High-speed linear optics quantum computing using active feed-forward.
As information carriers in quantum computing, photonic qubits have the advantage of undergoing negligible decoherence. However, the absence of any significant photon-photon interaction is problematic for the realization of non-trivial two-qubit gates. One solution is to introduce an effective nonlinearity by measurements resulting in probabilistic gate operations. In one-way quantum computation, the random quantum measurement error can be overcome by applying a feed-forward technique, such that the future measurement basis depends on earlier measurement results. This technique is crucial for achieving deterministic quantum computation once a cluster state (the highly entangled multiparticle state on which one-way quantum computation is based) is prepared. Here we realize a concatenated scheme of measurement and active feed-forward in a one-way quantum computing experiment. We demonstrate that, for a perfect cluster state and no photon loss, our quantum computation scheme would operate with good fidelity and that our feed-forward components function with very high speed and low error for detected photons. With present technology, the individual computational step (in our case the individual feed-forward cycle) can be operated in less than 150 ns using electro-optical modulators. This is an important result for the future development of one-way quantum computers, whose large-scale implementation will depend on advances in the production and detection of the required highly entangled cluster states.


A water-forming NADH oxidase from Lactobacillus pentosus suitable for the regeneration of synthetic biomimetic cofactors.
The cell-free biocatalytic production of fine chemicals by oxidoreductases has continuously grown over the past years. Since especially dehydrogenases depend on the stoichiometric use of nicotinamide pyridine cofactors, an integrated efficient recycling system is crucial to allow process operation under economic conditions. Lately, the variety of cofactors for biocatalysis was broadened by the utilization of totally synthetic and cheap biomimetics. Though, to date the regeneration has been limited to chemical or electrochemical methods. Here, we report an enzymatic recycling by the flavoprotein NADH-oxidase from Lactobacillus pentosus (LpNox). Since this enzyme has not been described before, we first characterized it in regard to its optimal reaction parameters. We found that the heterologously overexpressed enzyme only contained 13% FAD. In vitro loading of the enzyme with FAD, resulted in a higher specific activity towards its natural cofactor NADH as well as different nicotinamide derived biomimetics. Apart from the enzymatic recycling, which gives water as a by-product by transferring four electrons onto oxygen, unbound FAD can also catalyze the oxidation of biomimetic cofactors. Here a two electron process takes place yielding H2O2 instead. The enzymatic and chemical recycling was compared in regard to reaction kinetics for the natural and biomimetic cofactors. With LpNox and FAD, two recycling strategies for biomimetic cofactors are described with either water or hydrogen peroxide as by-product.


Serum lactate dehydrogenase level in patients with nasopharyngeal carcinoma.
Serum lactic dehydrogenase (LDH) levels of 465 patients with nasopharyngeal carcinoma (NPC) were assayed retrospectively. Four cohorts were selected in order to investigate the enzymes: 1) stage IV disease (118 cases) with pretreatment measurement, 2) relapse cases (159 cases) with pretreatment measurements, 3) no evidence of disease (217 cases) with spotting or serial measurements, and 4) monitoring of response to cytotoxic chemotherapy (34 cases). Higher serum LDH levels and more cases with elevated values were found in metastatic disease, especially relapse cases with liver and/or multiple organ site metastases. Serum LDH levels in locoregional disease were rarely found to be greater than two times the normal level. The value of serial serum LDH measurement for detecting disease relapse in the follow-up of patients with NPC is limited. Twelve percent of cases with no evidence of disease demonstrated elevation in serum levels. Serum LDH levels were found to correlate with the clinical responsiveness to systemic chemotherapy. Cases with normal serum LDH before treatment had a better chance of survival than those with elevated levels (median: 53 vs. 10 months, p = 0.008).


In vitro Mechanistic Exploration of Novel Spiropyrrolidine Heterocyclic Hybrids as Anticancer Agents.
Novel spiro acenaphthylene pyrrolo[1,2-b]isoquinoline/pyrrolidine hybrids have been achieved through Pictet-Spengler/Eschweiler-Clarke reactions depending on the substitution in the benzyl ring. The in vitro biological efficacy of N-methyl spiropyrrolidine derivatives toward different cancer and non-cancer cell lines revealed that these novel spiro heterocyclic hybrids induced cancer cell death at moderate concentrations, while slight reduction in non-cancer cell viability at the higher concentrations. The analysis of cancer cells proved that the major pathway of cell death is apoptosis and in addition, the role of caspases is confirmed by the appearance of fluorescent cells in microscopic images. Therefore, this study indicates a sustainable way of treating cancer cells by inducing apoptotic pathways and associated caspases, while simultaneously protecting the non-cancer cells.


Mortality after endovascular versus open repair of abdominal aortic aneurysm in the elderly.
Age is a well-known risk factor for postoperative death in patients with abdominal aortic aneurysms (AAA), and the efficacy of open aneurysm repair (OAR) and endovascular aneurysm repair (EVAR) remains controversial in the elderly population. The aim of this study was to determine the predictors of 30-d mortality after AAA repair in elderly population. Using the National Surgical Quality Improvement Program vascular-targeted database (2011-2014), we identified all patients aged >70 y who underwent OAR and EVAR for nonruptured AAA. Univariate and multivariable logistic regression analyses were implemented to examine postoperative mortality adjusting for patient demographics and characteristics. A total of 4229 nonruptured AAA repairs were performed (OAR: 360 [8.5%] versus EVAR: 3869 [91.5%]). Most patients were males (79 %) and White (81%) with a mean age of 78 ± 6 y. Obesity was more prevalent in EVAR group (31% versus 24%, P = 0.008). Whereas, smoking was more likely to be seen in patients undergoing an OAR (35% versus 22%, P < 0.001). The 30-d mortality was significantly higher after OAR versus EVAR (8% versus 2%, P < 0.001). After adjusting, OAR was associated with almost five times higher mortality than EVAR (adjusted odds ratio: 4.88; 2.85-8.34, P < 0.001). This study reflects contemporary real world outcomes of nonruptured AAA repair in the elderly. Open repair was associated with almost fivefold increase in mortality compared with endovascular repair. Elderly patients who are functionally dependent are less likely to benefit from AAA repair, whether OAR or EVAR. Further prospective studies are required to better understand the predictors of mortality after AAA repair in the geriatric population which could guide decision-making and improve outcomes in this population.


G protein-receptor kinases 5/6 are the key regulators of G protein-coupled receptor 35-arrestin interactions.
Human G protein-coupled receptor 35 is regulated by agonist-mediated phosphorylation of a set of five phospho-acceptor amino acids within its C-terminal tail. Alteration of both Ser300 and Ser303 to alanine in the GPR35a isoform greatly reduces the ability of receptor agonists to promote interactions with arrestin adapter proteins. Here, we have integrated the use of cell lines genome edited to lack expression of combinations of G protein receptor kinases (GRKs), selective small molecule inhibitors of subsets of these kinases, and antisera able to specifically identify either human GPR35a or mouse GPR35 only when Ser300 and Ser303 (orce; the equivalent residues in mouse GPR35) have become phosphorylated to demonstrate that GRK5 and GRK6 cause agonist-dependent phosphorylation of these residues. Extensions of these studies demonstrated the importance of the GRK5/6-mediated phosphorylation of these amino acids for agonist-induced internalization of the receptor. Homology and predictive modeling of the interaction of human GPR35 with GRKs showed that the N terminus of GRK5 is likely to dock in the same methionine pocket on the intracellular face of GPR35 as the C terminus of the α5 helix of Gα13 and, that while this is also the case for GRK6, GRK2 and GRK3 are unable to do so effectively. These studies provide unique and wide-ranging insights into modes of regulation of GPR35, a receptor that is currently attracting considerable interest as a novel therapeutic target in diseases including ulcerative colitis.


Molecular Viability Testing of UV-Inactivated Bacteria.
PCR is effective in detecting bacterial DNA in samples, but it is unable to differentiate viable bacteria from inactivated cells or free DNA fragments. New PCR-based analytical strategies have been developed to address this limitation. Molecular viability testing (MVT) correlates bacterial viability with the ability to rapidly synthesize species-specific rRNA precursors (pre-rRNA) in response to brief nutritional stimulation. Previous studies demonstrated that MVT can assess bacterial inactivation by chlorine, serum, and low-temperature pasteurization. Here, we demonstrate that MVT can detect inactivation of Escherichia coli, Aeromonas hydrophila, and Enterococcus faecalis cells by UV irradiation. Some UV-inactivated E. coli cells transiently retained the ability to synthesize pre-rRNA postirradiation (generating false-positive MVT results), but this activity ceased within 1 h following UV exposure. Viable but transiently undetectable (by culture) E. coli cells were consistently detected by MVT. An alternative viability testing method, viability PCR (vPCR), correlates viability with cell envelope integrity. This method did not distinguish viable bacteria from UV-inactivated bacteria under some conditions, indicating that the inactivated cells retained intact cell envelopes. MVT holds promise as a means to rapidly assess microbial inactivation by UV treatment.IMPORTANCE UV irradiation is increasingly being used to disinfect water, food, and other materials for human use. Confirming the effectiveness of UV disinfection remains a challenging task. In particular, microbiological methods that rely on rapid detection of microbial DNA can yield misleading results, due to the detection of remnant DNA associated with dead microbial cells. This report describes a novel method that rapidly distinguishes living microbial cells from dead microbial cells after UV disinfection.


Xpert(®) MTB/RIF detection of rifampin resistance and time to treatment initiation in Harare, Zimbabwe.
Patients at elevated risk of drug-resistant tuberculosis (TB) are prioritized for Xpert(®) MTB/RIF testing; however, the clinical usefulness of the test in this population is understudied. From November 2011 to June 2014, consecutive out-patients with a history of previous TB in high-density suburbs of Harare, Zimbabwe, were tested using Xpert, solid and liquid culture, and the microscopic observation drug susceptibility assay. Diagnostic accuracy for rifampin (RMP) resistance and time to initiation of second-line regimens were ascertained. The rpoB gene was sequenced in cases with culture-confirmed RMP resistance and genotypic susceptibility. Among 352 retreatment patients, 71 (20%) were RMP-resistant, 98 (28%) RMP-susceptible, 64 (18%) culture-negative/Xpert-positive, and 119 (34%) culture-negative/Xpert-negative. Xpert had a sensitivity of 86% (95%CI 75-93) and a specificity of 98% (95%CI 92-100) for RMP-resistant TB. The positive predictive value of Xpert-determined RMP resistance for multidrug-resistant TB (MDR-TB) was 82% (95%CI 70-91). Of 71 (83%) participants, 59 initiated treatment with second-line drugs, with a median time to treatment initiation of 18 days (IQR 10-44). The diagnostic accuracy of Xpert for RMP resistance is high, although the predictive value for MDR-TB was lower than anticipated. Xpert allows for faster initiation of second-line treatment than culture-based drug susceptibility testing under programmatic conditions.


Epidemiological status quo of hypertension in elderly population in Changchun, China: a cross-sectional study.
To investigate the epidemiological status quo of hypertension in elderly population in Changchun, China, and provide a reference for the prevention and control strategies of hypertension of elderly population in this region. A cross-sectional study, as a part of a comprehensive project in Northeast China, was designed to perform in 10 districts in Changchun. A total of 6846 participants who were ≥60 years old were selected using a random sampling method. The epidemiological status quo of hypertension. The prevalence of hypertension in Changchun was 52.6%. Among participants with hypertension enrolled in this study, 87.6% of the participants had been diagnosed with hypertension before the study, 69.1% was taking antihypertensive medications and 66.9% had effective blood pressure control. Obesity, widower/widow, history of diseases and family history of hypertension were risk factors of hypertension (all p<0.05). Participants with obesity, a personal history of heart coronary disease, or a family history of hypertension were susceptible to realising risks of hypertension (all p<0.05). However, participants with diabetes, hyperlipidaemia, or a family history of hypertension were difficult to control blood pressure within the normal range (all p<0.05). In addition, 92.6% participants taking antihypertensive medications used a single medication, and calcium channel blockers was the most commonly used antihypertensive medications in monotherapy. The rates of awareness, treatment and control of hypertension are greater in Changchun than those in China, indicating that the prevention and control of hypertension in Changchun are effective. However, the prevalence of hypertension in the elderly population in China is lower than that in Changchun, also rendering Changchun a substantial challenge for the supervision of hypertension.


Leiomyoma of the round ligament of the liver: report of one case.
Tumoral conditions in the round ligament of the liver are very uncommon and exhibit nonspecific manifestations, hence a high level of suspicion is necessary for their diagnosis. We report the case of a 47-year-old female patient who presented with abdominal pain for several months; imaging studies showed a lesion of indeterminate nature likely connected with the falciform ligament, and only intraoperative findings acknowledged the presence of an apparently benign tumor in the round ligament of the liver, which biopsy confirmed. Following the excision of the round ligament the patient had a favorable course. As this is a pathologically benign lesion we deem its surgical management both advisable and sufficient. However, because of its small prevalence and the scarcity of literature involving this condition, further studies would be needed to provide information on natural history, treatment, and long-term prognosis.


Determination of the growth fraction in monoclonal gammopathy with the monoclonal antibody Ki-67.
The monoclonal antibody Ki-67 reacts with a nuclear antigen that is present only in proliferating cells. The proportion of Ki-67 positive cells may therefore serve as a reliable measurement for the growth fraction in normal and neoplasmic cell populations. We have tested the significance of the MoAb Ki-67 in the classification of monoclonal gammopathy and compared the results with the plasma cell labelling index. In benign monoclonal gammopathy the percentage of Ki-67 positive plasma cells (median 1.6%) was significantly lower than in untreated multiple myeloma (median 9.6). Among the patients with more than 10% Ki-67 positive plasma cells there were some very short survivors. The largest growth fractions (median 41.8%) were found in patients with relapsing multiple myeloma indicating here a different growth pattern more resembling the high-grade lymphomas. A linear correlation between the proportion of Ki-67 positive plasma cells and the labelling index was not found. Determination of the plasma cell growth fraction with the monoclonal antibody Ki-67 in monoclonal gammopathy may help to discriminate benign monoclonal gammopathy from multiple myeloma and will probably identify a subgroup of multiple myeloma patients with a poor prognosis, including those with relapsing multiple myeloma.


Bladder Carcinoma after ABVD Chemotherapy for Hodgkin's Lymphoma: A Case Report.
The treatment of lymphomas may result in the development of second malignancies, as evident by the numerous reports in the literature. Treatment with cyclophosphamide-based chemotherapy regimens may lead to bladder lesions such as haemorrhagic cystitis and also to carcinoma of the urinary bladder. Previous pelvic radiotherapy treatment is also implicated as a cause for local second cancers. We present the case of a patient treated for Hodgkin's lymphoma, who was diagnosed with transitional cell carcinoma of the bladder soon after treatment completion. On completion of 6 cycles of ABVD chemotherapy the patient was on follow-up. Two months after treatment completion the patient complained of dysuria and was investigated for a suspected urinary tract infection. Urine microscopy did not reveal any abnormality. Symptomatic treatment was prescribed and cystoscopy was arranged. The cystoscopic findings suggested an irregular growth overlying the trigone and the biopsy reported it as transitional cell carcinoma. This case report demonstrates that symptoms attributed to common medical causes in patients treated for cancer may be a sign of second malignancy. This case report also demonstrates the need for a thorough evaluation of patients' complaints during follow-up, although the likelihood for the occurrence of a second malignancy may be low. The assumption that these symptoms were due to a commonly occurring urinary tract infection would have had serious implications leading to a delay in the treatment of the bladder cancer.


Community Health Worker Knowledge, Attitudes, Practices and Readiness to Manage Intimate Partner Violence.
Intimate partner violence (IPV) is an important public health concern with higher prevalence among women. Community health workers (CHWs) are trusted frontline public health workers that bridge gaps between communities and healthcare services. Despite their effectiveness in delivering services and improving outcomes for different chronic conditions, there is a dearth of understanding regarding CHW management of IPV. The purpose of this study is to examine knowledge, attitudes, practices, and readiness to manage IPV among a sample of CHWs (n = 152). Participants completed an online version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), which was modified for CHW practice. Psychometrics of the newly adapted tool, along with empirical relationships between knowledge, attitudes, and readiness to manage IPV were examined. Most sub-scales yielded moderate to high reliability (0.70 < α's < 0.97), some sub-scales had low reliability (0.57 < α's < 0.64), and construct validity was established for several of the subscales. On average, many CHWs had low scores on objective knowledge of IPV (mean = 15.4 out of 26), perceived preparation to manage IPV (mean = 3.8 out of 7), and perceived knowledge of IPV (mean = 3.7 out of 7). About 56% of CHWs indicated having no previous IPV training, 34% did not screen for IPV, and 65% were in the contemplation stage of behavior change. Multiple regression models indicated that knowledge, staff capabilities and staff preparation were significant predictors of perceived preparedness to manage IPV (all p's < 0.05). Results can inform future credentialing requirements and training programs for CHWs to better assist their clients who are victims of IPV.


Decrease in heart ventricular ejection fraction during multiple sclerosis.
Recent studies have shown that mitoxantrone is effective in patients with active multiple sclerosis (MS) and that cardiac monitoring is usually required. However, right and left ventricular ejection fractions (VEFs) have never been studied in MS patients as compared with control subjects. Radionuclide angiocardiography (RA) was performed to assess right and left VEFs at rest in 40 consecutive patients with active definite MS [15 men and 25 women; mean age 33.9 +/- 10 years; mean disease duration 8 +/- 6.5 years; 18 had relapsing-remitting and 22 had secondary progressive forms of the disease; mean Expanded Disability Status Scale (EDSS) score 4.8 +/- 1.9]. The control group consisted of 40 subjects free of neurological or cardiovascular disease (17 men and 23 women; 44.6 +/- 13.4 years of age). The VEF values obtained in the control group defined the normal limits (right VEF 32-54%; left VEF 50-74%). A statistically significant decrease of right (P=0.02) and left (P < 0.0001) VEFs was found in MS patients as compared with control subjects. RA showed pathological results for right (7.5%), left (10%) and both (7.5%) VEFs in 25% of MS patients. No correlation was found between VEF and sex, age, disease duration, disease course, EDSS score or previous treatment. Autonomic impairment, which frequently occurs in MS patients, may have accounted for the decrease in VEFs. Further physiological studies are required to determine factor responsible for the decrease of VEFs in MS.


A DNA barcode reference library of Portuguese mosquitoes.
Mosquitoes are important biological vectors of pathogens and species identification in all life stages is the first step for effective monitoring and control of mosquito-borne diseases. Molecular methods for species identification have been developed over the last years to overcome the limitations of the taxonomic identification based on morphology. DNA barcoding, using a fragment of the mitochondrial cytochrome oxidase I (COI) gene, can be used for species identification but a reliable and comprehensive reference database of verified sequences is required. In this study, we aimed to generate a DNA barcode reference library for the identification of mosquito species from Portuguese mosquito fauna, including most relevant vector species. Mosquitoes captured under the National Vector Surveillance Program (REVIVE) were processed for DNA extraction, COI gene fragment amplification and sequencing. Nighty-eight barcode sequences were obtained, representing 26 species and 6 genera. Sequences were submitted to GenBank and BOLD and were used for validation of phenetic classification. Barcode Index Number (BIN) assignment and Automatic Barcode Gap Discovery (ABGD) were used and clustered COI sequences into twenty-five molecular operational taxonomic units (MOTUs). This is the first comprehensive study that combines morphological and molecular identification of most mosquito species present in Portugal aiming to offer a reliable framework for mosquito species identification.


Orlistat in the treatment of Type 2 diabetes mellitus.
The prevalence of Type 2 diabetes mellitus (DM-2) is increasing throughout the world and poses a major public health concern. With the majority of patients DM-2 are overweight or obese and weight loss is generally recommended, both as a first-line therapy and as an adjunct to pharmacological therapies. However, it is generally acknowledged that weight loss, a difficult goal for many overweight and obese individuals, is especially difficult for those with DM-2 and there is interest in whether pharmacological adjuncts may be useful for this purpose. Orlistat is an intestinal lipase inhibitor previously approved for the treatment of obesity. During the past several years, clinical trials have been completed concerning the use of orlistat in the treatment of overweight or obese patients with DM-2. The purpose of this review is to examine the results of these clinical trials. Data on > 2500 orlistat-treated patients with DM-2 are reviewed and summarised. Orlistat therapy led to greater weight loss and improved metabolic control in overweight and obese patients with DM-2.


Recent advances in canine leptospirosis: focus on vaccine development.
Leptospirosis is a global infection of humans and animals caused by pathogenic Leptospira spp. Leptospirosis is a major zoonosis, with infection acquired from wild and domestic animals. It is also a significant cause of morbidity, mortality, and economic loss in production and companion animals. Leptospirosis in dogs is prevalent worldwide and as well as a cause of canine disease, it presents a zoonotic risk to human contacts. Canine leptospirosis does not differ greatly from the syndromes seen in other animal species, with hepatic, renal, and pulmonary involvement being the main manifestations. While the pathogenesis of disease is well documented at the whole animal level, the cellular and molecular basis remains obscure. Killed, whole-cell bacterin vaccines are licensed worldwide and have not changed greatly over the past several decades. Vaccine-induced immunity is restricted to serologically related serovars and is generally short-lived, necessitating annual revaccination. The appearance of new serovars as causes of canine leptospirosis requires constant epidemiological surveillance and tailoring of vaccines to cover emerging serovars. At the present time, there is no realistic prospect of alternative, non-bacterin vaccines in the foreseeable future.


Influence of the gamma subunit and expression system on acetylcholine receptor gating.
We have developed a partial kinetic theory for the gating of murine nicotinic acetylcholine receptors (AChRs) expressed in Xenopus oocytes and have used this theory to characterize the role of the gamma subunit in single-channel behavior. Permeation and gating were found to be largely unaffected in AChRs produced in oocytes when the gamma subunit transcript was omitted from microinjections of AChR subunit RNAs. In contrast, marked changes in gating kinetics resulted when even very conservative single amino acid substitutions were introduced into the gamma subunit, indicating that the gamma subunit can have a large effect on AChR gating. We also found that channel openings were much prolonged when murine AChRs were expressed in BC3H-1 cells.


Folding lambda-repressor at its speed limit.
We show that the five-helix bundle lambda(6-85) can be engineered and solvent-tuned to make the transition from activated two-state folding to downhill folding. The transition manifests itself as the appearance of additional dynamics faster than the activated kinetics, followed by the disappearance of the activated kinetics when the bias toward the native state is increased. Our fastest value of 1 micros for the "speed" limit of lambda(6-85) is measured at low concentrations of a denaturant that smooths the free-energy surface. Complete disappearance of the activated phase is obtained in stabilizing glucose buffer. Langevin dynamics on a rough free-energy surface with variable bias toward the native state provides a robust and quantitative description of the transition from activated to downhill folding. Based on our simulation, we estimate the residual energetic frustration of lambda(6-85) to be delta(2) G approximately 0.64 k(2)T(2). We show that lambda(6-86), as well as very fast folding proteins or folding intermediates estimated to lie near the speed limit, provide a better rate-topology correlation than proteins with larger energetic frustration. A limit of beta > or = 0.7 on any stretching of lambda(6-85) barrier-free dynamics suggests that a low-dimensional free-energy surface is sufficient to describe folding.


Investigation of dietary supplements prevalence as complementary therapy: Comparison between hospitalized psoriasis patients and non-psoriasis patients, correlation with disease severity and quality of life.
Psoriasis patients are often displeased with traditional medical treatments and they may self-prescribe dietary supplements as an alternative or complementary treatments. We aimed to investigate the prevalence of self-medication of dietary supplements among psoriasis and non-psoriasis cases and its impact on disease severity and quality of life. This case-control study evaluated 252 records of psoriasis patients and 245 non-psoriasis cases. Dietary supplementation over last 30days and characteristics, including age, age at onset of disease, co-morbidities, smoking and education were recorded. Psoriasis area and severity index (PASI) and dermatology quality of life index (DLQI) were calculated. P value less than 0.05 was considered as significant level. This study consisted 138 psoriasis (females; 54) and 138 non-psoriasis cases (females; 50), aged between 21 and 91 years. Among psoriasis patients, 72% reported using at least one of dietary supplements, which was different from non-psoriasis cases (25.36%, P=0.01). Multivitamin/mineral supplements (MVM) were the most frequent used dietary supplements (26.81%) and the most common reasons for the consumption of these supplements were to maintain and improve health. The consumption of folic acid (21.73%), omega-3 fatty acids or fish oil (10.14%), herbs (12.31%) and vitamin E (1.44%) had the most frequencies after MVM. No significant differences in PASI and DLQI were found among patients with consumption of different supplements (P>0.05). There was non-significant and negative correlation between education and use of supplements (P=0.21, r=-0.02). Self-medicating of MVM over last 30days was prevalent among studied psoriasis patients. They took dietary supplements in order to improve and maintain their health.


Pharmacologic intervention can reestablish baseline hemodynamic parameters during laparoscopy.
Several studies in both animal models and human beings have shown that CO2 abdominal insufflation for laparoscopy can cause a variety of alterations in hemodynamic and pulmonary physiology. These physiologic changes could potentially have deleterious effects in patients with underlying cardiopulmonary disease. We prospectively evaluated 15 patients with preexisting heart and/or lung disease to determine whether the use of invasive monitoring would allow early identification and treatment of these physiologic alterations and thus enable laparoscopy to be performed safely in this group of patients. CO2 abdominal insufflation caused statistically significant increases in systemic vascular resistance, mean arterial pressure, left ventricular stroke work index, and pulmonary capillary wedge pressure along with a concomitant decrease in cardiac index and oxygen delivery in these patients. The use of intravenous nitroglycerin resulted in a rapid return of the systemic vascular resistance, mean arterial pressure, pulmonary capillary wedge pressure, and cardiac index to baseline levels. No significant intraoperative or postoperative cardiac or pulmonary complications were noted. These results suggest that laparoscopy with CO2 pneumoperitoneum can be safely performed in high-risk patients if appropriate monitoring and pharmacologic interventions are used.


Dietary GABA and food selection by rats.
To obtain further information pertaining to amino acid-induced alterations in feeding behavior, studies were performed to examine the food choices made by rats fed low protein diets made more or less aversive by the addition of various amino acids. When rats were allowed to choose between two diets, they preferred a low protein control, threonine-imbalanced or nonprotein diet to one containing 2.5% gamma-aminobutyric acid (GABA). Acceptance increased when GABA content was lowered to 1.5%; rats preferred this diet when the alternative diet was made sufficiently aversive. There were large individual differences among rats selecting from pairs of unacceptable diets. Avoidance of, or preference for, a given diet is clearly affected by the relative aversive qualities of the offered pair of diets.


Radiology of the urinary tract: some physiological considerations. Annual oration in memory of John S. Bouslog, M.D., 1890-1973.
This paper reviews some of the fundamental technical and diagnostic problems in clinical uroradiology, such as (a) the reason for the obstructive nephrogram; (b) why high-dose urography gives better studies than low-dose; (c) why the Trueta phenomenon has not been demonstrated in man; (d) the case for an intrarenal arterial collateral pathway via the pericalyceal network (these vessels can be demonstrated in man and must not be misinterpreted as tumor vessels or vascular malformations). One of the most baffling problems sometimes occurs with the sudden partial block of a single segmental vessel: the kidney ceases to excrete urine and eventually becomes atrophic even though some excretory function returns. To date, there is no satisfactory explanation for this course of events.


Respiratory system model for quasistatic pulmonary pressure-volume (P-V) curve: generalized P-V curve analyses.
A normalized P-V curve is proposed for quantitative comparisons of quasistatic P-V curves from different sources, including data from different investigators, airway pressure-volume curves versus transpulmonary pressure-volume curves, normal versus injured respiratory system, and animal tests versus clinical data. Similarities and differences among five different data groups we analyzed are shown to be quantified through the nondimensional pressure range of an individual data set, combined with the magnitudes of two nondimensional parameters of the inflation limb, derived from a respiratory system model previously reported.


Comparison of intestinal lengthening procedures for patients with short bowel syndrome.
Review the clinical results of 24 years of intestinal lengthening procedures at one institution. Retrospective review of a single center experience comparing the outcome of 2 intestinal lengthening procedures (Bianchi and serial transverse enteroplasty [STEP]) in terms of survival, total parenteral nutrition (TPN) weaning, and complications. Sixty-four patients, including 14 adults, underwent 43 Bianchi and 34 STEP procedures between 1982 and 2007. Three patients had prior isolated liver transplants. The median (range) remnant bowel length before first lengthening was 45 (11-150) cm overall; (Bianchi=44 cm, STEP=45 cm) and 68 (20-250) cm after lengthening; (Bianchi=68 cm, STEP=65 cm). Actual survival is 91% overall (Bianchi 88%, STEP 95%) with median follow-up of 3.8 years (Bianchi=5.9 years, STEP=1.7 years). Average enteral caloric intake in pediatric patients was 15 kcal/kg before lengthening and 85 kcal/kg at 1 year after lengthening. Sixty-nine percent of patients are off TPN at most recent follow-up, including 8 who were weaned from TPN after intestinal transplantation. Liver disease (when present) was reversed in 80%. Surgical complications occurred in 10%, more commonly requiring reoperation after Bianchi than STEP. Intestinal transplantation salvage was required in 14% at a median of 2.9 years (range=8 months to 20.7 years) after lengthening. Surgical lengthening with both Bianchi and STEP procedures results in improvement in enteral nutrition, reverses complications of TPN and avoids intestinal transplantation in the majority with few surgical complications. Intestinal transplantation can salvage most patients who later develop life-threatening complications or fail to wean TPN.


Characterization and exposure measurement for indium oxide nanofibers generated as byproducts in the LED manufacturing environment.
This article aimed to elucidate the physicochemical characteristics and exposure concentration of powder and airborne particles as byproducts generated from indium tin oxide thin film process by an electron beam evaporation method during maintenance in light-emitting diode manufacturing environment. The chemical composition, size, shape, and crystal structure of powder and airborne particles as byproducts were investigated using a scanning electron microscope equipped with energy dispersive spectrometer, and an X-ray diffractometer. The number and mass concentration measurements of airborne particles were performed by using an optical particle counter of direct-reading aerosol monitor and an inductively coupled plasma-mass spectrometry after sampling, respectively. The airborne particles are composed of oxygen and indium. On the other hand, the powder byproducts consist mostly of oxygen and indium, but tin was found as a minor component. The shapes of the airborne and powder byproducts were fiber type. The length and diameter of fibrous particles were approximately 500-2,000 nm and 30-50 nm, respectively. The powder byproducts indicated indium oxide nanofibers with a rhombohedral structure. On the other hand, the indium oxide used as a source material in the preparation of ITO target showed spherical morphology with a body-centered cubic structure, and it was the same as that of the pure crystalline indium oxide powder. During maintenance, the number concentrations ranged from 350-75,693 particles/ft(3), and arithmetic mean±standard deviation and geometric mean±geometric standard deviation were 11,624±15,547 and 4,846±4.12 particles/ft(3), respectively. Meanwhile, under the same conditions, the airborne mass concentrations of the indium based on respirable particle size (3.5 µm cut-point 50%) were 0.09-0.19 µg/m(3). Physicochemical characteristics of nanoparticle can affect toxicity so the fact that shape and crystal structure have changed is important. Thus, nanoparticle occupational toxicology greatly needs observations like this.


Position statements: advocacy or futility?
This introduction lays the groundwork for this issue on a Collection of Oncology Nurses' Position Papers. Position papers developed by professional nursing organizations reflect a theoretical and research foundation. The position papers in this collection are relevant to oncology nurses in various practice settings and discuss how we can use them most effectively in our various roles as patient advocates.


Concentrations of Lead, Mercury, Arsenic, Cadmium, Manganese, and Aluminum in Blood of Romanian Children Suspected of Having Autism Spectrum Disorder.
Environmental exposure to lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), manganese (Mn), and aluminum (Al) has been associated with neurodevelopmental disorders including autism spectrum disorder (ASD). We conducted a pilot study during May 2015-May 2107 to estimate blood concentrations of six metals (Pb, Hg, As, Cd, Mn, and Al) and identify their associated factors for children with ASD or suspected of having ASD in Romania. Sixty children, age 2-8 years, were administered versions of ADOS or ADI-R translated from English to Romanian. After assessment, 2-3 mL of blood was obtained and analyzed for the concentrations of the six metals. The mean age of children was 51.9 months and about 90% were male. More than half (65%) of the children were born in Bucharest. Over 90% of concentrations of As and Cd were below limits of detection. Geometric mean concentrations of Pb, Mn, Al, and Hg were 1.14 μg/dL, 10.84 μg/L, 14.44 μg/L, and 0.35 μg/L, respectively. Multivariable linear regression analysis revealed that children who were female, had less educated parents, exhibited pica, and ate cold breakfast (e.g., cereal), watermelon, and lamb had significantly higher concentrations of Pb compared to their respective referent categories (all p < 0.05 except for eating lamb, which was marginally significant, p = 0.053). Although this is the first study that provides data on concentrations of the six metals for Romanian children with ASD, the findings from this study could be useful for designing future epidemiologic studies for investigating the role of these six metals in ASD in Romanian children.


The effects of bone chips dehydrated with solvent on healing bone defects.
The effect of bone chips dehydrated with solvent on the healing of bone defects was evaluated. Solvent-dehydrated spongiose bone chips were placed in experimentally formed cavities in the right back tibia of rabbits. After 10, 20 and 30 days, histopathological cross-sections from the bone grafts were examined microscopically for bone healing and formation of spongiose bone, cortex and bone marrow. Spongiose bone chips had a positive and accelerating influence on the healing of bone defects in the 10-day period after transplantation, but no significant differences were observed between the treated and control groups 20 and 30 days after transplantation.


Tumor Endothelial Cell-A Biological Tool for Translational Cancer Research.
Going from bench to bedside is a simplified description of translational research, with the ultimate goal being to improve the health status of mankind. Tumor endothelial cells (TECs) perform angiogenesis to support the growth, establishment, and dissemination of tumors to distant organs. TECs have various features that distinguish them from normal endothelial cells, which include alterations in gene expression patterns, higher angiogenic and metabolic activities, and drug resistance tendencies. The special characteristics of TECs enhance the vulnerability of tumor blood vessels toward antiangiogenic therapeutic strategies. Therefore, apart from being a viable therapeutic target, TECs would act as a better mediator between the bench (i.e., angiogenesis research) and the bedside (i.e., clinical application of drugs discovered through research). Exploitation of TEC characteristics could reveal unidentified strategies of enhancing and monitoring antiangiogenic therapy in the treatment of cancer, which are discussed in this review.


Chlamydial heat shock protein 60 and lipopolysaccharide: potential virulence determinants in atherogenesis.
Chlamydia pneumoniae infection is associated with atherosclerosis and may be an emerging risk factor in coronary artery disease. C. pneumoniae can infect, multiply within and modulate the function of all atheroma cell types. Specific chlamydial virulence determinants have been identified that permit interaction with host cells and dysregulate cell function. In particular, chlamydial heat shock protein 60 and lipopolysaccharide may modulate cell function to dysregulate lipid metabolism, induce inflammatory cytokine cascades and trigger production of cross-reactive antibodies that initiate and promote atherogenesis. This paper reviews chlamydial heat shock protein 60 and lipopolysaccharide as potential virulence determinants in atherogenesis.


[Prostate cancer detection by assessing stiffness of different tissues using shear wave ultrasound elastog- raphy].
Early detection of prostate cancer (PCa) remains a challenging issue. There are studies underway aimed to develop and implement new methods for prostate cancer screening by tumor imaging and obtaining tissue samples from suspicious areas for morphological examination. One of these new methods is shear wave ultrasound elastography (SWUE). The current literature is lacking sufficient coverage of informativeness and specificity of SWUE in the prostate cancer detection, there is no clear criteria for assessing tissue stiffness at different values of PSA and tumor grade, and in prostate hyperplasia and prostatitis. To evaluate the informativeness and specificity of SWUE compared with other diagnostic methods. SWUE has been used in the Clinic of Urology of Sechenov First MSMU since October 2015. During this period, 302 patients were examined using SWUE. SWUE was performed with Aixplorer ultrasound system (Super Sonic Imagine), which provides a single-stage SWUE imaging with both B-mode and real-time mode. The first group (prospective study) included 134 men aged 47 to 81 years with suspected prostate cancer scheduled to either initial or repeat prostate biopsy. PSA levels ranged from 4 to 24 ng/ml. The second group (retrospective study) comprised 120 men with confirmed prostate cancer and PSA levels between 4 and 90 ng/ml. The third group (the control group), comprised 48 healthy men whose PSA level did not exceed 3 ng/ml. All patients of the groups 1 and 2 underwent a standard comprehensive examination. Patients in group 1 were subsequently subjected to transrectal prostate biopsy guided by localization of areas with abnormal tissue stiffness. PCa was detected in 100 of 134 patients. 217 patients of groups 1 and 2 underwent radical prostatectomy. In 28 of them, the match between the cancer location and differentiation in the removed prostate and SWUE findings before surgery was examined. Contrast-enhanced magnetic resonance imaging of pelvic organs was performed in 63 patients of groups 1 and 2. Threshold values of stiffness (Emean) were determined, which normally range from 0 to 23 kPa, from 23.4 to 50 kPa in prostatic hyperplasia and 50.5 kPa and greater in prostate cancer. A total of 220 patients in groups 1 and 2 were found to have prostate cancer. The findings showed increased stiffness of prostate tissue depending on tumor differentiation, Gleason score, and hence, cancer risk. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) were calculated for SWUE, biopsy based on 6 peripheral points used during SWUE, and for histologic findings from prostate cross sections. When compared to needle biopsy, Se, Sp, PPV, NPV for SWUE were 90.8, 94.6, 56.6 and 97.9%, respectively. The study findings suggest a high diagnostic performance of SWUE in detecting prostate cancer.


CpG-based immunotherapy impairs antitumor activity of BRAF inhibitors in a B-cell-dependent manner.
Combining immunotherapy with targeted therapy has increasingly become an appealing therapeutic paradigm for cancer treatment due to its great potential for generating durable and synergistic antitumor response. In this study, however, we unexpectedly found that two types of CpG-based tumor peptide vaccine treatments consistently negated the antitumor activity of a selective BRAF inhibitor in tumors with BRAF mutation rather than showing a synergistic antitumor effect. Our further studies demonstrated that CpG alone was sufficient to dampen BRAF inhibitor-induced antitumor responses, suggesting that the impaired antitumor activity of the BRAF inhibitor observed in mice receiving CpG-based peptide vaccine is mainly dependent upon the use of CpG. Mechanistically, CpG increased the number of circulating B cells, which produced elevated amounts of tumor necrosis factor-α (TNFα) that contributed to the increased tumor resistance to BRAF inhibitors. More importantly, B-cell depletion or TNFα neutralization can restore the antitumor effect of BRAF inhibition in mice receiving CpG treatment, indicating that TNFα-secreting B cells play an indispensable role in BRAF inhibitor resistance induced by CpG. Taken together, our results strongly suggest that precautions must be implemented when designing combinatorial approaches for cancer treatment, because distinct regimens, despite their respective therapeutic benefit as monotherapy, may together provide antagonistic clinical outcomes.


Risk Factors for Functional Constipation in Young Children Attending Daycare Centers.
Our objective was to determine the risk factors associated with the development of functional constipation (FC) in young children attending daycare centers. A cross-sectional survey using a questionnaire based on the Rome III criteria was conducted in children aged 25 to 84 months from 3 randomly selected daycare centers in January 2016. The items in a questionnaire were statistically compared in the constipated and non-constipated groups. A total of 212 children were included and FC was found in 8.5%. Multivariate logistic regression analyses revealed that maternal history of constipation (odds ratio [OR] = 4.1, 95% Confidence Interval [CI] 1.2-13.9), history of painful defecation before age 1 (OR = 10.4, 95% CI 1.1-101.3), history of painful defecation during toilet training (OR = 28.9, 95% CI 1.9-423.8), no or difficult defecation at a daycare center (OR = 5,804.6, 95% CI 134.4-250,718.4), no meat consumption (OR = 10.1, 95% CI 1.2-88.1), and 500 mL or less of water intake per day (OR = 9.9, 95% CI 0.9-99.5) were powerful predictors of FC in young children (P < 0.05). Additionally, the constipated group was significantly associated with 2 hours or less of outdoor play activities per day, entry into daycare centers before 24 months age, 6 hours or more of attendance at a daycare center per day, breastfeeding for less than 6 months, 3 meals or less per day, and 3 or fewer servings of fruits and vegetables per day (P < 0.05). The findings of this study can guide parents, daycare teachers, and clinicians in prevention, early recognition and early intervention for the risk factors associated with FC in young children.


[Smartphone usage among adolescents].
Among our technological gadgets smartphones play the most important role, new generation devices offer other functions beyond calling (internet availability, computer games, music player, camera functions etc.) In everydays can be experienced that youth spend more and more time with their smartphones and despite the actuality of this issue there are no studies on the excessive smartphone usage in Hungary and we can find only a few international studies. Our goal is to examine smartphone usage in primary and secondary schools in Hajdu-Bihar county, Hungary and its relationship with personality traits. Our sample consist of 263 youth from primary and secondary schools. We measured the characteristics of smartphone using and attitudes with a Mobilephone Using Questionnare. Personality traits are measured with Impulsiveness, Venturesomeness, Empathy Scale. The Child Behavior Checklist gives information about peer relationships, mental state and emotions. Average phone using time is 4,48 hours per day regarding the whole sample. This mean for boys is 3,40 hour for girls 5,39 hour. Average phone using time is higher at 16 (6,35 hour per day). The most frequent used applications are calling and visiting community sites. There is no connection between phone using and grades. The smartphone using time per day shows a significant positive relationship with Impulsivity, Anxiety and Depression, Attention deficits and Somatic problems within 17-19 ages. One of the explanation of excessive smartphone using may be the frequent visiting of community sites. Mobile phones in this case raise the availability of addictive object (community site) therefore contribute to the development of community site addiction. The connection with impulsivity, somatic problems and attention deficits refer to the anxiety reducing role of smartphones within 17-19 ages.


Palliation of painful bone metastases: Strontium-89.
Most patients with bony metastases experience painful symptoms. Strontium-89 isotope therapy is an alternative to traditional hemibody radiation in cases of multiple, diffuse metastases. Generally given as a single i.v. slow-push infusion, relief begins in one to three weeks, peaks at six weeks, and has a mean duration of 12 months. Up to 22 percent of patients are pain-free at three months.


[Behavorial and psychological symptoms in dementia: what alternative to drug?].
Behavioral and psychological symptoms of dementia (BPSD) are frequent and represent a challenge for an optimal care of patients. They must be investigated systematically and if necessary analyzed with specialized teams in the domain of old age Psychiatry so that these disorders are optimally addressed and complications are prevented. A precise analysis of potential causes of BPSD in concertation with both family members and caring team allows clinicians to avoid the use of drugs that may appear to solve the immediate issue but happen to have serious side effects or even toxicity over time.


Progress in transcriptionally targeted and regulatable vectors for genetic therapy.
Safety is an important consideration in the development of genetic therapy protocols; for example, proteins that are therapeutic in the context of one tissue may be harmful in another. This is particularly relevant to suicide gene strategies for cancer, which require in vivo delivery of DNA and which, in general, demand that the therapeutic product be limited as far as possible to malignant cells. This has led to a requirement for "transcriptionally targeted" vectors that can restrict the expression of the therapeutic sequence to appropriate cells. Furthermore, there may be a therapeutic window for certain proteins such that levels of expression below and above certain thresholds may be ineffective or toxic, respectively. Therefore, it would also be desirable to create vectors that allow exogenous control of expression, so that levels of the therapeutic protein can be raised or lowered according to therapeutic need. In the context of transcriptional targeting, one may sometimes use cis-acting sequences to limit transgene expression to the target cell type. In genetic therapy for cancer, for example, it may be possible to identify and use transcriptional control elements that drive expression of proteins unique to, or over-expressed in, malignant cells. These controls would greatly reduce collateral expression of the transgene, and hence reduce toxicity to healthy cells. With regard to exogenous control of expression subsequent to transduction, several synthetic gene regulation systems have now been produced. In these systems, an inducer or repressor acts on a synthetic transcription factor that recognizes motifs unique to the promoter of the transgene; this allows regulated expression of the therapeutic protein without nonspecific effects on cellular promoters. It is likely that a vector will soon be produced in which tissue-restricted expression of the synthetic transcription factor is combined with regulatable transgene expression thereby allowing precise control of therapeutic protein production in specific tissues via administration of an inducing or repressing agent.


Expression of polyomavirus large T antigen by using a baculovirus vector.
A gene encoding the large T antigen of polyomavirus was inserted into the baculovirus Autographa californica nuclear polyhedrosis virus so that gene expression was under the control of the strong, very late polyhedrin gene promoter. Significantly more large T antigen was produced in recombinant virus-infected insect cells than was observed in polyomavirus-transformed mouse cells. The insect-derived T antigen exhibited polyomavirus origin-specific DNA binding. The baculovirus expression system provides a convenient source of T antigen for in vitro studies.


The modern paediatric injury pyramid: injuries in Massachusetts children and adolescents.
The objective of this study was to develop a modern version of the paediatric injury pyramid, a visual classification of injury severity, and to present mechanism-based pyramids. As the original paediatric injury pyramid was described in 1980, the injury epidemiology from 1980 was compared with 2004. Comprehensive emergency department, hospital discharge and death data for Massachusetts in 2004 were used to determine injury rates for residents aged 0-19 years. Injury pyramids were constructed on the basis of the number of injuries resulting in death, hospitalisations and emergency department visits. In 2004, unintentional and intentional injuries accounted for 197 deaths, 7120 hospitalisations and 199,814 emergency department visits giving a ratio of 1:36:1014. The 2004 injury pyramids differed by mechanism and intent. Compared with 1980, there were lower rates for overall injury and for most major injury mechanisms in Massachusetts in 2004.


[Determination of Salmonella typhimurium antigens in the excreta of children with salmonellosis using the passive hemagglutination reaction].
1,390 samples of different excreta obtained from salmonellosis patients have been tested for the presence of S. typhimurium O- and H-antigens. S. typhimurium antigens, detected with the use of antibody diagnostica, have been found to occur more frequently than S. typhimurium cells. Particulate O- and H-antigens capable of agglutinating antibody diagnostica are excreted differently with saliva and urine. Salmonella antigens are best detected in feces in the passive hemagglutination test with the use of antibody diagnostica, but not in the antibody neutralization test. The combination of the passive hemagglutination test, carried out with the use of antibody diagnostica, and bacteriological study considerably enhances the efficiency of diagnosing salmonellosis in children in comparison with bacteriological study alone.


Drug eluting balloons for resistant arteriovenous dialysis access stenosis.
Vascular access maintenance is vital for hemodialysis patients. Conventional balloon angioplasty is the gold standard of treatment in endovascular therapy according to published guidelines, accompanied by bare metal stents as a bail-out method. Several devices have been used so far with a view to improve patency outcomes, but only covered stents have been proposed as a valid alternative and only for venous juxta-anastomotic stenosis of arteriovenous grafts. Paclitaxel-coated balloons (PCBs) have been extensively investigated in the last few years in pilot studies with small numbers of patients in dialysis access. Results from these studies have been promising so far; however, a larger number of subjects is needed to prove outcomes. Aim of this analysis is to discuss current available studies and explore some critical aspects of PCB use in dialysis access treatment.


Acute chorea: case series from the emergency room of a Brazilian tertiary-level center.
Chorea is a movement disorder characterized by random, brief and migratory involuntary muscle contractions. It is defined as acute when present within hours to days. Three main causes for this scenario have emerged as most likely: vascular, toxic-metabolic and inflammatory. To identify the prevalence of the main etiologies and major clinical findings of acute chorea in the emergency room of a tertiary-level referral center; and to suggest an approach for guiding the diagnostic workup and clinical management. We retrospectively reviewed the clinical aspects and neuroimaging data of 10 patients presenting with acute chorea at the neurological emergency room of our hospital from 2015 to 2019. Stroke was the most common etiology (50% of the cases). All of them were ischemic. It was noteworthy that only one case demonstrated the classical ischemic topographic lesion at the contralateral subthalamic nuclei. Regarding nonvascular etiologies, nonketotic hyperglycemia was the major cause, followed by drug-related chorea. One patient showed inflammatory etiology, which was probably Sydenham chorea reactivation. Acute chorea is an uncommon and challenging problem at the emergency room, often associated with potentially treatable causes. We suggest that use of the acronym DANCE (Diagnosis of chorea, Acute stroke protocol, Normal glucose levels, Check neuroimaging, Exposure to drugs) could form a potential initial approach in the evaluation, in order to emphasize causes that require prompt proper management (e.g. thrombolysis).


[DNA-RNA cytofluorometry for a primary cancer of the stomach and choledochus].
We standardized DNA-RNA cytofluorometry with AO stain using a NIKON SPM-RFI-D instrument for cell smears. We applied this technique in a 72-year-old woman with primary double cancer of the stomach and choledochus. We first suspected malignancy of the choledochus and examined the desquamated cells in the bile cytofluorometrically to obtain by X-Y plotting the irregularly increased polyploid cells with a high percentage of cells in S phase. These polyploid cells and S phase cells were found to have an increased RNA content. Before operation, the presence of another malignancy of the stomach was also ascertained. The surgical specimens were diagnosed histopathologically as well differentiated, tubular adenocarcinoma of the stomach and moderately differentiated, tubular adenocarcinoma of the choledochus. By cytofluorometric analysis similar results were obtained, i.e., polyploidization with increase of S phase cells. Based on these results, we concluded that our method is useful for the diagnosis of alimentary tract malignancy, and that the criteria of malignancy appear to be unusual polyploidization with increased fractions of S phase cells.


Gene therapy for acute liver failure.
Acute liver failure (ALF) is a life-threatening medical emergency and occurs when the liver rapidly loses its function within a short period. ALF can develop secondary to a variety of causes. Currently, the orthotopic liver transplantation is the "Gold Standard" therapy for the disease. However, due to the limited availability of donor organs and rapid progression of the disease, the mortality of ALF remains high. Therefore, it is imperative to develop novel therapeutic reagents for ALF. Gene therapy by delivering a target gene to the patients appears to be a promising approach for the treatment of ALF. Here, we review the recent advance of gene therapy for ALF, focusing on the three technical elements, animal models, vehicles for gene delivery and technique for gene delivery, which are important for the success of gene therapy as well as the potential targets used for the treatment of ALF.


A large quantity synthesis of ultra-thin ZnO nanobelts induced from stacking faults.
Thin ZnO nanobelts with average width of 7.5 nm have been synthesized using vapor phase transport method. It was found that stacking faults directed the growth of the thin nanobelts along the (0110) direction with {2110} top/bottom surfaces and {0001} side surfaces. The {0002} stacking fault with translation of 1/3(0110) extends throughout entire length of the ZnO nanobelts. The growth steps at the {0110} growth fronts resulted from the {0002} stacking fault are believed to direct fast axial growth of the thin ZnO nanobelts. The thin ZnO nanobelts are expected to be promising candidates for highly sensitive chemical and biological sensor applications.


Diagnosis of bladder cancer from the voided urine specimens using multi-target fluorescence in situ hybridization.
The present study aimed to evaluate the diagnostic value of chromosomal analysis by fluorescence in situ hybridization (FISH) for bladder cancer in light of the histological diagnosis. Several valuable observations using FISH technologies in voided urine cells were also reported. The multi-target FISH-containing probes for the centromeres of chromosomes 3, 7 and 17 and the 9p21 locus were applied to cytospin specimens prepared from voided urine. Urine samples from 53 bladder cancer patients and 30 patients with benign alterations were used for this study. The histological observations of surgical resection specimens showed that the specificity and sensitivity for the technique were 100.0 and 88.0%, respectively. Statistical analyses showed that there was no significant correlation between FISH-positive rate and the tumor stage/grade (P<0.05). However, the proportion of tumor cells with genetic abnormalities positively correlated with the tumor stage (P<0.01). Furthermore, the number of abnormal cells in muscle-invasive pT2 was significantly higher than that in non-muscle-invasive pTa, pT1 (P<0.01). Of 50 patients with bladder cancer, polysomies of chromosomes 3, 7 and 17 were detected in 84.0, 48.0 and 78.0% of cases, respectively, and loss of the 9p21 gene was detected in 80.0% of cases. In addition, the detailed results from different urine specimens showed that FISH assay was required. FISH assay for chromosomes 3, 7 and 17 and 9p21 has a high specificity and sensitivity in the detection of bladder cancer and may reduce the necessity for cytoscopy treatment.


Visual development. From darkness into light.
The spatio-temporal pattern of spontaneous electrical activity in retinal neurons before the onset of visual responsiveness may provide information used in the development of orderly connections in the visual system.


Use of calcaneal ultrasound and biochemical markers to assess the density and metabolic state of the bones of adults with hepatic cirrhosis.
Bone loss has been shown to be associated with chronic liver disease (CLD) caused by ethanol consumption or viral infection, and trabecular bone is affected more than cortical bone. We therefore used calcaneal ultrasound to compare the bone status of 54 males and 20 females with CLD in northern Nigeria with 88 age- and gender-matched healthy controls. Serum levels of bone-specific alkaline phosphatase (BSAP) and the N-terminal telopeptide of type-1 collagen (NTx) were also measured to estimate relative rates of bone synthesis and turnover, respectively. The mean stiffness index (SI) of the males with CLD and the male controls were not different; however, the mean SI of the female subjects with CLD was lower than for the female controls (101 vs. 86, p=0.003). The levels of NTx and BSAP were markedly elevated in the males, but not in the females, with CLD. Liver function tests did not correlate with ultrasound parameters or biochemical markers of bone metabolism. These results show that Nigerian women, but not males, with CLD have decreased bone density as assessed by calcaneal ultrasound; however, the high rate of bone turnover in Nigerian males with CLD indicates that they are at risk for bone loss.


Phylogenetic analysis of Hoxa 11 sequences reveals absence of transposable elements, conservation of transcription factor binding sites, and suggests antisense coding function.
Nine thousand and eighty-eight base pairs of the chicken Hoxa 11 gene, including 8470 bases 5' of the translation start site were sequenced, and the characteristics of the upstream sequence investigated. Consistent with previous findings that middle repetitive elements are rare in the HoxA cluster, no repetitive elements were found other than simple oligonucleotide repeats. Multiple and pairwise alignments of the chicken upstream sequence with its human and mouse orthologs revealed multiple regions of 80% or higher homology across species. For the chicken, these regions were separated by sequences with no significant homology to human, mouse, or in most cases any other Genbank sequences. Selective clustering of transcription factor binding motifs was found to occur within the conserved homologous regions, suggesting evolutionary conservation of critical regulatory sequences. Of particular interest, seven conserved Cdx binding sites were found in the Hoxa 11 promoter, suggesting regulation by a non-clustered Caudal homeobox gene. Previous analysis of the mouse and human Hoxa 11 genes found a conserved antisense transcript, of unknown function. The chicken Hoxa 11 antisense strand included a conserved open reading frame capable of encoding 168 amino acids. Comparison of this region in mouse and chicken showed seven insertion/deletions, with each a multiple of three bases, thereby preserving open reading frame.


Absence of YbeY RNase compromises the growth and enhances the virulence plasmid gene expression of Yersinia enterocolitica O:3.
YbeY was recently recognized as an endoribonuclease playing a role in ribosome biosynthesis. In Escherichia coli it functions as a single-strand-specific RNase that processes the 3' end of the 16S rRNA and is crucial for the late-stage 70S ribosome quality control system. Here we report that YbeY is not essential in Yersinia enterocolitica serotype O:3, yet its absence strongly compromised the bacterium. The lack of YbeY resulted in misprocessing of 16S rRNA and a severe decrease of growth rate with complete growth arrest observed at elevated temperatures. Moreover, a ybeY mutation severely disturbed regulation of the Yersinia virulence plasmid (pYV) genes and affected the expression of regulatory small RNA species. Transcription of the pYV genes was upregulated in the ybeY mutant at 22 °C; the same genes were repressed in the wild-type bacterium. Furthermore, ybeY inactivation impaired many virulence-related features, such as resistance to elevated temperature and acid, and hindered utilization of different carbohydrates. In addition, the ybeY mutant strain showed decreased infectivity in a tissue culture infection model, especially at the stage of cell adhesion. Taken together, this study demonstrates the crucial role of YbeY in Y. enterocolitica O:3 physiology and pathogenicity.


Salmonella-a new threat to neonates.
Hospital admitted 582 neonates with suspected septicaemia were studied in Microbiology Department of Dhaka Medical College, Dhaka, Bangladesh. Samples being taken from neonatal unit of Dhaka Medical College Hospital and a Neonatal Private Hospital in one year (January to December 2004). Blood culture was done by Lytic-centrifugation method. The isolated organisms were identified using standard laboratory procedures. Among 582 sick neonates 59(10.14%) were culture positive and the predominant organisms were Gram Negative Bacteria (89.83%). Among the isolates Klebsiella spp. was the prime organism (33.90%). Salmonella was observed as the 2nd most common cause (22.03%) for sepsis of neonates. Of these isolated Salmonella strains 46.15% were Salmonella typhi and 53.85% were Salmonella spp. Next to Imipenem, Ciprofloxacin was observed as the drug of choice for treatment of Sepsis neonatorum.


Suppression by protein kinase C inhibitors of tumor promoter enhancement of Epstein-Barr virus-induced growth transformation.
The tumor promoter teleocidin activates latent Epstein-Barr virus (EBV) genomes and enhances EBV-induced growth transformation of human B cells, with an activity comparable to that of 12-O-tetradecanoyl-phorbol-13-acetate (TPA). It has been suggested that the TPA induction of EBV genomes is mediated by protein kinase C (PKC), an enzyme closely linked to signal transduction. We examined newly isolated, highly selective PKC inhibitors, UCN-01 (7-hydroxyl-staurosporine) and calphostin C, for the possible suppression of teleocidin enhancement of cord blood B lymphocyte growth transformation by EBV. 0.2 nM teleocidin B4 enhanced EBV-induced 3H-thymidine uptake 6 times, outgrowth in limiting dilution culture 5 times, and colony formation in semisolid agar 3 times. All these events were suppressed by exposure to 10-100 nM UCN-01 or to calphostin C. Our findings suggest that the tumor promoter enhancement of EBV growth transformation is probably mediated by PKC.


A clinical decision support tool to predict survival in cancer patients beyond 120 days after palliative chemotherapy.
Palliative chemotherapy is often administered to terminally ill cancer patients to relieve symptoms. Yet, unnecessary use of chemotherapy can worsen patients' quality of life due to treatment-related toxicities. Thus, accurate prediction of survival in terminally ill patients can help clinicians decide on the most appropriate palliative care for these patients. However, studies have shown that clinicians often make imprecise predictions of survival in cancer patients. Hence, the purpose of this study was to create a clinical decision support tool to predict survival in cancer patients beyond 120 days after palliative chemotherapy. Data were obtained from a retrospective study of 400 randomly selected terminally ill cancer patients in the National Cancer Centre Singapore (NCCS) from 2008 to 2009. After removing patients with missing data, there were 325 patients remaining for model development. Three classification algorithms, naive Bayes (NB), neural network (NN), and support vector machine (SVM) were used to create the models. A final model with the best prediction performance was then selected to develop the tool. The NN model had the best prediction performance. The accuracy, specificity, sensitivity, and area under the curve (AUC) of this model were 78%, 82%, 74%, and 0.857, respectively. Five patient attributes (albumin level, alanine transaminase level (ATL), absolute neutrophil count, Eastern Cooperative Oncology Group (ECOG) status, and number of metastatic sites) were included in the model. A decision support tool to predict survival in cancer patients beyond 120 days after palliative chemotherapy was created. With further validation, this tool coupled with the professional judgment of clinicians can help improve patient care.


Periodontal ligament fibroblasts as a cell model to study osteogenesis and osteoclastogenesis in fibrodysplasia ossificans progressiva.
Fibrodysplasia Ossificans Progressiva (FOP) is a progressive disease characterized by periods of heterotopic ossification of soft connective tissues, including ligaments. Though progress has been made in recent years in unraveling the underlying mechanism, patient-derived cell models are necessary to test potential treatment options. Periodontal ligament fibroblasts (PLF) from extracted teeth can be used to study deviant bone modeling processes in vitro since these cells are derived from genuine ligaments. They further provide a tool to study the hitherto unknown role of the bone morphogenesis protein receptor type 1 (BMPR-1) Activin A type 1 receptor ACVR1-R206H mutation in osteoclastogenesis. To further validate this potential model, osteogenesis and osteoclastogenesis was studied in the presence of TGF-β/activin receptor inhibitor GW788388. Control and FOP fibroblasts (n=6 of each) were used in osteogenesis and osteoclastogenesis assays in the absence or presence of TGF-β/activin receptor inhibitor GW788388. For osteogenesis, alkaline phosphatase (ALP) activity, alizarin red staining for mineralization and qPCR for expression of osteogenic markers was assessed. TRACP staining, multinuclearity and expression of osteoclastogenesis markers were used as a measure of osteoclast formation. FOP fibroblasts cultured in osteogenic medium displayed a trend of higher ALP activity at 7days. Gene expression of ALP from FOP fibroblasts was significantly higher at 3days. Mineralization was similar at 21days for both groups. GW788388 did not influence mineral deposition in both groups. Osteoclast formation was inhibited by GW788388 on plastic for both controls and FOP. On cortical bone slices, however, osteoclast formation was significantly lowered by GW788388, only in FOP cultures. qPCR revealed strong expression of RANKL at 7days and a significant decline at 14 and 21days in both FOP and control cultures. In contrast to the osteoclastogenesis results, the RANKL/OPG ratio was higher in the presence of GW788388, only in FOP cultures. TGF-β expression was significantly higher at 14 and 21days compared to 7days, possibly signifying a role in later stages of osteoclast formation. Addition of GW788388 strongly decreased TGF-β expression. Our study shows that periodontal ligament fibroblasts from FOP patients displayed at most slightly enhanced in vitro osteogenesis and osteoclastogenesis. This model could be useful to elucidate molecular mechanisms leading to heterotopic ossification in FOP such as in the presence of specific ACVR1-R206H activators as Activin A.


Dermoid cyst in undescended testis in a 9-year-old boy.
Testicular dermoid cysts are rare in the pediatric age group: their discovery in an undescended testis is exceptional. The origin of this lesion is still unclear, but it should be considered as a monolayer expression of a mature teratoma. Though surgeons when confronted with these intratesticular cysts have traditionally opted for castration, in presence of small, compact masses, simple enucleation may be recommended, provided that the integrity of the neighboring parenchyma is not affected.


[Down-regulation of expression of survivin and induction of apoptosis in the human Burkitt lymphomas cells by ligation of CD40-CD40L].
To study the biological effects of ligation of CD40 mediated by soluble recombinant human CD40 ligand (srhCD40L) on the human malignant hematogenous cells and to explore the molecular mechanism thereof. Human Burkitt lymphoma cells of the line CA46 were cultured. Flow cytometry was used to detect the expression of CD40 molecule on the cell surface. CA46 cells were put into 96-well plate and added with solutions of srhCD40L of the terminal concentrations of 0.04 microg/ml, 0.2 microg/ml, 1.0 microg/ml, and 5.0 microg/ml respectively, and 24, 28, 72, 96, and 120 hours later cell growth curve was drawn. MTT assay was used to other CA46 cells co-incubated with srhCD40L of the terminal concentrations of 0.04 microg/ml, 0.2 microg/ml, 1.0 microg/ml, and 5.0 microg/ml respectively so as to calculate the proliferation inhibition rate. CA46 cells were treated with srhCD40L of the concentrations of 1.0 microg/ml for 24, 48, and 72 hours respectively, FCM was used to analyze the DNA cycle and TUNEL was used to calculate the apoptotic rate. Annexin-V labeling method was used to detect the positive rate of apoptotic cells. CA46 cells were treated with srhCD40L of the concentration of 1 microg/ml for 24, 48, 72, or 96 hours, semi-quantitative RT-PCR was used to detect the mRNA expression of survivin, an anti-apoptosis protein, and the protein expression of survivin was detected by Western blotting. The expression rate of CD40 in the human Burkitt CA46 cells was 99%. srhCD40L dose-dependently inhibited the proliferation of the CD46 cells. Treated by srhCD40L, the progress of cells at S stage into G(2)/M stage was inhibited. TUNEL showed that treated by srhCD40L (1.0 microg/ml) for 24, 48, and 72 hours the apoptotic rates of the cells were 9%, 18%, and 35% respectively. Annexin-V showed that after incubation with srhCD40L (1.0 microg/ml) for 24 h the apoptotic rate was 10.04%. Two apoptotic peaks appeared 48 and 72 hours later. Semi-quantitative RT-PCR and Western blotting showed that the survivin mRNA expression and protein expression were both down-regulated. Ligation of CD40 by srhCD40L inhibits the proliferation of malignant hematogenous cells and induces their apoptosis. Expression of survivin mRNA and protein may be related to cell growth inhibition and to the apoptosis mediated by Ligation of CD40 by srhCD40L.


[Low dose contrast-enhanced 4D DSA with the 320-detector row computed tomography scanner for post-operative evaluation of the hepatic artery complications after liver transplantation].
To evaluate the value of low-dose contrast-enhanced 4D DSA acquired from 320-detector row CT on the diagnosis of the hepatic artery complications after liver transplantation. 320-detector row CT were performed in fifth patients with liver dynamic enhanced using volume CT body-perfusion protocol, hepatic artery phase images obtained after intravenous injection of 50 ml of contrast at a rate of 6 ml/s were acquired based on 4D DSA. The time-density curve (TDC) of the hepatic artery was delineated. The time to peak, peak contrast enhancement were recorded. The data of artery phase were sent to workstation to reconstruct the hepatic artery with VR, MIP and MPR. The delay mean time and the peak CT value of hepatic artery was 20 (10.0 - 24.2) s and 373 (310 - 440) HU; 4D DSA revealed hepatic artery pseudo-aneurysm (n = 2), and hepatic artery mild stenosis (n = 3), moderate stenosis (n = 4), severe stenosis (n = 1) and occlusion (n = 1). Compensatory circulation was seen in 2 cases. 4 patients were appeared segmental stenosis and hepatoportal arteriovenous fistulas (HPAVF). Hepatic arterial branch are decreased and opened in 9 cases and 4 cases. 4D DSA also displayed other signs including hepatic hemangioma and the splenic artery aneurysms (SAA) and ectasi (n = 1), donor-recipient hepatic artery mismatch (n = 3). 4D DSA provided a safe, noninvasive and accurate method for guiding the diagnosis of hepatic artery complication and play an effective role after liver transplantation.


[Trends in the prevalence of tuberculosis among six-year-olds in Albacete (Spain)].
To analyze the prevalence and evolution of tuberculous infection among 6-year-olds in Albacete and its relation to socioeconomic status of the family. A tuberculin test (2UT RT-23 Tween 80) was given to 6-year-old school children in and around Albacete in 1992 and 1999. We calculated the prevalence of tuberculosis and the relation to family socioeconomic level as assessed by the parents' level of education of the area of residence. The tuberculin test was given to 2,783 children, 1,532 in 1992 (8% bacille-Calmette-Guerin-vaccinated) and 1,251 in 1999. The prevalence of tuberculosis infection among non-vaccinated children was 0.78% in 1992 (3.37% among vaccinated children, p = 0.012) and 0.72% in 1999. No significant differences between the two screenings were found except for the vaccinated and non-vaccinated children. The annual decline was 1.1% and the annual decrease in risk of tuberculosis infection was 0.12%. No significant differences related to level of parental education or area of residence were detected. The prevalence of tuberculosis infection among 6-year-old school children in Albacete is low, although there is a very slight non-significant downward trend, which may be biased by the inclusion of bacille-Calmette-Guerin-vaccinated children. No differences related to family socioeconomic level were found.


Incidence of pathogenic bacteria from mesenteric lymph nodes and ileal serosa during Crohn's disease surgery.
Samples of ileal serosa and mesenteric lymph nodes have been harvested before antibiotic administration during 46 non-contaminated operations for Crohn's disease and compared with 43 operations for conditions other than Crohn's. Potentially pathogenic bacteria were isolated from the serosa in 12 (27 per cent) Crohn's patients, compared with 6 (15 per cent) controls (P = 0.04). Intestinal bacteria were recovered from mesenteric nodes in 15 (33 per cent) Crohn's patients compared with 2 (5 per cent) controls (P = 0.006). These findings suggest that bacteria leak from the small bowel lumen in a high proportion of Crohn's disease patients. This may explain the pathogenesis of abscess and fistula in this disorder as well as the high rate of sepsis following elective surgery even in the absence of macroscopic contamination.


[Birth Cohort Technical Specification Part 1: Field Survey (T/CPMA 015.1-2020)].
Field survey is an important foundation for of birth cohort. In a field survey, data such as the environmental exposures, genetics, lifestyle and biological samples will be collected. This document establishes specifications for institutions' establishment, site preparation, coding system, the recruitment of participants, and quality control in the field survey of birth cohort research.


Myocarditis secondary to Borrelia infection in a dog: a case report.
The aim of this study was to recognise the etiological factor of a disease with symptoms of lameness and cardiac failure, which occurred in one dog 4 weeks after invasion by ticks. A serological examination as well as molecular examination (PCR) was done. In the sample of the serum, the presence of antibodies specific to Borrelia burgdorferi were detected. Antibiotic therapy with doxycycline did not cause significant improvement, so the owners of the dog decided about its euthanasia. During the necroscopy, a dilated heart was recognised. In the heart samples, the genetic material of Borrelia was detected. The results of serological and molecular examinations showed that in the discussed case, an etiological factor of the disease was spirochetes. In light of the research, veterinary practitioners should keep in mind the presence of Lyme disease in dogs in Poland and include it in differential diagnoses for lameness and cardiological problems.


Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial.
Cash-transfer programmes can improve the wellbeing of vulnerable children, but few studies have rigorously assessed their effectiveness in sub-Saharan Africa. We investigated the effects of unconditional cash transfers (UCTs) and conditional cash transfers (CCTs) on birth registration, vaccination uptake, and school attendance in children in Zimbabwe. We did a matched, cluster-randomised controlled trial in ten sites in Manicaland, Zimbabwe. We divided each study site into three clusters. After a baseline survey between July, and September, 2009, clusters in each site were randomly assigned to UCT, CCT, or control, by drawing of lots from a hat. Eligible households contained children younger than 18 years and satisfied at least one other criteria: head of household was younger than 18 years; household cared for at least one orphan younger than 18 years, a disabled person, or an individual who was chronically ill; or household was in poorest wealth quintile. Between January, 2010, and January, 2011, households in UCT clusters collected payments every 2 months. Households in CCT clusters could receive the same amount but were monitored for compliance with several conditions related to child wellbeing. Eligible households in all clusters, including control clusters, had access to parenting skills classes and received maize seed and fertiliser in December, 2009, and August, 2010. Households and individuals delivering the intervention were not masked, but data analysts were. The primary endpoints were proportion of children younger than 5 years with a birth certificate, proportion younger than 5 years with up-to-date vaccinations, and proportion aged 6-12 years attending school at least 80% of the time. This trial is registered with ClinicalTrials.gov, number NCT00966849. 1199 eligible households were allocated to the control group, 1525 to the UCT group, and 1319 to the CCT group. Compared with control clusters, the proportion of children aged 0-4 years with birth certificates had increased by 1·5% (95% CI -7·1 to 10·1) in the UCT group and by 16·4% (7·8-25·0) in the CCT group by the end of the intervention period. The proportions of children aged 0-4 years with complete vaccination records was 3·1% (-3·8 to 9·9) greater in the UCT group and 1·8% (-5·0 to 8·7) greater in the CCT group than in the control group. The proportions of children aged 6-12 years who attended school at least 80% of the time was 7·2% (0·8-13·7) higher in the UCT group and 7·6% (1·2-14·1) in the CCT group than in the control group. Our results support strategies to integrate cash transfers into social welfare programming in sub-Saharan Africa, but further evidence is needed for the comparative effectiveness of UCT and CCT programmes in this region. Wellcome Trust, the World Bank through the Partnership for Child Development, and the Programme of Support for the Zimbabwe National Action Plan for Orphans and Vulnerable Children.


The Impact of Gender, Nativeness, and Subject Matter on the English as a Second Language University Students' Perception of Instructor Credibility and Engagement: A Qualitative Study.
In instructional contexts, instructor credibility or ethos is deemed to play a paramount role in teacher-student interaction and relationships. Much effort has been devoted to instructor credibility conceptualization, measurement, and its association with other instructional variables of interest in dominantly quantitative inquiries. However, little research has been undertaken in second-language education in which communication is both a means and an end. This qualitative research set out to explore the perception of the students of instructor credibility in the context of higher English education and how gender, nativeness, and subject matter might impact their perceptions. It also aimed to study how instructor credibility could, in turn, influence the engagement and success of the students. Thirteen senior students of English as a foreign language from a university in Iran participated in this study. They were given a scenario about their prospective professors for two courses of "Research Methodology" and "Essay Writing." The professors included four native English- and Persian-speaking male and female PhD holders. The participants were, then, interviewed about their perceptions of instructor credibility, their choices of instructors, and how they would affect their engagement. The data were recorded, transcribed, and recursively analyzed using an inductive thematic analysis. While instructor credibility is commonly characterized as a three-dimensional construct, involving competence, character, and caring, the data analysis generated a new component of performance concerned with the effectiveness of classroom knowledge presentation and activity organization. Caring also emerged as a constituent of a more inclusive component of rapport. Interestingly, albeit they viewed native English professors as generally more competent due to their nativeness, they perceived non-native professors as more credible for both courses, mainly because of their rapport building and familiarity with the needs and challenges of the students. Most of the participants also viewed male professors as more competent and communicative for both courses. The participants also tended to argue that perceived instructor credibility would encourage them to put in more effort in their academic undertakings and to engage in class activities. This would ultimately enhance their academic achievements and success. The paper discusses the findings and implications for second-language instructor credibility conceptualization and practice.


MIC Distributions and Evaluation of Fungicidal Activity for Amphotericin B, Itraconazole, Voriconazole, Posaconazole and Caspofungin and 20 Species of Pathogenic Filamentous Fungi Determined Using the CLSI Broth Microdilution Method.
For filamentous fungi (moulds), species-specific interpretive breakpoints and epidemiological cut-off values (ECVs) have only been proposed for a limited number of fungal species-antifungal agent combinations, with the result that clinical breakpoints are lacking for most emerging mould pathogens. In the current study, we have compiled minimum inhibitory concentration (MIC) data for 4869 clinical mould isolates and present full MIC distributions for amphotericin B, itraconazole, voriconazole, posaconazole, and caspofungin with these isolates which comprise 20 species/genera. In addition, we present the results of an assessment of the fungicidal activity of these same five antifungal agents against a panel of 123 mould isolates comprising 16 of the same species.


Chondrocyte cell death mediated by reactive oxygen species-dependent activation of PKC-betaI.
Signals generated by the extracellular matrix (ECM) promote cell survival. We have shown that chondrocytes detached from their native ECM and plated without serum at low density on poly-l-lysine undergo significant cell death that is associated with the production of reactive oxygen species (ROS). No cell death or ROS production was observed when cells were plated on fibronectin under the same conditions. Cell death on poly-l-lysine could be completely inhibited with the addition of either antioxidants or inhibitors of specific protein kinase C (PKC) isoforms including PKC-betaI. PKC-betaI was noted to translocate from the cytosol to the particulate membrane after plating on poly-l-lysine, and this translocation was inhibited by the addition of an antioxidant. Time-course analyses implicated endogenous ROS production as a secondary messenger leading to PKC-betaI activation and subsequent chondrocyte cell death. Cell survival on poly-l-lysine was significantly improved in the presence of oligomycin or DIDS, suggesting that ROS production occurred via complex V of the electron transport chain of the mitochondria and that ROS were released to the cytosol via voltage-dependent anion channels. Together, these results represent a novel mechanism by which ROS can initiate cell death through the activation of PKC-betaI.


Adolescent Health: Substance Use.
Substance use in adolescents affects brain development and can influence health in adulthood. The substances most commonly used by adolescents are alcohol, cannabis, and tobacco. Adolescent alcohol use has been shown to inhibit and alter normal brain development, and has been associated with alcohol use disorder and other mental disorders in adulthood. Cannabis use during adolescence has been associated with adverse mental health outcomes. Adolescents may incorrectly assume that the negative health effects of smoking will not affect them. Electronic nicotine delivery systems, such as e-cigarettes, for vaping may be used to inhale nicotine, cannabis, or both. Strong family relationships and parental monitoring are protective factors against substance use. Screening at every preventive services visit is an essential element of adolescent care. The evidence-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) strategy has been shown to decrease substance use and its adverse effects in adolescents. On societal and community levels, family physicians have numerous opportunities to advocate for adolescent well-being and prevention of substance use. The American Academy of Family Physicians (AAFP) recommends that family physicians advocate for legislation and governmental policies that facilitate the prevention, diagnosis, and treatment of substance use.


Thyroid hormone deiodinases revisited: insights from lungfish: a review.
In vertebrates, hormones released from the thyroid gland travel in the circulation to target tissues where they may be processed by deiodinating enzymes into more active or inactive iodothyronines. In mammals, there are three deiodinating enzymes described. Type1 (D1), which primarily occurs in the liver, converts reverse T3 into T2 for clearance. It also converts T4 into T3. This production of T3 is believed to contribute to the bulk of circulating T3 in mammals. The type2 (D2) enzyme may be found in many other tissues where it converts T4 to T3, which is then transferred to the receptors in the nucleus of the same cell, i.e. does not contribute to the circulating T3. The type3 (D3) enzyme converts T3 into T2. The expression of the genes for these three enzymes and/or the activity of the enzymes have been studied in several non-mammalian groups of vertebrates. From agnathans to birds, D2 and D3 appear to occur universally, with the possible exception of squamate reptiles (lack D2?). D1 has not been found in amphibians, lungfish or agnathans. All three enzymes are selenoproteins, in which a selenocysteine is found in the active centre. The nucleotide code for translation of a selenocysteine is UGA, which under normal circumstances is a stop codon. In order for UGA to code for selenocysteine, there must be a SECIS element in the 3'UTR of the mRNA. Any disruption of the SECIS will result in a truncated protein in the region of its active centre. It is suggested that such alternative splicing may be a mode of altering the expression of deiodinases in particular tissues to change the response of such tissues to thyroid hormones under differing circumstances such as stages of development.


Postoperative segmental C5 palsy after cervical laminoplasty may occur without intraoperative nerve injury: a prospective study with transcranial electric motor-evoked potentials.
Intraoperative neurophysiologic monitoring with transcranial electric motor-evoked potentials was performed on patients who underwent cervical laminoplasty at a university hospital in a prospective study. To evaluate the usefulness of intraoperative spinal cord monitoring with transcranial electric motor-evoked potentials for prediction of the occurrence of segmental motor paralysis after cervical laminoplasty. Segmental motor paralysis occasionally occurs among patients who undergo expansive laminoplasty for cervical myelopathy, and it has been attributed to nerve root lesions caused by either a traumatic surgical technique or a tethering effect after decompression. Sixty-two consecutive patients (47 men and 15 women; mean age 64 years [range 32-89]) who were scheduled to undergo cervical laminoplasty under intraoperative spinal cord monitoring with transcranial electric motor-evoked potentials were included in this study. Transcranial electrical stimulations were delivered through pin-type electrodes, and the evoked potentials were recorded over the deltoid, biceps, and triceps muscles in the bilateral upper extremities and thoracic spinal cord. Intraoperative evoked potentials were successfully recorded in all muscles in 57 patients (92%), and incomplete evoked potentials were recorded in the remaining 5 patients. No critical decrease in the amplitude of the evoked potentials was observed in any of the 62 patients. All patients showed sufficient postoperative recovery from their clinical symptoms; however, postoperative transient C5 palsy occurred in 3 patients. No abnormalities were observed on transcranial electric motor-evoked potential monitoring, even in those patients who developed postoperative transient C5 palsy. These results suggest that the development of postoperative C5 palsy after cervical laminoplasty is not associated with intraoperative injury of the nerve root or the spinal cord, although the precise mechanism of its development is still unclear. Surgeons should be aware that C5 palsy is a possible complication of cervical laminoplasty, even in the absence of intraoperative nerve injury.


Bochdalek hernia with intrathoracic spleen treated by robotic-assisted mesh repair utilizing indocyanine green contrast media intraoperatively. A case report.
Bochdalek hernias are usually diagnosed in newborns. However, they can occur in adults. Few reports exist regarding robotic repair of such hernias. We present a case of a female patient with symptomatic Bochdalek hernia, including the spleen. Patient was successfully treated by robotic-assisted surgical mesh with the use of indocyanine green (ICG). An 80-year-old female patient presented with dyspnea, angina and intermittent abdominal pain. She had loss of appetite and 15-kg weight loss within 3 months. Past medical history was unremarkable. Imaging revealed a left Bochdalek hernia. The patient underwent robotic-assisted surgery; hernia contents included stomach, parts of colon, omentum and remarkably the spleen. Sac was dissected free. Patency of organs was assessed with ICG. Diaphragmatic defect was repaired with mesh. Bochdalek hernias should be surgically repaired. Minimally invasive therapy is safe and effective. Intraoperative ICG use can provide excellent results with favorable clinical outcomes.