[Endemic status of schistosomiasis in People's Republic of China in 2014].
This report presented the endemic status of schistosomiasis in the People's Republic of China at national level in 2014, and analyzed the data captured from the national schistosomiasis prevention and control system and 81 national schistosomiasis surveillance sites. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis japonica in China, 5 provinces (municipality and autonomous region) of Shanghai, Zhejiang, Fujian, Guangdong and Guangxi had achieved transmission interruption, 4 provinces of Sichuan, Yunnan, Jiangsu and Hubei had achieved transmission control, and Anhui, Jiangxi and Hunan provinces were still at infection control until 2014. There were 453 counties (city, district) endemic for schistosomiasis, with 251 million residents, and 30,048 villages endemic for schistosomiasis, with 68 million 507 thousand and 3 hundred residents. Among the 453 endemic counties (city, district), 69.09% (313/453) and 29.80% (135/ 453) endemic counties (city, district) reached the transmission interruption and transmission control respectively while the number of counties (city, district) at the stage of infection control reduced from 34 in 2013 to 5 in 2014 (accounted for 1.10% of the total number of endemic counties, 5/53). Till 2014, 115,614 people were estimated to have schistosomiasis and only 2 acute schistosomiasis cases were reported. In addition, there were 30,880 advanced schistosomiasis cases documented in 2014. In 2014, a total of 9,461,348 individuals received schistosomiasis examinations and 8,270 persons were found stool positives with the reduction rate of 50.96% as compared to that (16,865 cases) in 2013. The Oncomelania hupensis snail survey was performed in 20 123 endemic villages in 2014, and the snails were detected in 5,653 villages, which accounted for 28.09% of total villages, with 13 newly detected villages with snails. The snail survey covered an area of 576,506.37 hm² and snails were found in an area of 364 324.42 hm², including an area of 531.13 hm² detected snails for the first time. No schistosome infected snails were found in 2014. A total of 919,579 head of cattle were raised in the schistosomiasis endemic areas of China. In 2014, 494,620 head of cattle received examinations and only 666 were determined as stool positives. Based on the data from the 81 national schistosomiasis surveillance sites of China, the mean Schistosomajaponicum infection rate was 0.11% and 0.05% in humans and cattle respectively, and no infected snails were detected in 2014. There were 280,855 schistosomiasis cases receiving treatments, with 2,565,555 cases undergoing expanded chemotherapy; there were 798 head of cattle with schistosomiasis receiving treatments, with 408,690 head of cattle undergoing expanded chemotherapy; there was a total 138,923.90 hm² area with snail control by using molluscicides , with actual mollusciciding of 74,538.17 hm²; and there was an environmental modification of 5,331.42 hm². These data demonstrate a decline in the endemic city of schistosomiasis in China in 2014. However, the risk of schistosomiasis transmission remains high in some regions. Further control and effective surveillance should be strengthened to consolidate the achievements and reduce the endemic situation of schistosomiasis in China.


Factors and Predictors of Health Related Quality of Life of the General Population of Pakistan.
The standards of living, improvement in public health, and medical care in Pakistan are increasing day by day, health-related quality of life (HRQoL) has been increasingly acknowledged in various patient's reported outcomes in Pakistan. However, a large-scale general population-based study on assessing HQRoL in Pakistan was not conducted. Therefore, this study aimed to evaluate HRQoL for the general Pakistani population. A cross-sectional study with a population sample (n = 16,672) was selected from all Pakistan provinces using a stratified sampling approach. The EQ-5D-3L tool was used to measure the HRQoL of the general population of Pakistan. The descriptive and inferential statistics have been done by using SPSS version 20. Overall, 121 health states were reported in this study. EQ-5D index and EQ-VAS scores were 0.74 ± 0.32 and 0.75 ± 0.25, respectively. The percentage of people responding to any problems increased with age. Males have better health as compared to females in all age groups. All demographics were significantly associated (P < 0.01) with the mean EQ5D index and VAS scores except residence (p > 0.05). The regression model reported that age was the best predictor of the EQ-5D index scores after adjusting for the covariates (beta = 0.19; p < 0.001). This study provides Pakistani population HRQoL data measured by the EQ-5D tool, based on a national representative sample. The current study concluded that Age, City, Gender, Education, Occupation, Residence, and House occupancy are significantly affecting HRQOL. The socioeconomically deprived groups and females have inferior health status than more advantaged. The trends detected in high-income nations were usually similar to Pakistan.


Divine space: contemplating the object behind a religious patient's spatial metaphor.
If we accept that psychic space is fundamentally all about "having somewhere to put what we find" (Winnicott, 1967, p. 99), then the patient's becoming aware of and pointing out the metaphor--and her ability to utilize it--indicates that such "place" is well on the way of having been experienced as available for creative psychic use. In the course of this exposition, I also think we've managed to confirm Charles Taylor's contention that "the self only exists in a space of moral questions, that moral topography is not an external addition, an optional extra, but that the question of being or failing to be a self could not arise outside of this space" (1988, p. 317, emphasis mine). In Bollas's terms (1992, p. 31), makom may be identified as "the place of the complex self." No longer played upon according to the whim of external objects, nor even lost--albeit creatively--in the world of transitional illusoriness, the complex self has attained a modicum of detachment from which high point it questions, challenges, and redefines its relationship to objects. Moses and my patient, each in their own ways, sought out this place in the presence of what they identified as Other. Each individual found a medium for carving out a better sense of internal dimensionality, even though this achievement required relinquishing the concrete comforts of the ever-present object and welcoming a certain degree of existential loneliness. In some sense, the Other's reciprocal sense of loneliness and alterity also has been discerned and must be internalized as well, adding that characteristically bittersweet element increasingly recognized as proper to the domain of the unknown within the very limnal categories of internal space. Ultimately, the makom of utmost psychological relevance to humankind is that place made sacred by internalization. And "there, in the solitary space, we repeatedly contact that essential aloneness that launches our idiom into its ephemeral being" (Bollas, 1989, p. 22).


Involvement of Estrogen and Its Receptors in Morphological Changes in the Eyes of the Japanese Eel, Anguilla japonica, in the Process of Artificially-Induced Maturation.
During the long migration from river habitats to the spawning ground, the Japanese eel undergoes sexual maturation. This spawning migration occurs concurrently with morphological changes, such as increases in eye size; however, the mechanisms by which sex steroids and their receptors influence these changes in peripheral tissues remain unclear. The aim of this study was to investigate changes in the eyes of female Japanese eels during sexual maturation, and our research focused on estrogen receptor (ER)α and ERβ transcripts. During ovarian development, the gonadosomatic index increased and yolk-laden oocytes developed rapidly. These changes occurred in conjunction with a steady increase in plasma levels of estradiol-17β (E₂). Concomitant increases in transcript levels of ERα and ERβ in eye, brain, pituitary, and ovary were also observed. Fluorescence in-situ hybridization analyses revealed that ERα and ERβ transcripts were present in the choriocapillary layer and photoreceptor layer of the eyes, and the analysis also revealed that their signals in these layers became stronger in mature females compared to those observed in immature females, suggesting that under the influence of gonadotropins, morphological changes in the eyes are regulated by E₂ through the activation of its receptors. In conclusion, E₂ plays a crucial role in physiological adaptations that occur in peripheral tissues during the spawning migration.


Structure of a regulatory 3' untranslated region from Trypanosoma brucei.
The African trypanosome Trypanosoma brucei multiplies in mammalian extracellular fluids (bloodstream forms) and in the midgut of Tsetse flies (procyclic forms). The control of gene expression that is necessary to survive in these two environments operates almost exclusively at the posttranscriptional level, and the sequences responsible are located in the 3' untranslated regions of the mRNAs. The major surface proteins of procyclic trypanosomes, EP1, EP2, EP3, and GPEET, are not expressed in bloodstream forms. The 3' untranslated regions of these four mRNAs are not very similar, but all contain a conserved 26mer sequence that is required for developmental regulation. We have analyzed the conformation of the EP1 3' UTR in vitro by enzymatic digestion and lead hydrolysis, and in vivo by modification with DMS and with CMCT (introduced by electroporation). Results indicate that the 3' UTR can be divided into three domains. Domains I and III, at the 5' and 3' ends, form stable structures, but the central domain (domain II), which includes the 26mer, has no stable interactions either within itself, or with other parts of the 3' UTR. Domain I contains three leadzymes that do not conform to the previously reported consensus.


Design and Performance Investigation of a Robot-Assisted Flexible Ureteroscopy System.
Flexible ureteroscopy (FURS) has been developed and has become a preferred routine procedure for both diagnosis and treatment of kidney stones and other renal diseases inside the urinary tract. The traditional manual FURS procedure is highly skill-demanding and easily brings about physical fatigue and burnout for surgeons. The improper operational ergonomics and fragile instruments also hinder its further development and patient safety enhancement. A robotic system is presented in this paper to assist the FURS procedure. The system with a master-slave configuration is designed based on the requirement analysis in manual operation. A joint-to-joint mapping strategy and several control strategies are built to realize intuitive and safe operations. Both phantom and animal experiments validate that the robot has significant advantages over manual operations, including the easy-to-use manner, reduced intraoperative time, and improved surgical ergonomics. The proposed robotic system can solve the major drawbacks of manual FURS. The test results demonstrate that the robot has great potential for clinical applications.


Structural insights in interactions between RNase from Bacillus Intermedius and rhamnogalacturonan I from potato.
Being biocompatible and biodegradable polymers, polysaccharides present a perspective material for drug delivery systems. This study aimed at unraveling the molecular details of interactions between rhamnogalacturonan I, brunched with galactan side chains, and RNase from Bacillus Intermedius, binase. FTIR- and NMR-spectroscopic analyses showed that binase interacts with side chains of the polysaccharide. In complexes with polysaccharide, the protein retains its native structure. The 2D-NMR techniques revealed eight protein residues responsive to polysaccharide binding. Further, computer simulations were carried out to provide the atomistic details of binase-polysaccharide complexes. Both blind and knowledge-based docking procedures elucidate the existence of epitopes on the binase surface with the preferential binding of galactan fragments. The refinement of these complexes by molecular dynamics simulations confirmed stable protein-polysaccharide interactions. The results of this study strengthen the knowledge on non-specific protein-carbohydrate interactions and outline the rhamnogalacturonan I as a possible matrix material for protein delivery systems.


Role conflict, role ambiguity, and job satisfaction in nurse executives.
This article reports the results of a cross-sectional correlational survey design of nurse executives' (NEs') views on role conflict, role ambiguity, job satisfaction, and depression. A total of 380 surveys were returned from 1000 randomly selected participants. Four instruments were utilized, 1 for demographic data and 3 established instruments. Results indicated that the respondents had low to moderate amounts of role ambiguity, high levels of job satisfaction, low levels of depression, a negative relationship between role conflict and role ambiguity and job satisfaction, and a positive relationship between role conflict and depression. Furthermore, although levels of role conflict are decreasing, levels of role ambiguity are increasing. Neither educational level nor age was related to the dependent variables. Role conflict and role ambiguity are both forms of role stress. This study indicates that stress levels are not overwhelming to the NE and may be encouraging development of required skills. Healthcare organizations will continue to evolve and increase in complexity putting pressure on NEs in their many roles. Although this study did not consider strategies for coping with stress, this important avenue needs to be considered as NEs move forward with more extensive roles in the leadership of our healthcare system.


Intense splenic 99mTc-MDP uptake in a patient with myelofibrosis.
99mTc-MDP bone scan was performed in a 49-year-old woman with breast cancer. Whole-body bone scan showed multiple foci of increased MDP activity in the bone and intense splenic 99mTc-MDP uptake. Initial bone marrow aspiration in multiple locations yielded no blood cells. A subsequent bone marrow biopsy in the left anterior superior iliac spine showed myelofibrosis in addition to the known bone metastasis.


[Evaluation of the embryonic and foetal heart rate at 6(+0) to 11(+6) weeks of gestation].
To establish the normal range of embryonic heart rate (EHR) and foetal heart rate (FHR) at 6(+0) to 11(+6) weeks of gestation, to evaluate the risk of pregnancy loss depending on EHR and FHR values and to establish if checking of FHR with the use of M-mode method is possible in different levels obstetric departments. Transvaginal or transabdominal ultrasound using M-mode in 255 singleton pregnancies. Maternal age varied between 16 and 44 years (mean 29 +/- 5 years). There were 67% primigravidas. Gestational week was established on the basis of CRL measurements. Demographic factors, obstetrical history and follow-up were collected. Data was statistically reviewed. FHR varied between 47 and 192 bpm (mean 154 +/- 26 bpm). At 6 weeks, mean EHR was 116 +/- 21 bpm, then slowly increased, reaching mean 172 +/- 9 bpm at 10 weeks. At 11 weeks the mean FHR achieved the level of 165 +/- 7 bpm. The difference was statistically significant. The r-correlation ratio between FHR and the gestational week was 0.58. In case of 7 embryos (2.75%) at 6.1 to 8.1 weeks of gestation slow FHR was noted (< 100 bpm). The scan performed 7-10 days later revealed miscarriages in all cases. EHR and FHR in the first trimester depends on gestational week. It increases since 6 to 9 weeks and decreases after 10 weeks. The highest values of FHR are observed between 9 and 10 weeks of gestation. The risk of early pregnancy loss increases significantly in case of detecting slow FHR. FHR can be checked by M-mode methods using any kind of ultrasound machine.


Lobular distribution pattern of lactate dehydrogenase and 6-phosphogluconate dehydrogenase activity in rat liver.
Lactate dehydrogenase (LDH) and 6-phosphogluconate dehydrogenase (6-PGDH) activities were measured in lobular areas expanding between 3 portal tracts and an efferent central vein in the livers of male Wistar rats, using a Lowry technique. The maximum of LDH activity was found in a nearly uniform broad area in the lobular periphery. From that area values decreased along periportal/septal-->perivenous gradients, but only slightly within that area along the periportal-->septal axis of the vascular septum. Maximum values of 6-PGDH activity were present in an intermediate area close to the central vein demonstrating a rather inhomogeneous distribution pattern without a clear definition of zonal limits. Our data on the distribution pattern of LDH are in agreement with the concept of the metabolic lobulus and are supported by a recent evaluation of the vascular architecture in rat liver. The lobular distribution pattern of 6-PGDH cannot be interpreted without doubt in accordance with that concept.


IDH2 mutations are frequent in angioimmunoblastic T-cell lymphoma.
Mutations in isocitrate dehydrogenase 1 (IDH1) and isocitrate dehydrogenase 2 (IDH2) occur in most grade 2 and 3 gliomas, secondary glioblastomas, and a subset of acute myelogenous leukemias but have not been detected in other tumor types. The mutations occur at specific arginine residues and result in the acquisition of a novel enzymatic activity that converts 2-oxoglutarate to D-2-hydroxyglutarate. This study reports IDH1 and IDH2 genotyping results from a set of lymphomas, which included a large set of peripheral T-cell lymphomas. IDH2 mutations were identified in approximately 20% of angioimmunoblastic T-cell lymphomas (AITLs), but not in other peripheral T-cell lymphoma entities. These results were confirmed in an independent set of AITL patients, where the IDH2 mutation rate was approximately 45%. This is the second common genetic lesion identified in AITL after TET2 and extends the number of neoplastic diseases where IDH1 and IDH2 mutations may play a role.


Screening and Identification of Therapeutic Targets for Pulmonary Arterial Hypertension Through Microarray Technology.
Pulmonary arterial hypertension (PAH) is a rare but fatal disease characterized by vascular cell proliferation; the pathogenesis of PAH has yet to be fully elucidated. Publicly available genetic data were downloaded from the Gene Expression Omnibus (GEO) database, and gene set enrichment analysis (GSEA) was used to determine significant differences in gene expression between tissues with PAH and healthy lung tissues. Differentially expressed genes (DEGs) were identified using the online tool, GEO2R, and functional annotation of DEGs was performed using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Next, the construction and module analysis of the protein-protein interaction (PPI) network and verification of the expression level of hub genes was performed. Finally, prediction and enrichment analysis of microRNAs associated with the hub genes was carried out. A total of 110 DEGs were detected by screening PAH and healthy lung samples. The expression of nine genes [polo-like kinase 4 (PLK4), centromere protein U, kinesin family member 20B, structural maintenance of chromosome 2 (SMC2), abnormal spindle microtubule assembly, Fanconi Anemia complementation group I, kinesin family member 18A, spindle apparatus coiled-coil protein 1, and MIS18 binding protein 1] was elevated in PAH; this was statistically significant compared with their expression in healthy lung tissue, and they were identified as hub genes. GO and KEGG analysis showed that the variations in DEGs were abundant in DNA-templated transcription, sister chromatid cohesion, mitotic nuclear division, cell proliferation, and regulation of the actin cytoskeleton. In conclusion, this study has successfully identified hub genes and key pathways of PAH, with a total of 110 DEGs and nine hub genes related to PAH, especially the PLK4 and SMC2 genes, thus providing important clues for the in-depth understanding of the molecular mechanism of PAH and providing potential therapeutic targets.


Adsorption and removal kinetics of phosphonate from water using natural adsorbents.
The removal of phosphonate from water was studied using some natural adsorbents. Potassium phosphonate is a fungicide used for the control of Phytophthora capsici, which is prevalent in black pepper (Piper nigrum L.). Batch adsorption kinetic experiments were conducted on the adsorption of phosphonate onto the adsorbents. The concentration of phosphonate was measured on a high-performance liquid chromatograph fitted with a conductivity detector. The percentage removal of phosphonate by powdered laterite stone (PLS) from water was 40.4%, within a residence time of 15 minutes. The mechanisms of the rate of adsorption were analyzed and compared using the pseudo-second-order, Elovich, and intraparticle diffusion models. The experimental data was found to correlate well with the pseudo-second-order kinetic model, indicating adsorption as a chemisorption process. A possible reaction in the phosphonate-PLS system also has been proposed. The PLS can be used as a low-cost natural adsorbent for phosphonate removal from water.


[Infectious diseases among military personnel in the catchment area of the United Nations Interim Force in Lebanon hospital, from 1993 to 2000].
In the study the incidence of infectious diseases among military personnel of the United Nations Interim Force in Lebanon and local civilian population is examined. Additionally, the authors investigate the potential risk factors, including environmental conditions, influencing the incidence of infectious diseases. Epidemiological analysis was conducted based on the medical records of patients treated in the Internal and Surgical Ward of the UNIFIL Hospital from 1993 to 2000. The patients with infectious diseases accounted for 5.84 % of all patients hospitalized during the analyzed period. The most frequent infectious diseases treated during that time were salmonellosis and staphylococcal food poisoning.


Predictors of depressive symptoms in caregivers of patients with heart failure.
Millions of family members deliver informal care and support to patients with heart failure (HF). Caregivers of patients with HF experience depressive symptoms, but factors associated with depressive symptoms are unknown. The purposes of this study were (1) to examine differences between caregivers with and without depressive symptoms in patients' characteristics and caregivers' functional status, caregiving burden (time devoted to caregiving, difficulty of caregiving tasks, and overall perceived caregiving distress), and perceived control; and (2) to determine predictors of depressive symptoms of caregivers. A total of 109 caregivers (mean age of 57 years; spousal caregiver, 79%) and patients with HF participated in this study. Depressive symptoms, perceived control, and functional status of both patients and caregivers were assessed using the Beck Depression Inventory II, the Control Attitudes Scale-Revised, and the Duke Activity Status Index, respectively. Caregivers' burden (time and difficulty of caregiving tasks and burden) were assessed using the Oberst Caregiving Burden Scale and the Zarit Burden Interview. The 27.5% of HF caregivers with depressive symptoms (Beck Depression Inventory II score > or =14) had poorer functional status, lower perceived control, and higher perceived caregiving distress; experienced more caregiving difficulty; and spent more time in caregiving tasks than did caregivers without depressive symptoms. Controlling for age and sex in a multiple regression, caregivers' own functional disability (standard beta [sbeta] = -.307, P < .001), perceived control (sbeta = -.304, P < .001), and caregiver burden (sbeta = .316, P = .002) explained 45% of the variance in caregivers' depressive symptoms. Patients' New York Heart Association class and functional status did not predict caregivers' depressive symptoms. Caregivers' poor functional status, overall perception of caregiving distress, and perceived control were associated with depressive symptoms. Depressed caregivers of patients with HF may benefit from interventions that improve caregivers' perceived control, address the caregiving burden, and improve or assist with caregivers' functional status.


[When to suspect pulmonary embolism in a patient with deep venous thrombosis?].
The approach to take in trying to establish or disprove a diagnosis of pulmonary embolism in the presence of deep vein thrombosis is the subject of some controversy nowadays. Systematic perfusion lung scan can be proposed, given the mediocre specificity of the clinical symptoms of embolism or the high frequency of asymptomatic pulmonary embolism. This strategy, however, is not validated in terms of cost-efficacy. In practical terms, favourable evolution and the low rate of recurrent embolism observed with a well executed anticoagulant treatment pleads against systematic scintigraphy. Because of its moderate sensitivity, systematic echocardiography probably should not be an element of the assessment of asymptomatic pulmonary embolism. The advent of spiral CT scan in the management of such patients could however make it necessary to reconsider this position, by allowing complete venous and pulmonary examination in thrombo-embolic disease.


[TcpC induces apoptosis of human vascular endothelial cells and its mechanisms].
To investigate the effects of TcpC on human umbilical vascular endothelial cells (HUVECs) and its mechanisms. HUVECs were co-cultured with TcpC secreting wild-type E. coli strain CFT073 (TcpC(wt)) or tcpc gene-deleted CFT073 mutant strain (TcpC(mut)) in transwell system,respectively. Apoptosis of HUVECs was analyzed by Annexin-V/PI double staining. Mitochondrial membrane depolarization was detected by JC-1 staining. Expression of apoptosis-related proteins in HUVECs was determined by Western blot. HUVECs showed morphological changes after co-cultured with TcpC(wt) for 24 h: the cells became detached and cell debris increased,and cell number was also decreased when compared to HUVECs co-cultured with TcpC(mut). The apoptosis of HUVEC cells co-cultured with TcpC(wt) for 24 h significantly increased,compared to that of control group and TcpC(mut) group (60.1% 9.7% compared with 9.0% 1.3% and 16.9% 0.4%,respectively, P<0.05); meanwhile the mitochondrial depolarization of HUVECs co-cultured with TcpC(wt) was significantly increased,compared to that in control and TcpC(mut) groups (64.5% 0.9% compared with 14.5% 2.1% and 15.6% 3.3%, respectively,P<0.05). Cleavage of PARP and inhibition of Mcl-1 and XIAP expression were seen in HUVECs co-cultured with TcpC(wt),but not in groups of control and TcpC(mut). TcpC secreted from CFT073 can induce apoptosis of HUVECs through mitochondrial pathway, in which PARP is cleaved and Mcl-1 and XIAP expressions are inhibited.


Birth of a gene: locus of neuronal BC200 snmRNA in three prosimians and human BC200 pseudogenes as archives of change in the Anthropoidea lineage.
The gene encoding brain-specific dendritic BC200 small non-messenger RNA is limited to the primate order and arose from a monomeric Alu element. It is present and neuronally expressed in all Anthropoidea examined. By comparing the human sequence of about 13.2 kb with each of the prosimian (lemur 14.6 kb, galago 12 kb, and tarsier 13.8 kb) orthologous loci, we could establish that the BC200 RNA gene is absent from the prosimian lineages. In Strepsirhini (lemurs and lorises), a dimeric AluJ-like element integrated very close to the BC200 insertion point, while the corresponding tarsier region is devoid of any repetitive element. Consequently, insertion of the Alu monomer that gave rise to the BC200 RNA gene must have occurred after the anthropoid lineage diverged from the prosimian lineage(s). Shared insertions of other repetitive elements favor proximity of simians and tarsiers in support of their grouping into Haplorhini and the omomyid hypothesis. On the other hand, the nucleotide sequences in the segment that is available for comparison in all four species reveal less exchanges between Strepsirhini (lemur and galago) and human than between tarsier and human. Our data imply that the early activity of dimeric Alu sequences must have been concurrent with the activity of monomeric Alu elements that persisted longer than is usually thought. As BC200 RNA gave rise to more than 200 pseudogenes, we used their consensus sequence variations as a molecular archive recording the BC200 RNA sequence changes in the anthropoid lineage leading to Homo sapiens and timed these alterations over the past 35-55 million years.


Abortion training to be required in standard Ob / Gyn curriculum.
On February 15, (1995) the Accreditation Council for Graduate Medical Education announced that it will now require medical schools seeking accreditation to provide abortion training for all residents in obstetrics and gynecology. The new "Program Requirements for Residency Education in Obstetrics and Gynecology," approved unanimously, will take effect on January 1, 1996. According to the Council, the newly issued standards are the first to refer specifically to abortion. The language states, "Experience with induced abortion must be part of residency training, except for residents with moral or religious objections .... Experience with management of complications of abortion must be provided to all residents." The Council also mandates that if a medical school itself has "a religious, moral or legal" objection to teaching the procedure, it must "ensure that residents ... who do not have a religious or moral objection receive education and experience in performing abortion at another institution." Other revisions provide for expanded resident education in "primary and preventive care," due to the fact that many women rely on their obstetricians and gynecologists as their primary care physicians, as well as additional training experience in family planning, including "all reversible methods of contraception" and sterilization. In order to be certified by the American Board of Obstetrics and Gynecology, ob/gyns must graduate from an accredited residency program. In addition, teaching hospitals must be accredited to secure federal reimbursements for the medical services patients receive from residents. The Accreditation Council for Graduate Medical Education operates under the aegis of the American Medical Association, the American Board of Medical Specialties, the American Hospital Association, the Association of American Medical Colleges, and the Council of Medical Specialty Societies. Both the American Board of Obstetrics and Gynecology and the American College of Obstetricians and Gynecologists support the Council's revised standards.


Single isomer technetium-99m tamoxifen conjugates.
To produce an imaging agent for breast cancer using a technetium-99m-labeled agent specific for estrogen receptors, an N(2)S(2) bifunctional chelator was conjugated to Z- and E-aminotamoxifens through an amide linker. These bioconjugates have been chelated with both technetium-99m and rhenium. For the Z-isomer, chelation with rhenium in the presence of sodium acetate yields a mixture of two isomers, anti and syn, in a 1:1 ratio and in the presence of hydroxide results in only the anti isomer. Both the Z- and E-tamoxifen conjugates have been chelated with technetium-99m at the tracer level yielding a single isomer product, which is assigned as anti based on chromatographic comparison to the rhenium complexes. Radiochemical yields were consistently greater than 80%, with Sep-Pak column purification yielding a final product with >99% radiochemical purity and no residual starting material. Both in vitro and in vivo biological evaluation of the tamoxifen chelates indicated very limited estrogen receptor binding.


[Pressure ulcers in the elderly: analysis of prevalence and risk factors].
Studies on the prevalence of pressure ulcer and e.rperiences of living with elderly people with injuries during practice in long-stay institutions for the elderly have given rise to many concerns. This work aims to examine the prevalence and risk factors of pressure ulcer in the institutionalized elderly. This retrospective, quantitative study was held in a public long-stay institution for the elderly in Fortaleza, Ceará, Brazil. The sample consisted of 300 medical records of elderly from 2006 to 9009. It was used for data collection form. All ethical guidelines were followed. The most prevalent risk factors were: stroke (60%) and hypertension (74.3%). The average prevalence of pressure ulcers in the period was 18.8%, rangingfrom 11.1% to 23.2%. The recommendations for the prevention of pressure ulcers include the development of a prevention program to promote active aging


Observation of the pη^{'} Cusp in the New Precise Beam Asymmetry Σ Data for γp→pη.
Data on the beam asymmetry Σ in the photoproduction of η mesons off protons are reported for tagged photon energies from 1130 to 1790 MeV (mass range from W=1748 MeV to W=2045 MeV). The data cover the full solid angle that allows for a precise moment analysis. For the first time, a strong cusp effect in a polarization observable has been observed that is an effect of a branch-point singularity at the pη^{'} threshold [E_{γ}=1447 MeV (W=1896 MeV)]. The latest BnGa partial wave analysis includes the new beam asymmetry data and yields a strong indication for the N(1895)1/2^{-} nucleon resonance, demonstrating the importance of including all singularities for a correct determination of partial waves and resonance parameters.


Comparative transcriptomics reveals the difference in early endosperm development between maize with different amylose contents.
In seeds, the endosperm is a crucial organ that plays vital roles in supporting embryo development and determining seed weight and quality. Starch is the predominant storage carbohydrate of the endosperm and accounts for ∼70% of the mature maize kernel weight. Nonetheless, because starch biosynthesis is a complex process that is orchestrated by multiple enzymes, the gene regulatory networks of starch biosynthesis, particularly amylose and amylopectin biosynthesis, have not been fully elucidated. Here, through high-throughput RNA sequencing, we developed a temporal transcriptome atlas of the endosperms of high-amylose maize and common maize at 5-, 10-, 15- and 20-day after pollination and found that 21,986 genes are involved in the programming of the high-amylose and common maize endosperm. A coexpression analysis identified multiple sequentially expressed gene sets that are closely correlated with cellular and metabolic programmes and provided valuable insight into the dynamic reprogramming of the transcriptome in common and high-amylose maize. In addition, a number of genes and transcription factors were found to be strongly linked to starch synthesis, which might help elucidate the key mechanisms and regulatory networks underlying amylose and amylopectin biosynthesis. This study will aid the understanding of the spatiotemporal patterns and genetic regulation of endosperm development in different types of maize and provide valuable genetic information for the breeding of starch varieties with different contents.


Differential diagnosis of hepatic tumor-like lesions in dog by using dynamic CT scanning.
Dynamic liver CT scanning is used to observe the hemodynamics of hepatic tumor-like lesions by taking images sequentially after administration of contrast media. In this study in dogs, we compared the hemodynamic patterns of hepatocellular carcinoma (HCC), one of the malignant tumors, and nodular hyperplasia (NH), a benign tumor that is more common in older dogs. Thirty-six dogs with HCC and 40 dogs with NH, which were histopathologically diagnosed at Taniura Animal Hospital, were used as subjects. Dynamic CT scanning was performed and the data of each scanning phase were collected. Dilated blood vessels, septum formation, and capsule formation were noted in the tumors from 25, 17, and 25 animals with HCC, respectively. In the arterial phase, high density and low contrast were noted in 8 and 23 dogs, respectively. Low density was noted in 34 dogs in the equilibrium phase. In contrast, no dilated blood vessels, septum formation, or capsule formation was noted in the dogs with NH. High density, low contrast, and low density were noted in 8, 9, and 23 dogs, respectively, in the arterial phase. In the equilibrium phase, the enhancement level was equal to the surrounding liver tissues in all animals. The CT values of HCC in the plain, the arterial phase, portal venous phase and equilibrium phase after the administration of contrast media, were significantly (p < 0.05 to 0.001) lower than those of the surrounding liver tissues. In the arterial phase, the percent incidence of low density was significantly less in HCC than NH, while that of low contrast was significantly greater (p < 0.001) in HCC than NH. Dynamic CT scanning identified differences between the hemodynamics and internal structures of HCC and NH in dogs. Dynamic liver CT scanning can therefore be considered a useful technique in the differential diagnosis of hepatic tumor-like lesions in dogs.


The intraductal approach to the breast: raison d'être.
Opportunities for the detection, prediction, and treatment of breast cancer exist at three biological levels: systemically via the blood, at the whole organ level, and within the individual ductal lobular structures of the breast. This review covers the evaluation of approaches targeted to the ductal lobular units, where breast cancer begins. Studies to date suggest the presence of 5 to 12 independent ductal lobular systems per breast, each harboring complex cellular fluids contributed by local and systemic processes. New techniques for accessing and interrogating these systems offer the potential to gauge the microenvironment of the breast and distill biological risk profiles.


Active flow management in preparative chromatographic separations: a preliminary investigation into enhanced separation using a curtain flow inlet fitting and segmented flow outlet fitting.
Active flow management in the form of curtain flow sample introduction and segmented outlet flow control has been shown to enable sample to elute through a chromatography column under the principles of the "infinite diameter column". Such an elution process avoids the detrimental effects of the heterogeneity of particle-packed chromatographic columns by injecting the sample directly into the radial core region of the column, thus avoiding wall effects. The process described herein illustrates how the principles of the infinite diameter column can be applied using conventional injection devices suitable for long-term analysis that requires robust protocols. Using this approach, sensitivity in separation was 2.5 times greater than conventional chromatography, yielding a product at twice the concentration. Benefits of curtain flow injection are thus relevant to both preparative-scale and analytical-scale separations.


Recent trends and future prospects in computational GPCR drug discovery: from virtual screening to polypharmacology.
Extending virtual screening approaches to deal with multi-target drug design and polypharmacology is an increasingly important aspect in drug design. In light of this, the concept of accessible chemical space and its exploration should be reviewed. The great advantages of re-using drugs with safe pharmacological profiles with favourable pharmacokinetic properties highlights drug repositioning as a valid alternative to rational drug design, massive drug development efforts, and high-throughput screening, especially when supported by in silico techniques. Here, we discuss some of the advantages of multi-target approaches, and we review some significant examples of their application in the last decade to that well known class of pharmaceutical targets, the G-protein coupled receptors.


Association between race, obesity and diabetes in elderly community dwellers: data from the FIBRA study.
This study sought to investigate the effect of race on measures of body fat (body mass index - BMI, waist circumference - WC and waist-hip ratio - WHR), as well as its relationship with diabetes, among elderly individuals living in urban areas in seven places in Brazil, according to gender. This is a cross-sectional study carried out with a probabilistic sample comprising 2,566 individuals with 65 years of age or more who participated in the FIBRA Study (Frailty in Elderly Brazilians). We used several self-reported sociodemographic variables (gender, age, race, schooling and family income), anthropometric measures of general (BMI) and abdominal obesity (WC and WHR) and self-reported diabetes. Adjusting for schooling and income, white race was associated with higher WC values (p = 0.001) and WHR (p > 0.001) for male gender, regardless of diabetes status. However, when we considered only diabetic individuals, black race became associated with general (BMI) (p = 0.007) and central obesity (CC) (p > 0.001), only among women.


[Psychosomatic Consultation in the Workplace--Description and Modelling of a New Health-Related Service].
In Germany, mental disorders have increasing importance for disability and early retirement. However, patients may have to wait several months before becoming an appointment with a psycho(somatic) therapist. Accordingly, several companies initiated a "psychosomatic consultation in the workplace" (PCIW). This concept has been explored. Qualitative data analysis (expert interviews with stakeholders, focus group interviews with occupational health physicians; Mayring's content analysis) focussed on the question of how the concept of a PCIW can be tailored to meet the employees' needs. Concepts and implementation of PCIW differed with regard to the aspects dissemination of information about the consultation, gatekeeping, place of the consultation, and number of appointments with the psycho(somatic) therapist. The concepts of PCIW may be described as more or less "restrictive" or "liberal". The interviewees emphasised the need for PCIW and discussed the involvement of the occupational health physician within this approach. PCIW proved of value. Yet, the interviewees were ambivalent regarding the fact that companies offer and pay for treatment which should be provided within standard health care. Shaping company-based elements of standard health care should respect setting-specific needs and involve in-company stakeholders into the process.


Assessment & treatment of persons with pedophilia.
1. Like any other form of major mental disorders, pedophilia is an AXIS-I diagnosis that warrants psychiatric treatment. 2. The combination of anti-androgenic medications and individual/group psychotherapy are common treatments for pedophilia. 3. The social stigmatization of pedophilia brands mental health professionals who provide treatment for pedophiles as supporters of illegal sexual acts against children rather than as professionals treating a psychiatric disorder.


Increasing Transcutaneous Oxygen Pressure in Patients With Neuroischemic Diabetic Foot Ulcers Treated With a Sucrose Octasulfate Dressing: A Pilot Study.
Regarding the positive clinical outcomes of sucrose octasulfate impregnated dressing documented in neuroischemic diabetic foot ulcers (DFUs), we aimed to evaluate the microcirculatory status in patients with neuroischemic DFU through the use of sucrose octasulfate dressing. Eleven patients with neuroischemic DFU were included in a prospective pilot study between July 2019 and March 2020. We evaluated the effect in transcutaneous oxygen pressure (TcPO2; mm Hg) values within the use of a sucrose octasulfate dressing in the course of the healing process of neuroischemic DFUs (UrgoStart Contact, Laboratoires Urgo Medical). TcPO2 values were assessed at day 0 and monthly until wound healing was achieved. Additionally, wound healing process was evaluated using the Wollina score system and wound area surface, at day 0 and monthly until 20 weeks of follow-up or wound healing first occurred. TcPO2 values showed a significant increase between day 0 (29.45 ± 7.38 mm Hg) and wound closure (46.54 ± 11.45 mm Hg, P = .016), after dressing application. Wollina wound scores showed a significant improvement (4.2 ± 1.7 at day 0 to 5.4 ± 1.3 at the end of the study; P = .004). Median wound area at day 0 was 1.30 cm2, interquartile range [1.60-1] cm2, and 0.5 cm2 at week 4, interquartile range [1.1-0.1], P < .001. Median healing time was 8 weeks, interquartile range [8-5]. Treating a neuroischemic DFU with a sucrose octasulfate dressing in the standard of care showed an increase in skin oxygen pressure.


Bis(mu-acetato-kappa3O,O':O')bis[bis(acetato-kappa2O,O')diaquadysprosium(III)] tetrahydrate.
The title compound, [Dy(2)(C(2)H(3)O(2))(6)(H(2)O)(4)].4H(2)O, crystallizes in the form of dimeric units related by an inversion centre. Each cation is nine-coordinate, binding to two water molecules and three acetate groups, two of which are bidentate and the third tridentate. This last acetate group acts as a bridge between neighbouring metal atoms, leading to an intradimer Dy...Dy separation of 4.170 (1) A.


Choroid plexus hemangioma with port-wine nevus of the face: relationship to Sturge-Weber syndrome--case report.
The authors describe a case of choroid plexus hemangioma in a 49-year-old male. Computed tomographic scan showed an isodense mass at the trigone of the right lateral ventricle with homogeneous enhancement. He also displayed a port-wine nevus on the ipsilateral side of the face. At operation, the tumor was found not to adhere to the lateral ventricular wall but to be connected to the choroid plexus, and was colored similarly to the facial nevus. Histological examination showed a capillary hemangioma with many crowded capillaries. This case was not included in the category of Sturge-Weber syndrome but is thought to be closely related, considering the syndrome from the viewpoint of generalized neurocutaneous hemangiomatosis.


Gene therapy for cancer through adenovirus vector‑mediated expression of the Ad5 early region gene 1A based on loss of IGF2 imprinting.
Loss of (genomic) imprinting (LOI) of the insulin-like growth factor 2 gene (IGF2) is a common epigenetic abnormality in many human cancers. IGF2 imprinting is regulated by differentially methylated domains (DMD) in the imprinting control region that is located between IGF2 and H19 on human chromosome 11. In the present study, combined expression of adenoviral vectors (Ad-EGFP and Ad-E1A) driven by H19 enhancer-DMD-H19 promoter complex was investigated and their effects on the tumor growth were assessed in vitro and in vivo. When infected with Ad-EGFP, the cancer cell lines with the LOI, such as HRT-18 and HT-29 cells, had the expression of the EGFP protein, whereas three cancer cell lines with the maintenance of imprinting (MOI) (HCT-116, MCF-7 and GES-1) had weak expression of EGFP. Furthermore, the expressed Ad-E1A significantly decreased cell viability and induced cell apoptosis only in HRT-18 and HT-29 cells in vitro, and effectively suppressed tumor development in HRT-18 and HT-29 xenograft in nude mice. It is concluded that this gene therapy vector is effective in the suppression of the growth of human colon cancer cells in vitro and in vivo, and that cancer gene therapy based on loss of IGF2 imprinting may prove to be a novel therapeutic option.


Consensus on the clinical use of myeloid growth factors.
Myeloid growth factors have significantly improved the quality of life and reduced the morbidity of patients experiencing chemotherapy-induced neutropenia or undergoing bone marrow transplantation. However, in only a few instances have they directly contributed to improved response rates, better disease-free survival, or decreased mortality. With their increased use, concern has risen about their cost-effectiveness and appropriateness. To justify the use of myeloid growth factors and maximize patient benefit while minimizing the cost to health care systems and society, the development of guidelines for the clinical use of these expensive drugs is of great importance. In recent years both a European and an American expert panel have tried to establish consensus guidelines based on published evidence. A remarkable agreement can be found between results of both working parties. Clear recommendations for an optimal and more rational use of myeloid growth factors in clinical practice on both sides of the ocean have been delineated.


Formulation of sunscreens with enhancement sun protection factor response based on solid lipid nanoparticles.
Solid lipid nanoparticle (SLN) was regarded as new topical delivery systems for pharmaceutical and cosmetic active ingredients. The purpose of this study is to develop carrier systems for organic and inorganic sunscreens based on a matrix composed of carnauba wax and decyl oleate. Formulae (F1-F7) were prepared using butyl methoxydibenzoylmethane and octyl methoxycinnamate as organic components, and titanium dioxide (TiO(2) ) was used as inorganic component. Both types of sunscreens were incorporated into SLN formulations using classical method of preparation. To evaluate the effect of the pigments on the nanoparticles, particle size was measured using Mastersizer particle size analyser. UV-protection abilities of formulations were investigated by the in vitro sun protection factor test (SPF). Further parameters determined were spreadability as well as viscosity. The rheological behaviour of the formulations was also carried out. From the plot of log of shear stress vs. log of shear rate, the slope of the plot representing flow index and ontology of the y-intercept indicating consistency index was calculated. The formulae showed a flow index of 0.2074-0.4005 indicating pseudoplastic flow behaviour. Significant increases in SPF values up to about 50 were reported after the encapsulation by using organic and inorganic filters in Canada wax and decyl oleate. So, SLN could be appropriate vehicles to carry organic and inorganic sunscreens. The rational combination of cinnamates, titanium dioxide and Zinc oxide has shown a synergistic effect to improve the SPF of cosmetic preparations.


High dose cyclophosphamide, fractionated total body irradiation with involved field irradiation and autologous bone marrow transplantation in malignant lymphoma.
The objective of this clinical trial was to determine if radiation to areas of recurrence or bulky disease prior to total body irradiation (TBI) and chemotherapy followed by autologous bone marrow transplantation (ABMT) altered the site of relapse and/or prolonged survival. Forty-eight patients with recurrent or refractory malignant lymphoma were treated with high-dose cyclophosphamide and fractionated TBI followed by ABMT. Thirty-four patients were eligible to receive involved field radiation therapy (IF-RT) to sites of recurrence or bulky disease. The overall response rate in 46 evaluable patients was 89% with 33 complete remissions (CR) and 8 partial remissions (PR). In a multivariant analysis increasing LDH, decreased serum albumin, older age, and lack of sensitivity to prior chemotherapy were associated with poorer survival. There were 10 deaths due to treatment related complications, 8 died of pulmonary complications of whom 6 were in CR. Of 11 who had received IF-RT and subsequently relapsed, 4 recurred in or adjacent to the involved field. We conclude that intensive chemo-radiotherapy proved to be an effective salvage therapy for patients with recurrent malignant lymphoma, resulting in a projected actuarial 33% DFS at 5 years, but was associated with a high transplant-related mortality.


Profiling Real-Time Aroma from Green Tea Infusion during Brewing.
Aroma substances are the most crucial criteria for the sensory evaluation of tea quality, and also key attractors influencing consumers to make the decision for purchasing tea. Understanding the aromatic properties of tea infusion during different brewing time is crucial to control the tea aromatic quality. Here, headspace and direct immersion solid-phase microextraction (HS-SPME and DI-SPME), coupled with GC-MS, were employed to investigate the impact of brewing time on the changes of the volatile features of green tea infusion. Esters, aldehydes, alcohols, fatty acids, and alkaloids were the predominant volatile groups from tea infusions. Two to three minutes was identified as the best duration for the tea brewing that can maximize the abundance of aromatic chemicals in the headspace emitted from the tea infusions. The variation of the key aromatic contributors between the tea infusion and the headspace over the infusion tended to equilibrate during the tea brewing process. This study provides a theory-based reference method by analyzing the real-time aromatic characteristics in green tea. The optimal time was determined for aromatic quality control, and the complementary relationship between the volatiles in the headspace and its counterpart, tea infusion, was primarily elucidated.


Regulation of hepcidin and iron-overload disease.
Hepcidin, a 25-amino-acid antimicrobial peptide, is the central regulator of iron homeostasis. Hepcidin transcription is upregulated by inflammatory cytokines, iron, and bone morphogenetic proteins and is downregulated by iron deficiency, ineffective erythropoiesis, and hypoxia. The iron transporter ferroportin is the cognate receptor of hepcidin and is destroyed as a result of interaction with the peptide. Except for inherited defects of ferroportin and hepcidin itself, all forms of iron-storage disease appear to arise from hepcidin dysregulation. Studies using multiple approaches have begun to delineate the molecular mechanisms that regulate hepcidin expression, particularly at the transcriptional level. Knowledge of the regulation of hepcidin by inflammation, iron, erythropoiesis, and hypoxia will lead to an understanding of the pathogenesis of primary hemochromatosis, secondary iron overload, and anemia of inflammatory disease.


Atorvastatin treatment induced peroxisome proliferator-activated receptor alpha expression and decreased plasma nonesterified fatty acids and liver triglyceride in fructose-fed rats.
We aimed to investigate the effect of atorvastatin (5 and 30 mg/kg/day for 2 weeks) on hepatic lipid metabolism in a well established model of dietary hypertriglyceridemia, the fructose-fed rat. Fructose feeding (10% fructose in drinking water for 2 weeks) induced hepatic lipogenesis and reduced peroxisome proliferator-activated receptor alpha (PPARalpha) expression and fatty acid oxidation. As a result, plasma and liver triglyceride and plasma apolipoprotein B (apoB) levels were increased. Atorvastatin, 5 and 30 mg/kg during 2 weeks, markedly reduced plasma triglyceride, but decreased apoB levels only at the highest dose tested (50%). Triglyceride biosynthetic enzymes and microsomal triglyceride transfer protein were unchanged, whereas liver PPARalpha, acyl-CoA oxidase, and carnitine palmitoyltransferase I mRNA levels (1.9-, 1.25-, and 3.4-fold, respectively) and hepatic fatty acid beta-oxidation activity (1.25-fold) were increased by atorvastatin at 30 mg/kg. Furthermore, hepatic triglyceride content (45%) and plasma nonesterified fatty acids (NEFAs) (49%) were reduced. These results show for the first time that liver triglyceride increase in fructose-fed rats is linked to decreased expression of PPARalpha, which is prevented by atorvastatin treatment. The increase in PPARalpha expression caused by atorvastatin was associated with reduced liver triglyceride and plasma NEFA levels.


[Lung cancer mortality and cigarette smoking in Europe, North America, Japan, and Australia: regional differences and chronological development].
Trends and regional differences in lung cancer mortality and cigarette smoking are examined for 26 developed countries. "In 1975, lung cancer mortality figures for females aged 55 to 64 years...showed 12 to 60 deaths per 100,000 inhabitants, for males 60 to 270 deaths. In nearly all countries the mortality rates of males have been increasing since 1958.... For females the rise in lung cancer mortality is particularly steep...." An increase in cigarette smoking between 1935 and 1973 is also noted, and it is found that "the ranking of the countries by cigarette consumption essentially corresponds to that by lung cancer mortality." (summary in ENG)


Label-free high-throughput microRNA expression profiling from total RNA.
MicroRNAs (miRNAs) are key biological regulators and promising disease markers whose detection technologies hold great potentials in advancing fundamental research and medical diagnostics. Currently, miRNAs in biological samples have to be labeled before being applied to most high-throughput assays. Although effective, these labeling-based approaches are usually labor-intensive, time-consuming and liable to bias. Besides, the cross-hybridization of co-existing miRNA precursors (pre-miRNAs) is not adequately addressed in most assays that use total RNA as input. Here, we present a hybridization-triggered fluorescence strategy for label-free, microarray-based high-throughput miRNA expression profiling. The total RNA is directly applied to the microarray with a short fluorophore-linked oligonucleotide Universal Tag which can be selectively captured by the target-bound probes via base-stacking effects. This Stacking-Hybridized Universal Tag (SHUT) assay has been successfully used to analyze as little as 100 ng total RNA from human tissues, and found to be highly specific to homogenous miRNAs. Superb discrimination toward single-base mismatch at the 5' or 3' end has been demonstrated. Importantly, the pre-miRNAs generated negligible signals, validating the direct use of total RNA.


Aggressive variants of follicular cell derived thyroid carcinoma; the so called 'real thyroid carcinomas'.
The pathological diagnoses and classification schemes for thyroid carcinoma have changed over the past 20 years and continue to do so. New entities have been described and molecular analyses have suggested better characterisation and grouping of certain tumours. Because some of the lesions have been named differently by different authors, clinicians and patients may be confused as to what a specific patient's lesion represents. In this review, we discuss the thyroid tumours of follicular origin which are clinically unusual but important to recognise as their behaviour may be aggressive, they may not respond to radioiodine treatment and they may cause significant mortality. This paper describes these important but rare lesions, their pathological features, important clinicopathological correlations, molecular correlates and prognostic implications.


High-resolution mapping of D16led-1, Gart, Gas-4, Cbr, Pcp-4, and Erg on distal mouse chromosome 16.
More than 500 backcross progeny from four intersubspecific backcrosses were typed for six markers on distal mouse chromosome 16. Five of these represented genes that mapped within the Sod-1 to Ets-2 interval, which was shown previously to contain the weaver (wv) gene. The map order, including previously mapped reference markers, is (cen)-D16H21S16-D16Led-1-App-Sod-1-Gart-Gas-4-Cbr++ +-wv-Pcp-4-Erg-Ets-2. This gene order recapitulates the order of the genes on human chromosome 21 where known. Two of these markers further define the region containing the weaver gene to a 3.9-cM segment between Cbr and Pcp-4. In addition, Pcp-4 was localized to human chromosome 21 by the presence of a human-specific restriction fragment in WAV-17, a mouse-human somatic cell hybrid with human chromosome 21 as the only human contribution.


Differential Effects of Quercetin and Quercetin Glycosides on Human α7 Nicotinic Acetylcholine Receptor-Mediated Ion Currents.
Quercetin is a flavonoid usually found in fruits and vegetables. Aside from its antioxidative effects, quercetin, like other flavonoids, has a various neuropharmacological actions. Quercetin-3-O-rhamnoside (Rham1), quercetin-3-O-rutinoside (Rutin), and quercetin- 3-(2(G)-rhamnosylrutinoside (Rham2) are mono-, di-, and tri-glycosylated forms of quercetin, respectively. In a previous study, we showed that quercetin can enhance α7 nicotinic acetylcholine receptor (α7 nAChR)-mediated ion currents. However, the role of the carbohydrates attached to quercetin in the regulation of α7 nAChR channel activity has not been determined. In the present study, we investigated the effects of quercetin glycosides on the acetylcholine induced peak inward current (IACh) in Xenopus oocytes expressing the α7 nAChR. IACh was measured with a two-electrode voltage clamp technique. In oocytes injected with α7 nAChR copy RNA, quercetin enhanced IACh, whereas quercetin glycosides inhibited IACh. Quercetin glycosides mediated an inhibition of IACh, which increased when they were pre-applied and the inhibitory effects were concentration dependent. The order of IACh inhibition by quercetin glycosides was Rutin≥Rham1>Rham2. Quercetin glycosides-mediated IACh enhancement was not affected by ACh concentration and appeared voltage-independent. Furthermore, quercetin-mediated IACh inhibition can be attenuated when quercetin is co-applied with Rham1 and Rutin, indicating that quercetin glycosides could interfere with quercetin-mediated α7 nAChR regulation and that the number of carbohydrates in the quercetin glycoside plays a key role in the interruption of quercetin action. These results show that quercetin and quercetin glycosides regulate the α7 nAChR in a differential manner.


Cutaneous polyarteritis nodosa successfully treated with topical diflucortolone valerate: a case report & review of the literature.
Cutaneous Polyarteritis Nodosa (cPAN) was first described in 1931. cPAN is considered a rare disease, its true incidence is unknown. The age of onset is diverse. Most studies have shown no significant gender predominance. cPAN presents with distinct skin findings, such as a maculopapular rash, subcutaneous nodules, livedoid vasculitis, panniculitis, ischemic finger lesions, or erythematous patchy rash. Etiology is unclear. It is still believed to be an immune complex-mediated disease, although a possible mechanism recently proposed relates a familial form of the disease to impaired activity of Adenosine Deaminase 2. cPAN may reflect an underlying disease, infection or medical treatment. There is no consensus as to initial treatment, dosage and length of treatment. Patients with constitutional symptoms, visceral involvement, a more severe course of the disease, or high acute phase reactants, were treated mainly with systemic corticosteroids and/or cytotoxic agents for varying durations. However, persistence of cutaneous lesions has been documented. We describe a 14 year old male suffering from persistent cPAN, with no constitutional symptoms or involvement of internal organs. The patient was treated with a local corticosteroid-based ointment during exacerbations, until complete remission. Although reported in only one study, treatment with topical corticosteroid compound may result in significant improvement or complete regression of skin lesions in cPAN patients.


Antidiuretic hormone modulates membrane phosphoproteins in toad urinary bladder and retrieved water channel containing apical membrane vesicles.
Antidiuretic hormone (ADH) dramatically increases the water permeability of toad urinary bladder by insertion of unique highly selective water channels into the apical membranes of granular cells. Before ADH stimulation, water channels are stored in high concentrations in the limiting membranes of large cytoplasmic vesicles called aggrephores. ADH stimulation causes aggrephore fusion with the granular cell apical membrane and increases water permeability. Transepithelial osmotic water flow causes a rapid attenuation of the ADH-elicited increase in water permeability through a process called flux inhibition. Flux inhibition is due to retrieval of ADH water channels by apical membrane endocytosis. When phosphoproteins of intact bladders are labeled with (32P)orthophosphate, the 32P content of 34-, 28-, and 17-kDa proteins is increased by ADH stimulation. When flux inhibition occurs, the 32P-labelling of a 15.5-kDa protein is reduced to approximately one half its original value (Konieczkowski M, Rudolph SA, J Pharmacol Exp Ther 1985;234:515). These observations have been confirmed, and these studies have been extended, by using a combination of subcellular fractionation and membrane protein chemistry techniques. All four of these phosphoproteins are present in membrane fractions of granular cells. Analysis of membrane proteins by a combination of Triton X-114 partitioning and an alkaline stripping technique reveals that the 28- and 17-kDa species are integral membrane proteins of unknown function. In contrast, the 32P-labeled 15.5-kDa protein is a peripheral membrane protein. It is attached to the cytoplasmic (outer) surface of highly water-permeable vesicles retrieved during flux inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)


Statins for the Treatment of Pulmonary Hypertension in Patients with Chronic Obstructive Pulmonary Disease.
Background: Patients with chronic obstructive pulmonary disease (COPD) are at risk for pulmonary hypertension (PH). The aim of our study was to investigate the benefit of statins for PH in patients with COPD. Methods: The study enrolled 23 million individuals from Taiwan's population database from January 1, 2002, to December 31, 2017. COPD patients who met the inclusion criteria were enrolled, and patients with lung cancer, less than one year of observation, specific drug therapy for PH and lung transplantation were excluded. Results: A total of 643,131 COPD patients were included in the study, and only 12,308 patients developed PH during follow-up. Based on the inclusion and exclusion criteria, 8,577 PH patients were included in the cohort of patients with PH related to COPD for analysis. According to the definition of statin exposure, the final study population had 1,487 statin users and 7,090 statin non-users. The statin user group had a lower mortality related to PH than the non-user group (3.87 vs. 5.55 per 100 person-years, p < 0.001). The mortality rate for PH in the multivariate analysis (aHR = 0.78, 95% CI = 0.62-0.98, p = 0.046) was significantly lower for statin users than for non-users. Conclusion: Statins seem to benefit patients with PH and COPD.


[A Reflection on Innovative Nursing Teaching Strategies Following an Experience Training Competitors for the Worldskills Competition].
Worldskills Competition provides students from around the world with an interactive platform for learning, training, and communication. Participating in Worldskills Competition and related teaching activities highlights the critical problems that affect new nursing graduates such as insufficient knowledge application and integration skills and inadequate adaptation and problem-solving abilities. This paper reflects on nursing courses to suggest improved teaching strategies and innovative teaching methods. Problem-based learning (PBL), simulation-based objective strcutured clinical examination (SOSCE), and mobile-assisted teaching are applied to guide students to learn, to increase the self-learning ability of students, and to enhance their problem-solving skills. It is hoped that these teaching methods improve the ability of participants, whether they are Worldskills competitors or new employees, to think strategically about and to resolve problems.


Soluble (pro)renin receptor promotes the fibrotic response in renal proximal tubule epithelial cells in vitro via the Akt/β-catenin/Snail signaling pathway.
Tubulointerstitial fibrosis has been regarded as a critical event in the pathogenesis of chronic kidney disease. The soluble form of (pro)renin receptor (sPRR), generated by site-1 protease (S1P) cleavage of full-length PRR, can be detected in biological fluid and elevated under certain pathological conditions. The present study was designed to evaluate the potential role of sPRR in the regulation of the fibrotic response in a cultured human renal proximal tubular cell line (HK-2 cells) in the setting of transforming growth factor (TGF)-β or sPRR-His treatment. The TGF-β-induced fibrotic response of HK-2 cells was indicated by upregulation of fibronectin (FN) expression; meanwhile, TGF-β could also induce the generation of sPRR, due to enhanced cleavage of full-length PRR. To explore the role of sPRR in the fibrotic response of HK-2 cells, we blocked the production of sPRR with a the S1P inhibitor PF429242 and found that PF429242 remarkably suppressed TGF-β-induced sPRR generation and FN expression in HK-2 cells. Administration of sPRR-His restored the PF429242-attenuated FN expression in HK-2 cells, indicating that sPRR could promote the TGF-β-induced fibrotic response. Furthermore, sPRR-His alone also increased the abundance of FN in HK-2 cells. These data suggested that sPRR was sufficient and necessary for the TGF-β-induced fibrotic response of HK-2 cells. Mechanistically, sPRR activated the AKT and β-catenin pathway in HK-2 cells, and blockade of the AKT or β-catenin pathway significantly abrogated sPRR-induced FN and Snail expression. Taking together, sPRR promoted the fibrotic response of HK-2 cells by activating Akt/β-catenin/Snail signaling, and it may serve as a potential therapeutic target in renal fibrosis.


Clinical characteristics and functional outcome of pediatric ocular trauma in a third level reference hospital in Guadalajara, Mexico.
Ocular trauma is one of the leading causes of decreased visual acuity and monocular blindness in the pediatric population. Since its occurrence is potentially preventable, it is essential to understand its demographic characteristics and risk factors to alert and implement prevention and health promotion programs. We conducted a retrospective study in which we reviewed 187 clinical records of patients ≤ 15 years old with the diagnosis of severe ocular trauma admitted in 2017 to the Hospital Civil de Guadalajara. We analyzed demographic variables, circumstances of the event, type of treatment, and the evolution of visual acuity and complications. In total, 187 patients and 188 eyes were included; the average age was 6.99 ± 4.1 years. Children of 2 to 5 years of age (41%) were the most affected, and a higher occurrence was observed in males (73%). Open ocular trauma was the most common type of injury (72.7%) caused by sharp objects (45.4%). Most injuries occurred at home (78.1%), without adult supervision (48.1%), and during leisure time (74.9%). Most events were accidental (80.4%), although 12.3% were direct aggression. Surgery was required in 179 patients, in whom corneal injury repair (43.2%) was the most commonly used procedure. Final visual acuity was quantified in 132 eyes, and visual acuity < 20/200 was found in 18.1%. Loss of 4.2% of the eyeballs was recorded. The highest proportion of cases was identified in male patients ≤5 years old, unsupervised by an adult. Many eye injuries are preventable, so it is necessary to implement socio-educational programs in alliance with pediatric organizations that alert the severity of the problem and promote safe environments.


Abdominal aortic endograft infection with Clostridium difficile.
The increase in endovascular aortic aneurysm repair has led to increasing incidence of aortic endograft infections. Additionally, more atypical organisms are being identified as pathogens. We report on a rare aortic endograft infection to further characterize and understand these infections. We report a Clostridium difficile culture-positive aortic endograft infection in an 82-year-old male 3 years after endovascular abdominal aortic aneurysm repair. The patient underwent successful open, complete explant of his endograft and in-situ repair using a rifampin-soaked Dacron graft. He continues to do well. Aortic endograft infections are a complex problem further complicated by rare and virulent infections. Unless the patient is at prohibitive risk, the management of infected aortic endografts is surgical graft explant and in-situ or extra-anatomic reconstruction due to the exceedingly high mortality rate with non-operative management.


Cesarean childbirth and psychosocial outcomes: a meta-analysis.
A comprehensive literature review with meta-analysis examines the differences between vaginal and cesarean delivery on 23 psychosocial outcomes of childbirth. The most robust findings suggest that cesarean mothers, compared with mothers who delivered vaginally, expressed less immediate and long-term satisfaction with the birth, were less likely ever to breast-feed, experienced a much longer time to first interaction with their infants, had less positive reactions to them after birth, and interacted less with them at home. Some differences were also found between unplanned and planned cesarean sections; none were found between birthing methods for maternal confidence for infant caretaking soon after birth, maternal anxiety in the hospital and at home, maternal stress at home, maternal return to work, and continuation of breast-feeding once begun. Implications of these findings for theory, research, and childbirth practice are discussed.


Traditional pharmaceutical practice in Gondar region, northwestern Ethiopia.
The knowledge and skills of Ethiopian traditional healers in Gondar region on the pharmaceutical aspects of their practice were assessed using a questionnaire. Of the 86 healers interviewed, only 83 gave responses good enough to be considered in the analysis of results. It was shown that the healers obtained their drugs mainly from natural substances and these in descending order of frequency were plants, animals and minerals. The healers prepared the drugs in various dosage forms including liquids, ointments, powders and pills. They also prescribed drugs in a "non-formulated" form. They usually incorporated additives and more than one drug in a single dosage form. Drugs were administered using eight routes, the main ones being, topical, oral and respiratory. Most of the healers claimed to determine doses and to know about side-effects of drugs. When side-effects became severe, "antidotes" were claimed to be used. The healers imposed restriction when certain types of drugs were taken by patients. Most of them stored the drugs that should not be dispensed immediately after collection or preparation. Drugs were usually stored in containers such as bottles, papers, pieces of cloth, leaves and horns, and were kept anywhere at home. The results are discussed mainly in relation to modern pharmaceutical and medical practices and their importance to health care services among the people in Gondar region is also stated.


Hemosuccus pancreaticus caused by gastroduodenal artery pseudoaneurysm associated with chronic pancreatitis: A case report and review of literature.
Hemosuccus pancreaticus is a very rare but severe form of upper gastrointestinal hemorrhage. The most common etiology is peripancreatic pseudoaneurysm secondary to chronic pancreatitis. Due to the rarity of gastroduodenal artery pseudoaneurysms, most of the current literature consists of case reports. Limited knowledge about the disease causes diagnostic difficulty. A 39-year-old man with a previous history of chronic pancreatitis was hospitalized due to hematemesis and melena for 2 wk, with a new episode lasting 1 d. Two weeks prior, the patient had visited a local hospital for repeated hematemesis and melena. Esophagogastroduodenoscopy indicated hemorrhage in the descending duodenum. The patient was discharged after the bleeding stopped, but hematemesis and hematochezia recurred. Bedside esophago-gastroduodenoscopy showed no obvious bleeding lesion. On admission to our hospital, he had hematemesis, hematochezia, left middle and upper abdominal pain, severe anemia, and elevated blood amylase. After admission, intermittent hematochezia was observed. Abdominal contrast-enhanced computed tomography revealed a pseudoaneurysm in the pancreas head. Angiography confirmed the diagnosis of gastroduodenal artery pseudoaneurysm. The pseudoaneurysm was successfully embolized with a coil and cyanoacrylate. No bleeding was observed after the operation. After discharge from the hospital, a telephone follow-up showed no further bleeding signs. Hemosuccus pancreaticus caused by gastroduodenal artery pseudoaneurysm associated with chronic pancreatitis is very rare. This diagnosis should be considered when upper gastrointestinal bleeding and abdominal pain are intermittent. Abdominal enhanced computed tomography and angiography are important for diagnosis and treatment.


Influence of factors related to implant stability detected by wireless resonance frequency analysis device.
Resonance frequency analysis (RFA) was introduced as a method for measuring implant stability more than a decade ago. Implant stability quotient (ISQ) values obtained using a recently introduced wireless RFA device have made it possible to evaluate stability in a non-invasive technique; however, there are few studies of the factors that affect ISQ values determined using this device. The aim of the present study was to evaluate the association between ISQ values determined by wireless RFA and various factors related to dental implant stability using a pig cortical bone model. Dental implants (Replace) Select Tapered implants) with a length of 10 mm were placed into pig cortical bone samples, then, ISQ values were determined using wireless RFA under various conditions (probe orientation, diameter of implant, insertion torque and peri-implant bone loss). The results of this study showed that ISQ values were not affected by the direction of the probe from parallel to perpendicular to the long axis of the pig bone or to the smart peg. In addition, the diameter of the implant did not have a significant effect on the measured ISQ values. Statistically significant correlations were found between insertion torque and ISQ values (Spearman's test, P < 0.05), and lower ISQ values were observed for deeper peri-implant vertical defects (Mann-Whitney U-test, P < 0.05). A wireless RFA device appears to be useful for measuring implant stability within the limits of the present in vitro study.


Unmasking a functional allosteric domain in an allosterically nonresponsive carbamoyl-phosphate synthetase.
Although carbamoyl-phosphate synthetases (CPSs) share sequence identity, multidomain structure, and reaction mechanism, they have varying physiological roles and allosteric effectors. Escherichia coli CPS (eCPS) provides CP for both arginine and pyrimidine nucleotide biosynthesis and is allosterically regulated by metabolites from both pathways, with inhibition by UMP and activation by IMP and ornithine. The arginine-specific CPS from Saccharomyces cerevisiae (sCPS), however, apparently responds to no allosteric effectors. We have designed and analyzed a chimeric CPS (chCPS, in which the C-terminal 136 residues of eCPS were replaced by the corresponding residues of sCPS) to define the structural basis for the allosteric nonresponsiveness of sCPS and thereby provide insight into the mechanism for allosteric selectivity and responsiveness in the other CPSs. Surprisingly, ornithine and UMP each had a significant effect on chCPS activity, and did so at concentrations that were similar to those effective for eCPS. We further found that sCPS bound both UMP and IMP and that chCPS bound IMP, although none of these interactions led to changes in enzymatic activity. These findings strongly suggest that the nonresponsive sCPS is not able to communicate occupancy of the allosteric site to the active site but does contain a latent allosteric interaction domain.


Animal models of calcium cholelithiasis.
Bile contains four calcium anions which are readily precipitated by calcium: bilirubinate, "palmitate", carbonate and phosphate. Precipitation of insoluble calcium salts is common in calculous biliary disease. All animal models of calcium cholelithiasis probably share a common pathogenesis--an increased concentration of a calcium-sensitive anion. In calcium bilirubinate cholelithiasis, an increased concentration of bilirubinate occurs. In mice, this occurs in animals having a genetic hemolytic anemia; in rats, it may be induced by an essential fatty acid in combination with diet modification; in dogs, by a low-taurine, low-protein diet; and in prairie dogs, by ileal resection which probably increases the bilirubinate/bile acid ratio in bile. In the two models of calcium-bile acid cholelithiasis, an increased biliary concentration of a calcium-sensitive glycine conjugated bile acid is induced by administration of a suitable precursor. In the rabbit, gallstones composed mostly of calcium allodeoxycholyl glycine are induced by the feeding of 5 beta-cholestan-3 beta-ol. In the taurine-deficient rat, the feeding of lithocholate leads to formation of gallstones which contain a mixture of calcium lithocholyl glycine and 3 alpha, 6 beta-dihydroxy cholanoyl glycine. These animal models may be of value in testing agents designed to lower calcium activity in bile.


Facial Artery Pseudoaneurysm in a Child Diagnosed With Point of Care Ultrasound.
This case describes a 3-year-old boy who was brought to the pediatric emergency department for evaluation of facial swelling. The patient's history was remarkable for a deep facial laceration 5 days prior that required surgical repair in the operating room. On the day of presentation, he was noted to have mild swelling and tenderness to palpation of the left jaw below the mandible, in the same location as his recent laceration repair. Point-of-care ultrasound (POCUS) revealed a pseudoaneurysm with an arterial feeding vessel. This was confirmed by radiology-performed ultrasound, and the patient underwent a coil embolization procedure. To our knowledge, this is the first reported case of a pseudoaneurysm being diagnosed by POCUS in a pediatric patient. This case demonstrates the utility of POCUS in facilitating the timely recognition of vascular mass lesions and guiding management in the emergency department to avoid complications.


MMP-13 enzyme and pH responsive theranostic nanoplatform for osteoarthritis.
Stimulus-responsive therapy permits precise control of therapeutic effect only at lesion of interest, which determines it a promising method for diagnosis and imaging-guided precision therapy. The acid environment and overexpressed matrix metalloproteinases-13 (MMP-13) are typical markers in osteoarthritis (OA), which enables the development of stimulus-responsive drug delivery system with high specificity for OA. We herein demonstrate a nano-micelle based stimuli-responsive theranostic strategy with reporting and drug release controlled by acidic pH and MMP-13 for OA therapy. Such nanoplatform is incorporated with a motif specifically targeting on cartilage, a motif responsive to matrix metalloproteinases-13 to specifically report OA condition and biodynamics of nano-micelles, an anti-inflammatory drug (e.g., psoralidin (PSO)) from traditional Chinese medicine, and a biocompatible polymeric skeleton for sustainable drug release in response to the acidic OA condition. The high effectiveness of this targeted precision therapy is demonstrated comprehensively by both in vitro and vivo evidences.


Heritability of conventional and ambulatory blood pressures. A study in twins.
Conventional and 24-hour ambulatory blood pressures were measured in 26 pairs of monozygotic twins and 27 pairs of dizygotic twins, all male, ages 18 to 38 years, to determine the heritability of blood pressure measured under various conditions. Conventional pressure was the average of three well-standardized measurements in the supine position, and ambulatory pressure was recorded during the subjects' normal activities by use of the SpaceLabs 90202 device. Heritability was assessed by classic methods and by model fitting and path analysis. In the latter approach, the percent genetic variance was 70% for mean 24-hour systolic pressure and 73% for diastolic pressure, which was similar to the results for the conventional pressures (64% and 73%, respectively). During the night, these estimates were 72% and 51% for systolic and diastolic pressures, respectively, and also the average pressures of the total awake daytime period were under partial genetic control (63% and 55%, respectively). The remaining variances could be attributed primarily to unique environmental influences. However, shared and nonshared environmental factors were predominant for the pressures during a fixed 6-hour afternoon period. We conclude that the heritability of blood pressure is relatively high in young adult healthy men, for standardized conventional pressure and the average 24-hour pressure. Genetic variance is somewhat higher for the asleep pressure than for the awake systolic pressure.


Chitosan-microcapsulated insulin alleviates mesenteric microcirculation dysfunction via modulating COX-2 and VCAM-1 expression in rats with diabetes mellitus.
The study of the experiment was to display the therapeutic function of insulin-loaded chitosan (insulin/chitosan) on mesenteric microcirculation via down-regulating cyclooxygenase-2 (COX-2) and vascular cell adhesion molecule (VCAM-1) expressions in rats with diabetes mellitus (DM) as compared to free insulin. Diabetic rats were administrated with 24 U/kg insulin or 120 U/kg insulin/chitosan compounds. The blood and mesenteriums were collected, blood glucose levels, arteriole velocity, arteriole diameter, venular diameter, and hemodiapedesis were measured, and COX-2, VCAM-1 expressions were measured in mesenteriums tissues. Both insulin and insulin/chitosan administration decreased blood glucose and improved the state of mesenteric microcirculation through down-regulating COX-2 and VCAM-1 expressions as compared to DM groups, while insulin/chitosan remarkably augmented this functions. Chitosan-microcapsulated insulin alleviates mesenteric microcirculation dysfunction via modulating COX-2 and VCAM-1 expressions in rats with DM.


A Survey on State-of-the-Art Denoising Techniques for Brain Magnetic Resonance Images.
The accuracy of the magnetic resonance (MR) image diagnosis depends on the quality of the image, which degrades mainly due to noise and artifacts. The noise is introduced because of erroneous imaging environment or distortion in the transmission system. Therefore, denoising methods play an important role in enhancing the image quality. However, a tradeoff between denoising and preserving the structural details is required. Most of the existing surveys are conducted on a specific MR image modality or on limited denoising schemes. In this context, a comprehensive review on different MR image denoising techniques is inevitable. This survey suggests a new direction in categorizing the MR image denoising techniques. The categorization of the different image models used in medical image processing serves as the basis of our classification. This study includes recent improvements on deep learning-based denoising methods alongwith important traditional MR image denoising methods. The major challenges and their scope of improvement are also discussed. Further, many more evaluation indices are considered for a fair comparison. An elaborate discussion on selecting appropriate method and evaluation metric as per the kind of data is presented. This study may encourage researchers for further work in this domain.


Self-Reporting of Risk Pathways and Parameter Values for Foot-and-Mouth Disease in Slaughter Cattle from Alternative Production Systems by Kenyan and Ugandan Veterinarians.
Countries in which foot-and-mouth disease (FMD) is endemic may face bans on the export of FMD-susceptible livestock and products because of the associated risk for transmission of FMD virus. Risk assessment is an essential tool for demonstrating the fitness of one's goods for the international marketplace and for improving animal health. However, it is difficult to obtain the necessary data for such risk assessments in many countries where FMD is present. This study bridged the gaps of traditional participatory and expert elicitation approaches by partnering with veterinarians from the National Veterinary Services of Kenya (n = 13) and Uganda (n = 10) enrolled in an extended capacity-building program to systematically collect rich, local knowledge in a format appropriate for formal quantitative analysis. Participants mapped risk pathways and quantified variables that determine the risk of infection among cattle at slaughter originating from each of four beef production systems in each country. Findings highlighted that risk processes differ between management systems, that disease and sale are not always independent events, and that events on the risk pathway are influenced by the actions and motivations of value chain actors. The results provide necessary information for evaluating the risk of FMD among cattle pre-harvest in Kenya and Uganda and provide a framework for similar evaluation in other endemic settings.


Natural products from ethnodirected studies: revisiting the ethnobiology of the zombie poison.
Wade Davis's study of Haitian "zombification" in the 1980s was a landmark in ethnobiological research. His research was an attempt to trace the origins of reports of "undead" Haitians, focusing on the preparation of the zombification poison. Starting with this influential ethnopharmacological research, this study examines advances in the pharmacology of natural products, focusing especially on those of animal-derived products. Ethnopharmacological, pharmacological, and chemical aspects are considered. We also update information on the animal species that reportedly constitute the zombie poison. Several components of the zombie powder are not unique to Haiti and are used as remedies in traditional medicine worldwide. This paper emphasizes the medicinal potential of products from zootherapy. These biological products are promising sources for the development of new drugs.


Stent graft repair in the aortic arch and descending thoracic aorta: a 4-year experience.
Thoracic aortic aneurysms (TAAs) and type B aortic dissections (ADs) are relatively frequent, serious conditions that are often managed nonoperatively because of perceived poor outcome of standard surgical reconstruction. Recently developed stent graft techniques represent a more attractive, less invasive option. We sought to determine the technical feasibility and safety of endovascular repair in the thoracic aorta with a retrospective review of our experience with such an approach. Forty-seven patients received thoracic stent graft implants during the 4-year period ending March 31, 2002. All patients signed an Institutional Review Board-approved informed consent. Thirty-one patients had TAAs, and 16 had ADs. Device design and implant strategy were on the basis of evaluation of morphology with angiography and computed tomographic scan. The procedures were done with fluoroscopic guidance, with local anesthesia in five cases, spinal anesthesia in 19 cases, and general anesthesia in 23 cases. Endovascular access was achieved with femoral cutdown in 41 cases and a temporary iliac conduit in six cases. A Talent patient-specific device, with 4-mm to 6-mm oversize, was used in all. Proximal endograft attachment was in the descending thoracic aorta in 16 cases, parasubclavian in 21 cases, and the suprasubclavian aorta in 10 cases. Eight patients had adjunctive cervical reconstruction to transpose or revascularize the left subclavian or left common carotid arteries, enabling more proximal endograft attachment in the aortic arch. Access failure occurred in one patient (2.1%). One patient (2.1%) died within 30 days of access-related iliac artery rupture. Another death occurred at 60 days from a ruptured thoracoabdominal aneurysm with type I endoleak. No instances of paraplegia, stroke, or surgical conversion were seen. Five patients (TAA) were found to have endoleak on 30-day computed tomographic scan. Repair of type I endoleak was undertaken in three cases at 1, 4, and 6 months. Eight patients (17%) had adverse events within the first 30 days. Length of follow-up ranged from 1 to 44 months, with a mean of 18 months. Two patients were lost to follow-up, and one withdrew from the study. Four additional mortalities were observed, none related to the endograft or aortic pathology. Stent graft repair of TAA and AD is feasible and can be achieved with technical success and relatively low rates of perioperative morbidity and mortality. The Talent customized design proved versatile in various morphologies. More information is needed on indications, clinical efficacy, and long-term results.


Unchanged frequency of loss of heterozygosity and size of the deleted region at 8p21-23 during metastasis of lung cancer.
The genetic mechanisms involved in lung cancer development and progression are beginning to be understood. Many studies have documented frequent loss of heterozygosity (LOH) at specific chromosomal regions in cancer cells; this implies that tumor suppressor genes (TSG) are usually present in those regions. Recently, it has been reported that LOH or chromosomal deletions at chromosome 8p21-23 represent early events frequently occurring in lung cancer. In addition, the size of these chromosome 8 deletions, as well as their frequency, was also reported to increase during lung cancer progression. To determine the spectrum and frequency of alterations of chromosome 8p21-23 in human lung cancer and whether these increase with progression of the tumors, we performed LOH analysis of chromosome 8p and 3p in the genomic DNA from cells from primary and metastatic sites of lung cancer, as well as from normal lung. We studied 35 subjects with primary lung cancer including 30 tumors with distant metastasis. Detection of allelic deletion utilized a PCR-based approach of microsatellite polymorphism analysis, which was performed using the microsatellite markers D8S1130, D8S1106, D8S511, D8S1827, D8S549, D8S261, LPL, D8S258, D8S136, NEFL, D3S1295, D3S1313, D3S1234, D3S1300, D3S1351, D3S1339, and D3S1340. The overall allelic deletion rates were 10 of 28 (35.7%) at 8p and 13 of 33 (39.4%) at 3p. The allelic deletions in the primary cancer and its metastatic sites were in each case identical in both frequency and size of the deleted regions. In our analysis, 8p21-23 deletions were not always associated with 3p deletions in primary lung cancer. These results therefore suggest that allelic deletion at chromosome 8p21-23 is an early and frequent event in the carcinogenesis and development of lung cancer, independent of chromosome 3p deletion. However, a continuing increase in the frequency of LOH at 8p21-23 and in the size of the deleted region rarely occurs during the process of metastasis.


Pre-low raising in Cantonese and Thai: Effects of speech rate and vowel quantity.
Although pre-low raising (PLR) has been extensively studied as a type of contextual tonal variation, its underlying mechanism is barely understood. This paper explored the effects of phonetic vs phonological duration on PLR in Cantonese and Thai and examined how speech rate and vowel quantity interact with its realization in these languages, respectively. The results for Cantonese revealed that PLR always occurred before a large falling excursion (i.e., high-low); in other tonal contexts, it was observed more often in faster speech. In the Thai corpus, PLR also occurred before large falling excursions, and there was more PLR in short vowels. These results are discussed in terms of possible accounts of the underlying mechanism of PLR.


Infrared Spectroscopy of Bilberry Extract Water-in-Oil Emulsions: Sensing the Water-Oil Interface.
Water-in-oil (w/o) emulsions are of great interest in many areas of the life sciences, including food technology, bioprocess engineering, and pharmaceuticals. Such emulsions are complex multi-component systems and the molecular mechanisms which lead to a stable emulsion are yet to be fully understood. In this work, attenuated total reflection (ATR) infrared (IR) spectroscopy is applied to a series of w/o emulsions of an aqueous anthocyanin-rich bilberry extract dispersed in a medium chain triglyceride (MCT) oil phase. The content of the emulsifier polyglycerin-polyricinoleat (PGPR) has been varied systematically in order to investigate whether or not its concentration has an impact on the molecular stabilization mechanisms. The molecular stabilization is accessed by a careful analysis of the IR spectrum, where changes in the vibrational frequencies and signal strengths indicate alterations of the molecular environment at the water/oil interface. The results suggest that adding emulsifier in excess of 1% by weight does not lead to an enhanced stabilization of the emulsion.


α8β1 integrin regulates nutrient absorption through an Mfge8-PTEN dependent mechanism.
Coordinated gastrointestinal smooth muscle contraction is critical for proper nutrient absorption and is altered in a number of medical disorders. In this work, we demonstrate a critical role for the RGD-binding integrin α8β1 in promoting nutrient absorption through regulation of gastrointestinal motility. Smooth muscle-specific deletion and antibody blockade of α8 in mice result in enhanced gastric antral smooth muscle contraction, more rapid gastric emptying, and more rapid transit of food through the small intestine leading to malabsorption of dietary fats and carbohydrates as well as protection from weight gain in a diet-induced model of obesity. Mechanistically, ligation of α8β1 by the milk protein Mfge8 reduces antral smooth muscle contractile force by preventing RhoA activation through a PTEN-dependent mechanism. Collectively, our results identify a role for α8β1 in regulating gastrointestinal motility and identify α8 as a potential target for disorders characterized by hypo- or hyper-motility.