TWO HERBIVORES AND CONSTRAINTS ON SELECTION FOR RESISTANCE IN BRASSICA RAPA.
Although most plants experience herbivory by several insect species, there has been little empirical work directed toward understanding plant responses to these simultaneous selection pressures. In an experiment in which herbivory by flea beetles (Phyllotreta cruciferae) and diamondback moths (Plutella xylostella) was manipulated in a factorial design, I found that selection for resistance to these herbivores is not independent in Brassica rapa. Specifically, the effect of flea beetle damage on B. rapa fitness depends on the amount of diamondback moth damage a plant experiences: damage by these herbivores has a nonadditive effect on plant fitness. When diamondbacks are abundant, plants that sustain high levels of damage by flea beetles are favored by natural selection, but when diamondbacks are rare, a low level of damage by flea beetles is favored. However, resistance to the later-feeding diamondback moth is not affected by the presence or absence of damage by early-feeding flea beetles. Thus, there are no plant-mediated ecological interactions between these herbivores that affect the outcome of selection for resistance. Because these herbivores do not independently affect plant fitness, neither is likely to develop a pairwise coevolutionary relationship with its host. Instead, coevolution is diffuse.


A prospective study on infection with cytomegalovirus in renal allograft recipients immunosuppressed with cyclosporine A and low dose prednisone.
To investigate the course of infection with cytomegalovirus (CMV) in renal allograft recipients treated with cyclosporine A, 10 patients were followed for 1 year after transplantation. Virus cultures from blood, urine and throat washings were performed employing a quantitative technique. Complement-fixing and IgM antibodies to CMV were measured at scheduled intervals. The incidence 90% and course of CMV infections were found not to differ from those reported in patients receiving conventional immunosuppressive therapy. The quantitative virus cultures showed a consistent pattern with viremia most prominent at the beginning of an infection, and the highest concentration found in the one patient who developed symptoms of viral disease. It is suggested that information about the concentration of virus in a specimen will improve the diagnostic value of virus cultures in this group of patients.


Designing text-messaging (SMS) in HIV programs: ethics-framed recommendations from the field.
Text messages (SMS) are being increasingly integrated into HIV programs across Southern Africa to improve patient adherence, linkage to care and provide psycho-social support. Careful attention needs to be paid to the design of SMS-based interventions for clients of HIV-care services to ensure that any potential harm, such as unwanted disclosure of HIV status, is minimized. In this article we propose a set of best practice recommendations to ensure that any SMS-based intervention considers ethical principles to safeguard safety, autonomy and confidentiality of its targeted HIV-positive beneficiaries. This analysis draws from our operational experience in Southern Africa in the design and conduct of mHealth interventions in the frame of HIV projects. The recommendations, framed in the context of the Belmont Report's three ethical pillars, may contribute to more safely operationalize any SMS service integrated into an HIV program if adopted by mHealth planners and implementers. We encourage actors to report on the ethical and methodological pathways followed when conducting SMS-based innovations to improve the wellbeing and quality provision of HIV-care for their targeted clients.


Preparation and characterization of biodegradable electrospun polyanhydride nano/microfibers.
The biodegradable polyanhydride copolymers P(CPP-SA) composed of p-carboxyhenoxy propane (CPP) and sebacic acid (SA) at weight ratios of 20:80, 35:65 and 50:50 were polymerized by a melt polycondensation process without catalyst. The copolymers were characterized by fourier transform infrared spectroscopy (FT-IR), 1H-nuclear magnetic resonance (1H-NMR), Ubbelohde viscometer, differential scanning calorimetry (DSC) and wide angle X-ray powder-diffraction (XRD). P(CPP-SA) nano/microfibers were the first time to be fabricated by electrospinning. The copolymers hold an excellent fibre-forming performance and the diameter range of 80-3,200 nm can be obtained. The in vitro degradation of the polyanhydride copolymers was evaluated in form of the nano/microfibers by investigating the change of fibrous morphology, weight loss and pH change of degradation medium. The experimental results showed that degradation rate was fast in the fist day and slow in the following period, furthermore the degradation rate decreased with the increase of the content of CPP in copolymers. Therefore, the electrospun polyanhydride nano/microfibers exhibited strong potential as drug delivery vehicle and tissue engineering scaffold.


Initial experiences in robot-assisted middle pancreatectomy.
Initial results in robot-assisted middle pancreatectomy (MP) have been encouraging. However, data comparing outcomes of robot-assisted MP with those of open MP are limited. The aim of this study was to compare outcomes in patients undergoing open and robot-assisted MP, respectively. Outcomes in an initial experience with seven consecutive patients undergoing robot-assisted MP were compared with those in 36 patients undergoing open MP. The robot-assisted MP group included five women and two men with a median age of 55 years (range: 30-62 years). Median tumour size, operative time and blood loss were 3.0 cm (range: 0.5-5.0 cm), 210 min (range: 150-330 min) and 200 ml (range: 50-400 ml), respectively. Pancreaticogastrostomy was performed in all patients. No transfusion was given intraoperatively. Pathological examination revealed five serous cystic neoplasms, one mixed-type intraductal papillary mucinous neoplasm and one lipoma. Five patients experienced postoperative pancreatic fistula and one experienced post-pancreatectomy haemorrhage. No operative mortality was noted. Compared with the open MP group, the robot-assisted MP group demonstrated a shorter median length of postoperative gastrointestinal tract recovery [2 days (range: 2-3 days) versus 4 days (range: 2-11 days); P = 0.001]. Robot-assisted MP can be performed safely with satisfactory efficacy; patients experienced faster gastrointestinal tract recovery compared with patients undergoing open surgery.


[The role of the T-lymphocyte in atopic dermatitis].
Atopic dermatitis (AD) comprises a wide spectrum of clinical symptoms, among which dermatitis is the most prominent feature. Recent finding that Langerhans cells bind IgE molecules via Fc receptors brought new insight into the pathogenesis of dermatitis lesions in AD. Langerhans cells from AD patients can present environmental allergens to T cells, both in vivo and in vitro, because they can bind allergens through IgE. Alternatively, Langerhans cells from normal individuals do not bind IgE molecules and are ineffective in stimulation of allergen specific T cells. Thus, the dermatitis lesion in AD seem to be due to an IgE-mediated delayed type hypersensitivity mechanism.


Effects of frequent announced parasitology quizzes on the academic achievement.
The effect of frequent examinations on the students' learning has had inconsistent results. This study aimed to assess the effectiveness of frequent announced quizzes on the learning of a representative sample of Iranian medical students. This experimental study was conducted among 37 fifth semester medical students who had taken the course in Protozoology and Helminthology, in which the same basic information were provided about different types of protozoa and worms. Initially, in the teaching of helminthology, ten routine sessions were handled with lectures and interactive questions and answers. Then at the beginning of the protozoology topic in the beginning of all of the next 9 sessions, the students were informed that they will have a quiz at the end of each session. At the end of the semester, the total scores of quizzes were compared with the mean final scores of protozoology and helminthology using paired t and repeated measure tests. The mean final scores of the protozoology lesson were not significantly different from that of the helminthology (10.45 ± 2.75 vs.11.25 ± 2.56 on the scale of 20, respectively, P=0.13). There was no significant difference in the mean score of the five quizzes compared with the mean final term score of protozoology. The overall mean scores in the helminthology lesson (11.25±2.56), protozoology lesson (10.45±2.75), and the quizzes (9.16 ± 3.55) were significantly different (P <0.0001). Frequent announced quizzes were not effective on increasing the medical students' motivation and learning.


Nanotube and three-way nanotube formation with nonionic amphiphilic block peptides.
Amphiphilic block polypeptides having a helical hydrophobic block with a uniform chain length and a hydrophilic nonionic block were newly synthesized and self-assembled into homogeneous nanotubes with ca. 60 nm diameter and ca. 200 nm length. The tubular assembly was shown to be elongated by heating over micrometer length without changing the diameter. Notably, a distinctive three-way nanotube was obtained just by mixing two kinds of amphiphilic polypeptides with the same helical hydrophobic block but different chain lengths of the hydrophilic block. The morphology of the molecular assemblies was shown to be tunable from a curved sheet-shaped assembly to a long or short nanotubular assembly and a three-way nanotubular assembly by suitable molecular design of the hydrophobic block, selection of the chain length of the hydrophilic block, mixing two-type block peptides, and processing such as heating.


Long-Term Health-Related Quality of Life in Living Liver Donors.
BACKGROUND In living donor liver transplantation (LDLT), 2 patients undergo surgery, and the advantages and disadvantages for both patients should be considered. This study evaluated the long-term quality of life in living liver donors, and its impact on their activities of daily living focusing on mood and mental health. MATERIAL AND METHODS In total, 101 living liver donors (69 female and 32 male patients, median age of 36.8 years) were surveyed at a median time of 61.8 months after liver donation (range 7-169 months). The generic Short Form Health Survey (SF-36), the Patient Health Questionnaire 9 (PHQ-9), and the Questionnaire of Physical Activity (IPAQ) were used. The results of SF-36 were compared to a matched control group (n=72) using the Wilcoxon test; the SF-36, the PHQ-9, and the IPAQ scores were analyzed using Spearman's rank correlation. Linear regression model was used to check for dependencies between variables of interest. The IPAQ results were compared between the study group and the general Polish population. RESULTS There were no significant differences in the SF-36 domains between the study group and control group except body pain, which was higher in the living liver donor group (P<0.05). In 30.6% of patients, the PHQ-9 survey revealed mood disturbances. The PHQ-9 scores were higher in female-donors (P<0.05). Both summary scores of the SF-36 correlated to the PHQ-9 (P<0.001). In 89.1% of patients, physical activity was below the population norm and was lower in female donors than in male donors (P<0.01). CONCLUSIONS LDLT had no impact on donors' physical and mental health. Physical activity of living liver donors was lower than that of the general population. The SF-36 and the IPAQ measures seem to be reliable in the care of living liver donors. The PHQ-9 survey results and the inclination to depression of female living liver donors requires further study.


Gelastic seizures: incidence, clinical and EEG features in adult patients undergoing video-EEG telemetry.
This study aimed to determine clinical features of adult patients with gelastic seizures recorded on video -electroencephalography (EEG) over a 5-year period. We screened video-EEG telemetry reports for the occurrence of the term "gelastic" seizures, and assessed the semiology, EEG features, and duration of those seizures. Gelastic seizures were identified in 19 (0.8%) of 2,446 admissions. The presumed epileptogenic zone was in the hypothalamus in one third of the cases, temporal lobe epilepsy was diagnosed in another third, and the remainder of the cases presenting with gelastic seizures were classified as frontal, parietal lobe epilepsy or remained undetermined or were multifocal. Gelastic seizures were embedded in a semiology, with part of the seizure showing features of automotor seizures. A small proportion of patients underwent epilepsy surgery. Outcome of epilepsy surgery was related to the underlying pathology; two patients with hippocampal sclerosis had good outcomes following temporal lobe resection and one of four patients with hypothalamic hamartomas undergoing gamma knife surgery had a good outcome.


Physiatrics for deforming linear scleroderma.
When linear scleroderma traverses several joints, severe and mutilating deformities and contractures, with loss of limb function, can result. Drugs and surgical procedures are usually of little benefit in ameliorating the deformities. Physiatrics on the other hand, is a readily available modality than can restore much useful function and reverse the contractures and is probably the most effective means of treating patients with deforming linear scleroderma. This type of therapy should be instituted at the inception of the disease process so that the development and progression of any contraction can be minimized or prevented.


Effect of syringe underfilling on the quality of venous blood gas analysis.
There is limited information on the influence of collecting small amounts of blood on the quality of blood gas analysis. Therefore, the purpose of this study was to investigate the effects of different degrees of underfilling of syringes on test results of venous blood gas analysis. Venous blood was collected by venipuncture from 19 healthcare workers in three 1.0 mL syringes for blood gas analysis, by manually aspirating different volumes of blood (i.e., 1.0, 0.5 and 0.25 mL). Routine blood gas analysis was then immediately performed with GEM Premier 5,000. The results of the two underfilled syringes were compared with those of the reference syringe filled with appropriate blood volume. The values of most assayed parameters did not differ significantly in the two underfilled syringes. Statistically significant variations were found for lactate, hematocrit and total hemoglobin, the values of which gradually increased as the fill volume diminished, as well as for sodium concentration, which decreased in both insufficiently filled blood gas syringes. The bias was clinically meaningful for lactate in syringe filled with 0.25 mL of blood, and for hematocrit, total hemoglobin and sodium in both syringes containing 0.5 and 0.25 mL of blood. Collection of smaller volumes of venous blood than the specified filling volume in blood gas syringes may have an effect on the quality of some test results, namely lactate, hematocrit, total hemoglobin and sodium. Specific indications must be given for standardizing the volume of blood to be collected within these syringes.


Studies of the Process of Amyloid Formation by Aβ Peptide.
Studies of the process of amyloid formation by Aβ peptide have been topical due to the critical role of this peptide in the pathogenesis of Alzheimer's disease. Many articles devoted to this process are available in the literature; however, none of them gives a detailed description of the mechanism of the process of generation of amyloids. Moreover, there are no reliable data on the influence of modified forms of Aβ peptide on its amyloid formation. To appreciate the role of Aβ aggregation in the pathogenesis of Alzheimer's disease and to develop a strategy for its treatment, it is necessary to have a well-defined description of the molecular mechanism underlying the formation of amyloids as well as the contribution of each intermediate to this process. We are convinced that a combined analysis of theoretical and experimental methods is a way for understanding molecular mechanisms of numerous diseases. Based on our experimental data and molecular modeling, we have constructed a general model of the process of amyloid formation by Aβ peptide. Using the data described in our previous publications, we propose a model of amyloid formation by this peptide that differs from the generally accepted model. Our model can be applied to other proteins and peptides as well. According to this model, the main building unit for the formation of amyloid fibrils is a ring-like oligomer. Upon interaction with each other, ring-like oligomers form long fibrils of different morphology. This mechanism of generation of amyloid fibrils may be common for other proteins and peptides.


Regression pattern in retinopathy of prematurity.
We characterized the regression pattern of retinopathy of prematurity (ROP) for 266 infants examined over a 22-month period. Infants were included in the evaluation with a birth weight of less than or equal to 1500 g. Regression of retinopathy was observed in all but 11 infants, who were treated for threshold ROP. ROP limited to the peripheral retina resolved around term (40 weeks postconceptional age). Posterior ROP and/or stage 3 ROP underwent a protracted course of resolution, often not reaching zone 3 until 42 to 45 weeks after conception. Permanent retinal/vascular sequelae of ROP were observed in 10% of infants with ROP. The most common abnormality was failure to completely vascularize the temporal retinal periphery. Overall, retinal morbidity from ROP was an infrequent occurrence (18 of 266 premature infants--6.8%).


Apraxia screening predicts Alzheimer pathology in frontotemporal dementia.
Frontotemporal dementia (FTD) is a heterogeneous clinical syndrome linked to diverse types of underlying neuropathology. Diagnosis is mainly based on clinical presentation and accurate prediction of underlying neuropathology remains difficult. We present a large cohort of patients with FTD spectrum diseases (n=84). All patients were thoroughly characterised by cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers, neuroimaging, neuropsychological testing and standardised apraxia screening. A potential AD pathology was found in 43% of patients with FTD. CSF AD biomarker levels positively correlated with AD-typical apraxia scores in patients with FTD. The discriminative power of apraxia test results indicative of AD pathology was high (sensitivity: 90%, specificity: 66%). Apraxia is common in neurodegenerative dementias but under-represented in clinical workup and diagnostic criteria. Standardised apraxia screening may serve as bedside test to objectify an AD-typical apraxia profile as an early and robust sign of AD pathology in patients with FTD.


A modified bioassay for energy utilization in newly hatched chicks. 1. Determination of optimum durations for feed withdrawal and excreta collection.
Three experiments were conducted with view of a more suitable bioassay system for determination of energy utilization in newly hatched chick based on the TME assay system. The optimum duration for feed deprivation prior to tube feeding was determined with chicks aged 0, 2, 6, and 13 d old. In order to determine an appropriate duration for excreta collection after feeding, chicks deprived of feed for 24 h were force-fed and energy excretion was monitored every 12 h for the next 72 h. Irrespective of the age, energy excretion decreased to a low level at 24 h after feeding and then reached a constant rate: the endogenous energy excretion. In 0- and 2-d-old chicks, N excretion tended to increase from 12 h after commencement of feed withdrawal. On the other hand, energy excretion in the chicks force-fed paste or pellet of basal diet attained constant rates beyond 24 h after force-feeding at all ages, and the rates of excretion were almost comparable to the endogenous energy excretion for the corresponding age. In the chicks force-fed a high-fat diet, however, 36 h was required for the excreted energy to attain a constant rate. The increase in N excretion was also observed following 24 h after feeding in 1- and 3-d-old chicks. Deutectomy at 1 d posthatch modified the patterns of energy and N excretion after the commencement of feed withdrawal but not TME and TMEn values of diets. A modified bioassay system for the determination of energy utilization in newly hatched chicks based on TME assay system is proposed.


Extraction of trace polychlorinated biphenyls in environmental waters by well-dispersed velvet-like magnetic carbon nitride nanocomposites.
A velvet-like magnetic carbon nitride nanocomposites synthesized by chemical co-precipitation was used to develop a highly efficient magnetic solid-phase extraction method for the pre-concentration of trace polychlorinated biphenyls (PCBs) in water samples. The advantages of this nanocomposite such as large surface area, good dispersity, low solvent consumption, rapid analyte adsorption (30s) and reusability make it a good sorbent. Factors affecting extraction efficiency were systematically investigated and optimized by response surface methodology (RSM). Under optimal experimental conditions, the limits of detection (LODs S/N=3) of the developed method for PCBs investigated were in the range of 9.0×10-6-5.8×10-5μg/mL. This method was then used for the analysis of four real water samples. Good spiked recoveries over the range of 80.1-118.4%, and RSDs (n=5) of 0.02-3.7% were obtained. This work demonstrated the potential of using this nanocomposite for adsorption, pre-concentration, or even removal of different carbon-based aromatic compounds or other hydrophobic pollutants.


[Lactic acid inhibits the formation of semen-derived amyloid fibrils].
To investigate the inhibitory effect of lactic acid on semen-derived amyloid (SEVI) fibril formation. PAP248-286 (2 mg/mL) was incubated with 4.0, 2.0, 1.0, 0.5, 0.25, and 0.125 mg/mL of lactic acid. After incubation for different times, aliquots were drawn from each sample for Thioflavin T (ThT) and Congo red staining to monitor semen-derived amyloid fibril formation. The β sheet structure formation of PAP248-286 was measured by circular dichroism spectrum, and the morphology of amyloid fibrils incubated with or without lactic acid was observed with transmission electron microscopy (TEM). The enhancing effect of amyloid fibril incubated with lactic acid at different time points was determined using virus infection assay. PAP248-286 (2 mg/mL) was incubated with dilutions of vaginal secretion from healthy women, and amyloid fibril formation was detected with ThT and Congo red staining. Lactic acid inhibited SEVI fibril formation in a dose-dependent manner in vitro. Lactic acid at 0.5 mg/mL completely inhibited 2 mg/mL SEVI fibril formation within 48 h. After incubation for 48 h, lactic acid at 1 mg/mL inhibited the formation of β-sheet structure of SEVI (2 mg/mL) and completely inhibited 2 mg/mL PAP248-286 aggregation as observed with TEM. In the presence of lactic acid, PAP248-286 lost the ability to enhance virus infection. Vaginal secretion inhibited SEVI fibril formation in a dose-dependent manner, and virtually no SEVI fibril occurred after incubation of 2 mg/mL PAP248-286 with 67% vaginal secretion. Lactic acid inhibits SEVI fibril formation in vitro.


Supercritical CO2 Interaction Induced Pore Morphology Alterations of Various Ranked Coals: A Comparative Analysis Using Corrected Mercury Intrusion Porosimetry and Low-Pressure N2 Gas Adsorption.
Enhanced coal bed methane (ECBM) recovery via CO2 geological storage (CGS) involves CO2 adsorption and CH4 desorption from coal pores, gas diffusion, and flow through coal matrix and cleats, which are closely related to coal pore morphology. To characterize and quantify the alterations of pore morphology of different ranked coals treated by supercritical CO2 (ScCO2), CGS was simulated with a custom-built high-pressure ScCO2 geochemical reactor at 10 MPa and 35 °C for sub-bituminous coal, bituminous coal, and anthracite, respectively. The bituminous coal was collected from a ScCO2-rich reservoir to examine the effect of second exposure to ScCO2 on pore morphology. Mercury intrusion porosimetry (MIP) after data correction using the Tait equation (TE) and low-pressure N2 gas adsorption (LPN2GA) were employed. The decrease of coal matrix compressibility and increase of pore volume compressibility indicate that sub-bituminous coal becomes more resistant to microfracture closure and pore shrinkage after ScCO2 treatment. Both the thermodynamics fractal model after MIP data correction and Frenkel-Halsey-Hill (FHH) model, which are strongly scale-dependent and meaningful from a geometric viewpoint, reveal a downward trend of the irregularity and heterogeneity of pore structures for sub-bituminous coal. The effects of hydrocarbon mobilization and inorganic matter dissolution by ScCO2 play an important role in pore size distribution (PSD), pore volume (PV), and pore shape (PS) alterations, whereas these changes are quite small for bituminous coal. The above observed alterations of sub-bituminous coal are all positive, such as closed pore reopening, pore volume enlargement, pore roughness decline, pore connectivity enhancement, and gas desorption improvement, which makes sub-bituminous coal a desired option for CO2-ECBM recovery.


Macrothrombocytopenia and dense granule deficiency associated with FLI1 variants: ultrastructural and pathogenic features.
Congenital macrothrombocytopenia is a family of rare diseases, of which a significant fraction remains to be genetically characterized. To analyze cases of unexplained thrombocytopenia, 27 individuals from a patient cohort of the Bleeding and Thrombosis Exploration Center of the University Hospital of Marseille were recruited for a high-throughput gene sequencing study. This strategy led to the identification of two novel FLI1 variants (c.1010G>A and c.1033A>G) responsible for macrothrombocytopenia. The FLI1 variant carriers' platelets exhibited a defect in aggregation induced by low-dose adenosine diphosphate (ADP), collagen and thrombin receptor-activating peptide (TRAP), a defect in adenosine triphosphate (ATP) secretion, a reduced mepacrine uptake and release and a reduced CD63 expression upon TRAP stimulation. Precise ultrastructural analysis of platelet content was performed using transmission electron microscopy and focused ion beam scanning electron microscopy. Remarkably, dense granules were nearly absent in the carriers' platelets, presumably due to a biogenesis defect. Additionally, 25-29% of the platelets displayed giant α-granules, while a smaller proportion displayed vacuoles (7-9%) and autophagosome-like structures (0-3%). In vitro study of megakaryocytes derived from circulating CD34+ cells of the carriers revealed a maturation defect and reduced proplatelet formation potential. The study of the FLI1 variants revealed a significant reduction in protein nuclear accumulation and transcriptional activity properties. Intraplatelet flow cytometry efficiently detected the biomarker MYH10 in FLI1 variant carriers. Overall, this study provides new insights into the phenotype, pathophysiology and diagnosis of FLI1 variant-associated thrombocytopenia.


Intravitreal expansile gas in the treatment of early macular hole: reappraisal.
To study the effects of intravitreal injection (IVI) of expansile gas for early macular holes (EMH). Prospective interventional case series. Twelve eyes of 12 patients with EMH (stage 2) underwent IVI of perfluoropropane 0.2 ml followed by 5 days' facedown positioning. Six cases (50%) achieved vitreous-macula separation. Three cases (25%) had hole closure with vision improvement; one of them developed rhegmatogenous retinal detachment (RRD) and hole re-opening. Another case with persistent hole also developed RRD. Seven of the 9 cases without hole closure and the one where the hole re-opened had vitrectomy, all resulting in hole closure and vision improvement. Duration of symptoms had borderline significance for hole closure (p = 0.11) and subsequent visual improvement (p = 0.03). With its low success rate, IVI of gas may not be a good option for EMH. Complications include retinal detachment. The procedure seems to not affect hole closure with subsequent vitrectomy.


Barriers to care and psychopathology among Bolivian migrants living in São Paulo, Brazil.
The objective of this study was to investigate barriers to appropriate mental health care in a sample of Bolivian migrants living in São Paulo and to examine the association between barriers of care and the presence of symptoms of non-psychotic psychiatric disorders in this population. Considering that treatment usually reduces symptoms, it could be hypothesized that individuals reporting more barriers to care also will report more symptoms. The sample comprised 104 individuals born in Bolivia, with Bolivian nationality and living in São Paulo for at least 30 days prior to enrolling in the study, between 18 and 80 years of age and able to read and write in Spanish or Portuguese. The symptoms of mental disorders were assessed using the Self-Reporting Questionnaire (SRQ-20) and barriers to appropriate mental health care were evaluated using the Barriers to Assessing Care Evaluation (BACE). A multiple linear regression analysis was performed to determine the predictive effect of the BACE total score (independent variable) in the SRQ-20 score (dependent variable), including in the model, and the variables that were significantly correlated with the BACE total score or SRQ-20. Our results indicate that more than a half of the sample of Bolivian migrants living in Sao Paulo, Brazil, especially females, presented significant non-psychotic psychopathology. Individuals reporting more barriers to care, especially instrumental and attitudinal barriers, also have a higher risk of psychiatric symptoms, independently of sex, age and family income. Our results suggest that actions to increase availability of mental health services, especially culturally sensitive services, could reduce barriers to care and improve mental health among migrants.


Should gastroenterologists prescribe cannabis? The highs, the lows and the unknowns.
Cannabis, commonly known as marijuana, is a drug extracted from the Cannabis plant known for its psychotropic and medicinal properties. It has been used for healing purposes during ancient times, although its psychoactive components led to its restricted use in medicine. Nonetheless, cannabis is found to have modulatory effects on the endocannabinoid system exhibiting its medicinal role in the gastrointestinal (GI) system. Emerging animal and human studies demonstrate the influential effects of cannabis on a variety of GI diseases including inflammatory bowel disease, motility disorders and GI malignancies. It also has a regulatory role in GI symptoms including nausea and vomiting, anorexia, weight gain, abdominal pain, among others. However, both its acute and chronic use can lead to undesirable side effects such as dependency and addiction, cognitive impairment and cannabinoid hyperemesis syndrome. We will discuss the role of cannabis in the GI system as well as dosing strategies to help guide gastroenterologists to assess its efficacy and provide patient counseling before prescription of medical marijuana.


First report of Leishmania infantum infection in the endangered orangutan (Pongo pygmaeus pygmaeus) in Madrid, Spain.
Some wild animals have been recognized as potential reservoirs of Leishmania infantum infection (e.g. carnivores, lagomorphs, rodents, etc.). Leishmania infantum was also identified infecting humans and lagomorphs (i.e. hares and rabbits) over the period of 2009-2016, with the latter acting as the main reservoirs involved in the human leishmaniosis outbreak in Madrid. Two cases of clinical leishmaniosis are reported in orangutans (Pongo pygmaeus pygmaeus) housed at two different centres in Madrid. The first is the case of a 36-year-old male orangutan with severe weight loss and apathy. A complete blood count and biochemical profile revealed anaemia, neutropenia, hypoalbuminaemia and elevated transaminases. Hepato-splenomegaly was also observed. Four months later, due to worsening of clinical signs (mainly bilateral epistaxis), blood and bone marrow samples were collected. Amastigotes of L. infantum were detected in macrophages from a bone marrow aspirate and by specific polymerase chain reaction. The second case was a 34-year-old female orangutan with severe weight loss and apathy and no other apparent clinical signs. A complete blood count and biochemical profile revealed anaemia, pancytopenia and hypoalbuminaemia. Splenomegaly and pericardial effusion were also observed. As leishmaniosis was included in the differential diagnosis, both blood and bone marrow samples were collected. Leishmania infantum infection was confirmed by microscopy, molecular diagnosis and serology (immunofluorescence antibody test). Both animals were treated daily with oral miltefosine for 28 days; allopurinol was also given uninterruptedly in Case 2 for at least 6 months. During follow-up, though good clinical recovery was clear, a lack of parasitological cure was confirmed molecularly in both blood and bone marrow samples from the two orangutans. In both habitats, the presence of the sand fly vector identified as Phlebotomus perniciosus was confirmed. To our knowledge, this is the first report of L. infantum infection in great apes and in the endangered species P. p. pygmaeus. We are presently looking for L. infantum in other non-human primates living in the same peri-urban areas. If detected, we will examine the impacts of this serious disease on these critically endangered species.


Missense mutations (p.H371Y, p.D438Y) in gene CHEK2 are associated with breast cancer risk in women of Balochistan origin.
CHEK2 encodes a serine/threonine-protein kinase which plays a critical role in DNA damage signaling pathways. CHEK2 directly phosphorylates and regulates the functions of p53 and BRCA1. Most women with breast and/or ovarian cancer are not carriers of mutant BRCA1 or BRCA2. Multiple studies have shown that a CHEK2*1100delC confers about a two-fold increased risk of breast cancer in unselected females and a tenfold increase in males. Moreover, studies have shown that first-degree relatives of bilateral breast cancer cases who carried the CHEK2*1100delC allele had an eight-fold increased risk of breast cancer. It has been suggested that CHEK2 functions as a low-penetrance susceptibility gene for cancers and multiplies the risks associated with other gene(s) to increase cancer risk. The main goal of this study was to evaluate and to compare the role of truncating mutations, splice junction mutations and rare missense substitutions in breast cancer susceptibility gene CHEK2. Present study was performed on 140 individuals including 70 breast cancer patients both with and without family history and 70 normal individuals. Written consent was obtained and 3 ml intravenous blood was drawn from all the subjects. DNA was extracted from all the samples through inorganic method published already. Primers were synthesized for all the 14 exons of CHEK2 gene. Coding and adjacent intronic sequences of CHEK2 gene were amplified and sequenced. Two genetic variants (p.H371Y, p.D438Y) were found in exon 10 and exon 11 of gene CHEK2 which were not found in any of the 70 control individuals from same geographical area and ethnic group. The genetic variant c.1312G>T (p.D438Y) identified in a patient with a family history of breast cancer. To our knowledge, this is first mutation scanning study of gene CHEK2 from Balochistan population.


Group psychological intervention for maternal depression: A nested qualitative study from Karachi, Pakistan.
To understand the experience of maternal depression, the factors implicated in accessing health, and the acceptability of the psychosocial intervention. The participants were recruited from the paediatrics outpatient department of Civil Hospital Karachi, Pakistan. The study started in December 2009 and completed in December 2010. Women with maternal depression, aged 18-44 years with children aged 0-30 mo who had received nutritional supplements, and participated in the intervention programme [called Learning through Play (LTP) plus] were included in the study. Qualitative interviews were conducted with 8 participants before the intervention and 7 participants after the intervention. A semi structured topic guide was used to conduct the interviews. Framework analysis procedures were used to analyse the qualitative data. Four themes emerged: (1) the women's contextual environment: Interpersonal conflicts, lack of social support and financial issues being the major barriers in assessing healthcare; (2) women's isolation and powerlessness within the environment: Sense of loneliness was identified as a restricting factor to access healthcare; (3) the impact of the intervention (LTP-Plus): Women felt "listened to" and seemed empowered; and (4) empowered transformed women within the same contextual environment: The facilitator provided a "gardening role" in nurturing the women resulting in a positive transformation within the same environment. The women's homes seemed to be more happy homes and there was a positive change in their behaviour towards their children. Findings informed the further development and testing of culturally-appropriate psychosocial intervention (LTP+) for addressing maternal depression.


A small-scale concept-based laboratory component: the best of both worlds.
In this article, we describe an exploratory study of a small-scale, concept-driven, voluntary laboratory component of Introductory Biology at the Massachusetts Institute of Technology. We wished to investigate whether students' attitudes toward biology and their understanding of basic biological principles would improve through concept-based learning in a laboratory environment. With these goals in mind, and using our Biology Concept Framework as a guide, we designed laboratory exercises to connect topics from the lecture portion of the course and highlight key concepts. We also strove to make abstract concepts tangible, encourage learning in nonlecture format, expose the students to scientific method in action, and convey the excitement of performing experiments. Our initial small-scale assessments indicate participation in the laboratory component, which featured both hands-on and minds-on components, improved student learning and retention of basic biological concepts. Further investigation will focus on improving the balance between the minds-on concept-based learning and the hands-on experimental component of the laboratory.


The politics of pharmaceutical reform: the case of the Philippine National Drug Policy.
A national drug policy was formulated in the Philippines after the rise of the Aquino government in 1986. In this article, the author discusses the pharmaceutical situation before the policy was announced, and argues that the major push for a policy came from the confluence of four factors: a change in the structures of political power, especially the rise of a new government and the empowerment of health non-governmental organizations as new participants in the policy process; members of the Department of Health who pushed for a policy; a more conductive social and political climate, both locally and internationally; and a growing body of knowledge about the drug issue. The author discusses the policy's achievements as well as the limitations that have beset the policy from 1987 to 1992.


[Gonotrophic dissociation in Culex pipiens pipiens L. (author's transl)].
Under certain conditions gonotrophic dissociation has been observed in Culex pipiens pipiens. To contribute to a better understanding of the factors which govern the appearance of this phenomenon and of its ecological importance a population in Northern Germany has been investigated. Follicular development, feeding activity and occurrence of gonotrophic dissociation were examined in females obtained from wild-caught larval stages and kept under outdoor conditions after emergence in July and August. In addition overwintering females collected in cellars in September and October were investigated after reactivation by exposure to 16 hours illumination periods and 28 degrees C. In females emerging in August the follicles were generally small, the feeding activity was very low but the rate of gonotrophic dissociation appeared to be higher than that in mosquitoes which had emerged in July. Overwintering females had small follicles and did not take a blood meal during the first days under reactivation conditions. Only after five days a development of follicles and an increase in feeding activity became apparent. Through the effect of long illumination and high temperature the state of diapause was gradually overcome and the females were fully reactivated. At the same time the rate of gonotrophic dissociation in fed females which was high in the early time of exposure to reactivation conditions became low. This suggests that gonotrophic dissociation occurs commonly in females with low feeding activity, i.e. those which are not reactivated completely. In Northern Germany the overwintering females are unfed and nulliparous and gonotrophic dissociation does not seem to play an important role for the overwintering of the mosquito in this area.


Decrease in oxygen uptake at the end of a high-intensity submaximal running in humans.
The purpose of the present study was to examine oxygen consumption (VO(2) ) kinetics during severe-intensity running exercise through a four-phase model that considered a decrease in VO(2) at the end of the exercise in light of previous research in which this decrease was only noticed. After determination of maximal oxygen consumption VO(2) max), thirteen highly trained males performed a square-wave running to exhaustion at approximately 95 % of VO(2) max on a level treadmill. VO(2) and ventilatory gas exchange variables were determined breath-by-breath. Computerised non-linear regression techniques incorporating exponential and linear terms were used to describe VO(2) and ventilatory gas exchange variable responses. In contrast with the classical 3-component model that describes the increase in VO(2) for severe-intensity exercise, we observed a 4(th) phase characterised by a significant decrease in VO(2) before exhaustion (slope of VO(2)-time relationship significantly different from a zero value, p < 0.01) in 7 out of 13 subjects. Following a time delay of 31 +/- 44 s after the decrease in VO(2), a significant decrease of minute ventilation (V(E)) was present for 6 of the 7 subjects (p < 0.02). During the exercise for the subjects who decreased V(E), a reduction of 288 +/- 169 ml in tidal volume was associated with an increase of 10.2 +/- 2.4 min(-1) in breathing frequency. These data suggest that the respiratory system might be stressed more for some endurance-trained athletes. The specific link between reduced VO(2) and reduced V(E) remains to be explored.


The dlt operon in the biosynthesis of D-alanyl-lipoteichoic acid in Lactobacillus casei.
The D-alanine incorporation system allows Lactobacillus casei to modulate the chemical properties of lipoteichoic acid (LTA) and hence control its proposed functions, i.e., regulation of autolysin action, metal ion binding, and the electromechanical properties of the cell wall. The system requires the D-alanine-D-alanyl carrier protein ligase (Dcl) and the D-alanyl carrier protein (Dcp). Our results indicate that the genes for these proteins are encoded in the dlt operon and that this operon contains at least 2 other genes, dltB and dltD. The aim of this paper is to describe the genetic organization of the operon, the role of the D-alanyl carrier protein, and the function of the putative protein encoded by dltB in the intramembranal translocation of the activated D-alanine.


Side chain hydroxylation of cholesterol, campesterol and beta-sitosterol in rat liver mitochondria.
The extent of the side chain hydroxylation of cholesterol, campesterol (24 alpha-methylcholesterol), and beta-sitosterol (24 alpha-ethylcholesterol) in rat liver mitochondria has been compared. Two beta-sitosterol metabolites, tentatively identified by liquid chromatography, thin-layer chromatography, gas-liquid chromatography, combined with radioactivity detection, and gas-liquid chromatography-mass spectrometry as the 26- and 29-hydroxy derivatives, were formed in the proportion 1:1. The sum of 26-hydroxy- and 29-hydroxy-beta-sitosterol obtained amounted only to about one-fourth of the yield of 26-hydroxycholesterol. Campersterol appeared to give rise only to 26-hydroxycampesterol (tentatively identified), which was formed in similar yields as 26-hydroxycholesterol (0.2-0.4%). The formation of 29-hydroxy-beta-sitosterol but not of 28-hydroxycampesterol indicates that the omega-hydroxylation of the steroid side chain is dependent on the length of the side chain. Cholesterol gave rise to identifiable amounts of a 25-hydroxy derivative but the formation of 25-hydroxy derivatives of beta-sitosterol and campesterol could not be established with certainty. 24-hydroxycholesterol was also found to be formed in the mitochondrial system. The ratio between the yields of 26- and 25-hydroxychoelsterol ranged between 2 and 3, and that between 26- and 24-hydroxycholesterol was about 10.


Linker histones H1 and H5 prevent the mobility of positioned nucleosomes.
We have previously identified a generally occurring short-range mobility of nucleosome cores on DNA in relatively low ionic strength conditions. Here we report that this mobility of histone octamers positioned on constructs of 5S rDNA is suppressed by the binding of histone H1 or H5 to the nucleosome. Histone H5 is the more potent inhibitor of nucleosome mobility, in accordance with its higher affinity for chromatin. We propose that this reversible restraint on chromatin dynamics may play a role in local regulation of processes that require access to the DNA.


Increased differentiation of dermal mast cells in mice lacking the Mpl gene.
Thrombopoietin interactions with its receptor, Mpl, play an important role in the regulation of hematopoietic stem/progenitor cell proliferation and differentiation. In this study, we report that the mast cell restricted progenitor cells (MCP) and the mast cell precursors in the bone marrow of wild-type mice express Mpl on their surface. Furthermore, targeted deletion of the Mpl gene in mice decreases the number of MCP while increasing the number of mast cell precursors present in the marrow and spleen. It also increases the number of mast cells present in the dermis, in the peritoneal cavity, and in the gut of the mice. In addition, serosal mast cells from Mpl(null) mice have a distinctive differentiation profile similar to that expressed by wild-type dermal mast cells. These results suggest that not only does ligation of thrombopoietin with the Mpl receptor exert an effect at the mast cell restricted progenitor cell level, but also plays an unexpected yet important role in mast cell maturation.


Complex-path prediction of resonance-assisted tunneling in mixed systems.
We present a semiclassical prediction of regular-to-chaotic tunneling in systems with a mixed phase space, including the effect of a nonlinear resonance chain. We identify complex paths for direct and resonance-assisted tunneling in the phase space of an integrable approximation with one nonlinear resonance chain. We evaluate the resonance-assisted contribution analytically and give a prediction based on just a few properties of the classical phase space. For the standard map excellent agreement with numerically determined tunneling rates is observed. The results should similarly apply to ionization rates and quality factors.


Influence of crystal structure on the fluorescence emission of Eu3+:LaOF nanocrystals.
Optical transitions of Eu(3+)-doped LaOF nanocrystals with tetragonal and rhombohedral structures were studied experimentally using laser spectroscopic method. Fluorescence emissions from 5D1 and 5D0 of Eu3+ in LaOF nanocrystals were detected by exciting the sample with a 532 nm pulsed laser, and the influence of local symmetry on the fluorescence emission of doped ions was observed. The specific crystalline phase as well as the local symmetry on the fluorescence emission was investigated in both the frequency domain and time domain. It was found that Eu3+ ions doped in the tetragonal crystal structure present more efficient fluorescence emission, which was explained by lower symmetric distribution of local field at the doped ions.


Identification of OmpU of Vibrio vulnificus as a fibronectin-binding protein and its role in bacterial pathogenesis.
Vibrio vulnificus is a pathogenic bacterium that causes gastroenteritis and primary septicemia. To identify factors involved in microbial adherence to the host cells, we investigated bacterial proteins capable of binding to fibronectin, one of the main components comprised of the extracellular matrix of mammalian cells. A protein of approximately 35 kDa was purified from the extracts of V. vulnificus by its property to bind to immobilized fibronectin. This protein was identified as OmpU, one of the major outer membrane proteins of V. vulnificus. In binding assays using immobilized fibronectin, the number of ompU mutant cells bound to fibronectin was only 4% of that of wild-type cells bound to fibronectin. In addition, the exogenous addition of antibodies against OmpU resulted in a decreased ability of wild-type V. vulnificus to adhere to fibronectin. The ompU mutant was also defective in its adherence to RGD tripeptide (5% of the adherence of the wild type to RGD), cytoadherence to HEp-2 cells (7% of the adherence of the wild type to HEp-2), cytotoxicity to cell cultures (39% of the cytotoxicity of the wild type), and mortality in mice (10-fold increase in the 50% lethal dose). The ompU mutant complemented with the intact ompU gene restored its abilities for adherence to fibronectin, RGD tripeptide, and HEp-2 cells; cytotoxicity to HEp-2 cells; and mouse lethality. This study indicates that OmpU is an important virulence factor involved in the adherence of V. vulnificus to the host cells.


Neural-network-based direct waveform to symbol conversion for joint ISI and ICI cancellation in non-orthogonal multi-band CAP based UDWDM fiber-mmWave integration.
The six-generation mobile network (6G) based on millimeter-wave (mmWave) is expected to deliver more capacity and higher connection density compared with 5G. We demonstrate an ultra-dense wavelength division multiplexing (UDWDM) fiber-mmWave integration network based on non-orthogonal multiband carrier less amplitude and phase (NM-CAP) modulation to address the needs for dense access cells, high-spectral efficiency, and high data rate. We demonstrate a neural-network-based waveform to symbol converter (NNWSC), which can directly convert the received NM-CAP waveform into quadrature amplitude modulation (QAM) symbols to simultaneously handle the inter-symbol interference (ISI) and inter-channel interference (ICI), without the need for conventional matched filters and additional ISI and ICI equalizers. Experimental results show that this method is also effective for QAM constellations with probabilistic shaping. Since NNWSC simplifies the demodulation process of NM-CAP and avoids error accumulation caused by cascading filters and post-equalizers, NNWSC can reduce the computational complexity and provide good performance. Compared with the regular receiver with cascaded least mean square equalizer, matched filters, and ICI equalizer, NNWSC can reduce the computational complexity by 93%. The demonstrated spectrally efficient fiber-mmWave transmission is achieved at a total 414-Gbps net data rate with 24 PS-QAM NM-CAP sub-bands on 8 UDWDM channels with 25-GHz spacing.


Radiation-modified structure of Ge25Sb15S60 and Ge35Sb5S60 glasses.
Atomic structures of Ge(25)Sb(15)S(60) and Ge(35)Sb(5)S(60) glasses are investigated in the gamma-irradiated and annealed after gamma-irradiation states by means of high-energy synchrotron x-ray diffraction technique. The first sharp diffraction peak (FSDP) is detected at around 1.1 A(-1) in the structure factors of both alloys studied. The FSDP position is found to be stable for radiation/annealing treatment of the samples, while the FSDP intensity shows some changes between gamma-irradiated and annealed states. The peaks in the pair distribution functions observed between 2 and 4 A are related to the Ge-S, Ge-Sb, and Sb-Sb first neighbor correlations and Ge-Ge second neighbor correlations in the edge-shared GeS(42) tetrahedra, and S-S and/or Ge-Ge second neighbor correlations in the corner-shared GeS(42) tetrahedra. Three mechanisms of the radiation-/annealing-induced changes are discussed in the framework of coordination topological defect formation and bond-free solid angle concepts.


Mutagenicity of ethyl carbamate to lacZ- transgenic mice.
The mutagenicity of the rodent carcinogen ethyl carbamate (EC, urethane) has been assessed using the lacZ- transgenic mouse mutation assay (Muta Mouse). In two separate experiments a single i.p. dose of 900 mg/kg urethane followed by a 14-16 day expression period yielded statistically significant (approximately 2-fold) increases in mutation frequency (MF) in the lung and liver of the mice. In the second experiment MF in the spleen and bone marrow was also assessed and statistically significant increases in MF were observed in each case. Concomitantly conducted bone marrow micronucleus assays gave 15.8- and 8-fold increases respectively in the incidence of micronucleated polychromatic erythrocytes in the two studies.


Internal mammary sentinel lymph node biopsy with modified injection technique: A case report.
In addition to axillary lymph node (ALN), internal mammary lymph node (IMLN) is also the first-echelon drainage nodes reached by metastasising cancer cells from breast cancer, which can provide important prognostic information. In this paper, we will introduce a case of breast cancer patient whose postoperative pathology result showed that she had internal mammary sentinel lymph node (IMSLN) metastases but no axillary sentinel lymph node (ASLN) metastases. She was diagnosed as pT1cN1bM0 breast cancer based on the positive IMSLN but negative ASLN. She received axillary-sentinel lymph node biopsy (A-SLNB) and internal mammary-sentinel lymph node biopsy (IM-SLNB) guided by modified injection technique. In the choice of chemotherapy, she received dose-dense AC × 4 times followed P × 4 times for chemotherapy. As to irradiation therapy, she received irradiation therapy include chest wall, superclavicular region, and internal mammary nodes. After performing IM-SLNB, the nodal staging of this patient increased (from N0 to N1b). And she received additional chemotherapy and irradiation therapy. With the guidance of modified injection technique, the preoperative visualization rate of IMLN has been improved. IM-SLNB could be a minimally invasive technique for effective evaluation of the status of IMLN to provide information for staging and guide the adjuvant treatment.


[Treatment of Cr( VI) in deoxygenated simulated groundwater using nanoscale zero-valent iron].
Laboratory experiments and theoretical modeling studies were performed to investigate the mechanisms of Cr( VI) removal from deoxygenated simulated groundwater using nanoscale zero-valent iron, and to evaluate influencing factors and kinetics based on zeta potential, redox potential, ferrous concentrations, and the pe-pH diagram of Fe-Cr-H2O system. Experimental results demonstrate that the removal efficiency of Cr(VI) decreases with the increasing Cr( VI)/Fe mass ratio. When the Cr(VI)/Fe mass ratios are 0.025, 0.050, 0.075, and 0.100, the corresponding Cr(VI) removal rates are 100.0%, 85.6%, 72.7% and 39.6%, respectively. The Cr( VI) removal is favorable at acidic pH with fixed Cr(VI)/Fe mass ratio of 0.100. When pH are 3.0, 5.0, 7.0, 9.0 and 11.0, the Cr(VI) removal rates are 73.4%, 57.6%, 39.6%, 44.1%, and 41.2%, accordingly. The Cr(VI) removal follows the pseudo second-order kinetics. When pH is 7.0 and Cr(VI)/nZVI mass ratio is 0.025, the rate of Cr(VI) removal is the highest with rate constant at 9.76 x 10(-3) g x (mg x min)(-1). The conversion from Cr2O7(2-) to Cr3+ should be instantaneous when Cr2O7(2-) is absorbed on the surface of Fe. The Cr(VI) was reduced to Cr(III), which was subsequently incorporated into the FeOOH shell and formed a Cr-Fe film. The film once formed could further inhibit the electron transfer between Cr2O7(2-) and Fe. Then Cr(V) removal was primary controlled by the adsorption process.


Esophagogastrostomy in continuity for carcinoma of the esophagus. Its use for unresectable tumors of the lower third of the esophagus and cardia.
Esophagogastrostomy in continuity without removal of the tumor was performed on six patients with carcinoma of the lower third of the esophagus and cardia found to be unresectable at the time of surgery. There was no operative morbidity or mortality. Satisfactory palliation, with restoration of the swallowing mechanism, was achieved in all six cases. Average survival time after surgery was 7 1/2 months. This compares satisfactorily with other palliative procedures for far-advanced tumors in this area.


Potential use of caprylic acid in broiler chickens: effect on Salmonella enteritidis.
The effect of dietary caprylic acid (CA) on Salmonella Enteritidis, as well as the surface treatment of chicken skin contaminated with Salmonella Enteritidis was evaluated. To evaluate the dietary effect of CA on Salmonella Enteritidis, the individually housed broiler chickens (n=48) were divided into 4 groups (positive control, negative control, 2.5 g/kg of CA in the feed, and 5 g/kg of CA in the feed). The feed of all groups, except the negative control, was artificially contaminated with Salmonella Enteritidis ATCC 13076 (10(7) colony-forming units/100 g of feed). Both concentrations of dietary CA significantly decreased counts of Salmonella Enteritidis in the crop and cecum of experimental chickens (p<0.05). The effect of CA in the crop contents was more pronounced than in the cecum. Surface treatment of chilled chicken halves with CA at 1.25 and 2.5 mg/mL significantly decreased Salmonella Enteritidis contamination of chicken skin (p<0.05). The sensory evaluation of the skin and meat showed that treatment of the skin with 1.25 mg/mL of CA worsened odor and appearance of the chicken skin, while sensory traits of chicken meat were not significantly affected. Taste and overall acceptability was not influenced by CA in both meat and skin. Treatment of the skin with 2.5 mg/mL of CA resulted in more pronounced changes of the skin odor and appearance. In conclusion, dietary CA reduced carriage of Salmonella Enteritidis in chickens, whereas surface-treatment reduced or eliminated Salmonella Enteritidis contamination in the processed bird.


Conjunctivodacryocystorhinostomy with Jones tube: a history and update.
Current opinions and trends in the management of upper lacrimal obstruction include design variations on the original Lester Jones tube and updated awareness and management of the problems associated with the tubes. This article includes a brief review of the fascinating history of the development of the Jones tube, which sets the perspective for the current scientific dialog. First, many design modifications have been proposed to reduce the risk of tube migration and extrusion, with no consensus on the best tube. Second, the issue of retrograde airflow through the Jones tube with the use of continuous positive airway pressure is an increasingly common and challenging problem. Third, bacterial biofilms on the surface of the Jones tube can play a role in recalcitrant infections. Jones tubes can be cleaned or replaced in the office setting with topical anesthesia. Conjunctivodacryocystorhinostomy (CDCR) with placement of a Jones tube remains the gold standard for management of upper lacrimal obstruction. This article provides an updated perspective on issues with extrusion or migration of the tube, bothersome retrograde airflow with the use of a continuous positive airway pressure device, and management of crusting and possible infectious biofilms on the tube.


[The sentinel node: first cases in Panama].
Ideal treatment planning in cancer is primarily defined by proper staging. The presence of metastasis in the regional nodal basin must be determined. The best and least invasive manner to achieve this purpose in the nodal basin is by studying the sentinel node. We present the first series of patients treated in Panama with identification and evaluation of the sentinel node. Initially we used only the dye technique and our rate of identification was 77%. When the radioisotope technique was used combined with dye, the localization was successful in 100% of the cases. We recommend the combined technique for a higher yield and minimal false negatives.


Prevalence of lower urinary tract symptoms and self-reported diagnosed 'benign prostatic hyperplasia', and their effect on quality of life in a community-based survey of men in the UK.
To assess the prevalence of lower urinary tract symptoms (LUTS) in a community-based population in the UK, to measure the impact of these symptoms on quality of life and health status in men with self-reported 'benign prostatic hyperplasia' ('BPH'), and to evaluate health-seeking behaviour in this population. A postal survey was distributed to an age-stratified random sample of 1500 men aged 50 years or older from throughout England, Scotland and Wales. The self-administered survey included: demographic questions; the EuroQoL (EQ-5D) instrument, consisting of a health-status index questionnaire and a visual analogue scale (VAS) on which participants rated their current health status; the International Prostate Symptom Score (IPSS) questionnaire; and a questionnaire assessing the participants' health-seeking behaviour and awareness of BPH. Responses to the survey were received from 1115 (74%) of the 1500 men. Overall, 41% (450/ 088) had an IPSS of > or =8, indicating moderate-to-severe LUTS, yet only 196 men (18%) reported that they had been diagnosed with 'BPH'. Both quality of life (as measured by the EQ-5D) and general health status (as measured by the VAS) decreased as urinary symptom severity increased, and the greater the severity, the more men who reported a problem with mobility, self-care, usual activity, pain/discomfort, and anxiety/depression (the five domains of the EQ-5D). The possibility of symptoms worsening appeared to be the key determinant in the respondents' decisions to consult a medical professional for their LUTS. Less than 11% of the respondents were aware of the availability of specific prescription drug therapies or surgical options for the treatment of 'BPH'. The most common first treatment strategy for those consulting for symptoms was watchful waiting (34%), followed by surgery (30%) and prescription drugs (21%). Moderate-to-severe LUTS were relatively common in this UK population of men over the age of 50, yet relatively few had been diagnosed with 'BPH'. As LUTS adversely affect quality of life, improved treatment options and increased public awareness of BPH and LUTS are needed to combat a problem facing the growing number of elderly men in the population.


Synthesis, Structure, and Properties of Near-Infrared [b]Phenanthrene-Fused BF2 Azadipyrromethenes.
A new class of phenanthrene-fused BF2 azadipyrromethene (azaBODIPY) dyes have been synthesized through a tandem Suzuki reaction and oxidative ring-fusion reaction, or a palladium-catalyzed intramolecular C-H activation reaction. These phenanthrene-fused azaBODIPY dyes are highly photostable and display markedly redshifted absorption (up to λ=771 nm) and emission bands (λ≈800 nm) in the near-infrared region. DFT calculations and cyclic voltammetry studies indicate that, upon annulation, more pronounced stabilization of the LUMO is the origin of the bathochromic shift of the absorption and high photostability.


Application of improved ELM algorithm in the prediction of earthquake casualties.
Earthquake casualties prediction is a basic work of the emergency response. Traditional forecasting methods have strict requirements on sample data and lots of parameters are required to be set manually, which can result in poor results with low prediction accuracy and slow learning speed. In this paper, the Extreme Leaning Machine (ELM) is introduced into the earthquake disaster casualty predictions with the purpose of improving the prediction accuracy. However, traditional ELM model still has the problems of poor network structure stability and low prediction accuracy. So an Adaptive Chaos Particle Swarm Optimization (ACPSO) is proposed to the optimize traditional ELM's network parameters to enhance network stability and prediction accuracy, and the improved ELM model is applied to earthquake disaster casualty prediction. The experimental results show that the earthquake disaster casualty prediction model based on ACPSO-ELM algorithm has better stability and prediction accuracy. ACPSO-ELM algorithm has better practicality and generalization in earthquake disaster casualty prediction.


[Croatian guidelines for use of enteral nutrition in Crohn's disease].
Nutrition has an important role in the management of inflammatory bowel disease (IBD), especially in patients with Crohn's disease (CD). This role includes the prevention and correction of malnutrition, the prevention of osteoporosis and the promotion of optimal growth and development in children. In active Crohn's disease, nutritional therapy (in the form of enteral feeding) is an effective primary therapy for pediatric patients. Studies have shown that there is no difference in the efficacy of elemental, oligomeric and polymeric enteral formulas. Therefore, the use of polymeric formula is recommended because of higher palatability, better acceptance by patients, lower rate of complications and lower cost when compared with other enteral formulas. Today we have knowledge that some nutrients which are added to modified special enteral formulas have almost pharmacological terapeutic potential in the management of inflammatory bowel disease. Novel nutritional therapeutic strategies for inflammatory bowel disease, such as transforming growth factor-beta-enriched (TGF-beta2) enteral feeding, showed beneficial effects in several clinical studies. Croatian guidelines for enteral nutrition in Crohn's disease have been developed by interdisciplinary expert group of Croatian clinicians involved with inflammatory bowel disease. The guidelines are based on evidence from relevant medical literature and clinical experience of working group.


Ulcerative colitis and Sjogren's syndrome in the same patient: report of two cases and a review of the literature.
Two cases of coexisting ulcerative colitis and Sjogren's syndrome are presented. Both patients were women and in both ulcerative colitis preceded the diagnosis of Sjogren's syndrome by several years. The course of ulcerative colitis before the onset of Sjogren's syndrome was quite severe. On the basis of clinical signs and serological and immunogenetic patterns, both patients were classified as suffering from secondary Sjogren's syndrome. Although the combination of the two diseases in the same patient seems to be the result of chance, we think that this combination offers an opportunity for future studies related to the pathogenesis of ulcerative colitis.


Purification of thirteen toxins active on mice from the venom of the North African scorpion Buthus occitanus tunetanus.
A combination of several equilibrium chromatographic steps permitted us to purify thirteen proteins from the venom of Buthus occitanus tunetanus using the mouse as the test animal for lethality measurement. These proteins have been characterized by their amino acid composition and, for seven of them, by their N-terminal or complete amino acid sequence. The structural data obtained correlate well with the pharmacological and antigenic properties of the neurotoxins.


Radiologic findings are strongly associated with a pathologic diagnosis of usual interstitial pneumonia.
To determine which clinical and radiologic findings are independently associated with a pathologic diagnosis of usual interstitial pneumonia (UIP). We recently reported, using a prospective, multicenter study of patients suspected of having idiopathic interstitial pneumonia (IIP), that a confident diagnosis of UIP made by experienced radiologists was correct in 95% of cases. In the current article, we further analyzed data from this study. Ninety-one patients were entered into the study. Clinical, physiologic, chest radiographic, and CT features were prospectively recorded, and analyzed using univariate and multivariate logistic regression analysis to compare the patients with a histologic diagnosis of UIP with those who received other pathologic diagnoses. Fifty-four of 91 patients (59%) received a pathologic diagnosis of UIP. The following features recorded at the referring clinical centers were associated with a pathologic diagnosis of UIP on multivariate analysis: lower-lobe honeycombing on high-resolution CT (HRCT) [odds ratio, 11.45], radiographic findings consistent with UIP (odds ratio, 5.73), elevated ratio of FEV(1) to FVC (odds ratio, 4.8), and absence of smoking history (odds ratio, 0.19). On multivariate analysis of specific HRCT features recorded by four experienced chest radiologists, lower-lung honeycombing (odds ratio, 5.36) and upper-lung irregular lines (odds ratio, 6.28) were the only independent predictors of UIP. Using only these two factors, a diagnosis of UIP could be established with a sensitivity of 74%, a specificity of 81%, and a positive predictive value of 85%. In patients presenting with a clinical syndrome suggestive of IIP, CT findings of lower-lung honeycombing and upper-lung irregular lines are most closely associated with a pathologic diagnosis of UIP.


Aerobic and anaerobic determinants of repeated sprint ability in team sports athletes.
The aim of this study was to examine in team sports athletes the relationship between repeated sprint ability (RSA) indices and both aerobic and anaerobic fitness components. Sixteen team-sport players were included (age, 23.4 ± 2.3 years; weight, 71.2 ± 8.3 kg; height, 178 ± 7 cm; body mass index, 22.4 ± 2 kg · m(-2); estimated VO2max, 54.16 ± 3.5 mL · kg(-1) · min(-1)). Subjects were licensed in various team sports: soccer (n = 8), basketball (n = 5), and handball (n = 3). They performed 4 tests: the 20 m multi-stage shuttle run test (MSRT), the 30-s Wingate test (WingT), the Maximal Anaerobic Shuttle Running Test (MASRT), and the RSA test (10 repetitions of 30 m shuttle sprints (15 + 15 m with 180° change of direction) with 30 s passive recovery in between). Pearson's product moment of correlation among the different physical tests was performed. No significant correlations were found between any RSA test indices and WingT. However, negative correlations were found between MASRT and RSA total sprint time (TT) and fatigue index (FI) (r = -0.53, p < 0.05 and r = -0.65, p < 0.01, respectively). No significant relationship between VO2max and RSA peak sprint time (PT) and total sprint time (TT) was found. Nevertheless, VO2max was significantly correlated with the RSA FI (r = -0.57, p < 0.05). In conclusion, aerobic fitness is an important factor influencing the ability to resist fatigue during RSA exercise. Our results highlighted the usefulness of MASRT, in contrast to WingT, as a specific anaerobic testing procedure to identify the anaerobic energy system contribution during RSA.


Partially purified antigen preparations of Toxoplasma gondii protect against lethal infection in mice.
Antigens of Toxoplasma gondii eluted from polyacrylamide gels after electrophoresis under reducing conditions were examined for their capacity to react with antibodies from infected humans, to induce antibody formation, and to protect mice against T. gondii. Antigens with approximate molecular weights of 35,000 and 14,000 strongly reacted in an enzyme-linked immunosorbent assay of human immunoglobulin M (IgM) and IgG antibodies to T. gondii. Mice injected with the eluted antigen preparations formed antibodies that reacted differently in four serological tests for Toxoplasma antibodies. All mice formed antibodies that reacted in the IgG and IgM enzyme-linked immunosorbent assay. Antibodies reacting in the conventional indirect immunofluorescent antibody test were detected in all mice except those injected with low-molecular-weight (14,000 or less) antigens. Sabin-Feldman dye test antibodies were not detected in any of the mice. Antibodies reacting in the latex agglutination test were detected mainly in mice injected with antigens with an approximate molecular weight of 66,000. Challenge of the injected mice with a lethal inoculum of T. gondii revealed that the highest survival rate was in animals that received antigens with approximate molecular weights of 35,000 and 14,000.


Brainstem volume changes in myalgic encephalomyelitis/chronic fatigue syndrome and long COVID patients.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID patients have overlapping neurological, autonomic, pain, and post-exertional symptoms. We compared volumes of brainstem regions for 10 ME/CFS (CCC or ICC criteria), 8 long COVID (WHO Delphi consensus), and 10 healthy control (HC) subjects on 3D, T1-weighted MRI images acquired using sub-millimeter isotropic resolution using an ultra-high field strength of 7 Tesla. Group comparisons with HC detected significantly larger volumes in ME/CFS for pons (p = 0.004) and whole brainstem (p = 0.01), and in long COVID for pons (p = 0.003), superior cerebellar peduncle (p = 0.009), and whole brainstem (p = 0.005). No significant differences were found between ME/CFS and long COVID volumes. In ME/CFS, we detected positive correlations between the pons and whole brainstem volumes with "pain" and negative correlations between the midbrain and whole brainstem volumes with "breathing difficulty." In long COVID patients a strong negative relationship was detected between midbrain volume and "breathing difficulty." Our study demonstrated an abnormal brainstem volume in both ME/CFS and long COVID consistent with the overlapping symptoms.


The complete mitochondrial genome of the Australian ghost bat Macroderma gigas.
The Ghost bat Macroderma gigas is a monotypic bat species that is endemic to northern Australia and named on the basis of the large size of its partially conjoined ears. It is the only carnivorous bat found in Australia and its conservation status is currently listed as Vulnerable. Here, we describe the complete mitochondrial genome of M. gigas and compare it to other vertebrates. The M. gigas circularized mitogenome was 16,661 bp and contained 13 protein-coding genes, two rRNA genes, 22 tRNAs and a control region (D-loop) of 1228 bp. Phylogenetic analysis of available entire mitogenomes reveals that Macroderma gigas is most closely related to the Indian false vampire bat Megaderma lyra in the family Megadermatidae (false vampire bats).


Investigating factors associated to dysphagia and need for percutaneous endoscopic gastrostomy in patients with head and neck cancer receiving radiation therapy.
Purpose: In this study we sought to investigate factors associated to dysphagia and subsequent need for percutaneous gastrostomy (PEG) usage, in patients with head and neck cancer receiving radiation therapy. Methods: The records of 123 patients with non-metastatic, stage I-IV head and neck cancer who were submitted to radiation therapy were retrospectively reviewed. Logistic regression models were used to investigate for associations between the outcomes of interest (grade ≥2 dysphagia and need for [PEG] usage) and potential predictive factors. Results: Mean dose to pharyngeal constrictor muscles (OR=1.08, p=.002), concurrent chemotherapy (OR=3.78, p=0.015) and upper aerodigestive tract malignancies (OR=3.27, p=0.044) were associated with dysphagia grade≥2. A threshold of constrictors mean dose for dysphagia manifestation was also identified at 43 Gy (OR=4.51, p=0.002). Need for PEG use was correlated with definitive treatment (OR=7.03, p=.022), nasopharyngeal (OR=12.62, p=0.003), upper aerodigestive tract (OR=9.12, p=0.007) or occult primary malignancies (OR=10.78, p=0.016). Conclusion: Patients suffering from upper aerodigestive tract malignancies, those with calculated constrictors mean dose >43 Gy, or planned to receive concurrent chemotherapy-radiotherapy should be closely monitored during treatment for dysphagia manifestation. Prophylactic PEG could be considered for patients receiving definitive therapy of the nasopharynx, upper aerodigestive tract or occult primary malignancies.


An Overview of Structurally Modified Glycyrrhetinic Acid Derivatives as Antitumor Agents.
Glycyrrhetinic Acid (GA), a triterpenoid aglycone component of the natural product glycyrrhizinic acid, was found to possess remarkable anti-proliferative and apoptosis-inducing activity in various cancer cell lines. Though GA was not as active as other triterpenes, such as betulinic acid and oleanolic acid, it could trigger apoptosis in tumor cells and it can be obtained easily and cheaply, which has stimulated scientific interest in using GA as a scaffold to synthesize new antitumor agents. The structural modifications of GA reported in recent decades can be divided into four groups, which include structural modifications on ring-A, ring-C, ring-E and multiple ring modifications. The lack of a comprehensive and recent review on this topic prompted us to gather more new information. This overview is dedicated to summarizing and updating the structural modification of GA to improve its antitumor activity published between 2005 and 2016. We reviewed a total of 210 GA derivatives that we encountered and compiled the most active GA derivatives along with their activity profile in different series. Furthermore, the structure activity relationships of these derivatives are briefly discussed. The included information is expected to be of benefit to further studies of structural modifications of GA to enhance its antitumor activity.


Real-time ultrasonic evaluation of the baboon pregnancy: biometric measurements.
Ultrasonic and direct biometric measurements of nine fetal baboons were made during 23 evaluations. Both the femur length and the biparietal diameter were correlated to gestational age. These initial results have facilitated intrauterine surgery. The data presented will help in determining adequate fetal growth and in dating the baboon pregnancy.


Temporal properties of posterior parietal neuron discharges during working memory and passive viewing.
Working memory is mediated by the discharges of neurons in a distributed network of brain areas. It was recently suggested that enhanced rhythmicity in neuronal activity may be critical for sustaining remembered information. To test whether working memory is characterized by unique temporal discharge patterns, we analyzed the autocorrelograms and power spectra of spike trains recorded from the posterior parietal cortex of monkeys performing a visuospatial working-memory task. We compared the intervals of active memory maintenance and fixation and repeated the same analysis in spike trains from monkeys never trained to perform any kind of memory task. The most salient effect we observed was a decrease of power in the 5- to 10-Hz frequency range during the presentation of visual stimuli. This pattern was observed both in the working-memory condition and the control condition, although it was more prominent in the former, where it persisted after cue presentation when the monkeys actively remembered the spatial location of the stimulus. Low-frequency power suppression resulted from relative refractory periods that were significantly longer in the working-memory condition and presumably emerged from local-circuit inhibition. We also detected a spectral peak in the 15- to 20-Hz range, although this was more prominent during fixation than during the stimulus and working-memory periods. Our results are in line with previous reports in prefrontal cortex and indicate that unique temporal patterns of single-neuron firing characterize persistent delay activity, although these do not involve the appearance of enhanced oscillations.


Pyrimidine nucleoside monophosphate kinase hyperactivity in hereditary erythrocyte pyrimidine 5'-nucleotidase deficiency.
The pyrimidine nucleoside triphosphates (CTP, UTP) increase in the pyrimidine 5'-nucleotidase (P5N) deficient red blood cell (RBC) to a greater degree than do the pyrimidine nucleoside monophosphates (CMP, UMP). Pyrimidine nucleoside monophosphate (PNMP) kinase phosphorylates CMP and UMP to their respective phosphodiesters. We tested the hypothesis that increased PNMP kinase activity contributes to the disproportionate increase in CTP and UTP in the P5N deficient RBC. CMP and UMP kinase activities were increased in high reticulocyte (4.4 +/- 2.1 and 8.5 +/- 3.3 mumol/ml RBC per minute) compared to normal RBC (2.8 +/- 1.0 and 6.0 +/- 2.5 mumol/ml RBC per minute). P5N deficient RBC (n = 2) had significantly increased CMP and UMP kinase activities (14.0 and 26.5 mumol/ml RBC per minute). UMP and CDP-ethanolamine were able to increase the activity of CMP kinase in crude haemolysate and the activity of partially purified enzyme. Since the Km for CMP of CMP kinase was 33 mumol/l in P5N deficient RBC and since the CMP concentration is 25-90 mumol/l in the P5N deficient RBC, the enzyme should be nearly saturated with CMP in the P5N deficient RBC. Thus, PNMP kinase hyperactivity appears to contribute to the disproportionate increase in CTP and UTP in the P5N deficient RBC.


[Evaluation of ovarian follicular reserve].
Qualitative and/or quantitative impairment of the ovarian follicular reserve is frequently observed in women consulting for infertility, whatever their age and the cause of infertility. The diagnosis of incipient ovarian failure can not be established on clinical signs. It is established by measuring serum FSH levels in the early phase of a spontaneous cycle and/or by measuring serum FSH level on day 10 of a cycle after administration of clomiphene citrate (100 mg/day) from day 5 to day 9.


Body size as a factor in different ages and breast cancer risk in Taiwan.
A matched case-control study was done on 175 pathologically proven new cases of female breast cancer from National Taiwan University Hospital from February 1993 to June 1994 and 457 hospital controls individually matched for age and date of admission. Height and weight during one year before the first full-term pregnancy and one year before admission were collected from a questionnaire interview. Body mass index (BMI) (kg/m2) was derived accordingly. Demographic and reproductive characteristics, and family history of breast cancer were collected and adjusted as potential confounders. Conditional multiple logistic regression analysis was used to estimate the effect for each risk factor regarding body size of different ages. After adjustment for potential confounders, higher weight and BMI during one year before first full-term pregnancy were associated with a moderately lower risk of breast cancer especially in the premenopausal group. The heaviest group (> or = 65 kg) during one year before admission also had a moderately lower breast cancer risk. Height did not show any significant association with breast cancer risk. Weight and BMI gain were associated with an elevated breast cancer risk in the postmenopausal group but with wide confidence limits. The results of this study imply that adipose tissue may interfere with ovarian endocrine in the younger age group, and that there is increased hormonal production after obvious weight gain.


Efficacy and toxicity of docetaxel combination chemotherapy for advanced squamous cell cancer of the head and neck.
The aim of the present study was to evaluate the clinical effectiveness and toxicity of docetaxel with 5-fluorouracil and cisplatin as combination treatment in patients with curable or metastatic/recurrent head and neck cancer by a retrospective cohort study of patients treated at a single institution between 2007 and 2012. Patients with locally advanced, metastatic and/or recurrent squamous cell carcinoma of the head and neck (SCCHN), who were treated with a combination therapy including docetaxel, were considered as eligible. Survival data, clinical side effects, quality of life (QoL) and toxicity profile were retrieved from patient charts, analyzed and scored according to the National Cancer Institute Common Toxicity Criteria, version 4, and the Response Evaluation Criteria In Solid Tumors, version 1.1. An overall response rate of 86% and a 3-year survival of 65.1% were observed. The median progression-free survival was 32 months. The cumulative incidence after 3 years was 16.9% for local recurrence and 10.4% for distant metastasis. Leukopenia (58%) and anemia (51%) were the most common hematological toxicities, followed by hepatotoxicity (53%) and nausea (27%). A total of 31% of the patients experienced a compromise in their QoL following therapy completion. In conclusion, docetaxel in combination with cisplatin and 5-fluorouracil was found to effectively prolong survival in patients with locally advanced and/or recurrent metastatic SCCHN. The overall survival, progression-free survival and response rates were in accordance with those reported by previous clinical trials. Therefore, this therapy protocol is recommended for patients with SCCHN in the curative as well as the palliative settings.


Current Approaches to Low Vision (Re)Habilitation
With increased life expectancy at birth and especially the rising incidence of age-related macular degeneration, low vision (re)habilitation is becoming more important today. Important factors to consider when presenting rehabilitation and treatment options to patients presenting to low vision centers include the diagnosis of the underlying disease, the patient's age, their existing visual functions (especially distance and near visual acuity), whether visual loss is central or peripheral, whether their disease is progressive or not, the patient's education level, and their expectations from us. Low vision patients must be guided to the right centers at the appropriate age, with appropriate indications, and with realistic expectations, and the rehabilitation process must be carried out as a multidisciplinary collaboration.


A Novel Approach for Responsive Neural Stimulator Implantation With Infraclavicular Placement of the Internal Pulse Generator.
The Responsive Neurostimulation System (RNS, Neuropace, Mountain View, California) has been proven to be effective at reducing seizures in patients with partial-onset epilepsy. The system incorporates a skull-mounted neurostimulator that requires a cranial incision for replacement. Although integral to the functioning of the system, in some circumstances, such as in the setting of infection, this can be disadvantageous. At present, there are no alternatives to cranial implantation of the RNS System. We describe a novel procedure enabling implantation of the neurostimulator within the chest wall, using components from a peripheral nerve stimulator. In a patient who achieved complete seizure freedom with the use of the RNS System, distant site implantation provided a viable means of continuing therapy in a setting where device explantation would have otherwise been inevitable as a result of cranial infection. We present continuous electrocorticographic data recorded from the device documenting the performance of the system with the subclavicular neurostimulator. Band pass detection rates increased by 50%, while line length detection rates decreased by 50%. The number of detections decreased from 1046 to 846, with a resultant decrease in stimulations. Although there was some compromise of function due to the elevated noise floor, more than 2 yr following the procedure the patient remains free of seizures and infection. The salvage procedure we describe offered an alternative therapeutic option in a patient with a complicated cranial wound issue, using heterogeneous components with marginal compromises in device functionality and no sacrifice in patient outcome.


Interleukin-1 alpha gene expression and localization of interleukin-1 alpha protein during tumor promotion.
Treatment of the dorsal epidermis of SENCAR mice with 12-O-tetradecanoylphorbol-13-acetate (TPA) induced a time- and dose-dependent stimulation of interleukin-1 alpha (IL-1 alpha) gene expression. Levels of IL-1 alpha mRNA were elevated as early as 15 min and peaked at 3-4 h after a single application of TPA (2 micrograms or 10 micrograms). IL-1 alpha gene expression increased in epidermal tissue isolated from SENCAR mice at 1, 3, 6, 10, 16, and 22 wk after a single treatment with 10 nmol 7,12-dimethylbenz[a]anthracene (DMBA) and subsequent twice-weekly application of 2 micrograms TPA. IL-1 alpha-immunoreactive protein was specifically localized within suprabasal keratinocytes in cutaneous tissue isolated from mice treated with DMBA-TPA for 1-22 wk and in nonproliferating cells located within papilloma tissue isolated from SENCAR mice at 22 wk after initiation and promotion. Basal cells within hyperplastic epidermis did not produce IL-1 alpha-immunoreactive protein. DMBA treatment alone did not induce IL-1 alpha gene expression. Injection of IL-1 alpha-specific antibodies (50 micrograms) into SENCAR mice via the tail vein 2 h before treatment with TPA (2 micrograms or 10 micrograms) significantly (P < 0.05) inhibited the skin thickening usually observed 24 h after treatment with TPA. Autoradiography studies showed that injection of anti-IL-1 alpha antibodies inhibited incorporation of [methyl-3H]thymidine by keratinocytes within the epidermis and by cells within hair follicles. It also inhibited neutrophil infiltration into the dermis, which usually results from topical application of TPA. These data suggest that IL-1 alpha is a pivotal cytokine produced by specific subpopulations of epidermal keratinocytes and that IL-1 alpha primarily regulates the epidermal proliferative response of a distinctly separate population of keratinocytes after topical exposure of murine epidermis to TPA and secondarily modulates neutrophil migration into the dermis. Consequently, manipulation of IL-1 alpha may be a way to attenuate or abrogate the cutaneous response to TPA by altering keratinocyte proliferation, the resultant hyperplasia, and a portion of the inflammatory response characterized by dermal infiltration of neutrophils.


Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.
In appropriate prescribing is a significant and persistent problem in elderly people, both in hospital and the community and has been described in several countries in Europe and also the USA. The problem of inappropriate prescribing has not been quantified in the Republic of Ireland. The most commonly used criteria for the identification of inappropriate prescribing are the Beers' criteria [both independent of diagnosis (ID) and considering diagnosis (CD) - 2003 version]. The Beers' criteria ID includes 48 different categories of either single medications or multiple medications of a similar class identified as inappropriate prescriptions and the Beers' criteria CD contains 19 different categories containing possible drug-disease interactions. A second tool, the improved prescribing in the elderly tool (IPET) has also been validated and used in hospital and community studies and has 14 categories of either explicitly contraindicated medications or possible drug-disease interactions. The primary aim of the study is to measure the incidence of inappropriate prescribing among older community-dwelling individuals presenting to an acute hospital in the Republic of Ireland. A secondary aim of this study was also therefore to compare the efficacy of the above two tools in identifying inappropriate prescribing. A prospective, consecutive observational cohort study was carried out over a 4-month period. The setting was an urban-based university hospital acute geriatric medicine assessment unit. Subjects in this study (n = 350) were consecutively screened on admission to hospital (mean age = 80.3 +/- 6.1 years) and all patients had both Beers' criteria ID and CD and IPET applied to their list of prescription drugs on admission, cross-referenced with their list of current active medical diagnosis. The results of the study identified a high rate of inappropriate prescribing among this population of community-dwelling subjects. The total number of inappropriate prescriptions identified using the Beers' criteria (ID) was 148 affecting 121 patients. The Beers' criteria (CD) identified 69 inappropriate prescriptions in 60 patients and the IPET identified 112 inappropriate prescriptions in 78 patients. The Beers criteria (ID and CD combined) identified at least one inappropriate prescription in 34% of subjects and the IPET identified one in at least 22% of subjects. This study identifies high rates of use of inappropriate medications in community-dwelling elderly presenting with acute illness to hospital. These are comparable with inappropriate prescribing rates identified in previous studies. The revised Beers' criteria (2003) identified more inappropriate prescriptions than the IPET in this population of elders.


Assessment of a Cavity to Optimize Ultrasonic Efficiency to Remove Intraradicular Posts.
The study assessed an in vitro protocol for the removal of cast metal posts using ultrasonic vibration in multirooted teeth by drilling a cavity in the coronal portion of the post followed by ultrasound application in the cavity. Forty endodontically treated molars received intraradicular cast posts and were divided into 4 groups according to the removal protocol: the control group, no cavity and no ultrasonic vibration; the ultrasonic group, no cavity and ultrasonic vibration in the coronal portion of the core; the cavity group, a cavity in the core and no ultrasonic vibration; and the cavity ultrasonic group, a cavity in the core and ultrasonic vibration inside the cavity. The traction test was performed on all samples using a universal testing machine (EMIC DL-2000; EMIC Equipamentos e Sistemas de Ensaio LTDA, São José dos Pinhais, PR, Brazil) at a speed of 1 mm/min, obtaining values in Newtons. The data were statistically analyzed using analysis of variance and the Tukey-Kramer test (P < .05). The results showed statistically significant differences between the tested groups (control group = 322.74 N, ultrasonic group = 283.09 N, cavity group = 244.00 N, and cavity ultrasonic group = 237.69 N). The lowest mean strength was found in the group that received ultrasonic vibration inside the cavity. Preparing a cavity in the coronal core followed by ultrasonic vibration reduces the traction force required for removal. The removal protocol was effective for removing posts in multirooted teeth cemented with zinc phosphate.


Azaepothilone B and its derivatives: a patent review.
Azaepothilone B, also known as ixabepilone, is a semi synthetic second generation epothilone B analogue. Azaepothilone B, its derivatives, and analogues, are used for treating advance metastatic breast cancer. It has been used as a chemotherapeutic medication for cancer. This review highlights the patents on different routes for synthesis of azaepothilone B, its derivatives and analogues. The review will also provide the reported pharmacological activity and its polymorphs in the treatment of several cancers, such as breast cancer (metastatic or locally advanced), non-Hodgkin's lymphoma, and pancreatic cancer. In addition, it considers other proliferative diseases such as viral infections, degenerative diseases of the musculoskeletal system, kidney disease, and immune response related diseases. Different databases such as Espacenet, ISI Web of Knowledge, Patbase, and Thomson Innovation have been searched extensively to review the patents. The analysis has been done to indicate the patenting trend across years and the comparison of active assignees. Azaepothilone B, along with its derivatives and analogues, can damage cancer cells in very low concentrations and retain its activity when tumor cells are insensitive to paclitaxel. Hence, it is highly potent agent. Azaepothilone B alone, in combination with other chemotherapeutics, or in the form of formulations, led to applications in various types of cancer. Also, antiproliferative activity of azaepothilone B has great potential for the treatment of proliferative diseases, such as skin diseases and infections. Recent progress in synthesizing azaepothilone B has encouraged researchers to develop new methods for the synthesis of azaepothilone B, its derivatives, and analogues, to obtain maximum yield in minimum steps.


Metabolic effects and the methylenetetrahydrofolate reductase (MTHFR) polymorphism associated with neural tube defects in southern Brazil.
The importance of metabolic factors in neural tube defects (NTDs) has been the focus of many investigations. Several authors have suggested that abnormalities in homocysteine metabolism, such as hyperhomocysteinemia, folate deficiency, and low vitamin B12, may be responsible for these malformations and that both nutritional factors and genetic abnormalities are associated with them. We conducted a case-control study to investigate the influence of biochemical and genetic factors in NTDs in infants in southern Brazil. Levels of folate, vitamin B12, total homocysteine (t-Hcy) and the 677C>T and 1298A>C polymorphisms of the MTHFR gene were analyzed in 41 NTD child-mother pairs and 44 normal child-mother control pairs. Subjects in the case group had a higher mean blood folate level than those in the control group. The level of vitamin B12 was lower in mothers in the NTD group than in control mothers (p = 0.004). The level of t-Hcy was not different in the two groups, but t-Hcy and vitamin B12 were correlated (p = 0.002). There was no difference in the genotype distribution for 677C>T and 1298A>C polymorphisms of MTHFR in the case and control pairs. The level of t-Hcy was correlated with 677TT. Despite the small sample in this study, we suggest that low vitamin B12 and, consequently, hyperhomocysteinemia are important risk factors for NTDs in our population.