Role of gender in road accidents.
Influence of driver sex on road accidents is assessed in this article. Accident records for 3 years and for three different income regions were analyzed. Annual distance traveled, social and economic participation, and effect of public vehicle accidents were considered. Effects of environmental factors and driver age were also included. Driver faults analysis identified possible reasons for accident differences. Analysis of accident severity was used to assess degree of harm. Statistical analysis at the 5% significance level was used to evaluate all differences. The results show that male accident rates are significantly higher. This trend is consistent through all the analyses. Accident differences are significant only in normal driving conditions. Drivers over age 50 had the lowest accident rates. Accident rate differences were caused by lack of attention and impatience among male drivers. Appropriate means of communication should alert concerned populations to these findings.


[The pharmacoepidemiology of drugs used in treatment of patients with chronic obstructive pulmonary disease].
For one hundred fifty eight patients with chronic obstructive pulmonary disease (COPD) were the subjects of a pharmacoepidemiological study. The study found that both pharmaceuticals indicated for the treatment of this disease, and drugs of low effectiveness, were used in treatment of these patients very intensively. Each hospital led its own policy of the distribution of expenses associated with COPD treatment.


Contact Hypersensitivity as a Murine Model of Allergic Contact Dermatitis.
Contact hypersensitivity (CHS) is an experimental model of allergic contact dermatitis (ACD) that can be studied in mice. This study aims to present an objective laboratory method that may help to study the CHS reaction in mice, which can be measured and quantified by various tests. To induce CHS, on day "0", mice were sensitized on a previously shaved spot by abdominal skin painting with the hapten 2,4,6-trinitrochlorobenzene (TNCB) in an acetone-ethanol mixture, whereas negative control mice were sham sensitized with vehicle alone-acetone-ethanol mixture. On day "4", the baseline ear thickness was measured with a micrometer prior to the elicitation of CHS (challenge) by painting both ears with diluted TNCB both in the test and control groups. After 24 h, the ear swelling was measured with a micrometer. CHS is an example of a T cell-mediated immune response that causes swelling in inflamed tissue, peaking 24 h after the skin challenge with the same hapten. An increase in ear edema correlated with augmented ear weight, myeloperoxidase (MPO) activity, pro-inflammatory cytokine concentration in the ear extracts, increased thickening of the edematous dermis in the histological examination, and ear vascular permeability. There was also an increase in the concentration of TNP-specific IgG1 antibodies in the sera of the test group when compared with the control mice. Additionally, CHS can be successfully transferred with the CHS-effector cells obtained from donors previously sensitized with TNCB. The CHS-effector cells were administered intravenously into naïve recipient mice, which were subsequently challenged with the same diluted hapten. Ear swelling was measured with a micrometer 24 h later.


Chronic Central Pain Among Community-Dwelling Survivors of Moderate-to-Severe Traumatic Brain Injury: A Quantitative Sensory Testing Study.
Central pain associated with changes in sensory thresholds is one of the most enduring consequences of major trauma. Yet it remains sparsely studied among community-dwelling survivors of moderate-to-severe traumatic brain injury (TBI). To describe and compare thermal and mechanical sensory thresholds in home-based patients with and without central pain after moderate-to-severe TBI with a cohort of healthy controls. Cross-sectional. Thresholds for cold/heat detection, thermal pain, touch, and distorted sensation were gathered using quantitative sensory testing (QST). QST was performed on the painful and contralateral pain-free body regions in TBI participants with pain (TBI-P) and on both forearms in TBI participants without pain (TBI-NP) and healthy controls (HC). Central pain was characterized using the Brief Pain Inventory-Short Form. We tested 16 TBI-P patients, 17 TBI-NP patients, and 16 HC. Mean time since injury for TBI patients was 24 ± 15 months. TBI-P and TBI-NP patients showed significant loss in innocuous mechanical sensitivity compared to HC (F = 18.929; Bonferroni-adjusted p ≤ .001). Right-left differences in cold pain sensations were significantly larger in TBI-P than in TBI-NP and HC participants (F = 14.352; Bonferroni-adjusted p ≤ .001). Elevated heat sensitivity thresholds were also observed in TBI-P participants but remained within normal range. Damage to cutaneous mechanoreceptors is a necessary, but not sufficient, condition for the development of chronic central pain following TBI. Damage or incomplete recovery of cutaneous thermoreceptors may be a contributing factor to chronic pain after TBI.


Detecting and addressing developmental and behavioral problems in primary care.
Pediatric primary care clinicians usually offer a range of in-office services designed to detect and address developmental and behavioral problems. Research suggests that selecting among these services is difficult because fewer than 30% of children with disabilities are detected by their health care providers. Undetected children fail to receive early intervention, which has substantive benefits in improving high school graduation and employment rates, and reducing teen pregnancy and criminal activities. Fortunately, many recently published tools help detect the majority of children with problems. Measures relying on information from parents are flexible, brief, and accurate. One of the briefest tools. Parents' Evaluation of Developmental Status (PEDS), also offers an evidenced-based approach that helps clinicians decide when to refer, screen, advise, or reassure families or observe children more carefully over time.


Brief communication: evidence of pathology on the frontal bone from Gongwangling.
The hominid fossil from Gongwangling (Lantian) is well known and described (Woo, [1965] Scientia Sinca 14:1032-1036; Woo [1966] Curr. Anthropol. 7:83-86; Wu and Dong [1985] in R Wu and JW Olsen (eds.): Palaeoanthropology and Paleolithic Archaeology in the People's Republic of China [New York: Academic Press, pp. 79-89]; Wu and Poirier [1995] Human Evolution in China: A Metric Description of the Fossils and a Review of the Sites [Oxford: Oxford University Press]). However, evidence of pathology on the frontal bone has been previously unreported. Two lesions occur on the right supraorbital region that can be distinguished from marks of erosion prevalent on this specimen. These are discrete and irregularly shaped, with evidence of secondary bone formation surrounding them. The cause of the condition is unclear. Possibilities include trauma or abscess from an unspecified infection.


Effects of Acupuncture Sensations on Transient Heart Rate Reduction and Autonomic Nervous System Function During Acupuncture Stimulation.
Objective: During acupuncture stimulation, heart rate (HR) transiently decreases and autonomic nervous system (ANS) function becomes parasympathetic-dominant. To clarify the effect of acupuncture sensations (pain, De Qi), the effects of deep acupuncture sensations on HR and ANS functions were determined. Materials and Methods: In this comparative study at Teikyo Heisei University, Tokyo, Japan, 40 healthy, male student volunteers rested for 20 minutes before undergoing manual acupuncture to the Shousanli (LI 10) acupoint on the left forearm for 2 minutes at a frequency of 1 Hz, with concurrent electrocardiography. Depth of stimulation was 15-20 mm. These subjects described their subjective acupuncture sensations. Calculations were performed, using HR variability analysis to find HR and low-frequency (LF) normalized units (nu), the ratio of LF components to total components (as an index of sympathetic nervous system function), high-frequency (HF)nu, the ratio of HF components to total components (as an index of parasympathetic nervous system function), and LF/HF (as an index of sympathetic and parasympathetic balance). Results: For the final analysis, data were available for 32 subjects. Compared to before acupuncture, HR decreased during acupuncture. HR decreased when no acupuncture sensations or when weak De Qi sensations were perceived, and remained unchanged when acupuncture sensations without De Qi or strong De Qi were perceived. LFnu decreased, HFnu increased, and LF/HF decreased, regardless of pain or De Qi. Conclusions: Acupuncture stimulation reduced HR even without De Qi sensations and caused ANS function to be parasympathetic-dominant, irrespective of the perception of acupuncture sensations.


Filtered backprojection proton CT reconstruction along most likely paths.
Proton CT (pCT) has the potential to accurately measure the electron density map of tissues at low doses but the spatial resolution is prohibitive if the curved paths of protons in matter is not accounted for. The authors propose to account for an estimate of the most likely path of protons in a filtered backprojection (FBP) reconstruction algorithm. The energy loss of protons is first binned in several proton radiographs at different distances to the proton source to exploit the depth-dependency of the estimate of the most likely path. This process is named the distance-driven binning. A voxel-specific backprojection is then used to select the adequate radiograph in the distance-driven binning in order to propagate in the pCT image the best achievable spatial resolution in proton radiographs. The improvement in spatial resolution is demonstrated using Monte Carlo simulations of resolution phantoms. The spatial resolution in the distance-driven binning depended on the distance of the objects from the source and was optimal in the binned radiograph corresponding to that distance. The spatial resolution in the reconstructed pCT images decreased with the depth in the scanned object but it was always better than previous FBP algorithms assuming straight line paths. In a water cylinder with 20 cm diameter, the observed range of spatial resolutions was 0.7 - 1.6 mm compared to 1.0 - 2.4 mm at best with a straight line path assumption. The improvement was strongly enhanced in shorter 200° scans. Improved spatial resolution was obtained in pCT images with filtered backprojection reconstruction using most likely path estimates of protons. The improvement in spatial resolution combined with the practicality of FBP algorithms compared to iterative reconstruction algorithms makes this new algorithm a candidate of choice for clinical pCT.


Autonomy rights and abortion after the point of viability.
It has been argued that Thomson's defense of abortion, if successful, implies that abortion is permissible only until the point of viability. After that point, if one wanted to end a pregnancy, one must do so by birthing the fetus through induction or cesarean. In this paper, I argue that Thomson's defense of abortion does, in fact, imply that abortion after the point of viability is sometimes permissible. To show this, I point out that the process of birthing a fetus makes use of the body of the pregnant person in significant ways. Indeed, the body of the pregnant person is as much a part of this process as it is a part of the process of carrying a fetus during pregnancy. Thus, just as it is sometimes morally permissible to choose to have an abortion rather than continue a pregnancy, it is sometimes morally permissible to choose to have an abortion rather than undergo an induction or cesarean. Those who support Thomson's defense of abortion, then, have reason not to support the view that induction or cesarean are the only permissible procedures for ending an unwanted pregnancy with a viable fetus. I then use this discussion to suggest that autonomy rights are more complicated than initially thought. Given the extent to which the body is involved in detaching the fetus, it is not merely that one has a right to detach a fetus, but also a right to actualize one's reasonable preferences over the method of detachment.


Fungal levels in houses in the Fukushima Daiichi Nuclear Power Plant evacuation zone after the Great East Japan Earthquake.
Residences located within 20 km of the damaged Fukushima Daiichi Nuclear Power Plant were evacuated shortly after the Great East Japan Earthquake. The levels of airborne and surface fungi were measured in six houses in the evacuation zone in August 2012 and February 2013. Airborne fungal levels in all of the houses in the summer were higher than the environmental standard levels for residential houses published in Architectural Institute of Japan (>1000 colony-forming units [CFU]/m3). In two houses whose residents rarely returned to visit, fungal levels were extremely high (>52,000 CFU/m3). Although fungal levels in the winter were much lower than those in the summer, they were still higher than environmental standard levels in several houses. Indoor fungal levels were significantly inversely related to the frequency with which residents returned, but they were not correlated with the air exchange rates, temperature, humidity, or radiation levels. Cladosporium spp. and Penicillium spp. were detected in every house. Aspergillus section Circumdati (Aspergillus ochraceus group) was also detected in several houses. These fungi produced ochratoxin A and ochratoxin B, which have nephrotoxic and carcinogenic potential. The present study suggests that further monitoring of fungal levels is necessary in houses in the Fukushima Daiichi Nuclear Power Plant evacuation zone, and that some houses may require fungal disinfection. The results suggest that residents' health could be at risk owing to the high levels of airborne fungi and toxic fungi Aspergillus section Circumdati. Therefore, monitoring and decontamination/disinfection of fungi are strongly recommended before residents are allowed to return permanently to their homes. In addition, returning to home with a certain frequency and adequate ventilation are necessary during similar situations, e.g., when residents cannot stay in their homes for a long period, because fungal levels in houses in the Fukushima Daiichi Nuclear Power Plant evacuation zone were inversely correlated with the frequency with which residents returned to visit their houses.


Peripheral blood chimerism following human liver transplantation.
The aim of this study was to prospectively investigate the peak levels and kinetics of donor leucocyte chimerism in human recipients following liver transplantation. The peak levels of chimerism were observed within the first 48 hours following transplantation and ranged from 0.15% to 20% of total peripheral blood mononuclear cells. In all but one patient, who developed graft versus host disease, there was an early peak level of chimerism that declined over time such that donor leukocytes were only intermittently detectable after 3 to 4 weeks. In 8 patients who had no episodes of graft rejection, the peak level of donor leukocyte chimerism ranged from 1.3% to 20% (mean +/- SEM; 5.5% +/- 2.1%). In 3 patients who were treated for episodes of acute graft rejection during the first four postoperative weeks, the peak level of donor leukocyte chimerism ranged from 0.15% to 0.2% (0.18 +/- 0.02, P = .012). The results demonstrate a marked variation in the total number of donor leukocytes detectable in the peripheral blood early after liver transplantation and also, that lower levels of chimerism may be associated with lower rates of initial graft acceptance and a higher incidence of acute rejection.


Proton magnetic resonance studies on the conformation of the hexanucleotide, GmpApApYpApsiP, and Related fragments from the anticodong loop of baker's yeast phenylalanine transfer ribonucleic acid.
A hexanucleotide, GmpApApYpAppsiP, and 11 related compounds from the anticodon loop of Baker's yeast tRNA-Phe were studied by proton magnetic resonance from 100 to 250 MHz. Totally 19 resonance lines from all the base protons (H8, H6, and H2), H1', and methyl proton resonances of the hexamer have been assigned by a systematic "incremental procedure" in comparing all the related shorter fragments. Emphasis is given to the Y base and its stacking conformation with respect to its nearest neighboring bases. The results reveal a strong tendency of the purine bases to have a maximal extent of base-base overlap with their neighbors in the sequence. This tendency is manifested in a zigzag (or balcony-like) mode of base-stacking pattern of the -ApYpA-sequence in the hexamer in which the -pA-residue tends to stack toward the adduct ring (C10, C11, and N12) of Y. This tendency is also shown in the formation of a stack of GmAAA closing the gap left behind by the excision of Y in the hexamer GmpApAp--pApp. The implication of these findings to the structure and function of tRNA is discussed.


Retreatment of Recurrent Internal Carotid-Posterior Communicating Artery Aneurysm after Coil Embolization.
Internal carotid-posterior communicating artery (IC-PC) aneurysms account for more than 20% of all intracranial aneurysms. As a result of the increase in coiling, there has also been an increase in recurrent IC-PC aneurysms after coiling. We present our experience of 10 recurrent IC-PC aneurysms after coiling that were retreated using surgical or endovascular techniques in order to discuss the choice of treatment and the points of clipping without removal of coils. From 2007 to 2014, 10 recurrent IC-PC aneurysms after coiling were retreated. When the previous frames covered the aneurysms all around or almost around except a part of the neck, coiling was chosen. In other cases, clipping was chosen. Clipping was attempted without removal of coils when it was technically feasible. Among the 10 IC-PC aneurysms retreated, 3 were retreated with coiling and 7 were retreated with clipping. In all three cases retreated with coiling, almost complete occlusion was accomplished. In the seven cases retreated with clipping, coil extrusion was observed during surgery in six cases. In most of them, it was necessary to dissect strong adhesions around the coiled aneurysms and to utilize temporary occlusion of the internal carotid artery. In all seven cases, neck clipping was accomplished without the removal of coils. There were no neurological complications in any cases. The management of recurrent lesions of embolized IC-PC aneurysms requires appropriate choice of treatment using both coiling and clipping. Clipping, especially without the removal of coils, plays an important role in safe treatment.


Percutaneous endoscopic gastrostomy for enteral nutrition: a 5-year clinical experience with 324 patients.
Percutaneous endoscopic gastrostomy (PEG) is considered the route of choice for long-term enteral nutrition. In this study, we evaluated the short term outcomes of PEG and aimed to identify the risk factors for in-hospital mortality as well as adverse events such as aspiration pneumonia. Three hundred and twenty-four patients who received PEG for enteral nutrition between January 2007 and December 2011 were included in this study. Data regarding baseline characteristics, preoperative biomarkers and clinical outcomes were collected and analyzed. The average patient age was 82.3±10.9 (SD) years old. 149 patients (46%) were men and 199 patients (61%) had stroke as a comorbidity. Postoperatively, feeding-related aspiration pneumonia was observed in 72 patients (22%), diarrhea in 40 patients (12%) and peristomal infection in 34 patients (11%). The average postoperative length of stay was 34.6 days. 51 patients (16%) died before discharge, 22 (6.8%) of them within 30 days after PEG. Two deaths (0.6%) were considered procedure-related (bleeding). Multivariate analysis revealed the male gender, lower serum albumin levels and higher blood urea nitrogen (BUN) levels as significant prognostic factors for in-hospital mortality. Higher C-reactive protein levels and BUN levels were found to be independently associated with the occurrence of postoperative aspiration pneumonia. Our experience reconfirmed PEG as a minimally invasive and safe procedure for long-term enteral nutrition in patients with impaired oral intake. However, significant prognostic factors should be taken into account during the preoperative evaluation of patients. Deferral of procedure or specialized postoperative care may be indicated in high risk patients.


[Gut human microbiota and multiple sclerosis].
Recently the relationship between gut microbiota changes and the development of immune-mediated diseases of the central nervous system (CNS) has been reported. This review presents literature data on the effect of gut microbiota on the function of the immune and nervous systems. The authors discuss possible mechanisms of the relationship between gut microbiota changes and CNS diseases on the model of multiple sclerosis (MS).


Expression of the renin gene in extra-renal tissues of the rat.
Expression of the renin gene in several rat organs is demonstrated by the detection of renin mRNA using a ribonuclease-protection technique. In two of these sites, the brain and the liver, renin mRNA levels are unaffected by changes in dietary salt which markedly affect renal renin mRNA levels. The findings provide the basis for an important ubiquitous local regulatory role for the renin-angiotensin system extending beyond the circulation.


Synovial sarcoma.
The contributions of Dr. Arthur Purdy Stout to surgical pathology and his observations pertaining to soft tissue tumors (and, more specifically, to synovial sarcoma) are briefly reviewed. In addition, a report on 185 patients treated at the Mayo Clinic for synovial sarcoma is reviewed. In that study, histologic subclassification stratified the tumors as follows: 33% with a predominant biphasic pattern, 31% with a monophasic pattern, and 36% with a mixed pattern. For all 185 patients, the 5-year survival rate was 38% and the 10-year rate was 23%. For patients treated since 1960, the survival rates were 55% at 5 years and 38% at 10 years. Female patients, young patients, and patients with tumors less than 5 cm in diameter had significantly higher survival rates than did their counterparts. Although histologic subtyping did not reveal significant differences in patient survival, patients with glandular differentiation of the epithelial elements seemed to do better.


Predictability of a New Orthodontic Extrusion Technique for Implant Site Development: A Retrospective Consecutive Case-Series Study.
In clinical daily practice, there are situations in which implant sites have vertical and/or horizontal bone defects and often we must improve their morphology and dimensions before fixture insertion. It is crucial to carefully evaluate the surgical site as regards the characteristics of both hard and soft tissues. The orthodontic extrusion technique can be used for nonsurgical augmentation of the implant site as an alternative to traditional regenerative/reparative surgical therapies. The orthodontic extrusion is based on a biological mechanism that uses the portion of periodontal ligament, still present on the root before the tooth extraction, for the increase of hard and soft tissues. In the literature, there is no evidence of common guidelines for this technique but only tips based on personal experience and/or previous studies. The aim of this study was to investigate and to validate the reliability of a new orthodontic extrusion technique (MF Extrusion Technique, by Dr. Mauro Fadda) by means of a retrospective consecutive case-series study. After we have done a review of the literature, we evaluated the X-rays of twelve consecutively treated patients before the orthodontic extrusion (T0) and after the stabilization period (T1), in order to quantify, by two different measurements, area and linear, the bone gain obtained by the application of the new technique. All the patients examined showed a significant increase in bone areas with an average value of 31.575 mm2. The linear bone gain had an average value of 4.63 mm. Data collected were statistically analysed by the Wilcoxon signed-rank test. The results obtained both from area and linear measurements at T0 and at T1 times showed that there was a statistically significant bone gain with p < 0.01.


Stability indicating methods for the determination of norfloxacin in mixture with tinidazole.
Three stability indicating assay methods are developed for the determination of norfloxacin (Nor) in the presence of its decarboxylated degradation product and in mixture with tinidazole (Tnd). The proposed methods are reversed phase ion pair liquid chromatography (LC), thin layer densitometry (TLC) and second derivative ratio spectra zero crossing spectrophotometry ((2)DD). Chromatographic separation was achieved on mu-Bondapack C18 column 5 microm (300 mm x 3.9 mm, I.D.) and precoated silica gel TLC stationary phases for LC and TLC methods, respectively. Mobile phases consisting of phosphate buffer pH 3.2 : methanol (3 : 1, v/v) containing 0.005 M pentane sulfonic acid sodium salt and isopropanol : butanol : concentrated ammonia : water (25 : 50 : 5 : 25, v/v/v/v) were used for resolution of Nor and Tnd by both techniques, respectively. Detection was carried at 280 nm. In the ratio spectra method, detection of Nor was carried at 282 nm. Linearity, accuracy and precision were found to be acceptable over concentration ranges of 20-225 microg/ml, 0.8-4 microg/spot and 1-7 microg/ml for Nor by LC, TLC and (2)DD methods and over concentration ranges of 37.5-375 microg/ml and 4.8-20 microg/spot for Tnd by LC and TLC methods respectively. The suggested methods were successfully applied for the determination of both drugs in bulk powder, laboratory prepared mixtures and in commercial samples. Statistical comparison between the results obtained by the proposed and the reference methods was carried out using Student t-test, F ratio and one way ANOVA.


Bilateral Trichosporon asahii keratitis after ptosis correction: A case report.
Fungal keratitis (FK) is a severe vision-threatening disease that can lead to corneal perforation or endophthalmitis despite proper treatment. It is important to diagnose the disease promptly due to its indolent nature and disproportionate disease symptoms. Trichosporon asahii is reported rarely as the causative organism of FK. We report a case of highly unusual bilateral T asahii keratitis following ptosis surgery. An 86-year-old female underwent bilateral levator resection surgery for ptosis. Postoperatively, the patient complained of gradually worsening bilateral ocular pain and a decrease in visual acuity associated with a chronic non-healing epithelial defect. Both eyes of the patient were evaluated using best-corrected visual acuity, intraocular pressure, slit-lamp examination, fundus examination, and corneal culture. Multifocal deep stromal infiltrates were found in both corneas. Cultures from both corneal ulcers revealed growth of T asahii. Optical coherence tomographic examination showed bilateral macular edema. The patient was treated with revisional ptosis surgery, an antifungal agent for the corneal ulcer, and intravitreal injection of steroid for macular edema. Both eyes recovered well. Her best-corrected visual acuity improved from 20/200 to 20/40 in the right eye and from 20/100 to 20/40 in the left eye. FK can develop in the cornea when certain risk factors are present, including recent lid surgery, chronic keratitis, and steroid eye drop use. Identification and correction of risk factors can be beneficial in the treatment of FK.


Development of testicular alpha-fetoprotein-secreting germ cell tumor 3 years after treatment of intracranial lesion identified as non-secreting germ cell tumor on the basis of clinical data--case report.
A 22-year-old Asian male developed testicular alpha-fetoprotein (AFP)-secreting germ cell tumor 3 years after treatment of a disseminated intracranial lesion identified as non-secreting germ cell tumor on the basis of clinical data. Magnetic resonance imaging showed a massive lesion with necrosis appearing as hypointense on T1- and hyperintense on T2-weighted imaging, with heterogeneous enhancement. The blood AFP level was as high as 129 ng/ml (previously, as low as 5 ng/ml) and abdominal computed tomography showed para-aortic lymph node swelling. Left orchidectomy was performed and histological examination indicated the presence of AFP-secreting germ cell tumor despite severe necrosis of the tissue. Improved chemoradiotherapy for intracranial germ cell tumor will lead to long-term survival of most patients with germ cell tumor. Patients may subsequently develop germ cell tumors at other sites in the body. Therefore, follow up should monitor for tumor recurrence not only in the brain but also in other locations.


The Doa locus encodes a member of a new protein kinase family and is essential for eye and embryonic development in Drosophila melanogaster.
Mutations at the Darkener of apricot (Doa) locus of Drosophila cause roughened eyes and increase transcript accumulation from the retrotransposon copia up to fourfold. Cloning of the gene and sequencing of cDNAs reveals that it encodes a putative serine/threonine protein kinase. Sequence data base searches identify it is a member of a novel highly conserved protein kinase family, with homologs in humans, mice, and Saccharomyces cerevisiae, not related to each other previously. Family members are characterized by a peptide motif reading EHLAMMERILG at kinase subdomain X, which is virtually 100% identical in all homologs. We therefore refer to this new family as the LAMMER protein kinases. As predicted from its primary sequence, Doa protein possess intrinsic protein kinase activity when expressed in bacteria, as assayed via autophosphorylation. The gene is expressed throughout development, and both stage and tissue-specific RNAs are found. Its function is essential, because maternally deposited or zygotically transcribed mRNA is required for development to larval stages, and defects in segmentation and development of the nervous system are observed in embryos derived from heteroallelic mothers. Doa function is also critical to Drosophila eye development, because the organization and development of pigment cells, bristles, and photoreceptors are affected in various mutant classes. In the most extreme cases that survive to adulthood, retinal photoreceptors degenerate prior to eclosion. These results demonstrate that the kinase encoded by Doa is required at multiple stages of development, for both differentiation and maintenance of specific cell types.


[Causes and treatment of ventricular arrhythmias].
Antiarrhythmic therapy is intended for relief of symptoms or to reduce the risk of sudden death. Recent observations have cast doubt on the causal correlation between ventricular premature beats, ventricular tachycardia and ventricular fibrillation. The therapeutic approach has therefore to be modified in the light of new trends, and take into consideration electrophysiologic aspects and new diagnostic and therapeutic procedures.


Spot-testing urine pH, a novel dietary biomarker? A randomised cross-over trial.
Spot-tests of urine pH are claimed to be an accessible biomarker of net acid excretion (NAE), and as such, they may be able to determine changes in an individual's intake of acid- or base-forming foods. To test this hypothesis, we aimed to determine if spot-tests of urine pH could index NAE and relay the consumption of a fruit and vegetable (F&V) concentrate whilst determining this concentrate's capacity to modulate NAE. In a double blind, placebo-controlled, cross-over trial, healthy adults (n = 13) were allocated by simple randomisation to receive a F&V concentrate or placebo for three days each, with diet standardised throughout. Measurements of 24-hour NAE, 24-hour urine pH and spot-tests of urine pH were taken throughout the study. The 24-hour urine pH predicted 24-hour NAE (P = <0.0001). However, spot-tested urine pH displayed prediction intervals too wide to infer 24-hour NAE and inconsistent ability to reflect concentrate ingestion, despite 24-hour NAE and 24-hour urine pH decreasing (-25.8 mEq, 95% CI -44.3 to -7.4, P = 0.01, d = 0.94) and increasing (+0.51, 95% CI 0.25-0.79, P = 0.002, d = 1.3), respectively, following supplementation. Spot-tests of urine pH are not a valid dietary biomarker of daily NAE and were unable to reliably track changes, despite a F&V concentrate clearly modulating the daily rate of NAE.


It Takes More Than Two to Tango: Building Secure Attachment Through Hypnotic and Ego-State Relationships.
This article explores how hypnotic strategies can be used within a polyvagal science framework to help create more secure attachment within the therapeutic relationship, as well as within the client in terms of ego-state relationships. Principles of safety and connection are emphasized, along with specific strategies to access the attachment circuits of the ventral vagal system, including the necessity of being present with the client without agenda. Uses of hypnosis related to safety and connection and methods to work with the center core self to facilitate empowerment, self-cohesion, and conflict-free experience are also reviewed. From an ego-state therapy perspective, a discussion of hypnosomatic approaches to connect with preverbal, nonverbal, and somatic aspects of self to accomplish developmental repair and facilitate secure attachment is also offered, along with case examples. A three-step model, which attempts to integrate polyvagal, somatic, and hypnotic approaches, is offered by the author to help structure corrective experiences for clients with trauma.


Artesunate Dry Emulsion Formulation Combined with Antibiotics for Treatment of Helicobacter pylori Infections: In Vitro/In Vivo Evaluation.
Helicobacter pylori is the primary pathogen responsible for causing gastroduodenal ulcers and stomach cancer. The standard treatment for H. pylori typically involves a combination of antibiotics and acid-reducing medications. However, the recurrence of ulcers is closely linked to the emergence of antibiotic resistance in H. pylori, necessitating the development of alternative drugs. This report focuses on the investigation of artesunate as a potential alternative to reduce antibiotic use and enhance effectiveness against H. pylori. Unfortunately, commercial artesunate is available in an acid form, which has poor solubility, especially in gastric acid fluid. The aim of this study is to utilize a water-soluble formulation of artesunate called dry emulsion formulation (ADEF) and combine it with amoxicillin to eradicate H. pylori. In vitro studies were conducted to evaluate the activity of ADEF against H. pylori and determine its inhibitory concentrations. In addition, pharmacokinetic parameters of orally administered ADEF and native artesunate were investigated in rats for in vivo studies. The results showed that when combined with amoxicillin and pantoprazole, ADEF exhibited effectiveness against H. pylori. It is worth noting that the solubility of ADEF in gastric acid appears to be a critical factor for achieving successful treatment. Consequently, ADEF could be considered a promising candidate for H. pylori therapy.


Self-Objectification and Personal Values. An Exploratory Study.
Self-objectification occurs when individuals treat themselves as objects to be viewed and evaluated based upon appearance. Literature has largely elucidated links between self-objectification and damaging outcomes in both men and women. The purpose of the present study was to extend past research on the antecedents of self-objectification. We were interested in the role played by specific ideological components, i.e., higher order personal values (self-enhancement, conservation, self-transcendence, and openness to change), in influencing the degree to which individuals internalize the objectifying perspective of the Western cultural milieu, i.e., self-objectify. Undergraduate participants (N = 371, 76.8% women) completed measures of self-objectification (i.e., body surveillance and body shame), and endorsement of higher order values. Regression analyses demonstrated that self-enhancement is linked to higher self-objectification in both men and women, whereas conservation is related only to women's body surveillance. Self-transcendence seemed to act as a buffer against men's body surveillance, whereas openness to change resulted as a buffer against women's body surveillance. Implications are discusses.


Isolated Rh atoms in dehydrogenation catalysis.
Isolated active sites have great potential to be highly efficient and stable in heterogeneous catalysis, while enabling low costs due to the low transition metal content. Herein, we present results on the synthesis, first catalytic trials, and characterization of the Ga9Rh2 phase and the hitherto not-studied Ga3Rh phase. We used XRD and TEM for structural characterization, and with XPS, EDX we accessed the chemical composition and electronic structure of the intermetallic compounds. In combination with catalytic tests of these phases in the challenging propane dehydrogenation and by DFT calculations, we obtain a comprehensive picture of these novel catalyst materials. Their specific crystallographic structure leads to isolated Rhodium sites, which is proposed to be the decisive factor for the catalytic properties of the systems.


The induction of augmented granulocyte adherence by inflammation. Mediation by a plasma factor.
The adherence of granylocytes to surfaces, measured in vitro in nylon fiber columns, is inhibited by in vivo administration of anti-inflammatory agents. Therefore, the effect of inflammation itself was assessed in blood from patients with acute inflammatory diseases. Mean adherence in these patients was twice normal (56.4 +/- 5.6% vs. 29.4 +/- 5.2%); their plasma contained a factor that augmented adherence of normal cells to 47.5 +/- 5.6% whereas the patient's cells showed a normal level of adherence (34.0 +/- 6.8%) when resuspended in normal plasma. Although exudate fluid from exprimental inflammation also contained the augmenting factor, cells from the exudate maintained their high level of adherence after washing and suspension in normal plasma. The augmenting factor detected in plasma from patients with inflammation was not present in serum and was inactivated by heating plasma to 56 degrees C for 30 min; restoration of augmenting activity was accomplished by addition of 20% guinea pig serum to the heat-treated plasma. Because the guinea pig serum itself did not increase adherence when added to normal plasma, it appears that the augmenting factor is heat-stable, but requires a heat-labile cofactor like complement. Sephadex G-200 fractionation of inflammatory plasma showed adherence-augmenting activity in the majority of fractions, with peak activity in the fractions corresponding to approximate molecular wts of 30,000, 160,000 and 400,000.


Medullary tachykinin precursor 1 neurons promote rhythmic breathing.
Rhythmic breathing is generated by neural circuits located in the brainstem. At its core is the preBötzinger Complex (preBötC), a region of the medulla, necessary for the generation of rhythmic breathing in mammals. The preBötC is comprised of various neuronal populations expressing neurokinin-1 receptors, the cognate G-protein-coupled receptor of the neuropeptide substance P (encoded by the tachykinin precursor 1 or Tac1). Neurokinin-1 receptors are highly expressed in the preBötC and destruction or deletion of neurokinin-1 receptor-expressing preBötC neurons severely impair rhythmic breathing. Although, the application of substance P to the preBötC stimulates breathing in rodents, substance P is also involved in nociception and locomotion in various brain regions, suggesting that Tac1 neurons found in the preBötC may have diverse functional roles. Here, we characterized the role of Tac1-expressing preBötC neurons in the generation of rhythmic breathing in vivo, as well as motor behaviors. Using a cre-lox recombination approach, we injected adeno-associated virus containing the excitatory channelrhodopsin-2 ChETA in the preBötC region of Tac1-cre mice. Employing a combination of histological, optogenetics, respiratory, and behavioral assays, we showed that stimulation of glutamatergic or Tac1 preBötC neurons promoted rhythmic breathing in both anesthetized and freely moving animals, but also triggered locomotion and overcame respiratory depression by opioid drugs. Overall, our study identified a population of excitatory preBötC with major roles in rhythmic breathing and behaviors.


The potential role of preoperative cystoscopy for determining the depth of invasion in the placenta accreta spectrum.
This study aims to determine the role of preoperative cystoscopy in specifying the degree of placental invasion to the bladder in the placenta accreta spectrum (PAS), especially in percreta. This prospective observational cohort study included 78 PAS patients. All included patients underwent the preoperative cystoscopy before the cesarean hysterectomy operation. The preoperative cystoscopy procedure identified markers of PAS as neovascularization, arterial pulsatility in neovascularized zones, and posterior bladder wall bulging. Then the patients were divided into subgroups according to the histopathological results of their cesarean hysterectomy specimens. Finally, the histopathological subgroups of PAS were estimated using preoperative cystoscopy signs in the designed logistic regression analysis model. The preoperative cystoscopic signs such as neovascularization, the posterior bladder wall bulging, and the arterial pulsatility in neovascularized zones were approximately associated with a 17-fold [OR = 16.9 (95% CI, 5.7-49.8)], 26-fold [OR = 26.1 (95% CI, 8.17-83.8)], and 9-fold [OR = 8.94 (95% CI, 2.94-27.1)] increase in the likelihood of placenta percreta, respectively. Preoperative cystoscopy may significantly contributions to other standard imaging modalities to identify the degree of placental invasion, especially placenta percreta. Experienced obstetricians trained in hysteroscopic visualization may safely perform this preoperative cystoscopy procedure under the guidance of a specialist urologist. Accordingly, it may be possible to estimate the degree of invasion and the course of surgery in patients with PAS using the preoperative cystoscopy procedure.


[What effect does using the Latham devices have on craniofacial growth in uni- and bilateral lip-jaw-palate clefts].
Primary gingivoperiosteoplasty according to Millard consists of active presurgical orthopedic treatment with the Latham device at the age of 4 months and surgical covering of the alveolar cleft by local mucoperiosteum flaps at the age of 6 months. The aim of this investigation was to evaluate the facial growth following use of the Latham device. Lateral head X-rays and plaster casts from 146 patients with unilateral and bilateral clefts of lip and palate were investigated (follow-up of 16 years). Ninety-one of these patients formed the control group and received no Latham device and no gingivoperiosteoplasty. The same surgeon and orthodontist treated all of the 146 patients. Three-dimensional growth disturbance was observed after application of the Latham device and gingivoperiosteoplasty. Forty-two percent of patients with UCLP and 40% patients with BCLP had an "open bite" following closure of the alveolar cleft (control group 5%-10%): the length of the upper jaw was shorter than in the control group and the frequency of cross-bite was higher. These results demonstrate that treatment with a Latham device followed by gingivoperiosteoplasty disturbs facial growth. Therefore this treatment should be rejected.


Concise synthesis of dimemorfan (DF) starting from 3-hydroxymorphinan (3-HM).
Dimemorfan (DF) has been known to possess neuroprotective properties. While this promising compound deserves further biological evaluation, synthetic methods have not improved since Murakami group unveiled the synthetic efforts in 1972. Herein a succinct synthesis toward DF from commercially available 3-hydroxymorphinan (3-HM) is disclosed. Other morphinan analogs have been effectively prepared by adopting the similar methodology.


IgE, IgG1 and IgG4 response to specific allergens in sensitized subjects showing different clinical reactivity to Anisakis simplex.
Background. Anisakis simplex hypersensitive subjects may be sensitized without clinical allergy, or experience acute symptoms or chronic urticaria induced by raw fish. We studied whether the 3 subgroups differ in IgE, IgG1 or IgG4 reactivity to specific Anisakis simplex allergens. Methods. 28 Anisakis simplex-hypersensitive adults, 11 with acute symptoms, 9 with chronic urticaria, and 8 sensitized were studied. IgE, IgG1 and IgG4 to rAni s 1, 5, 9 and 10 were sought by ELISA. IgE and IgG4 to nAni s 4 were determined by WB. Results. IgE to Ani s 1, 4, 5, 9, and 10 were found in 8, 3, 2, 5, and 9 sera, respectively. Nine sera did not react to any allergen. IgG1 to Ani s 1, 5, 9, and 10 were detected in 5, 16, 14, and 4 sera, respectively. Four sera did not react to any of the 4 allergens. IgG4 to Ani s 1, 4, 5, 9, and 10 were detected in 10, 0, 2, 6 and 1 sera, respectively. Fifteen subjects did not react to any of the 5 allergens. On ELISA sensitized subjects showed lower IgE and IgG1 levels than patients. IgG4 levels were highest in the sensitized group. The prevalence of IgE, IgG1 or IgG4 reactivity to any of the studied allergens did not differ between the 3 subgroups. Conclusion. The clinical expression of Anisakis simplex sensitization does not seem to depend on IgE reactivity to a specific allergen of the parasite, nor on the presence of IgG antibodies possibly related with blocking activity.


Atypical patterns in portable monitoring for sleep apnoea: features of nocturnal epilepsy?
Atypical cardiorespiratory patterns can be found during routine clinical use of portable monitoring for diagnosis of sleep-disordered breathing (SDB). Over 1,000 consecutive portable recordings were analysed to study the potential ictal nature of stereotyped cardiorespiratory and motor patterns. Snoring, airflow, thoracic effort, pulse rate, body position, oxygen saturation and activity of the anterior tibialis muscles were quantified. Recordings showing stereotyped polygraphic patterns recurring throughout the night, but without the features of sleep apnoea (apnoea/hypopnoea index <5 events·h(-1)), were selected for investigation. Once included in the study, patients underwent attended nocturnal video polysomnography. A total of 15 recordings showing repeated polygraphic patterns characterised by a sequence of microphone activation, respiratory activity atypical for sleep and wakefulness, heart rate acceleration and limb movements, followed by body position change, were selected for investigation. Once included in the study, patients underwent attended nocturnal video polysomnography that showed frontal epileptic discharges triggering periodic electroencephalographic arousals, autonomic activation and stereotyped motor patterns. A diagnosis of nocturnal frontal lobe epilepsy (NFLE) was established for all patients. NFLE should be taken into consideration in patients with stereotyped and recurrent behavioural features during portable monitoring carried out for diagnosis of SDB.


Direct determination of angiotensin-converting enzyme inhibitors in plasma by radioenzymatic assay.
We describe a simple, rapid, specific radioenzymatic assay for "CGS 16617," a new, potent inhibitor of angiotensin-converting enzyme (ACE; EC 220.127.116.11) in human plasma. This assay is based on the principle that the inhibitor (i.e., the drug) binds to the ACE in plasma and hence the amount of free ACE in plasma is inversely related to the amount of active inhibitor present. Free enzyme is reacted with a radiolabeled substrate, and the radioactive product is selectively extracted into the scintillation cocktail for quantification. Fivefold-diluted plasma samples are incubated with [3H]hippuryl-glycyl-glycine enzyme substrate at 37 degrees C for 30 min and the liberated [3H]hippuric acid is selectively extracted into scintillation cocktail. The radioactivity is counted in a liquid scintillation counter. Both within-run and between-run, the variability (CV) of the assay is less than 10%. As little as 200 ng of the drug per liter can be quantified in 50-microL plasma samples. The method can also be used to assay two other ACE inhibitors, pentopril and CGS 14831, demonstrating that the method can be readily adapted to any ACE inhibitor having a single active component in plasma. The ester prodrug pentopril can also be assayed after ester hydrolysis. This method is suitable for analysis of large numbers of samples in clinical laboratories for routine monitoring of the concentrations of active ACE inhibitors in blood.


Regulation of intestinal homeostasis by innate immune cells.
The intestinal immune system has an ability to distinguish between the microbiota and pathogenic bacteria, and then activate pro-inflammatory pathways against pathogens for host defense while remaining unresponsive to the microbiota and dietary antigens. In the intestine, abnormal activation of innate immunity causes development of several inflammatory disorders such as inflammatory bowel diseases (IBD). Thus, activity of innate immunity is finely regulated in the intestine. To date, multiple innate immune cells have been shown to maintain gut homeostasis by preventing inadequate adaptive immune responses in the murine intestine. Additionally, several innate immune subsets, which promote Th1 and Th17 responses and are implicated in the pathogenesis of IBD, have recently been identified in the human intestinal mucosa. The demonstration of both murine and human intestinal innate immune subsets contributing to regulation of adaptive immunity emphasizes the conserved innate immune functions across species and might promote development of the intestinal innate immunity-based clinical therapy.


Aldosterone and vasopressin responses in the heat: hydration level and exercise intensity effects.
We examined the separate and combined effects of hypohydration level and exercise intensity on aldosterone (ALD) and arginine vasopressin (AVP) responses during exercise-heat stress. Nine heat acclimated men performed 50 min of treadmill exercise in a warm room (30 degrees C dry bulb (DB), 50% relative humidity (RH) at 25%, 45% and 65% VO2max when euhydrated and when hypohydrated by 3% and 5% of body weight. Blood samples were drawn at rest and at 20 min of exercise. ALD and AVP increased (P < 0.05) in a graded manner with hypohydration level, and this effect persisted during exercise-heat stress. High intensity exercise produced greater ALD and AVP increases than low intensity exercise. ALD responses during exercise were independent of hypohydration level. AVP responses were closely related to osmolality (N = 6 of 7 subjects; r = 0.51 to r = 0.98; average r = 0.84) despite varying hydration, exercise intensity, or core temperature. We conclude that: 1) ALD and AVP increase in a graded manner with hypohydration, and this effect persists during exercise-heat stress; 2) ALD and AVP increases elicited by exercise are greater during high intensity than low intensity exercise; 3) Hypohydration and exercise intensity have additive effects on ALD: and 4) AVP responses are closely coupled to osmolality.


Changes in area and number of nature reserves in China.
Nature reserves (NR) are the cornerstone of biodiversity conservation. Over the past 60 years, the rapid expansion of NRs in China, one of the world's megadiverse countries, has played a critical role in slowing biodiversity loss. We examined the changes in the number and area of China's NRs from 1956 to 2014 and analyzed the effect of economic development on the expansion of China's NRs from 2005 to 2014 with linear models. Despite a continuing increase in the number of NRs, the total area of China's NRs decreased by 3% from 2007 to 2014. This loss resulted from downsizing and degazettement of existing NRs and a slowdown in the establishment of new ones. Nature reserves in regions with rapid economic development exhibited a greater decrease in area, suggesting that downsizing and degazettement of NRs are closely related to the intensifying competition between economic growth and conservation. For example, boundary adjustments to national NRs, the most strictly protected NRs, along the coast of China's Yellow Sea, a global biodiversity hotspot with a fast-growing economy, resulted in the loss of one-third of the total area. One of the most important ecosystems in these NRs, tidal wetlands, decreased by 27.8% because of boundary adjustments and by 25.2% because of land reclamation. Our results suggest conservation achievement, in terms of both area and quality, are declining at least in some regions in the Chinese NR estate. Although the designation of protected areas that are primarily managed for sustainable use has increased rapidly in recent years in China, we propose that NRs with biodiversity conservation as their main function should not be replaced or weakened.


Prospective randomized comparative study of antegrade and retrograde locked nailing for middle humeral shaft fracture.
Humeral shaft fractures can be effectively treated by either antegrade or retrograde locked intramedullary nailing, but these two methods have not been adequately compared. The present study compared the effectiveness and potential risks of these two approaches on middle humeral shaft fractures using the same locked nails. In this prospective comparative study, 92 fractures in 92 patients with middle humeral shaft fractures were randomly allocated to receive either antegrade or retrograde locked nailing by sealed-envelope technique. The clinical outcomes of fracture healing, time to healing, complications, elbow and shoulder functional recovery, and time for functional recovery were compared. Retrograde nailing required significantly longer time than antegrade nailing (64.8 vs. 51.3 minutes; p < 0.01) Except for three patients lost to follow-up, the average follow-up time was 18.6 months for 44 fractures in the antegrade group and 19.8 months for 45 fractures in the retrograde group. The fracture healed in 42 fractures (95%) in the antegrade group versus 42 fractures (93%) in the retrograde group, and this difference was not significant. After exclusion of two patients with brachial plexus injury and three with head injury, functional recovery was compared between 41 patients with antegrade and 43 with retrograde nailing. For shoulder joints, the difference in the average Neer shoulder score between the two groups was statistically significant (90.8 vs. 93.5; p = 0.03). However, if four elderly patients were excluded, the average score in the antegrade group was 91.9, and the difference became insignificant (p = 0.1). Still, the antegrade group needed significantly longer time for shoulder functional recovery (16.4 vs. 8.3 weeks; p < 0.01). For elbow joints, the average postoperative Mayo elbow performance score (96.3 vs. 94.8; p = 0.16) did not differ significantly between these two approaches, but the retrograde approach needed significantly longer time for elbow functional recovery (3.9 vs. 8.8 weeks; p < 0.01). All patients, except those with associated injuries, resumed their pretrauma occupations or activities. With proper patient selection, antegrade and retrograde nailing have similar treatment results, including healing rate and eventual functional recovery for middle humeral fractures. It is recommended that retrograde nailing be used in patients with a wide medullary canal or preexisting shoulder problems and antegrade nailing be used in patients with young age or a small medullary canal. In critically ill patients, antegrade nailing is preferred because of shorter operation time.


Festination Correlates with SNCA Polymorphism in Chinese Patients with Parkinson's Disease.
The genetic basis of festination, a common motor symptom in Parkinson's disease (PD), remains unclear. Since polymorphism in the alpha-synuclein (SNCA) gene is associated with PD phenotype, we examined whether such polymorphism is also associated with festination. SNCA polymorphisms rs11931074 and rs894278 were genotyped in a consecutive series of 258 patients with PD, of whom 122 (47.3%) suffered festination. Univariate analysis revealed significant differences in genotype and minor allele frequencies at rs11931074 or rs894278 between patients with festination and those without it (all p < 0.05). Based on logistic regression, a GG or GT genotype at rs11931074 was associated with higher risk of festination among patients with PD (OR 2.077, 95% CI 1.111-3.883, p = 0.022), as was the TT genotype at rs894278 (OR 2.271, 95% CI 1.246-4.139, p = 0.007). Therefore, we conclude that festination is associated with polymorphism at rs11931074 or rs894278 among patients with PD.


Bone regeneration in extraction sites after immediate placement of an e-PTFE membrane with or without a biomaterial. A report on 12 consecutive cases.
The efficacy in restoring a buccal dehiscence after tooth extraction has been studied in 12 consecutive cases using guided bone regeneration with (6 patients) or without (6 patients) a biomaterial (DFDBA or Bio Oss) beneath an e-PTFE membrane. A correlation between the clinical impression of density at drilling time and the histological signs of bone formation has been evaluated too. The membrane was removed after 6 or 9 months and a biopsy was performed. Clinically, GBR was highly predictable for regeneration of the alveolar bone after tooth extraction with buccal dehiscence. The histology fully confirmed the clinical and radiographical results, showing bone formation in all cases with individual variations in the amount of bone formed. 6-month biopsies from the membrane sites had lamellar bone with large medullary spaces, while a good bone density was observed at 9 months. The membrane/biomaterial sites demonstrated mineralization and large amounts of allograft at 6 months. Thus, bone regeneration seems to take more time when grafting material is used.


Clinical and neurophysiological study in diabetic children and adolescents.
We investigated 82 unselected insulin dependent diabetes mellitus children and adolescents by clinical and electrophysiological evaluation to assess the frequency of diabetic neuropathy and to relate the results to age and height of patients, duration of illness and degree of metabolic control. Clinical abnormalities were found in about 1/3 of patients: these signs of diabetic neuropathy were related to the age and the duration of diabetes but not to the degree of metabolic control. Neurophysiological study showed alterations, especially of sensory nerve conduction. These results were seen to be related to height and age of patients and duration of illness but not to the degree of metabolic control, probably due to the young age of the patients. Our study confirms that diabetic neuropathy is a heterogeneous disorder that may be caused by the interaction of host susceptibility and vascular, metabolic and perhaps environmental components also in diabetic children.


Pressure-induced denaturation of β-lactoglobulin in skim milk: effect of milk concentration.
The effect of milk concentration (10-40% TS) on the kinetics of the pressure-induced denaturation of β-lactoglobulin (β-LG) was studied. The denaturation was found to be a second-order process at all milk concentrations and pressures. There was a change in pressure dependence of the rate constants for denaturation at about 300 MPa, and this effect became more pronounced as the milk concentration increased. At pressures ≥300 MPa, a small effect of milk concentration was observed, with small decreases in the rate of denaturation as the milk concentration was increased above 20% TS. This was attributed to the lower pH as the milk concentration was increased. In contrast, at 200 MPa, β-LG denaturation was markedly retarded as the milk solids concentration was increased. This was attributed to the increased lactose concentration at higher milk concentrations. This would promote β-LG dimerization at this pressure and this would stabilize the β-LG to denaturation.


Acidic Fibroblast Growth Factor in Spinal Cord Injury.
Spinal cord injury (SCI), with an incidence rate of 246 per million person-years among adults in Taiwan, remains a devastating disease in the modern day. Elderly men with lower socioeconomic status have an even higher risk for SCI. Despite advances made in medicine and technology to date, there are few effective treatments for SCI due to limitations in the regenerative capacity of the adult central nervous system. Experiments and clinical trials have explored neuro-regeneration in human SCI, encompassing cell- and molecule-based therapies. Furthermore, strategies have aimed at restoring connections, including autologous peripheral nerve grafts and biomaterial scaffolds that theoretically promote axonal growth. Most molecule-based therapies target the modulation of inhibitory molecules to promote axonal growth, degrade glial scarring obstacles, and stimulate intrinsic regenerative capacity. Among them, acidic fibroblast growth factor (aFGF) has been investigated for nerve repair; it is mitogenic and pluripotent in nature and could enhance axonal growth and mitigate glial scarring. For more than 2 decades, the authors have conducted multiple trials, including human and animal experiments, using aFGF to repair nerve injuries, including central and peripheral nerves. In these trials, aFGF has shown promise for neural regeneration, and in the future, more trials and applications should investigate aFGF as a neurotrophic factor. Focusing on aFGF, the current review aimed to summarize the historical evolution of the utilization of aFGF in SCI and nerve injuries, to present applications and trials, to summarize briefly its possible mechanisms, and to provide future perspectives.


Assessing Patient and Community-Level Social Factors; The Synergistic Effect of Social Needs and Social Determinants of Health on Healthcare Utilization at a Multilevel Academic Healthcare System.
We investigated the role of both individual-level social needs and community-level social determinants of health (SDOH) in explaining emergency department (ED) utilization rates. We also assessed the potential synergies between the two levels of analysis and their combined effect on patterns of ED visits. We extracted electronic health record (EHR) data between July 2016 and June 2020 for 1,308,598 unique Maryland residents who received care at Johns Hopkins Health System, of which 28,937 (2.2%) patients had at least one documented social need. There was a negative correlation between median household income in a neighborhood with having a social need such as financial resource strain, food insecurity, and residential instability (correlation coefficient: -0.05, -0.01, and - 0.06, p = 0, respectively). In a multilevel model with random effects after adjusting for other factors, living in a more disadvantaged neighborhood was found to be significantly associated with ED utilization statewide and within Baltimore City (OR: 1.005, 95% CI: 1.003-1.007 and 1.020, 95% CI: 1.017-1.022, respectively). However, individual-level social needs appeared to enhance the statewide effect of living in a more disadvantaged neighborhood with the OR for the interaction term between social needs and SDOH being larger, and more positive, than SDOH alone (OR: 1.012, 95% CI: 1.011-1.014). No such moderation was found in Baltimore City. To our knowledge, this study is one of the first attempts by a major academic healthcare system to assess the combined impact of patient-level social needs in association with community-level SDOH on healthcare utilization and can serve as a baseline for future studies using EHR data linked to population-level data to assess such synergistic association.


Vascular evaluation in laryngeal diseases: comparison between contact endoscopy and laser Doppler flowmetry.
To determine the efficacies of 2 methods for evaluating vascular changes in laryngeal diseases. Prospective comparative study. University hospital. Twenty-four adults planning to undergo laryngomicrosurgery for unilateral lesions in their vocal cords. Vascular evaluation was performed using contact endoscopy and laser Doppler flowmetry during laryngomicrosurgery. Morphological and physiological variables of the vascular changes. Contact endoscopy examinations revealed changes in the fine vascular network patterns in the vocal cords. Hypervascularity was present in patients with polyps but not in those with nodules, and the degree of vascularity was variable in patients with malignant neoplasms. Patients with papillomas and patients in the postradiation therapy group showed hypovascularity with losses in the capillary network. Laser Doppler flowmetry revealed high mean blood flows in patients with polyps, dysplasia, and malignant neoplasms, whereas patients with papillomas and those in the postradiation therapy group had low blood flows. The variables measured by laser Doppler flowmetry and endoscopy were strongly correlated. Evaluations of morphological and physiological changes of vascularity in laryngeal diseases are important for understanding their pathophysiology, and combining contact endoscopy and laser Doppler flowmetry is useful in such evaluations.


Magnetic resonance imaging of the abdomen--1988.
This article reviews the current clinical use of magnetic resonance imaging (MRI) in the abdomen with regard to recent technological advances, organ analysis and the integration of MRI in diagnostic imaging. The authors conclude that while MRI is not at present establishing itself as a leading diagnostic imaging method in the abdomen, if MRI machines were to become more widely available, abdominal applications could become a reality.


Nurses' knowledge and attitudes regarding major immobility complications among bedridden patients: A prospective multicentre study.
To gain insight into nurses' knowledge and attitudes regarding major immobility complications (pressure ulcers, pneumonia, deep vein thrombosis and urinary tract infections) and explore the correlation of nurses' knowledge and attitudes with the incidence of these complications. Immobility complications have adverse consequences, and effective management requires appropriate knowledge, attitudes and skills. Evidence about nurses' knowledge and attitudes regarding immobility complications is lacking. Cross-sectional study. A total of 3,903 nurses and 21,333 bedridden patients from 25 hospitals in China were surveyed. Nurses' knowledge and attitudes regarding major immobility complications were assessed using researcher-developed questionnaires. The content validity, reliability and internal consistency of the questionnaires were validated through expert review and a pilot study. The incidence of major immobility complications among bedridden patients from selected wards was surveyed by trained investigators. Correlations between knowledge, attitudes and the incidence of major immobility complications were evaluated with multilevel regression models. Mean knowledge scores were 64.07% for pressure ulcers, 72.92% for deep vein thrombosis, 76.54% for pneumonia and 83.30% for urinary tract infections. Mean attitude scores for these complications were 86.25%, 84.31%, 85.00% and 84.53%, respectively. Knowledge and attitude scores were significantly higher among nurses with older age, longer employment duration, higher education level, previous training experience and those working in tertiary hospitals or critical care units. Nurses' knowledge about pressure ulcers was negatively related to the incidence of pressure ulcers, and attitude towards pneumonia was negatively correlated with the incidence of pneumonia. Clinical nurses have relatively positive attitudes but inadequate knowledge regarding major immobility complications. Improved knowledge and attitudes regarding major immobility complications may contribute to reducing these complications. Nursing managers should implement measures to improve nurses' knowledge and attitudes regarding major immobility complications to reduce the incidence of these complications in bedridden patients.


Analgesic effect of calcitonin in osteoporosis.
Bone pain is the most common symptom in osteoporotic patients. To date, there is mounting evidence that calcitonin significantly reduces bone pain in osteoporosis, and that the analgesic effect can be evident as soon as the second week of treatment. The limitations to the use of calcitonin, which are parenteral administration and side effects, can now be overcome by the availability of the nasal spray preparation. At present, controlled studies have demonstrated the analgesic activity of calcitonin given by nasal spray in patients with vertebral crush fractures and bone pain. The mechanism for the analgesic effect of calcitonin is yet to be clarified. In humans, similarities between calcitonin and morphine-induced analgesia, and reports of calcitonin-induced elevation of plasma beta-endorphin levels, suggest the possible involvement of the endogenous opiate system in mediating the analgesic action of calcitonin. However, the demonstration of calcitonin binding sites in areas of the brain involved in pain perception and a series of animal studies have raised the possibility that calcitonin may directly modulate nociception in the central nervous system. In support of this hypothesis are some observations of an analgesic effect obtained by direct epidural or subaracnoidal injection of calcitonin in humans.


Evaluation of extravesical and Leadbetter-Politano ureteroneocystostomy in renal transplantation.
In a series of 650 renal transplantations performed over a 4- year period, the results were evaluated of 125 Leadbetter-Politano and 125 extravesical ureteroneocystostomies. The Leadbetter-Politano technique had a complication rate of 4%, with 3.2% of these patients having a vesical leak. Extravesical ureteroneocystostomy also had a 4% complication rate but only 1.6% of these patients had a vesical leak. Although there was no statistical difference between the two groups with regard to complications, we feel that extravesical ureteroneocystostomy is a quick and simple procedure and well suited to the special challenge presented by renal transplant recipients.


Dendritic cells and the regulation of a granulomatous immune response in the lung.
To investigate the contribution of dendritic cells (DC) in a pulmonary granulomatous immune response, C57BL/l6 mice, nonimmunized or immunized with purified protein derivative (PPD) of Mycobacterium bovis, were intravenously injected with PPD-coated Sepharose-4B beads. One and three days later lungs were harvested, granuloma size was measured, and immunolabeled cells in granulomas were counted. On Day 1, granulomas in immunized mice were 3-fold larger and contained more major histocompatibility complex class II+, CD11c+ DCs than nonimmunized mice. By Day 3, these differences had diminished. In all granulomas MHC class II+, CD11c+ DCs were in contact with the beads. By in situ hybridization these DCs expressed interleukin (IL)-12 p40 mRNA. MOMA2+ macrophages were present throughout the granulomas, whereas CD4+ and CD8alpha+ T cells were localized at the granuloma periphery. DCs isolated from granulomatous lungs at Day 1, and from thoracic lymph nodes (LNs) at Days 1 and 3, stimulated PPD-specific T cell proliferation without exogenously added antigen, indicating that they had acquired bead-bound antigen. By Day 3, however, granuloma DCs presented little antigen, suggesting that newly immigrated DC lacked access to antigen or that antigen uptake/processing was inhibited. RNase protection assays of whole-lung mRNA showed increased interferon-gamma, IL-1beta, IL-1 receptor antagonist, IL-6, and macrophage inhibitory factor, but no IL-10 mRNA on Days 1 and 3. These observations support the premise that DCs are key in initiating granulomatous cell-mediated immunity. However, factors generated within the granuloma downregulate the antigen presenting function of DC by Day 3 in this experimental model.


The Integrity of the Acromioclavicular Capsule Ensures Physiological Centering of the Acromioclavicular Joint Under Rotational Loading.
The acromioclavicular (AC) capsule is an important stabilizer against horizontal translation and also contributes to the strut function of the clavicle, which guides rotation of the scapula. To best reproduce the biomechanical properties and the complex 3-dimensional (3D) guidance of the AC joint, detailed knowledge of the contribution of each of the distinctive capsular structures is needed. Purpose/Hypothesis: To perform a detailed biomechanical evaluation of the specific capsular structures of the AC joint and their contribution to translational and rotational stability. The hypothesis was that successive cutting of each quadrant of the AC capsule would result in increased instability and increased amplitude of the clavicle's motion in relation to the acromion. Controlled laboratory study. Thirty-two fresh-frozen human cadaveric shoulders were used. Each scapula was fixed to a swivel fixture of a servohydraulic materials testing system. The AC capsule was dissected in serial steps with immediate rotational and horizontal testing after each cut. A 3D optical measuring system was used to evaluate 3D movement. Posterior translation, rotation, and displacement of the lateral clavicle in relation to the center of rotation were measured. Torques and axial forces required to rotate and translate the clavicle were recorded. When posterior translational force was applied, all specimens with a completely cut AC capsule demonstrated a significant loss of resistance force against the translational motion when compared with the native state ( P < .05). The resistance force against posterior translation was reduced to less than 27% of the native state for all specimens. Sequential cutting of the AC capsule resulted in a significant reduction of resistance torque against anterior rotation for all specimens with less than 22% of resistance force compared with the native state. Cutting 50% of the capsule reduced the resistance torque for all segments and all testing modalities (posterior translation as well as anterior and posterior rotation) significantly compared with the native state ( P < .05). Cutting the entire AC capsule resulted in a significant increase in motion within the joint as a sign of decentering of the AC joint when torque was applied. All groups demonstrated a significant increase of motion in all directions when the AC capsule was cut by 50%. Cutting the entire capsule (with intact coracoclavicular [CC] ligaments) reduced the resistance force to less than 25% compared with the native state during translational testing and less than 10% compared with the native state during rotational testing. However, the anterior segments of the capsule provided the greatest stability under rotational loading. Second, the amplitude of the joint's motion significantly increased under rotational stress, indicating increased amplitude of the clavicle's motion in relation to the acromion when the ligamentous structures of the AC capsule are dissected. To best restore stability to the AC joint, the relevance and function of each section of the circumferential AC capsule need to be understood. Our findings support the synergistic contribution of the CC ligaments and AC capsular structures to AC joint stability. This synergy supports the need to address both structures to achieve anatomic reconstruction.


The complete mitochondrial genome of the Epinephelus akaara (Perciformes: Serranidae).
The complete mitochondrial genome of the Epinephelus akaara was presented in this study. The mitochondrial genome is 16,743 bp long and consists of 13 protein-coding genes, 2 rRNA genes, 22 tRNA genes and a control region. The gene order and composition of Epinephelus akaara mitochondrial genome was similar to that of most other vertebrates. The nucleotide compositions of the light strand are 27.31% of A, 16.20% of C, 28.68% of T and 27.81% of G. With the exception of the NADH dehydrogenase subunit 6 (ND6) and eight tRNA genes, all other mitochondrial genes are encoded on the heavy strand.


Microscopic polyangiitis and polyarteritis nodosa: how and when do they start?
To describe initial clinical symptoms attributable to microscopic polyangiitis (MPA) or polyarteritis nodosa (PAN). We retrospectively reviewed the medical files of 72 patients (mean followup 6.7 years) with biopsy-proven MPA (n = 36) or PAN (n = 36). Initial manifestations were similar in both entities except for peripheral neuropathy (P = 0.02) and gastrointestinal tract involvement (P = 0.006), which were significantly more frequent in PAN, and general signs alone in MPA (8%; P = 0.02). The mean time to diagnosis was 9.8 +/- 19.4 months; 35% of the patients died and 26% relapsed; significantly more MPA than PAN patients relapsed (P = 0.03). Time to diagnosis >/=90 days was associated with a trend toward more patients relapsing (P = 0.12), but not with an increased risk of mortality. Initial symptoms of MPA and PAN are usually nonspecific and last for several months before the diagnosis is made. A longer time to diagnosis is associated with a tendency to a higher relapse rate.


Anticorrosion Investigation of New Diazene-Based Schiff Base Derivatives as Safe Corrosion Inhibitors for API X65 Steel Pipelines in Acidic Oilfield Formation Water: Synthesis, Experimental, and Computational Studies.
The current study examines the evaluation of diazene-based Schiff base derivatives, namely, 4-((E)-(3-((E)-(hexylimino)methyl)-4-hydroxyphenyl)diazenyl)benzonitrile (S1) and 4-((E)-(3-((E)-(dodecylimino) methyl)-4-hydroxyphenyl)diazenyl)benzonitrile (S2). The structure elucidation of prepared the Schiff base compounds was performed by FTIR, 1H NMR, and 13C NMR. In addition, the corrosion inhibition capacity of these compounds was investigated for API X65 steel pipelines in 1 M HCl utilizing gravimetric and electrochemical methods. By conducting the experimental investigations at various doses, it was possible to assess the inhibition effectiveness and adsorption behavior of S1 and S2. With increasing concentration, both inhibitors became more effective at inhibiting corrosion. S1 and S2 suppressed both cathodic and anodic processes, as shown by the potentiodynamic polarization study. The charge transfer resistance (Rct) increased when S1 and S2 concentrations increased, according to the electrochemical impedance analysis (EIS) data. According to the Langmuir isotherm model, the adsorption of S1 and S2 inhibitors on carbon steel was discovered based on gravimetric measurements. The results were confirmed by theoretical data in addition to the experimental tests for the presence of S1 and S2 inhibitor films over the API X65 carbon steel surface.


A general approach to antibody thermostabilization.
Antibody engineering to enhance thermostability may enable further application and ease of use of antibodies across a number of different areas. A modified human IgG framework has been developed through a combination of engineering approaches, which can be used to stabilize antibodies of diverse specificity. This is achieved through a combination of complementarity-determining region (CDR)-grafting onto the stable framework, mammalian cell display and in vitro somatic hypermutation (SHM). This approach allows both stabilization and maturation to affinities beyond those of the original antibody, as shown by the stabilization of an anti-HA33 antibody by approximately 10°C and affinity maturation of approximately 300-fold over the original antibody. Specificities of 10 antibodies of diverse origin were successfully transferred to the stable framework through CDR-grafting, with 8 of these successfully stabilized, including the therapeutic antibodies adalimumab, stabilized by 9.9°C, denosumab, stabilized by 7°C, cetuximab stabilized by 6.9°C and to a lesser extent trastuzumab stabilized by 0.8°C. This data suggests that this approach may be broadly useful for improving the biophysical characteristics of antibodies across a number of applications.


Pediatric all-terrain vehicle (ATV) injuries: An epidemic of cost and grief.
Evaluate cost of care of all-terrain vehicle (ATV) related injuries sustained by riders 16 years and younger in Pennsylvania. Population-based retrospective cohort design reviewing costs of care of 78 patients (≤16 years), admitted (01/01/2007-12/31/2009) to our institution for injuries sustained during an ATV accident. Cost of care varied from $322 to $310,435. Mean and median costs for all patients were $25,760 and $8,066, respectively. Average costs increased with increasing age. Patients wearing helmets or driving the ATV had lower mean costs, but these trends were not statistically significant. Crashes with stationary objects not involving rollover or ejection had significantly lower mean costs than other crash types (p = 0.01). Patients involved in rollover accidents were significantly more likely to require an overnight hospital stay (OR = 3.45, p = 0.02). Patients wearing helmets were marginally less likely to require an overnight admission (OR = 0.34, p = 0.07). ATV crashes involving unhelmeted riders and rollover accidents result in significant medical costs. Interventions to increase helmet use and measures to improve stability are likely to reduce these costs and shorten hospital stays. Level IV, Economic study.


The burden of influenza B: a structured literature review.
We reviewed the epidemiology, clinical characteristics, disease severity, and economic burden of influenza B as reported in the peer-reviewed published literature. We used MEDLINE to perform a systematic literature review of peer-reviewed, English-language literature published between 1995 and 2010. Widely variable frequency data were reported. Clinical presentation of influenza B was similar to that of influenza A, although we observed conflicting reports. Influenza B-specific data on hospitalization rates, length of stay, and economic outcomes were limited but demonstrated that the burden of influenza B can be significant. The medical literature demonstrates that influenza B can pose a significant burden to the global population. The comprehensiveness and quality of reporting on influenza B, however, could be substantially improved. Few articles described complications. Additional data regarding the incidence, clinical burden, and economic impact of influenza B would augment our understanding of the disease and assist in vaccine development.


Diaqua-(1,4,8,11-tetra-aza-cyclo-tetra-decane-κN,N,N,N)copper(II) didodeca-noate dihydrate.
The title compound, [Cu(C(10)H(24)N(4))(H(2)O)(2)][CH(3)(CH(2))(10)CO(2)](2)·2H(2)O, consists of one cationic copper(II) complex, two dodeca-noate anions and two water solvent mol-ecules. The Cu(II) atom is located on an inversion center and is chelated by the four aza N atoms of the neutral 1,4,8,11-tetra-aza-cyclo-tetra-decane (cyclam) ligand and by two water mol-ecules in axial positions, giving an octa-hedral coordination geometry, distorted as a consequence of the Jahn-Teller effect. The uncoordinated water mol-ecules link the complex cations and the dodeca-noate counter-ions through O-H⋯O hydrogen bonding, forming a layer structure parallel to (001). Inter-molecular N-H⋯O inter-actions also occur.


Current developments in cell- and biomaterial-based approaches for stroke repair.
Stroke is one of the most devastating diseases and a leading cause of mortality worldwide. So far, clinical management of stroke involves surgical clot retrieval or thrombolytic treatment inducing reperfusion of the occluded vessels in the cerebral infarcted area, which is dependent on early intervention following insult. New treatment strategies involve the promotion of angiogenesis and neuroplasticity, stimulation of endogenous neurogenesis, remyelinization, and immunomodulation by means of cell transplantation and sustained drug delivery. This review describes different types of stem cells (endogenous and exogenous neural progenitors, pluripotent stem cell derivatives, mesenchymal stem cells [MSCs], olfactory ensheathing cells) and biomaterials, their routes of administration, means of noninvasive imaging, and the prerequisites and hurdles for the successful translation of the cell therapies to the clinic. Neural precursors (NPs) derived from pluripotent stem cells, unlike MSCs, can not only remodel the CNS by promoting neuroplasticity, angiogenesis, and immunomodulation, but also replace damaged cells. To transfer NPs into the clinic, step by step guidelines for researchers are identified and discussed.


Comparison of multisegment anterior cervical fixation using bone strut graft versus a titanium rod and buttress prosthesis: analysis of outcome with long-term follow-up and interview by independent physician.
A retrospective study of 73 consecutive patients who underwent cervical corpectomy and anterior strut fixation over 3 or more disc levels between July 1989 and May 1999. To compare the efficacy of cervical spine fixation by autologous strut graft from iliac crest or fibula versus a titanium prosthesis without bone graft. Strut grafting after multilevel anterior cervical corpectomy remains a challenging procedure, with published dislocation rates from 0% to 71%, and nonunion from 0% to 54%. This paper describes a quicker and easier alternative to the use of a bone strut, imparting a very high degree of immediate spinal stability, and osseous integration equivalent to bone fusion. Thirty-eight bone-graft operations and 38 titanium prosthesis operations were performed on 73 patients between July 24, 1989 and May 20, 1999. Average follow-up was 53.2 months (range 19.8-134). The group of patients who received the prosthesis was significantly older than the bone-grafted group and required significantly more segments excised, but operation times were significantly shorter than for the bone strut operation. The titanium prosthesis had a lower incidence of dislodgement in the early postoperative period (1/38 vs. 4/38 for bone struts) but a higher rate of late reoperation (4/38 vs. 1/38 for bone struts). The SF-36 scores in the domain of Physical Function (only) were significantly higher in the bone-grafted group (P = 0.016, Mann Whitney), consistent with the difference in mean ages of the 2 groups. The groups were indistinguishable by Odom criteria, patient verdict, pain scores, analgesic intake, length of hospital stay, radiologic fusion rate, and residual symptoms. A titanium rod and buttress prosthesis may be a faster and easier alternative to conventional iliac crest/fibula autograft after multisegmental cervical vertebral corpectomy.


A novel three-component reaction catalyzed by dirhodium(II) acetate: decomposition of phenyldiazoacetate with arylamine and imine for highly diastereoselective synthesis of 1,2-diamines.
[reaction: see text] A practical highly diastereoselective synthesis of 1,2-diamines through carbon-carbon bond formation involving an ammonium ylide intermediate is reported for the first time. By treating methyl phenyldiazoacetate with arylamine and imine in the presence of dirhodium acetate, the erythro diastereomer of methyl 1,2-diaryl-1,2-diaminopropanoate is formed with stereochemical preferences greater than 10:1.


Regional Trends for the 2021 COVID-19 Independent Plastic Surgery Match Cycle.
The coronavirus disease (COVID) created an abrupt change to virtual experiences and interviews for both the integrated and independent plastic surgery match cycle of 2021. Studies have shown that during the 2021 match cycle, integrated applicants were more likely to match at their home institution and region of medical school. These geographic and location trends for the 2021 match cycle have not been explored yet for the independent plastic surgery match. Information for independent plastic surgery applicants that successfully matched was gathered using publicly available data for the 2019 and 2020 pre-COVID and 2021 COVID match cycles. Zip codes for applicant medical school, applicant residency program, and plastic surgery program were gathered to compare regional and distance outcomes between the pre-COVID and COVID match cycles. Data was collected on 182 applicants from 42 programs. There was no significant difference in the breakdown of gender percentages between the COVID match cycle (63.2% males) and the pre-COVID match cycles (72% males) (p=0.23). The COVID match cycle had 38.6% of applicants match at a plastics program within the same region as their residency, while the pre-COVID match cycles had 47.2% of applicants match the same region (p=0.28). These results continued to be nonsignificant when stratified by the regions of the west, south, midwest, and northeast (p=1.00). With regional matches with respect to medical school, the COVID match cycle had 33.3% of applicants match at a plastics program within the same region as their medical school, while the pre-COVID match cycles had 43.6% (p=0.20). These results continued to be nonsignificant when stratified by the four regions (p=1.00). When comparing the median distances between the COVID match cycle and the pre-COVID match cycle, no region of the United States showed a significant difference in travel distance to a plastics program with respect to medical school or residency (p=1.00). Transitions to virtual interviews and cancellation of away rotations during the COVID match cycle for the independent plastic surgery match did not significantly affect an applicant's ability to match outside of their region of previous medical school or residency. This may represent diminished program preference for applicants within the same region as their plastic residency.


Psychopathology in children of patients with panic disorder or animal phobia.
Several studies reveal a heightened risk for anxiety and other mental disorders in the offspring of patients with panic disorder and other anxiety disorders. Data on the specific type of transmitted disorders, however, are inconsistent. We investigated the specificity of the relationship between parents' and children's psychopathology. We assessed current and past mental disorders in 5- to 15-year-old children of patients with panic disorder (CPAN, n = 34), children of parents with no diagnosis of a mental disorder (CCON, n = 30) and children of animal phobics (CPHOB, n = 23) using a structured diagnostic interview according to DSM-III-R criteria. Diagnoses are based on parent as well as child information. CPAN and CPHOB had significantly more often at least one current mental disorder than children of the healthy control parents. Compared to CPHOB and CCON, children of panic patients had significantly more severe diagnoses and more often multiple diagnoses. Furthermore, a higher rate of internalizing anxiety disorders, particularly separation anxiety disorder, was found in CPAN. In contrast, children of animal phobics showed a higher rate of externalizing anxiety disorders. Our results suggest a specific transmission of such disorders that share common features of parental symptomatology.


Analysis of Granulocyte-Macrophage Colony-Stimulating Factor-Producing T Helper Cells in a Mouse Model of Contact Hypersensitivity.
Parallel to traditional Th1/Th2/Th17/Treg lineages, granulocyte-macrophage colony-stimulating factor-producing T helper (Th-GM) cells have been identified as a distinct subset of T helper cells (GM-CSF+ IFN-γ- IL-17A- IL-22- effector CD4+ T cells) in human and mice. Contact hypersensitivity (CHS) is considered an excellent animal model for allergic contact dermatitis (ACD) in human, manifesting an intact T cell-mediated immune response. To provide a standardized and comprehensive assay to analyze the Th-GM cell subset in the T cell-dependent immune response in vivo, a murine CHS model was induced by sensitization/challenge with a reactive, low-molecular-weight, organic hapten, 2,4-dinitrofluorobenzene (DNFB). The Th-GM subset in effector CD4+ T cells generated upon immunization with the hapten was analyzed by flow cytometry. We found that Th-GM was mainly expanded in lesions and draining lymph nodes in the DNFB-induced CHS mouse model. This method can be applied to further study the biology of Th-GM cells and pharmacological research of therapeutic strategies centered on GM-CSF in various conditions, such as ACD.


In vitro activity of RP 59500 (quinupristin/dalfopristin) and ramoplanin against vancomycin-resistant Enterococcus faecium.
Vancomycin-resistant Enterococcus faecium (VREF) collected between July 1991 and February 1994 were tested in vitro against RP 59500 and ramoplanin using agar dilution and standard macro broth dilution procedures. Colony counts were determined at 0, 4, and 24 h. RP 59500 had an MIC range of < or = 0.5-8 micrograms/ml with an MIC90 of 2 micrograms/ml and a MBC range of < or = 0.5-16 micrograms/ml with an MBC90 of 16 micrograms/ml. Ramoplanin had an MIC range of < or = 0.125-1 microgram/ml with an MBC range of < or = 0.125-4 micrograms/ml. The MIC90 for ramoplanin was 1 microgram/ml and the MBC90 was 4 micrograms/ml for the tested isolates. Against these isolates of E. faecium, RP 59500 was bactericidal at 8x MIC, a potentially achievable level using a high drug dosage. Ramoplanin was bactericidal at 2x MIC.


Transjugular Intrahepatic Portosystemic Shunts: Advances and New Uses in Patients with Chronic Liver Disease.
Transjugular intrahepatic portosystemic shunts is an established treatment for portal hypertensive complications. Advancements in technology and technique have led to novel indications, including treatment of chronic portal vein thrombosis and use before abdominal surgery to alleviate portal hypertensive complications. Use of TIPS can facilitate the embolization of large portal-systemic shunts to alleviate refractory hepatic encephalopathy owing to excessive portal shunting. Despite these advances, transjugular intrahepatic portosystemic shunts is an invasive procedure with risk for complications and should be performed at a center with expertise to ensure a successful patient outcome.


Spatially defined microsatellite analysis reveals extensive genetic mosaicism and clonal complexity in intestinal metaplastic glands.
Intestinal metaplasia (IM) has been recognized as the first irreversible precancerous stage of intestinal-type gastric cancer at which genetic instabilities, such as microsatellite (MS) instability and loss of heterozygosity, can already be detected. However, the extent and clonal relationship of these genetic lesions in the precancerous tissues are not fully appreciated. In this work, we have used well established MS markers to analyze the relatedness of spatially separated individual metaplastic glands as well as subsegments within single glands from the same patients. We found that individual IM glands frequently show different marker lengths even for closely apposed IM glands, suggesting that these tissues have already gained the ability to independently evolve their genome regardless of whether or not they share a common origin. Furthermore, within individual IM glands, there is also significant intra-gland diversity in the MS markers. Since most of these cells are not dividing and only have a limited lifespan, this result indicates that in each IM gland, a single dominant clone is rare and new clones are constantly created by either progenitor cells or stem cells. This greatly enhanced ability to create de novo genetic alterations may underlie the importance of this stage in the eventual progression toward cancer. Given the widely observed phenotype switch in the early stages of many solid tumors, whether this associated genetic stability is also an intrinsic property of metaplastic transformation should be extensively characterized to further our understanding of cancer initiation.


A survey of semen donation: phase I--the view of UK licensed centres.
It has been suggested that the implementation of the Human Fertilisation and Embryology Act in the UK in 1991 may have had a detrimental effect on the supply of semen donors. The aim of this survey was to obtain data relating to semen donation in the UK during 1989-1992. A questionnaire designed to obtain information about the recruitment and screening of semen donors, the supply of semen donors, and use of donated semen for infertility treatment was sent to all licensed centres in April 1993 and 93% were returned for analysis. The results demonstrate that while the number of centres recruiting donors and the number of men offering to be donors have increased in recent years, this has not resulted in an increased supply of donors. Reasons for these findings are discussed in the light of the Human Fertilisation and Embryology Authority regulations relating to semen donation.


Repurposing Auranofin, Ebselen, and PX-12 as Antimicrobial Agents Targeting the Thioredoxin System.
As microbial resistance to drugs continues to rise at an alarming rate, finding new ways to combat pathogens is an issue of utmost importance. Development of novel and specific antimicrobial drugs is a time-consuming and expensive process. However, the re-purposing of previously tested and/or approved drugs could be a feasible way to circumvent this long and costly process. In this review, we evaluate the U.S. Food and Drug Administration tested drugs auranofin, ebselen, and PX-12 as antimicrobial agents targeting the thioredoxin system. These drugs have been shown to act on bacterial, fungal, protozoan, and helminth pathogens without significant toxicity to the host. We propose that the thioredoxin system could serve as a useful therapeutic target with broad spectrum antimicrobial activity.