implicated in Huntington's and other polyglutamine (polyQ) expansion diseases can cause axonal transport defects. Reduction of Drosophila huntingtin and expression of proteins containing pathogenic polyQ repeats disrupt axonal transport. Pathogenic polyQ proteins accumulate in axonal and nuclear inclusions, titrate soluble motor proteins, and cause neuronal apoptosis and organismal death. Expression of a cytoplasmic polyQ repeat protein causes adult retinal degeneration, axonal blockages in larval neurons, and larval lethality, but not neuronal apoptosis or nuclear inclusions. A nuclear polyQ repeat protein induces neuronal apoptosis and larval lethality but no axonal blockages. We suggest that pathogenic polyQ proteins cause neuronal dysfunction and organismal death by two non-mutually exclusive mechanisms. One mechanism requires nuclear accumulation and induces apoptosis; the other interferes with axonal transport. Thus, disruption of axonal transport by pathogenic polyQ proteins could contribute to early neuropathology in Huntington's and other polyQ expansion diseases.