Decidual spiral artery remodeling during early post-implantation period in mice: investigation of associations with decidual uNK cells and invasive trophoblast.
Circumferential remodeling of spiral arteries (SAs) during pregnancy is crucial for regulating maternal blood flow into the placenta and clinically important. However its mechanism is still ill defined in humans and mice. In mice, several important aspects of decidual SA remodeling (SAR) remain unexplored and were addressed here using morphometrics by examining SAs within the mesometrial half of the decidua basalis between embryonic day 6.5 (E6.5) and midgestation (E10.5). The data presented here provide evidence that supports the following novel conclusions about SAR: (a) SAs (defined by their muscular walls) appear between E6.5 and E7.5, undergo 'outward hypertrophic' SAR (SA lumen widening with muscular wall thickening) during the E7.5-E8.5 and E9.5-E10.5 periods, and 'outward hypotrophic' SAR (SA lumen widening with muscular wall thinning) during the E8.5-E9.5 interval. (b) 'Outward hypotrophic' SAR is associated with decreases in the overall number, but not density, of SA media nuclei, suggesting loss of SA muscular wall cells. Proximity of placenta-derived invasive trophoblast to SAs appears not be involved in SAR, as these cells were undetectable in the mesometrial region of decidua basalis throughout the E6.5-E10.5 period. Although the maternally derived lymphocytes of the decidual uterine natural killer (uNK) cell type are required for decidual SAR, the timing of this, the uNK cell parameter involved and the type of SAR they influence have not been adequately explored. Evidence is presented here that not all decidual SAR during this period is uNK cell-dependent. Rather, the data suggest that uNKs only influence 'outward hypotrophic' SAR during the E8.5-E9.5 period. Evidence is presented that the uNK cell parameter involved is the attainment of a certain maturation state (based on uNK cell size) by SA wall uNKs of the Dolichos biflorus agglutinin (DBA) lectin-positive uNK cell subset. This work also suggests that the previously shown loss of contractile mural cell character from the SA wall does not depend on either uNKs or trophoblast proximity. The novel implications of the present data for early mouse pregnancy are discussed.


Cats and dogs: Best friends or deadly enemies? What the owners of cats and dogs living in the same household think about their relationship with people and other pets.
Although popular culture describes them as mortal enemies, more and more often, dogs and cats live under the same roof. Does this make them best friends? Can sharing the same social and physical environment make them similar? This study compares the approaches of dogs and cats living in the same household have towards humans and other pets as perceived by the owner. Questionnaires collected from 1270 people owning both dog(s) and cat(s) were analysed. Most dogs and cats living together are playful with familiar humans (76.2%) but dogs have a more sociable approach towards strangers and conspecifics than cats (P<0.001). Moreover, the percentage of dogs that have a playful relationship with the owner (84.0%) was higher than cats (49.2%; P<0.001). Dogs and cats living together eat in different places and show different mutual interactions: more dogs lick the cat (42.8%) and more cats ignore the dog (41.8%) than vice versa (P<0.001). However, most dogs and cats sleep at least occasionally (68.5%) and play together (62.4%; P<0.001). Although some body postures, such as the tail's position, are interpreted differently by the two species, the greater proportions of dogs and cats show a relaxed response to several kinds of approaches of their roommate. Our questionnaire confirms the common beliefs about the sociability of the dog and the privacy of the cat, but this does not result in continuous internal struggles. Most cohabitations are peaceful. Moreover, it is true that they speak different languages, but they seem to understand each other well and interpret each other's approaches in the right way. Thus, aspiring owners should not blindly believe popular assumptions, but both knowledge and respect for species-specific pet behaviours are essential to establish a balance in the household.


The influence of care provider access to structural empowerment on individualized care in long-term-care facilities.
Implementing management initiatives that enable formal caregivers to provide quality, individualized care to older adults in long-term-care (LTC) facilities is increasingly important given that the number of LTC residents is projected to triple by 2031. The objective of this study was to explore the relationship between care provider access to structural empowerment and the provision of individualized care in LTC. We computed structural equation models separately for registered nurses and licensed practical nurses (n = 242) and care aides (n = 326) to examine the relationship between access to empowerment structures (i.e., informal power, formal power, information, support, resources, opportunity) and the provision of individualized care. We subsequently undertook invariance analyses to determine if the association between empowerment structures and reported provision of individualized care differed between caregiver groups. Access to structural empowerment had a statistically significant, positive association with provision of individualized care for both groups. For registered nurses/licensed practical nurses and care aides, empowerment explained 50% and 45% of observed variance in individualized care, respectively. These notable percentages did not differ significantly between caregiver groups. Of the empowerment structures, support, especially in the form of access to educational opportunities and recognition for a job well done, seems to be particularly significant to care providers. Findings from this study suggest that provision of individualized care in LTC may be enhanced when formal caregivers have appreciable access to empowerment structures.


hMAGE-A1 overexpression reduces TNF-alpha cytotoxicity in ME-180 cells.
Melanoma antigen (MAGE) belongs to a large family of tumor-associated antigens that are expressed in tumors, but not in normal adult tissues with the exception of a few normal cell types. However, its cellular function has not been characterized. In this study, we screened tumor cell lines for the hMAGE-A1, -A2, and -A3 gene expressions by reverse transcription-polymerase chain reaction, then examined the sensitivity of the cell lines to TNF cytotoxicity. Cell lines, which express at least one of the three hMAGE-A genes, were more resistant to TNF cytotoxicity than cell lines that expressed none of the MAGE genes. By stably expressing hMAGE-A1 mRNA in the ME-180 line of human cervical carcinoma cells, it was possible to isolate clones in which the hMAGE-A1 is constitutively expressed. These clones displayed a diminished sensitivity to the cytotoxicity that was mediated by TNF, indicating that MAGE-A1 is a protective protein.


[Development of bladder capacity, nocturnal urinary volume and urinary behavior in nonenuretic and enuretic children].
Bladder capacity, nocturnal urinary volume and nocturnal urinary behavior were investigated in 1751 nonenuretic and 282 enuretic children in two primary schools and four kindergartens. The results were as follows: 1. A statistically significant linear correlation was observed between the age and the bladder capacity in the morning and daytime, as well as nocturnal urinary output, in nonenuretic children. 2. The bladder capacity of enuretic children was smaller in the ages below 6 but larger in the ages over 7 than that of noneuretic children. It was not likely from this evidence that an immature bladder capacity was a primary cause of enuresis. 3. For the estimation of the maximum bladder capacity in the study of enuresis, urinary output in the morning immediately after awakening with sufficient urinary sensation was thought to be more reasonable than that in the daytime, because output in the morning was approximately 50% more than that of the daytime. 4. Ten to 15% of nonenuretic children showed nocturnal polyuria with nocturnal urination after complete awakening more than one time every week. It was also not likely from this evidence that polyuria was a primary cause of enuresis. 5. The overall occurrence rate of enuresis was 14%, higher in males up to the ages of 9, and almost equal in males and females after the ages of 10. 6. The average age for the spontaneous disappearance of enuresis was 7.3 y.o., therefore, adequate treatments for enuresis should be instituted after the age of 8.


DNA Epigenetics in Addiction Susceptibility.
Addiction is a chronically relapsing neuropsychiatric disease that occurs in some, but not all, individuals who use substances of abuse. Relatively little is known about the mechanisms which contribute to individual differences in susceptibility to addiction. Neural gene expression regulation underlies the pathogenesis of addiction, which is mediated by epigenetic mechanisms, such as DNA modifications. A growing body of work has demonstrated distinct DNA epigenetic signatures in brain reward regions that may be associated with addiction susceptibility. Furthermore, factors that influence addiction susceptibility are also known to have a DNA epigenetic basis. In the present review, we discuss the notion that addiction susceptibility has an underlying DNA epigenetic basis. We focus on major phenotypes of addiction susceptibility and review evidence of cell type-specific, time dependent, and sex biased effects of drug use. We highlight the role of DNA epigenetics in these diverse processes and propose its contribution to addiction susceptibility differences. Given the prevalence and lack of effective treatments for addiction, elucidating the DNA epigenetic mechanism of addiction vulnerability may represent an expeditious approach to relieving the addiction disease burden.


Vaginal birth after cesarean section. Acceptance and outcome at a rural hospital.
A retrospective review of all pregnant women with a history of cesarean section was conducted at an isolated military hospital. During the two-year period 1988-1989, 62 patients were initially considered eligible for attempting vaginal birth after cesarean section (VBAC). Seventy-nine percent (49/62) of the patients initially requested a trial of labor, and 14 of them ultimately did not meet American College of Obstetricians and Gynecologists criteria. Three patients reversed their decision late in pregnancy. Eighty-eight percent (28/32) of those undergoing a trial of labor delivered vaginally. The three patients with more than one prior cesarean section all delivered vaginally. The four failures occurred in patients who had a history of well-documented cephalopelvic disproportion. Perinatal morbidity consisted of intrauterine fetal demise prior to the onset of labor at 40 weeks' gestation. Maternal morbidity included postcesarean endometritis (n = 1) and vaginal sidewall laceration (n = 1). These results indicate that in a rural hospital VBAC was well accepted by patients and was safe; however, further study is required.


Pediatric extracorporeal life support after high frequency ventilation: predictors of survival.
Previous studies of extracorporeal life support in pediatric patients have identified variables associated with survival. However, none of these studies focused on extracorporeal life support after failure of high frequency ventilation (HFV). In the present study, we determined variables associated with survival for pediatric respiratory failure patients who received HFV prior to extracorporeal life support, using data reported to the Extracorporeal Life Support Organization Registry from 1992 to 1998. Patients with neonatal diagnoses, immune compromising conditions, or congenital cardiac defects were excluded. The 243 patients who met inclusion criteria had a 58% survival rate (95% CI 48-66%). The mean age was 22 +/- 39 months. Mean duration of mechanical ventilation prior to extracorporeal life support was 6.6 +/- 5.8 days. Venoarterial extracorporeal life support was used in 72% of the patients; venovenous in 28%. The survival rate for the subset of patients with an oxygenation index greater than 42 cm H2O/torr on HFV (n = 122) was not significantly different from the overall sample. We determined that lower mean airway pressure, lower pressure amplitude, decreased oxygenation index, increased PaO2, and increased oxygen saturation on HFV were associated with increased survival in patients who were subsequently treated with extracorporeal life support.


Behavioral distraction by auditory deviance is mediated by the sound's informational value. Evidence from an auditory discrimination task.
Sounds deviating from an otherwise repetitive background in some task-irrelevant respect (deviant sounds among standard sounds) capture attention in an obligatory fashion and result in behavioral distraction in an ongoing task. Traditionally, such distraction has been considered as the ineluctable consequence of the deviant sound's low probability of occurrence relative to that of the standard. Recent evidence from a cross-modal oddball task challenged this idea by showing that deviant sounds only yield distraction in a visual task when auditory distractors (standards and deviants) announce with certainty the imminent presentation of a target stimulus (event information), regardless of whether they predict the target's temporal onset (temporal information). The present study sought to test for the first time whether this finding may be generalized to a purely auditory oddball task in which distractor and target information form part of the same perceptual stimulus. Participants were asked to judge whether a sound starting from a central location moved left or right while ignoring rare and unpredictable changes in the sound's identity. By manipulating the temporal and probabilistic relationship between sound onset and movement onset, we disentangled the roles of event and temporal information and found that, as in the auditory-visual oddball task, deviance distraction is mediated by the extent to which distractor information harbingers the presentation of the target information (event information). This finding suggests that the provision of event information by auditory distractors is a fundamental prerequisite of behavioral deviance distraction.


Squamosamide Derivative FLZ Protects Pancreatic β-Cells from Glucotoxicity by Stimulating Akt-FOXO1 Pathway.
Chronic hyperglycemia increases apoptosis and reduces glucose-stimulated insulin secretion. Although protective agents have been searched extensively, none has been found so far. Here we tested FLZ, a synthetic derivative of squamosamide from a Chinese herb, as a potential candidate for antiglucotoxicity in INS-1E cells and mouse islets. Chronic culture of β-cells in 30 mM glucose caused progressive reduction of cell viability, accompanied with increased apoptosis and reduced insulin secretion. These effects on apoptosis and insulin were reversed by FLZ in a dose-dependent manner. FLZ treatment also increased forkhead box O1 protein phosphorylation and reduced its nuclear location. On the contrary, FLZ increased pancreatic and duodenal homeobox-1 expression and its nuclear localization, an effect mediated by increased p-Akt. Consistently, Akt selective inhibitor MK-2206 completely abolished antiglucotoxicity effect of FLZ. Furthermore, FLZ treatment increased cytosolic ATP/ADP ratio. Taken together, our results suggest that FLZ could be a potential therapeutic agent to treat the hyperglycemia-induced β-cell failure.


Cattle grazing results in greater floral resources and pollinators than sheep grazing in low-diversity grasslands.
Land-use and land-cover change associated with agriculture is one of the main drivers of biodiversity loss. In heavily modified agricultural landscapes, grazing lands may be the only areas that can provide essential resources for native grassland species. Management decisions, such as choice of livestock species, affect the extent to which grazing lands provide suitable habitat for native species such as pollinators.Our study compared how sheep versus cattle herbivory affected floral resources and butterfly abundance across low-diversity, former Conservation Reserve Program (CRP) pastures managed with patch-burn grazing.Across all years (2017-2019), flowering species richness and abundance were significantly higher in cattle pastures than sheep pastures. On average, we recorded 6.9 flowering species/transect in cattle pastures and 3.8 flowering species/transect in sheep pastures. The average floral abundance per transect was 1278 stems/transect in cattle pastures and 116 stems/transect in pastures grazed by sheep.Similarly, we observed higher butterfly species richness, diversity, and abundance in cattle than in sheep pastures. In cattle pastures, we observed an average of 75 butterflies and 6.75 species per transect, compared with an average of 52 butterflies and 3.37 species per transect in sheep pastures. However, the butterfly community composition did not significantly differ between grazing treatments likely because agricultural-tolerant, habitat generalists comprised the majority of the butterfly community. Five generalist butterflies comprised 92.3% of observations; Colias philodice was the most abundant (61% of observations). Speyeria idalia and Danaus plexippus, two butterflies of conservation concern, comprised less than 0.5% of butterfly observations.Our results, which are among the first attempt quantifying butterfly use of post-CRP fields grazed by livestock, show that increased precipitation and cattle grazing promoted higher forb abundance and richness. However, additional interventions may be needed to enhance floral resources to sustain and improve pollinator diversity in these landscapes.


Orthogonal Amplification Circuits Composed of Acyclic Nucleic Acids Enable RNA Detection.
Construction of complex DNA circuits is difficult due to unintended hybridization and degradation by enzymes under biological conditions. We herein report a hybridization chain reaction (HCR) circuit composed of left-handed acyclic d-threoninol nucleic acid (d-aTNA), which is orthogonal to right-handed DNA and RNA. Because of its high thermal stability, use of an aTNA hairpin with a short 7 base-pair stem ensured clear ON-OFF control of the HCR circuit. The aTNA circuit was stable against nucleases. A circuit based on right-handed acyclic l-threoninol nucleic acid (l-aTNA) was also designed, and high orthogonality between d- and l-aTNA HCRs was confirmed by activation of each aTNA HCR via a corresponding input strand. A dual OR logic gate was successfully established using serinol nucleic acid (SNA), which could initiate both d- and l-aTNA circuits. The d-aTNA HCR was used for an RNA-dependent signal amplification system via the SNA interface. The design resulted in 80% yield of the cascade reaction in 3000 s without a significant leak. This work represents the first example of use of heterochiral HCR circuits for detection of RNA molecules. The method has potential for direct visualization of RNA in vivo and the FISH method.


Can QT interval prolongation or dispersion detected in a positive exercise ECG test predict critical coronary artery disease?
Exercise electrocardiography (EET) is frequently used in coronary artery disease, but the specificity of this test is very low. In the literature, parameters such as QT prolongation and QT dispersion which show coronary artery disease and arrhythmia were not sufficiently investigated using EET. The aim of this study was to investigate whether QT interval prolongation or dispersion (QT disp) in a positive EET test could predict critical coronary artery disease (CAD). Patients with a positive exercise test were included in the study. Data regarding QT, QTc (corrected QT interval) and QT disp values before, during and after EET were noted. Critical coronary artery occlusions (≥ 70%) was recorded from coronary angiographic images. Patients were divided into two groups (critical CAD and non-critical CAD). A total of 192 patients were found to be eligible for the study. There were 126 patients in the non-critical CAD group (group 1) and 66 patients in the critical CAD group (group 2). Recovery QTc, peak QT disp, and recovery QT disp were significantly increased in group 2 (p < 0.001 for each). Also, target heart rate (p = 0.012), basal systolic blood pressure (p = 0.005) and diastolic blood pressure (p < 0.001) were significantly higher in group 1. Recovery QTc (OR = 1.051) and recovery QT disp (OR = 1.117) were determined as the independent predictors for critical CAD. The ROC analysis results indicated that critical CAD could be diagnosed with 90% sensitivity when the recovery QTc cut-off value was set as 404 ms. In patients with positive EET, prolonged QTc and QT disp values measured during the recovery period would predict critical CAD. Thus, the clinical accuracy of EET may be enhanced.


[The real and ideal in the evaluation of functional competence among demented patients].
The progressive nature of the dementia of Alzheimer's disease has significant clinical, functional, legal and nursing implications. Traditionally, the grading of severity of the disease is based on evaluation of the patients' independence and competence. However, the term competence has been used in different respects, leading to obscuration and confusion. Moreover, the evaluation of competence is based on different tests and there is no single accepted method for this purpose. In the absence of such a criterion, there is a need for an objective test to evaluate the functional competence of the patient. This will be based on complex behavioral activities and instrumental activities of daily living in real situations, in the natural environment of the patient. The limits of available methods are discussed with practical suggestions for the development of such a test.


Infections, atherosclerosis, and coronary heart disease.
Atherosclerosis is a chronic inflammatory disease. Pathophysiological similarities between chronic infections and atherosclerosis triggered interest in a clinical association between these conditions. Various infectious microbes have been linked to atherosclerotic vascular disease in epidemiological studies. However, this association failed to satisfy the Koch's postulates of causation with multiple clinical trials demonstrating inefficacy of anti-infective therapies in mitigating atherosclerotic cardiovascular events. Identification of underlying pathophysiological mechanisms and experience with vaccination against various infectious agents has ushered a new avenue of efforts in the development of an anti-atherosclerotic vaccine. Studies in animal models have identified various innate and adaptive immune pathways in atherosclerosis. In this review, we discuss the patho-biological link between chronic infections and atherosclerosis, evaluate existing evidence of animal and human trials on the association between infections and cardiovascular disease and introduce the concept of an anti-atherosclerotic vaccine.


New concepts in ischemic heart disease.
Over the past several years a number of new concepts have greatly increased our knowledge about the pathophysiology and therapy of ischemic heart disease. These concepts include (1) reperfusion following acute myocardial infarction, (2) balloon angioplasty of coronary lesions, (3) secondary prevention of coronary events, (4) the role of coronary tone in producing ischemia, and (5) prevention of atherosclerosis. The use of calcium entry blockers has emphasized the potential importance of spasm or increased tone in the genesis of myocardial ischemia. In standard exercise-induced angina, however, the primary mechanism whereby calcium entry blockers relieve angina appears to be related to a reduction in myocardial oxygen demand rather than to an increase in coronary flow. The calcium entry blockers have also been shown experimentally to retard the development of atherosclerosis in animals fed high-lipid diets. This emphasizes the potential role of calcium in the atherosclerotic process and the potential role of calcium blockers in preventing this sequence.


Stuttered and fluent speakers' heart rate and skin conductance in response to fluent and stuttered speech.
Previous studies have found simultaneous increases in skin conductance response and decreases in heart rate when normally fluent speakers watched and listened to stuttered speech compared with fluent speech, suggesting that stuttering induces arousal and emotional unpleasantness in listeners. However, physiological responses of persons who stutter observing stuttering and fluent speech has not been measured. Research suggests that the mechanism responsible for listeners' reactions is the mirror neuron system. The mirror neuron system activates when perceiving and producing goal-directed actions and forms the link between action perception and action production. To compare physiological responses elicited via fluent and stuttered speech in fluent and persons who stutter groups. Participants included 15 adult persons who stutter (mean age = 29.7 years) and 21 normally fluent controls (mean age = 23.7 years). Participants watched and listened to six speech samples read by three persons who stutter speakers and three fluent speakers, while their skin conductance response and heart rate were recorded simultaneously. Participants' responses to each speech sample were defined as changes in mean heart rate and mean skin conductance response between 15 s before and 15 s during stimuli presentation. Both groups showed similar patterns of response: skin conductance response was significantly increased and heart rate was significantly decreased in response to stuttered versus fluent speech. Similar to previous findings, the highest skin conductance response measures were induced by the first presentation of stuttered speech, with the response attenuating on subsequent presentations, while the heart rate was stable over time. Results confirmed past research that showed arousal and emotional unpleasantness when observing stuttering. Clinically, these results acknowledge the arousal and emotional discomfort in fluent speakers and persons who stutter. The physiological responses to stuttering and the underlying emotional aspects should be discussed in the therapeutic milieu with notions about coping strategies.


Identification and cloning of the glnR locus, which is required for transcription of the glnA gene in Streptomyces coelicolor A3(2).
Six Streptomyces coelicolor mutants that required glutamine for growth at the wild-type rate on all nitrogen sources (Gln-) were isolated. The phenotypes of all six mutants were similar. The glutamine synthetase (GS) levels were 20- to 100-fold lower in extracts of the Gln- mutants than in extracts of their parents. The reduced levels of GS activity in the Gln- mutants were not due to adenylylation of the GS protein, because GS activity in Gln- extracts did not increase after snake venom phosphodiesterase treatment. No transcripts of the GS structural gene (glnA) could be detected in RNA isolated from the Gln- mutants in primer extension experiments. All six gln mutations mapped adjacent to adeA. S. coelicolor chromosomal DNA complementing the Gln- mutants was isolated from a library of S. coelicolor chromosomal DNA constructed in the low-copy-number S. coelicolor plasmid pIJ922. Subcloning experiments showed that a 1.45-kb DNA fragment could complement all six Gln- mutants. This DNA fragment did not hybridize with either the cloned S. coelicolor glnA gene or the cloned S. viridochromogenes GSII gene in Southern blots. Since glnA transcription was restored in the Gln- mutants containing the complementing DNA, the gln mutations appear to lie in one or more closely linked genes that are required for glnA transcription in S. coelicolor.


The clinical effectiveness and safety of traditional Chinese medicine Jinfeng pill in adjuvant treatment of infertility with polycystic ovary syndrome: A protocol for systematic review and meta-analysis.
Polycystic ovary syndrome (PCOS) is the main cause of infertility in women, the essence of which is an endocrine disorder syndrome with abnormal sugar metabolism and reproductive dysfunction, and the incidence rate of about 6% of women. Traditional Chinese medicine (TCM) Jinfeng pill has achieved very good clinical results in the treatment of infertility with PCOS, but there is currently a lack of strong evidence-based medical evidence. This study uses meta-analysis method to analyze the clinical effectiveness and safety of TCM Jinfeng pill in the treatment of infertility with PCOS, hoping to provide help for the clinical treatment of infertility with PCOS. Using the computer to retrieve SinoMed, CNKI, VIP, WANFANG Database, as well as Public, The Cochrane library, Medline (Ovid SP), Embase and other foreign language databases, while manually retrieving the relevant magazine supplements, special issues, professional materials, network information, and so on. The retrieval time is from the beginning of each database to June 2021. The selected literature is evaluated using the Cochrane System Rating Manual Bias Risk Tool. Statistical analysis and graphics of the inclusion literature are performed using Review Manager 5.3 statistical software. All the results of this study on the clinical effectiveness and safety of TCM Jinfeng pill in adjuvant treatment of infertility with PCOS will be published in a peer-reviewed academic journal of medicine. The type of study is systematic evaluation, the whole process of research does not involve human trials, the data used in the institute are obtained through published literature, so ethical review is not suitable for this study. 10.17605/OSF.IO/JEP2D. (https://osf.io/jep2d). Our research will provide evidence-based medical evidence on whether the TCM Jinfeng pill is effective and safe in the treatment of infertility with PCOS.


The bronchial leak squeak: a new sign for the physical diagnosis of bronchopleurocutaneous fistula.
We describe a unique physical diagnostic sign that we have observed in seven patients with bronchopleurocutaneous fistulas. Such patients have a highpitched squeak over the affected chest area during sustained Valsalva maneuver. We postulate that turbulence across the bronchial fistula due to high transbronchial pressure gradient during the Valsalva maneuver produces the squeaking sound. The pitch of the leak squeak sign is higher in smaller fistulas than in larger fistulas; decreases in intensity and increases in pitch occurred in two patients in whom the bronchial fistula slowly closed. The absence of the leak squeak sound in patients with spontaneous pneumothorax suggests that this sign can be used to differentiate central airways from alveolar air leaks.


A sticky and heavily armed new species of Solanum (Solanumsubg.Leptostemonum, Solanaceae) from eastern Brazil.
We describe a new species of spiny Solanum (Solanumsubg.Leptostemonum), endemic to the Brazilian Atlantic Forest and associated with granitic outcrops (inselbergs or sugar loaf mountains). Solanumkollastrum Gouvêa & Giacomin, sp. nov. is morphologically similar to the poorly known S.sublentum Hiern, but is a heavily armed, much more robust plant with stellate-glandular indumentum. Together with S.sublentum, it is morphologically related to some species of Solanum such as S.hexandrum Vell., S.robustum H.Wendl., and S.stagnale Moric. that share strongly accrescent calyces, large leaves with the bases decurrent on to the petiole, pendent simple inflorescences and large, robust flowers. The new species is restricted to a few known populations in southern Bahia and north-eastern Minas Gerais states and conservation efforts are needed.


Outcomes of a community-based three-year breast and cervical cancer screening program for medically underserved, low income women.
To evaluate a community level three-year breast and cervical cancer screening program for medically underserved, low income women. Descriptive data on 128 women gathered from five semiannual screening programs held between 1995 and 1997 were analyzed. Poor and medically under served women often face barriers that may discourage or prevent screening activity and measures for early detection of breast and cervical cancer. Besides success in recruiting women to the program, community collaborative partnerships were established that continue to sustain this program. The results from this project provide an example of how advance practice nurses (APNs) can demonstrate meaningful and competitive health care services for underserved women and how APNs can actively evaluate programs they offer that affect the health practices of communities in need.


Preoperative assessment of gastric cancer vascularity by flash echo imaging.
Tumor vascularity as indicated by immunohistochemical staining is a significant prognostic factor in gastric and other cancers. Non-invasive preoperative assessment of the vascularity of gastric cancers has not been possible. We aim to determine the reliability of harmonic flash echo imaging (FEI) for assessment of vascularity of gastric cancers by comparison with CD34 staining of resected specimens. Twelve patients undergoing surgical resection of advanced gastric cancer were studied. An ultrasound system transmitting ultrasound pulses at 2.3 MHz and receiving them at 4.6 MHz (second harmonic image) was used for harmonic FEI. Approximately 30 s after intravenous injection of ultrasonic contrast medium (SHU 508A, Levovist), second harmonics (4.6 MHz) emitted from microbubbles were obtained to enhance the B-mode images. Using the tumor image showing strongest enhancement in each FEI series, regions of interest were determined to measure mean echo intensity in the tumor. Immunohistochemistry using antibodies against CD34 was carried out in resected specimens. Tumor vascularity was determined by counting stained microvessels. A significant positive correlation was noted between sonographic amplitude determined preoperatively by FEI analysis and number of CD34-stained microvessels in tumor specimens (r = 0.869, P = 0.004). Vascularity of gastric cancers now can be evaluated non-invasively by harmonic FEI.


Surgical correction of entropion and excess upper eyelid skin in congenital cutis laxa: a case report.
Congenital cutis laxa is a rare generalized inherited elastosis, characterized by the appearance of premature aging and skin laxity with mild to severe systemic anomalies. Ocular manifestations include excess skin in the eyelids, ptosis and lower lid ectropion. Of the hyperelasticity syndromes - Ehlers Danlos, Pseudoxanthoma elasticum and cutis laxa - only cutis laxa has normal skin wound healing. The diagnosis must therefore be established before surgical options for treatment are considered. We report an unusual case of a 5-month-old male child with cutis laxa who presented with upper lid entropion secondary to severe redundant upper eyelid skin. An anterior lamellar repositioning procedure successfully corrected the lid margin malposition with complete relief of symptoms.


Edoxaban improves atrial fibrillation and thromboembolism through regulation of the Wnt-β-induced PI3K/ATK-activated protein C system.
Thromboembolism is a commonly observed condition in geriatrics that is caused by vascular endothelial injury, platelet activation, physiological coagulation processes, reduction of anticoagulant activity, decreased fibrinolytic activity and abnormal flow in the heart chamber, artery or vein. The protein C anticoagulant system serves a crucial role in anticoagulant therapy for the treatment of thromboembolism. Previous findings have suggested that edoxaban is an efficient oral anticoagulant in the acute treatment of venous thromboembolism. In the present study, the efficacy of edoxaban on thromboembolism induced by atrial fibrillation was investigated in a mouse model. Inflammatory factors interleukin (IL)-1, -4, -8 and tumor necrosis factor (TNF)-α were analyzed in the sera of mice with fibrillation induced by thromboembolism. Expression and activity of thymic stromal lymphopoietin (TSLP) and activated protein C resistance were investigated in platelets and vascular endothelial cells (VECs). TSLP-induced platelet viability, Wnt-β phosphorylation and integrin expression were analyzed in platelets. Furthermore, Wnt-β expression and the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway in VECs were analyzed. Results demonstrated that the expression levels of IL-1, -4, -8 and TNF-α were significantly downregulated in the sera of mice with fibrillation and thromboembolism following treatment with edoxaban (P<0.01). Furthermore, the expression levels of prostacyclin (PGI2), prostaglandin (PG)E2, PGD2 and PGF2α were significantly increased in the sera of experimental mice that received edoxaban therapy (P<0.01). Results also indicated that edoxaban significantly stimulated the protein expression of TSLP and activated Wnt-β phosphorylation and integrin expression in platelets (P<0.01). In addition, edoxaban therapy significantly upregulated the expression levels of PI3K and AKT, and subsequently increased the activity of protein C and S in VECs (P<0.01). Notably, edoxaban treatment improved atrial fibrillation and thromboembolism, as determined by pathological analysis. In conclusion, these results suggested that edoxaban elicited beneficial effects for mice with atrial fibrillation induced by thromboembolism through the regulation of the Wnt-β-induced PI3K/ATK-activated protein C system.


Vascular endothelial cell growth factor (VEGF) produced by A-431 human epidermoid carcinoma cells and identification of VEGF membrane binding sites.
A distinct family of endothelial cell mitogens that are homologous to platelet-derived growth factor has recently been identified. Unlike other known endothelial cell mitogens, these vascular endothelial cell growth factors (VEGFs) are secreted and appear to act specifically on endothelial cells. We have purified VEGF 2083-fold to apparent homogeneity from protein-free culture medium conditioned by A-431 human epidermoid carcinoma cells. This A-431-derived VEGF was characterized as a homodimer composed of 22-kDa subunits with an N-terminal sequence that was similar to VEGFs produced by human HL-60 leukemic and U-937 histiocytic lymphoma cells. A-431 VEGF was used to identify specific and saturable binding sites for VEGF on human umbilical vein endothelial cells (HUVEC). By affinity cross-linking, VEGF-binding site complexes of 230, 170, and 125 kDa were detected on HUVEC. VEGF specifically induced the tyrosine phosphorylation of a 190-kDa polypeptide, which was similar in mass to the largest binding site detected by affinity cross-linking.


Salinomycin inhibits prostate cancer growth and migration via induction of oxidative stress.
We have shown that a sodium ionophore monensin inhibits prostate cancer cell growth. A structurally related compound to monensin, salinomycin, was recently identified as a putative cancer stem cell inhibitor. The growth inhibitory potential of salinomycin was studied in a panel of prostate cells. To get insights into the mechanism of action, a variety of assays such as gene expression and steroid profiling were performed in salinomycin-exposed prostate cancer cells. Salinomycin inhibited the growth of prostate cancer cells, but did not affect non-malignant prostate epithelial cells. Salinomycin impacted on prostate cancer stem cell functions as evidenced by reduced aldehyde dehydrogenase activity and the fraction of CD44(+) cells. Moreover, salinomycin reduced the expression of MYC, AR and ERG, induced oxidative stress as well as inhibited nuclear factor-κB activity and cell migration. Furthermore, profiling steroid metabolites revealed increased levels of oxidative stress-inducing steroids 7-ketocholesterol and aldosterone and decreased levels of antioxidative steroids progesterone and pregnenolone in salinomycin-exposed prostate cancer cells. Our results indicate that salinomycin inhibits prostate cancer cell growth and migration by reducing the expression of key prostate cancer oncogenes, inducing oxidative stress, decreasing the antioxidative capacity and cancer stem cell fraction.


Remarkable catalytic property of nanoporous gold on activation of diborons for direct diboration of alkynes.
A novel catalytic property of nanoporous gold for activation of bis(pinacolato)diboron has been reported that allows the direct diboration of alkynes to proceed sufficiently in a heterogeneous process. The experimental results revealed that the nanoporous gold catalyst is able to cleave the B-B bond of bis(pinacolato)diboron without using any additives.


Control of carcinoembryonic antigen gene family expression in a differentiating colon carcinoma cell line, Caco-2.
The levels of control involved in the regulation of expression of the carcinoembryonic antigen (CEA) gene family members were investigated using cultured Caco-2 cells that differentiated after confluence as characterized by the production of polarized monolayers and the subsequent appearance of domes. Three transcripts representing CEA (3.0 and 3.5 kilobases) and nonspecific cross-reacting antigen (NCA) (2.6 kilobases) were detected in Northern analyses of mRNA preparations of such cells when probed with human CEA cDNA, albeit at different levels. The major CEA 3.0-kilobase transcript increased 3-fold over an 11-day culture period after confluence, whereas the NCA transcript increased 25-fold over the same time period. gamma-interferon treatment enhanced CEA mRNA levels 32-fold and NCA mRNA levels 53-fold in Caco-2 monolayers 11 days after confluence. The NCA gene thus appears to be regulated by a mechanism different from that of CEA. During gamma-interferon treatment, the normal increase in Caco-2 dome formation with time in culture was increased further by a factor of 2. Over the 13-day time span for Caco-2 cultures, CEA protein levels increased 7-fold, NCA (Mr 48,000) protein 5-fold, while gamma-interferon treatment augmented CEA 18.5-fold further and NCA 20-fold. In 2 other colon carcinoma cell lines, SW1222 and T84, which are differentiated in culture to varying degrees, little if any changes were seen in CEA and NCA mRNA and protein levels in pre- versus postconfluent cultures. Both cell lines, however, responded to gamma-interferon treatment by increases in CEA and NCA mRNA levels and, in some cases, disproportionate increases in the corresponding proteins. The lack of direct proportionality between mRNA and protein expression suggests that, as observed in human colon carcinoma and adjacent normal tissue, both transcriptional and post-transcriptional control mechanisms regulate CEA gene family member expression in colon carcinoma cells.


CAD risk factors and acute myocardial infarction in Pakistan.
Acute myocardial infarction (AMI) in adult patients under the age of 45 is relatively unusual. Recent studies have shown a higher prevalence of AMI in young South Asian migrants. Data on South Asians in South Asia on cardiovascular disease (CVD) patients is lacking. The purpose of this study is to look at the classical risk factors of coronary artery disease (CAD) in young men and women and their older counterparts who presented to the emergency service of the Aga Khan university hospital (AKUH) and were diagnosed with AMI. 976 consecutive patients admitted to AKUH with AMI between January 2000-December 2002 were divided into two groups: < 45 years (young) and > 45 years (old). Demographic factors, clinical symptoms and presence of risk factors for CAD were recorded with the help of pre-tested data extraction forms. Young patients represented 16.1% of all patients with AMI. 93.1% of the young patients were men. Young male patients were more likely to be smokers and have high cholesterol levels as compared to their young female counterparts. Young AMI patients when compared to old AMI patients, were more likely to have hypertension, positive family history of coronary artery disease, high cholesterol, high LDL and high triglycerides. In this study, the risk factor profile between young and old patients and between the two genders was found to be different. Thus adult management protocols for AMI should be different from the ones for older patients and gender difference should also be considered.


New triterpenoid saponins from the flowers of Pueraria thomsonii.
Two new oleanane-type triterpenoid saponins, kakkasaponin II (1) and kakkasaponin III (2), were isolated from the methanol extract of the flowers of Pueraria thomsonii (Leguminosae), together with seven known oleanane-type triterpenoid saponins, phaseoside IV (3), sophoradiol monoglucuronide (4), kakkasaponin I (5), kaikasaponin III (6), soyasaponin I (7), soyasaponin III (8), and soyasaponin IV (9). The structures of 1 and 2 were elucidated by spectroscopic methods including IR, ESI-TOF-MS, and 1D and 2D NMR experiments.


[Streptococcus pneumoniae growth based on drug resistance genotype].
Marked Streptococcus pneumoniae tolerance is attributed to a penicillin and macrolide resistance genotypes, yet no report has, to our knowledge, compared the ability of these two genotypes to grow. Deviations in the number of clinical appearances of Streptococcus pneumoniae depend on the combination of these genotypes, thought primarily due to the individual strain growth. To test this, we compared ATCC6303 and a strain of each genotype with an absorption spectrophotometer. Time points-T0, T2, T4, T8, T10, T12, and T24-were compared to each of the following factors: initial value, dullness time, doubling time (D.B.T.), peak attainment, peak value, and stationary value. ATCC6303 and the clinical strain (PSSP8) showed no difference in time points or tested factors. Penicillin susceptible Streptcoccus pneumoniae (PSSP) 8 and Penicillin intermediately resistant Streptcoccus pneumoniae (PISP) (2b, mefA) strains showed significant differences in some time pointsT8, T10, and T12-and in certain factors-dullness time, D.B.T., and peak attainment-. In penicillin-resistant genotypes, the sequential growth rate priority was PSSP>PISP>PRSP, while in macrolide-resistant genotypes, it was mefA>non-mefA, and non-ermB>ermB. PISP (2x) and PISP (2x+2b, mefA) begin doubling immediately, suggesting that they proliferate earlier than other strains. Differences in the start of doubling time and doubling speed suggest that different strains are distributed among clinical resistant S. pneumoniae strains.


Optical properties and stress of ion-assisted aluminum nitride thin films.
The optical properties and stress in thin films of aluminum nitride have been studied as a function of ion energy and the ion-to-vapor arrival ratio (J(i)/J(v)) for the N(2)(+) ion-assisted deposition of aluminum. The ion energy was varied between 75 and 1000 eV. The refractive index was found to depend on the ion energy and flux. The highest index was 2.10 at 633 nm. The films were found to be highly transparent over the wavelength region 275-800 nm. The films were found to be free of major oxide contamination, and x-ray photoelectron spectroscopy studies revealed the presence of excess nitrogen in films prepared at high J(i)/J(v) values. The film stress was also found to be related to the ion energy, and an anomalously high compressive stress of -5.0 GPa was found for 100-eV N(2)(+)-assisted depositions. By comparison, films prepared by magnetron deposition were found to have lower refractive indices (1.97-1 99, n633) and higher stress (-8 to -12 GPa) when deposited in pure nitrogen.


A one-year survey of inpatient dental consultations at a children's hospital.
This study describes dental consultations for pediatric inpatients. Records of inpatient dental consultations in 2007 were analyzed to determine consultation reasons, diagnoses, treatment, and demographics. Consultations from Hematology-Oncology (Hem-Onc) and Transplant Oncology (T-Onc) were further analyzed. One hundred and fifty-five consultations were performed for 133 subjects. Hem-Onc (37%) and T-Onc (17%) were the most frequent consultations. Requests were most frequently for baseline evaluation (33%) and oral pain/discomfort (10%). Frequent dental diagnoses were soft tissue conditions (29%) and caries (23%). A dental home preexisted for 48% of subjects and in 44% of consultations with caries and 53% without caries. Caries was present in 30% of consultations where Medicaid was sole payer versus 18% with non-Medicaid payers. Subjects from the Oncology department had more baseline evaluations, frequently had soft tissue diagnoses, and more often received preventive counseling and treatment under general anesthesia. In conclusion, dentists play an important role in optimal management of certain hospital inpatients.


Effects of high altitude acclimatization on heart rate variability in resting humans.
The sympatho-vagal nerve interaction at the heart was studied by means of power spectrum analysis of heart rate variability in seven Caucasians (aged 27-35 years) in resting supine and sitting positions before and during 35 days of a sojourn at 5050 m above sea level (asl) and in six Sherpas (aged 22-30 years) at high altitude only. A high frequency peak (HF)-central frequency between 0.20 and 0.33 Hz, a low frequency peak (LF)-central frequency between 0.08 and 0.14 Hz, and a very low frequency component (< 0.05 Hz), no peak observed, were found in the power spectrum in both positions and independent of altitude. The peak powers, as a percentage of the total power, were affected by both body position and altitude. At sea level the change from a supine to a sitting position yielded a decrease in percentage HF from 25 (SEM 1.9)% to 6.2 (SEM 1.5)% (P < 0.05) and a significant increase in the ratio between LF and HF powers (LF:HF) from 1.7 (SEM 0.4) to 6.9 (SEM 1.6). At altitude compared to sea level in the supine position, percentage HF decreased from 25% to 10.9 (SEM 1.0)% (P < 0.05) and the LF:HF ratio increased from 1.7 to 4.8 (SEM 0.7) (P < 0.05). No changes occurred at altitude in the sitting position either in the peak powers or in the LF:HF ratio, but the central frequency of HF peak increased significantly from 0.25 (SEM 0.02) Hz to 0.32 (SEM 0.01) Hz. In the Sherpas comparable results to the Caucasians were found in both body positions. The high LF:HF ratios observed at altitude in both body positions and groups would suggest that hypoxia caused a shift of sympatho-vagal nerve interaction at rest toward a dominance of the sympathetic system, which was found at sea level only in the sitting position. An acclimatization period of 10 days higher than 2850 m asl and 1 month at 5050 m asl did not modify the interactions of the autonomic systems.


Liraglutide Inhibits Hepatitis C Virus Replication Through an AMP Activated Protein Kinase Dependent Mechanism.
Insulin resistance and diabetes are both associated with chronic hepatitis C virus (HCV) infection, and the glucagon-like peptide-1(GLP-1) receptor agonist, liraglutide, is a common therapy for diabetes. Our aim was to investigate whether liraglutide treatment can inhibit HCV replication. A cell culture-produced HCV infectious system was generated by transfection of in vitro-transcribed genomic JFH-1 ribonucleic acid (RNA) into Huh-7.5 cells. Total RNA samples were extracted to determine the efficiency of HCV replication. The Ava5 cells were treated with liraglutide and cell viability was calculated. A Western blot analysis of the protein expression was performed. The immunoreactive blot signals were also detected. Liraglutide activated GLP-1 receptors in the HCV infectious system, and inhibited subgenomic HCV RNA replication in the HuH-7.5 cells. The Western blot analysis revealed both HCV protein and replicon RNA were reduced after treatment with liraglutide in a dose-dependent manner. Liraglutide decreased the cell viability of HCV RNA at an optimum concentration of 120 μg/mL, activated the 5' adenosine monophosphate-activated protein kinase (AMPK) and the phosphorylated- transducer of regulated cyclic adenosine monophosphate (CAMP) response element-binding protein 2 (TORC2), thereby decreasing the cell viability of phosphoenolpyruvate carboxykinase (PEPCK) and G6pase RNA Therefore, we conclude that liraglutide can inhibit HCV replication via an AMPK/TORC2-dependent pathway.


A carrier that makes the grade. Conduct a performance review to find a reinsurer that meets your needs.
Remember report card day? As kids, some of us looked forward to-or dreaded-handing our grades over to our parents more than others. In the same way that a report card gives parents an indication of how well their children are performing in school, a similar type of performance review can help HMO reinsurance purchasers evaluate and select a reinsurer.


[Pulmonary lymphangioleiomyomatosis--review and personal results].
Pulmonary lymphangioleiomyomatosis (LAM) is characterised by the proliferation of smooth muscle cells in the peribronchial, perivascular and perilymphatic tissue resulting in severe destructive changes of the lung parenchyma. We reviewed the literature and compared the findings in chest radiograph and CT with our own results obtained in a group of 12 patients suffering from histological proven LAM. The main findings of LAM in chest radiograph are a diffuse reticular opacity and an increased lung volume, often large cysts are visible. The CT scans reveal that cystic lesions are present in all patients, but the reported size of the cystic lesions is contradictory. We postulate two main types of LAM: the one resulting in a diffuse distribution of multiple small cysts, partially demonstrating a honey-combing pattern, the other showing severe destruction of the lung parenchyma due to large cysts. The presence of fibrotic changes and architectural distraction does not exclude LAM. So chest radiograph as well as computed tomography reveal neither uniform nor pathognomonic findings. Differential diagnosis of LAM seems to be more difficult than most authors believe.


Chronic effects of a beta-adrenoceptor blocking drug, 4-[3-(tert-butylamino)-2-hydroxypropoxy]-N-methylisocarbostyril hydrochloride (N-696), in hypertensive rats.
4-[3-(tert-Butylamino)-2-hydroxypropoxy]-N-methylisocarbostyril hydrochloride (N-696) is a new beta-adrenoceptor blocking drug with direct vasodilatory activity, and may be classified into the fourth generation. Antihypertensive effects of N-696 were studied for 12 weeks in spontaneously (SHR), two kidney, one clip (CLIP), and deoxycorticosterone-salt (DOC) hypertensive rats. Propranolol (PPL) was used as the reference drug. In indirect blood pressure (BP) determination at the tail, milder prewarming condition was employed to observe antihypertensive effects clearly. Rats were prewarmed in rat holders on a hot plate for 30-60 min. Surface temperature of the hot plate was 35-45 degrees C. N-696 (20 mg/kg per day p.o.) and PPL (100 mg/kg per day, p.o.) treatments significantly decreased heart rate (HR) and maximum BP determined indirectly in SHR rats, even at the early stage of the experiments. These antihypertensive effects were shown also by mean BP determined directly at the 12th week. N-696 and PPL treatments showed no significant antihypertensive effects in CLIP rats, and slight antihypertensive effects in DOC rats. N-696 treatments showed a tendency to decrease plasma renin concentration (PRC) in SHR and DOC rats, whereas PPL treatments significantly decreased PRC in these hypertensive rats. N-696 and PPL treatments prevented nephrosclerosis and vascular lesions in SHR and DOC rats only slightly.


Simultaneous determination of free amino acid content in tea infusions by using high-performance liquid chromatography with fluorescence detection coupled with alternating penalty trilinear decomposition algorithm.
In this paper, a novel application of alternating penalty trilinear decomposition (APTLD) for high-performance liquid chromatography with fluorescence detection (HPLC-FLD) has been developed to simultaneously determine the contents of free amino acids in tea. Although the spectra of amino acid derivatives were similar and a large number of water-soluble compounds are coextracted, APTLD could predict the accurate concentrations together with reasonable resolution of chromatographic and spectral profiles for the amino acids of interest owing to its "second-order advantage". An additional advantage of the proposed method is lower cost than traditional methods. The results indicate that it is an attractive alternative strategy for the routine resolution and quantification of amino acids in the presence of unknown interferences or when complete separation is not easily achieved.


Purification and Properties of 2-Carboxy-d-Arabinitol 1-Phosphatase.
Carboxyarabinitol 1-phosphatase (2-carboxy-d-arabinitol 1-phosphate phosphohydrolase), a chloroplast enzyme that metabolizes the naturally occurring inhibitor of ribulose-1,5-bisphosphate carboxylase/oxygenase, was isolated from tobacco (Nicotiana tabacum) leaves. The enzyme was purified more than 3500-fold using a protocol that included ammonium sulfate fractionation and gel filtration, ion-exchange, and hydrophobic interaction chromatography. Analysis of the final preparation by sodium dodecyl sulfate polyacrylamide gel electrophoresis revealed the presence of a single polypeptide with a molecular mass of 53 kilodaltons. The enzyme exhibited an apparent K(m) (carboxyarabinitol 1-phosphate) of 33 micromolar and a pH optimum of 7.5. Enzyme activity did not require divalent cations and was unaffected by the metal chelators EDTA and cysteine. Carboxyarabinitol 1-phosphatase activity was inhibited by zinc, copper and molybdate and stimulated by sulfate. Chloroplast metabolites that affected activity included inorganic phosphate and ATP, which were inhibitory, and ribulose-1,5-bisphosphate, fructose-1,6-bisphosphate and NADPH which stimulated activity 2.5-fold. Activation of carboxyarabinitol 1-phosphatase activity by these positive effectors, together with the previously reported requirement for dithiothreitol, explain the light/dark modulation of carboxyarabinitol 1-phosphatase activity in vivo.


Forecasting Healthy Life Expectancy Among Chilean Community-Dwelling Older Adults With and Without Sarcopenia.
Sarcopenia is an important risk factor for disability and dependency at old age. The prevalence of sarcopenia among the Chilean older population is high. To estimate life expectancy, healthy life expectancy and unhealthy life expectancy among sarcopenic and non-sarcopenic older adults from Santiago, Chile. A sample of 1,897 community-dwelling older adults aged 60 years or more, living in Santiago, was observed between 5-15 years. Disability was defined as the unhealthy state, assessed through self-reported difficulties in activities of daily living. Sarcopenia was determined via HTSMayor software. Total and marginal life expectancies were estimated using the Interpolated Markov Chain method "IMaCh". At 60 years, estimated life expectancy for sarcopenic and non-sarcopenic older adults was similar (22.7 and 22.5 years, respectively). The proportion of years to be lived with disability was three times greater in sarcopenic adults, compared to non-sarcopenic people. This difference was observed up to 80 years. Non-sarcopenic women had a higher proportion of years to be lived with disabilities compared to non-sarcopenic men of the same age, but this proportion was higher among sarcopenic men, compared to sarcopenic women until 70 years of age. People with sarcopenia expect to live a higher proportion of years with disabilities. Sarcopenic men until 70 years expected to live a higher proportion of years with disability, compared to sarcopenic women. Monitoring sarcopenia among older people may help to identify individuals with higher risk of disability onset. Future research should focus on disentangling the mechanisms explaining sex differences.


Experimental and DFT Studies on the Identity Exchange Reactions between Phenyl Chalcogen Iranium Ions and Alkenes.
The gas-phase ion-molecule identity exchange reactions of phenyl chalcogen iranium ions with alkenes have been examined experimentally in a linear ion trap mass spectrometer by isotope labeling experiments. The nature of both the alkene and the chalcogen play crucial roles, with the bimolecular rates for π-ligand exchange following the order: [PhTe(c-C6H10)]+ + c-C6D10 > [PhTe(C2D4)]+ + C2H4 > [PhSe(c-C6H10)]+ + c-C6D10, with no reaction being observed for [PhSe(C2D4)]+ + C2H4, [PhS(C2D4)]+ + C2H4, and [PhS(c-C6H10)]+ + c-C6D10. The experimental results correlate with RRKM modeling and density functional theory (DFT) calculations, which also demonstrates that these reactions proceed via associative mechanisms. Natural bond orbital (NBO) analysis reveals a shift in the association complexes from a σ-hole interaction to ones mirroring the π-p+ and n-π* at the transition state in accordance with the rates of reaction.


Can intensive treatment alter the progress of established diabetic nephropathy to end-stage renal failure?
Diabetic nephropathy is now the leading cause of end-stage renal disease in the Western world, and is associated with a higher patient morbidity and mortality than other causes of renal failure, largely because of associated cardiovascular disease. Numerous studies have elucidated the factors which influence its onset and progression. The St Vincent Declaration in 1994 proposed standards for the appropriate management of patients with diabetic nephropathy. We assessed whether referral to a nephrology clinic attempting to apply these standards influenced the progression of diabetic nephropathy. The results show a significant improvement in blood pressure, glycosylated haemoglobin and serum cholesterol following referral. There was a significant reduction in the rate of decline of renal function following referral in 39% of patients. With the possible exception of diabetic control there were no significant differences in the management of those that did and did not show improvement. The results show that with intensive out-patient clinic monitoring it is possible to improve the quality of patient care, and that even in established diabetic nephropathy it is possible to slow the rate of progression to end-stage renal failure.


Do antidepressants prevent suicide?
As in many developed countries, the use of antidepressants in Denmark has been substantially increasing during recent years, coinciding with a decreasing suicide rate. We aimed to investigate the relationship between treatment with antidepressants and suicide on individualized data from a nationwide study comprising an observational cohort study with linkage of registers of all prescribed antidepressants and recorded suicides in Denmark during the period 1995-99. A total of 438 625 patients who purchased at least one prescription of antidepressants and 1073 862 individuals from the general population were included in the study. Patients who continued treatment with selective serotonin reuptake inhibitors (SSRIs) (i.e. who purchased SSRIs twice or more) had a decreased rate of suicide compared with patients who purchased SSRIs once only [rate ratio (RR)=0.63; 95% confidence interval (CI)=0.56-0.71]. Furthermore, the rate of suicide decreased consistently with the number of prescriptions. Similarly, among patients treated with newer antidepressants other than SSRIs, the rate of suicide was decreased compared with the rate for patients who purchased other newer antidepressants once only (RR=0.70; 95% CI=0.52-0.94). Continued antidepressant treatment with SSRIs or other newer antidepressants is found to be associated with a reduced risk of suicide.


Multidisciplinary collaborative care planning.
Over many years, healthcare professionals have strived to improve the quality of patient care. The idea that collaborative care might achieve further improvements is relatively new but is a natural consequence of the Patient's Charter (1992) and other national standards. This article describes how multidisciplinary care planning was introduced in the stroke rehabilitation unit at Clatterbridge Hospital, Wirral Hospital NHS Trust.


EMSA Eritin Drives Expansion of Regulatory T Cells and Promotes T Cells Differentiation in Irradiated Mice.
Sublethal irradiation therapy in cancer treatment causes generalized immunosuppression, which results in a range of DNA damage. We examined the significance of a polyherbal medicine called "EMSA Eritin" on immunological responses in sublethally irradiated mice focusing on the involvement of Treg, naïve T cell, and also the development and differentiation of T cells in thymus. Normal BALB/c mice were sublethally irradiated with dose of 600 rad. The irradiated mice were then orally administered by EMSA Eritin once a day at different doses: 1.04, 3.12, 9.37 mg/g body weight. The treatment was performed for 14 days. On day 15, immunological responses were observed by analyzing the status of Treg and differentiation of T cells in thymus. The administration of EMSA Eritin to irradiated mice resulted in a significant increase of pre T cells, Treg cells, and naïve T cells, which in general could maintain and normalize healthy condition in mice.


Characterisation of bioactive compounds and assessment of antioxidant activity of different traditional Lycopersicum esculentum L. varieties: chemometric analysis.
Eight different Serbian genotypes were analysed for their polyphenol, carotenoid, vitamin C content and evaluated for their antioxidant properties. The highest content of biologically important carotenoids such as lutein (4.58 mg/10 g), lycopene (160.64 mg/10 g) and β-carotene (189.64 mg/10 g) were detected in the genotype S606. Rutin was the most abundant phenolic compound in all tastes samples, but its content is highest in the genotype S615 (1424.30 µg/100 g dw). All tomato samples were the great source of vitamin C, where the sample S615 stood out (68.54 mg AA g-1 of dw). Their content of antioxidant compounds suggested that genotypes S606 and S615 showed the best antioxidant potential. Principal component analysis (PCA) and Partial least squares (PLS) were applied to analyse results. The results obtained in the present study could be of considerable interest for breeding programmes wishing to select tomato genotypes with high biological and nutritional properties.


Enhancing effect of surgical bursectomy on antibody response.
Effect of surgical bursectomy on antibody response was studied in chicks injected intrabursally with sheep red blood cells (SRBC) and Brucella abortus on day 2 of life and challenged intravenously with the same antigens on day 9. Bursectomy performed 2 days after the priming resulted in a significantly decreased anti-SRBC plaque-forming cell (PFC) response, whereas bursectomy performed 4 or 5 days after the priming clearly enhanced the PFC response. The enhancing effect of bursectomy on the PFC response was also observed if the priming was made intravenously. In antibody titers against SRBC the enhancing effect was observed only if a secondary and tertiary challenge was performed at the age of 28 and 36 days, respectively. Titers of Brucella antibodies were either reduced by the bursectomy (performed 2 or 4 days after the intrabursal priming) or left unaffected (bursectomy performed 5 days after the priming). These findings are discussed in relation to bursa-derived suppressor cells.


Two populations of erythroid cell progenitors in paroxysmal nocturnal hemoglobinuria.
We have grown erythroid cell colonies from two patients with paroxysmal nocturnal hemoglobinuria (PNH). At 11 to 13 days, individual bursts were picked and incubated for 24 hours with 3H-leucine in order to label total cell protein (mainly hemoglobin). After appropriate washing, each burst was subjected to a miniaturized acidified serum test, and lysis was measured by the release of radioactivity. In bursts from normal controls, lysis was 19% +/- 13% SD. By contrast, of 58 bursts from PNH patients, 14 had lysis similar to that of controls (mean 15.4% +/- 10.6%), while 44 had lysis ranging from 42.2% to 85.8% (mean 70.3% +/- 10.4%). Colonies sensitive to acidified serum were acetylcholinesterase (AchE) negative, whereas normal colonies were AchE-positive. Thus, based on two independent criteria, a dual population of erythroid burst-forming units (BFU-E) can be demonstrated in PNH. These data confirm directly the somatic mutation model of the pathogenesis of PNH, and by these methods the relative sizes of the normal and the PNH cell populations can be measured at the level of the erythroid cell precursors.


Gibberellin and auxin influence the diurnal transcription pattern of photoreceptor genes via CRY1a in tomato.
Plant photoreceptors, phytochromes and cryptochromes, regulate many aspects of development and growth, such as seed germination, stem elongation, seedling de-etiolation, cotyledon opening, flower induction and circadian rhythms. There are several pieces of evidence of interaction between photoreceptors and phyto-hormones in all of these physiological processes, but little is known about molecular and genetic mechanisms underlying hormone-photoreceptor crosstalk. In this work, we investigated the molecular effects of exogenous phyto-hormones to photoreceptor gene transcripts of tomato wt, as well as transgenic and mutant lines with altered cryptochromes, by monitoring day/night transcript oscillations. GA and auxin alter the diurnal expression level of different photoreceptor genes in tomato, especially in mutants that lack a working form of cryptochrome 1a: in those mutants the expression of some (IAA) or most (GA) photoreceptor genes is down regulated by these hormones. Our results highlight the presence of molecular relationships among cryptochrome 1a protein, hormones, and photoreceptors' gene expression in tomato, suggesting that manipulation of cryptochromes could represent a good strategy to understand in greater depth the role of phyto-hormones in the plant photoperceptive mechanism.


Antineoplastic chemotherapy in cancer patients with methicillin-resistant Staphylococcus aureus (MRSA).
Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen causing serious morbidity and mortality in immunosuppressed patients. Antineoplastic chemotherapy causes immunosuppression, and thus there is concern whether such patients should proceed to therapy without delay or dose reduction. There are presently no guidelines with appropriate provisions for antineoplastic chemotherapy in cancer patients with MRSA colonization or infection. We retrospectively analyzed the clinical outcome of all 27 patients with known MRSA infection or colonization undergoing antineoplastic chemotherapy for solid or hematological malignancies in our institution. In our patients, MRSA was detected at multiple sites. 11 patients were found to be colonized with MRSA, whereas 16 patients had colonization and/or infection. MRSA sepsis occurred in 12 cases. Interestingly, at the time of MRSA sepsis, neutrophil counts were less than 500/μl in 42% of our patients. However, fatal complications due to MRSA occurred in only 2 patients. Among patients with MRSA sepsis, the mortality rate was 14%. Our results with a limited number of patients support the contention that antineoplastic chemotherapy may well be administered to patients with MRSA and should not necessarily lead to dose reduction or treatment delay, especially in cases with curative intent.


Managed care and economic dynamics.
Over the past several decades, health care delivery in the United States evolved in an environment lacking marketplace constraints. The unforeseen result was the current health care crisis--uncontrolled costs, shrinking access, and redundant technological capabilities. Managed care is a strategy to impose fiscal constraints on health care delivery. A diagrammatic analysis of the economic dynamics between consumers and producers in an open marketplace is compared with that of patients, providers, and payers under the health care scheme that produced the health care crisis and under managed care. Patient demands, expectations, and needs for health care are not subject to fiscal constraint under managed care since the dislinkage between consumer and payer still exits. Managed care does not impose true open marketplace fiscal constraints on health care delivery. Furthermore, any solution to the US health care crisis that used true marketplace fiscal constraints would necessitate fundamental changes in societal values concerning individual rights to health care.


Preparation of figure 8 and cruciform DNAs and their use in studies of the kinetics of branch migration.
We have re-examined the kinetics of the branch migration of double-stranded DNA that is mediated by the stepwise movement of the Holliday junction. This work revises and extends our previous treatment (Thompson, B. J., Camien, M. N., and Warner, R. C. (1976) Proc. Natl. Acad. Sci. U.S.A. 73, 2299-2303). New methodology and new highly purified substrates have been used. The latter include figure 8s prepared from phage G4 DNA by annealing single-stranded components and two sizes of a novel cruciform. We treat the process as a one-dimensional diffusion based on the random walk, the mathematical basis of which is discussed in detail. The step rate is shown to be 3 orders of magnitude slower than we reported previously. The most important contribution to the erroneously high rate was a result of the presence of EDTA in the spreading solution used for electron microscopy at that time. A second contribution of about 4-fold resulted from catalysis by EcoRI and other proteins. The rates reported here are for the uncatalyzed reaction.


[Risk factors in calcium urolithiasis].
The aim of the study has been to evaluate, retrospectively, if the association of urolithiasis different pathogenetic factors increases stone formation and recurrences. The study included 41 children, 20 males and 21 females, aged 3-15 years, divided into three groups: patients with hypercalciuric or normocalciuric urolithiasis and isolated hypercalciuria. In all of them renal function, blood and urinary pH, serum and urinary electrolytic levels, citraturia (dosed with anenzymatic quantitative method), oxalaturia (enzymatic colorimetric method), urinary glycosaminoglycans (dosed by means of cetylpyridinum chloride precipitation and quantitative analysis) have been considered. Statistical analysis was done using Student's "t"-test, with p < 0.05. In all children with hypercalciuric urolithiasis who during the follow-up presented a decreased citraturia, the number of recurrences increased and was above two. The children who during the follow-up remained hypercalciuric without urolithiasis, in spite of the high familiarity, presented an increased citraturia. In conclusion the association between hypercalciuria and low citraturia increases the risk of stone formation and recurrences in children with calcic urolithiasis.


Comparison of the characteristics and outcome among patients suffering from out-of-hospital primary cardiac arrest and drowning victims in cardiac arrest.
In 2003, the International Liaison Committee on Resuscitation (ILCOR) published the Recommended Guidelines for Uniform Reporting of Data from Drowning: the "Utstein style" ("Utstein Style for Drowning," USFD) to improve the understanding of epidemiology, treatment, and outcome prediction after drowning. The aim of this study was to compare the characteristics and outcome between patients suffering from out-of-hospital primary cardiac arrest (OHPCA) and drowning victims in cardiac arrest (DCA) by analysis of variables based on the USFD. All cases of OHPCA and DCA from February 1998 to February 2007 were included in the research and analysis. Data on OHPCA and DCA patients were collected using the Utstein method. Data on DCA patients were then compared with data of OHPCA patients. During the study period 788 cardiac arrests with resuscitation attempts were identified: 528 of them were OHPCA (67%) and 32 (4%) were DCA. The differences between DCA and OHPCA patients were: the DCA patients were younger (46.5 +/- 21.4 vs 62.5 +/- 15.8; p = 0.01), suffered a witnessed cardiac arrest less frequently (9/32 vs 343/528; p = 0.03), were more often found in a nonshockable rhythm (29/32 vs 297/528; p < 0.0001), had a prolonged ambulance response time (11 vs 6 min; p = 0.001), had a relatively better (but not statistically significant) return of spontaneous circulation (ROSC) in the field [22/32 (65%) vs 301/528 (57%); p = 0.33], more of them were admitted to hospital [19/32 (60%) vs 253/528 (48%); p = 0.27], and also had a significantly higher survival rate (discharge from hospital) [14/32 (44%) vs 116/528 (22%); p = 0.01]. DCA patients had higher values of initial PETCO(2) (53.2 +/- 16.8 vs 15.8 +/- 8.3 mmHg; p < 0.0001) and average PETCO(2) (43.5 +/- 13.8 vs 23.5 +/- 8.2; p = 0.002). These values of PETCO(2) suggest an asphyxial mechanism of cardiac arrest. The analysis showed that DCA patients who survived were younger, had more bystander cardiopulmonary resuscitation (CPR), shorter call-arrival interval, higher values of PETCO(2) after 1 min of CPR, higher average and final values of PETCO(2), lower value of initial serum K+, and more of them received vasopressin (p < 0.05) in comparison with DCA patients who did not survive. DCA patients had a better survival rate (discharge from hospital), higher initial and average PETCO(2) values, and more of them had nonshockable initial rhythm. Survival (discharge from hospital) in DCA patients is associated with the PETCO(2) values, initial serum K+ values, administration of vasopressin, and ambulance response time.


Reliable gene signatures for microarray classification: assessment of stability and performance.
Two important questions for the analysis of gene expression measurements from different sample classes are (1) how to classify samples and (2) how to identify meaningful gene signatures (ranked gene lists) exhibiting the differences between classes and sample subsets. Solutions to both questions have immediate biological and biomedical applications. To achieve optimal classification performance, a suitable combination of classifier and gene selection method needs to be specifically selected for a given dataset. The selected gene signatures can be unstable and the resulting classification accuracy unreliable, particularly when considering different subsets of samples. Both unstable gene signatures and overestimated classification accuracy can impair biological conclusions. We address these two issues by repeatedly evaluating the classification performance of all models, i.e. pairwise combinations of various gene selection and classification methods, for random subsets of arrays (sampling). A model score is used to select the most appropriate model for the given dataset. Consensus gene signatures are constructed by extracting those genes frequently selected over many samplings. Sampling additionally permits measurement of the stability of the classification performance for each model, which serves as a measure of model reliability. We analyzed a large gene expression dataset with 78 measurements of four different cartilage sample classes. Classifiers trained on subsets of measurements frequently produce models with highly variable performance. Our approach provides reliable classification performance estimates via sampling. In addition to reliable classification performance, we determined stable consensus signatures (i.e. gene lists) for sample classes. Manual literature screening showed that these genes are highly relevant to our gene expression experiment with osteoarthritic cartilage. We compared our approach to others based on a publicly available dataset on breast cancer. R package at http://www.bio.ifi.lmu.de/~davis/edaprakt


Desmoplastic malignant mesothelioma of the pericardium: Description of a case and review of the literature.
Desmoplastic mesothelioma (DMM) is a rare and highly lethal subtype of diffuse malignant mesothelioma and is often difficult to distinguish from reactive pleural fibrosis. The term "desmoplastic" refers to the growth of fibrous or connective tissue. We report the clinical, radiological, and pathological features of a primary DMM of the pericardium and a short review of the literature. A 72-year-old man was admitted presenting shortness of breath, cough, and asthenia. Computed tomography scan showed thickenings and effusions both in the pleura and in the pericardium. Histopathological diagnosis was performed by surgical pericardial biopsy and confirmed by autopsy. The patient had a history of asbestos exposure. Primary mesothelioma of the pericardium is a rare tumor occurring in the fourth to seventh decades with nonspecific symptoms and a rapid clinical course. The diagnosis is difficult and often needing a surgical pericardial biopsy. The prognosis is poor although newer antiblastic drugs seem to prolong survival times.


Bizarre depressed skull fracture by a tile fragment in a young child, causing superior sagittal sinus injury.
Head injuries following fall from height are not very uncommon in developing countries due to a lack of safety standards. We describe this bizarre injury by a tile fragment penetrating the superior sagittal sinus (SSS) and its successful surgical management. A 7-year-old child presented with a tile fragment embedded in the skull, penetrating SSS. Urgent exploration and removal of the foreign body was done to prevent complications like infection and delayed development of intracranial hypertension. Although bleeding from the SSS was a problem, this was tackled by raising the head end and giving pressure with Surgicel and Gelatine sponge. This ensured a favorable outcome. Although compound depressed fractures of the SSS are managed conservatively due to the risk of fatal venous hemorrhage, the unique nature of the injury in this case warranted surgical management. This case illustrates that even in such a scenario, adherence to neurosurgical principles can ensure a good outcome.


Discovering small molecules to control stem cell fate.
Pluripotent stem cells promise to revolutionize drug discovery and offer new modes of therapy. The ease with which they can be grown in bulk and their differentiation controlled in vitro is of importance for their widespread adoption by industry and their clinical efficacy. Small molecules have already had a positive impact on several areas of stem cell biology, from maintenance of pluripotency, the promotion of single cell survival and steering differentiation to involvement in reprogramming somatic cells. High-throughput technology has played an important role in identifying novel compounds, however to date there are few published examples of medicinal chemistry input in this area. This review discusses the potential of pluripotent stem cells, the successful uses of small molecules and future prospects.


Activation of oxygen with sulfite for enhanced Removal of Mn(II): The involvement of SO4•.
Taking advantage of the active oxidants generated in the process of Mn(II)-catalyzed sulfite oxidation by oxygen, this study sought to enhance Mn(II) removal from water by activating oxygen with sulfite. The results revealed that Mn(II) can be effectively oxidized by oxygen to MnO2 with the addition of sulfite under environmentally relevant conditions, and the performance of this process is dependent on the dosage of sulfite and the initial pH. Mn K-edge XANES analysis indicates that Mn(II) removal is primarily due to the transformation of Mn(II) to MnO2 and, secondarily, to the adsorption of Mn(II) on generated MnO2. Co-existing NaCl and CaCl2 negatively affect Mn(II) removal, while the presence of Fe(II) considerably enhances Mn(II) removal by improving both Mn(II) oxidation and Mn(II) adsorption on the generated solids. Consequently, Mn(II) removal is as high as 98% in the presence of 1.0 mg/L of Fe(II) and both the residual Mn (<0.1 mg/L Mn) and Fe (<0.3 mg/L Fe) can meet China's drinking water standard. The experiments with real water samples also demonstrate the effectiveness of the sulfite-promoted Mn(II) removal process, especially in the presence of Fe(II). The enhancing effect of sulfite on Mn(II) oxidation by oxygen is mainly associated with the generation of HSO5-, and the critical step for generating HSO5- is the rapid oxidation of SO3•- by oxygen. EPR and radical scavenging studies demonstrate that SO4•- radical is the key reactive oxygen species responsible for Mn(II) oxidation by HSO5-.


Traumatic pulmonary pseudocyst due to thoracic trauma.
Traumatic pulmonary pseudocyst is uncommon and usually regresses spontaneously with conservative treatment. In rare cases, surgical intervention may be necessary. A pseudocyst may be treated surgically to prevent potential complications if the patient undergoes a thoracotomy for another reason. We present a patient with hemopneumothorax and traumatic pulmonary pseudocyst after a motor vehicle accident, who was operated on electively due to massive air leak.


A newly designed big cup nitinol stent for gastric outlet obstruction.
To find out whether a newly designed big cup nitinol stent is suitable for treatment of patients with gastric outlet obstruction resulting from gastric cancer. The new stent is composed of a proximal big cup segment (20 mm in length and 48-55 mm in diameter), a middle part (60 mm in length and 20 mm in diameter) covered by a polyethylene membrane and a distal sphericity (20 mm in length and 28 mm in diameter). Half of the proximal big cup segment is also covered by a polyethylene membrane, which is adjacent to the middle part of the stent. The stent is preloaded in a 6.0-mm-diameter introducer system. Thirteen patients with gastric outlet obstruction resulting from gastric cancer received the new stents under endoscopic and fluoroscopic guidance. Technical success was achieved in 12 of 13 (92.3%) patients. Among the 12 patients in whom endoscopic stent was placed successfully, the clinical success rate was 91.7% during a follow-up of average 6.5 mo. During the first month follow-up, the migration rate was 0%, recurrent obstruction 0% and gastric bleeding 8.3%. During the follow-up between 2-12 mo, no migration, recurrent obstruction and gastric bleeding occurred. The proximal big cup segment seems to be effective and promising for technical efficacy, clinical outcome, and preventing migration and tumor ingrowth and increasing the emptying rate of sinus ventriculi.


Pregnancy-specific transcriptional changes upon endotoxin exposure in mice.
Objectives Pregnant women are more susceptible to certain infections; however, this increased susceptibility is not fully understood. Herein, systems biology approaches were utilized to elucidate how pregnancy modulates tissue-specific host responses to a bacterial product, endotoxin. Methods Pregnant and non-pregnant mice were injected with endotoxin or saline on 16.5 days post coitum (n=8-11 per group). The uterus, cervix, liver, adrenal gland, kidney, lung, and brain were collected 12 h after injection and transcriptomes were measured using microarrays. Heatmaps and principal component analysis were used for visualization. Differentially expressed genes between groups were assessed using linear models that included interaction terms to determine whether the effect of infection differed with pregnancy status. Pathway analysis was conducted to interpret gene expression changes. Results We report herein a multi-organ atlas of the transcript perturbations in pregnant and non-pregnant mice in response to endotoxin. Pregnancy strongly modified the host responses to endotoxin in the uterus, cervix, and liver. In contrast, pregnancy had a milder effect on the host response to endotoxin in the adrenal gland, lung, and kidney. However, pregnancy did not drastically affect the host response to endotoxin in the brain. Conclusions Pregnancy imprints organ-specific host immune responses upon endotoxin exposure. These findings provide insight into the host-response against microbes during pregnancy.


Evaluation of Exfoliated Graphite to Graphene in Polyamide 66 Using Novel High Shear Elongational Flow.
Graphene has been publicized as the game changing material of this millennium. To this day, scalable production leading to exceptional material properties has been difficult to attain. Most methods require harsh chemicals, which result in destroying the graphene surface. A method was developed, exploiting high speed elongational flow in a novel designed batch mixer; creating a distribution of pristine few to many layer graphene flakes. The method focuses on exfoliating in a molten polyamide 66 (PA66) matrix, creating a graphene reinforced polymer matrix composite (G-PMC). The process revealed that high speed elongational flow was able to create few layer graphene. Graphite exfoliation was found driven in part by diffusion, leading to intercalation of PA66 in graphite. The intercalated structure lead to increases in the hydrogen bonding domain, creating anisotropic crystal domains. The thermal stability of the G-PMC was found to be dependent to the degree of exfoliation, PA66 crystal structure and composite morphology. The aim of this research is to characterize uniquely produced graphene containing polymer matrix composites using a newly created elongational flow field. Using elongational flow, graphite will be directly exfoliated into graphene within a molten polymer.


Dexrazoxane cardioprotection for patients receiving FAC chemotherapy: a pharmacoeconomic evaluation.
Anthracyclines are among the most effective and commonly-prescribed antitumor agents but have dose-limiting cumulative cardiotoxicity. We performed a pharmacoeconomic evaluation of the ability of dexrazoxane to prevent cardiac-related adverse events in patients with Stage IIIB or IV metastatic breast cancer who were treated with a median of 10 cycles of intravenous FAC (5-fluorouracil, doxorubicin and cyclophosphamide) at doses of 500/50/500 mg/m2 respectively. Dexrazoxane was given at 500 mg/m2 commencing at the seventh cycle of treatment. We determined the cost of each cardiac event prevented and the cost of each additional life-year saved by dexrazoxane use. The cost per cardiac event prevented was CDN $5745 and the cost per additional life-year saved was CDN $2856. With the increasing use of anthracyclines in Stages I and II breast cancer, these favorable clinical and economic results may broaden the range of therapeutic possibilities for anthracyclines in adjuvant and metastatic therapy of breast cancer.


[A new method for evaluating acute toxicity intragastrically for classification of chemical substances].
The authors reviewed and presented a critical analysis of the literature on defining acute toxicity of chemicals after intragastrical administration by means of traditional methods and new ones such as fixed procedure, up-down, acute-toxic-classification. Rules and conditions for the evaluation of acute toxicity by means of these methods were presented as well as the way of defining a median, lethal dose administrated intragastrically for the purpose of chemical classification.


Toxic money or paid altruism: the meaning of payments for identity-release gamete donors.
Public discourses commonly frame gamete, organ and other forms of bodily donation as altruistic 'gifts'. However, despite on-going debates about the ethics of payments to donors, few studies have examined the views of donors themselves regarding the meaning of payments and their compatibility (or not) with understandings of these practices as gifts. This article addresses this issue, analysing 24 in-depth interviews with UK identity-release gamete donors. It was crucial to all participants that their donation be viewed as fundamentally other-oriented, motivated by the desire to help others. However, whilst egg donors often accommodated payment within this narrative, male participants explained that any money would taint the gift they had given. I argue that sperm donors faced particular challenges to incorporating payment within a gift narrative for two key reasons: first, sperm donors relied on a discourse of 'pure altruism', including absolute opposition between gifts and market exchange, in order to present their donation as other-oriented. In contrast, egg donors were also able to mobilise a discourse of relational giving to present their donations as a personal gift. Second, according to a continued stereotype of sperm donors as financially motivated students, their payments have already been culturally earmarked as side-line earnings.


Measuring HCC Tumor Size in MRI-The Sequence Matters!
The aim of this paper was to assess and compare the accuracy of common magnetic resonance imaging (MRI) pulse sequences in measuring the lesion sizes of hepatocellular carcinomas (HCCs) with respect to the Milan criteria and histopathology as a standard of reference. We included 45 patients with known HCC who underwent contrast-enhanced MRI of the liver prior to liver transplantation or tumor resection. Tumor size was assessed pathologically for all patients. The MRI protocol contained axial T2-weighted images as well as T1-weighted imaging sequences before and after application of Gd-EOB-DTPA. Tumor diameters, the sharpness of lesions, and the presence of artifacts were evaluated visually on all available MRI sequences. MRI measurements and pathologically assessed tumor dimensions were correlated using Pearson's correlation coefficient and Bland-Altman plots. The rate of misclassifications following Milan criteria was assessed. The mean absolute error (in cm) of MRI size measurements in comparison to pathology was the smallest for the hepatobiliary phase T1-weighted acquisition (0.71 ± 0.70 cm, r = 0.96) and largest for the T2w turbo-spin-echo (TSE) sequence (0.85 ± 0.78 cm, r = 0.94). The misclassification rate regarding tumor size under the Milan criteria was lowest for the T2w half-Fourier acquisition single-shot turbo spin-echo sequence and the hepatobiliary phase T1w acquisition (each 8.6%). The highest rate of misclassification occurred in the portal venous phase T1w acquisition and T2w TSE sequence (each 14.3%). The hepatobiliary phase T1-weighted acquisition seems to be most accurate among commonly used MRI sequences for measuring HCC tumor size, resulting in low rates of misclassification with respect to the Milan criteria.


Low-cost simulation models in Urology: a systematic review of the literature.
Simulation models have been found to be effective and valid for training in Urology. Due to increasing costs of surgical training, there is a need for low-cost simulation models to enable Urology trainees to improve their skills. A literature review was performed using the PubMed and Embase databases until March 2020. A total of 157 abstracts were identified using the search criteria, of which 20 articles were identified describing simulation models for Urology training. Articles reviewed described simulation models created from materials costing less than $150. Data was extracted from the relevant articles in order to critically assess each paper for validity, ease of construct and educational impact. Models were found pertaining to suprapubic catheterization (6), cystoscopy (3), percutaneous nephrolithotomy (5), scrotal examination (1), circumcision (1), ureteroscopy (1), transurethral resection of the prostate and bladder (2), and open prostatectomy (1). 18/20 (90%) assessed for either face, content, or construct validity. None of the papers evaluated assessed for transferability of skills to performance in real patients. A plethora of low-cost simulation models for urological procedures are described in the literature, many of which can be easily constructed from cheap and accessible materials. However there is a need for further efforts to validate or assess for transferability of skills to clinical practice.


Photodynamic effectiveness and vasoconstriction in hairless mouse skin after topical 5-aminolevulinic acid and single- or two-fold illumination.
Several options were investigated to increase the efficacy of photodynamic therapy (PDT) using protoporphyrin IX (PpIX) induced by topically applied 5-aminolevulinic acid (ALA). Hairless mice with normal skin or UVB-light-induced skin changes were used as a model. In the first part of the study animals were illuminated immediately (t = 4) or 6 h (t = 10, PpIX fluorescence maximum) after the end of a 4 h ALA application. A total incident light fluence of 100 J/cm2 (514.5 nm) was delivered at a fluence rate of 100 or 50 mW/cm2. The PDT-induced damage to normal skin was more severe after treatment at t = 10 than at t = 4. Illumination at 50 mW/cm2 caused significantly more visible damage than the same light fluence given at 100 mW/cm2. For UVB-illuminated skin, different intervals or fluence rates made no significant difference in the severity of damage, although some qualitative differences occurred. In situ fluence rate measurements during PDT indicated vasoconstriction almost immediately after the start of the illumination. A fluorescein exclusion assay after PDT demonstrated vasoconstriction that was more pronounced in UVB-treated skin than in normal skin. The second part of the study examined the effect of two illuminations. The first illumination bleaches the PpIX fluorescence. At the start of the second illumination, new PpIX had been formed. Light of 514.5 nm was delivered at 100 mW/cm2 to a total incident light fluence of 200 J/cm2 at t = 4 (single illumination) or 100 J/cm2 at t = 4 plus 100 J/cm2 at t = 10. There was no visual difference in skin damage between 100 and 200 J/cm2 single illumination. Two-fold illumination (100 + 100 J/cm2) caused significantly more skin damage, indicating a potentially successful option for increasing the efficacy of topical ALA-PDT.


Tracheal granulation tissue. A study of bacteriology.
We prospectively examined 19 patients (21 laryngotracheal reconstructions) over a 6-month period to evaluate the bacteriology of granulation tissue present at the time of Teflon stent removal and at the first laryngoscopy several weeks later. The most frequently recovered isolates were viridans streptococci, Pseudomonas aeruginosa, nonhemolytic Streptococcus, and Staphylococcus aureus. All but one positive culture were polymicrobial. The amount of tissue did not correlate with the duration of stenting and the amount of granulation tissue and number of organisms decreased after stent removal. Further prospective study of the most appropriate antimicrobial therapy is needed.