Conjugated Polymers for Aptasensing Applications.
Rapid and specific assaying of molecules that report on a pathophysiological condition, environmental pollution, or drug concentration is pivotal for establishing efficient and accurate diagnostic systems. One of the main components required for the construction of these systems is the recognition element (receptor) that can identify target analytes. Oligonucleotide switching structures, or aptamers, have been widely studied as selective receptors that can precisely identify targets in different analyzed matrices with minimal interference from other components in an antibody-like recognition process. These aptasensors, especially when integrated into sensing platforms, enable a multitude of sensors that can outperform antibody-based sensors in terms of flexibility of the sensing strategy and ease of deployment to areas with limited resources. Research into compounds that efficiently enhance signal transduction and provide a suitable platform for conjugating aptamers has gained huge momentum over the past decade. The multifaceted nature of conjugated polymers (CPs), notably their versatile electrical and optical properties, endows them with a broad range of potential applications in optical, electrical, and electrochemical signal transduction. Despite the substantial body of research demonstrating the enhanced performance of sensing devices using doped or nanostructure-embedded CPs, few reviews are available that specifically describe the use of conjugated polymers in aptasensing. The purpose of this review is to bridge this gap and provide a comprehensive description of a variety of CPs, from a historical viewpoint, underpinning their specific characteristics and demonstrating the advances in biosensors associated with the use of these conjugated polymers.


Localization and symptoms associated with removal of negative motor area during awake surgery.
In awake surgery, cortical mapping may identify the negative motor area (NMA). However, since speech arrest occurs regardless of whether the NMA or the frontal language area (FLA) is stimulated, the presence of speech arrest alone does not distinguish the NMA from the FLA. Furthermore, the exact location and function of the NMA is not well understood. The purpose of this study was to more accurately locate the NMA in a group of cases in which the NMA and FLA could be identified in different brain gyri, and to describe symptoms in cases in which the NMA was removed. There were 18 cases of awake surgery at our institution between 2000 and 2013 in which cortical stimulation allowed identification of FLA and NMA in separate brain gyri. In these cases, the pre- and post-removal mapping results were projected onto a 3D model postoperatively. We investigated the symptoms and social rehabilitation in a case in which the tumour invaded the same brain gyrus as the NMA and the NMA had to be resected in combination with the tumour. In cases where the NMA and FLA could be identified in different brain gyri, NMA was localized inferior to the precentral gyrus in all cases. In four cases where NMA was removed with the tumour, apraxia of speech was observed during the surgery; the same symptoms persisted after it, but it improved within a few months, and the patients were able to return to work. In cases where NMA and FLA could be identified separately by awake mapping, the NMA was commonly localized inferior to the precentral gyrus. When NMAs were resected in combination with tumour invasion, they did not lead to serious, long-term complications.


Some thoughts on dental education.
It is suggested that immediately after dental school there should be a pre-registration year--a whole year of clinical training and instruction in general practice under the close supervision of a competent general practitioner/teacher. This year should end with a period of 3--4 weeks at the dental school for feedback discussion, seminars and some examinations. In order to involve every dentist, teacher, therapist, hygienist, assistant technician in a well-planned continuing educational program it seems necessary to introduce a compulsory system. It is also suggested that there should be a control system for the quality of care and individual professional performance. The demand for dental care increases. It is therefore highly desirable to utilize modern preventive measures on a broad scale, more effective and careful planning of the dental services for the individual patient and for the community as a whole and increased quality of treatment in order to reach a better prognosis and more ancillary personnel.


Heterotopic calcification as a late radiation effect: report of 15 cases.
The LENT-SOMA scoring system for reporting late tissue effects following therapeutic radiation does not include heterotopic calcification as an end-point. Here we report on 15 long-term radiotherapy survivors with significant heterotopic calcifications. In all cases heterotopic calcification was linked to other radiation sequelae, e.g. ulceration, bone necrosis, nerve damage and fibrosis. The median time interval between radiotherapy and the occurrence of heterotopic calcification was 19 years (range 2-31 years). All patients received doses in excess of 40 Gy; overlap of adjacent fields played a role in some cases. It appears that heterotopic calcification can be regarded as end-stage damage following high dose radiotherapy. Heterotopic calcification in conjunction with local tissue breakdown is highly suggestive of previous radiation treatment.


Prevotella nanceiensis sp. nov., isolated from human clinical samples.
Three strains of anaerobic, non-pigmented, Gram-negative bacilli isolated from various human clinical samples were characterized in terms of phenotypic and genotypic tests, including sequence analysis of 16S rRNA and rpoB genes. The strains were most closely related to the type strains of Prevotella marshii and Prevotella shahii on the basis of both 16S rRNA (89.8 and 89.0 % identity, respectively) and rpoB gene sequences (83.1 and 82.8 % identity, respectively). Phylogenetic analysis showed that the isolates constituted a robust homogeneous group distinct from known species in the genus Prevotella. The rrn skeleton (as determined by PFGE) and the DNA G+C content, determined to be 39.4 mol% for strain LBN 293(T), distinguished the novel isolates from the type strains of P. marshii and P. shahii. The three strains were saccharolytic and produced acetic, lactic and succinic acids as major metabolic end products. Polyphasic investigations supported the proposal of a novel species, Prevotella nanceiensis sp. nov., with LBN 293(T) (=AIP 261.03(T) =CIP 108993(T) =CCUG 54409(T)) as the type strain.


Intraperitoneal hydrostatic pressure and flow characteristics of peritoneal catheters in automated peritoneal dialysis.
In automated peritoneal dialysis (APD) one of the most important factors that influence the efficiency of the treatment is the total volume of dialysate infused per session and the dwell time. This study is aimed at examining the relationships between i.p. pressure (IPP), dialysate flow characteristics, and different dialysate fill volumes in order to optimize APD. We studied 20 patients who received APD, with the standard fill volume (2 l, A), or individualized fill volumes based on the patient's body surface area (2.5 l/BSA/1.73 m, B) or on body weight (40 ml/kg body weight, C). The patient's tolerance to a given fill volume was evaluated by measuring IPP, and catheter flow characteristics were evaluated by an automated machine. IPP increased with the increase of the infused volume of dialysate (P < 0.05) and tended towards a positive relationship with the patient's body mass index (BMI: A vs IPP: R = 0.39, P = 0.0019; B vs IPP: R = 0.66, P = 0.0012; C vs IPP R = 0.55, P = 0.009). We also found a relationship between fill volume, BMI and IPP: IPP = 1.0839 + 0.53 (beta) x BMI + 0.211 (beta) x fill volume (R = 0.65; r(2) = 0.40 P < 0.01). The mean IPP with different dialysate fill volumes tended to be related to the volume of dialysate drained at the transition point (R = 0.37; P < 0.05). The pre-transition flow rate/mean IPP ratio tended towards a positive relationship with the volume of dialysate drained at the transition point (R = 0.35, P < 0.05), the transition time (R = 0.34; P < 0.05) and a negative one with the transition volume (R = -0.35, P = 0.05). It is possible to customize APD, where the tidal percentage coincides with the transition point for a given catheter and a specific initial dialysate fill volume, the tolerance of which can be measured by assessing IPP.


Pharmacogenomics of membrane transporters: past, present and future.
Membrane transporters are major determinants of the absorption, distribution and elimination of many of the most commonly used drugs. In the past decade, the field of membrane transporter pharmacogenomics has undergone enormous growth. In particular, functional genomic and clinical studies have provided new information regarding the contribution of coding variants in transporters to drug disposition and response. With continuing advances in sequencing technologies and large-scale human variation studies, over the next decade, knowledge in the field will be transformed. In particular, functional variants in noncoding regions of transporters will be discovered, and large clinical studies will result in the identification of variants in multiple genes, including transporter genes, which contribute to variation in clinical drug response.


Linguistics of nucleotide sequences: morphology and comparison of vocabularies.
The concept of "words" in continuous languages devoid of blanks is introduced and an operational definition of words given. With this novel concept nucleotide sequences become object for linguistic analysis. The typical word size of the nucleotide language is found to be 3 to 5 (tri- to pentamers). Different genomes have distinct vocabularies. Comparison of these vocabularies can serve as a basis for revealing functional and evolutionary relatedness of sequences.


A qualitative systematic review of service user and service provider perspectives on the acceptability, relative benefits, and potential harms of art therapy for people with non-psychotic mental health disorders.
This systematic review aimed to synthesize qualitative evidence relating to user and service provider perspective on the acceptability and relative benefits and potential harms of art therapy for people with non-psychotic mental disorders. A comprehensive literature search was conducted in 13 major bibliographic databases from May to July 2013. A qualitative evidence synthesis was conducted using thematic framework synthesis. The searches identified 10,270 citations from which 12 studies were included. Ten studies included data from 183 service users, and two studies included data from 16 service providers. The evidence demonstrated that art therapy was an acceptable treatment. The benefits associated with art therapy included the following: the development of relationships with the therapist and other group members; understanding the self/own illness/the future; gaining perspective; distraction; personal achievement; expression; relaxation; and empowerment. Small numbers of patients reported varying reasons for not wanting to take part, and some highlighted potentially negative effects of art therapy which included the evoking of feelings which could not be resolved. The findings suggest that for the majority of respondents art therapy was an acceptable intervention, although this was not the case for all respondents. Therefore, attention should be focussed on both identifying those who are most likely to benefit from art therapy and ensuring any potential harms are minimized. The findings provide evidence to commissioners and providers of mental health services about the value of future art therapy services. Art therapy was reported to be an acceptable treatment for the majority of respondents. Art therapy may not be a preferred treatment option for a small number of patients, emphasizing the importance of considering patient preference in choice of treatment, and selection of the most suitable patients for art therapy. Consideration should be made of adjustments to make art therapy inclusive, particularly for those with physical illnesses. Ensuring the competence of the deliverer, providing patients with additional support, such as other therapies if required, and ensuring continuity of care should be key considerations in service provision.


Development and validation of a simple LC method for the determination of phenacetin, coumarin, tolbutamide, chlorzoxazone, testosterone and their metabolites as markers of cytochromes 1A2, 2A6, 2C11, 2E1 and 3A2 in rat microsomal medium.
Cytochrome P450 enzymes are responsible for the oxidative metabolism of most pharmaceutical compounds. A "cocktail" approach which employs simultaneous administration of a mixture of substrates of CYP enzymes was often used to assess the metabolic activity of multiple P450 forms in one experiment. Phenacetin, coumarin, tolbutamide, chlorzoxazone and testosterone are commonly used as probe substrates to evaluate cytochrome P450 function. An analytical strategy to simultaneously extract and analyze the five probe substrates and their major metabolites by HPLC-DAD was developed. The incubation was done with all the substrates in one step. The ten analytes were extracted simultaneously by solid-phase extraction (SPE) from rat liver microsomes. A C18 analytical column and mobile phase composed of acetonitrile and 0.02% aqueous phosphoric acid were used for the chromatographic separation with DAD detection. Limits of quantification varied between 0.02378 and 0.2361 microg/mL which contributed to quantify all these drugs and metabolites with UV detection. The method is applicable for the modeling and description of pharmacological interactions on rat cytochromes P450 or can be used for in vitro evaluation of cytochromes 1A2, 2A6, 2C11, 2E1 and 3A2.


A generative model for measuring latent timing structure in motor sequences.
Motor variability often reflects a mixture of different neural and peripheral sources operating over a range of timescales. We present a statistical model of sequence timing that can be used to measure three distinct components of timing variability: global tempo changes that are spread across the sequence, such as might stem from neuromodulatory sources with widespread influence; fast, uncorrelated timing noise, stemming from noisy components within the neural system; and timing jitter that does not alter the timing of subsequent elements, such as might be caused by variation in the motor periphery or by measurement error. In addition to quantifying the variability contributed by each of these latent factors in the data, the approach assigns maximum likelihood estimates of each factor on a trial-to-trial basis. We applied the model to adult zebra finch song, a temporally complex behavior with rich structure on multiple timescales. We find that individual song vocalizations (syllables) contain roughly equal amounts of variability in each of the three components while overall song length is dominated by global tempo changes. Across our sample of syllables, both global and independent variability scale with average length while timing jitter does not, a pattern consistent with the Wing and Kristofferson (1973) model of sequence timing. We also find significant day-to-day drift in all three timing sources, but a circadian pattern in tempo only. In tests using artificially generated data, the model successfully separates out the different components with small error. The approach provides a general framework for extracting distinct sources of timing variability within action sequences, and can be applied to neural and behavioral data from a wide array of systems.


[Selected body proportions in girls with Turner's syndrome].
Typical features in Turner s syndrome (TS) are growth deficit and abnormal body proportions resulting from shorter lower extremities in relation to trunk height and larger shoulder girdle, compared with healthy girls. To compare upper body length to body height (bh) in TS and healthy girls. The following variables were recorded: body height (bh), sitting height (sh), upper extremity length, chest and hips girth (cg). In addition, body stature index equal to the ratio bs/bh was computed. Girls with TS aged 7-14 years (n=46) and healthy short-statured girls (below 10th percentile) in the same age ranges (n=46, respectively) were studied. Compared to healthy short-statured girls, Turner ones did not differ significantly with respect to body height (bh), and upper extremity length,. The index of height proportion (sh/bh) in healthy and TS girls aged 7-14 years amounted to 0.519+/-0.002 and 0.546+/-0.003, The differences were in both cases highly significant (p<0.001). Moreover, Turner girls were significantly heavier, had significantly larger hip and chest girths than healthy short-statured girls. Basic anthropometric measurements or the index of height proportion measured at the early-school age may serve as a simple diagnostic tool in screening abnormal growth proportions, e.g. in Turner s syndrome.


[T-lymphocyte subpopulations in bronchoalveolar lavage in pulmonary sarcoidosis and other interstitial pulmonary diseases].
In the bronchoalveolar lavage of 17 patients with pulmonary sarcoidosis and in the lavage of 18 patients with other diseases of the pulmonary interstitium the authors assessed by means of monoclonal antibodies, T-lymphocyte subpopulations. In the lavage from sarcoidosis helper-inducer lymphocytes (CD4+) dominated markedly, while in other interstitial pulmonary diseases a predominance of suppressor-cytotoxic lymphocytes (CD8+) was found. The different ratio of CD4+ and CD8+ lymphocytes was manifested particularly markedly when for evaluation the CD4/CD8 ratio was used: in sarcoidosis it was 7.2 +/- 3.5, while in other interstitial lung diseases only 0.9 +/- 0.6. The presented results indicate possible practical use of assessment of lymphocyte subpopulations in bronchoalveolar lavage for the differential diagnosis of interstitial lung diseases.


Is glycine a surrogate for a D-amino acid in the collagen triple helix?
Collagen is the most abundant protein in animals. Every third residue in a collagen strand is a glycine with phi, psi = -70 degrees, 175 degrees. A recent computational study suggested that replacing these glycine residues with D-alanine or D-serine would stabilize the collagen triple helix. This hypothesis is of substantial importance, as the glycine residues in collagen constitute nearly 10% of the amino acid residues in humans. To test this hypothesis, we synthesized a series of collagen mimic peptides that contain one or more D-alanine or D-serine residues replacing the canonical glycine residues. Circular dichroism spectroscopy and thermal denaturation experiments indicated clearly that the substitution of glycine with D-alanine or D-serine greatly disfavors the formation of a triple helix. Host-guest studies also revealed that replacing a single glycine residue with D-alanine is more destabilizing than is its replacement with L-alanine, a substitution that results from a common mutation in patients with collagen-related diseases. These data indicate that the glycine residues in collagen are not a surrogate for a D-amino acid and support the notion that the main-chain torsion angles of a glycine residue in the native structure (especially, phi > 0 degrees ) are critical determinants for its beneficial substitution with a D-amino acid in a protein.


Chronic care costs in managed care.
This DataWatch presents estimates of the health care costs for all adults who were continuously enrolled in a large staff-model health maintenance organization (HMO) during 1992. More than one-third of these adults were diagnosed with at least one chronic condition in 1992, and costs for this population are at least twice those of the population without chronic conditions. A diagnosis of a chronic condition results in an expected increase in costs of 80 percent-300 percent, depending on age, sex, and chronic condition profile. Previous studies of the costs of chronic illness have focused on the fee-for-service sector. As managed care continues to grow, it is important that economic analyses focus on this market segment.


Dynamics in development of experimental streptococcal immunity in mice.
The interrelation between the humoral and cellular factors in the development of immunity to experimental streptococcal infection was investigated. Early resistance to infection was caused by stimulating the phagocytic cells to function efficiently in the absence of opsonins. Subsequently, the appearance of cytophilic antibodies provided further means for elimination of streptococci. Thus, in the early stages of specific antistreptococcal immunity, resistance was observed in the absence of circulating anti-M antibodies. The type-specific antibodies that appeared in the later stage did not seem to improve clearance of streptococci in the splanchnic tissues. After an intravenous lethal challenge of mice with virulent streptococci, these antibodies did not provide increased protection. The circulating anti-M antibodies were shown to play a beneficial, indeed, a crucial, role when the infection occurred in a region in which the phagocytic cells were present in a rather limited number.


Effects of dietary supplementation with epidermal growth factor on nutrient digestibility, intestinal development and expression of nutrient transporters in early-weaned piglets.
The abnormalities in intestinal morphology and digestive function during weaning are associated with the loss of milk-borne growth factors. Epidermal growth factor (EGF) has been shown to stimulate the growth of animals. This study was to determine the effect of dietary EGF on nutrient digestibility, intestinal development and the expression of genes encoding nutrient transporters in weaned piglets. Forty-two piglets were weaned at 21 days and assigned to one of three treatment groups: (1) basal diet (control), (2) basal diet + 200 µg/kg EGF or (3) basal diet + 400 µg/kg EGF. Each treatment consisted of 14 replicates, and seven piglets from each treatment were sampled on day 7 and 14. The EGF supplementation significantly elevated (p < 0.05) the coefficients of total tract apparent digestibility of crude protein, calcium and phosphorus, but tended to decrease sucrase activity (p < 0.10) than the control group. At day 7 post-weaning, animals receiving EGF diets showed a tendency (p < 0.10) towards greater ileal villus height (VH), jejunal crypt depth (CD) and duodenal VH:CD when compared with the control group. Moreover, the mRNA levels of glucose transporter 2 (Slc2a2), neutral amino acid transporter (Slc6a19) and calbindin D9k (S100G) tended to be higher (p < 0.10) for EGF groups than the control group. By day 14, EGF supplementation markedly enhanced (p < 0.05) the VH, CD and VH:CD in the jejunum compared to the control group. This addition also up-regulated (p < 0.05) the mRNA level and the protein abundance of peptide transporter 1 than the control group. These findings demonstrated that dietary EGF beneficially enhanced nutrient digestibility, improved intestinal development and increased the mRNA expression of nutrient transporters in weaned piglets.


Management of psoriatic arthritis among cutaneous psoriasis patients: from pathogenesis to therapy.
Psoriatic arthritis (PsA) is an inflammatory rheumatism belonging to spondyloarthritis family and which occurs in about 30% of patients with psoriasis. The pathogenesis entails a genetic predisposition, environmental and immunologic factors. Most of the time, cutaneous lesions precede apparition of articular manifestations and dermatologists who treat psoriatic patients have to regularly screen for early PsA, especially in patients with risk factors (notably nail psoriasis). Early detection greatly increases the chances for successful treatment and can prevent slow joint destruction. EULAR and GRAPPA have recently published PsA treatment recommendations. Pharmacological therapies for PsA begin with non-steroidal anti-inflammatory drugs, then conventional synthetic as methotrexate, and lastly biological disease-modifying anti-rheumatic drugs. There are significant metabolic comorbidities and increased cardiovascular morbidity in patients with PsA. This aspect must be taken into account in PsA management by pharmaceutical and non-pharmaceutical approach (including educational programs). Close collaboration between dermatologists, rheumatologists and primary care clinicians is recommended to provide optimum care and to prevent the occurrence of structural damages or quality of life alteration.


The diagnosis and classification of epileptic seizures.
Appropriate classification of epileptic seizures is possible based on clinical historical, physical, and laboratory findings. Specific seizure types are more likely to respond to selected antiepileptic drugs (AED's). Correct classification allows for the selection of the appropriate AED and thus increases the likelihood of seizure control. There are numerous epilepsy syndromes or specific types of epilepsy and their description is beyond the scope of this article. The selection of treatment and the description of presently available and future AED's will be discussed in subsequent articles.


Unusual mechanism of hydrocarbon formation in the housefly: cytochrome P450 converts aldehyde to the sex pheromone component (Z)-9-tricosene and CO2.
An unusual mechanism for hydrocarbon biosynthesis is proposed from work examining the formation of (Z)-9-tricosene (Z9-23:Hy), the major sex pheromone component of the female housefly, Musca domestica. Incubation of (Z)-15-[1-14C]- and (Z)-15-[15,16-3H2]tetracosenoic acid (24:1 fatty acid) with microsomes from houseflies gave equal amounts of [3H]Z9-23:Hy and 14CO2. The formation of CO2 and not CO, as reported for hydrocarbon formation in plants, animals, and microorganisms [Dennis, M. & Kolattukudy, P. E. (1992) Proc. Natl. Acad. Sci. USA 89, 5306-5310], was verified by trapping agents and by radio-GLC analysis. Incubation of (Z)-15-[15,16-3H2]tetracosenoyl-CoA with microsomal preparations in the presence of NADPH and O2 gave almost equal amounts of (Z)-15-3H2]tetrasosenal (24:1 aldehyde) and Z9-23:Hy. Addition of increasing amounts of hydroxylamine (aldehyde trapping agent) caused a decrease in hydrocarbon formation with a concomitant increase in oxime (aldehyde derivative) formation. The 24:1 aldehyde was efficiently converted to (Z)-9-tricosene only in the presence of both NADPH and O2. Bubbling carbon monoxide (20:80 CO/O2) or including an antibody against housefly cytochrome P450 reductase inhibited the formation Z9-23:Hy from 24:1 aldehyde. These data demonstrate an unusual mechanism for hydrocarbon formation in insects in which the acyl-CoA is reduced to the corresponding aldehyde and then carbon-1 is removed as CO2. The requirement for NADPH and O2 and the inhibition by CO and the antibody to cytochrome P450 reductase strongly implicate the participation of a cytochrome P450 in this reaction.


Effects of exercise training amount and intensity on peak oxygen consumption in middle-age men and women at risk for cardiovascular disease.
Although increasing aerobic fitness by exercise training is advocated as part of a healthy lifestyle, studies examining the different effects of intensity and amount on peak consumption (V(O2)) remain sparse. This randomized controlled trial compared the effects of three different exercise regimens differing in amount and intensity on fitness improvements. Overweight men and women with mild-to-moderate dyslipidemia were recruited. The exercise groups were as follows: (1) low amount/ moderate intensity (LAMI, n = 25), the caloric equivalent of walking 19 kilometers (km)/wk at 40 to 55% of peak V(O2); (2) low amount/high intensity (LAHI, n = 36), the equivalent of jogging 19 km/wk at 65 to 80% of peak V(O2); (3) high amount/high intensity (HAHI, n = 35), the equivalent of jogging 32 km/wk at 65 to 80% of peak V(O2); and (4) a control group (n = 37). Peak V(O2) and time to exhaustion (TTE) were tested before and after 7 to 9 months of training. All exercise groups increased peak V(O2) and TTE compared to baseline (p < or = 0.001). Improvements in peak V(O2) were greater in the LAHI and HAHI groups compared to the control group (p < 0.02); HAHI group improvements were greater than the LAMI group (p < 0.02) and the LAHI group (p < 0.02). Increased TTE for all exercise groups was higher compared to the control group (p < 0.001) Exercising at a level of 19 km/wk at 40 to 55% of peak V(O2) is sufficient to increase aerobic fitness levels, and increasing either exercise intensity or the amount beyond these parameters will yield additional separate and combined effects on markers of aerobic fitness. Therefore, it is appropriate to recommend mild exercise to improve fitness and reduce cardiovascular risk yet encourage higher intensities and amounts for additional benefit.


F.L. de Castelnau's Norman River fishes housed in the Macleay Museum, University of Sydney.
Type specimens were located in the Macleay Museum for five species described by F.L. de Castelnau: Kurtus gulliveri (syntype), Pseudoambassis macleayi (lectotype and two paralectotypes), Pseudoambassis elongatus (lectotype and paralectotype), Acanthoperca gulliveri (syntype) and Engraulis nasutus (syntypes). The last-named is shown to be a senior subjective synonym of Anchovia aestuaria Ogibly 1910, and is referred to the genus Thryssa Cuvier 1829.


Statin therapy depresses fat metabolism in older individuals.
Statins (3-hydroxy-3-methylglutaryl coenzyme A [HMG CoA] reductase inhibitors) reduce blood lipoproteins and reduce the risk of cardiovascular events. However, they may reduce fat metabolism. This study tested the hypothesis that total body fat oxidation is reduced by statins in older subjects and the reduction is not due to substrate availability. A total of 14 elderly patients (71 ± 6 years) on statin therapy were compared with 14 matched elderly controls (75 ± 7 years). Subjects were tested for respiratory exchange ratio (RER) during both maximal and submaximal sustained (70% Vo(2max)) exercise to voluntary exhaustion. Blood samples were drawn for lipoprotein analysis and substrate availability. RER was significantly higher in subjects taking statins during both the max and submax tests, indicating reduced fat oxidation. Blood lipoprotein levels after a fast were not different between the statin and control groups. Levels of glucose, lactate, or triglyceride were not different between groups; however, free fatty acid levels were elevated by exercise in the statin group. Fat oxidation was significantly reduced in older subjects taking statin drugs that were not associated with diet, exercise, and fitness, which were matched between groups, nor availability of fat from the blood, which was higher in the statin group. Although statin therapy normalizes blood lipoproteins, it reduced fat metabolism in older individuals, which cannot be a result of lower availability from blood.


[Whole PTH and 1-84/84 PTH ratio for the non invasive determination of low bone turnover in renal osteodysthrophy].
The conventional intact PTH assays detect not only PTH 1-84 but also inactive fragments (as PTH 7-84) that accumulate in renal failure. There has been a recent development of a new PTH assay that measures only true 1-84 PTH (Whole PTH or CAP assay, Scantibodies). As 7-84 PTH fragment is antagonistic on bone effects of 1-84 PTH, Moniere-Faugere has suggested that 1-84/7-84 PTH ratio less than 1 is predictive of low turnover. We evaluated the usefulness of CAP assay and the 1-84/7-84 PTH ratio as markers of bone turnover in a groups of 24 patients in peritoneal dialysis (PD). Patients were classified as having low bone turn over if they had a Total PTH (similar to intact PTH) of less than 100 pg/ml. We also measured serum CrossLaps (CTX) as another serum resorption marker. Patients had a mean Whole PTH of 95.5 pg/ml and a mesan total PTH of 155.4 pg/l (range 9 to 900). Whole PTH represented 69.1% of total PTH. Fifteen patients (62.5%) had a total PTH of less than 100. These patients had a 1-84/7-84 relationship of 1.9 +/- 1.8 while 9 patients with Total PTH more than 100 had a relationship of 1.29 +/- 0.6 (p = NS). There was a tight correlation between Whole PTH and total PTH (r = 0.98; p < 0.0001) and with serum CTX (r = 0.78; p < 0.0001). We conclude that 1-84/7-84 ratio does not seem useful in the prediction of low bone turnover and that Whole PTH does not seem to be more useful than intact PTH in the prediction of bone turnover in this population. Future studies should correlate this markers with direct measurements of bone turnover in bone biopsies to demonstrate their usefulness in the prediction of the type of renal osteodystrophy.


Granulomatosis with Polyangiitis Presenting with Acute Aortic and Mitral Regurgitation: Case Report and Big-Data Analysis.
Granulomatosis with polyangiitis (GPA) is a rare vasculitis that can have multisystem involvement, though cardiac involvement is very rare. The case is described of a 53-year-old woman who presented with acute aortic and mitral valve regurgitation requiring surgical intervention. Pathology from the excised aortic valve showed geographic necrosis concerning for GPA. Subsequent rheumatologic testing was positive for anti-serine proteinase 3 (PR3) antibody, consistent with GPA. A year after the valve surgery the patient was found to have a vegetation of the mitral valve and elevated PR3 antibody levels, and was successfully treated with an intensification of immunosuppression. The cardiac involvement of GPA is discussed and big data analyzed to identify the epidemiology of valvular involvement. In conclusion, GPA can have multiple different valvular manifestations with a high recurrence rate. GPA should be considered in patients who present with acute valvular disease without any clear precipitant.


Spontaneous mutation frequency and emergence of ciprofloxacin resistance in Campylobacter jejuni and Campylobacter coli.
We analysed the contribution of spontaneous mutation frequency to the evolution of ciprofloxacin resistance and the diversity of mutations in the quinolone resistance-determining region (QRDR) of gyrA and in the intergenic region, cmeR-cmeA, of the CmeABC efflux pump in Campylobacter jejuni and Campylobacter coli. The mutation frequency was measured in 11 quinolone-susceptible C. jejuni and 5 C. coli strains, with and without ox bile. MICs and target-specific and efflux-associated mutations were studied for a number of colonies of each strain selected from plates containing 1 mg/L ciprofloxacin. The spontaneous mutation frequency level among susceptible C. jejuni and C. coli strains ranged from hypomutable (approximately 4 x 10(-9)) to strongly mutable (approximately 7 x 10(-3)). Ox bile had no effect on mutation frequency. Pre-existing ampicillin and tetracycline resistance increased the MICs of ciprofloxacin for two strains from 0.032-0.125 to 0.5 mg/L. MICs of ciprofloxacin for the colonies selected from plates containing 1 mg/L ciprofloxacin varied from 1 to 16 mg/L, with the Thr-86-->Ile or Asp-90-->Asn mutation detected in the QRDR of gyrA. In 21.5% (14/65) of the selected colonies, no specific mutations existed. Two types of mutations in CmeR promoter-binding inverted sequences were identified both in the parent strains and in the colonies selected from ciprofloxacin plates. The variation in mutation frequencies between most C. jejuni and C. coli strains was up to 700-fold. Mutation in the QRDR of gyrA or in the intergenic region was not associated with differences in spontaneous mutation frequencies. Previously acquired resistance to tetracycline and ampicillin predisposed strains to high-level ciprofloxacin resistance and to multiple antibiotic resistance.


Identifying potential small molecule-miRNA associations via Robust PCA based on γ-norm regularization.
Dysregulation of microRNAs (miRNAs) is closely associated with refractory human diseases, and the identification of potential associations between small molecule (SM) drugs and miRNAs can provide valuable insights for clinical treatment. Existing computational techniques for inferring potential associations suffer from limitations in terms of accuracy and efficiency. To address these challenges, we devise a novel predictive model called RPCA$\Gamma $NR, in which we propose a new Robust principal component analysis (PCA) framework based on $\gamma $-norm and $l_{2,1}$-norm regularization and design an Augmented Lagrange Multiplier method to optimize it, thereby deriving the association scores. The Gaussian Interaction Profile Kernel Similarity is calculated to capture the similarity information of SMs and miRNAs in known associations. Through extensive evaluation, including Cross Validation Experiments, Independent Validation Experiment, Efficiency Analysis, Ablation Experiment, Matrix Sparsity Analysis, and Case Studies, RPCA$\Gamma $NR outperforms state-of-the-art models concerning accuracy, efficiency and robustness. In conclusion, RPCA$\Gamma $NR can significantly streamline the process of determining SM-miRNA associations, thus contributing to advancements in drug development and disease treatment.


Taxonomic Importance of Pollen Morphology for Some Species of Brassicaceae.
Pollen morphology is one of the significant tools in solving some taxonomic problems on the family, generic or specific level and has become part of the multidisciplinary and collaborative approach in plant systematic and evolution. Therefore, this study aimed to investigate and describe the pollen morphology of 10 species belongs to 9 genera and five tribes of Brassicaceae from eastern region of Saudi Arabia by using light and scanning electron microscope. To study the pollen morphology for ten species representing 9 genera and 5 tribes of Brassicaceae the Light Microscope (LM) and Scanning Electron Microscope (SEM). For the SEM the pollen was placed directly on brass stubs without treatment and mounted onto a metallic stub with a double-sided adhesive tape. Gold coating of few nanometers was applied using sputter coating machine (Quorum, Q150R ES, UK) to avoid charging and capture high quality images. Two statistical program; PRIMER 6, version 6.1.6 and SPSS version 16are used to fine the relationships among the studied species. The shape of pollen grains recorded three types; prolate, subprolate and prolate-spheroidal, the main types were prolate. The apertures were tricolpate in all studied species. Exine ornamentation of studied species recorded two types; reticulate and coarsely reticulate. The results of numerical analysis showed that species were grouped into two major clusters and each cluster divided into two groups. The results show that the morphology of pollen grains cannot be useful for taxonomical classification of the tribes but can be useful for differentiate between species belong to the same genera.


Regiocontrolled Reductive Vinylation of Aliphatic 1,3-Dienes with Vinyl Triflates by Nickel Catalysis.
The regiocontrolled functionalization of 1,3-dienes has become a powerful tool for divergent synthesis, yet it remains a long-standing challenge for aliphatic substrates. Herein, we report a reductive approach for a branch-selective 1,2-hydrovinylation of aliphatic 1,3-dienes with R-X electrophiles, which represents a new selectivity pattern for diene functionalization. Simple butadiene, aromatic 1,3-dienes, and highly conjugated polyene were also tolerated. The combination of Ni(0) and the phosphine-nitrile ligand generally resulted in >20:1 regioselectivity with the retention of the geometry of the C3-C4 double bonds. This reaction proceeds with a broad substrate scope, and it allows for the conjugation of two biologically active units to form more complex polyene molecules, such as tetraene and pentaene as well as heptaene.


Plant protoplast agglutination and membrane-bound beta-lectins.
Plant protoplast agglutination caused by normal and immune serum and by artificial carbohydrate antigens is described. Evidence is presented that the new class of lectins, called all-beta lectins by previous authors, are present in protoplast membranes and responsible for both forms of agglutination. Some non-specific serum component and the artificial antigens are the 2 respective passive 'bridge' molecules between agglutinating protoplasts.


Prophylactic antibiotics to reduce morbidity and mortality in neonates with umbilical venous catheters.
Umbilical venous catheters are often used in unwell neonates. Infection related to the use of these catheters may cause significant morbidity and mortality. The use of prophylactic antibiotics has been advocated for newborns with umbilical venous catheters in order to reduce the risk of colonisation and acquired infection. Countering this is the possibility that harm may outweigh benefit. Prophylactic antibiotics may be effective in preventing catheter-related blood stream infection, but may have the undesirable effect of promoting the emergence of resistant strains of micro-organisms. A policy of prophylactic antibiotic use should take into account this possibility, and has been used as a basis for arguing against its implementation. The primary objective was to assess whether prophylactic antibiotics, in neonates with umbilical venous catheters, reduce mortality and morbidity. In separate comparisons, we planned to review two different policies regarding the prophylactic use of antibiotics in neonates with umbilical venous catheters: 1) Among neonates with umbilical venous catheters, a policy of prophylactic antibiotics for the duration of catheterisation (or other fixed duration of antibiotic treatment) versus placebo or no treatment; 2) Among neonates with umbilical venous catheters who had been started on antibiotics at the time of catheterisation, but whose initial cultures to rule out sepsis are negative, a policy of continuing versus discontinuing prophylactic antibiotics. We searched MEDLINE (January 1966 to April 2005), CINAHL (1982 to April 2005), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005). Randomised controlled trials or quasi-randomised trials in which newborn infants with umbilical venous catheters are randomised to receive prophylactic antibiotics versus placebo or no treatment. Two reviewers independently assessed trial quality. One study, of poor quality, met the criteria for inclusion in this review. Twenty-nine term infants, who had umbilical venous catheters inserted specifically for transfusion procedures for hyperbilirubinaemia or polycythaemia, allocated non-randomly (quasi-randomised - alternate allocation) to treatment (n = 15) or control (n = 14) groups. Those in the treatment group received penicillin and gentamicin for three days. 5/15 infants given antibiotics and 5/14 control infants having positive blood cultures three days after catheter insertion. All positive blood cultures were considered contaminated, due to lack of corroborating clinical and haematological evidence of infection. Therefore, no infants were identified with evidence of septicaemia. There is insufficient evidence from randomised trials to support or refute the use of prophylactic antibiotics when umbilical venous catheters are inserted in newborn infants. There is no evidence to support or refute continuing antibiotics once initial cultures rule out infection in newborn infants with umbilical venous catheters.


The involvement of noradrenergic mechanisms in the suppressive effects of diazepam on the hypothalamic-pituitary-adrenal axis activity in female rats.
To elucidate the involvement of noradrenergic system in the mechanism by which diazepam suppresses basal hypothalamic-pituitary-adrenal (HPA) axis activity. Plasma corticosterone and adrenocorticotropic hormone (ACTH) levels were determined in female rats treated with diazepam alone, as well as with diazepam in combination with clonidine (α(2)-adrenoreceptor agonist), yohimbine (α(2)-adrenoreceptor antagonist), alpha-methyl-p-tyrosine (α-MPT, an inhibitor of catecholamine synthesis), or reserpine (a catecholamine depleting drug) and yohimbine. Diazepam administered in a dose of 2.0 mg/kg suppressed basal HPA axis activity, ie, decreased plasma corticosterone and ACTH levels. Pretreatment with clonidine or yohimbine failed to affect basal plasma corticosterone and ACTH concentrations, but abolished diazepam-induced inhibition of the HPA axis activity. Pretreatment with α-MPT, or with a combination of reserpine and yohimbine, increased plasma corticosterone and ACTH levels and prevented diazepam-induced inhibition of the HPA axis activity. The results suggest that α(2)-adrenoreceptors activity, as well as intact presynaptic noradrenergic function, are required for the suppressive effect of diazepam on the HPA axis activity.


Modeling Demonstrates That Folic Acid Fortification of Whole-Wheat Flour Could Reduce the Prevalence of Folate Inadequacy in Canadian Whole-Wheat Consumers.
Mandatory folic acid fortification of white-wheat flour and selected other grain products has reduced the prevalence of neural tube defects in Canada; however, the fortification of whole-wheat flour is not permitted. The objective of this study was to model the impact of adding folic acid to whole-wheat flour on the folate intake distribution of Canadians. Twenty-four-hour dietary recall and supplement intake data (n = 35,107) collected in the 2004 Canadian Community Health Survey 2.2 were used to calculate the prevalence of folate inadequacy (POFI) and the proportion of folic acid intakes above the Tolerable Upper Intake Level (UL). In model 1, folic acid was added to whole-wheat flour-containing foods in amounts comparable to those that are mandatory for white-wheat flour-containing foods. In model 2, a 50% overage of folic acid fortification was considered. Models 3 and 4 included assessment of folate intake distributions in adult whole-wheat consumers with or without a fortification overage. SIDE (Software for Intake Distribution Estimation; Department of Statistics and Center for Agricultural and Rural Development, Iowa State University) was used to estimate usual folate intakes. Mean folate intakes increased by ∼ 5% in all sex and age groups when whole-wheat foods were fortified (models 1 and 2; P < 0.0001). Folic acid fortification of whole-wheat flour-containing foods did not change the POFI or percentage of intakes above the UL in the general population, whether in supplement users or nonusers. Among whole-wheat consumers, the POFI was reduced by 10 percentage points after fortification of whole-wheat flour-containing foods (95% CIs did not overlap). The percentage of whole-wheat consumers with intakes above the UL did not change. Although folic acid fortification of whole-wheat flour-containing foods is unlikely to change the POFI or proportion of folic acid intakes above the UL in the general Canadian population, this fortification strategy may reduce the POFI in adult whole-wheat consumers.


Lipoprotein ratios are better than conventional lipid parameters in predicting arterial stiffness in young men.
Although dyslipidemia is associated with cardiovascular disease, there are conflicting data about the role of serum lipids and their ratios in promoting arterial stiffness. The authors aimed to compare serum lipid profiles to predict arterial stiffness, which was assessed by brachial-ankle pulse wave velocity in young Chinese men. A total of 1015 participants aged 18 to 44 years without serious comorbidities were recruited for conventional detection. Anthropometrics, brachial-ankle pulse wave velocity, serum lipids, and other laboratory data were measured. Univariate analysis and multivariate logistic regression were performed to examine the relationship between serum lipid profiles and brachial-ankle pulse wave velocity. Participants with high brachial-ankle pulse wave velocity exhibited higher levels of total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C, TG/HDL-C, low-density lipoprotein cholesterol/HDL-C, and non-HDL-C/HDL-C. The subsequent multivariable logistic regression showed that TG/HDL-C, total cholesterol/HDL-C, non-HDL-C/HDL-C, and TG significantly increased the risk for arterial stiffness after adjustment for confounding factors. Results indicate that lipid ratios are superior to conventional lipid parameters for predicting arterial stiffness in young men and that the TG/HDL-C ratio has the strongest association with arterial stiffness.


No IL-18BP? Avoid HAV.
Fulminant viral hepatitis occurs in a very small number of infected individuals. Until now, the basis for this phenotype has remained unknown. In this issue of JEM, Belkaya et al. (https://doi.org/10.1084/jem.20190669) identify a deletion in the IL18BP gene in a severely affected child that results in excessive natural killer cell activation and uncontrolled killing of hepatocytes.


An evaluation of the National Institutes of Health Early Stage Investigator policy: Using existing data to evaluate federal policy.
To assist new scientists in the transition to independent research careers, the National Institutes of Health (NIH) implemented an Early Stage Investigator (ESI) policy beginning with applications submitted in 2009. During the review process, the ESI designation segregates applications submitted by investigators who are within 10 years of completing their terminal degree or medical residency from applications submitted by more experienced investigators. Institutes/centers can then give special consideration to ESI applications when making funding decisions. One goal of this policy is to increase the probability of newly emergent investigators receiving research support. Using optimal matching to generate comparable groups pre- and post-policy implementation, generalized linear models were used to evaluate the ESI policy. Due to a lack of control group, existing data from 2004 to 2008 were leveraged to infer causality of the ESI policy effects on the probability of funding applications from 2011 to 2015. This article addresses the statistical necessities of public policy evaluation, finding administrative data can serve as a control group when proper steps are taken to match the samples. Not only did the ESI policy stabilize the proportion of NIH funded newly emergent investigators but also, in the absence of the ESI policy, 54% of newly emergent investigators would not have received funding. This manuscript is important to Research Evaluation as a demonstration of ways in which existing data can be modeled to evaluate new policy, in the absence of a control group, forming a quasi-experimental design to infer causality when evaluating federal policy.


Unity is strength in joint research project.
The advent of the purchaser/provider split produced a number of challenges for a coordinated approach to supporting research. This article describes a collaboration between North Derbyshire Health Commission and Chesterfield and North Derbyshire Royal Hospital NHS Trust in bringing together purchaser and provider. A research interest group spanning purchaser and provider organisations has been responsible for a number of initiatives including training days, a research database and a resource pack for would-be researchers which aim to raise the profile of research across North Derbyshire.


Intraretinal oxygen consumption in the rat in vivo.
To make the first quantitative assessment of the rate of oxygen consumption in high oxygen-consuming layers of both the outer and inner retina of the rat in vivo. Oxygen-sensitive microelectrodes were used to measure the oxygen tension as a function of depth through the retina in anesthetized rats. Individual PO2 profiles were fitted to a multilayer mathematical model of PO2 distribution that is able to determine the oxygen uptake in those retinal layers in which the oxygen supply is through diffusion from vascular layers of the retina. This includes the entire outer retina and the region of the inner retina containing the inner plexiform layer. Measurements were performed in the light (13 mW/cm2 at the cornea) and in the dark and the amplitude and time constant for light-induced changes in outer retinal oxygenation determined. Under light-adapted conditions, the oxygen consumption of the outer retina was 148 +/- 11 nL O2/min/cm2 (n = 20) [corrected] and that of the included portion of the inner retina was 184 +/- 17 nL O2/min/cm2 [corrected]. In the dark, outer retinal oxygen consumption increased by 47.8% (P < 0.001), and the time constant for the resultant PO2 decrease in the outer retina was 14.9 +/- 1.8 seconds (n = 16). There was no significant change in inner retinal oxygen consumption between light and dark conditions (P = 0.89). Under light-adapted conditions the oxygen uptake by the selected region of the inner retina (primarily the inner plexiform layer) is greater than that of the outer retina (P < 0.01). Dark adaptation rapidly and significantly increases outer retinal oxygen consumption, but the inner retina remains unaffected.


Cardiovascular adaptations to resistance training in elderly postmenopausal women.
The purpose of this study was to investigate the effect of resistance training on resting blood pressure and heart rate variability in elderly postmenopausal women. 29 untrained, non-hypertensive elderly women were randomly assigned to 2 groups: an intervention group (n=15, 65.5±5.0 years, 57.3±6.5 kg, 156.7±5.1 cm) that underwent a supervised resistance training program (8 exercises, 2 sets, 10-15 repetitions, 3 times/week) or a control group (n=14, 66.2±4.1 years, 61.1±11.7 kg, 157.5±7.1 cm) that participated in a supervised stretching program (25-30 min/session, 2 times/week). Resting auscultatory blood pressure, heart rate variability, evaluated from short recordings in a seated position, and maximal dynamic strength (1-RM test) were measured at baseline and after 12 weeks. A group x time ANOVA revealed that muscular strength increased significantly in the resistance training group (+ 10.2% for bench press and +12.7% for leg extension, P<0.05). Systolic blood pressure was reduced significantly in the resistance training group from pre- to post-intervention period (- 5 mmHg; P<0.05), while no significant effect was noted for diastolic blood pressure and heart rate variability indexes (P>0.05). None of these variables changed in the control group throughout the study. In conclusion, a supervised resistance training program improved muscular strength and reduced systolic blood pressure without affecting diastolic blood pressure and heart rate variability in elderly postmenopausal women.


Untangling the Web--the impact of Internet use on health care and the physician-patient relationship.
The use of Web (i.e. Internet)-derived health information within the health care encounter is rapidly increasing. In this article, an extensive review of the complex effects and sometimes contradictory roles of the Web in regard to health care delivery and the physician-patient relationship is presented. A review of relevant literature was conducted, with key points integrated into a physician guide for effective interaction with Web-activated patients. An emerging consumerist model with "triangulation" of patient-Web-physician can be expected to significantly impact dynamics of the physician-patient relationship. Potential advantages of Web-acquired information include helping patients make informed health care choices (with potential to decrease health care disparities), shared decision-making with a collaborative, teamwork approach, more efficient use of clinical time, augmenting of physician-provided information, online support groups, and/or access to patients' own health information. Alternatively, factors such as misinformation due to highly variable quality of Web information, possible exacerbation of socioeconomic health disparities, and shifting of conventional notions of the physician-patient relationship ("traditional" medical authority) present their own set of challenges for the health care provider. A tangible guide to the integration of patients' use of the Web within a medical practice is thus offered with recommended communication skills. The "net-friendly" clinician can be effective by engendering a genuine partnership with patients, thus contributing to quality health care.


[The timing and surgical choice of surgical treatment for carotid stenosis after radiotherapy].
Objective: To evaluate the safety and efficacy of carotid endarterectomy (CEA) and carotid angioplasty with stenting(CAS) for carotid artery stenosis after radiotherapy. Methods: The clinical data of 73 cases with carotid artery stenosis after radiotherapy from October 2007 to September 2017 were analyzed retrospectively. Among them, 36 cases underwent CEA and 37 cases underwent CAS. Results: No complications occurred during the perioperative period in both groups. During the follow-up period, transient cerebral ischemia occurred in 1 case in the CEA group. There was no in-stent restenosis or adverse events such as stroke or myocardial infarction. In the CAS group, transient cerebral ischemia occurred in 2 cases, postoperative restenosis occurred in 2 cases, and myocardial infarction occurred in 1 case. The restenosis rate and incidence of adverse events were lower in the CEA group. Conclusions: Both surgical methods are safe and effective in the treatment of carotid artery stenosis after radiotherapy. CEA surgery can be more beneficial to long-term outcome, and it is supposed to be the preferred surgical method.


Generating variable and random schedules of reinforcement using Microsoft Excel macros.
Variable reinforcement schedules are used to arrange the availability of reinforcement following varying response ratios or intervals of time. Random reinforcement schedules are subtypes of variable reinforcement schedules that can be used to arrange the availability of reinforcement at a constant probability across number of responses or time. Generating schedule values for variable and random reinforcement schedules can be difficult. The present article describes the steps necessary to write macros in Microsoft Excel that will generate variable-ratio, variable-interval, variable-time, random-ratio, random-interval, and random-time reinforcement schedule values.


Identification of metastasis-associated genes in early stage non-small cell lung cancer by subtractive hybridization.
Non-small cell lung cancer (NSCLC) is a leading cause of death and a substantial fraction of patients with surgically resected disease ultimately dies due to distant metastasis. To identify gene expression differences in early stage adenocarcinoma that either did or did not metastasize within a 5-year period, we employed a subtractive hybridization strategy of pooled RNA from primary adenocarcinomas (stage I) of the lung. Individual clones (n=225) of the subtracted cDNA library were sequenced. Further analyses of mRNA expression levels in a cohort of 70 NSCLC patients (stage I to IIIA) showed that the metastasis association of the identified genes was stage and histology specific. Cox regression analyses identified two genes (EIF4A1, MALA1) to be independent prognostic parameters for patients' survival in stage I and II disease. These findings could help to identify early-stage NSCLC patients at high risk for the development of distant metastasis.


Association of hypertension with stroke recurrence depends on ischemic stroke subtype.
The association between hypertension (HTN) and stroke recurrence is unclear, but may be influenced by different subtypes of stroke. This study aims to explore whether HTN contributes to the recurrence of certain subtypes of ischemic stroke (IS). Data from the China National Stroke Registry was examined and 1-year follow-up data for stroke recurrence was analyzed. Trial of Org 10172 in Acute Stroke Treatment criteria was used to classify the subtypes of all IS. HTN was defined when resting blood pressure was ≥ 140/90 mm Hg on repeated measurements during hospitalization or a patient had been on antihypertensive medication. Recurrent stroke was defined as a new neurological deficit compatible to IS or intracerebral hemorrhage. The association between HTN and stroke recurrence in patients with different IS subtypes was analyzed by using univariable and multivariable logistic regression models. Of 11 560 patients with IS, 8409 (72.7%) had HTN and 2050 (17.7%) experienced a recurrent stroke within 1 year. Patients with HTN had an insignificantly higher stroke recurrence rate than those without (18.0% versus 17.0%; P=0.21). After stratification by Trial of Org 10172 in Acute Stroke Treatment subtypes, multivariable analysis revealed a significant association between HTN and stroke recurrence in small-artery occlusion subtype (odds ratio, 1.52; 95% confidence interval, 1.03-2.31), but not in the other subtypes (large-artery atherosclerosis: odds ratio, 0.99; 95% confidence interval, 0.81-1.21; cardioembolic: odds ratio, 1.14; 95% confidence interval, 0.75-1.73; other: odds ratio, 0.88; 95% confidence interval, 0.71-1.09). Our results showed that HTN is specifically related to the recurrent strokes in patients with small-vessel diseases, not other subtypes of IS.


Gastroesophageal Variceal Bleeding Successfully Controlled by Partial Splenic Embolization.
A 53-year-old male patient with a history of hepatocellular carcinoma developed gastroesophageal varices refractory to endoscopic injection sclerotherapy (EIS). He required EIS six times in 2 years for recurring variceal bleeding. After hepatic resection, he developed massive splenomegaly. Partial splenic embolization (PSE) was performed to reduce the portal pressure. Varices and variceal bleeding were not detected during 13-year follow up, until the patient died of hepatocellular carcinoma. This is a unique case of gastroesophageal varices controlled by PSE and improved portal hypertension.


Large Energy Barrier and Magnetization Hysteresis at 5 K for a Symmetric {Dy2} Complex with Spherical Tricapped Trigonal Prismatic DyIII Ions.
The introduction of the Schiff base ligand N-salicylidene-2-amino-5-chlorobenzoic acid (sacbH2) in 4f-metal chemistry has afforded a new dinuclear complex, [Dy2(NO3)4(sacbH)2(H2O)2(MeCN)2] (1), with the metal ions adopting a rare spherical tricapped trigonal prismatic coordination geometry. The deprotonated phenoxido O atoms of the organic chelate occupy the axial triangular faces of the prism and were found to be very close to the main anisotropy axes of the two DyIII ions. As a result, the {DyIII2} compound exhibits frequency- and temperature-dependent out-of-phase ac signals below ∼25 K in the absence of a static dc field, yielding an energy barrier of 109.3(1) K for the reversal of magnetization. Fast and efficient quantum tunneling of magnetization, attributed to the strong tails of signals below ∼15 K, was suppressed through the application of a small dc field, yielding entirely visible χM″ signals below 27 K. Single-crystal magnetic hysteresis studies confirmed the single-molecule magnet (SMM) behavior of 1; the hysteresis loops appear at temperatures below ∼5 K, which is one of the highest blocking temperatures in the field of 4f-SMMs to date. This joint magneto-structural and ab initio study demonstrates the ability of more common coordination numbers (i.e., 9), but with rare coordination geometries (i.e., spherical tricapped trigonal prismatic), to promote axiality that enhances the molecular anisotropy and subsequently the magnetization dynamics of the system.


The YCR079w gene confers a rapamycin-resistant function and encodes the sixth type 2C protein phosphatase in Saccharomyces cerevisiae.
Type 2C protein phosphatase (PP2C) is a monomeric enzyme and requires Mg(2+) or Mn(2+) for its activity. Up to now, seven PP2C-like genes have been identified in the genome of Saccharomyces cerevisiae. However, the protein encoded by the sixth PP2C-like gene, YCR079w, has not been demonstrated to have PP2C activity. In this study, we show that YCR079w confers a rapamycin-resistant function in yeast cells, and we also demonstrate that the YCR079w-encoded protein exhibits characteristics of a typical PP2C. Therefore, YCR079w encodes the sixth PP2C, PTC6, in budding yeast.


Tumor necrosis factor-related apoptosis inducing ligand overexpression and Taxol treatment suppresses the growth of cervical cancer cells in vitro and in vivo.
Tumor necrosis factor-related apoptosis inducing ligand (TRAIL) is a member of tumor necrosis factor (TNF) superfamily and functions to promote apoptosis by binding to cell surface death receptor (DR)4 and DR5. Cancer cells are more sensitive than normal cells to TRAIL-induced apoptosis, and TRAIL-based therapeutic strategies have shown promise for the treatment of cancer. The present study investigated whether enforced overexpression of TRAIL in cervical cancer cells promoted cell death in the presence or absence of Taxol, an important first-line cancer chemotherapeutic drug. Hela human cervical cancer cells were transfected with a TRAIL expression plasmid, and the effects of the combination treatment with Taxol on apoptosis was investigated in vitro and in tumor xenografts in vivo. The results indicated that Taxol treatment and TRAIL overexpression enhanced apoptosis compared with either treatment alone. The present data indicate that Taxol may enhance the pro-apoptotic effects of TRAIL overexpression in HeLa cells by increasing cleaved caspase-3 and DR5 expression levels and decreasing Bcl-2 expression levels. Furthermore, the findings suggest a possible novel treatment option for cervical cancer and uncovers a potential mechanism of the enhancing effects of Taxol on TRAIL-induced apoptosis.


A multicentre pilot study of sulphasalazine in juvenile chronic arthritis.
In this multicentre pilot study of sulphasalazine in juvenile chronic arthritis, the mode of onset and course of the disease, and when available, the HLA status, was recorded on the entry form. After appropriate clinical and laboratory appraisal, sulphasalazine up to 40 mg/kg/day was given for one year with assessments at 0, 1, 3, 6, 9 and 12 months. Fifty-one patients enrolled, 8 of whom were withdrawn because of side effects. In the remainder by 12 months a good effect was noted in 12, 8 having pauci-articular onset disease commencing after the age of 9 years, of whom 6 carried HLA B27. It was relatively ineffective in the other subgroups. The frequency and severity of side effects was similar to that seen in adults. Further evaluation in controlled trials is required in older onset pauci-articular arthritis, taking due note of the patient's HLA status, and also in juvenile psoriatic arthritis and seropositive juvenile rheumatoid arthritis.


Imaging and quantifying skeletal involvement in Gaucher disease.
Radiological imaging is used in patients with Gaucher disease to estimate the disease burden, to evaluate the presence of specific skeletal complications and to track response to therapy. MRI is currently the best technique for assessing bone marrow involvement in Gaucher disease. Gaucher cell infiltrated bone marrow is characterized by an abnormal low signal intensity on conventional T1- and T2-weighted spin echo sequences, owing to a reduction in fat marrow, which gives a high signal intensity. Enzyme replacement therapy results in a degradation of Gaucher cell deposits with a reconversion of marrow fat and consequently an increased signal on T(1)-weighted images. Conventional MRI also detects other skeletal complications in Gaucher disease, including oedema resulting from acute bone infarction, infection and trauma, avascular necrosis, pathological fractures and vertebral compression. The main drawback of conventional MRI is that it is not quantitative. Quantitative chemical shift imaging is the most sensitive quantitative method for evaluating bone marrow but is not widely available. Alternative MRI-based methods include calculation of the T1 relaxation constant and proton spectroscopy. Scoring of imaging changes detected on conventional MRI may be useful in estimating disease burden and risk of complications. Dual-energy X-ray absorptiometry (DXA) is sensitive to generalized osteopenia and changes in bone mineral density with extended enzyme replacement therapy. However, DXA is insensitive to local changes and cannot yet be used to predict fracture risk in these patients. Until the ideal quantitative technique is developed, conventional MRI will remain the best diagnostic modality for assessing skeletal complications in Gaucher disease and monitoring response to enzyme replacement therapy.


Response to Growth Hormone Treatment in a Patient with Insulin-Like Growth Factor 1 Receptor Deletion.
We report a six-year-old boy who presented with short stature, microcephaly, dysmorphic features, and developmental delay and who was identified with a terminal deletion of 15q26.2q26.3 containing the insulin-like growth factor receptor (IGF1R) gene in addition to a terminal duplication of the 4q35.1q35.2 region. We compare our case with other reports of deletions and mutations affecting the IGF1R gene associated with pre-and postnatal growth restriction. We report the dramatic response to growth hormone therapy in this patient which highlights the importance of identifying patients with IGF1R deletion and treating them early.


Systematic mapping of DNAzymes research from 1995 to 2019.
DNAzymes (catalytic DNA) have gained significant diagnostic and therapeutic applications with increasing research output over the years. Functional oligonucleotides are used as molecular recognition elements within biosensors for detection of analytes and viral infections such as SARS-CoV-2. DNAzymes are also applied for silencing and regulating cancer specific genes. However, there has not been any report on systematic analysis to track research status, reveal hotspots, and map knowledge in this field. Therefore, in the present study, research articles on DNAzymes from 1995 to 2019 were extracted from Web of Science (SCI-Expanded) after which, 1037 articles were imported into Rstudio (version 3.6.2) and analysed accordingly. The highest number of articles was published in 2019 (n = 138), while the least was in 1995 (n = 1). The articles were published across 216 journals by 2344 authors with 2337 multi-author and 7 single authors. The most prolific authors were Li Y (n = 47), Liu J (n = 46), Wang L (n = 33), Willner I (n = 33) and Zhang L (n = 33). The top three most productive countries were China (n = 2018), USA (n = 447) and Canada (n = 251). The most productive institutions were Hunan University, China (n = 141), University of Illinois, USA (n = 139) and Fuzhou University, China (n = 101). Despite the increasing interest in this field, international collaborations between institutions were very low which requires immediate attention to mitigate challenges such as limited funding, access to facilities, and existing knowledge gap.


Village-Integrated Eye Worker trial (VIEW): rationale and design of a cluster-randomised trial to prevent corneal ulcers in resource-limited settings.
Corneal opacity is a leading cause of blindness worldwide. In resource-limited settings, untreated traumatic corneal abrasions may result in infection and ultimately, opacity. Although antimicrobial treatment of corneal ulcers may successfully cure infections, the scarring that accompanies the resolution of infection can still result in visual impairment. Prevention may be the optimal approach for reducing corneal blindness. Studies have employed community health workers to provide prompt administration of antimicrobials after corneal abrasions to prevent infections, but these studies were not designed to determine the effectiveness of such a programme. The Village-Integrated Eye Worker trial (VIEW) is a cluster-randomised trial designed to assess the effectiveness of a community health worker intervention to prevent corneal ulcers. Twenty-four Village Development Committees (VDCs) in Nepal were randomised to receive a corneal ulcer prevention programme or to no intervention. Female Community Health Volunteers (FCHVs) in intervention VDCs are trained to diagnose corneal abrasions, provide antimicrobials and to refer participants when needed. An annual census is conducted over 3 years in all study VDCs to assess the incidence of corneal ulceration via corneal photography (primary outcome). Masked outcome assessors grade corneal photographs to determine the presence or absence of incident corneal opacities. The primary analysis is negative binomial regression to compare the incidence of corneal ulceration by study arm. The University of California San Francisco Committee on Human Research, Nepal Netra Jyoti Sangh and the Nepal Health Research Council have given ethical approval for the trial. The results of this trial will be presented at local and international meetings and submitted to peer-reviewed journals for publication. NCT01969786; Pre-results.


VEGF in nuclear medicine: Clinical application in cancer and future perspectives (Review).
Clinical trials using antiangiogenic drugs revealed their potential against cancer. Unfortunately, a large percentage of patients does not yet benefit from this therapeutic approach highlighting the need of diagnostic tools to non-invasively evaluate and monitor response to therapy. It would also allow to predict which kind of patient will likely benefit of antiangiogenic therapy. Reasons for treatment failure might be due to a low expression of the drug targets or prevalence of other pathways. Molecular imaging has been therefore explored as a diagnostic technique of choice. Since the vascular endothelial growth factor (VEGF/VEGFR) pathway is the main responsible of tumor angiogenesis, several new drugs targeting either the soluble ligand or its receptor to inhibit signaling leading to tumor regression could be involved. Up today, it is difficult to determine VEGF or VEGFR local levels and their non-invasive measurement in tumors might give insight into the available target for VEGF/VEGFR-dependent antiangiogenic therapies, allowing therapy decision making and monitoring of response.


Quality Improvement in Diabetes Care: A Review of Initiatives and Outcomes in the T1D Exchange Quality Improvement Collaborative.
Despite immense strides in therapeutic advances, clinical outcomes continue to be less than ideal for people with type 1 diabetes. This discrepancy has prompted an outpouring of quality improvement (QI) initiatives to address the medical, psychosocial, and health equity challenges that complicate ideal type 1 diabetes care and outcomes. This article reviews a framework for QI in diabetes care that guided the development of the T1D Exchange Quality Improvement Collaborative to improve care delivery and health outcomes in type 1 diabetes. Evaluation of the methodology, outcomes, and knowledge gained from these initiatives will highlight the importance of continued QI initiatives in diabetes care.


[Chronic fatigue syndrome].
Chronic fatigue syndrome is a controversial disease entity. Opinions range from non-disease via psychiatric disorder to a somatic disturbance. Somatic pathogenetic hypotheses include persisting infections, intoxications, metabolic or immunologic disturbances, nervous system diseases and endocrine pathology. None of these hypotheses has been substantiated as yet. Psychological factors are important in the course of the disorder and can be used in the therapeutic approach of patients with chronic fatigue syndrome.


Cell Invasion Dynamics into a Three Dimensional Extracellular Matrix Fibre Network.
The dynamics of filopodia interacting with the surrounding extracellular matrix (ECM) play a key role in various cell-ECM interactions, but their mechanisms of interaction with the ECM in 3D environment remain poorly understood. Based on first principles, here we construct an individual-based, force-based computational model integrating four modules of 1) filopodia penetration dynamics; 2) intracellular mechanics of cellular and nuclear membranes, contractile actin stress fibers, and focal adhesion dynamics; 3) structural mechanics of ECM fiber networks; and 4) reaction-diffusion mass transfers of seven biochemical concentrations in related with chemotaxis, proteolysis, haptotaxis, and degradation in ECM to predict dynamic behaviors of filopodia that penetrate into a 3D ECM fiber network. The tip of each filopodium crawls along ECM fibers, tugs the surrounding fibers, and contracts or retracts depending on the strength of the binding and the ECM stiffness and pore size. This filopodium-ECM interaction is modeled as a stochastic process based on binding kinetics between integrins along the filopodial shaft and the ligands on the surrounding ECM fibers. This filopodia stochastic model is integrated into migratory dynamics of a whole cell in order to predict the cell invasion into 3D ECM in response to chemotaxis, haptotaxis, and durotaxis cues. Predicted average filopodia speed and that of the cell membrane advance agreed with experiments of 3D HUVEC migration at r(2) > 0.95 for diverse ECMs with different pore sizes and stiffness.


Effect of neuromuscular blocking drugs on arterial pressure and heart rate in rats.
The effects of neuromuscular blocking drugs on mean arterial pressure (MAP) and heart rate (HR) were studied in rats which were anaesthetised, tracheotomized and ventilated artificially. The arterial pressure was recorded from the carotid artery. Seven neuromuscular blocking drugs were injected intravenously at doses of 1, 5, and 25 mumol/kg. d-Tubocurarine, alcuronium and vecuronium lowered MAP in a dose dependent manner (maximum 40%). Succinylcholine, 1 mumol/kg, reduced MAP and HR, whereas the two larger doses increased them. Gallamine, 25 mumol/kg, or metocurine and pancuronium, 1 or 5 mumol/kg, each, induced short-lasting rises in MAP. Pancuronium, 25 mumol/kg, decreased MAP by 25%, while the largest dose of metocurine appeared to be toxic. The cardiovascular responses to neuromuscular blocking drugs were antagonized or abolished by pretreatment with the ganglionic blocking agent pentolinium. Pentolinium itself markedly reduced MAP and HR. After ganglionic blockade and restoration of MAP by noradrenaline infusion, all the neuromuscular blocking drugs induced short-lasting increases in MAP (10-30%), except d-tubocurarine which still reduced MAP by 30%, a fall which, in contrast to the effect in the absence of the pretreatments, was transient. This response to d-tubocurarine could not be abolished by a combined pretreatment with H1 and H2 antagonists showing that the hypotensive effect of this drug was not due to the liberation of histamine. These results suggest that the cardiovascular responses to neuromuscular blocking drugs in rats might be partly due to ganglionic effects. Other mechanisms are also involved since after the restoration of blood pressure by noradrenaline during the ganglionic blockade some cardiovascular responses to these drugs still occurred.


Topical Formulation Comprising Fatty Acid Extract from Cod Liver Oil: Development, Evaluation and Stability Studies.
The purpose of this study was to develop a pharmaceutical formulation containing fatty acid extract rich in free omega-3 fatty acids such as eicosapentaenoic acid and docosahexaenoic acid for topical use. Although the health benefits of cod liver oil and other fish oils taken orally as a dietary supplement have been acknowledged and exploited, it is clear that their use can be extended further to cover their antibacterial properties. In vitro evaluation showed that 20% (v/v) fatty acid extract exhibits good activity against strains of the Gram-positive bacteria Staphylococcus aureus, Enterococcus faecalis, Streptoccoccus pyogenes and Streptoccoccus pneumonia. Therefore, free polyunsaturated fatty acids from cod liver oil or other fish oils can be used as safe and natural antibacterial agents. In this study, ointment compositions containing free fatty acids as active antibacterial agents were prepared by using various natural waxes and characterized. The effects of different waxes, such as carnauba wax, ozokerite wax, laurel wax, beeswax, rice bran wax, candelilla wax and microcrystalline wax, in the concentration range of 1% to 5% (w/w) on the ointment texture, consistency and stability were evaluated. The results showed significant variations in texture, sensory and rheological profiles. This was attributed to the wax's nature and chain composition. Microcrystalline wax gave the best results but laurel wax, beeswax and rice bran wax exhibited excellent texturing, similar sensory profiles and well-balanced rheological properties.


Diagnostic accuracy and use of aspiration biopsy in the management of thyroid nodules.
The diagnostic accuracy of fine-needle aspiration biopsy of thyroid nodules was assessed in 111 patients who underwent thyroidectomy and in three persons whose thyroid glands were examined at autopsy. The basis for not performing surgery in 107 patients studied during the same period is also discussed. Carcinoma (excluding incidental occult carcinoma) was found in 76% of the nodules with malignant cytologic findings (class 5, 10/10; and class 4, 3/7), 20% (3/15) of the nodules with suspicious cytologic findings (class 3), and 9% (8/87) of the nodules with benign cytologic findings (classes 1 and 2). The major reasons for avoiding surgery included resolution of the nodule after aspirating a cyst (eight cases) or after hemorrhage (two cases), multinodular goiter (13 cases), functioning nodule (ten cases), lymphocytic thyroiditis (nine cases), high operative risk without suspicious cytologic findings (15 cases), and response to suppression therapy (27 cases). Among 186 patients given thyroxine suppression therapy, 10% of the nodules disappeared and 12% decreased to less than 1 cm in diameter or more than 50% in volume. Aspiration biopsy is useful to select patients for early surgery or for long-term medical management. Its lack of precision, however, requires that it be employed as an adjunct to other clinical considerations.


The impact of social capital and social support on the health of female-headed households: a systematic review.
Social capital and social support as determinants of health play an important role in the health of female heads of households. Considering the increasing number of female-headed families in Iran and the world, this study was conducted to systematically review the impact of social capital and social support on the health of female heads of households. This study was conducted as a systematic review in September 2016. Its data were collected from available papers in different databases including Iranmedex, Magiran, Scientific Information Database (SID), Irandoc, Scopus, Science Direct, PubMed and Google Scholar. Using advanced search, all published papers from 2000 to 2015 with full text were selected using related keywords. After reviewing by browsers and adapting to the inclusion and exclusion criteria, 15 papers were entered into the study. The Strengthening the Reporting of Observational Studies in epidemiology (STROBE) checklist was used to evaluate the quality of papers. Based on the findings of these studies, there was a significant relationship between social capital and its components (trust, sense of belonging and social participation) as well as all aspects of health. Additionally, social support and its dimensions (emotional, instrumental and informational) affected health; however, among these dimensions, instrumental support of a stronger predictor was concerned with health, especially mental health. Social factors such as social capital and social support are effective on human health, particularly health of female-headed households, since they affect proactive identity and increase information resources, collaboration as well as collective decisions and actions. Furthermore, they provide emotional and instrumental support to group members and prevent further health problems.


The chloroplast genome of the gymnosperm Pinus contorta: a physical map and a complete collection of overlapping clones.
Overlapping restriction fragments of chloroplast DNA from the conifer Pinus contorta were cloned. Out of a total of 49 clones, 33 comprise the minimum set required to represent the entire genome. Using the purified inserts of these clones as probes in filter hybridizations, all sites for the three restriction enzymes KpnI, HpaI and SacI in the P. contorta chloroplast genome were mapped. Heterologous filter hybridizations and sequence analysis of some of the P. contorta clones were used to determine the position of 15 genes on the restriction map. The size of the genome, which lacks an inverted repeat organization, was found to be approximately 121 kilobase pairs (kbp). Unusual features of this genome are a duplication of the psbA gene and the presence of two genes, gidA and frxC, which are not found in angiosperms. The genome appeared essentially colinear with that of Pinus radiata, for which a map has previously been published. Two different restriction fragment length polymorphisms were found to be produced by variable numbers of copies of 124 bp- and 150 bp-long, tandemly repeated elements.


Chemical determination of polypeptide hormones.
The presence or absence of peptide hormones in tissue extracts may in certain cases be demonstrated by exposing the extracts to conditions under which characteristic fragments of the polypeptide molecule in question are formed and then analyzing for such fragments. An approximate quantitation of the hormones may also be achieved thereby. In the present work the COOH-terminal fragments of polypeptides containing characteristic alpha-amide groups were released enzymatically and then converted into the fluorescent dansyl derivatives, which were identified by thin-layer chromatography. In this way the presence of secretin, cholecystokinin, and the vasoactive intestinal peptide in concentrates of porcine intestinal extracts were demonstrated by their COOH-terminal amide fragments: valine (or leucylvaline) amide, phenylalanine amide, and asparagine (or leucylasparagine) amide, respectively. The analytical methodology used in the present study may also be useful in devising simple and reliable chemical assay methods for the isolation of already known polypeptides and in the isolation of previously uncharacterized polypeptides from natural sources.


Microsurgical Strategies for Prophylaxis of Cancer-Related Extremity Lymphedema: A Comprehensive Review of the Literature.
Cancer-related lymphedema represents the first cause of noninfectious secondary extremity lymphedema. This entity is a progressive and debilitating disease with no curative treatment available. With the advent of lymphedema microsurgery, focus has turned into risk reduction and prevention of the disease progression. Literature review was conducted to clarify current microsurgical approach to prophylaxis of cancer treatment-related extremity lymphedema. Prophylactic approach could be classified into primary and secondary prevention; microsurgical procedures were performed simultaneously with cancer ablation in primary prevention, and secondary prevention was performed secondarily after cancer treatment for selected high-risk subclinical cases. Indocyanine green lymphography was the most useful method for lymphedema screening after cancer treatment and to diagnose subclinical lymphedema. Several lymphovenous shunt operations were performed as prophylactic procedures, and classified into microsurgical lymphovenous implantation and supermicrosurgical lymphovenous intima-to-intima coaptation. Both showed clinically significant prophylactic effects. This review provides a comprehensive overview of the literature regarding microsurgical interventions for the prevention of cancer-related extremity lymphedema. There are several methods for lymphedema prophylaxis and further studies are required to clarify indication of each method.


Surge Capacity Crisis and Mitigation Plan in Trauma Setting Based on Real-Time National Trauma Registry Data.
The objective of this study was to assess the current breaking point of crisis surge capacity of trauma services in Qatar and to develop a mitigation plan. The study utilized real-time data from the National Trauma Registry. Data was explored cumulatively by weeks, months and a year's interval and all trauma admissions within this time frame were considered as 1 'Disaster Incident.' A total of 2479 trauma patients were included in the study over 1 year. The mean age of patients was 31.5 ± 15.9 and 84% were males. The number of patients who sustained severe trauma which necessitated Level 1 activation was 16%. The emergency medical services (EMS) surge attained crisis of operational capacity at 5 months of disaster incident for priority 1 cases. Bed capacity at the floor was the first to reach operational crisis followed by the ICU and operating room. The gap in the surge for surgical interventions was specific to the specialty and surgery type which reached operational crisis at 3 months. The study highlights the surge capacity and capability of the healthcare system at a Level 1 trauma center. The identified gaps in surge capacity require several key components of healthcare resources to be addressed across the continuum of care.


Astragaloside IV reduces cardiomyocyte apoptosis in a murine model of coxsackievirus B3-induced viral myocarditis.
Apoptosis plays a crucial role in regulating cardiomyopathy and injuries of coxsackievirus B3 (CVB3)-induced viral myocarditis (VM). It has been reported that Astragaloside IV (AST-IV) from Astragalus membranaceus could inhibit apoptosis under a variety of pathological conditions in vivo or in vitro. However, the functional roles of AST-IV in CVB3-induced VM still remain unknown. Here, we found that AST-IV significantly enhanced survival for CVB3-induced mice. AST-IV protected the mice against CVB3-induced virus myocarditis characterized by the increased body weight, decreased serum level of creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH), supressed expression of Ifn-γ, Il-6 in heart, enhanced systolic and diastolic function of left ventricle. At the pathological level, AST-IV ameliorated the mice against CVB3-induced myocardial damage and myocardial fibrosis. In vitro, the results from flow cytometry showed that AST-IV significantly suppressed CVB3-induced cardiomyocytes apoptosis, which also were verified in vivo. Moreover, an increased expression of pro-apoptotic genes including FAS, FASL, cleaved caspase-8 and cleaved caspase-3 was found in CVB3-induced cardiomyocytes, while those was inhibited in cardiomyocytes treated with AST-IV. Taken together, the data suggest that AST-IV protected against CVB3-induced myocardial damage and fibrosis, which may partly attribute to supress activation of FAS/FASL signaling pathway.


A Retrospective Analysis of Post-Stroke Berg Balance Scale Scores: How Should Normal and At-Risk Scores Be Interpreted?
Purpose: The Berg Balance Scale (BBS) is a performance-based measure of standing balance commonly used by clinicians working with individuals post-stroke. Performance on the BBS can be influenced by compensatory strategies, but measures derived from two force plates can isolate compensatory strategies and thus better indicate balance impairment. This study examined BBS scores that reflect "normal" and disordered balance with respect to dual force-plate measures of standing balance in individuals post-stroke. Methods: BBS and force-plate measures were extracted from 75 patient charts. Individuals were classified by BBS score with respect to (1) age-matched normative values and (2) values that suggested increased risk of falls. Multiple analysis of variance was used to examine the effect of group assignment on force-plate measures of standing balance. Results: Individuals with BBS scores within and below normative values did not differ in force-plate measures. Individuals with BBS scores below the falls risk cutoff loaded their affected leg less than individuals with BBS scores above the cutoff. There were no other differences in force-plate measures between these two groups. Conclusions: BBS scores indicating either normal or disordered balance function are not necessarily associated with normal or disordered quiet standing-balance control measured by two force plates. This finding suggests that the BBS may reflect a capacity for compensation rather than any underlying impairments.


[Treatment of primary bone sarcoma of the jaws].
Head and neck bone sarcomas are very uncommon tumors. Therefore, treatment modalities are not clearly established. The medical record of 12 patients with bone sarcoma of the jaw were reviewed. Six patients with osteosarcoma underwent primary chemotherapy followed by wide surgical resection, radiation therapy or combined radiosurgical treatment. The 2 and 5 years survivals were 66% and 40% respectively. Five patients with chondrosarcoma were treated by wide surgical resection alone or combined with postoperative radiotherapy and possibly chemotherapy. All patients were alive; the mean follow-up was 9 years. One patient had Ewing's tumor. Osteosarcoma and chondrosarcoma in head and neck patients have a high rate of local recurrences. Surgery is the mainstay of treatment. Patients with voluminous tumors and high-grade lesions should receive postoperative radiotherapy. The role of chemotherapy has not been defined.


Efficient Negative Photochromism by the Photoinduced Migration of Photochromic Merocyanine/Spiropyran in the Solid State.
Efficient negative photochromism was achieved by the photoinduced migration of merocyanine in mesoporous silica to an organophilic clay as spiropyran. Depending on the nature of the organophilic clays (dioctadecyldimethylammonium and dioleyldimethylammonium clays), important differences in the negative photochromisms and the thermal coloration were observed; the dioleyldimethylammonium clay gave a higher yield (98%) and faster reaction (half-life t1/2 = 2.8 h) than the dioctadecyldimethylammonium clay (94% and t1/2 = 3.2 h) of the negative photochromism, indicating the important role of the surfactant assembly to control the molecular diffusion.


Citizenship, length of stay, and screening for breast, cervical, and colorectal cancer in women, 2000-2010.
Two factors jointly account for significant gaps in access to health care among immigrants who are present in the U.S.-legal status, and length of residence. The objective of this study is to examine the association between citizenship and length of residence in the U.S. and cancer screening (breast, cervical, and colorectal) among women. We analyzed 11 years (2000-2010) of consolidated data from the Medical Expenditure Panel Survey linked with the National Health Interview Survey. Multivariate analyses compared cancer screening among U.S.-born citizens (n = 58,484), immigrant citizens (n = 8,404), and immigrant non-citizens (n = 6,564). Immigrant non-citizens living in the U.S. for less than 5 years were less likely to receive guideline-concordant breast (OR = 0.68 [0.53-0.88]), cervical (OR = 0.65 [0.54-0.78]), and colorectal (OR = 0.31 [0.19-0.50]) cancer screening compared to U.S.-born citizens. Immigrant citizens and non-citizens living in the U.S. for 5 years or more had higher odds of being screened for breast and cervical cancer compared to U.S.-born citizens; (OR = 1.26 [1.13-1.41] and OR = 1.17 [1.06-1.29]) for immigrant citizens, (OR = 1.28 [1.13-1.45] and OR = 1.23 [1.09-1.38]) for non-citizens. Immigrant non-citizens living in the U.S. for 5 years or more had lower odds of being screened for colorectal cancer compared to U.S.-born citizens (OR = 0.76 [0.65-0.90]). Based on these findings, duration mandates in immigration policy may indirectly influence future pathways to preventive health care and cancer disparities disproportionately affecting immigrant women. We suggest that limits of duration mandates be reevaluated, as they may offer pathways to preventive health care for this vulnerable population, and prevent future cancer disparities.


Neuronal cytomechanics: the actin-based motility of growth cones.
The patterns of synaptic connection that underlie brain function depend on the elaborate forms characteristic of neurons. It is therefore a central goal of neuroscience to understand the molecular basis for neuronal shape. Neuronal pathfinding during development is one major determinant of neuronal shape: growing nerve axons and dendrites must navigate, branch, and locate targets in response to extracellular cue molecules within the embryo. The leading tips of growing nerve processes, structures known as growth cones, contain especially high concentrations of the ubiquitous mechanochemical protein actin. Force generation involving this cytoskeletal molecule appears to be essential to the ability of growing nerve fibers to respond structurally to extracellular cues. New results from electronically enhanced light microscopy of living growth cones are helping to show how actin-based forces guide neurite growth and synapse formation.


In-stent restenosis after revascularization of myocardium with drug-eluting stents is accompanied by elevated level of blood plasma eosinophil cationic protein.
The aim of this study was to assess the involvement of eosinophil cationic protein, a marker of eosinophil activation, in the development of in-stent restenosis after drug-eluting stent implantation. Follow-up angiography at 6 to 12 months was performed in 32 patients who were treated with percutaneous coronary intervention and implantation of sirolimus-eluting stents. Blood plasma levels of eosinophil cationic protein (ECP) and total immunoglobulin E (IgE) were measured by enzyme-linked immunosorbent assay and the level of C-reactive protein (hs-CRP) by high-sensitivity nephelometry. According to angiography data, in-stent restenosis occurred in 13 patients, while 19 patients did not develop it. There were no differences between the hs-CRP and IgE levels in patients with or without restenosis. In contrast, ECP level was higher in patients with restenosis compared with that in patients without restenosis [17.7 ng/mL (11.2-24.0) vs. 9.0 ng/mL (6.4-12.9), p = 0.017]. The incidence of in-stent restenoses was 63% in patients with ECP level higher than or equal to 11 ng/mL, and 19% in patients with an ECP level lower than 11 ng/mL (p = 0.019). These findings suggest that elevated eosinophil activation may play an important role in the pathogenesis of in-stent restenosis after implantation of drug-eluting stents.