Prevalence and Factors Associated with Low Birth Weight among Teenage Mothers in New Mulago Hospital: A Cross Sectional Study.
The World Health Organization defines low birth weight (LBW) as a new born having a weight of less than 2,500 g at birth. Low birth weight is one of the major determinants of perinatal survival, infant morbidity and mortality as well as the risk of developmental disabilities and illnesses in future lives. WHO estimates that about 30 million low birth weight babies are born annually (23.4% of all births) and they often face short and long term health consequences. Whereas the global prevalence of LBW has slightly declined, the rate in many developing countries is still quite high. In Uganda, low birth weight among teenage mothers is a problem. Our study aimed to estimate the prevalence of and identify the factors associated with low birth weight among teenage mothers in New Mulago hospital. We conducted an analytical cross sectional study among teenage mothers who delivered from new Mulago Hospital Complex labour suite from August 2013 to August 2014. Trained interviewers, administered pre-tested questionnaires to consecutive mothers to obtain information on their socio-demographic characteristics, obstetric history and child factors. Odds ratios and P-values were calculated to determine the relationship between independent and dependent variables. We also used descriptive statistics for the quantitative data. A total of 357 teenage mothers were enrolled on the study. Their mean age was 18 years (Range 13-19), majority, 98.4% aged 15-19 years. The prevalence of LBW was 25.5%. Pre-term delivery (OR = 3.3032 P = 0.0001) and multiple pregnancies (OR = 0.165 P = 0.039) were associated with LBW. Malaria, young maternal age and ANC attendance were not associated with LBW. Child factors such as birth order, congenital anomalies and sex of the baby were also not associated with LBW. The prevalence of LBW is high among teenage mothers, pre-term delivery and multiple pregnancies were associated factors with LBW. Health professional's need to address teenage maternal health. Health workers should encourage teenage mothers to attend focused antenatal care as recommended by the Uganda ministry of Health. A specialized maternal facility centre that is friendly for adolescent/teenage mothers is advisable so as to improve on completion rates and capture high risk teenage mothers early.


[The euglycemic insulin and hyperglycemic clamp technic. Methods for the determination of insulin sensitivity of tissues and glucose sensitivity of the B cell. A review].
The estimation of insulin-dependent glucose metabolism and endogenous insulin secretion in man by means of the euglycaemic insulin clamp- and hyperglycaemic clamp-technique is described. In the euglycaemic insulin clamp study plasma insulin concentration is acutely raised by approximately 100 microU/ml by a primed-continuous insulin infusion, while plasma glucose is maintained at the fasting level by means of a variable glucose infusion. Under these conditions of euglycaemic hyperinsulinaemia the amount of glucose infused plus the residual endogenous glucose release equals the amount of glucose taken up by all cells of the body. This rate of glucose metabolism ("M") thus represents an index of tissue sensitivity to exogenous insulin. In the hyperglycaemic clamp study plasma glucose is acutely raised by 125 mg/dl above basal. The amount of glucose infused to maintain hyperglycaemia too serves as a measure of tissue sensitivity to endogenous insulin. In addition, glucose-induced insulin secretion can be estimated on the basis of the plasma insulin response provided that insulin extraction by the liver remains constant.


Molecular cloning of a transcription factor, AGP/EBP, that belongs to members of the C/EBP family.
A C/EBP-like transcription factor, AGP/EBP, that binds to three distinct motifs in the 5'-flanking region of alpha 1-acid glycoprotein gene (AGP) has been identified. Here we report the cloning and properties of cDNA corresponding to mouse AGP/EBP. AGP/EBP and C/EBP share 87% amino acid sequence homology in the "leucine zipper" and its associated DNA-binding domains, while their sequences outside these domains and the sizes of their mRNAs are different. Unlike the limited expression of C/EBP in tissues and cells, AGP/EBP appears to be ubiquitously expressed in tissues like lung, spleen, kidney, heart, testis, and liver and cell lines like p388D1, 129P (hepatoma cell line of C3H/HeJ), FO (mouse myeloma), and L929. Antibody against cloned and expressed AGP/EBP which was raised in rabbits could recognize AGP/EBP from nuclear extract of a number of cells and tissues. On the basis of our findings about the structural relationship and the similarity of motif recognition, we propose that a family of C/EBP-like transcription factors exists.


High occurrence and persistence of antibiotic-resistant enterococci in poultry food samples in Portugal.
We determined the presence of antibiotic-resistant enterococci (ARE) in commercialized poultry samples from Portugal and analysed their clonal diversity and the resistance genes harboured by these strains. Ninety-nine retail poultry samples of 10 widely commercialized brands were studied (1999-2001). Samples were enriched and plated on selective media with and without vancomycin, gentamicin, streptomycin or kanamycin. Antibiotic susceptibility was established following standard criteria. Identification and detection of genes coding for resistance were determined by PCR. Clonal relatedness was established by PFGE. A high percentage of samples contained vancomycin-resistant enterococci (VRE) (48%), or enterococci highly resistant (HLR) to gentamicin (34%), streptomycin (32%) or kanamycin (30%). Co-resistance to tetracycline, erythromycin, ciprofloxacin and quinupristin/dalfopristin was observed in most of these isolates. VRE were classified as VanA phenotype-vanA genotype (38% of samples), VanB phenotype-vanA (13%) or VanC phenotype-vanC1 (23%). All HLR to gentamicin isolates contained aac(6')-Ie-aph(2'')-Ia. We detected erm(B) in both erythromycin-resistant and -susceptible isolates. Some VRE and HLR to gentamicin strains were recovered from different samples and brands. Long-term persistence of particular VRE strains (>2 years), exhibiting different Van phenotypes, was observed. High occurrence of ARE suggests maintenance of selective pressure by the use of antibiotics/other substances in the Portuguese poultry environment. Persistence of a number of widespread PFGE types containing different resistance genes might reflect environmental/host-adapted enterococcal strains that might contribute to the maintenance of antibiotic resistance, thus constituting a resistance reservoir that is non-sensitive to banning interventions.


New applications of radionuclide studies in thoracic imaging.
Future radionuclide studies in the lung will encompass not only improved evaluation of regional ventilation and perfusion in pulmonary embolism and lung cancer, but should also provide new information about alveolar-capillary permeability, cell kinetics in the lung, and pulmonary metabolism and receptors. With this increase in the scope of pulmonary nuclear medicine must come further refinement of current imaging techniques and development of new radiopharmaceuticals. Pulmonary emission tomography (via single photons or positrons), which reduces or eliminates functional superimposition in the lung, seems to be the most promising technique for performing such studies. In the area of new radiopharmaceuticals, radiolabeled monoclonal antibodies appear promising for studies of lung cancer. These developments suggest that the next few years will be exciting ones for those interested in pulmonary radionuclide studies.


Role of IgE in autoimmunity.
There is accumulating evidence to suggest that IgE plays a significant role in autoimmunity. The presence of circulating self-reactive IgE in patients with autoimmune disorders has been long known but, at the same time, largely understudied. However, studies have shown that the increased IgE concentration is not associated with higher prevalence for atopy and allergy in patients with autoimmune diseases, such as systemic lupus erythematosus. IgE-mediated mechanisms are conventionally known to facilitate degranulation of mast cells and basophils and promote TH2 immunity, mechanisms that are not only central to mounting an appropriate defense against parasitic worms, noxious substances, toxins, venoms, and environmental irritants but that also trigger exuberant allergic reactions in patients with allergies. More recently, IgE autoantibodies have been recognized to participate in the self-inflicted damaging immune responses that characterize autoimmunity. Such autoimmune responses include direct damage on tissue-containing autoantigens, activation and migration of basophils to lymph nodes, and, as observed most recently, induction of type 1 interferon responses from plasmacytoid dendritic cells. The importance of IgE as a central pathogenic mechanism in autoimmunity has now been clinically validated by the approval of omalizumab, an anti-IgE mAb, for patients with chronic spontaneous urticaria and for the clinical benefit of patients with bullous pemphigoid. In this review we summarize recent reports describing the prevalence of self-reactive IgE and discuss novel findings that incriminate IgE as central in the pathogenesis of inflammatory autoimmune disorders.


An assessment of petrosal sinus sampling for localization of pituitary microadenomas in children with Cushing disease.
Pituitary adenomas in Cushing disease (CD) are usually small and difficult to visualize. Bilateral inferior petrosal venous sampling (BIPSS) before and after ovine CRH stimulation is reserved for patients who have ACTH-dependent Cushing syndrome and negative magnetic resonance imaging (MRI) or positive MRI but inconsistent biochemical data. The objective of the study was to evaluate the usefulness of BIPSS as a tool for localization of a pituitary adenoma in children with CD. The study was a retrospective review of the records of 141 children who were admitted for evaluation of CD from 1982 to 2004. The study was conducted at a tertiary care center. Lateralization of ACTH secretion during BIPSS was compared with MRI and surgical findings for the localization of a microadenoma. A total of 94 patients, 49 males and 45 females with an age range of 5.3 to 18.7 yr (13 +/- 3.2 yr), underwent BIPSS. Localization of a microadenoma by BIPSS agreed with surgical location in only 58% of the cases (95% confidence interval, 43-66). The combined use of information from the MRI and inferior petrosal venous sampling did not predict the location of the tumor more frequently than MRI alone (P > 0.1), which in this study localized a lesion in 39% of the patients (95% confidence interval, 28-50). The procedure was completed successfully in all patients, and no serious complications were recorded. Although BIPSS was safe and well tolerated in an experienced center, lateralization of the ACTH gradient during BIPSS was a poor predictor of the site of the adenoma in children with CD.


Mortality in England in the eighteenth and the nineteenth centuries: a reply to Sumit Guha.
In the last issue of Social History of Medicine, Sumit Guha published a critique of the thesis presented in Szreter (1988), which argued that an increasing weight and diversity of social interventions were primarily responsible for the reduction in Britain's mortality achieved from the 1870s. Previoiusly neglected and harmful urban, factory, and eventually even home environments were improved, as both political and social as well as scientific approaches gradually changed, albeit in a locally diversified manner. Guha's critique is shown to be fundamentally misguided because it is premissed on the assumption that the disease ecologies of eighteenth- and of nineteenth-century England were essentially comparable. This ignores important recent research in the historical epidemiology and demography of seventeenth- and eighteenth-century England. In conclusion, it is suggested that some of the information presented by Guha in fact further supports the plausibility of the interpretation in Szreter (1988), rather than the McKeown thesis.


When is an aster not an aster? A new deep-sea Discorhabdella (Demospongiae, Poecilosclerida) with asters, from the Mozambique Channel.
Discorhabdella pseudaster n. sp. is an incrusting sponge from the upper bathyal zone of the 'Banc du Geyser', north of Madagascar, Mozambique Channel. This new species is described only from a single specimen but it is remarkable by the presence of spicules similar to euasters, a type of microsclere unknown in Poecilosclerida. These spicules are in fact a new example of homoplasy, being derivatives of the typical Discorhabdella pseudoastrose acanthostyles, which are here reduced to the aster-like tyles. The isochelae with a large lamella on the shaft are also quite unique in Poeciloclerida.


Modulation of dendritic cell function by cowshed dust extract.
We have shown previously that inhalation of cowshed dust extract (CDE) resulted in decreased airway reactivity, eosinophilic inflammation and sensitization in a mouse model of allergic asthma. Our data suggested down-regulation of allergic immune response rather than activation of a Th1 response towards the model allergen. However, the precise mechanism of allergy protection is not yet understood in detail. To gain deeper insight into CDE-induced immune modulation, we have analysed the effects of CDE on dendritic cell biology. Dendritic cells were generated from murine bone marrow cells (BMDC). Cells were stimulated with CDE and subsequently used to sensitize mice via the airways. Our results showed that cells were not able to prime mice for allergic immune response when they were treated with CDE 2 days before pulsing with allergen, whereas cells that were stimulated with CDE simultaneously to OVA pulsing induced a fully developed allergic immune response. Surprisingly, CDE-treated cells that were not able to prime mice for allergic immune response exhibit an activated phenotype with high expression of the co-stimulatory surface molecule CD86. Moreover, CDE-treated cells transiently produced high amounts of cytokines such as IL-10, IL-12p70 and TNF-alpha. Interestingly, blocking of autocrine-produced IL-10 in vitro partially restored the allergy-inducing capacity of CDE-exposed cells. Thus, we conclude that prolonged exposure to CDE reduces the allergy-inducing capacity of dendritic cells. Furthermore, we present evidence that an autocrine IL-10 dependent mechanism seems to be involved in down-regulation of dendritic cell function due to stimulation with CDE.


Outcomes of a Single Surgeon-Based Transanal-Total Mesorectal Excision (TATME) for Rectal Cancer.
Several studies have shown the transanal total mesorectal excision (TATME) is emerging as a safe and effective technique for proctectomy. The majority of these studies to date, however, is based on procedures done in centers with teams of two surgeons working simultaneously. Few were performed by single-surgeon teams with sizeable case load. The objective of our study was to identify the feasibility and safety of a single-surgeon TATME. Chart review of prospectively collected data on 27 patients who underwent TATME at our institution from June 2015 to September 2016 were included in this study. Indications for TATME included mid and low rectal cancers. Only patients who underwent surgery for neoplastic lesions were included in the study. Outcomes assessed included mesorectal integrity, margin status, operative time, complications, morbidity, LOS, and 30-day readmission. A total of 27 cases were available for inclusion. A single surgeon performed all procedures. The average BMI was 27.2 ± 1.3 kg/m2. The average tumor distance from anal verge was 6.8 ± 0.6 cm. The median operative time was 283 min. No intraoperative complications, including injuries and conversions, occurred. Circumferential resection margin (CRM) and distal resection margin (DRM) were R0 in 96 and 100% of patients, respectively. Mesorectal integrity was "Complete" in 67% and "Near complete" in 33% of patients. There were no incomplete specimens. The total lymph node (LN) harvest was 26 ± 2. The average LOS was 4 days for 75% of all patients. There were no mortalities. The overall morbidity was 33% (9/27). There were 4/27 anastomotic leaks, one required a laparoscopic ileostomy, one had laparoscopic drainage of an abscess, and the other two were endoscopically washed and trans-rectal drains inserted. TATME performed by a one-surgeon team is oncologically adequate, and it is safe and feasible. Morbidities are comparable with existing literature data from two-surgeon teams. In addition, resection margins, mesorectal integrity, and LN harvests are also comparable or superior to some of the existing studies.


[Establishment of heat acclimatization model in rabbits and its pathophysiological characteristics].
To establish an effective and stable rabbit heat acclimatization model for the experiment of heat acclimatization mechanisms. Sixteen healthy male rabbits were divided into heat acclimatization group and control group randomly (n = 8). Heat acclimatization (HA) group was kept in simulation chamber with dry bulb temperature of (36 +/- 1) degrees C, wet bulb temperature of (29 +/- 0.5) degrees C, black-bulb temperature of (40 +/- 1.0) degrees C, 100 min/day for 21 days. Control group was kept in the room with temperature of 20 degrees C and relative humidity < 60% during 20 days, then removed into simulation chamber on day 21 to estimate and monitor the rectal temperature together with the heat acclimatization group. Venous blood of control and heat acclimatization group before and after heat exposure on the 1st day, 11th day and 21st day were collected to detect levels of tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6) and heat shock protein 70 (HSP70) by ELISA analysis. (1) Rectal temperature: There was no significant change in control group during 21 days. In heat acclimatization group, it increased (2.07 +/- 0.43) degrees C after the 1st exposure, and increased (1.78 +/- 0.37) degrees C after the 11th exposure, the range of increasing decreased (0.29 +/- 0.09) degrees C. After the 21st exposure, it increased (1.52 +/- 0.29) degrees C, which was (0.55 +/- 0.14) degrees C lower than that of the 1st (P < 0.05),and (0.53 +/- 0.14) degrees C lower to that of the control group under 1st heat stress (P < 0.05); (2) The level of TNF-alpha after the 1st exposure increased significantly (P < 0.05), but didn't raise along with the exposure times. And fell back to the original level after the 11th and 21st exposure. Compared with control group, the level of IL-6 increased after the 1st, 11th and 21st exposure (P < 0.05), and maintained highly after the 11th and 21st exposure. Compared with the control group, the level of HSP70 increased dramatically with the heat exposure times. Significant increasing of (HSP70) could be detected after the 11th and 21st exposure (P < 0.05), but there was no difference to that of the 1st exposure. Prolonged or repeated exposure to heat stressful environmental conditions can reduce the physiological strain, improve heat tolerance, elicits heat acclimatization.


Identification of blood biomarkers for use in point of care diagnosis tool for Alzheimer's disease.
Early diagnosis of Alzheimer's Disease (AD) is widely regarded as necessary to allow treatment to be started before irreversible damage to the brain occur and for patients to benefit from new therapies as they become available. Low-cost point-of-care (PoC) diagnostic tools that can be used to routinely diagnose AD in its early stage would facilitate this, but such tools require reliable and accurate biomarkers. However, traditional biomarkers for AD use invasive cerebrospinal fluid (CSF) analysis and/or expensive neuroimaging techniques together with neuropsychological assessments. Blood-based PoC diagnostics tools may provide a more cost and time efficient way to assess AD to complement CSF and neuroimaging techniques. However, evidence to date suggests that only a panel of biomarkers would provide the diagnostic accuracy needed in clinical practice and that the number of biomarkers in such panels can be large. In addition, the biomarkers in a panel vary from study to study. These issues make it difficult to realise a PoC device for diagnosis of AD. An objective of this paper is to find an optimum number of blood biomarkers (in terms of number of biomarkers and sensitivity/specificity) that can be used in a handheld PoC device for AD diagnosis. We used the Alzheimer's disease Neuroimaging Initiative (ADNI) database to identify a small number of blood biomarkers for AD. We identified a 6-biomarker panel (which includes A1Micro, A2Macro, AAT, ApoE, complement C3 and PPP), which when used with age as covariate, was able to discriminate between AD patients and normal subjects with a sensitivity of 85.4% and specificity of 78.6%.


Faecal microbiota transplantation in recurrent Clostridium difficile infection: Recommendations from the French Group of Faecal microbiota Transplantation.
Faecal microbiota transplantation is effective for treating recurrent forms of Clostridium difficile infection and its use in this indication is recommended in the most recent European and North American guidelines. In this context, faecal microbiota transplantation is beginning to be performed in France in clinical practice, while the rules governing this procedure have been defined in France only for clinical trials. To unify, secure, and evaluate practice in this field in France, the French Group of Faecal microbiota Transplantation (FGFT) was created in October 2014 with the support of the French National Society of Gastroenterology, the French Infectious Disease Society, and the National Academy of Pharmacy. We present here the deliberations of this group regarding the use of faecal microbiota transplantation for recurrent Clostridium difficile infection. The issues addressed are the indications, therapeutic sequence, delivery procedures, donor selection, methods and conditions of specimen preparation, and traceability.


Adolescent weight control: an intervention targeting parent communication and modeling compared with minimal parental involvement.
Adolescent weight control interventions demonstrate variable findings, with inconsistent data regarding the appropriate role for parents. The current study examined the efficacy of a standard adolescent behavioral weight control (BWC) intervention that also targeted parent-adolescent communication and parental modeling of healthy behaviors (Standard Behavioral Treatment + Enhanced Parenting; SBT + EP) compared with a standard BWC intervention (SBT). 49 obese adolescents (M age = 15.10; SD = 1.33; 76% female; 67.3% non-Hispanic White) and a caregiver were randomly assigned to SBT or SBT + EP. Adolescent and caregiver weight and height, parental modeling, and weight-related communication were obtained at baseline and end of the 16-week intervention. Significant decreases in adolescent weight and increases in parental self-monitoring were observed across both conditions. Analyses of covariance revealed a trend for greater reduction in weight and negative maternal commentary among SBT condition participants. Contrary to hypotheses, targeting parent-adolescent communication and parental modeling did not lead to better outcomes in adolescent weight control.


p53 gene dosage modifies growth and malignant progression of keratinocytes expressing the v-rasHa oncogene.
Epidermal keratinocyte cultures were established from newborn mice expressing a null mutation in the p53 gene to explore the contribution of p53 to epidermal growth regulation and neoplasia. Keratinocytes were initiated by transduction with a replication-defective retrovirus encoding the v-rasHa oncogene and grafted onto nude mouse hosts. Tumors arising from keratinocytes heterozygous or null for functional p53 in the presence of v-rasHa have growth rates approximately 5-fold higher than those derived from p53(+/+) controls and rapidly form carcinomas, in contrast to the benign phenotype observed in p53(+/+)/v-rasHa grafts. In vitro, p53-deficient keratinocytes with and without v-rasHa expression display decreased responsiveness to the negative growth regulators transforming growth factors beta 1 and beta 2. In combination with v-rasHa, p53-deficient keratinocytes also exhibit decreased responsiveness to elevated Ca2+. These differences between genotypes cannot be attributed to changes in transforming growth factor beta receptor types present or altered levels of epidermal growth factor receptor and are independent of c-myc transcript levels. mRNA expression for the p-53 inducible protein WAF1 correlates with p53 gene dosage, but low levels are still detectable in p53(-/-) keratinocytes. The altered responsiveness of p53 deficient keratinocytes to negative growth regulators may provide a growth advantage to such cells in vivo and render them more susceptible to genetic alterations and malignant conversion.


Spontaneous flow of active polar gels in undulated channels.
Active systems are those where energy is constantly injected by an external source. A typical example is the cytoskeleton of cells made of actin filaments and myosin molecular motors which consume ATP. In this paper, we study the behavior of an active polar gel in a thin, non-uniform channel modeled as a two-dimensional strip with periodically undulated walls. Using our recent hydrodynamic theory of active polar gels, we show that the orientation of the actin filaments parallel to the walls of the channel induces a flow even in the absence of any pressure gradient. The average flow is a simple shear if there is a phase difference between the undulations of the two walls of the channel. We also discuss applications of these results to various biological problems.


The Drosophila ETV5 Homologue Ets96B: Molecular Link between Obesity and Bipolar Disorder.
Several reports suggest obesity and bipolar disorder (BD) share some physiological and behavioural similarities. For instance, obese individuals are more impulsive and have heightened reward responsiveness, phenotypes associated with BD, while bipolar patients become obese at a higher rate and earlier age than people without BD; however, the molecular mechanisms of such an association remain obscure. Here we demonstrate, using whole transcriptome analysis, that Drosophila Ets96B, homologue of obesity-linked gene ETV5, regulates cellular systems associated with obesity and BD. Consistent with a role in obesity and BD, loss of nervous system Ets96B during development increases triacylglyceride concentration, while inducing a heightened startle-response, as well as increasing hyperactivity and reducing sleep. Of notable interest, mouse Etv5 and Drosophila Ets96B are expressed in dopaminergic-rich regions, and loss of Ets96B specifically in dopaminergic neurons recapitulates the metabolic and behavioural phenotypes. Moreover, our data indicate Ets96B inhibits dopaminergic-specific neuroprotective systems. Additionally, we reveal that multiple SNPs in human ETV5 link to body mass index (BMI) and BD, providing further evidence for ETV5 as an important and novel molecular intermediate between obesity and BD. We identify a novel molecular link between obesity and bipolar disorder. The Drosophila ETV5 homologue Ets96B regulates the expression of cellular systems with links to obesity and behaviour, including the expression of a conserved endoplasmic reticulum molecular chaperone complex known to be neuroprotective. Finally, a connection between the obesity-linked gene ETV5 and bipolar disorder emphasizes a functional relationship between obesity and BD at the molecular level.


High resolution image in bone biology I. Review of the literature.
Bone microstructure has usually been assessed by obtaining samples invasively and analyzing them with conventional histomorphometric methods. Improvements in high-resolution image acquisition systems have enabled non-invasive assessment of bone morphology and a more precise 3-D evaluation by means of "virtual biopsies", permitting bone assessment in regeneration or remodeling processes. This review describes the characteristics and limitations of bone assessment using different high-resolution image systems (synchrotron-radiation computed tomography, micro-computed tomography, acoustic scanning microscope; micro-magnetic resonance imaging). Morphometric variables that can be obtained from these images are reported and compared with conventional histomorphometric variables.


Antiproliferative effects of rapamycin as a single agent and in combination with carboplatin and paclitaxel in head and neck cancer cell lines.
Recent data suggested that combining targeted therapies with chemotherapy may counteract drug resistance. Activation of the PI3K/AKT/mTOR pathway downstream to kinase receptors, such as EGFR, was found in 57-81% of head and neck squamous cell carcinoma (HNSCC), and was eventually associated with a loss of PTEN function. mTOR was shown to modulate cell proliferation, apoptosis, invasion, and angiogenesis. This study aimed to evaluate molecular and cellular effects of rapamycin in a panel of cell lines either as single agent or in combination with cytotoxics commonly used in HNSCC. Antiproliferative effects of rapamycin, carboplatin, and paclitaxel were evaluated in a panel of three HNSCC cell lines (SCC61, SQ20B and HEP2). Cells were exposed to rapamycin for 48 h, to carboplatin for 48 h, or to paclitaxel for 24 h. Antiproliferative effects of simultaneous and sequential rapamycin-based combinations were studied using MTT assay and median effect plot analysis. Cell cycle effects were analysed using flow cytometry. Rapamycin induced concentration dependent antiproliferative effects in HNSCC cell lines with IC(50) of 5 +/- 1, 12 +/- 2 and 20 +/- 2 microM in SCC61, SQ20B, and HEP2 cells, respectively. Higher antiproliferative effects were observed in SCC61 cells overexpressing NOXA and cyclin D1 than in HEP2 that overexpressed MDR1 and BCL2. In our panel, antiproliferative effects of rapamycin were associated with G0/G1 cell cycle accumulation and apoptosis induction, at concentrations ranging 3-30 microM. Combinations of rapamycin with paclitaxel and carboplatin displayed synergistic and additive effects. Synergistic effects were observed with paclitaxel in SQ20B and HEP2 cells and with carboplatin in SQ20B cells, when cells were exposed to cytotoxics prior to rapamycin. Our results show that rapamycin displays antiproliferative effects and induces apoptosis in HNSCC cell lines, cellular effects being more potent in cells that do not express BCL2 and MDR1. Additive and synergistic effects were observed when rapamycin was combined with carboplatin and paclitaxel.


Smurf1 regulates macrophage proliferation, apoptosis and migration via JNK and p38 MAPK signaling pathways.
Smad ubiquitylation regulatory factor 1 (Smurf1) has been identified to play a critical role in bone homeostasis, development, cell cycle regulation and tumorigenesis. However, the role of Smurf1 in macrophage proliferation, apoptosis and migration is still unclear. Here, we show that Smurf1 expression was elevated in LPS-induced RAW264.7 macrophage and mouse embryonic fibroblasts (MEFs). And we found that knockdown of Smurf1 suppresses macrophage proliferation but promotes apoptosis and migration. Furthermore, JNK and p38 MAPK signaling were upregulated in Smurf1-depleted cells. And inhibition of JNK and p38 MAPK signaling in Smurf1 knockdown cells rescue the phenotypes of macrophage proliferation, apoptosis and migration. Therefore, our study suggests that Smurf1 is a new positive regulator for macrophage proliferation and apoptosis, but a negative regulator for macrophage migration.


Multidimensional assessment of quality of life of children and problems of parents in Indian society after pediatric renal transplant: Beyond the conventional thoughts.
This study evaluated multidimensional QoL after renal transplant to find the physical, psychosocial, and economic issues after pediatric transplant. Sixty-two patients under the age of 18 at the time of assessment were asked to complete WHOQOL questionnaires. Assessment of behavioral, emotional status of child, problems of parents, and SEC of family were also performed. The beneficial effect of transplantation was observed across all domains of QoL (physical, psychological, social, environmental, and overall QoL). The greatest change was observed in QoL domains that dealt with overall satisfaction (81.28±15.76 vs 45.32±10.98; P<.0001). The domain dealing with environmental factors showed the least variation after transplantation (65.58±17.45 vs 51.34±17.81; P<.0001). Feelings of happiness and peer group socialization were reported in 81% and 69% of patients, respectively. There was no marital disharmony in 52% of families. However, SEC deteriorated in 16% of families and 59% of the families availed financial assistance. Sixty-nine percent of children had not attended school after one year of transplantation, but return to school after transplant was reduced to 8% at 5 years. Pre- and post-transplant social and psychological support may help these patients and their families adjust in society and have a positive outlook for their future.


Inhaled fluticasone propionate by diskus in the treatment of asthma: a comparison of the efficacy of the same nominal dose given either once or twice a day.
In September 2000, the US Food and Drug Administration (FDA) approved the use of Flovent Diskus (FD) [fluticasone propionate; GlaxoSmithKline; Research Triangle Park, NC], which is an orally inhaled, dry-powder corticosteroid, for the maintenance treatment of asthma at dosages of 50 to 1,000 microg administered twice-daily. Once-daily dosage regimens did not receive approval. This article will detail six clinical trials, five of which incorporated comparative once-daily and twice-daily treatment arms of the same nominal dose of FD. Six 12-week, randomized, double-blind, placebo-controlled studies in patients with mild-to-moderate asthma, including two pediatric asthma trials (patient age, 4 to 11 years) of total daily doses of fluticasone propionate (FP) of 100 or 200 microg, and four adult and adolescent studies of total daily doses of FP of 100, 200, or 500 microg. Twice-daily dosing was numerically superior to once-daily dosing at the same nominal dose in all comparative studies for the primary end point, change in predose FEV(1). In five trials, the results of the once-daily dosage of FP were statistically indistinguishable from those with placebo. One trial demonstrated the superiority of FP, 500 microg once-daily, over placebo; however, the effect size was half that observed with twice-daily dosing. Once-daily FP dosing showed no advantage in safety or in patient adherence to medication. In the FDA review of once-daily dosing of the FD regimen, 100 or 200 microg once-daily dosing was not shown to be significantly better than placebo. FP 500 microg once-daily was found to be superior to placebo, but at about one half the effect size as the same nominal dose given bid. No advantage in patient safety or adherence was demonstrated for once-daily administration over twice-daily administration, and once-daily administration is not currently recommended.


Automated fluorescent analysis procedure for enzymatic mutation detection.
The Enzymatic Mutation Detection (EMD) assay detects mutations or polymorphisms in DNA. The assay procedure takes <1 h and is followed by electrophoretic detection. We report an automated procedure, using fluorescently labeled probe and quantitative analysis on the ABI Prism 377 DNA Sequencer, that improves on earlier methods (1, 2) by eliminating the need for sample purification, shortening the hybridization time, and increasing the signal-to-noise ratio. The EMD assay uses the bacteriophage resolvase T4 endonuclease VII, which cleaves the heteroduplex molecules at the mismatch site, forming two shorter fragments that are resolved by gel electrophoresis. Unlike existing mutation techniques, the EMD method uses a single protocol to identify point mutations, deletions, and insertions for all DNA fragments. Test DNA samples are assayed directly from PCR reactions, and fragments up to 4 kb in size have been assayed successfully. A independent analysis on the p53 tumor suppressor gene from clinical samples has shown 100% sensitivity and 94% specificity. Because the fluorescent EMD assay has been optimized for high signal-to-noise ratios, mutations can be identified in mixed samples containing up to a 20-fold excess of normal DNA.


Effect of cytotoxic T-lymphocyte antigen-4, TNF-alpha polymorphisms on osteosarcoma: evidences from a meta-analysis.
Previous studies have investigated the role of cytotoxic T-lymphocyte antigen-4 (CTLA-4) and tumor necrosis factor-alpha (TNF-α) in carcinogenesis of osteosarcoma, but their results were inconsistent. We aimed to clarify the associations between CTLA-4, TNF-α polymorphism and osteosarcoma risk by using meta-analysis. We searched relevant studies without language restriction in PubMed, EMbase, Cochrane Library, Google Scholar databases, Chinese National Knowledge Infrastructure (CNKI) and conference literature in humans published prior to March 2013. The strengths of the associations between genetic variants and osteosarcoma risk were estimated by odds ratio (OR) with 95% confidence interval (95% CI). A total of seven studies with 1,198 osteosarcoma patients and 1,493 controls were selected. Four studies were eligible for CTLA-4 (1,003 osteosarcoma and 1,162 controls), and three studies for TNF-α (195 osteosarcoma and 331 controls). Pooled results showed that rs231775 polymorphism of CTLA-4 was associated with osteosarcoma risk (GG vs. AA: OR=1.63, 95% CI=1.24-2.13; GG + GA vs. AA: OR=1.56, 95% CI=1.21-2.01; AA + GA vs. GG: OR=0.83, 95% CI=0.71-0.97; G vs. A: OR=1.21, 95% CI=1.08-1.36). No significant heterogeneity was observed across the studies. No significant associations were found between rs5742909 polymorphism of CTLA-4 or rs1800629 polymorphism of TNF-α and osteosarcoma risk. These results suggest that the rs231775 polymorphism of CTLA-4 may play an important role in carcinogenesis of osteosarcoma.


Impact of flanking chromosomal sequences on localization and silencing by the human non-coding RNA XIST.
X-chromosome inactivation is a striking example of epigenetic silencing in which expression of the long non-coding RNA XIST initiates the heterochromatinization and silencing of one of the pair of X chromosomes in mammalian females. To understand how the RNA can establish silencing across millions of basepairs of DNA we have modelled the process by inducing expression of XIST from nine different locations in human HT1080 cells. Localization of XIST, depletion of Cot-1 RNA, perinuclear localization, and ubiquitination of H2A occurs at all sites examined, while recruitment of H3K9me3 was not observed. Recruitment of the heterochromatic features SMCHD1, macroH2A, H3K27me3, and H4K20me1 occurs independently of each other in an integration site-dependent manner. Silencing of flanking reporter genes occurs at all sites, but the spread of silencing to flanking endogenous human genes is variable in extent of silencing as well as extent of spread, with silencing able to skip regions. The spread of H3K27me3 and loss of H3K27ac correlates with the pre-existing levels of the modifications, and overall the extent of silencing correlates with the ability to recruit additional heterochromatic features. The non-coding RNA XIST functions as a cis-acting silencer when expressed from nine different locations throughout the genome. A hierarchy among the features of heterochromatin reveals the importance of interaction with the local chromatin neighborhood for optimal spread of silencing, as well as the independent yet cooperative nature of the establishment of heterochromatin by the non-coding XIST RNA.


Bisphosphonates in the treatment of thalassemia-induced osteoporosis.
The aim of our randomized, placebo-controlled study was to investigate the effects of 2 years' daily oral administration of alendronate or intramuscular administration of clodronate every 10 days, on bone remodeling parameters and bone mineral density (BMD), safety and tolerability in a group of osteoporotic thalassemic patients. Twenty-five young patients (mean age 26.6 +/- 7.1 years) with beta-thalassemia major were randomly divided to receive placebo or 100 mg of clodronate intramuscularly every 10 days or 10 mg of alendronate per os daily. All patients took 500 mg of elemental calcium and 400 IU cholecalciferol in the evening at meal time. After 2 years, pyridinium crosslinks, which are bone resorption markers, did not differ significantly from baseline values in the placebo group, whereas they had decreased significantly in the clodronate and alendronate groups. Osteocalcin, a bone formation marker, did not change significantly in the placebo group, whereas it decreased slightly, but not significantly, in the clodronate and alendronate groups after 12 and 24 months. At the end of the study, the lumbar spine BMD had decreased significantly in the placebo group; it did not change significantly in the clodronate group; in the alendronate group it had increased but not significantly, whereas the increase was significant with respect to the placebo group. Femoral neck BMD decreased significantly in the placebo group; it did not change significantly in the clodronate group, but increased significantly in the alendronate group. No relevant side effects were recorded during our study. In conclusion, in patients with thalassemia-induced osteoporosis, the daily administration of alendronate significantly increases BMD, the most important predictor of the risk of fracture at several sites. Clodronate treatment at our dosage is ineffective in this pathology in spite of the good compliance of patients.


Effect of Loss of Teeth and its Association with General Quality of Life using Geriatric Oral Health Assessment Index (Gohai) among Older Individuals Residing in Rural Areas.
The development of measures for assessing oral health status is essential to the evolution and maturation of a scientific knowledge based in geriatric dentistry. Their development as branches of clinical care depends in part as ability to demonstrate an effective grasp of the problems of elderly and their solutions. Any strategy for altering the health status of elderly requires a technology for first assessing that health status and then detecting increments of progress. Development of geriatric oral health assessment index (GOHAI) is a self reported measure designed to assess the oral health problems of older individuals. The goal of geriatric assessment is to collect information that will facilitate diagnosis and suggest appropriate interventions. Such a measure would facilitate estimation of prevalence of oral functional problems in older individuals, It would also increase understanding of psychological impact of oral disease and provide a means for comparing the effectiveness of various dental treatment. It also emphasizes on social well being and reflects quality of life following replacement of missing teeth.


The kinetochore and cancer: what's the connection?
The molecular mechanisms ensuring accurate chromosome segregation during meiosis and mitosis are critical to the conservation of euploidy (normal chromosome number) in eukaryotic cells. A dysfunctional kinetochore represents one possible source for chromosome instability (CIN) and the generation of aneuploidy. The kinetochore is a large complex of proteins and associated centromeric DNA that is responsible for mediating the segregation of sister chromatids to daughter cells via its interactions with the mitotic spindle. Continued identification of conserved kinetochore components in model systems such as yeast has provided a rich resource of candidate genes that may be mutated or misregulated in human cancers. Systematic mutational testing and transcriptional profiling of CIN candidate kinetochore genes should shed light on the kinetochore's role in tumorigenesis, and on the general role CIN plays in cancer development.


From Primary Health Care to Universal Health Coverage in the Islamic Republic of Iran: A Journey of Four Decades.
Despite all the problems caused by the imposed war, sanctions and accidents after the Islamic Revolution, materializing primary health care (PHC) in Iran through establishing the National Health Network (NHN) has had substantial gains. Many health indicators in Iran have undergone significant changes. As an example, the change in death of children under the age of 5 years has been studied by adjusting the economic status, and it is estimated that about 2 million deaths in this age group were avoided within 30 years after the Islamic Revolution. Nevertheless, the global experience implies that the PHC has its limitations. By changing the social, economic, and epidemiological patterns of diseases, demands and expectations of community has changed. With the emergence of chronic conditions and new technologies, health expenditures have become a major concern. Meanwhile, in the 2000s, the revision at PHC was aimed at strengthening through the universal health coverage (UHC). Therefore, UHC is along the PHC and not against it.


EGFP expression controlled by GFAP promoter in mesenchymal cells: an efficient tool for glial lineage selection and transplantation.
In order to demonstrate a new method to label and select enough glial cells from induced MSCs to provide cells for cell therapy, MSCs were induced with Beta-mercaptoethanol followed by retinoic acid, forskolin, basic-FGF, PDGF and heregulin. Induced MSCs were transfected with reconstructed vector pGFAP-EGFP by inserting GFAP promotor into pEGFP-N3 to substitute CMV promotor. Living cells against G418 were enriched and checked by flowcytometry. EGFP expressing cells were sorted and used for transplantation in vivo. Immunoelectronmicroscopy was accomplished using anti-EGFP to relocalize the transplanted cells. Almost all MSCs took on phenotypes of glial cells after induction, expressing S100 and GFAP. The EGFP expression rate of survived MSCs against G418 was 82.74%. Glial cells expressing EGFP accumulated mainly around the damaged nerve fibers. MSCs were relocalized by immunoelectronmicroscopy and remyelination was observed. EGFP expression controlled by GFAP promoter in mesenchymal cells was an efficient tool for glial lineage selection and transplantation. Induced MSCs can promote nerve regeneration by participating remyelination.


Serial triple quantum sodium MRI during non-human primate focal brain ischemia.
Triple quantum (TQ) sodium MRI techniques with clinically acceptable 18-min data acquisition times were demonstrated in vivo in a nonhuman primate model of focal brain ischemia. Focal brain ischemia was induced in four animals using embolization coils to occlude the posterior cerebral artery, and a balloon catheter to occlude the middle cerebral artery. A statistically significant increase (P < 0.001) in the TQ sodium MRI signal intensity in the ischemic hemisphere relative to the contralateral hemisphere was seen at all time points in all four animals. This increased TQ sodium MRI signal intensity was demonstrated as early as 0.6 hr after the onset of ischemia. The TQ sodium MRI hyperintensity corresponded to the anatomical location of the ischemic cortex, as indicated by the registration of the TQ imaging data with anatomical proton MRI data. The results demonstrate that early after the onset of ischemia, there was an increase in the TQ signal intensity in the ischemic hemisphere, and a negligible change in the single quantum (SQ) signal intensity.


Line Intensities for the 8-µm Bands of SO2
Using both high-resolution (R = 0.003 cm-1) and medium-resolution (R = 0.12 cm-1) Fourier transform spectroscopy, it has been possible to measure accurately a large set of individual line intensities for the nu1 and nu3 bands of SO2 in the 950-1400 cm-1 spectral region. These intensities were introduced into a least-squares fit calculation allowing one to obtain the expansion of the transition moment operator of the nu1 and nu3 bands. For these intensity calculations, the theoretical model takes into account the vibration-rotation interactions linking the upper levels involved in the nu1, 2nu2, and nu3 interacting SO2 bands. Finally, a synthetic spectrum of the 8-µm SO2 bands has been generated using the dipole moment expansion determined in this work and the molecular parameters and the Hamiltonian matrix given in a previous analysis. Copyright 1998 Academic Press.


[Mini-invasive ways of cholecystectomy for acute cholecystitis in aged patients].
Analysis of radical surgical treatment results by means of laparoscopic cholecystectomy and cholecystectomy from modified mini-access in 203 patients from senior age group with acute cholecystitis is presented. Using experimental studies optimal localization of mini-access on the anterior abdominal cavity was proved. Taking into account the dynamics of stress hormones (prolactin and cortisol) level at mini-invasive radical operations it is proved that pneumoperitoneum is one of the most significant intraoperative aggressive factors. Priority indications for cholecystectomy from mini-access in case of acute cholecystitis are defined. Technical facilities of this treatment mode are shown.


Ross Syndrome: A Patient with a 23-Year History.
We present a 60-year-old female with a 23-year history of anhidrosis with concomitant heat intolerance. At examination, we found a right-sided tonic pupil, absent tendon reflexes, and a segmental patch of compensatory hyperhidrosis in the left lower quadrant of her trunk. To further confirm this finding, a minor test (a starch-iodine test, which is used to evaluate the sudomotor function, sweating) was performed. Nerve conduction studies revealed evidence of a mild distal sensory polyneuropathy of the axonal type. Tilt-table testing showed signs of orthostatic hypotension with evidence of reduced sympathetic function. Skin biopsy excluded pathology in the sweat glands. Our patient met the criteria for a diagnosis of Ross syndrome. This case describes the long-term outcome of this rare entity and highlights how careful examination and bedside autonomic testing can confirm the diagnosis of autonomic neurological disorders.


Extended Outcomes of Complex Coronary Disease in the Drug Eluting Stent Era.
Several randomized trials comparing bare-metal stents to Drug-Eluting Stents (DES) have demonstrated a significant reduction in Target Vessel Revascularization (TVR) and Target Lesion Revascularization (TLR) exists with the use of drug-eluting stents, without compromising survival. These conclusions are based on restricted inclusion criteria for patients and lesion. It is unknown if these results can be generalized to an unselected patient population and more complex disease. The objective of this study was to determine to what extent the availability of DES has impacted survival, TVR, and TLR in a large regional experience without the restriction of on-label indications. Patients registered with the Northern New England Cardiovascular Disease Study Group's PCI registry with single vessel coronary disease undergoing a first PCI were sorted according to the Bare-Metal stent (BMS) era (2001 - 2002) or the Drug-Eluting stent (DES) era (2004 - 2005) based on the time period their first PCI took place. Totally, 6,093 BMS and 5,651 DES patients were identified. Outcomes of survival, TLR and TVR were measured after one year. After 1 year, survival was comparable, TLR was reduced by 4.9% (absolute) and TVR was reduced by 5.4% (absolute) in the DES era compared to the BMS era. The TLR/TVR differences remained significant after propensity matching in the DES era vs BMS era (Mortality: HR 1.00, 95% CI: 0.83 - 1.28; TLR: HR 0.40, 95% CI 0.32 - 0.46; TVR: HR 0.44, 95% CI 0.38 - 0.51). In large regional experience with a consecutive series of patients representing the contemporary practice of PCI, including both on and off label use, the frequent use of DES reduces the risk of TVR and TLR without compromising survival.


DNA barcoding of ancient parasites.
Ancient samples present a number of technical challenges for DNA barcoding, including damaged DNA with low endogenous copy number and short fragment lengths. Nevertheless, techniques are available to overcome these issues, and DNA barcoding has now been used to successfully recover parasite DNA from a wide variety of ancient substrates, including coprolites, cesspit sediment, mummified tissues, burial sediments and permafrost soils. The study of parasite DNA from ancient samples can provide a number of unique scientific insights, for example: (1) into the parasite communities and health of prehistoric human populations; (2) the ability to reconstruct the natural parasite faunas of rare or extinct host species, which has implications for conservation management and de-extinction; and (3) the ability to view in 'real-time' processes that may operate over century- or millenial-timescales, such as how parasites responded to past climate change events or how they co-evolved alongside their hosts. The application of DNA metabarcoding and high-throughput sequencing to ancient specimens has so far been limited, but in future promises great potential for gaining empirical data on poorly understood processes such as parasite co-extinction.


A parsimonious weight function for modeling publication bias.
Quantitative research literature is often biased because studies that fail to find a significant effect (or that demonstrate effects in an undesired or unexpected direction) are less likely to be published. This phenomenon, termed publication bias, can cause problems when researchers attempt to synthesize results using meta-analytic methods. Various techniques exist that attempt to estimate and correct meta-analyses for publication bias. However, there is no single method that can (a) account for continuous moderators by including them within the model, (b) allow for substantial data heterogeneity, (c) produce an adjusted mean effect size, (d) include a formal test for publication bias, and (e) allow for correction when only a small number of effects is included in the analysis. This article describes a method that we believe helps fill that gap. The model uses the beta density as a weight function that represents the selection process and provides adjusted parameter estimates that account for publication bias. Use of the beta density allows us to represent selection using fewer parameters than similar models so that the proposed model is suitable for meta-analyses that include relatively few studies. We explain the model and its rationale, illustrate its use with a real data set, and describe the results of a simulation study that shows the model's utility. (PsycINFO Database Record


Magnetic Stimulation Therapy in Patients with COPD: A Systematic Review.
Magnetotherapy (MT) is a therapeutic treatment based on the use of magnetic fields (MF) that can have an anti-inflammatory and analgesic effect. MT represents a possible treatment or an ancillary therapeutic intervention for a wide range of diseases and it is often used in the field of physiotherapeutic practices. A crucial point in the treatment of chronic obstructive pulmonary disease (COPD) patients, to counteract muscular depletion and respiratory symptoms, is represented by physiotherapy. Nevertheless, the knowledge about the application of MF as a therapeutic option in COPD patients is very limited. The purpose of the present study was to define what is currently known about the use of MF in patients with COPD. A systematic review of the literature was conducted during the month of October 2017, searching three main databases. Only those citations providing detailed informations about the use of MF to treat COPD symptoms either during an acute or a chronic phase of the disease, were selected. Following the selection process three articles were included in the final analysis. The present review focused on a total of thirty-six patients with COPD, and on the effects of the application of MF. In the majority of cases, the treatment sessions with MF were carried-out in an outpatient setting, and they differed with regard to the duration; frequency of application; dosage; intensity of the applied MF. Basing on the available informations, it seems that MF is a feasible, well tolerated, safe therapeutic option, for the treatment of motor-related COPD symptoms.


Assessment of Anxiety and Depression Status in Turkish Cutaneous Melanoma Patients
Background: Even though anxiety and depression are two mood disorders encountered commonly in cancer patients only few trials have been carried out so far in melanoma patients. The aim of the study was to determine the clinical prevalence of these disorders in Turkish cutaneous melanoma patients and to clarify possible clinicopathological factors influencing them. Material and methods: A total of 100 consecutive outpatient melanoma patients were enrolled and asked to complete the Hospital Anxiety and Depression Scale (HADS) questionnaire immediately after scheduled visits. Results: A total of 24 participants had clinical anxiety and 8 were diagnosed with borderline anxiety. Fifteen were diagnosed with clinical depression and 20 with borderline depression. Prior to melanoma diagnosis the majority of the patients, 93 and 86, were assessed as normal in terms of their anxiety and depression status, respectively (p<0.001). A statistically significant correlation was found between anxiety and depression scores (p<0.001). The patients with advanced disease were significantly more anxious and depressive than those with early stage disease. None of the other socio-demographic parameters was found to be correlated with anxiety and depression status. Conclusions: Because a large group of Turkish melanoma patients, nearly one third of the cohort, was found to be suffering from relevant anxiety and depression, it is of uttermost importance that psychological support and pharmacological intervention for these patients be commenced as soon as possible.


Popliteal artery entrapment syndrome presenting with acute limb ischaemia: a case report.
Popliteal artery entrapment syndrome (PAES) is a relatively rare condition that occurs in young patients as a result of anomalous anatomic relationships between the popliteal artery and the surrounding musculotendinous structures. Patients usually lack atherogenic risk factors and most commonly present with intermittent claudication in the early stages. In the later stages of undiagnosed PAES, acute ischaemia can occur as a result of complete arterial occlusion or embolism. Hence, early diagnosis and surgical release of the entrapment is crucial for good operative outcome and to prevent limb loss.


Ambulatory paediatrics: does it work?
To determine whether a paediatric ambulatory assessment service is an effective and acceptable replacement for an inpatient unit. Analysis of hospital paediatric medical admissions. Postal questionnaire survey of local general practitioners. Telephone survey of parents of children who had attended the ambulatory service. Rural General Hospital in Northern Ireland. General practitioners. Parents of children referred to assessment service. Number of paediatric medical hospital admissions from the local area before and after the introduction of an ambulatory assessment service. General practitioner satisfaction levels. Parental satisfaction levels. Since the introduction of the new service in April 1996 there has been a marked progressive reduction in paediatric medical hospital admissions from the local area. By the third year of operation of the ambulatory service (1998/99), a 47% reduction in admissions was recorded, compared to the 1995/96 baseline year. The response rate to the general practitioner questionnaire was 65% (37 of 57) of whom most (31, 84%) found the service beneficial. Of the 37 respondents, 31 had referred patients to the service. The majority of these general practitioners (30, 97%) reported that the service was easy to access, and the same proportion felt that requests for consultation were met promptly. Most felt that feedback was appropriate (29, 94%). A telephone survey of 50 parents showed that most were either very satisfied (38, 76%), or satisfied (11, 22%) with the service. Most parents (41, 82%) felt their child had benefited by not being admitted to hospital. Most (46, 92%) felt they had received adequate information regarding their child's illness. A paediatric ambulatory assessment unit can reduce the number of children admitted to hospital and meet the needs of children, their families and general practitioners.


[Expression and significance of MIF and CD147 in non-small cell lung cancer].
To investigate the expression of macrophage migration inhibitory factor (MIF) and extracellular matrix metalloproteinase inducer (CD147) in non-small cell lung cancer (NSCLC) and its metastatic lymph node with tissue microarray technique, and to reveal clinical significance of these two molecules expression in NSCLC. MIF and CD147 proteins were detected in 40 cases of benign pulmonary tissues, 327 cases of primary NSCLC and 112 cases of lymph node metastatic tissues by SP method of immunohistochemical staining. The expression of both MIF and CD147 in benign pulmonary tissues, NSCLC primary foci and metastatic lymph node appeared upward tendency (P < 0.05). Furthermore, expression level of MIF and CD147 proteins in NSCLC were related to the metastasis (P < 0.05) and TNM staging (P < 0.05). The Spearman correlation analysis showed that the expression of MIF and CD147 was positively correlated (r = 0.400, P = 0.000). Kaplan-Meier survival analysis indicated that the survival rate was markedly lower in patients with high expression level of MIF or CD147 than those with low expression level (P < 0.05). Multivariate analysis using Cox regression model identified that pathologic grading, metastasis, TNM staging and CD147 expression were independent prognostic factors of NSCLC patients (P < 0.05). MIF and CD147 may play important roles in invasion and metastasis in NSCLC, so might be employed to evaluate the prognosis of NSCLC patients.


Liver transplantation for intermediate hepatocellular carcinoma: An adaptive approach.
Hepatocellular carcinoma is becoming an increasing indication for liver transplantation, but selection and allocation of patients are challenging because of organ shortages. Conventional Milan criteria are the reference for the selection of patients worldwide, but many expanded criteria, like University of California San Francisco criteria and up-to-7 criteria, have demonstrated that survival and recurrence results are lower than those for restricted indications. Correct staging is crucial and should include surrogate markers of biological aggressiveness (α-fetoprotein, response to loco-regional treatments). Successful down-staging can select between patients with tumor burden initially beyond transplantation criteria those with a more favorable biology, provided a 3-mo stability in meeting the transplantation criteria. Allocation rules are constantly adjusted to minimize the imbalance between the priorities of candidates with and without hepatocellular carcinoma, and take into account local donor rate and waitlist dynamics. Recently, Mazzaferro et al proposed a benefit-oriented "adaptive approach", in which the selection and allocation of patients are based on their response to non-transplantation treatments: low priority for transplantation in case of complete response, high priority in case of partial response or recurrence, and no listing in case of progression beyond transplantation criteria.


Comparison between theoretical predictions and direct numerical simulation results for a decaying turbulent suspension.
A recently developed theoretical model for a turbulently flowing suspension has been applied to a homogeneous, isotropic, and decaying turbulent suspension. The predictions are compared with results from direct numerical simulations. The agreement is reasonable. Special attention is paid to a physical explanation of the influence of the particles on the turbulence of the carrier fluid.


Identification of DNA sequences specific for Vibrio vulnificus biotype 2 strains by suppression subtractive hybridization.
Vibrio vulnificus can be divided into three biotypes, and only biotype 2, which is further divided into serovars, contains eel-virulent strains. We compared the genomic DNA of a biotype 2 serovar E isolate (tester) with the genomic DNAs of three biotype 1 strains by suppression subtractive hybridization and then tested the distribution of the tester-specific DNA sequences in a wide collection of bacterial strains. In this way we identified three plasmid-borne DNA sequences that were specific for biotype 2 strains irrespective of the serovar and three chromosomal DNA sequences that were specific for serovar E biotype 2 strains. These sequences have potential for use in the diagnosis of eel vibriosis caused by V. vulnificus and in the detection of biotype 2 serovar E strains.


Relatedness mapping and tracts of relatedness for genome-wide data in the presence of linkage disequilibrium.
Estimates of relatedness have several applications such as the identification of relatives or in identifying disease related genes through identity by descent (IBD) mapping. Here we present a new method for identifying IBD tracts among individuals from genome-wide single nucleotide polymorphisms data. We use a continuous time Markov model where the hidden states are the number of alleles shared IBD between pairs of individuals at a given position. In contrast to previous methods, our method accurately accounts for linkage disequilibrium using pairwise haplotype probabilities. The method provides a map of the local relatedness along the genome. We illustrate the potential of the method for mapping disease genes on a real data set, and show that the method has the potential to map causative disease mutations using only a handful of affected individuals. The new IBD mapping method provides considerable improvement in mapping power in natural populations compared to standard association mapping methods.


[Four cases of esophageal metastasis from breast cancer].
The 4 patients with esophageal metastasis from breast cancer were women aged 55 to 68, who had multiple metastases and long term survival (9 to 13 years) from diagnosis of primary breast cancer. All of them presented with progressive dysphagia. Computed tomography revealed a circumferential wall thickening of the upper to middle esophagus without enlarged mediastinal lymph nodes or other lesions that would cause esophageal obstruction through external compression. Endoscopic examination revealed circumferential stricture without mucosal abnormality. In 3 cases, biopsy or EMR specimens revealed adenocarcinoma, which suggested metastasis of breast cancer resected previously. In the other case, biopsy failed to detect any malignancy. Metastatic cancer to the esophagus is a rare occurrence. We report these rare cases with references to the literature.


L-arginine administration reverses anemia associated with renal disease.
Recombinant human erythropoietin (rhEpo) has proved to be remarkably safe and effective for the treatment of anemia. Despite the use of rhEpo, concerns about its cost, the need for frequent parenteral administration, and the development of anti-Epo antibodies have prompted the development of improved agents to rescue anemia. Patients with anemia associated with renal disease are usually treated by intravenous or subcutaneous rhEpo administration; however, some patients do not respond well to rhEpo, because of the presence of Epo antibody or other unknown reasons. A new, orally administered drug is needed as an economical and effective method to treat such patients. We administered 1.3 g/day of L-arginine to 8 elderly patients with anemia associated with renal disease. All 8 patients responded to the treatment with increases in hemoglobin levels. Six of the patients showed improved renal function. There were no significant adverse effects. Our data show that oral administration of 1.3 g/day of L-arginine significantly improves Epo production and reverses anemia without adverse effects in elderly patients who have anemia associated with renal disease and are in the predialysis state of chronic renal failure.


Strategies for an effective tobacco harm reduction policy in Indonesia.
Tobacco consumption is a major causative agent for various deadly diseases such as coronary artery disease and cancer. It is the largest avoidable health risk in the world, causing more problems than alcohol, drug use, high blood pressure, excess body weight or high cholesterol. As countries like Indonesia prepare to develop national policy guidelines for tobacco harm reduction, the scientific community can help by providing continuous ideas and a forum for sharing and distributing information, drafting guidelines, reviewing best practices, raising funds, and establishing partnerships. We propose several strategies for reducing tobacco consumption, including advertisement interference, cigarette pricing policy, adolescent smoking prevention policy, support for smoking cessation therapy, special informed consent for smokers, smoking prohibition in public spaces, career incentives, economic incentives, and advertisement incentives. We hope that these strategies would assist people to avoid starting smoking or in smoking cessation.


How Expertise Changes Cortical Sources of EEG Rhythms and Functional Connectivity in Divers Under Simulated Deep-Sea Conditions.
Although the recent years have witnessed a growing interest in functional connectivity (FC) through brain sources, the FC in extreme situations has not been completely elucidated. This paper is aimed at investigating whether the expertise acquired during the deep-sea diving is reflected in FC in a group of professional divers (PDs) compared to a group of new divers (NDs), and how it could affect the concentration and stress levels. The sources of brain frequency rhythms, derived by the electroencephalography acquisition in a hyperbaric chamber, were extracted in different frequency bands and the corresponding FC was estimated in order to compare the two groups. The results highlighted a significant decrease of the alpha source in PDs during air breathing and a significant increase of the upper beta source over central areas at the beginning of post-oxygen air, as well as an increase of beta FC between fronto-temporal regions in the last minutes of oxygen breathing and in the early minutes of post-oxygen air. This provides evidence in support of the hypothesis that experience and expertise differences would modulate brain networks. These experiments provided the unique opportunity of investigating the impact of the neurophysiological activity in simulated critical scenarios in view of the investigation in real sea-water experiments.


Functional Classification of Super-Large Families of Enzymes Based on Substrate Binding Pocket Residues for Biocatalysis and Enzyme Engineering Applications.
Large enzyme families such as the groups of zinc-dependent alcohol dehydrogenases (ADHs), long chain alcohol oxidases (AOxs) or amine dehydrogenases (AmDHs) with, sometimes, more than one million sequences in the non-redundant protein database and hundreds of experimentally characterized enzymes are excellent cases for protein engineering efforts aimed at refining and modifying substrate specificity. Yet, the backside of this wealth of information is that it becomes technically difficult to rationally select optimal sequence targets as well as sequence positions for mutagenesis studies. In all three cases, we approach the problem by starting with a group of experimentally well studied family members (including those with available 3D structures) and creating a structure-guided multiple sequence alignment and a modified phylogenetic tree (aka binding site tree) based just on a selection of potential substrate binding residue positions derived from experimental information (not from the full-length sequence alignment). Hereupon, the remaining, mostly uncharacterized enzyme sequences can be mapped; as a trend, sequence grouping in the tree branches follows substrate specificity. We show that this information can be used in the target selection for protein engineering work to narrow down to single suitable sequences and just a few relevant candidate positions for directed evolution towards activity for desired organic compound substrates. We also demonstrate how to find the closest thermophile example in the dataset if the engineering is aimed at achieving most robust enzymes.


Association of eye strain with dry eye and retinal thickness.
The purpose of this cohort study was to investigate the association between the prevalence of abnormal ocular examination results and the common visual symptoms of eye strain, blurred vision and photophobia. Consecutive first-visit outpatients with best-corrected visual acuity better than 20/30 in both eyes were enrolled and those with a history of intra-ocular lens implantation and glaucoma were excluded. Dry eye-related examinations and retinal thickness measurement were conducted. The odds ratio (OR) was calculated with logistic regression analyses of ocular data in relation to the presence of visual symptoms. A total of 6078 patients (3920 women, mean age 49.0 ± 20.4 years) were analyzed. The prevalence of each symptom was 31.8% for eye strain, 22.5% for blurred vision and 16.0% for photophobia. A significant risk factor for eye strain was short tear break-up time (TBUT) (OR 1.88), superficial punctate keratitis (SPK) (OR 1.44), and thickness of ganglion cell complex (GCC) (OR 1.30). Risk factors for blurred vision were short TBUT (OR 1.85), SPK (OR 1.24) and GCC (OR 0.59). Risk factors for photophobia were short TBUT (OR 1.77) and SPK (OR 1.32). Schirmer test value, peripapillary nerve fiber layer thickness and full macular thickness were not associated with the tested symptoms. The current study successfully identified female gender, short TBUT, and SPK as significant risk factors for eye strain, blurred vision, and photophobia with considerable ORs.


Comparing storage battery and solar cell in assisting Eucalyptus Globulus to phytoremediate soil polluted by Cd, Pb, and Cu.
Metal decontamination and leaching alleviation capacity of Eucalyptus globulus with and without electric field were investigated using ICP-MS. The biomass production of the chosen plant increased from 0.87 kg in planting control without electrokinetic treatment to 1.16 and 1.42 kg in experiments with electric field supplied by storage battery and solar cell, respectively. Under the influence of electric field with a voltage of 6.5 V, significantly more Cd, Pb and Cu were extracted by the species. Precipitation simulation was performed to evaluate the capacity of battery and solar panel to intercept leaching. The total volume of leachate gathered from the control decreased from 1012 mL to 299 and 336 mL in containers treated by storage battery and solar cell, respectively. In addition to reduction of leachate, the leaching mass of Cd, Pb and Cu was decreased significantly by electric fields (both battery and solar cell) treatments. The effect of remediation and environmental risk alleviation by solar cell was comparable with storage battery, at least during the 30-day experimental period. On the basis of the present study, solar cell should be a suitable substitute for conventional power supply to improve metal polluted soil when considering phytoremediation efficiency and energy consumption.


Stage 1B cervical cancer in a pregnant woman at 25 weeks of gestation.
Cervical cancer associated with pregnancy is rare (0.05%), although it is the most frequently diagnosed malignancy in pregnant women. We present the case of a 28-year-old woman at 25 weeks of gestation diagnosed with Stage 1B cervical cancer. Treatment was delayed until fetal maturity, and an elective cesarean section was performed at 33 weeks' gestation, followed by a total hysterectomy preserving the ovaries, and a pelvic lymphadenectomy. A review of the literature on the treatment of cervical cancer during pregnancy relevant to the case described is also presented.


Relationship of anxiety level and recall of information to the interval between orientation and first patient care day.
Sophomore students' responses to two different intervals between orientation and first clinical day in medical/surgical nursing were examined. Variables studied were anxiety state and ability to recall information which had been presented. Prior to orientation all students were given the Spielberger STAI-S and STAI-T anxiety scales. At the beginning of the first laboratory session the students completed the STAI-S scale and a teacher-made quiz on information presented in orientation. Students in Group I (n = 51) had their first laboratory one week after orientation. Group II (n = 39) had their first laboratory the day following orientation. There was no significant difference between the two groups on cumulative grade point average, beginning STAI-T or STAI-S. Likewise, there was no significant difference between the scores made on the quiz. (The validity and reliability of the quiz were not determined.) There was a significant difference between the two groups on changes in state anxiety from orientation to the first laboratory. Group I (laboratory one week after orientation) was more anxious than Group II (laboratory one day after orientation) (p = 0.024). Both groups were significantly more anxious in the Spring than Fall quarter (p = 0.034). It was concluded that anxiety related to a new clinical experience might be lessened if the first clinical day closely followed orientation. It was also noted that students may be more anxious in the Spring than in the Fall of the year.


Learning to visually perceive the relative mass of colliding balls in globally and locally constrained task ecologies.
Novice observers differ from each other in the kinematic variables they use for the perception of kinetic properties, but they converge on more useful variables after practice with feedback. The colliding-balls paradigm was used to investigate how the convergence depends on the relations between the candidate variables and the to-be-perceived property, relative mass. Experiment 1 showed that observers do not change in the variables they use if the variables with which they start allow accurate performance. Experiment 2 showed that, at least for some observers, convergence can be facilitated by reducing the correlations between commonly used nonspecifying variables and relative mass but not by keeping those variables constant. Experiments 3a and 3b further demonstrated that observers learn not to rely on a particular nonspecifying variable if the correlation between that variable and relative mass is reduced.


Traumatic pseudoaneurysm of the popliteal artery after blunt trauma: case report and a review of the literature.
Pseudoaneurysms of the popliteal artery following trauma are rare lesions. We present 3 cases of pseudoaneurysms of the popliteal artery (4, 20, and 45 years old respectively) with a delayed presentation, following blunt trauma, presenting over a 3-year period, and a short review of the relevant literature. A delayed pattern of presentation, over 2 years after blunt popliteal trauma, was observed in all patients. They presented with a painful pulsatile mass in the popliteal fossa, and their peripheral pulses were normal. Orthopedic and rheumatologic evaluation findings were negative. Diagnostic evaluation included triplex, arteriography, and computed tomography angiography. A posterior popliteal approach was used, and after aneurysmal excision, reversed great saphenous vein and lesser saphenous vein (1 patient) grafts were used. After 2 to 4 years of follow-up, all grafts remain patent and the patients have fully functional limbs. A literature search revealed 70 cases of pseudoaneurysms of the popliteal artery reported in civilian settings. These lesions should be repaired shortly because their complications (rupture, thromboembolic episodes) carry a high risk for limb dysfunction and amputation. Penetrating or blunt trauma is the main causative factor (62.5%), but iatrogenic trauma accounts for an increasing number of reports (37.5%). Strict follow-up of popliteal trauma is essential. A high level of suspicion and awareness can lead to early diagnosis and treatment of pseudoaneurysms of the popliteal artery and prevent the serious complications associated with these lesions.


Endoscopic lesions of postoperative anastomotic area in patients with Crohn's disease in the biologic era: A Japanese multi-center nationwide cohort study.
Many patients have endoscopic evidence of recurrent Crohn's disease (CD) at one year after intestinal resection. These lesions predict future clinical recurrence. We endoscopically evaluated postoperative anastomotic lesions in CD patients from a large cohort of postoperative CD patients. We retrospectively enrolled CD patients who underwent surgical resection between 2008 and 2013 at 19 IBD-specializing institutions. The initial analyses included patients who underwent ileocolonoscopy approximately 1 year after intestinal resection. Follow-up analyses assessed any changes in the endoscopic findings over time. We evaluated the postoperative endoscopic findings which were classified into four categories (no lesion, mild, intermediate, severe) at the sites of the anastomotic line (AL) and peri-anastomosis (PA). Two hundred sixty-seven CD patients underwent postoperative ileocolonoscopy. Postoperative anastomotic lesions were highly detected in the index ileocolonoscopy (61.0%) and were more frequently detected in follow-up ileocolonoscopy (74.9%). Endoscopic severity also increased. Patients with intermediate or severe peri-anastomotic or anastomotic line lesions at the index ileocolonoscopy required significantly more interventions, including endoscopic dilatation or surgery, than patients with mild lesions or no lesions. Frequent anastomotic lesions were observed at the postoperative index ileocolonoscopy. These gradually increased for subsequent ileocolonoscopy, even in the biologic era. Regarding lesions on the anastomotic line, intermediate lesions on the anastomotic line (e.g., irregular or deep ulcers) might be considered recurrent disease, and mild lesions (e.g., linear superficial ulcers) might be considered non-recurrent disease. Prospective studies are needed to resolve this issue, including treatment enhancement.


[Safety of proton pump inhibitors].
The significant inhibitory capacity of gastric acid secretion of PPIs makes them the drugs of choice for treating acid-related diseases. The considerable prevalence of these diseases and the need for maintaining the administration of the drug during considerably long periods results in this therapeutic group being one of the most widely used. However, in spite of their extensive use, there continue to emerge concerns about their potential toxicity; concerns surrounding the specificity of their mechanism of action and a consequential suspicion that something so potent must involve harmful effects. PPIs act selectively on the final stage of the process of gastric acid secretion, namely the H+/K+-ATPase or proton pump. This enzyme represents an essential step in the process of secretion of H+, and PPIs exert a very specific action on the parietal cell, as they need an environment with very low pH levels, which only exist in this cell. In the present article, the adverse effects of PPIs are reviewed, with special emphasis on those related to their continued administration and on the special circumstances of patients, as in the case of the elderly, those with liver failure, pregnant and breastfeeding mothers and children. All the PPIs on the market share a common chemical basis and there are no great differences in their potential adverse effects, the possibility of them promoting opportunist infections or their capacity to generate pharmacokinetic interactions with other drugs, which, if occur, are generally insignificant. After two decades of use, PPIs have proved to be very effective and safe drugs.


Wound dressings.
Each child, wound and wound site is unique and these factors will impact on the type of dressing the nurse decides to use. Wound dressings broadly fall into a number of classes, depending on the material they are made of. The nurse should be aware of the particular characteristics of each class of dressing and the impact these can have on wound healing. Modern wound dressings are designed to do one or more of three things: protect, debride and absorb excess exudate. With this knowledge the nurse can make the most appropriate selections and provide explanations to parents and child about the choices available.


Mn concentration and mycorrhizal colonization in understory native species grown at areas of manganese mine tailings disposal.
Revegetation of areas with mine tailings should consider not only the best technique but also the choice of species adapted to this condition. This study aimed to analyze the occurrence of plant species, their Mn concentrations, and mycorrhizal colonization after implementation of two revegetation techniques (replacement of topsoil with natural seed bank and planting of seedlings) in an area of disposal of tailings from Mn processing compared to a native forest area as well as to a place that was not revegetated. Plant samples (at least three individuals/species) were collected from the understory at revegetated locations and forest. The established plant species and their Mn concentrations, mycorrhizal colonization, and forms of Mn in the soil were analyzed. The use of topsoil led to greater plant diversity. The high concentrations of Mn in the substrates did not affect the occurrence of vegetation in the understory and mycorrhizal colonization. The plant species established in the revegetated areas differed in relation to Mn concentration (471-27,842 mg kg-1 in leaves), Mn translocation factor (0.2-125.3) and mycorrhizal colonization rates (1-35%). Four potential Mn hyperaccumulators species were identified: Aparisthmium cordatum, Clidemia hirta, Socratea exorrhiza, and Vismia latifolia.


Dysfunction of the pancreas in healthy smoking persons and patients with chronic pancreatitis.
The aim of the study was to assess the effect of cigarette smoking on the endocrine pancreatic function by determining the levels of serum glucose and plasma insulin as well as by defining immunohistochemical localization of insulin and glucagon in tissue specimens of the pancreata derived from healthy persons and smoking and nonsmoking patients with diagnosed chronic pancreatitis (CP). The oxidative method was used to measure fasting glycemia in blood plasma and the method enzyme-linked immunoassay to determine the level of insulin in plasma. Immunohistochemical localization of hormones in paraffin tissue specimens of the pancreas was performed using the LSAB2-HRP visual test with polyclonal insulin and glucagon antibodies. The intensity of immunohistochemical reaction was calculated with digital imaging methodology. The study revealed a substantially higher level of serum glucose in smoking CP patients and in healthy persons compared with nonsmoking patients and healthy persons, whereas insulin concentration in smoking patients was statistically lower than in nonsmokers. Smoking patients showed significantly lower expression of insulin and glucagon in the pancreas compared with nonsmoking patients and healthy persons. Impairment of the endocrine function of beta and alpha cells in the pancreatic islets is frequently manifested by complications in pancreatitis resulting among others from long-term smoking.


Evidence of Crohn's disease-related anti-glycoprotein 2 antibodies in patients with celiac disease.
Autoantibodies to exocrine-pancreatic glycoprotein 2 (anti-GP2) are Crohn's disease (CD) markers. However, CD-specific antibodies have also been found in celiac-disease (CeD) patients, in which type 1 diabetes-specific autoantibodies against endocrine pancreatic targets can be present. We investigated whether anti-GP2 are also present in CeD, a disease like CD which is also characterised by intestinal mucosal inflammation with barrier impairment. Antibodies against GP2, tissue transglutaminase (tTG), deamidated gliadin (dGD), glutamic decarboxylase (GAD), and islet antigen-2 (IA2) were tested in sera from 73 CD patients, 90 blood donors (BD), and 79 (58 de novo) CeD patients (2 consecutive sera were available from 40 patients). IgA and/or IgG anti-GP2 were found in 15/79 (19.0%) CeD patients on at least one occasion, in 25/73 (34.2%) CD patients, and in 4/90 (4.4%) BD (CeD vs. CD, p=0.042; BD vs. CeD and CD, p<0.001, respectively). Amongst the 58 de novo CeD patients, anti-GP2 IgA and/or IgG were present in 11 (19.0%). Anti-GP2 IgA was significantly less prevalent in CeD compared with CD (p=0.004). Anti-GP2 IgA and IgG in CD patients demonstrated a significantly higher median level compared to patients with CeD (p<0.001, p=0.008, respectively). IgA anti-GP2 levels correlated significantly with IgA anti-tTG and anti-dGD levels in CeD Spearman's coefficient of rank correlation (ρ)=0.42, confidence interval (CI): 0.26-0.56, p<0.001; ρ=0.54, CI 0.39-0.65, p<0.001, respectively. The presence of anti-GP2 in CeD patients supports the notion that loss of tolerance to GP2 can probably be a manifestation of an autoinflammatory process in this intestinal disorder.


Hardness and in vitro wear of a novel ceramic restorative cement.
The aim of the present work was to compare a new ceramic restorative cement for posterior restorations, DoxaDent, with other types of tooth-colored materials for direct use as regards hardness and in vitro wear. Four hybrid resin composites, one polyacid-modified resin composite, one resin-modified glass ionomer cement, one conventional glass ionomer cement, one zinc phosphate cement, an experimental version as well as the marketed version of the ceramic restorative cement, were investigated. Hardness of the materials was tested with the Wallace indentation tester and wear was tested with the ACTA wear machine. All tests were carried out on 2-wk-old specimens. DoxaDent was as hard as the zinc phosphate cement and the hardest resin composite. The ceramic restorative cement wore significantly more than the resin composites, the same as the zinc phosphate cement, and less than the glass ionomer cements. No correlation between hardness and wear was found. It can be concluded that the ceramic restorative cement is a rather hard material but with a relatively low wear resistance.


Structure-property relationships in push-pull amino/cyanovinyl end-capped oligothiophenes: quantum chemical and experimental studies.
A series of push-pull chromophores built around thiophene-based pi-conjugating spacers and bearing various types of amino donors and cyanovinyl acceptors have been analyzed by means of UV-vis-NIR, IR, and Raman spectroscopic measurements in the solid state as well as in solution. The intramolecular charge transfer (ICT) of these pi-conjugated systems has also been tested by analyzing the ability of the solute molecules to undergo shifts in their fluorescence emission maxima with increasing solvent polarity. These push-pull oligomers also display an attractive electrochemical behavior since they generate stable species both upon oxidation and reduction. Oxidation mainly involves changes in the electron-rich aminooligothienyl half-part of the molecule and leads to the formation of stable cations. On the other hand, reduction to radical anions and dianions is mainly cyanovinyl-centered but also affects the pi-conjugated electron relay. Density functional theory (DFT) calculations have been carried out to help the assignment of the most relevant electronic and vibrational features and to derive useful information about the molecular structure of these NLO-phores.


Biocontrol Properties of Basidiomycetes: An Overview.
In agriculture, there is an urgent need for alternate ecofriendly products to control plant diseases. These alternate products must possess preferable characteristics such as new modes of action, cost effectiveness, biodegradability, and target specificity. In the current scenario, studies on macrofungi have been an area of importance for scientists. Macrofungi grow prolifically and are found in many parts of the world. Basidiomycetes (mushrooms) flourish ubiquitously under warm and humid climates. Basidiomycetes are rich sources of natural antibiotics. The secondary metabolites produced by them possess antimicrobial, antitumor, and antioxidant properties. The present review discusses the potential role of Basidiomycetes as anti-phytofungal, anti-phytobacterial, anti-phytoviral, mosquito larvicidal, and nematicidal agents.


Interaction of dopamine, (+/-)-dobutamine and the (-)-enantiomer of dobutamine with alpha- and beta-adrenoceptors in the pulmonary circulation of the dog.
The effects of dopamine, (+/-)-dobutamine (racemic mixture) and (-)-dobutamine on alpha-adrenoceptor-mediated vasoconstriction were evaluated in the pulmonary circulation of the anesthetized dog. The drugs were studied in the absence and presence of propranolol (1 mg/kg, i.v.) in order to assess beta-adrenoceptor-mediated effects in the pulmonary circulation. Intra-arterial administration of dopamine, (+/-)-dobutamine and (-)-dobutamine elicited dose-dependent increases in pulmonary perfusion pressure, reflecting increases in pulmonary vascular resistance. In control animals, dopamine elicited the largest increases in pulmonary perfusion pressure (45% above resting pulmonary pressure) followed by (-)-dobutamine (30% increase) and (+/-)-dobutamine (15% increase). The pressor effects of dopamine in the pulmonary circulation were mediated by both postjunctional vascular alpha 1- and alpha 2-adrenoceptors, since prazosin, (100 micrograms/kg, i.v.), a selective alpha 1-adrenoceptor antagonist, and rauwolscine (100 micrograms/kg, i.v.), a selective alpha 2-adrenoceptor antagonist, both inhibited the vasopressor response elicited by dopamine to roughly equivalent degrees. Pulmonary vasoconstriction produced by (+/-)-dobutamine and (-)-dobutamine was mediated primarily by postsynaptic vascular alpha 1-adrenoceptors, although alpha 2-adrenoceptor-mediated vasoconstriction was observed. In propranolol-pretreated animals, the increase in pulmonary perfusion pressure elicited by dopamine and (-)-dobutamine was qualitatively and quantitatively similar to that observed in control animals, suggesting that these agents have little activity on vascular beta 2-adrenoceptors in the pulmonary circulation. In marked contrast, the maximum pulmonary vasopressor response obtained with (+/-)-dobutamine were greater in propranolol-pretreated animals, indicating that (+/-)-dobutamine also has the capacity to stimulate pulmonary vascular beta 2-adrenoceptors which mediate pulmonary vasodilation that, in part, mask alpha-adrenoceptor-mediated pulmonary vasoconstriction. Since the (-)-enantiomer of dobutamine has little or no beta 2-adrenoceptor agonist activity, the beta 2-adrenoceptor-mediated effect of (+/-)-dobutamine must result from the (+)-enantiomer as has been previously proposed. The results of the present study indicate that dopamine has a greater propensity for increasing pulmonary vascular resistance, and therefore pulmonary arterial blood pressure, relative to (+/-)-dobutamine. This results, at least in part, from the relatively weaker activity of dopamine in stimulating pulmonary vascular beta 2-adrenoceptors which mediate vasodilation.(ABSTRACT TRUNCATED AT 400 WORDS)


Passive Recovery Strategies after Exercise: A Narrative Literature Review of the Current Evidence.
Passive recovery techniques are popular and offer a diverse spectrum of options for athletes and the clinicians providing care for them. These techniques are intended to minimize the negative effects of training or competition, thus enabling the athlete a quicker return to peak performance. Current evidence demonstrates improved athlete recovery with compression garments, cold water immersion, partial body cryotherapy, hyperbaric oxygen, and vibratory therapies. Other popular modalities, such as compression devices, whole body cryotherapy, percussive gun-assisted therapy, neuromuscular electrical stimulation, and pulsed electromagnetic therapy lack convincing evidence concerning athlete recovery. This article seeks to review the current literature and offer the reader an updated understanding of the mechanisms for each modality and the evidence regarding each modality's potential benefit in an athlete's recovery strategy.