[The Ohtahara's syndrome: a special form of age-dependent epilepsy].
The aim of this report is to review the clinical and the outcome data in four patients with Ohtahara syndrome at Sant Joan de Déu Hospital, Barcelona, following the same clinical and electroencephalografic criteria reported by the author. The etiology of this syndrome is unknown and plurifactorial. Investigation studies were negative except for the EEG and neuroimaging. MRI was performed in two children, and pachigyria was observed in one and mycropoligyria in the other. There were no response to cofactors, phenobarbital, vigabatrine and valproate. Therefore two patients underwent treatment with ACTH with no response in one and good response in the other. Two patients died at 2 and 6 months; other one was transferred to another center at 6 months-old and was lost at follow-up. The fourth patient, fourteen-month-old, is free of seizures with improvement of EEG register with important development retardation. We conclude that Ohtahara syndrome is a severe neonatal epilepsy with poor neurologic outcome; MRI detects often brain malformations as cortical dysplasia and a therapeutic trial of ACTH is indicated because the possibility of control of the seizures.


Case series: Sensory intolerance as a primary symptom of pediatric OCD.
Marked intolerance or intrusive re-experiencing of ordinary sensory stimuli that in turn drive functionally impairing compulsive behaviors are occasionally seen in young children with OCD. We describe a number of children with DSM-IV OCD ascertained from a family genetic study of pediatric OCD, whose intolerance of ordinary sensory stimuli created significant subjective distress and time-consuming ritualistic behavior that was clinically impairing. In each case, these sensory symptoms were the primary presenting symptoms and were experienced in the absence of intrusive thoughts, images, or ideas associated with "conventional" OCD symptoms. These symptoms suggest abnormalities in sensory processing and integration in at least a subset of OCD patients. Recognition of these sensory symptoms and sensory-driven behaviors as part of the broad phenotypic variation in children with OCD could help clinicians more easily identify OCD patients and facilitate treatment.


N-doped carbon dots as robust fluorescent probes for the rapid detection of hypochlorite.
Great advances have been made in the development of carbon dot (CD)-based fluorescent materials for the detection of hypochlorite in the past few years. However, developing new CDs with high quantum yield (QY) for the rapid detection of hypochlorite and gaining a deeper insight into the detection mechanism still need to be further investigated. Herein, N-doped carbon dots (NCDs) with high QYs, which can reach as high as 67%, were efficiently prepared employing citric acid and o-phenylenediamine as raw materials. Significantly, the NCDs could act as fluorescent probes for the rapid detection of hypochlorite and the limit of detection is calculated to be as low as 12.6 nM on the basis of fluorescent "on-off" effects upon the addition of hypochlorite. Furthermore, UV-vis absorption spectra, Density Functional Theory (DFT) calculations and kinetic analysis of fluorescence (FL) decay were used to investigate the detection mechanism. The results indicate that the electron transfer (ET) process from NCDs to imine-functionalized NCDs (imine-NCDs) and the higher energy gap of imine-NCDs will facilitate the excited-energy of NCDs to be dissipated in the form of a non-radiative decay procedure, resulting in a static quenching mechanism. Therefore, these observations are useful in deepening the understanding of the hypochlorite induced FL quenching mechanism and thereby developing oxidative stress-related detection materials.


Accurate intracranial pressure monitoring: technical note.
Intracranial pressure (ICP) monitoring may be misleading or inaccurate in patients who have sustained cerebral death or who have had cerebrospinal fluid drainage (e.g., due to skull fracture or craniotomy). ICP recording in these patients requires particular attention to the monitoring technique to avoid misleading values that may result in inappropriate therapy. We review methods for obtaining accurate ICP readings from fluid-interface systems using either a ventricular catheter or a subarachnoid screw. We suggest attention to the following: (a) elevation of the pressure in the external tubing and connections to ensure that there are no microleaks , (b) injection of a small volume of saline intracranially, and (c) awareness of what constitutes a true ICP reading.


[Surgical treatment for aortic root dilatation and aortic regurgitation after arterial switch operation].
Aortic regurgitation (AR) and, aortic root dilatation are serious problems occurring after arterial switch operation (ASO). We have experienced a case of 12-year-old boy with aortic root dilatation and AR after ASO. Consistent progression of AR and aortic root dilatation were observed during the follow-up period. The latest Z-score of Valsalva sinus was about 9. We performed the Bentall procedure instead of aortic valve-sparing operation because of the degenerative aortic valve and the excessive aortic root dilatation. The postoperative course was uneventful. Histopathological findings of the aortic wall showed degeneration of elastic fibers on both sides of the anastmosis.


Hematopoietic growth factors: biology and clinical application.
A number of recently identified cytokines have been implicated in the development of blood cells and their functional activation. These include granulocyte colony-stimulating factor (G-CSF), granulocyte/macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF), and interleukins-1, -3, and -6. The two that have been studied most extensively clinically are G- and GM-CSF. Biologic differences between these two agents have important implications for their use in particular clinical settings. Whereas G-CSF for the most part has demonstrated lineage specificity in stimulating production of neutrophil granulocytes, GM-CSF stimulates production of all types of granulocytes and is a potent activator of monocytes and macrophages as well. In addition, GM-CSF has been found to induce other cytokines, such as tumor necrosis factor and interleukin-1. Functional differences such as influencing neutrophil migration have also been noted; GM-CSF can be a potent inhibitor of neutrophil migration. The interaction of these and other cytokines in inflammation and injury is the determinant of the ultimate clinical outcome. Potential clinical applications for these growth factors are discussed, and specific clinical studies during which recombinant human G-CSF was used are reviewed.


Single-molecule magnets of ferrous cubes: structurally controlled magnetic anisotropy.
Tetranuclear Fe(II) cubic complexes were synthesized with Schiff base ligands bridging the Fe(II) centers. X-ray structural analyses of six ferrous cubes, [Fe4(sap)4(MeOH)4].2H2O (1), [Fe4(5-Br-sap)4(MeOH)4] (2), [Fe4(3-MeO-sap)4(MeOH)4].2MeOH (3), [Fe4(sae)4(MeOH)4] (4), [Fe4(5-Br-sae)4(MeOH)4].MeOH (5), and [Fe4(3,5-Cl2-sae)4(MeOH)4] (6) (R-sap and R-sae were prepared by condensation of salicylaldehyde derivatives with aminopropyl alcohol and aminoethyl alcohol, respectively) were performed, and their magnetic properties were studied. In 1-6, the alkoxo groups of the Schiff base ligands bridge four Fe(II) ions in a mu3-mode forming [Fe4O4] cubic cores. The Fe(II) ions in the cubes have tetragonally elongated octahedral coordination geometries, and the equatorial coordination bond lengths in 4-6 are shorter than those in 1-3. Dc magnetic susceptibility measurements for 1-6 revealed that intramolecular ferromagnetic interactions are operative to lead an S = 8 spin ground state. Analyses of the magnetization data at 1.8 K gave the axial zero-field splitting parameters (D) of +0.81, +0.80, +1.15, -0.64, -0.66, and -0.67 cm(-1) for 1-6, respectively. Ac magnetic susceptibility measurements for 4-6 showed both frequency dependent in- and out-of-phase signals, while 1-3 did not show out-of-phase signals down to 1.8 K, meaning 4-6 are single-molecule magnets (SMMs). The energy barriers to flip the spin between up- and down-spin were estimated to 28.4, 30.5, and 26.2 K, respectively, for 4-6. The bridging ligands R-sap2- in 1-3 and R-sae2- in 4-6 form six- and five-membered chelate rings, respectively, which cause different steric strain and Jahn-Teller distortions at Fe(II) centers. The sign of the D value was discussed by using angular overlap model (AOM) calculations for irons with different coordination geometry.


Cytoskeletal adaptation following long-term dysregulation of actomyosin in neuronal processes.
Microtubules, intermediate filaments, and actin are cytoskeletal polymer networks found within the cell. While each has unique functions, all the cytoskeletal elements must work together for cellular mechanics to be fully operative. This is achieved through crosstalk mechanisms whereby the different networks influence each other through signaling pathways and direct interactions. Because crosstalk can be complex, it is possible for perturbations in one cytoskeletal element to affect the others in ways that are difficult to predict. Here we investigated how long-term changes to the actin cytoskeleton affect microtubules and intermediate filaments. Reducing F-actin or actomyosin contractility increased acetylated microtubules and intermediate filament expression, with the effect being significantly more pronounced in neuronal processes. Changes to microtubules were completely reversible if F-actin and myosin activity is restored. Moreover, the altered microtubules in neuronal processes resulting from F-actin depletion caused significant changes to microtubule-based transport, mimicking phenotypes that are linked to neurodegenerative disease. Thus, defects in actin dynamics cause a compensatory response in other cytoskeleton components which profoundly alters cellular function.


Prazosin in the treatment of chronic asthma.
The role of prazosin, an alpha 1 adrenoceptor blocker, was investigated in patients with chronic stable asthma who continued to have symptoms despite conventional treatment. Forty patients were entered into a double blind, placebo controlled, crossover trial to examine the effect of adding oral prazosin (2 mg twice daily) to previous medication for three weeks. Sixteen patients withdrew from the study. The remaining 24 patients showed no significant change in peak expiratory flow, FEV1, forced vital capacity (FVC), FEV1/FVC ratio, diary card symptom scores, or dose of beta sympathomimetic.


Flexible small molecular anti-estrogens with N,N-dialkylated-2,5-diethoxy-4-morpholinoaniline scaffold targets multiple estrogen receptor conformations.
Estrogen mediates various cellular processes including cell proliferation, differentiation, growth and mammary gland function. Estrogen Receptors (ERs) are expressed in 70% of breast cancers. Consequently, estrogen mediated ER signaling plays a critical role in breast cancer diagnosis, prognosis, and treatment. ERs are ligand-triggered transcription factors. However, in the absence of a cognate estrogenic ligand, ERs can be activated by a variety of other extracellular signals. Tamoxifen, an anti-estrogen that selectively targets ER, induces substantial regression of breast tumors and an increase in disease-free survival. Tamoxifen mimics estrogen effects in other tissues thereby providing some beneficial effects including reduced risk of osteoporosis. However, breast cancers that initially respond well to tamoxifen tend to develop resistance and resume growth despite the continued presence of the antagonist. Library of compounds with substituted morpholinoaniline scaffold, a set of structurally divergent potential ER antagonists that fit the tamoxifen pharmacophore, were designed to target ER Ligand Binding Domain (LBD) and to recruit co-regulator proteins including BRCA1 over a range of conformational changes. Two of the lead compounds in the library, BR46 and BR47, were found to inhibit estrogen induced cell proliferation and cell viability. Discovery of novel lead molecules targeting ligand binding pockets of hER has provided structural clues toward the development of new breed of small molecule therapeutics for tamoxifen-resistant breast cancers and would complement already existent anti-estrogen therapy.


Convergence of the discrete dipole approximation. II. An extrapolation technique to increase the accuracy.
We propose an extrapolation technique that allows accuracy improvement of discrete dipole approximation computations. The performance of this technique was studied empirically on the basis of extensive simulations for five test cases using many different discretizations. The quality of the extrapolation improves with refining discretization, reaching extraordinary performance especially for cubically shaped particles. A 2-order-of-magnitude decrease of error is demonstrated. We also propose estimates of the extrapolation error, which are proven to be reliable. Finally, we propose a simple method to directly separate shape and discretization errors and illustrate this for one test case.


New method of serological testing for Mycobacterium avium subsp. paratuberculosis (Johne's disease) by flow cytometry.
Johne's disease (JD) or paratuberculosis, caused by Mycobacterium avium subsp. paratuberculosis (MAP), is one of the most widespread and economically important diseases of livestock and wild ruminants worldwide. Attempts to control JD have proven inordinately difficult due to low levels of sensitivity by currently available diagnostic tests, which are also incapable of detecting prepatent MAP infections. In the present work, we describe the use of a flow cytometry method (FCM) for serological diagnosis of subclinical and clinical JD in cattle. The FCM was capable of distinguishing MAP-infected from MAP-non-infected cattle as well as MAP from M. scrofulaceum and M. avium subsp. avium. Results of the FCM were compared to that of a commercially available ELISA using 82 serum samples from JD-positive and JD-negative dairy and beef cattle farms that were separated into the following groups: (1) sera from a JD-free farm; (2) sera from JD-positive farms that had tested negative by ELISA; and (3) sera from JD-positive farms that tested JD-positive by ELISA. The FCM found that groups 1-3 were 6.6%, 73.3%, and 97.3% positive for MAP infections, respectively. By using 30 fecal culture-negative samples from a JD-free farm and 21 fecal culture-positive samples from JD-positive farms, diagnostic sensitivity and specificity of the FCM were calculated to be 95.2% and 96.7%, respectively. A retrospective study of 10 JD-positive cows showed that the FCM detected MAP infections 6-44 months earlier than the fecal culture test. Further, the FCM specifically detected MAP infections in serum samples as early as 170 days after experimental inoculation of calves with MAP and did not react with calves inoculated with other mycobacteria. Production of IgG against MAP was detected by FCM in all the calves inoculated with MAP 240 days after inoculation, whereas positive anti-MAP IgG production was not detected in control calves or calves experimentally infected with M. avium subsp. avium or M. bovis. The FCM assay is rapid and is completed in less than 4 h. Moreover, the FCM is objective, technically easy and can be automated for handling large numbers of samples. This novel assay might form the basis of a highly sensitive and subspecies-specific test for the diagnosis of JD.


Concerted hydrogen-bond dynamics in the transport mechanism of the hydrated proton: a first-principles molecular dynamics study.
First-principles molecular dynamics calculations performed in a fully converged basis set are used to reveal new details about the mechanism of the anomalous proton-transport process in water, a fundamental question dating back over 200 years. By separating actual structural diffusion from simple rattling events, wherein a proton shuttles forth and back in a hydrogen bond, it is found that the former are driven by a concerted mechanism in which hydronium begins to accept a hydrogen bond from a donor water molecule while the proton-receiving water molecule simultaneously loses one of its acceptor hydrogen bonds. The kinetics of the process are found to be in good agreement with recent experiments.


Effect of Social-Psychological Intervention on Self-Efficacy, Social Adaptability and Quality of Life of Internet-Addicted Teenagers.
Internet addiction leads to psychological and social damage to teenagers. Rehabilitation treatment of Internet-addicted adolescents has aroused widespread concern. This study aims to explore the effect of social-psychological intervention on self-efficacy, social adaptability, and quality of life of Internet-addicted teenagers. A total of 100 Internet-addicted teenagers in Guilin mental health center in China were selected and were randomly divided into control (n=50) and observation (n=50) groups. The teenagers in the control group received general withdrawal intervention, whereas those in the observation group received social-psychological intervention based on general withdrawal intervention. The intervention duration was 3 months. After intervention, the time management, interpersonal and health, Internet addiction tolerance, Internet withdrawal response, compulsive surfing of the Internet, and total score of Chinese Internet Addiction Scale of Internet-addicted teenagers in the two groups decreased significantly. Conversely, the total scores of boring and relaxation, stimulation and exposure, communication and information acquisition, negative emotion, and self-efficacy increased significantly, and the scores improved more significantly after the intervention in the observation group (P<0.05). Moreover, the scores of social adaptability, quality of life, and Internet avoidance of Internet-addicted teenagers in the two groups increased significantly after the intervention, whereas the scores of behavior monitoring and hazard perception decreased significantly, and the scores mentioned above improved more significantly in the observation group after the intervention (P<0.05). Social psychological intervention can effectively improve the self-efficacy of Internet-addicted teenagers, correct their bad surfing habits, and improve their social adaptability and quality of life, which is an intervention method worthy of promotion in the rehabilitation of Internet addiction.


The Dementia Friendly Hospital Initiative education program for acute care nurses and staff.
Individuals with Alzheimer's disease and other dementias have 3.2 million hospital stays annually, which is significantly more than older individuals without dementia. Hospitalized patients with dementia are at greater risk of delirium, falls, overwhelming functional decline that may extend the hospital stay, and prolonged or complicated rehabilitation. These risks highlight the need for staff education on the special care needs of this vulnerable population. This article describes a one-day education program, the Dementia Friendly Hospital Initiative, designed to teach staff how to provide the specialized care required by patients with dementia. Participants (N = 355) from five different hospitals, including 221 nurses, completed a pretest-posttest evaluation for the program. Changes in participants attitudes and practices, confidence, and knowledge were evaluated. Scores indicated significant improvement on the posttest. The evaluation provides further evidence for recommending dissemination of the Dementia Friendly Hospital Initiative.


Coronary Artery Disease and Type 2 Diabetes Mellitus.
Type 2 diabetes mellitus (T2DM) is a major risk factor of coronary artery diseases (CAD). Clinical outcomes in CAD with T2DM are poor despite improvement in medications and intervention devices. Coronary artery bypass grafting (CABG) is superior to percutaneous coronary intervention (PCI) in treating diabetic patients with multivessel coronary artery diseases (MVD). However, selecting a revascularization strategy should depend not only on the lesion complexity but also on the patient's background and comorbidities. In addition, comprehensive risk management with medical and non-pharmacological therapies is important, as is confirmation of whether risk managements are appropriately achieved. Recently, novel anti-diabetic drugs have been demonstrated to have effectiveness in reducing cardiovascular events, which was independent of their glucose-lowering effect. Furthermore, non-pharmacological interventions using exercise and diet during the earlier stages of abnormal glucose metabolism might be beneficial in preventing the development or progression of T2DM and reducing the incidence of cardiovascular events.


[Cephalic duodenopancreatectomy with preservation of the pylorus in treating a malignant tumor of Vater's ampulla].
The paper reports on the clinical observation of a patient with mechanical jaundice in which the biliary obstruction was caused by an ampulla of Vater. Cephalic duodenopancreatectomy with preservation of the pylorus was used. Distally the duodenum was excised to its intersection with the mesenteric vessels. For recovery of the digestive circuits, a loop excluded "en Y" à la Roux ascending transmesocolically was used. The anastomoses had the following stages: choledochojejunostomy (T-T) the most proximal; pancreatic-jejunal anastomosis (T-L); and the most distal, the duodeno-jejunal one (T-L). After surgery, the evolution was good, and the patient left the hospital with the wound cured. Starting from this observation, the authors discuss aspects connected with the technique of cephalic duodenopancreatectomy with or without preservation of the pylorus.


A colony-forming assay for determining the establishment efficiency of S/MAR-containing nonviral episomal expression vectors.
As with all eukaryotic replicons, the stable establishment of S/MAR (scaffold/matrix attached region) vectors is a stochastic event that depends on poorly understood epigenetic factors such as chromatin structure and nuclear localization. Establishment efficiency describes the percentage of cells in which a particular S/MAR vector is stably retained as an episome after an initial selection period. Expected establishment efficiency for S/MAR vectors is 1-5%. This article describes a colony-forming assay that may be used either to determine establishment efficiency or to generate single cell clones.


Component-resolved diagnostics in Thai children with cow's milk and egg allergy.
Component-resolved diagnostics (CRD) have garnered a lot of attention in recent years in the diagnosis of food allergies. We aimed to investigate sensitization against cow's milk and egg white components, and to study the clinical usefulness of serum food-specific immunoglobulin E (sIgE) to cow's milk and egg white components in Thai children with cow's milk and egg allergies. Children with IgE-mediated cow's milk and/or egg allergy were enrolled. Clinical reactions were determined. Specific IgE against cow's milk, egg white, alpha-lactalbumin (ALA), beta-lactoglobulin (BLG), casein, ovomucoid, ovalbumin and conalbumin were measured. Thirteen cow's milk allergic subjects and 32 egg allergic subjects were identified. The sensitization rate to BLG and casein was 91.7%, followed by ALA (66.7%) for cow's milk, and the sensitization rate to ovalbumin was 93.8%, followed by ovomucoid (81.3%) and conalbumin (37.5%) for egg. Patients in the urticaria group had a higher level of casein sIgE than the atopic dermatitis (AD) group but this difference was not significant (9.8 kUA/L vs. 0.9 kUA/L, p = 0.11). The level of ovomucoid sIgE was significantly higher in the non-AD group than in the AD group (3.8 kUA/L vs. 1.3 kUA/L, p = 0.048). BLG and casein for cow's milk and ovomucoid and ovalbumin for egg were the common components causing sensitization in cow's milk and egg allergic patients. Among the patients with cow's milk allergy, the level of casein sIgE in the urticaria group tended to be higher than the AD group, and in egg allergic patients, the non-AD group had a significantly higher ovomucoid sIgE level compared with the AD group.


Peptidomics for Studying Limited Proteolysis.
Limited proteolysis is a pivotal mechanism regulating protein functions. Identifying physiologically or pathophysiologically relevant cleavage sites helps to develop molecular tools that can be used for diagnostics or therapeutics. During proteolysis of secretory and membrane proteins, part of the cleaved protein is liberated and destined to undergo degradation but should retain original cleavage sites created by proteolytic enzymes. We profiled endogenous peptides accumulated for 4 h in media conditioned by primary cultured rat cardiac fibroblasts. A total of 3916 redundant peptide sequences from 94 secretory proteins and membrane proteins served to identify limited cleavage sites, both annotated and unannotated, for signal peptide or propeptide removal, peptide hormone processing, ectodomain shedding, and regulated intramembrane proteolysis. Incorrectly predicted signal cleavage sites are found in typical proteins such as extracellular matrix proteins and the peptide hormone precursor adrenomedullin ADM. The revealed signal peptide cleavage site for ADM was experimentally verified by identifying the major molecular form of flanking proadrenomedullin N-terminal peptide. We suggest that profiling of endogenous peptides, like transcriptome sequence reads, makes sense in regular cells such as fibroblasts and that peptidomics provides insight into proteolysis-regulated protein functions.


[Correlation of stimulus-induced ventricular echo beats and left ventricular function in patients without ventricular tachycardia].
110 patients (105 male, 5 female, mean age +/- S.D.: 52.9 +/- 5.9 years) with and without coronary artery disease were prospectively studied by programmed right ventricular stimulation (single and double premature stimuli during sinus rhythm and a paced ventricular drive of rates of 120, 140, 160 and 180 b.p.m.). The incidence of ventricular echobeats (VE) was correlated with angiographic and electrocardiographic findings. The end of the stimulation protocol was reached as soon as four or more ventricular echobeats were initiated. 0 to 3 VE occurred in 61/110 patients, 4-9 VE in 31 patients (28%), and greater than or equal to 10 VE were induced in 16 patients. Four or more VE were initiated in 68% of cases up to a paced ventricular rhythm of 120 b.p.m. after one or two premature stimuli. Patients with abnormal results of stimulation showed a tendency to an increase in the frequency of ventricular extrasystoles and couplets during long-term ECG recording. 86% of the patients with normal angiographic findings had 0-3 VE and 14% greater than or equal to 4 VE. In 49% of the patients with abnormal left ventricular function, 0-3 VE and in 51%, greater than or equal to 4 VE could be induced. The type of left ventricular contraction abnormality was significantly correlated to the results of programmed ventricular stimulation. greater than or equal to 4 VE were observed in 74% of patients with anterior wall myocardial infarction. Patients with inferior wall myocardial infarction had greater than or equal to 4 VE in 54% of cases. Ventricular tachycardia was induced in 30% of patients with anterior and in only 12% of patients with inferior wall myocardial infarction (n.s.). To conclude, this prospective study has shown a correlation between the incidence of inducible ventricular echobeats in response to programmed ventricular stimulation and left ventricular function. The prognostic significance of these findings has to be assessed.


Posterior composites: a practical guide revisited.
Direct placement resin composite is revolutionizing the restoration of posterior teeth. Compared to amalgam, its use not only improves aesthetics but, more importantly, promotes a minimally invasive approach to cavity preparation. Despite the benefits, the use of composite to restore load-bearing surfaces of molar and premolar teeth is not yet universally applied. This may be due to individual practitioner concerns over unpredictability, time and the fact that procedures remain technique sensitive for many, particularly with regard to moisture control, placement and control of polymerization shrinkage stress. New materials, techniques and equipment are available that may help to overcome many of these concerns. This paper describes how such techniques may be employed in the management of a carious lesion on the occlusal surface of an upper molar. Direct posterior composite is the treatment of choice for the conservative restoration of primary carious lesions.


The clear cell adenocarcinoma of the colon: case report and review of the literature.
Primary clear cell adenocarcinoma of the colon is a rare oncological entity. We report a case of such a tumor in the left colonic flexure of an 89-year-old patient who was treated surgically in our Department. We also review published cases which include primary colonic clear cell formations. The patient sustained a segmental resection of the region [pT2 N0 (0/12) M0]. Histochemical examination indicated a primary clear cell colonic adenocarcinoma. The patient was discharged in good health but died from his disease 2 years later. Primary clear cell colonic adenocarcinoma is found exclusively in the left colon and generally in elderly men. From the few cases that have been published it is not possible to estimate the oncological impact of this tissue. Even in advanced age surgical resection is the mainstay of the recommended treatment.


Potential reduction of interstitial myocardial fibrosis with renal denervation.
Hypertensive cardiomyopathy is characterized by myocyte hypertrophy and interstitial fibrosis. The effects of renal denervation (RD) on the heart are poorly understood. New magnetic resonance imaging techniques (extracellular volume fraction) permit the quantitative assessment of myocardial fibrosis. Our aim was to study the effects of RD on myocardial fibrosis. Twenty‐three patients with resistant hypertension undergoing RD and 5 resistant hypertensive controls were prospectively included. Cardiac magnetic resonance imaging at 1.5 T was performed before RD and at 6‐month follow‐up. Indexed left ventricular mass, septal extracellular volume fraction, and indexed absolute extracellular volume (a quantitative measure of extracellular matrix) were quantified. All data are reported as mean±SD deviation (median). Decreases in systolic (161.96±19.09 [160] versus 144.78±16.48 [143] mm Hg, P<0.0001) and diastolic (85.61±12.88 [83] versus 80.39±11.93 [81] mm Hg, P=0.018) blood pressures and in indexed left ventricular mass (41.83±10.20 [41.59] versus 37.72±7.44 [38.49] g/m1.7, P=0.001) were observed at follow‐up only in RD patients. No significant differences in extracellular volume were found (26.24±3.92% [26.06%] versus 25.74±4.53% [25.63%], P=0.605). A significant decrease in absolute extracellular volume was observed after 6 months in RD patients exclusively (10.36±2.25 [10.79] versus 9.25±2.38 [9.79] mL/m1.7, P=0.031). This effect was observed independently of blood pressure reduction. RD significantly decreases left ventricular mass, while extracellular volume remains stable. Our results suggest that the observed left ventricular mass decrease was due not exclusively to a reversion of myocyte hypertrophy but also to an additional reduction in collagen content, indicating interstitial myocardial fibrosis.


Dicoumarol-induced 9-gamma-carboxyglutamic acid prothrombin: isolation and comparison with the 6-, 7-, 8-, and 10-gamma-carboxyglutamic acid isomers.
The role of gamma-carboxyglutamic acid (Gla) in prothrombin function can be effectively evaluated by characterizing dicoumarol-induced, Gla-deficient prothrombin structural isomers. In addition to the isolation of 8-, 7-, 6-, 5-, 3-, 2-, 1-, and 0-Gla isomers, we have now purified a variant prothrombin containing 9(8.80) Gla residues by barium citrate adsorption, elution, and finally by DEAE-cellulose and immunoaffinity chromatographies. Agar gel electrophoretic mobilities of the 9-Gla isomer and its fragment 1 were slower than those of the respective 10-Gla (normal) prothrombin and fragment 1, both in the absence and presence of Ca(II). In the presence of Ca(II), both 9- and 10-Gla fragments 1 moved slower than 8- and 7-Gla fragments 1. However, in the absence of metal ions, 9- and 7-Gla fragments 1 migrated at the same rate, but slower than 10- and 8-Gla fragments. Similarly, the 9-Gla fragment 1 electrofocused cathodically to 10- and 8-Gla, but comparably with 7-Gla fragment 1. The 9-Gla fragment 1 exhibited a Ca(II)-induced 44% decrease in the intrinsic fluorescence, compared with a 40% decrease in that of 10-Gla; 8-Gla fragment 1 revealed only 23% quenching. Ca(II)-dependent anti-normal prothrombin antibodies are not specific for 10-Gla prothrombin, since only a twofold molar excess of the 9-Gla isomer was required to displace equal amounts of labeled normal prothrombin. The most critical Gla residue for influencing the functional, thrombin-generating properties of prothrombin appears to be the one present in the 9-Gla isomer but absent in the 8-Gla variant, since 9-Gla prothrombin possesses four times the normal coagulant activity (78 versus 20%) of the 8-Gla isomer.


Abdominal angiostrongyliasis: what does the rheumatologist must know about it?
Abdominal angiostrongyliasis (AA) is a disease caused by Angiostrongylus costaricensis, a nematode that can infect humans accidentally through the ingestion of larvae. Worms live inside intestinal small vessels and can lead to gastrointestinal symptoms and bowel necrosis in otherwise healthy patients. Therefore, abdominal angiostrongyliasis may be important in the differential diagnosis with systemic vasculitides and other rheumatic diseases with vascular involvement. We report a case of abdominal angiostrongyliasis in an 18-year-old woman presenting with necrosis of the terminal ileum.


Effects of relaxation on anxiety in primary caregivers of chronically ill children.
To evaluate the effects of self-applied breathing and guided imagery relaxation techniques, separately and in combination, and a reinforcement tool on primary caregivers (PCGs) coping with anxiety when caring for a chronically ill child. Twenty PCGs, aged 25-57, of chronically ill children were randomly assigned to an experimental or control group. The State Anxiety Scale of the State-Trait Anxiety Inventory (Form Y) was used to measure state anxiety across three test administrations. While there were no statistically significant changes in state anxiety, behavioral evaluations indicated that PCGs used both the self-applied relaxation techniques and the reinforcement tool more than twice daily. Relaxation techniques may be useful for those people caring for chronically ill children.


[The treatment of deep venous thrombosis of the lower limbs].
The various therapeutic modalities in deep venous thrombosis of the lower limbs (surgical thrombectomy, thrombolysis, anticoagulation, bed rest) are discussed with special reference to developments in the last ten years (new generation of thrombolytics, introduction of INR to express prothrombin time). Tentative therapeutic guidelines are proposed.


Age and spread of the haplochromine cichlid fishes in Africa.
The Haplochromini are by far the most species-rich cichlid fish tribe that originated along with the so-called primary radiation of the Lake Tanganyika cichlid species flock, i.e. at the same time during which the majority of the endemic Lake Tanganyika cichlid tribes emerged. Unlike the other tribes, the haplochromines are not restricted to Lake Tanganyika but distributed throughout Africa, except for the northwestern part of the continent. Haplochromine cichlids seeded the adaptive radiation of cichlid fishes in Lakes Malawi, Kivu, Victoria, Turkana, as well as in the now extinct paleo-Lake Makgadikgadi. Here we present a comprehensive phylogenetic and phylogeographic analysis of haplochromine cichlids that is based upon DNA sequences of two mitochondrial gene segments of riverine taxa covering all major African biogeographic regions where haplochromines are found. Our analysis revealed that six lineages of haplochromines originated within a short period of time, about 5.3-4.4 MYA. These haplochromine lineages show a highly complex phylogeographic pattern, probably severely influenced by climate- and/or geology-induced changes of the environment, with river capture events most likely playing an important role for species dispersal.


On the mutual diffusion properties of ethanol-water mixtures.
The structural organization, the number of hydrogen bonds (H bond), and the self- and mutual diffusion coefficients of ethanol-water mixtures were studied by molecular dynamics simulation. It was found that both the numbers of H bonds per water and per ethanol decrease as the mole fraction of ethanol increases. The composition dependences and the relationships between the self- and the mutual diffusion coefficients were further discussed. The self-diffusion coefficient of water has a large drop as the concentration of ethanol increases from 0 to 0.3 and then it nearly keeps constant, while that of ethanol has a minimum around ethanol mole fraction of 0.5. The mutual diffusion coefficient could be divided into two parts, the kinematic factor and the thermodynamic factor. Both the kinematic and thermodynamic factors for ethanol-water mixtures were calculated. It was found that the change trend of mutual diffusion coefficients with the composition is mainly dependent on the thermodynamic factors.


Is human papillomavirus involved in laryngeal neuroendocrine carcinoma?
The purpose of this study was to detect human papillomavirus (HPV) infection in laryngeal neuroendocrine carcinoma (LNEC) and to explore the possible relationship between HPV-induced malignant transformation and prognosis in LNEC. Ten cases of LNEC from a tertiary referral hospital were retrospectively analyzed. Clinical data were subtracted from patients' files. Pretreatment biopsy material was tested for the presence of HPV6, 11, 16, and 18 using a PCR-based detection method. Immunohistochemical staining was performed for Ki-67, p16(INK4A), and p53 expression. All cases were negative for the low-risk HPV types HPV6 and HPV11 that are associated with laryngeal papillomatosis. High-risk HPV was detected in two cases; an atypical carcinoid was positive for HPV16 and a large-cell neuroendocrine carcinoma for HPV18. Both HPV-positive tumors had a high Ki-67 labeling index. Two of the four cases with a good response to therapy were hrHPV-positive (both HPV DNA positive) compared with none of the five poor responders. Our findings show that HPV may play a role in the pathogenesis of LNEC. The relationship between HPV, improved prognosis and good response to therapy for squamous cell carcinoma of the head and neck may also be true for a subset of LNEC.


Challenges and solutions of echocardiography generalization for deep learning: a study in patients with constrictive pericarditis.
The inherent characteristics of transthoracic echocardiography (TTE) images such as low signal-to-noise ratio and acquisition variations can limit the direct use of TTE images in the development and generalization of deep learning models. As such, we propose an innovative automated framework to address the common challenges in the process of echocardiography deep learning model generalization on the challenging task of constrictive pericarditis (CP) and cardiac amyloidosis (CA) differentiation. Patients with a confirmed diagnosis of CP or CA and normal cases from Mayo Clinic Rochester and Arizona were identified to extract baseline demographics and the apical 4 chamber view from TTE studies. We proposed an innovative preprocessing and image generalization framework to process the images for training the ResNet50, ResNeXt101, and EfficientNetB2 models. Ablation studies were conducted to justify the effect of each proposed processing step in the final classification performance. The models were initially trained and validated on 720 unique TTE studies from Mayo Rochester and further validated on 225 studies from Mayo Arizona. With our proposed generalization framework, EfficientNetB2 generalized the best with an average area under the curve (AUC) of 0.96 (±0.01) and 0.83 (±0.03) on the Rochester and Arizona test sets, respectively. Leveraging the proposed generalization techniques, we successfully developed an echocardiography-based deep learning model that can accurately differentiate CP from CA and normal cases and applied the model to images from two sites. The proposed framework can be further extended for the development of echocardiography-based deep learning models.


The therapeutic role of Jingchuan tablet on ischaemic cerebral stroke via the HIF-1α/EPO/VEGFA signalling pathway.
Jingchuan tablet (JCT) is a Chinese medicine prescription for treating ischaemic cerebral stroke (ICS). However, its relevant mechanisms remain unclear. To unravel the intrinsic mechanisms of JCT anti-ICS. 'Hongjingtian', 'chuanxiong', 'yanhusuo', 'bingpian', 'cerebral infarction', 'cerebral ischemia' or 'stroke' were used as keywords, and then components, targets and underlying mechanisms of JCT anti-ICS were analysed in TCMSP, TTD, DrugBank, STRING and Metascape databases up to June 2020. Male Sprague-Dawley rats under permanent middle cerebral artery occlusion (pMCAO) model, randomly assigned as: model, sham, nimodipine (0.012 g/kg/d) and JCT (0.78, 1.56 and 3.12 g/kg/d) groups, received oral gavage administration for a week. Therapeutic effects were evaluated by detecting the proportion of cerebral infarction, neuronal apoptosis and neurological deficits. Bioactive components were detected by HPLC-MS. Molecular biology and computational docking were used to verify the underlying mechanisms. Eighty-one components, 166 targets and HIF-1α/EPO/VEGFA pathway contributed to the anti-ICS effect of JCT. JCT treatment effectively reduced the proportion of cerebral infarction (33.13%), apoptosis rate (14.80%) and neurobehavioural score (2.00). JCT increased the protein levels of HIF-1α (0.84), EPO (0.64) and VEGFA (0.69), respectively (p < 0.05). Gallic acid, salidroside, chlorogenic acid, ethyl gallate, ferulic acid and tetrahydropalmatine detected by HPLC-MS showed good interaction and binding with HIF-1α/EPO/VEGFA. Our study demonstrated the mechanisms of JCT anti-ICS associated with the activation of the HIF-1α/EPO/VEGFA pathway, which provided a pharmacological basis for expanding the clinical application and some scientific ideas for further research into the material basis JCT anti-ICS.


Dense electron-positron plasmas and ultraintense γ rays from laser-irradiated solids.
In simulations of a 10 PW laser striking a solid, we demonstrate the possibility of producing a pure electron-positron plasma by the same processes as those thought to operate in high-energy astrophysical environments. A maximum positron density of 10(26) m(-3) can be achieved, 7 orders of magnitude greater than achieved in previous experiments. Additionally, 35% of the laser energy is converted to a burst of γ rays of intensity 10(22) W cm(-2), potentially the most intense γ-ray source available in the laboratory. This absorption results in a strong feedback between both pair and γ-ray production and classical plasma physics in the new "QED-plasma" regime.


Screening for intracranial aneurysms? Prevalence of unruptured intracranial aneurysms in Hong Kong Chinese.
OBJECT The objective of this study was to generate data on the local prevalence of unruptured intracranial aneurysms (UIAs) in asymptomatic Hong Kong Chinese individuals. First-degree relatives of patients with aneurysmal subarachnoid hemorrhage (aSAH) were recruited as surrogates of the general population and to explore the potential role of screening in this locality. METHODS The authors identified first-degree relatives of consecutive patients with subarachnoid hemorrhage from a ruptured aneurysm who were admitted to a university hospital in Hong Kong from June 2008 to December 2010. Magnetic resonance angiography (MRA) was the imaging modality used to screen the cerebral vasculature of these asymptomatic individuals. If MRA showed abnormal findings, CT angiography was performed to confirm the MRA findings. RESULTS In total, 7 UIAs were identified from the 305 MR angiograms obtained. The prevalence of UIAs in first-degree relatives of patients with aSAH in the Hong Kong Chinese population was 2.30% (95% CI1.02%-4.76%). This percentage was lower than the prevalence rate of 3.2% from a meta-analysis of the literature. The sizes of the UIAs detected ranged from 1.4 mm to 7.5 mm; 85.7% of the UIAs detected in this study were < 5 mm, in contrast to 66% noted in the literature. One of the UIAs identified underwent endovascular stent placement with a flow diverter. None of the UIAs identified ruptured or became symptomatic during a median follow-up period of 3.5 years. CONCLUSIONS The prevalence of UIAs in first-degree relatives of patients with aSAH in the Hong Kong Chinese population was lower than that in Caucasians. At the same time, most of the UIAs detected in this study were small (85.7% were < 5 mm, vs 66% in a meta-analysis). With a similar incidence of aSAH in Hong Kong (7.5 per 100,000 person-years) as compared with data cited in the literature, the hypothesis that UIA rupture risk size threshold is different in Chinese patients should be further investigated.


Trace amine-associated receptor 1 agonists RO5263397 and RO5166017 attenuate quinpirole-induced yawning but not hypothermia in rats.
Increasing evidence suggests that trace amine-associated receptor 1 (TAAR1) is an important modulator of the dopaminergic system. Existing molecular evidence indicates that TAAR1 regulates dopamine levels through interactions with dopamine transporters and D2 receptors. However, investigations to date have not been exhaustive and other pathways may be involved. In this study, we used a well-described set of behaviors, quinpirole-induced yawning and hypothermia, to explore the potential interaction of TAAR1 and D3 receptors, which are members of the 'D2-like' dopamine receptor subfamily. Previous studies have shown that for D2/D3 receptor agonists, the induction of yawning is a D3 receptor-mediated effect, whereas the inhibition of yawning and induction of hypothermia are D2 receptor-mediated effects. Quinpirole produced an inverted U-shaped dose-effect curve for yawning, which was shifted downward dose-dependently by each of the TAAR1 agonists RO5263397 and RO5166017. Quinpirole also produced dose-dependent hypothermia, which was not affected by either TAAR1 agonist. These results suggest that TAAR1 agonists may interact with D3 receptors and/or its downstream pathways, as opposed to D2 receptors. These findings may shed light on a previously unexplored possibility for the mechanism of TAAR1-mediated effects.


Use of a Patient Portal During Hospital Admissions to Surgical Services.
Patient portal research has focused on medical outpatient settings, with little known about portal use during hospitalizations or by surgical patients. We measured portal adoption among patients admitted to surgical services over two years. Surgical services managed 37,025 admissions of 31,310 unique patients. One-fourth of admissions (9,362, 25.3%) involved patients registered for the portal. Registration rates were highest for admissions to laparoscopic/gastrointestinal (55%) and oncology/endocrine (50%) services. Portal use occurred during 1,486 surgical admissions, 4% of all and 16% of those registered at admission. Inpatient portal use was associated with patients who were white, male, and had longer lengths of stay (p < 0.01). Viewing health record data and secure messaging were the most commonly used functions, accessed in 4,836 (72.9%) and 1,626 (24.5%) user sessions. Without specific encouragement, hospitalized surgical patients are using our patient portal. The surgical inpatient setting may provide opportunities for patient engagement using patient portals.


Relation of thoracic aortic and aortic valve calcium to coronary artery calcium and risk assessment.
Aortic calcium, aortic valve calcium (AVC), and coronary artery calcium (CAC) have been associated with cardiovascular event risk. We examined the prevalence of thoracic aortic calcium (TAC) and AVC in relation to the presence and extent of CAC, cardiovascular risk factors, and estimated risk of coronary heart disease (CHD). In 2,740 persons without known CHD aged 20 to 79 years, CAC was assessed by electron beam- or multidetector-computed tomography. We determined the prevalence of TAC and AVC in relation to CAC, CHD risk factors, and predicted 10-year risk of CHD. A close correspondence of TAC and AVC was observed with CAC. TAC and AVC increased with age; by the eighth decade of life, the prevalence of TAC was similar to that of CAC (>80%), and 36% of men and 24% of women had AVC. Age, male gender, and low-density lipoprotein cholesterol were directly related to the likelihood of CAC, TAC, and AVC; higher diastolic blood pressure and cigarette smoking additionally predicted CAC. Body mass index and higher systolic and lower diastolic blood pressures were also related to TAC, and higher body mass index and lower diastolic blood pressure were related to AVC. Calculated risk of CHD increased with the presence of AVC and TAC across levels of CAC. TAC and AVC provided incremental value over CAC in association with the 10-year calculated risk of CHD. If longitudinal studies show an incremental value of aortic and aortic valve calcium over that of CAC for prediction of cardiovascular events, future guidelines for risk assessment incorporating CAC assessment may additionally incorporate the measurement of aortic and/or aortic valve calcium.


Rifamycin SV MMX for the treatment of traveler's diarrhea.
Rifamycin SV MMX®, a non-absorbable rifamycin antibiotic formulated using the multi-matrix system, was designed to exhibit its pharmacological action on the distal small intestine and colon. Its clinical efficacy and safety profile in the treatment of traveler's diarrhea were evaluated in several clinical studies. Areas covered: This review summarizes all available evidence regarding clinical trials of the efficacy and safety profile of rifamycin SV MMX for the treatment of traveler's diarrhea. Expert opinion: Rifamycin SV MMX demonstrated an excellent pharmacokinetic profile with decreased systemic toxicity similar to rifaximin. In phase II and phase III clinical trials, concerns have been raised regarding the medicine's efficacy in terms of the time to last unformed stool and cure rate compared to current recommended antibiotics in the treatment of acute diarrhea caused by diarrheagenic Escherichia coli and invasive pathogens. The significance of the increase in MICs after the use of rifamycin SV MMX warrants further examination.


Mapping global non-floodplain wetlands.
Non-floodplain wetlands - those located outside the floodplains - have emerged as integral components to watershed resilience, contributing hydrologic and biogeochemical functions affecting watershed-scale flooding extent, drought magnitude, and water-quality maintenance. However, the absence of a global dataset of non-floodplain wetlands limits their necessary incorporation into water quality and quantity management decisions and affects wetland-focused wildlife habitat conservation outcomes. We addressed this critical need by developing a publicly available "Global NFW" (Non-Floodplain Wetland) dataset, comprised of a global river-floodplain map at 90 m resolution coupled with a global ensemble wetland map incorporating multiple wetland-focused data layers. The floodplain, wetland, and non-floodplain wetland spatial data developed here were successfully validated within 21 large and heterogenous basins across the conterminous United States. We identified nearly 33 million potential non-floodplain wetlands with an estimated global extent of over 16×106 km2. Non-floodplain wetland pixels comprised 53% of globally identified wetland pixels, meaning the majority of the globe's wetlands likely occur external to river floodplains and coastal habitats. The identified global NFWs were typically small (median 0.039 km2), with a global median size ranging from 0.018-0.138 km2. This novel geospatial Global NFW static dataset advances wetland conservation and resource-management goals while providing a foundation for global non-floodplain wetland functional assessments, facilitating non-floodplain wetland inclusion in hydrological, biogeochemical, and biological model development. The data are freely available through the United States Environmental Protection Agency's Environmental Dataset Gateway (https://gaftp.epa.gov/EPADataCommons/ORD/Global_NonFloodplain_Wetlands/, last access: 24 May 2023) and through https://doi.org/10.23719/1528331 (Lane et al., 2023a).


Migration of schrapnel from lung to bronchus.
Erosion of metallic foreign bodies from the pulmonary parenchyma into a bronchus is rare. In this case, bronchoscopic removal of the shrapnel was possible 64 years after the injury. The 89-year-old veteran enjoys life and has had no further pulmonary problems one year after bronchoscopic removal of a metallic foreign body. Possibly this is the oldest patient on record to have had a foreign body erode into a bronchus and to have undergone removal through a rigid bronchoscope.


The development of the revised COPE 68 inventory with English and Slovak versions.
Although there have been several attempts at improving the COPE Inventory, the factor structure of the instrument is still in dispute. In addition, studies have shown low reliability coefficients for some of the first-order factors, with Mental Disengagement having the lowest factor loadings. In a recent study on the external validation of the instrument, two additional first-order factors were identified in the qualitative analysis, namely Self-care and Care for Others. Based on these arguments we created the Revised COPE 68 Inventory, changing some of the problematic items in the first order factor Mental Disengagement and adding items for the two new factors (Self-care and Care for Others). We then tested its reliability and performed factor analyses on the first and second-order factorial structure. The data were collected through social media in two languages, English and Slovak, using convenience and snowball sampling techniques. The English sample contained 834 participants with mean age 25.27 years (SD = 8.467) and the Slovak sample comprised 1,425 participants with mean age 33 years (SD = 14.59). For the statistical analyses we used Exploratory Structural Equation Model (ESEM) analyses with target rotation and WLSMV, Exploratory and second-order confirmatory factor analysis with the scores of the COPE Inventory and EFA. The Revised COPE 68 inventory had a good fit for all 17 first-order factors in both languages, including for the new factors Self-care and Care for Others. It appears that the first-order factors form a three-factor solution in both samples, consisting of active coping, social-emotional coping and avoidant coping. The revised Mental Disengagement has better psychometric properties as well. The Revised COPE 68 inventory was found to be a reliable multidimensional instrument for measuring various coping strategies in both the English and Slovak language versions.


[The application of the method of radiofrequency myringotomy under the experimental conditions and in the clinical practice].
Exudative otitis media is a widespread pathological condition in the human population. In the recent years, the treatment with the electric current having the frequency up to 3.8 MHz has found the increasingly frequent application, in addition to shunting and laser myringotomy, for the perforation of the tympanic membrane to facilitate removal of exudate. The objective of the present study was to evaluate the effectiveness of the application of the electric current with the frequency up to 4 MHz for myringotomy in the patients presenting with exudative otitis media under the experimental conditions and in the clinical practice. The experimental studies were carried out with the use of the isolated temporal bones (ex vivo) and laboratory animals (in vivo). The clinical studies included the surgical treatment of 41 patients presenting with exudative otitis media using the electric current with the frequency of 4 MHz and laser irradiation with the subsequent evaluation of the inflammatory manifestations in the tympanic membrane tissues during the early post-operative period. It was shown that the method of myringotomy with the application of the electric current having the frequency of 4 MHz is safe and causes no complications. Moreover, it is accompanied by the development of the minimally active inflammatory processes in the tympanic membrane tissues during the early post-operative period.


Nanoscale Mosaic Works: Tetragonal Lattices of Iso-Oriented Heterogeneous Nanocubes.
Tetragonal 2D lattices are spontaneously formed by the self-assembly of homogeneous nanocubes. However, ordered arrays consisting of differently sized rectangular nanoblocks have not been achieved because the regulation of the assembly is weakened by the combination of binary units. In the present work, ordered arrays comprising binary nanocubes were investigated using the combination of 10 nm Pt nanocubes and 20 nm BaTiO3 nanocubes. Heterogeneous but ordered 2D tetragonal lattices were successfully produced using differently sized rectangular nanoblocks. The highly ordered self-assembly in the heterogeneous system requires the matching of the size ratio of binary nanocubes with the buffer effect of oleic acid covering the building units.


Process optimization in navigated total knee arthroplasty.
Although navigation achieves better alignment results in total knee arthroplasty (TKA), it is generally assumed that navigation also needs more time and effort than conventional surgeries. After optimizing the treatment procedure of navigated TKA, the operation times needed for navigated surgeries were documented and compared with the average time of conventional surgeries, registered before the introduction of the navigation system. Sixty consecutive patients for uncemented TKAs were included in the navigated series. Results show an average of 49 minutes for the navigated surgeries, which is less than the average of the manual surgeries. For all patients, alignment was within 3 degrees varus/valgus postoperatively, and the mean Knee Society Score improved from 25 points preoperatively to 83 points 6 weeks postoperatively.


Role of Manganese Oxyhydroxides in the Transport of Rare Earth Elements Along a Groundwater Flow Path.
Rare earth elements (REE) are known to be emerging contaminants in hydrosphere, but roles of hydrous manganese oxyhydroxides (HMO) in REE transport in groundwater remains unknown. In this study, groundwater was sampled along a flow path in the North China Plain to determine the behavior of REE surface complexation to HMO by a modeling and field study approach. Results show that the proportion of neodymium (Nd) complexed by HMO ranges from 0.2% to 95.8%, and from 0.3% to 99.6% in shallow groundwater and deep groundwater, respectively. The amount of complexed REE increases along the flow path. REE bound to HMO exhibit decreasing trends with increasing atomic number. The process was determined to be independent of pH, HMO content, and metal loading. This finding further demonstrates HMO-REE complexation plays a key role in transport of REE in groundwater through preferential scavenging of light REE (LREE) over heavy REE (HREE). Nevertheless, carbonate ligands appear to be robust competitors in reducing the amount of REE sorbed to HMO when solution pH rises above 8.0. Assuming that 50% of Mn concentration occurs as HMO, the amount of complexed REE was predicted to show a more marked decrease in LREE compared to that of HREE.


Geological and physicochemical controls of the spatial distribution of partition coefficients for radionuclides (Sr-90, Cs-137, Co-60, Pu-239,240 and Am-241) at a site of nuclear reactors and radioactive waste disposal (St. Petersburg region, Russian Federation).
The paper presents a study of the sorption properties of sediments of different geological ages and lithological types, governing radionuclide retention in the subsurface (up to 160 m beneath the surface) within the area of potential influence of the Northwestern Center of Atomic Energy (NWCAE), St. Petersburg region, RF. The focus of this work is mostly on the sedimentary rocks of two types, i.e., weakly cemented sandstone and lithified clay formations of Cambrian and Vendian series. The first lithological unit is associated with a groundwater reservoir (Lomonosov aquifer), and the second one, with both a relative aquitard in the upper part of the Vendian formation (Kotlin clay) and a regional aquifer (Gdov aquifer) in the lower part of the formation. The main mechanisms responsible for the variability of the sorption distribution coefficient (Kd, defined as the ratio of the concentration of solute on solid phase to its concentration in solution at equilibrium) was identified for radionuclides such as Sr-90, Cs-137, Co-60, Pu-239,240, and Am-241. It was shown that the main factors contributing to the chemical heterogeneity of the Cambrian sandstone were related to the presence of secondary minerals (iron and magnesium oxides and hydroxides produced by the weathering process) in trace amounts, forming correlated layer structures. The statistical analysis of nonlinear isotherms confirmed this conclusion. For the Vendian formation, a determinate trend was established in the Kd change over depth as a result of temporal trends in the sedimentation process and pore-water chemistry. The geostatistical characteristics and the spatial correlation models for describing linear sorption of different radionuclides are not identical, and the exhibition of chemical heterogeneity of sedimentary rock of a particular lithological type depends on radionuclide chemistry. Moreover, variogram analysis for some Kd data sets (both in Cambrian and Vendian formations) demonstrates the total absence of auto-correlation (pure nugget effect). It can be supposed that sampling distances did not allow the evaluation of small-scale variability in sediment sorption properties.


The role of visuo-spatial working memory in map learning: new findings from a map drawing paradigm.
Recently, increasing attention has been devoted to the study of the role of visuo-spatial working memory (VSWM) in environmental learning and spatial navigation. The present research was aimed at investigating the role of VSWM in map learning using a map drawing paradigm. In the first study, a dual task methodology was used. Results showed that map drawing was selectively impaired by a spatial tapping task that was executed during the map learning phase, hence supporting the hypothesis that VSWM plays an essential role in learning from maps. In the second study, using a correlational methodology, it was shown that performance in simultaneous VSWM tasks, but not in sequential VSWM tasks, predicted map drawing skills. These skills "in turn" correlated with map learning abilities. Finally, in the third study, we replicated the results of the second study, by using a different map. To our knowledge, the present study is the first to find evidence that the simultaneous aspects of VSWM play a fundamental role in learning from maps.


Do citation classics in rhinology reflect utility rather than quality?
Citation rates have been suggested to be more of an indicator of utility than quality. The aim of this study was to apply measures of utility and quality to articles identified as citation classics in rhinology/anterior skull base surgery. There were 14 articles analysed in the study. The assessment of quality was performed by combining factors from previous publications on quality assessment and the various elements were categorised into four groups; quality of written article and publication, quality of research, quality of evidence-based methodology and quality of outcome. This study revealed that citation classics in rhinology/anterior skull base surgery were well-written and satisfied peer review in reputable journals in the specialty. Quality is satisfied by clarity of exposition and patient numbers. The research was generally asking an important question and the methodology overall was adequate and appropriate for the type of study performed. A good quality of research and outcome was demonstrated with a definite historical importance, and reports that stimulated further research and enquiry. Quality is not satisfied by the lack of randomised controlled trials, appropriate statistical analysis or patient criteria. In conclusion citation rates when considered as an individual measure, reflect utility rather than quality.


Recent Insights into the Paradoxical Effect of Echinocandins.
Echinocandin antifungals represent one of the most important drug classes for the treatment of invasive fungal infections. The mode of action of the echinocandins relies on inhibition of the β-1,3-glucan synthase, an enzyme essentially required for the synthesis of the major fungal cell wall carbohydrate β-1,3-glucan. Depending on the species, echinocandins may exert fungicidal or fungistatic activity. Apparently independent of this differential activity, a surprising in vitro phenomenon called the "paradoxical effect" can be observed. The paradoxical effect is characterized by the ability of certain fungal isolates to reconstitute growth in the presence of higher echinocandin concentrations, while being fully susceptible at lower concentrations. The nature of the paradoxical effect is not fully understood and has been the focus of multiple studies in the last two decades. Here we concisely review the current literature and propose an updated model for the paradoxical effect, taking into account recent advances in the field.


The Experience of Depression during the Careers of Elite Male Athletes.
The topic of depression during the career of elite male athletes has been the subject of much public interest and attention in recent years. Despite numerous debates and personal disclosures within the media, there is a dearth of published research directly exploring the phenomenon. This study sought to explore how elite male athletes experience depression during their sporting careers. Eight former/current elite male athletes who had previously publically self-identified as having experienced depression while participating in sport were recruited for this study. A qualitative methodology was employed and each participant was interviewed using semi-structured interviews. Data analysis which was conducted using descriptive and interpretive thematic analysis uncovered three domains: (1) The emergence of depression, (2) The manifestation of symptoms of depression, and (3) Adaptive and Maladaptive proceesses of recovery. Findings from the current study reveal the nature of how male athletes experience, express, and respond to depression during their careers. Additionally, this is influenced by a myriad of factors embedded in the masculine elite sport environment. Implications are discussed particularly in relation to atypical expressions of depression not necessarily reflected on or in standard diagnostic criteria. Future research is encouraged to examine in depth moderating factors (e.g., athletic sense of identity and masculine elite sport environments) for the relationship between depression and participation in elite sport.


An Enhanced Carbon Capture and Storage Process (e-CCS) Applied to Shallow Reservoirs Using Nanofluids Based on Nitrogen-Rich Carbon Nanospheres.
The implementation of carbon capture and storage process (CCS) has been unsuccessful to date, mainly due to the technical issues and high costs associated with two main stages: (1) CO2 separation from flue gas and (2) CO2 injection in deep geological deposits, more than 300 m, where CO2 is in supercritical conditions. This study proposes, for the first time, an enhanced CCS process (e-CCS), in which the stage of CO2 separation is removed and the flue gas is injected directly in shallow reservoirs located at less than 300 m, where the adsorptive phenomena control CO2 storage. Nitrogen-rich carbon nanospheres were used as modifying agents of the reservoir porous texture to improve both the CO2 adsorption capacity and selectivity. For this purpose, sandstone was impregnated with a nanofluid and CO2 adsorption was evaluated at different pressures (atmospheric pressure and from 3 × 10-3 MPa to 3.0 MPa) and temperatures (0, 25, and 50 °C). As a main result, a mass fraction of only 20% of nanomaterials increased both the surface area and the molecular interactions, so that the increase of adsorption capacity at shallow reservoir conditions (50 °C and 3.0 MPa) was more than 677 times (from 0.00125 to 0.9 mmol g-1).


Insulin release is glucose anomeric specific in the human.
The alpha-glucose anomer produces a greater insulin release than beta-glucose in various animal models. These glucose anomers were dissolved rapidly and administered intravenously to human volunteers at a high dose (0.5 g/kg) over a 3-min period or a low dose (3.5 g) over a 20-s period. Blood samples were obtained at frequent time intervals for measurement of whole blood glucose (ferricyanide), plasma glucose (beta-glucose oxidase) and serum immunoreactive insulin. The high-dose infusion test showed no differences between the anomers of either blood glucose or serum insulin levels. However, at the lower dose, the alpha-glucose anomer stimulated a significantly greater insulin release than did beta-glucose. It is concluded that the alpha-glucose anomer stimulates a greater insulin release than the beta-glucose anomer in human subjects at low but not at high doses intravenously and that this response is not apparently related to approximations of the degree of mutarotation. These results suggest that a steric specific glucose receptor site exists on the beta-cell as a rapid insulin release trigger, although the alpha-anomer does not exclusively produce this stimulation.


Social class and BMI among Canadian adults: a focus on occupational prestige.
The objective was to examine BMI of working-age Canadian adults in relation to occupational prestige, adjusting for other aspects of social class including household income and respondent's education. We analyzed data from 49,252 adults (age 25-64) from Cycle 2.1 of the Canadian Community Health Survey, a cross-sectional self-report survey conducted in 2003. Multiple linear regression was used to examine the relation between BMI and occupational prestige, adjusting for other sociodemographic variables. For women, higher ranking occupations showed lower average BMI relative to the lowest ranking occupations, but this effect was largely eliminated when adjusting for education. For men, occupation effects endured in adjusted models and we detected some evidence of a pattern whereby men in occupations characterized by management/supervisory responsibilities were heavier than those in the lowest ranking occupations (i.e., elemental sales and service). Results are interpreted in light of the symbolic value of body size in western culture, which differs for men and women. Men in positions of management/supervision may benefit from the physical dominance conveyed by a larger body size, and thus occupational prestige rankings may help us to understand the gender differences in the patterning of BMI by different indicators of social class.


Geochemical properties of topsoil around the coal mine and thermoelectric power plant.
The results of the systematic study of the spatial distribution of trace metals in surface soil over the Bitola region, Republic of Macedonia, known for its coal mine and thermo-electrical power plant activities are reported. The investigated region (3200 km2) is covered by a sparse sampling grid of 5 × 5 km, but in the urban zone and around the thermoelectric power plant the sampling grid is denser (1 × 1 km). In total, 229 soil samples from 149 locations were collected including top-soil (0-5 cm) and bottom-soil samples (20-30 cm and 0-30 cm). Inductively coupled plasma - atomic emission spectrometry (ICP-AES) was applied for the determinations of 21 elements (Al, As, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Na, Ni, P, Pb, Sr, V and Zn). Based on the results of factor analyses, three geogenic associations of elements have been defined: F1 (Fe, Ni, V, Co, Cr, Mn and Li), F2 (Zn, B, Cu, Cd, Na and K) and F3 (Ca, Sr, Mg, Ba and Al). Even typical trace metals such as As, Cd, Cu, Ni, P, Pb and Zn are not isolated into anthropogenic geochemical associations by multivariate statistical methods still show some trends of local anthropogenic enrichment. The distribution maps for each analyzed element is showing the higher content of these elements in soil samples collected around the thermoelectric power plants than their average content for the soil samples collected from the whole Bitola Region. It was found that this enrichment is a result of the pollution by fly ash from coal burning which deposited near the plant having a high content of these elements.


Gaps and future of human-centered artificial intelligence in ophthalmology: Future Vision Forum consensus statement.
The Future Vision Forum discussed the current state of Human Centered Computing and the future of data collection, curation, and collation in ophthalmology. Although the uptake of electronic health record (EHR) systems and the digitization of healthcare data is encouraging, there are still barriers to implementing a specialty-wide clinical trial database. The article identifies several critical opportunities, including the need for standardization of image metadata and data, the establishment of a centralized trial database, incentives for clinicians and trial sponsors to participate, and resolving ethical concerns surrounding data ownership. Recommendations to overcome these challenges include the standardization of image metadata using the Digital Imaging and Communications in Medicine (DICOM) guidelines, the establishment of a centralized trial database that uses federated learning (FL), and the use of FL to facilitate cross-institutional collaboration for rare diseases. Forum faculty suggests incentives will accelerate artificial intelligence, digital innovation projects, and data sharing agreements to empower patients to release their data. A specialty-wide clinical trial database could provide invaluable insights into the natural history of disease, pathophysiology, why trials fail, and improve future clinical trial design. However, overcoming the barriers to implementation will require continued discussion, collaboration, and collective action from stakeholders across the ophthalmology community.


Impact of neighborhood racial composition and metropolitan residential segregation on disparities in breast cancer stage at diagnosis and survival between black and white women in California.
We examined the impact of metropolitan racial residential segregation on stage at diagnosis and all-cause and breast cancer-specific survival between and within black and white women diagnosed with breast cancer in California between 1996 and 2004. We merged data from the California Cancer Registry with Census indices of five dimensions of racial residential segregation, quantifying segregation among Blacks relative to Whites; block group ("neighborhood") measures of the percentage of Blacks and a composite measure of socioeconomic status. We also examined simultaneous segregation on at least two measures ("hypersegregation"). Using logistic regression we examined effects of these measures on stage at diagnosis and Cox proportional hazards regression for survival. For all-cause and breast-cancer specific mortality, living in neighborhoods with more Blacks was associated with lower mortality among black women, but higher mortality among Whites. However, neighborhood racial composition and metropolitan segregation did not explain differences in stage or survival between Black and White women. Future research should identify mechanisms by which these measures impact breast cancer diagnosis and outcomes among Black women.


Results of the regional intercomparison exercise for the determination of operational quantity HP(10) in Latin America.
Several intercomparison exercises were organised by the International Atomic Energy Agency (IAEA) on the determination of operational quantities at the regional or interregional basis. In the Latin American region an intercomparison for the determination of the operational quantity Hp(10) was completed mid-2004, as a follow-up to previous exercises carried out during the 1990s. Eighteen individual external monitoring services from nineteen Member States participated in the first phase. The second phase grouped 15 services that had participated in the first phase. Dosemeter irradiations in photon beams were done by four Secondary Standard Dosimetry Laboratories (SSDLs) of the region. The preparation of this exercises involved an audit by the IAEA SSDL, where reference irradiations were provided to all participants for verification of their systems. During the first phase (2002-2003) only 9 out of 18 services met the performance requirements for such monitoring services. Necessary corrective actions and procedure verification were implemented. During the second phase (2004) 11 out of 15 services fulfilled the performance criteria. This intercomparison shows that there has been improvement in the second phase and most participants demonstrated a satisfactory performance of the quantity tested.


A simple, non-nucleosidic base surrogate increases the duplex stability of DNA containing an abasic site.
Abasic sites represent a common type of lesion in DNA. If not repaired, they can lead to mutations during replication or to cell death. Due to their biological importance, there is a strong interest in methods of recognizing abasic sites in DNA both for diagnostic and also for potential pharmaceutical applications. Extended aromatic residues can have a substantial positive influence on the stability of double-stranded DNA containing abasic sites. We report here the use of a simple, non-nucleosidic phenanthrene as a base surrogate, which effectively enhances the duplex stability of DNA with an abasic site. The influence of the linker length on the stability of the duplex is investigated. Data and model considerations indicate that stabilization is a result of stacking interactions between the phenanthrene and DNA base pairs.


Advances of Hydrogel Therapy in Periodontal Regeneration-A Materials Perspective Review.
Hydrogel, a functional polymer material, has emerged as a promising technology for therapies for periodontal diseases. It has the potential to mimic the extracellular matrix and provide suitable attachment sites and growth environments for periodontal cells, with high biocompatibility, water retention, and slow release. In this paper, we have summarized the main components of hydrogel in periodontal tissue regeneration and have discussed the primary construction strategies of hydrogels as a reference for future work. Hydrogels provide an ideal microenvironment for cells and play a significant role in periodontal tissue engineering. The development of intelligent and multifunctional hydrogels for periodontal tissue regeneration is essential for future research.


International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder.
These international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice. Key questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on 'mechanisms', 'assessment', and 'intervention' were updated since the last recommendations in 2012. New searches were conducted for 'psychosocial issues' and 'adolescents/adults'. Evidence was rated according to the Oxford Centre for Evidence-Based Medicine (level of evidence [LOE] 1-4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations. Thirty-five recommendations were made. Eight were based on the evidence from literature reviews (three on 'assessment', five on 'intervention'). Twenty-two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity-oriented and participation-oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD. The CPR-DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR-DCD may serve as a basis for national guidelines. Updated international clinical practice guidelines on developmental coordination disorder (DCD). Refined and extended recommendations on clinical assessment and intervention for DCD. A critical synopsis of current research on mechanisms of DCD. A critical synopsis of psychosocial issues in DCD, with implications for clinical practice. The first international recommendations to consider adolescents and adults with DCD.


The avidity of tumor-specific T cells amplified by a plasmacytoid dendritic cell-based assay can predict the clinical evolution of melanoma patients.
The advent of immune checkpoint blockers and targeted therapies has changed the outcome of melanoma. However, many patients experience relapses, emphasizing the need for predictive and prognostic biomarkers. We developed a strategy based on plasmacytoid dendritic cells (pDCs) loaded with melanoma tumor antigens that allows eliciting highly efficient antitumor T-cell responses. We used it to investigate antitumor T-cell functionality in peripheral blood mononuclear cells and tumor-infiltrating lymphocytes from melanoma patients. The pDCs elicited tumor-specific T cells in different proportions and displaying diverse functional features, dependent upon the stage of the disease, but independent of the histological parameters at diagnosis. Strikingly, the avidity of the MelA-specific T cells triggered by the pDCs was found to predict patient relapse time and overall survival. Our findings highlighted unexplored aspects of antitumor T-cell responsiveness in melanoma, and revealed for the first time the structural avidity of tumor-specific T cells as a crucial feature for predicting clinical evolution.


Asthma and COPD in cystic fibrosis intron-8 5T carriers. A population-based study.
Carriers of cystic fibrosis intron-8 5T alleles with high exon-9 skipping could have increased annual lung function decline and increased risk for asthma or chronic obstructive pulmonary disease (COPD). We genotyped 9131 individuals from the adult Danish population for cystic fibrosis 5T, 7T, 9T, and F508del alleles, and examined associations between 11 different genotype combinations, and annual FEV1 decline and risk of asthma or COPD. 5T heterozygotes vs. 7T homozygous controls had no increase in annual FEV1 decline, self-reported asthma, spirometry-defined COPD, or incidence of hospitalization from asthma or COPD. In 5T/7T heterozygotes vs. 7T homozygous controls we had 90% power to detect an increase in FEV1 decline of 8 ml, an odds ratio for self-reported asthma and spirometry-defined COPD of 1.9 and 1.7, and a hazard ratio for asthma and COPD hospitalization of 1.8 and 1.6, respectively. Both 5T homozygotes identified in the study showed evidence of asthma, while none of four 5T/F508del compound heterozygotes had severe pulmonary disease. 7T/9T individuals had annual decline in FEV1 of 19 ml compared with 21 ml in 7T homozygous controls (t-test: P = 0.03). 6.7% of 7T homozygotes without an F508del allele in the cystic fibrosis transmembrane conductance regulator gene reported asthma vs. 11% of 7T/9T individuals with an F508del allele (chi2: P = 0.01) and 40% of 7T homozygotes with an F508del allele (P = 0.04). 7T homozygotes with vs. without an F508del allele also had higher incidence of asthma hospitalization (log-rank: P = 0.003); unadjusted and adjusted equivalent hazard ratios for asthma hospitalization were 11 (95%CI: 1.5-78) and 6.3 (0.84-47) in 7T homozygotes with vs. without an F508del allele. Polythymidine 5T heterozygosity is not associated with pulmonary dysfunction or disease in the adult Caucasian population. Furthermore, our results support that F508del heterozygosity is associated with increased asthma risk independently of the 5T allele.


The effects of race, weight, and gender on evaluations of writing competence.
This study examined the potential interactive effects of target race, weight, and gender on American Caucasian students' ratings of writing competency. Stimulus materials were eight articles in a newspaper byline format with photographs of the authors that conveyed the characteristics of race (African American/Caucasian), weight (overweight/nonoverweight), and gender (male/female). The participants were given eight articles and were asked to rate the writing competency of the author on the four qualities of style, clarity, logic, and overall writing ability/competency. The results showed that the women gave higher style, logic, and overall writing ability/competency ratings than did the men, and overweight authors received higher ratings of logic than nonoverweight authors. The men gave female Caucasian authors lower ratings of clarity than did female participants.


[Primary care enlightenment to local inhabitants--cooperation of medical institution and community pharmacy in treatment of chronic hepatitis C].
Community pharmacy is evolving to provide additional services to patients such as compliance improvement, self-care and OTC consultations and advising on daily activities to supplement medical treatment. Currently in Japan, it has been estimated that 1.5 to 2 million people have chronic hepatitis C. We have attempted to increase the population's knowledge of this important issue with educational brochures about hepatitis C and placing posters encouraging them to ask medical professionals about their health problems. Peg-interferon and ribavirin combination therapy has an efficacy rate of approximately 60%. The side effects might present in different ways and frequency depending on the treatment duration; therefore, pharmacists should monitor patients carefully during the entire treatment period with particular attention to OTC drug use, daily activity, etc. Additionally, for outpatients community pharmacy has responsibility to avoid drug-related adverse events in the patients' daily life, so monitoring for clinical signs of side effects is necessary. We created the "Clinical Pathway for Healthcare Network of Chronic Hepatitis C Treatment via the Medication Notebook Type" (Clinical Pathway) for patients who received Peg-interferon and ribavirin combination therapy. We are beginning to provide the new version of this service to patients as one of the pharmaceutical care components in the community pharmacy. I would like to describe how we cooperate with other community pharmacies using the "Clinical Pathway", which is to improve patient care in the community pharmacies.


Investigation on properties of electron-beam treated Mo back contact layer prepared by DC sputtering method.
Molybdenum (Mo) has been used as back contact layer in chalcopyrite solar cells family (CulnSe2 and its alloys) because it showed the excellence of electrical properties such as low resistivity at the Mo interference. Generally, there are strong corrleations between working pressure and properites such as adhesion and conductivity during deposition of Mo layer. Electrical properites might be inversely proportional to adehsion between Mo layer and glass substrate. Several methods have been executed for improvement of electrical properties and ahesion. In this study, DC sputtered Mo back contact layers on sodalime glass were prepared with working pressure range of 1-10 mTorr, and then all samples were treated by rounded exposure of electron beam at DC power of 3 kV for 5 minutes. After electron-beam treatement, all samples showed the lower resisitivity and sheet resisitance than as-deposited Mo layers. As working pressure decreased, grain size of e-beam treated samples gradually increased up to 30.7 nm. E-beam treated Mo layer might be a good candidate as back contact layer of tandem structured CIS families thin film solar cells.


Increased Left Atrial Stiffness is Significantly Associated with Paroxysmal Atrial Fibrillation in Diabetic Patients.
Atrial fibrillation (AF) and diabetes mellitus (DM) are common pathogenic diseases. Diabetes is an independent risk factor for AF, and coexisting AF is a risk factor for the diabetic pa-tient's progression. The purpose of this study was to see if two-dimensional-speckle tracking echocardiography (2D-STE) might provide valuable criteria for determining the risk of AF in diabetic patients. This retrospective study compared 30 adult diabetic patients with documented paroxysmal atrial fibrillation (PAF) with 30 age- and sex-matched diabetic patients without PAF. Inclusion criteria were: age ≥18 years, sinus rhythm, diabetes mellitus type 2, and the ability to sign the informed consent. Exclusion criteria included: moderate or severe valvular disease, previous myocardial infarction, left ventricular ejection fraction (LVEF) <50%, congenital heart disease, a history of cardiac surgery, paced atrial or ventricular rhythm, inadequate echocardiography imaging. The medical history, clinical, biochemical data and the results of the transthoracic cardiac ultrasound examination were registered during their evaluation at the outpatients cardiology clinics. The mean age of the patients was 62.5±1.7 years, 60% were men. Diabetic patients who experienced PAF episodes demonstrated significantly impaired left atrial (LA) deformation patterns, with decreased LA strains and increased LA stiffness (p < 0.05). The present study demonstrates that LA strains and LA stiffness are significantly associated with the occurrence of PAF in diabetic patients. As 2D-STE of the LA is more sensitive than routine echocardiographic examination, it should be performed in patients suspected of being suffering from PAF.


Present status of reconstructive surgery for aortic valve disease.
Most surgical techniques for reconstruction of the aortic valve, although described a long time ago, are now feasible with satisfactory results. The general surgical principles for successful reconstruction, and the operative techniques of annuloplasty, commissurotomy, free edge resuspension, unrolling and thinning, and cusp extension are described. Methods for intraoperative evaluation of the repaired valve are also described. Between August 1988 and April 1992, 166 patients underwent aortic valve reconstruction with a 3.2% hospital and 1.2% late mortality. There were no thromboembolic events in the patients with isolated aortic valve repair. The reoperation rate was 6.5%. Echocardiographic study at last follow-up showed stable results at 4 years maximum follow-up.


Utilizing adenovirus vectors for gene delivery in cancer.
Adenovirus (Ad) is a promising candidate vector for cancer gene therapy because of its unique characteristics, which include efficient infection, high loading capacity and lack of insertional mutagenesis. However, systemic administration of Ad is hampered by the host's immune response, hepatocytoxicity, short half-life of the vector and low accumulation at the target site. For these reasons, clinical applications of Ad are currently restricted. In this review, we focus on recent developments in Ad nanocomplex systems that improve the transduction and targeting efficacy of Ad vectors in cancer gene therapy. We discuss the development of different Ad delivery systems, including surface modification of Ad, smart Ad/nanohybrid systems and hydrogels for sustained release of Ad. The fusion of bioengineering and biopharmaceutical technologies can provide solutions to the obstacles encountered during systemic delivery of Ads. The in vivo transgene expression efficiency of Ad nanocomplex systems is typically high, and animal tumor models demonstrate that systemic administration of these Ad complexes can arrest tumor growth. However, further optimization of these smart Ad nanocomplex systems is needed to increase their effectiveness and safety for clinical application in cancer gene therapy.


Racial differences in predictors of college women's body image attitudes.
African-American and Euro-American women from three predominantly Euro-American colleges in the southeast U.S. between 17 and 23 years of age completed instruments assessing body image attitudes, social competence, sex-role attitudes, racial identity, and a measure of family and personal characteristics. Analyses revealed race differences on all body image measures with the exception of appearance evaluation which was influenced by family income and race. Specifically, African-American women reported more satisfaction with and positive feelings towards their bodies and less dissatisfaction than Euro-American women. Unlike Euro-Americans, African-American women attached importance to fitness and health. The relationship between personal/physical factors and body image was stronger for African-American than Euro-American women. Additionally, personal/physical characteristics were the best model of appearance evaluation for African-American women, whereas personal/physical and sociodemographic factors best predicted this measure for Euro-American women. The results are discussed in relation to body image norms and standards of the African-American subculture and middle-class, Euro-American mainstream culture.


Remarkably fast coupled folding and binding of the intrinsically disordered transactivation domain of cMyb to CBP KIX.
Association rates for interactions between folded proteins have been investigated extensively, allowing the development of computational and theoretical prediction methods. Less is known about association rates for complexes where one or more partner is initially disordered, despite much speculation about how they may compare to those for folded proteins. We have attached a fluorophore to the N-terminus of the 25 amino acid cMyb peptide used previously in NMR and equilibrium studies (termed FITC-cMyb), and used this to monitor the kinetics of its interaction with the KIX protein. We have investigated the ionic strength and temperature dependence of the kinetics, and conclude that the association process is extremely fast, apparently exceeding the rates predicted by formulations applicable to interactions between pairs of folded proteins. This is despite the fact that not all collisions result in complex formation (there is an observable activation energy for the association process). We propose that this is partially a result of the disordered nature of the FITC-cMyb peptide itself.


Effects of Primary Processing Techniques and Significance of Hall-Petch Strengthening on the Mechanical Response of Magnesium Matrix Composites Containing TiO₂ Nanoparticulates.
In the present study, Mg (1.98 and 2.5) vol % TiO₂ nanocomposites are primarily synthesized utilizing solid-phase blend-press-sinter powder metallurgy (PM) technique and liquid-phase disintegrated melt deposition technique (DMD) followed by hot extrusion. Microstructural characterization of the synthesized Mg-TiO₂ nanocomposites indicated significant grain refinement with DMD synthesized Mg nanocomposites exhibiting as high as ~47% for 2.5 vol % TiO₂ NPs addition. X-ray diffraction studies indicated that texture randomization of pure Mg depends not only on the critical amount of TiO₂ NPs added to the Mg matrix but also on the adopted synthesis methodology. Irrespective of the processing technique, theoretically predicted tensile yield strength of Mg-TiO₂ nanocomposites was found to be primarily governed by Hall-Petch mechanism. Among the synthesized Mg materials, solid-phase synthesized Mg 1.98 vol % TiO₂ nanocomposite exhibited a maximum tensile fracture strain of ~14.5%. Further, the liquid-phase synthesized Mg-TiO₂ nanocomposites exhibited higher tensile and compression properties than those primarily processed by solid-phase synthesis. The tensile-compression asymmetry values of the synthesized Mg-TiO₂ nanocomposite was found to be lower than that of pure Mg with solid-phase synthesized Mg 1.98 vol % TiO₂ nanocomposite exhibiting as low as 1.06.


Fragmentation and dimerization of copper-loaded prion protein by copper-catalysed oxidation.
Prion protein consists of an N-terminal domain containing a series of octapeptide repeats with the consensus sequence PHGGGWGQ and a C-terminal domain composed of three alpha-helices and two short beta-strands. Several studies have shown that the N-terminal domain binds five Cu2+ ions. In the present study, we have investigated copper-catalysed oxidation of a recombinant mouse prion protein, PrP23-231. The copper-loaded PrP23-231 was found to be carbonylated by incubation with dopamine. Besides the formation of carbonyls, a cross-linked species with the dimeric size and C-terminally truncated species were generated. These reactions were retarded in the presence of Cu+- and Cu2+-specific copper chelators, catalase, and SOD (superoxide dismutase), but not in the presence of various bivalent metal ions. Together, these results indicate that the copper bound to prion protein undergoes catalytic cycling in the presence of catecholamines and causes the oxidation of the protein.