Indigenous Peoples' Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review.
There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological issues as taboo. While there has been previous research on the impact of these beliefs on menstrual health literacy, this has almost entirely been confined to low- and middle-income countries, with very little information on high-income countries. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map the extent and range of evidence of health literacy of menstruation and gynecological disorders in Indigenous people in the colonized, higher-income countries of Australia, Canada, and New Zealand. PubMed, CINHAL, PsycInfo databases, and the grey literature were searched in March 2022. Five studies from Australia and New Zealand met the inclusion criteria. Only one of the five included studies focused exclusively on menstrual health literacy among the Indigenous population. Despite considerable research on menstrual health globally, studies focusing on understanding the menstrual health practices of the Indigenous populations of Australia, New Zealand, and Canada are severely lacking, and there is little to no information on how Indigenous beliefs of colonized people may differ from the broader society in which they live.


Prevalence of psychiatric ailments among patients with sexually transmitted disease.
A cross-sectional descriptive study conducted on 250 sexually transmitted disease patients was carried out in two teaching institutes and their tertiary hospitals. These subjects constitute a special group of population for psychiatric diagnosis by using Structured Clinical Interview for Diagnostic and Statistical Manual IIIR. The study was done in the dermatology and venereology outpatient department of two tertiary hospitals of Dhaka, between January 1998 and January 1999. The findings show that 34% of total sexually transmitted disease patients had psychiatric disorders. Anxiety disorders (11.2%) were found to be the most common disorder among these psychiatric patients; this was followed by depressive disorder (8.4%), psychoactive substance use disorder (6.8%), sexual dysfunction (6.8%), bipolar mood disorder (0.4%), and schizophrenia (0.4%). Four percent of anxiety disorder was associated with psychoactive substance use disorder and sexual dysfunction. Similarly 3.6% of depressive disorder was found with psychoactive substance use disorder and sexual dysfunction while 1.6% of sexual dysfunction was associated with substance use disorder. Most of the patients in the sexually transmitted disease population recruited in the present study had both anxiety disorder and depressive disorder though majority of them were undetected and untreated. These findings underscore that special attention needs to be given to the mental health component of our health care delivery system.


Usefulness of Quantification and Serial Monitoring of Fine Crackles for Early Detection of Treatment-related Lung Injury: A Report of Two Cases.
Early detection and appropriate management of treatment-related interstitial lung disease (ILD) are important in cancer treatment. We established an algorithm for quantifying fine crackles using machine learning and reported that the fine crackle quantitative value (FCQV) calculated by this algorithm was more sensitive than chest radiography for detecting interstitial changes. Using this algorithm, we periodically analyzed respiratory sounds in two patients with lung cancer who developed treatment-related ILDs and found that the FCQV was elevated before the diagnosis of ILD. These cases may indicate the usefulness of the FCQV in the early diagnosis of treatment-related ILDs.


Glucosamine enhances paracetamol bioavailability by reducing its metabolism.
Paracetamol has an extensive first-pass metabolism that highly affects its bioavailability (BA); thus, dose may be repeated several times a day in order to have longer efficacy. However, hepatotoxicity may arise because of paracetamol metabolism. Therefore, this project aimed to increase paracetamol BA in rats by glucosamine (GlcN). At GlcN-paracetamol racemic mixture ratio of 4:1 and paracetamol dose of 10 mg/kg, paracetamol area under the curve (AUC) and maximum concentration (Cmax ) were significantly increased by 99% and 66%, respectively (p < 0.05). Furthermore, paracetamol AUC and Cmax levels were increased by 165% and 88% in rats prefed with GlcN for 2 days (p < 0.001). Moreover, GlcN significantly reduced phase Ι and phase I/ΙΙ metabolic reactions in liver homogenate by 48% and 54%, respectively. Furthermore, GlcN molecule was found to possess a good in silico binding mode into the CYP2E1 active site-forming bidentate hydrogen bonding with the Thr303 side chain. Finally, serum ALT and AST levels of rats-administered high doses of paracetamol were significantly reduced when rats were prefed with GlcN (p < 0.01). In conclusion, GlcN can increase the relative BA of paracetamol through reducing its metabolism. This phenomenon is associated with reduction in hepatocytes injury following ingestion of high doses of paracetamol.


Drug-induced QRS morphology and duration changes.
Drug-induced ECG changes may affect all components of the ECG curve. The attention of regulatory agencies, researchers and clinicians has been directed towards drug-induced QT-interval prolongation and its well-documented proarrhythmia. This presentation focuses on druginduced changes, i.e., morphology, amplitude and QRS complex duration (QRSd). A great variety of pharmacological agents (e.g., class IA and IC antiarrhythmics, antihistamines, antidepressants, antipsychotics) exert an influence on the QRSd. The QRSd is assessed by a variety of ECG methodologies. Standardization of measurements of QRSd ensures the comparability of results by different ECG modalities, and of serial QRSd assessments. Some analgesics and hypoglycemic agents influence the amplitude of QRS complexes by way of their propensity to cause peripheral oedema (extracardiac mechanism). Perhaps a new culture could evolve in which the entire ECG curve, from the onset of the P-wave to the offset of the U-wave, will be used in the evaluation and monitoring of drug safety, with emphasis primarily on the standard ECG.


Messenger RNA fluctuations and regulatory RNAs shape the dynamics of a negative feedback loop.
Single-cell experiments of simple regulatory networks can markedly differ from cell population experiments. Such differences arise from stochastic events in individual cells that are averaged out in cell populations. For instance, while individual cells may show sustained oscillations in the concentrations of some proteins, such oscillations may appear damped in the population average. In this paper we investigate the role of RNA stochastic fluctuations as a leading force to produce a sustained excitatory behavior at the single-cell level. As opposed to some previous models, we build a fully stochastic model of a negative feedback loop that explicitly takes into account the RNA stochastic dynamics. We find that messenger RNA random fluctuations can be amplified during translation and produce sustained pulses of protein expression. Motivated by the recent appreciation of the importance of noncoding regulatory RNAs in post-transcription regulation, we also consider the possibility that a regulatory RNA transcript could bind to the messenger RNA and repress translation. Our findings show that the regulatory transcript helps reducing gene expression variability both at the single-cell level and at the cell population level.


[New spine and non-spine fractures in 871 women/year treated with oral pamidronate plus calcium and vitamin D supplements].
A sample of 871.3 patients/year was conformed by 205 postmenopausal women, aged 64.8 +/- 18.2 years (mean +/- SD), followed up during 51 +/- 12 months. All have osteoporosis, diagnosis assessed through radiological findings of at least one atraumatic fracture or vertebral crush ("severe osteoporosis" according to the new WHO classification). Each woman received 100 mg/day oral pamidronate (enteric coated soft gelatin capsules), half an hour before breakfast. Additional calcium and vitamin D were supplemented as follows: Total daily calcium = 1 g provided by diet and/or calcium carbonate. Vitamin D equivalent to 400-1200 IU/day. All patients were recommended to improve their physical activity, at least by walking exercise. Clinical examination radiological, bone mineral density (BMD) and biochemical studies were periodically performed. But, fracture indicence was the end-point of the study. Same was related to the 1,673 fall episodes recorded in the sample. In addition, height loss, lumbar BMD, proximal femur BMD, are also reported. Data has been cross-sectional collected in March 1995. All patients improved the symptomatology, specifically pain. This, and the good tolerability of the treatments proved to be considerably favorable for their compliance. Within the observation period, only 12 patients decreased their height (5.85%; mean = 0.85 cm; range = 0.5-2.0 cm). Lumbar spine BMD increased in 90% of 48 women. Mean gain after 2 years was 5.3 +/- 1.0% (p < 0.001). Proximal femur increased in 78% of other 32 women. Mean gain 6.3 +/- 0.7% (p < 0.001) after 2 years. A total of 78 new fractures were recorded, 47 vertebral crush, 29 forearm fractures and 2 hip fractures. Its incidence related to the fall episodes was of 2.8; 1.7 and 0.12% respectively. When compared with a historical estimated data, from an untreated population (Cummings SR et al, 1994), both, the total number of new fractures and the new hip fractures were significantly lower (p < 0.01) in our treated population than the reference data. Pamidronate, in oral doses of 100 mg/day, adequately supplemented with calcium and vitamin D, proved to be effective and a well tolerated therapy. The low rate of height's loss, BMD significant increases in subgroups of patients and the low rate of new fractures, strongly support the use of the compound to treat severe osteoporotic women. To our knowledge, this is the first time, that the new fracture incidence is related to the fall frequency reported in a bisphosphonate treated sample.


Technique to Improve Tracheostomy Speaking Valve Tolerance after Head and Neck Free Flap Reconstruction.
Increased upper airway resistance from postoperative changes after major head and neck surgery may cause elevated transtracheal pressures and result in tracheostomy speaking valve intolerance. This may be particularly true among patients with baseline pulmonary disease. We describe a patient recovering from oral cancer resection and flap reconstruction who demonstrated prolonged ventilator dependence and tracheostomy speaking valve intolerance with abnormal tracheal manometry. We attempted to improve speaking valve tolerance through the adaptation of a valve modification intended to reduce transtracheal pressures. Drilling holes into the 1-way speaking valve allowed for excess air egress and resulted in normalization of transtracheal pressures with improved speaking valve tolerance. This 1-way speaking valve modification may serve as a simple method to allow for earlier restoration of voicing and potentially reduce the number of ventilator- dependent days in this patient population.


[Rheumatoid arthritis--new imaging methods].
The radiology imaging in musculoskeletal system with a point on rheumatoid arthritis and modern methods such as magnetic resonance, power ultrasound, and color Doppler are described. Tomosynthesis, a new method for analysis of trabecular bone and bone density, which is important in rheumatoid arthritis, is described too.


Novel Ru-dioxolene complexes as potential electrochromic materials and NIR dyes.
A series of Ru(bpy)(2)-dioxolene complexes 1-4 (bpy = 2,2'- bipyridine) and corresponding Ru(dcb)(2)-dioxolene complexes 5-8 (dcbH(2) = 2,2'-bipyridine-4,4'-dicarboxylic acid) have been prepared, and their spectroelectrochemical behavior in solution has been investigated. The complexes show reversible electrochemical behavior accompanied by a strong NIR absorption in their semiquinone forms due to a Ru(dpi) --> sq(pi) MLCT band. Complete quenching of the NIR absorption occurs both upon oxidation (to the quinone form) and upon reduction (to the catechol form) very close to 0 V. The color of the systems can be tuned by using a wide range of ligands. The complexes 5-8 can be anchored onto nanocrystalline inorganic semiconductors allowing incorporation into potential electrochromic devices. As a proof of principle, compound 8 has been adsorbed on nanocrystalline Sb-doped SnO(2) supported on FTO glass, and it displays reversibly switchable electrochromic behavior in the NIR.


Fertility History and Cognitive Function in Late Life: The Case of Mexico.
Mexico is aging rapidly, which makes identification of life-course factors influencing cognition a public health priority. We evaluate how the number of children one has relates to cognition in Mexico, a rapidly aging country that experienced fertility declines across recent cohorts of older people. We analyze older adults (age 50+, n = 11,380) from the 2015 Mexican Health and Aging Study. Respondents were categorized by number of children ever born (0-1, 2-3, 4-5, 6+). Using ordinary least squares regression, we estimate independent associations between fertility history and cognition accounting for demographic, socioeconomic, health, and psychosocial factors. We observed an inverse U-shaped relationship between number of children (peaking at 2-3 children) and cognitive function, regardless of gender. In regression analyses adjusted for confounding variables, having 0-1 (vs 2-3 children) was associated with poorer cognitive function only for females. Regardless of gender, having 6+ (vs 2-3 children) was associated with poorer cognitive function. These associations remained significant even after accounting for socioeconomic, health, employment, and psychosocial factors. Our results suggest fertility history may play a role in late-life cognitive health and provide evidence that both low and high fertility may relate to poorer cognitive function. We discuss differences by gender.


Organotins in Neuronal Damage, Brain Function, and Behavior: A Short Review.
The consequences of exposure to environmental contaminants have shown significant effects on brain function and behavior in different experimental models. The endocrine-disrupting chemicals (EDC) present various classes of pollutants with potential neurotoxic actions, such as organotins (OTs). OTs have received special attention due to their toxic effects on the central nervous system, leading to abnormal mammalian neuroendocrine axis function. OTs are organometallic pollutants with a tin atom bound to one or more carbon atoms. OT exposure may occur through the food chain and/or contaminated water, since they have multiple applications in industry and agriculture. In addition, OTs have been used with few legal restrictions in the last decades, despite being highly toxic. In addition to their action as EDC, OTs can also cross the blood-brain barrier and show relevant neurotoxic effects, as observed in several animal model studies specifically involving the development of neurodegenerative processes, neuroinflammation, and oxidative stress. Thus, the aim of this short review is to summarize the toxic effects of the most common OT compounds, such as trimethyltin, tributyltin, triethyltin, and triphenyltin, on the brain with a focus on neuronal damage as a result of oxidative stress and neuroinflammation. We also aim to present evidence for the disruption of behavioral functions, neurotransmitters, and neuroendocrine pathways caused by OTs.


Mechanism of androstenedione formation from testosterone and epitestosterone catalyzed by purified cytochrome P-450b.
A purified rat hepatic monooxygenase system containing cytochrome P-450b oxidizes testosterone to androstenedione and 16 alpha- and 16 beta-hydroxytestosterone at approximately equal rates. The metabolism of epitestosterone by the same system is characterized by a marked stereoselectivity in favor of 16 beta-hydroxylation (4- to 5-fold relative to 16 alpha-hydroxylation), formation of 15 alpha-hydroxyepitestosterone, and a rate of androstenedione formation which is three to five times higher than that observed with testosterone. Apparent Km values for 16 alpha- and 16 beta-hydroxylation and androstenedione formation are 20-30 microM with either substrate. Mass spectral analysis of the androstenedione formed from [16,16-2H2]testosterone and [16,16-2H2] epitestosterone indicates essentially complete retention of deuterium, thereby ruling out a mechanism of androstenedione formation via C-16 hydroxylation followed by loss of water and rearrangement. Mass spectral analysis of the C-16 hydroxylation products from incubations of testosterone or epitestosterone in 18O2 shows essentially complete incorporation of 18O (greater than 95%). Androstenedione formed from testosterone is enriched in 18O only 2-fold (5-8%) over background, while the androstenedione formed from epitestosterone shows 84% enrichment. Kinetic experiments utilizing [17-2H]testosterone and [17-2H]epitestosterone as substrates indicate that cleavage of the C-17 carbon-hydrogen bond is involved in a rate-limiting step in the formation of androstenedione from both substrates. Taken together, our results indicate that androstenedione formation from epitestosterone proceeds exclusively through the gem-diol pathway, while androstenedione formation from testosterone may proceed through a combination of gem-diol and dual hydrogen abstraction pathways.


Anti-Xa activity relates to survival and efficacy in unselected acute coronary syndrome patients treated with enoxaparin.
Low-molecular-weight heparin (LMWH) is recommended in the treatment of unstable angina (UA)/non-ST-segment-elevation myocardial infarction (NSTEMI), but no relationship has ever been shown between anticoagulation levels obtained with LMWH treatment and clinical outcomes. In all, 803 consecutive patients with UA/NSTEMI were treated with subcutaneous enoxaparin and were followed up for 30 days. The recommended dose of enoxaparin of 1 mg/kg BID was used throughout the population except when physicians decided on dose reduction because of a history of a recent bleeding event or because of a high bleeding risk. Anti-factor Xa activity was >0.5 IU/mL in 93% of patients; subtherapeutic anti-Xa levels (<0.5 IU/mL) were associated with lower doses of enoxaparin. The 30-day mortality rate was significantly associated with low anti-Xa levels (<0.5 IU/mL), with a >3-fold increase in mortality compared with the patients with anti-Xa levels in the target range of 0.5 to 1.2 IU/mL (P=0.004). Multivariate analysis revealed low anti-Xa activity as an independent predictor of 30-day mortality at least as strong as age, left ventricular function, and renal function. In contrast, anti-Xa activity did not predict major bleeding complications within the range of anti-Xa levels observed in this study. In this large unselected cohort of patients with UA/NSTEMI patients, low anti-Xa activity on enoxaparin treatment is independently associated with 30-day mortality, which highlights the need for achieving at least the minimum prescribed anti-Xa level of 0.5 IU/mL with enoxaparin whenever possible.


Goal disturbance predicts health-related quality of life and depression 4 months after myocardial infarction.
The aim of this longitudinal study was to determine whether the event of a myocardial infarction (MI) would lead to a disturbance in important higher-order goals, and whether goal disturbance could predict health-related quality of life (HRQL) and depression 4 months later, in addition to baseline scores, demographic characteristics, presence of anginal complaints (AP) or chest pain, coping strategies and social support. A total of 113 MI patients completed questionnaires shortly after hospitalization (T1) and 4 months later (T2), assessing (an impact of the event on) important higher-order goals (T1), disease-related coping strategies (T1), perceived adequacy of social support (T2), AP (T2), HRQL, and depression (T2). Two separate hierarchical regression analyses were performed with HRQL and depression at T2 as dependent variables. The results suggest that the experience of an MI has an impact on the attainment of higher-order goals. Goal disturbance is an independent predictor of both HRQL and depression after MI. A goal theory perspective can provide additional insights into HRQL outcomes after an MI.


Kidney Function and Risk of Renal Cell Carcinoma.
We evaluated the temporal association between kidney function, assessed by estimated glomerular filtration rate (eGFR), and the risk of incident renal cell carcinoma (RCC). We also evaluated whether eGFR could improve RCC risk discrimination beyond established risk factors. We analyzed the UK Biobank cohort, including 463,178 participants of whom 1,447 were diagnosed with RCC during 5,696,963 person-years of follow-up. We evaluated the temporal association between eGFR and RCC risk using flexible parametric survival models, adjusted for C-reactive protein and RCC risk factors. eGFR was calculated from creatinine and cystatin C levels. Lower eGFR, an indication of poor kidney function, was associated with higher RCC risk when measured up to 5 years prior to diagnosis. The RCC HR per SD decrease in eGFR when measured 1 year before diagnosis was 1.26 [95% confidence interval (95% CI), 1.16-1.37], and 1.11 (95% CI, 1.05-1.17) when measured 5 years before diagnosis. Adding eGFR to the RCC risk model provided a small improvement in risk discrimination 1 year before diagnosis with an AUC of 0.73 (95% CI, 0.67-0.84) compared with the published model (0.69; 95% CI, 0.63-0.79). This study demonstrated that kidney function markers are associated with RCC risk, but the nature of these associations are consistent with reversed causality. Markers of kidney function provided limited improvements in RCC risk discrimination beyond established risk factors. eGFR may be of potential use to identify individuals in the extremes of the risk distribution.


Integrating Palliative Care Into Self-management of Breast Cancer: A Pilot Randomized Controlled Trial.
Breast cancer patients may not be well-informed about palliative care, hindering its integration into cancer self-management. The aim of this study was to test Managing Cancer Care: A Personal Guide (MCC-PT), an intervention to improve palliative care literacy and cancer self-management. This was a single-blind pilot randomized controlled trial to evaluate the feasibility/acceptability and intervention effects of MCC-PT on palliative care literacy, self-management behaviors/emotions, and moderation by demographic/clinical characteristics. We enrolled 71 stages I to IV breast cancer patients aged at least 21 years, with >6-month prognosis at an academic cancer center. Patients were randomized to MCC-PT (n = 32) versus symptom management education as attention-control (n = 39). At baseline, 1 month, and 3 months, participants completed the Knowledge of Care Options Test (primary outcome), Control Preferences Scale, Goals of Care Form, Medical Communication Competence Scale, Measurement of Transitions in Cancer Scale, Chronic Disease Self-efficacy Scale, Hospital Anxiety and Depression Scale, and the Mishel Uncertainty in Illness Scale. Mean participant age was 51.5 years (range, 28-74 years); 53.5% were racial/ethnic minority patients, and 40.8% had stage III/IV cancer. After adjusting for race/ethnicity, MCC-PT users improved their palliative care literacy with a large effect size (partial η2 = 0.13). Patients at late stage of disease showed increased self-management (partial η2 = 0.05) and reduced anxiety (partial η2 = 0.05) and depression (partial η2 = 0.07) with medium effect sizes. Managing Cancer Care: A Personal Guide is feasible and appears most effective in late-stage cancer. Research is needed to elucidate relationships among cancer stage, race/ethnicity, and self-management outcomes. Integration of palliative care into cancer care can assist in creation of appropriate self-management plans and improve emotional outcomes.


[Disorder of Gastric Myoelectric Activity in Patients with Cerebral Infarction:Electrogastrographic Assessment].
In this study, gastric myoelectric activity in patients with acute cerebral infarction was investigated using electrogastrography. The patients were divided into four groups; those with mild brainstem infarction(group A, n=13, men:8, women:5, 75±2 years old), severe brainstem infarction(group B, n=6, men:4, women:2, 79±4 years old), mild non-brainstem infarction(group C, n=14, men:7, women:7, 76±3 years old), and severe non-brainstem infarction(group D, n=9, men:3, women:6, 87±2 years old). In group B, the% ratio of normogastria(2.4-3.6 cycles per minute)was significantly lower in the fasting period. The dominant power(DP)significantly increased after the meal in group C, but did not in group A, compared to before the meal. The DP increased in all patients in group C after the meal, whereas it increased in only five of ten patients in group A. The possibility of gastric dysfunction should be considered in patients with brainstem infarction.


Novel transcriptome assembly and comparative toxicity pathway analysis in mahi-mahi (Coryphaena hippurus) embryos and larvae exposed to Deepwater Horizon oil.
The impacts of Deepwater Horizon (DWH) oil on morphology and function during embryonic development have been documented for a number of fish species, including the economically and ecologically important pelagic species, mahi-mahi (Coryphaena hippurus). However, further investigations on molecular events and pathways responsible for developmental toxicity have been largely restricted due to the limited molecular data available for this species. We sought to establish the de novo transcriptomic database from the embryos and larvae of mahi-mahi exposed to water accommodated fractions (HEWAFs) of two DWH oil types (weathered and source oil), in an effort to advance our understanding of the molecular aspects involved during specific toxicity responses. By high throughput sequencing (HTS), we obtained the first de novo transcriptome of mahi-mahi, with 60,842 assembled transcripts and 30,518 BLAST hits. Among them, 2,345 genes were significantly regulated in 96hpf larvae after exposure to weathered oil. With comparative analysis to a reference-transcriptome-guided approach on gene ontology and tox-pathways, we confirmed the novel approach effective for exploring tox-pathways in non-model species, and also identified a list of co-expressed genes as potential biomarkers which will provide information for the construction of an Adverse Outcome Pathway which could be useful in Ecological Risk Assessments.


Evaluating Scoliosis Severity Based on Posturographic X-ray Images Using a Contrastive Language-Image Pretraining Model.
Assessing severe scoliosis requires the analysis of posturographic X-ray images. One way to analyse these images may involve the use of open-source artificial intelligence models (OSAIMs), such as the contrastive language-image pretraining (CLIP) system, which was designed to combine images with text. This study aims to determine whether the CLIP model can recognise visible severe scoliosis in posturographic X-ray images. This study used 23 posturographic images of patients diagnosed with severe scoliosis that were evaluated by two independent neurosurgery specialists. Subsequently, the X-ray images were input into the CLIP system, where they were subjected to a series of questions with varying levels of difficulty and comprehension. The predictions obtained using the CLIP models in the form of probabilities ranging from 0 to 1 were compared with the actual data. To evaluate the quality of image recognition, true positives, false negatives, and sensitivity were determined. The results of this study show that the CLIP system can perform a basic assessment of X-ray images showing visible severe scoliosis with a high level of sensitivity. It can be assumed that, in the future, OSAIMs dedicated to image analysis may become commonly used to assess X-ray images, including those of scoliosis.


Transient Esotropia in the Child: Case Report and Review of the Literature.
The aim of this report is to investigate the possible causes of acute acquired onset of transient esotropia (AATE) in children and to help to differentiate ophthalmoplegic migraine (OM) from accommodative spasm (AS). A case of an 8-year-old Caucasian female affected by AATE and diplopia is described. The day before AATE onset, the patient complained of slight headache without nausea and vomiting, with spontaneous resolution. AATE diagnosis is challenging. The most likely ophthalmological causes of AATE are AS and OM. In these cases it is important to evaluate the presence of both a familial history of recurrent headaches and an AATE associated with migraine, ptosis, nausea, and vomiting. A full ophthalmological evaluation and a thorough refractive examination in cycloplegia are mandatory to exclude ophthalmological causes.


Sampling stored-product insect pests: a comparison of four statistical sampling models for probability of pest detection.
Developing sampling strategies to target biological pests such as insects in stored grain is inherently difficult owing to species biology and behavioural characteristics. The design of robust sampling programmes should be based on an underlying statistical distribution that is sufficiently flexible to capture variations in the spatial distribution of the target species. Comparisons are made of the accuracy of four probability-of-detection sampling models - the negative binomial model,(1) the Poisson model,(1) the double logarithmic model(2) and the compound model(3) - for detection of insects over a broad range of insect densities. Although the double log and negative binomial models performed well under specific conditions, it is shown that, of the four models examined, the compound model performed the best over a broad range of insect spatial distributions and densities. In particular, this model predicted well the number of samples required when insect density was high and clumped within experimental storages. This paper reinforces the need for effective sampling programs designed to detect insects over a broad range of spatial distributions. The compound model is robust over a broad range of insect densities and leads to substantial improvement in detection probabilities within highly variable systems such as grain storage.


Thoracic laminectomy with spinal fixation in a nonambulatory patient with metastatic vertebral tumor from endometrial carcinoma.
Vertebral metastasis from endometrial cancer is a rare event and requires emergency treatment at the onset of neurologic symptoms caused by spinal cord compression. We report a case of a metastatic vertebral tumor, according to the International Federation of Gynecology and Obstetrics classification, of stage IVb endometrial cancer with multiple lung metastases. Emergency irradiation to the spinal tumor was conducted as a result of a loss of ambulation. Thoracic laminectomy with spinal fixation was subsequently performed because the patient remained nonambulatory and her neurological function deteriorated. Spinal decompression surgery enabled her to regain the ability to walk. Complete remission was achieved by subsequent pelvic surgery followed by combined chemotherapy consisting of docetaxel and carboplatin. Finally, the patient had no evidence of disease 45 months after the initial treatment. Early recognition and expeditious treatment is crucial for neurological recovery from metastatic spinal cord compression.


Occult pulmonary arterial hypertension in patients with previous pulmonary tuberculosis.
Pulmonary tuberculosis (TB) still causes a significant public healthcare burden. Despite successful treatment, TB can lead to permanent lung damage and pulmonary hypertension (PH). PH can also occur in the absence of significant lung damage, leading clinicians to question whether pulmonary TB may cause pulmonary arterial hypertension (PAH), an entity that has not been otherwise described. To determine the prevalence of PAH in patients previously treated for TB. We recruited 20 participants who were previously treated for TB and had no other underlying risk factors for the development of PH. The participants underwent electrocardiography (ECG), chest radiography, lung function tests and echocardiography (ECHO). Data from these non-invasive investigations were evaluated to determine findings that were suggestive of PH. At a median duration of 30 months from diagnosis of TB, no participant had echocardiography findings that were suggestive of PH (pulmonary artery pressure (PAP) ≥40 mmHg). However, there was a negative correlation between the time from diagnosis and right ventricular dysfunction assessed by measuring a tricuspid annular plane systolic excursion (r=-0.5136; p=0.0205). Furthermore, one-third of the participants (n=7) had one or more ECG features supporting PH and 85% of the participants (n=17) demonstrated at least one chest X-ray (CXR) feature of PH. Although our study did not demonstrate ECHO findings supporting PH, ECG and CXR modalities were suggestive. Therefore, future studies consisting of larger cohorts and including the use of other sensitive modalities such as computed tomography are warranted. Moreover, these studies will need to determine whether the entity of PAH secondary to previously treated pulmonary TB exists.


Nutritional needs of special populations at risk.
The nutritional needs of special populations at risk require a concerned government, a concerned bureaucracy which funds and operates health, welfare and food delivery systems. Equally, if not even more important, is the concern and involvement of citizens at the "local-state-county-city" level. Some of the vulnerable groups, such as the migrant workers and the Native Americans, are the responsibiliity of the Federal Government. This does not mean that State and local citizens should do nothing, which by and large characterizes what has happened. The solution to provide optimum nutrition for the entire U.S. population is not merely a recitation of: food production figures, food costs, documentation of how much the Government spends on feeding people, how many free or reduced school lunches are served, how good or bad the problem is. We need to update and monitor programs that deal with the delivery of health, welfare and food; nutrition education for educators, Congress, doctors, and the public; food enrichment and fortification; nutrient analysis of foods; and nutrition research.


Evolutionary analysis of stakeholder behavior in green retrofitting of traditional residential buildings based on dissemination and game models.
To achieve carbon peaking and carbon neutrality goals in China, green retrofitting of traditional residential buildings is the one of the important ways. Therefore, the dynamics process of the change of the resident group intention to retrofit and its impact on the behavior of the tripartite game between the government, investment retrofitting enterprises and residents needs to be analyzed. Firstly, a dissemination model of green retrofitting intentions among resident groups is constructed, and it is coupled with the tripartite game model. Then, through numerical simulation, the dissemination laws of intention for green retrofitting among resident groups and its influence on the evolution process of the tripartite game are analyzed. The results show that: (1) The rate at which the triad of government, investment retrofitting enterprises and residents reaches steady state is influenced by the impact of changes in the level of social climate on the rate of conversion of potential and participating residents to immune residents. When the rate of enterprises investment and residents participation increases, the rate of government choice of incentive strategies decreases; (2) greater government regulation and subsidies will increase the intention of residents and retrofitting enterprises to participate. The ideal steady state without government incentives can be achieved when the group size of participating residents is increased by improving the level of government publicity and education and the technology level of the enterprises; (3) the intention of enterprises to invest is closely related to the cognitive benefits and the level of risk perception of residents. The conclusions of the study can be used as a reference for the government to make green retrofitting policies for traditional residential buildings.


Effects of intimate partner violence against women in international micro and small enterprises relationships: The mediator role of capabilities.
While previous studies have explored multiple constraints affecting women exporters, the effects of intimate partner violence against women (IPVAW) are still unexplored in the literature. Thus, this study aims to probe first whether women owners of micro and small enterprises (MSEs) in export markets experience IPVAW. Secondly, it aims to explore the effect of IPVAW on their relationship quality with business partners, mediated by the performance of export capabilities. Using a structured questionnaire applied through personal interviews, we surveyed 57 female owners of exporting MSEs in Peru. Partial least squares structural equation modeling was used to analyze the data and test the model. The preliminary findings indicate that women exporters who experience IPVAW are more likely to face problems performing export capabilities. In turn, these performance problems seem to affect the quality of their relationships with importers and suppliers. Moreover, there is a direct relationship between IPVAW and problems in performing export capabilities and between issues performing capabilities and the relationship quality. Our theoretical contribution is a conceptual model that proposes the variable "Problems Performing Capabilities" as a mediator to measure the effects of IPVAW on exporting MSEs owned by women. Our findings urge policymakers and trade organizations boosting women-owned export enterprises to include initiatives that address and prevent IPVAW in their export promotion programs.


Response inhibition during processing of sexual stimuli in males with problematic hypersexual behavior.
Individuals with problematic hypersexual behavior (PHB) are unable to control their sexual cravings, regardless of other situational factors. This inability to control cravings is a common trait in patients with neurological pathologies related to response inhibition. Until recently, however, it was unclear whether individuals with PHB have decreased inhibition and altered neural responses in the brain regions associated with inhibition compared to healthy control individuals, especially in the presence of distracting sexual stimuli. In this study, we examined the neural and psychological underpinnings of inhibition in individuals with PHB. Thirty individuals with PHB and 30 healthy subjects underwent functional magnetic resonance imaging while performing a modified go/no-go task with neutral or sexual backgrounds used as distractors. Individuals with PHB showed poorer response inhibition than healthy subjects, especially when sexual distractors were present. Further, compared to healthy control subjects, individuals with PHB showed decreased activation in the right inferior frontal gyrus (IFG) and reduced functional connectivity between the IFG and the pre-supplementary motor area (preSMA) when response inhibition was required. Finally, the reduced activation and connectivity were more pronounced in the presence of sexual distractors than in the presence of neutral distractors. These findings suggest that individuals with PHB show reduced ability to inhibit responses that might be related to lower IFG activation and IFG-preSMA connectivity during response inhibition. Our results provide insights into the neurobiological underpinnings of poor response inhibition in individuals with PHB.


A Vignette Study of Older Adults' Preferences for Intergenerational Transfers in the Context of Competition Between Grandparents and Grandchildren in Rural China.
The objective of this analysis was to examine older adults' preferences for economic support in the context of competition between grandparents and grandchildren for the middle generation's financial resources in rural China. Specifically, it examined how relative need, lineage, and gender of grandchildren depicted in a vignette were evaluated and how personal characteristics of the evaluators influenced beliefs for which generation should receive more support. The sample consisted of 989 older adults participating in three waves of a longitudinal study in Anhui Province, China. Multinomial logistic regression was applied to examine how older respondents evaluated the relative priority of grandparents versus grandchildren in their claim for monetary assistance using a hypothetical vignette with randomized conditions. Relatively greater need of either the vignette grandparent or grandchild increased their priority to receive economic support. The vignette granddaughter was most disadvantaged in the competition with her paternal grandparent. Respondents who were single, in worse functional health, and whose children all migrated gave the vignette grandparent greater priority; those who coresided with children gave the vignette grandparent lower priority. Findings support the altruistic perspective on filial support and the corporate group/mutual aid model of family functioning, within the family system that differentiates patrilineal from matrilineal lines of descent. Under budget constraints, selective children are considered to have legitimate claims on the resources of the middle generation, tempering filial piety toward aging parents. Lack of personal resources plays a role in whether self-interest shapes beliefs that favor older over younger generations.


Renal transplantation with venous drainage through the superior mesenteric vein in cases of thrombosis of the inferior vena cava.
Renal transplantation usually is performed by placing the graft in the iliac fossa, anastomosing the renal vein to the iliac vein or, when this is not possible, to the vena cava. When vascular complications occur, particularly on the venous side, the position of the graft may have to be changed. This report describes orthotopic renal grafts and positioning of the organ with anastomosis to the splenic vessels. Venous drainage was established directly into the mesenteric-portal territory, with two cases to the portal vein and one to the inferior mesenteric vein. A new technique for the venous drainage of the renal graft is shown. We have used this model in two cases of infrarenal inferior vena cava thrombosis. The kidney was located in a retroperitoneal position, with venous drainage to the superior mesenteric vein through an orifice in the posterior peritoneum.


Asymptomatic bacteriuria in adults.
A common dilemma in clinical medicine is whether to treat asymptomatic patients who present with bacteria in their urine. There are few scenarios in which antibiotic treatment of asymptomatic bacteruria has been shown to improve patient outcomes. Because of increasing antimicrobial resistance, it is important not to treat patients with asymptomatic bacteriuria unless there is evidence of potential benefit. Women who are pregnant should be screened for asymptomatic bacteriuria in the first trimester and treated, if positive. Treating asymptomatic bacteriuria in patients with diabetes, older persons, patients with or without indwelling catheters, or patients with spinal cord injuries has not been found to improve outcomes.


Non-intercourse and intercourse hookup intentions, drinking expectancies, and college students' heavy drinking.
The current study tested the associations between college students' intentions to hookup (i.e., specifically intending to go out and engage in sexual behavior with a non-romantic partner) and self-reported heavy drinking. Further, social and sexual enhancement drinking expectancies were tested as moderators of those associations. College students (N = 235) reported (a) if they had specifically intended to hookup (reported separately for non-intercourse and intercourse hookup intentions) in the past 6 months; (b) social and sexual enhancement drinking expectancies; and (c) heavy drinking (a composite of past-30-day drinking frequency, typical amount consumed per drinking occasion, and how many times they got drunk). Data were analyzed using a hierarchical multiple regression (HMR), controlling for demographic variables. Non-intercourse hookup intentions were positively associated with heavy drinking, but intercourse hookup intentions were not. Sexual but not social enhancement drinking expectancies moderated the associations between both types of hookup intentions and heavy drinking. Among those who had intended a non-intercourse hookup, heavy drinking was greater when they also reported high (+1 SD) sexual enhancement drinking expectancies. For intercourse hookup intentions, higher (+1 SD) sexual enhancement drinking expectancies were associated with less heavy drinking. Pursuing non-intercourse hookups appears to be associated with heavy drinking, but intercourse hookup intention is not. Sexual enhancement drinking expectancies moderated those associations. Thus, an interest in some types of casual sexual experiences may promote heavy drinking among college students.


Underwater Acoustic Source Localisation Among Blind and Sighted Scuba Divers: Comparative study.
Many blind individuals demonstrate enhanced auditory spatial discrimination or localisation of sound sources in comparison to sighted subjects. However, this hypothesis has not yet been confirmed with regards to underwater spatial localisation. This study therefore aimed to investigate underwater acoustic source localisation among blind and sighted scuba divers. This study took place between February and June 2015 in Elba, Italy, and involved two experimental groups of divers with either acquired (n = 20) or congenital (n = 10) blindness and a control group of 30 sighted divers. Each subject took part in five attempts at an under-water acoustic source localisation task, in which the divers were requested to swim to the source of a sound originating from one of 24 potential locations. The control group had their sight obscured during the task. The congenitally blind divers demonstrated significantly better underwater sound localisation compared to the control group or those with acquired blindness (P = 0.0007). In addition, there was a significant correlation between years of blindness and underwater sound localisation (P <0.0001). Congenital blindness was found to positively affect the ability of a diver to recognise the source of a sound in an underwater environment. As the correct localisation of sounds underwater may help individuals to avoid imminent danger, divers should perform sound localisation tests during training sessions.


Development and characterization of a prototypic pan-amyloid clearing agent - a novel murine peptide-immunoglobulin fusion.
Systemic amyloidosis is a progressive disorder characterized by the extracellular deposition of amyloid fibrils and accessory proteins in visceral organs and tissues. Amyloid accumulation causes organ dysfunction and is not generally cleared by the immune system. Current treatment focuses on reducing amyloid precursor protein synthesis and slowing amyloid deposition. However, curative interventions will likely also require removal of preexisting amyloid deposits to restore organ function. Here we describe a prototypic pan-amyloid binding peptide-antibody fusion molecule (mIgp5) that enhances macrophage uptake of amyloid. The murine IgG1-IgG2a hybrid immunoglobulin with a pan amyloid-reactive peptide, p5, fused genetically to the N-terminal of the immunoglobulin light chain was synthesized in HEK293T/17 cells. The binding of the p5 peptide moiety was assayed using synthetic amyloid-like fibrils, human amyloid extracts and amyloid-laden tissues as substrates. Binding of radioiodinated mIgp5 with amyloid deposits in vivo was evaluated in a murine model of AA amyloidosis using small animal imaging and microautoradiography. The bioactivity of mIgp5 was assessed in complement fixation and in vitro phagocytosis assays in the presence of patient-derived amyloid extracts and synthetic amyloid fibrils as substrates and in the presence or absence of human serum. Murine Igp5 exhibited highly potent binding to AL and ATTR amyloid extracts and diverse types of amyloid in formalin-fixed tissue sections. In the murine model of systemic AA amyloidosis, 125I-mIgp5 bound rapidly and specifically to amyloid deposits in all organs, including the heart, with no evidence of non-specific uptake in healthy tissues. The bioactivity of the immunoglobulin Fc domain was uncompromised in the context of mIgp5 and served as an effective opsonin. Macrophage-mediated uptake of amyloid extract and purified amyloid fibrils was enhanced by the addition of mIgp5. This effect was exaggerated in the presence of human serum coincident with deposition of complement C5b9. Immunostimulatory, amyloid-clearing therapeutics can be developed by incorporating pan-amyloid-reactive peptides, such as p5, as a targeting moiety. The immunologic functionality of the IgG remains intact in the context of the fusion protein. These data highlight the potential use of peptide-antibody fusions as therapeutics for all types of systemic amyloidosis.


Clinical Features and Outcomes of Invasive Breast Cancer: Age-Specific Analysis of a Modern Hospital-Based Registry.
We evaluated the clinical features and outcomes of invasive breast cancer (BC) among different age groups by analyzing a modern BC registry including subtypes and treatment information. This was a retrospective cohort study of 6,405 women aged 18 years or older with pathologically confirmed stage I, II, or III BC who underwent curative surgery followed by adjuvant therapy at a university-based hospital in Seoul, South Korea, between January 2003 and December 2011. The study end point was all-cause mortality. We used Cox proportional hazards models and hazard ratios (HRs) with 95% CIs calculated after adjusting for age, body mass index, stage, subtype, and treatment, including type of surgery and use of chemotherapy, radiation therapy, hormone therapy, and targeted therapy. During 36,360 person-years of follow-up (median follow-up: 5.45 years; interquartile range, 4.3-7.1), 256 deaths were reported (mortality rate, 7.0/1,000 person-years). The adjusted HR for all-cause mortality was higher in patients older than 40 years (HR, 2.03; 95% CI, 1.44 to 2.87) and older than 60 years (HR, 2.35; 95% CI, 1.63 to 3.39) than in patients aged 40 to 49 years. Across age groups, advanced stage at diagnosis, luminal type as well as triple-negative BC, and not receiving adjuvant treatment were associated with increased risk of mortality. A strong J-shaped relationship was observed between age and mortality, indicating worse clinical outcomes in young and old patients. This study suggested a possible benefit of personalized BC screening examination and precise and active treatment strategies to reduce BC-related mortality.


Weaning Premature Infants from Nasal Continuous Positive Airway Pressure - Current Practice and Scientific Evidence.
Objective In the past decade, a number of trials have been conducted to determine the optimal strategy of weaning premature infants from nasal continuous airway pressure (nCPAP). However, a paucity of information exists on how weaning is actually performed in clinical routine. Aim of this study was to investigate the current practice of weaning premature infants from nCPAP in Germany. Methods An online survey was performed in German tertiary care neonatal units. Results All 160 German tertiary care units were contacted. Replies were retrieved from 85/160 (53%) units, of which 83/160 (52%) completed the questionnaire. 66/83 (80%) respondents indicated to wean without the use of formal written policies. In 44/83 (53%) units weaning decisions are made jointly between physicians and nurses, whereas physicians are the sole decision makers in 33/83 (40%) as are nurses in 6/83 (7%) units. Many units use more than one weaning strategy. 81/83 units (98%) gradually reduce nCPAP pressure as the initial step in the weaning process. 9/83 (11%) units stop nCPAP at standard criteria [CICADA (CeasIng nCpap At standarD criteriA) method] and 58/83 (70%) units use a cycling nCPAP on/off strategy. 52/83 (63%) of the responding units use nasal high flow at least at some point during the weaning process, either as a gradual weaning method or during nCPAP breaks. Conclusion Weaning strategies from nCPAP vary widely in German tertiary care neonatal units. It appears that evidence is still insufficient to promote a distinct weaning strategy which in turn highlights the urgent need for further adequately powered clinical trials.


Association between 23 drugs and Parkinson's disease: A two-sample Mendelian randomization study.
Parkinson's disease (PD) is a common degenerative nervous system disease. At present, there are certain limitations in various treatment options aimed at preventing or delaying the progression of PD. Therefore, the exploration of new drugs for PD is beneficial. Mendelian randomization (MR) analysis can be used to explore the association between drugs and diseases. In this study, MR analysis was adopted to investigate the causal relationship between 23 drugs and PD. These drugs have been approved for the treatment of different diseases, such as salicylic acid and derivatives (collectively called salicylates, e.g., aspirin, used for fever and pain relief), antithrombotic agents (e.g., warfarin, aspirin, used for preventing thrombotic events). The GWAS data for the 23 drugs were obtained from the UK Biobank (UKB) project, while the GWAS data for PD were sourced from FinnGen. Single-Nucleotide Polymorphisms (SNPs) were selected as instrumental variables (IVs). We first performed a series of quality control steps (including MR-PRESSO) to select the appropriate SNPs. Two-sample MR analysis was performed using five different methods, including inverse variance weighting (IVW) with random-effects model, weighted median, MR-Egger, simple model, and weighted model. At the same time, sensitivity analysis was carried out using the MR-Egger and Cochran's Q test to ensure the authenticity and reliability of the results. In MR-PRESSO, salicylates and antithrombotic agents showed statistically significant associations with PD, respectively. In the main MR analysis (IVW), there was a negative causal relationship between salicylates and PD (OR = 0.73, 95% CI = 0.54-0.98, p = .039). Similarly, there was a negative causal relationship between antithrombotic agents and PD (OR = 0.70, 95%CI = 0.52-0.96, p = .027). No statistically significant association was found between the remaining 21 drugs and PD. This MR study demonstrated that salicylates and antithrombotic agents can reduce the risk of PD, thus providing a novel avenue for future drug exploration in PD.


Knowledge, attitude and practices about zoonoses with reference to Campylobacteriosis in a rural area of West Bengal.
Campylobacteriosis is a leading cause of zoonotic diarrhoea in the developed as well as developing countries. Domestic animals particularly the poultry act as a source of human infections. Domestic animal rearing is a very common practice in India particularly in rural areas. The present study of KAP of Zoonosis showed 68.2 % of 500 families interviewed did not have knowledge about zoonotic diseases in rural Bengal and not a single family had any idea of Campylobacter infections.


Nutcracker fracture of the cuboid: management and results.
Nutcracker fractures of the cuboid are rare and often missed at an initial visit. They can be difficult to manage and convey a high risk of long-term pain in the foot. During the last six years, 6 recent cuboid fractures in 6 patients were treated at our hospital by open reduction, allogeneic bone grafting (where necessary) and internal fixation. Shortening of the lateral column of the foot existed in all these fractures. At the time of follow-up the results concerning pain and function were good in 2 and fair in 4 patients. We recommend open treatment for cuboid fractures with shortening of the lateral column of the foot or articular displacement of more than 1 mm.


Controlled-release oxycodone versus naproxen at home after ambulatory surgery: a randomized controlled trial.
Strong opioids in the home setting after ambulatory surgery have rarely been studied for fear of hazardous adverse effects such as respiratory depression. We compared the efficacy of paracetamol/controlled-release (CR) oxycodone and paracetamol/naproxen for treatment of acute postoperative pain at home after ambulatory surgery. Secondary outcomes were adverse effects of study medication, treatment satisfaction, and postoperative analgesic compliance. Patients undergoing ambulatory knee arthroscopy or inguinal hernia repair surgery (n = 105) were randomized into 3 groups: Group1 paracetamol/naproxen (n = 35), Group 2 paracetamol/CR oxycodone for 24 hours (n = 35), and Group 3 paracetamol/CR oxycodone for 48 hours (n = 35). Pain intensity at movement and at rest using a visual analog scale as well as satisfaction with postoperative analgesia and side effects were recorded for up to 48 hours postoperatively. Compliance with study medication was also assessed. For pain at movement and at rest, no significant differences were found between the paracetamol/naproxen group and either the paracetamol/CR oxycodone for 24 hours group (β = 2.6 [4.9]; P = 0.597) or the paracetamol/CR oxycodone for 48 hours (β = -1.7 [5.1]; P = 0.736). No major adverse effects of study medication were registered and satisfaction with postoperative pain treatment was high in all groups. Compliance was comparable across the groups. Despite clear instructions, 8 patients with the lowest pain scores did not use any of the prescribed pain medication. Paracetamol/CR oxycodone and paracetamol/naproxen are equally effective in treatment of acute postoperative pain at home after ambulatory surgery with comparable patient satisfaction level. We suggest paracetamol/CR oxycodone to be a valuable alternative for the current paracetamol/naproxen gold standard, particularly in patients with a contraindication for nonsteroidal anti-inflammatory drugs. ClinicalTrials.gov identifier: NCT02152592.


Micrococcus spp. as a promising source for drug discovery: A review.
Historically, bacteria of the phylum, Actinobacteria have been a very prominent source of bioactive compounds for drug discovery. Among the actinobacterial genera, Micrococcus has not generally been prioritized in the search for novel drugs. The bacteria in this genus are known to have very small genomes (generally < 3 Mb). Actinobacteria with small genomes seldom contain the well-characterized biosynthetic gene clusters such as those encoding polyketide synthases and nonribosomal peptide synthetases that current genome mining algorithms are optimized to detect. Nevertheless, there are many reports of substantial pharmaceutically relevant bioactivity of Micrococcus extracts. On the other hand, there are remarkably few descriptions of fully characterized and structurally elucidated bioactive compounds from Micrococcus spp. This review provides a comprehensive summary of the bioactivity of Micrococcus spp. that encompasses antibacterial, antifungal, cytotoxic, antioxidant, and anti-inflammatory activities. This review uncovers the considerable biosynthetic potential of this genus and highlights the need for a re-examination of these bioactive strains, with a particular emphasis on marine isolates, because of their potent bioactivity and high potential for encoding unique molecular scaffolds.


Diamond-rich crystalline nanosheets seeded with a Langmuir monolayer of arachidic acid on water.
The enigmatic self-assembling ability of nanodiamond (ND) particles has been discovered herein. Diamond-rich crystalline nanosheets with thickness of approximately ∼25 nm were grown from a Langmuir monolayer of arachidic acid (AA) at the interface between air and a dilute aqueous ND solution. Their fine rectangular shapes with uniform uniaxial birefringence indicate appreciable crystallinity, thus supporting that they are hydrated colloidal crystals of homogeneous ND particles.


Synthesis and Biological Evaluation of 7-Deoxy-Epothilone Analogues.
The synthesis of two deoxygenated analogues of potent epothilones is reported in an effort to analyze the relative importance of molecular conformation and ligand-target interactions to biological activity. 7-deoxy-epothilone D and 7-deoxy-(S)-14-methoxy-epothilone D were prepared through total synthesis and shown to maintain the conformational preferences of their biologically active parent congeners through computer modeling and nuclear magnetic resonance (NMR) studies. The significant decrease in observed potency for each compound suggests that a hydrogen bond between the C7-hydroxyl group and the tubulin binding site plays a critical role in the energetics of binding in the epothilone class of polyketides.


Low-frequency pulse propagation over 510 km in the Philippine Sea: A comparison of observed and theoretical pulse spreading.
Observations of the spread of wander-corrected averaged pulses propagated over 510 km for 54 h in the Philippine Sea are compared to Monte Carlo predictions using a parabolic equation and path-integral predictions. Two simultaneous m-sequence signals are used, one centered at 200 Hz, the other at 300 Hz; both have a bandwidth of 50 Hz. The internal wave field is estimated at slightly less than unity Garrett-Munk strength. The observed spreads in all the early ray-like arrivals are very small, <1 ms (for pulse widths of 17 and 14 ms), which are on the order of the sampling period. Monte Carlo predictions show similar very small spreads. Pulse spread is one consequence of scattering, which is assumed to occur primarily at upper ocean depths where scattering processes are strongest and upward propagating rays refract downward. If scattering effects in early ray-like arrivals accumulate with increasing upper turning points, spread might show a similar dependence. Real and simulation results show no such dependence. Path-integral theory prediction of spread is accurate for the earliest ray-like arrivals, but appears to be increasingly biased high for later ray-like arrivals, which have more upper turning points.


Characterization of insulin and insulin-like growth factor-I ovarian receptors during the reproductive cycle of carp (Cyprinus carpio).
Insulin and insulin-like growth factor-I (IGF-I) receptors were characterized in glycoprotein fractions prepared by wheat germ agglutinin-agarose affinity chromatography from the ovaries of carp. Insulin-specific overall binding in carp ovaries was 6- to 11-fold lower than IGF-I binding (2.7 +/- 0.48% vs. 22.8 +/- 3.6% per 20 microg glycoprotein). Cold IGF-I displaced radiolabeled IGF-I binding in doses 1000- to 3000-fold lower than cold insulin. On the other hand, cold insulin displaced radiolabeled insulin binding at concentrations 5- to 30-fold lower than cold IGF-I. The alpha-subunit molecular masses of carp insulin and IGF-I receptors were smaller than the alpha-subunit molecular mass of rat insulin receptor (125 and 120 vs. 135 kDa, respectively). Autophosphorylation of carp beta-subunit insulin and IGF-I receptors showed similar molecular masses that did not differ from the molecular mass of rat insulin beta subunit. Receptor tyrosine kinase activity was stimulated in a dose-dependent manner by insulin and IGF-I. Insulin and IGF-I stimulated tyrosine kinase activity and reached a maximum, respectively, of 224 +/- 14% and 279 +/- 7% of basal phosphorylation. Insulin and IGF-I binding characteristics were measured through different stages of follicular development. High specific binding of both peptides in primary oocyte growth (5.6 +/- 0.8% and 50 +/- 10% per 20 microg glycoprotein for insulin and IGF-I, respectively) decreased to a minimum at the end of vitellogenesis, followed by a slight increase later, in the preovulatory stage. The presence of insulin and IGF-I receptors in carp ovaries and the changes in percentage of binding throughout the reproductive cycle suggest that, in carp, the roles of insulin and IGF-I depend on the ovarian maturation stage.


Toward a definition of Information Therapy.
In these days of healthcare reform, there is an increasing need to control the costs of medical care. Preventive medical care can help by providing information to the patient, not only for illnesses, but for prevention and wellness. "Information Therapy" is a new term for supplying patients with health information, enabling them to make informed decisions about their health and care, participate in their own well-being, and thus decrease the utilization of healthcare resources. The formal definition for Information Therapy is presented and the basis for defining it lies in bibliotherapy, patient education, consumer health trends, patient's rights, and the Freedom of Information Act. The parameters and coverage of Information Therapy are discussed, the roles that Information Therapy can play in healthcare are explored, and the dual nature of its goals is presented. Barriers to its implementation are listed, however, the electronic age with its information superhighways is expected to provide a unique delivery system for Information Therapy.


Not all that glitters is gold.
Embryo diagnosis also has costs in life and in liberty -- that of the women on whose bodies these experiments are done. While the proven deaths to date from IVF-related treatments are quite small, the long-term risks are not yet in. And the costs of pain, illness, and physical and emotional suffering from these procedures go largely unremarked....IVF and embryo retrieval procedures do not take place on a couple's body -- it is a woman on the table, a woman who bears the costs of this treatment.


Cardiolipin is not required for Bax-mediated cytochrome c release from yeast mitochondria.
Cardiolipin (CL) is an inner mitochondrial membrane phospholipid that contributes to optimal mitochondrial function and is gaining widespread attention in studies of mitochondria-mediated apoptosis. Divergent hypotheses describing the role of CL in cytochrome c release and apoptosis have evolved. We addressed this controversy directly by comparing the spontaneous- and Bax-mediated cytochrome c release from mitochondria isolated from two strains of Saccharomyces cerevisiae: one lacking CL-synthase and therefore CL (DeltaCRD1) and the other, its corresponding wild type (WT). We demonstrated by liquid chromatography-mass spectrometry that the main yeast CL species [(16:1)2(18:1)2] differs in fatty acid composition from mammalian CL [(18:2)4], and we verified the absence of the yeast CL species in the DeltaCRD1 strain. We also demonstrated that the mitochondrial association of Bax and the resulting cytochrome c release is not dependent on the CL content of the yeast mitochondrial membranes. Bax inserted equally into both WT and DeltaCRD1 mitochondrial membranes under conditions that lead to the release of cytochrome c from both strains of yeast mitochondria. Furthermore, using models of synthetic liposomes and isolated yeast mitochondria, we found that cytochrome c was bound more "loosely" to the CL-deficient systems compared with when CL is present. These data challenge recent studies implicating that CL is required for Bax-mediated pore formation leading to the release of proteins from the mitochondrial intermembrane space. In contrast, they support our recently proposed two-step mechanism of cytochrome c release, which suggests that CL is required for binding cytochrome c to the inner mitochondrial membrane.


U-Shaped Association between Plasma Manganese Levels and Type 2 Diabetes.
Manganese is both an essential element and a known toxicant, and it plays important roles in many mechanisms in relation to type 2 diabetes (T2D). However, epidemiological studies of this relationship are rare. We investigated the association between plasma manganese and newly diagnosed T2D as well as whether the association could be modified by manganese superoxide dismutase (MnSOD) polymorphisms. We conducted a case-control study of 3,228 participants in China: 1,614 T2D patients and 1,614 controls. Concentrations of plasma magnesium were measured, and all participants were genotyped for the MnSOD Val16Ala polymorphism (rs4880). A U-shaped association was observed between plasma manganese and T2D, with increased odds ratios (ORs) in relation to either low or high plasma manganese levels. Compared with the middle tertile, the multivariate-adjusted ORs [95% confidence intervals (CIs)] of T2D associated with the lowest tertile and the highest tertile of plasma manganese were 1.89 (1.53, 2.33) and 1.56 (1.23, 1.97), respectively. In spline analysis, the U-shaped association was consistently indicated, with the lowest odds of T2D at the plasma manganese concentration of 4.95 μg/L. Minor allele frequencies (C allele) of the MnSOD Val16Ala polymorphism (rs4880) in the normal glucose tolerance (NGT) and the T2D groups were 13.57% and 14.50%, respectively. The MnSOD rs4880 polymorphism was not associated with T2D, and no interaction was found between plasma manganese and the MnSOD rs4880 polymorphism in relation to T2D. Our results suggested a U-shaped association between plasma manganese and T2D; both low and high levels of plasma manganese were associated with higher odds of newly diagnosed T2D. The U-shaped association was not modified by the MnSOD rs4880 polymorphism. Citation: Shan Z, Chen S, Sun T, Luo C, Guo Y, Yu X, Yang W, Hu FB, Liu L. 2016. U-shaped association between plasma manganese levels and type 2 diabetes. Environ Health Perspect 124:1876-1881; http://dx.doi.org/10.1289/EHP176.


Polycatenar Ligand Control of the Synthesis and Self-Assembly of Colloidal Nanocrystals.
Hydrophobic colloidal nanocrystals are typically synthesized and manipulated with commercially available ligands, and surface functionalization is therefore typically limited to a small number of molecules. Here, we report the use of polycatenar ligands derived from polyalkylbenzoates for the direct synthesis of metallic, chalcogenide, pnictide, and oxide nanocrystals. Polycatenar molecules, branched structures bearing diverging chains in which the terminal substitution pattern, functionality, and binding group can be independently modified, offer a modular platform for the development of ligands with targeted properties. Not only are these ligands used for the direct synthesis of monodisperse nanocrystals, but nanocrystals coated with polycatenar ligands self-assemble into softer bcc superlattices that deviate from conventional harder close-packed structures (fcc or hcp) formed by the same nanocrystals coated with commercial ligands. Self-assembly experiments demonstrate that the molecular structure of polycatenar ligands encodes interparticle spacings and attractions, engineering self-assembly, which is tunable from hard sphere to soft sphere behavior.


Ceilings of treatment: a qualitative study in the emergency department.
Decision-making concerning the limitation of potentially life-prolonging treatments is often challenging, particularly in the Emergency Department (ED). Current literature in this area of Emergency Medicine is limited and heterogeneous. We seek to determine the factors that influence ceiling of treatment institution in the ED. We conducted a phenomenological qualitative study employing semi-structured interviews. Emergency Medicine Consultants were recruited via a sample of convenience from 5 hospitals in the West of Scotland. Data saturation was achieved after 15 interviews. Interviews were recorded, anonymised, transcribed, coded, and an iterative thematic analysis was carried out. A model was created to illustrate the identified themes. Patient wishes are central to decision-making. Acute clinical factors and patient-specific factors lay the foundations of ceiling of treatment decisions. This is heavily contextualised by family input, collateral information, anticipated outcome, and whether the patient is accepted for higher care. This decision-making process flows through a 'filter' of cultural and environmental factors. The overarching nature of patient benefit was found to be of key importance, framing all aspects of ceiling of treatment institution. Ultimately, all ceiling of treatment decisions result in one of three common patient pathways: full escalation, limited escalation, and maintenance of current care with the option of palliative care initiation. We present a conceptual model composed of 10 major thematic factors that influence Consultant ceiling of treatment decision-making in the ED. Clinicians should be cognizant of influential factors and associated biases when making these important and challenging decisions.


The various aspects of genetic and epigenetic toxicology: testing methods and clinical applications.
Genotoxicity refers to the ability of harmful substances to damage genetic information in cells. Being exposed to chemical and biological agents can result in genomic instabilities and/or epigenetic alterations, which translate into a variety of diseases, cancer included. This concise review discusses, from both a genetic and epigenetic point of view, the current detection methods of different agents' genotoxicity, along with their basic and clinical relation to human cancer, chemotherapy, germ cells and stem cells.


Prostacyclin does not change during an oxygen induced increase in pulmonary blood flow in the fetal lamb.
The role of prostacyclin in mediating the increase in pulmonary blood flow caused by an increase in oxygen tension in the fetal lamb was investigated. Plasma concentrations of 6-keto-PGF1 alpha, the hydrolysis product of prostacyclin, were measured during an increase in pulmonary blood flow caused by a rise in oxygen tension in eight intrauterine fetal lambs. Fetal oxygen tension was increased by placing the pregnant ewes in a hyperbaric chamber and having them breathe 100% oxygen at three atmospheres absolute pressure. This increased fetal PaO2 from 27 +/- 3 to 60 +/- 6 torr (mean +/- S.E., p less than or equal to 0.0001) and increased the proportion of right ventricular output distributed to the fetal lungs from 6 +/- 2 to 45 +/- 7% (mean +/- S.E., p less than or equal to 0.001). However, the fetal plasma concentration of 6-keto-PGF1 alpha did not change, 186 +/- 26 to 208 +/- 40 pg/ml (mean +/- S.E.). Indomethacin decreased plasma concentrations of 6-keto-PGF1 alpha in each of three fetuses but did not decrease the proportion of right ventricular output distributed to their lungs. The increase in pulmonary blood flow caused by an increase in oxygen tension in the fetal lamb is not associated with an increase in plasma concentrations of 6-keto-PGF1 alpha. Prostacyclin does not appear to be involved in the increase in pulmonary blood flow caused by the increase in oxygen tension at birth.


Sex differences in neural responses to stress and alcohol context cues.
Stress and alcohol context cues are each associated with alcohol-related behaviors, yet neural responses underlying these processes remain unclear. This study investigated the neural correlates of stress and alcohol context cue experiences and examined sex differences in these responses. Using functional magnetic resonance imaging, brain responses were examined while 43 right-handed, socially drinking, healthy individuals (23 females) engaged in brief guided imagery of personalized stress, alcohol-cue, and neutral-relaxing scenarios. Stress and alcohol-cue exposure increased activity in the cortico-limbic-striatal circuit (P < 0.01, corrected), encompassing the medial prefrontal cortex (mPFC), orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), left anterior insula, striatum, and visuomotor regions (parietal and occipital lobe, and cerebellum). Activity in the left dorsal striatum increased during stress, while bilateral ventral striatum activity was evident during alcohol-cue exposure. Men displayed greater stress-related activations in the mPFC, rostral ACC, posterior insula, amygdala, and hippocampus than women, whereas women showed greater alcohol-cue-related activity in the superior and middle frontal gyrus (SFG/MFG) than men. Stress-induced anxiety was positively associated with activity in emotion-modulation regions, including the medial OFC, ventromedial PFC, left superior-mPFC, and rostral ACC in men, but in women with activation in the SFG/MFG, regions involved in cognitive processing. Alcohol craving was significantly associated with the striatum (encompassing dorsal, and ventral) in men, supporting its involvement in alcohol "urge" in healthy men. These results indicate sex differences in neural processing of stress and alcohol-cue experiences and have implications for sex-specific vulnerabilities to stress- and alcohol-related psychiatric disorders.


[Clinical evaluation of wedge-shaped defect restored by gingival retraction technique].
To evaluate the periodontal conditions after the wedge-shaped defect was restored by gingival retraction technique. A total of 138 mandibular premolars with wedge-shaped defect were selected and divided into A, B groups. Group A was restored with Dyract after using retraction cord. Group B was directly restored with Dyract. Clinical parameters including plaque index (PLI), gingival index (GI), sulcus bleeding index (SBI), probing depth (PD), volumes of gingival crevicular fluid (GCF) and levels of aspartate aminotransferases (AST) of gingival crevicular fluid were measured at baseline, 1 week, 1 month, 3 months and 6 months after operation. There was no difference in PLI, GI, SBI, PD between group A and B during 6 months after operation, while the difference of GCF and AST was significant between group A and B at 3 months and 6 months after operation (P < 0.05, P < 0.01). Gingival retraction technique applied in wedge-shaped defect restoration can reduce the damage to the periodontal tissue.


Cancer Clinical Investigators Should Converge with Pharmacometricians.
The applied quantitative science pharmacometrics has significantly enhanced cancer therapeutics development. Pharmacometrics is now improving our understanding of complex diagnostics. Through the concept of convergence and methods of quantitative and systems pharmacology, pharmacometrics is poised to interconnect mathematical models of disease and therapy to advance cancer care.See related article by Colomban et al., p. 5342.


Elevated Expression of MiR-17 in Microglia of Alzheimer's Disease Patients Abrogates Autophagy-Mediated Amyloid-β Degradation.
Autophagy is a proposed route of amyloid-β (Aβ) clearance by microglia that is halted in Alzheimer's Disease (AD), though mechanisms underlying this dysfunction remain elusive. Here, primary microglia from adult AD (5xFAD) mice were utilized to demonstrate that 5xFAD microglia fail to degrade Aβ and express low levels of autophagy cargo receptor NBR1. In 5xFAD mouse brains, we show for the first time that AD microglia express elevated levels of microRNA cluster Mirc1/Mir17-92a, which is known to downregulate autophagy proteins. By in situ hybridization in post-mortem AD human tissue sections, we observed that the Mirc1/Mir17-92a cluster member miR-17 is also elevated in human AD microglia, specifically in the vicinity of Aβ deposits, compared to non-disease controls. We show that NBR1 expression is negatively correlated with expression of miR-17 in human AD microglia via immunohistopathologic staining in human AD brain tissue sections. We demonstrate in healthy microglia that autophagy cargo receptor NBR1 is required for Aβ degradation. Inhibiting elevated miR-17 in 5xFAD mouse microglia improves Aβ degradation, autophagy, and NBR1 puncta formation in vitro and improves NBR1 expression in vivo. These findings offer a mechanism behind dysfunctional autophagy in AD microglia which may be useful for therapeutic interventions aiming to improve autophagy function in AD.


Red- and Far-Red-Emitting Zinc Probes with Minimal Phototoxicity for Multiplexed Recording of Orchestrated Insulin Secretion.
Zinc biology, featuring intertwining signaling networks and critical importance to human health, witnesses exciting opportunities in the big data era of physiology. Here, we report a class of red- and far-red-emitting Zn2+ probes with Kd values ranging from 190 nM to 74 μM, which are particularly suitable for real-time monitoring the high concentration of Zn2+ co-released with insulin during vesicular secretory events. Compared to the prototypical rhodamine-based Zn2+ probes, the new class exploits morpholino auxochromes which eliminates phototoxicity during long-term live recording of isolated islets. A Si-rhodamine-based Zn2+ probe with high turn-on ratio (>100), whose synthesis was enabled by a new route featuring late-stage N-alkylation, allowed simultaneous recording of Ca2+ influx, mitochondrial signal, and insulin secretion in isolated mouse islets. The time-lapse multicolor fluorescence movies and their analysis, enabled by red-shifted Zn2+ and other orthogonal physiological probes, highlight the potential impact of biocompatible fluorophores on the fields of islet endocrinology and system biology.


Utility of MRI to Differentiate Clear Cell Renal Cell Carcinoma Adrenal Metastases From Adrenal Adenomas.
The purpose of this study is to compare MRI features of clear cell renal cell carcinoma (RCC) adrenal metastases and adenomas. Fifteen clear cell RCC adrenal metastases imaged with MRI were compared to 29 consecutive adenomas between 2006 and 2015. Two blinded radiologists assessed homogeneity (homogeneous vs heterogeneous), signal intensity (SI) decrease on chemical-shift MRI, and T2-weighted SI (isointense, mildly hyperintense, or markedly hyperintense) relative to muscle. A third blinded radiologist measured the chemical-shift SI index, adrenal-to-spleen SI ratio, T2-weighted SI ratio, AUC for contrast-enhanced MRI, and histogram analysis. Analyses were performed using chi-square, linear regression, ROC, and logistic regression modeling. Clear cell RCC metastases were larger than adenomas (mean [± SD], 5.0 ± 4.2 cm [range, 1.1-15 cm] vs 2.0 ± 0.7 cm [range, 1.2-3.7 cm]; p < 0.0001). Subjectively, 33.3% (5/15) of metastases and 68.9% (20/29) of adenomas showed an SI decrease on chemical-shift MRI (p = 0.0421; κ = 0.76). Chemical-shift SI index (mean, 9.2% ± 20.6%; range, -30.0% to 57.9%) and adrenal-to-spleen SI ratio (0.94 ± 0.23 [range, 0.44-1.33]) for metastases differed significantly from those for adenomas (47.3% ± 27.8% [range, -9.4% to 86%] and 0.52 ± 0.28 [range, 0.13-1.11], respectively) (p < 0.0001). Twenty percent (3/15) of metastases had chemical-shift SI index in the adenoma range (> 16.5%). Metastases had higher T2-weighted SI than did adenomas, both quantitatively (5.1 ± 3.0 [range, 1.5-10.6] vs 1.8 ± 0.8 [range, 0.5-3.8]; p < 0.0001) and subjectively (p < 0.0001; κ = 0.89). Metastases had higher entropy than did adenomas (6.76 ± 0.61 vs 6.1 ± 0.74; p = 0.0051) and were subjectively more heterogeneous (p < 0.0001; κ = 0.86). The contrast-enhanced MRI AUC, skewness, and kurtosis did not differ between groups (p > 0.05). The ROC AUCs were 0.91 (95% CI, 0.79-1.0) for T2-weighted SI ratio and 0.85 (95% CI, 0.68-1.0) for entropy. The logistic regression model of T2-weighted SI ratio plus entropy improved accuracy (ROC AUC, 0.97; 95% CI, 0.93-1.0]) compared with either feature alone (p = 0.0215). Increased T2-weighted SI and heterogeneity are features that can differentiate clear cell RCC adrenal metastases from adenomas using quantitative and subjective analysis.


Protective effect of alpha-mangostin on thioacetamide-induced liver fibrosis in rats as revealed by morpho-functional analysis.
Liver fibrosis is an excessive accumulation of scar tissue resulting from inflammation and cell death. Thioacetamide (TAA) is a well-known hepatotoxin that induces liver fibrosis. A marker of injured hepatocytes is transforming growth factor-beta 1 (TGF-β1), while alpha-smooth muscle actin (α-SMA) and tissue inhibitor of metalloproteinase 1 (TIMP-1) are markers of activated hepatic stellate cells. Alpha-mangostin, a major xanthone derivative from the mangosteen pericarp, has been shown to have anti-oxidant and anti-inflammatory activities. The objective of this study was to determine whether alpha-mangostin has a protective effect on TAA-induced liver fibrosis in rats. The rats were treated by intraperitoneal injection of compounds for eight weeks. For the control group a mixture of dimethyl sulfoxide and phosphate buffered saline was administered. Two hundred mg/kg BW of TAA was administered three times weekly. Alpha-mangostin was administered at 5 mg/kg BW and silymarin at 100 mg/kg BW, both twice weekly. TAA induced histologically recognizable liver damage and fibrosis, as anticipated. Furthermore, it increased immunohistochemically detectable TGF-β1, α-SMA and TIMP-1. Co-administration of alpha-mangostin or silymarin with TAA prevented or ameliorated the effects of TAA administration alone. The anti-fibrotic effect of alpha-mangostin was stronger than that of silymarin.


Direct numerical simulation study of statistically stationary propagation of a reaction wave in homogeneous turbulence.
A three-dimensional (3D) direct numerical simulation (DNS) study of the propagation of a reaction wave in forced, constant-density, statistically stationary, homogeneous, isotropic turbulence is performed by solving Navier-Stokes and reaction-diffusion equations at various (from 0.5 to 10) ratios of the rms turbulent velocity U^{'} to the laminar wave speed, various (from 2.1 to 12.5) ratios of an integral length scale of the turbulence to the laminar wave thickness, and two Zeldovich numbers Ze=6.0 and 17.1. Accordingly, the Damköhler and Karlovitz numbers are varied from 0.2 to 25.1 and from 0.4 to 36.2, respectively. Contrary to an earlier DNS study of self-propagation of an infinitely thin front in statistically the same turbulence, the bending of dependencies of the mean wave speed on U^{'} is simulated in the case of a nonzero thickness of the local reaction wave. The bending effect is argued to be controlled by inefficiency of the smallest scale turbulent eddies in wrinkling the reaction-zone surface, because such small-scale wrinkles are rapidly smoothed out by molecular transport within the local reaction wave.


Validation of a Single-Nucleotide Polymorphism-Based Non-Invasive Prenatal Test in Twin Gestations: Determination of Zygosity, Individual Fetal Sex, and Fetal Aneuploidy.
We analyzed maternal plasma cell-free DNA samples from twin pregnancies in a prospective blinded study to validate a single-nucleotide polymorphism (SNP)-based non-invasive prenatal test (NIPT) for zygosity, fetal sex, and aneuploidy. Zygosity was evaluated by looking for either one or two fetal genome complements, fetal sex was evaluated by evaluating Y-chromosome loci, and aneuploidy was assessed through SNP ratios. Zygosity was correctly predicted in 100% of cases (93/93; 95% confidence interval (CI) 96.1%-100%). Individual fetal sex for both twins was also called with 100% accuracy (102/102; 95% weighted CI 95.2%-100%). All cases with copy number truth were also correctly identified. The dizygotic aneuploidy sensitivity was 100% (10/10; 95% CI 69.2%-100%), and overall specificity was 100% (96/96; 95% weighted CI, 94.8%-100%). The mean fetal fraction (FF) of monozygotic twins (n = 43) was 13.0% (standard deviation (SD), 4.5%); for dizygotic twins (n = 79), the mean lower FF was 6.5% (SD, 3.1%) and the mean higher FF was 8.1% (SD, 3.5%). We conclude SNP-based NIPT for zygosity is of value when chorionicity is uncertain or anomalies are identified. Zygosity, fetal sex, and aneuploidy are complementary evaluations that can be carried out on the same specimen as early as 9 weeks' gestation.


Presentation and diagnosis of acute abdominal pain in Finland: a computer aided study.
326 patients presenting with acute abdominal pain to a hospital in Tampere were compared with others in England and Norway, and with a large series of 6097 cases collected under the auspices of the World Organization of Gastro-Enterology. The distribution of disease in these 326 Finnish patients bore remarkable similarities to the distribution in other countries. When subjected to a computer-aided diagnostic analysis, comparing Finnish patients with UK and world-wide data, as regards appendicitis, cholecystitis and nonspecific pain, the computer performed roughly as well as the clinicians diagnosing the same cases. It is concluded that these diseases therefore have a common presentation in Finland with that elsewhere. As regards small bowel obstruction however, the computer diagnosed only 22% of cases correctly, (compared with the accuracy of clinical diagnosis 73%). This leads us to conclude that this disease presents unusually in Scandinavia, and possible reasons are discussed.


Histopathology of ventricles, coronary arteries and mast cell accumulation in transverse and longitudinal sections of the rat heart after irradiation.
The aim of the study was to compare cross sections with longitudinal sections in histopathological examination of the rat heart after irradiation, to find the most optimal method for the detection of cardiac radiation injuries. For this purpose, rats were irradiated locally on the heart with a single dose of 0 or 20 Gy. At different time points after irradiation, hearts were perfused and cut into longitudinal or cross sections. In both sections, several histopathological changes were scored on a graded scale between 0 and 3. Mast cells, which are thought to play a role in tissue remodelling, were counted. After 20 Gy, frequently occurring lesions were most severe in the upper half of the ventricles and the septum. These lesions could only be detected when using longitudinal sections, resulting in a higher total histopathological score than the examination of a single cross section. From 3 months onwards, changes in coronary arteries of irradiated hearts included endothelial cell loss, a loss of smooth muscle cells and fibrosis in media and adventitia. Up to 1 month after irradiation, mast cell densities of the left and right ventricles were decreased after 15 and 20 Gy, compared to time-matched controls, followed by increases from 3 months onwards. In the left ventricle, mast cell densities correlated with myocardial degeneration and fibre loss. The results of this study show that the usage of a single longitudinal section in the histopathological examination of the irradiated rat heart leads to the recognition of more severe injuries, including myocardial degeneration and fibrosis, in ventricular tissue than the usage of a single midventricular cross section. Morphological changes observed in coronary arteries of irradiated hearts might lead to a decreased compliance of the coronary artery wall. Further investigation is needed to determine the role of mast cells in cardiac tissue remodelling after irradiation.


Roles of Ion-Exchangeable Sodium in the Conversion Process of Tar to Soot during Rapid Pyrolysis of Two Brown Coals in a Drop-Tube Reactor.
In this work, two series of brown coals (including acid-washed coal and ion-exchangeable Na-loaded coal) were pyrolyzed in a drop-tube reactor. The experimental results revealed that soot and tar yields of Na-loaded coals were significantly lower than that of acid-washed coals. Gasified Na can reduce the formation of big soot agglomerates. During coal primary pyrolysis, ion-exchangeable Na can reduce the amount and aromaticity of primary tar. Na released with volatiles can catalyze the cracking of aliphatic and aromatic compounds, inhibit the polymerization between aromatic rings, and promote the combination of soot/tar with oxygen-containing substances, resulting in the decrease of graphite crystallite size and the increase of amorphous carbon content. Na can also reduce the organization degree of soot by forming intercalation compounds.


Treatment Strategy for Dyslipidemia in Cardiovascular Disease Prevention: Focus on Old and New Drugs.
Prevention and treatment of dyslipidemia should be considered as an integral part of individual cardiovascular prevention interventions, which should be addressed primarily to those at higher risk who benefit most. To date, statins remain the first-choice therapy, as they have been shown to reduce the risk of major vascular events by lowering low-density lipoprotein cholesterol (LDL-C). However, due to adherence to statin therapy or statin resistance, many patients do not reach LDL-C target levels. Ezetimibe, fibrates, and nicotinic acid represent the second-choice drugs to be used in combination with statins if lipid targets cannot be reached. In addition, anti-PCSK9 drugs (evolocumab and alirocumab) provide an effective solution for patients with familial hypercholesterolemia (FH) and statin intolerance at very high cardiovascular risk. Recently, studies demonstrated the effects of two novel lipid-lowering agents (lomitapide and mipomersen) for the management of homozygous FH by decreasing LDL-C values and reducing cardiovascular events. However, the costs for these new therapies made the cost-effectiveness debate more complicated.


Complete mesocolic excision for colon cancer: current status and controversies.
According to Hohenberger's original description, complete mesocolic excision for colon cancer involves precise dissection of the avascular embryonic plane between the parietal retroperitoneum and visceral peritoneum of the mesocolon. This ensures mesocolic integrity, access to high ligation of the supplying vessels at their origin and an associated extended lymphadenectomy. Results from centres which have adopted this approach routinely have demonstrated that oncological outcomes can be improved by the rigorous implementation of established principles of cancer surgery. Meticulous anatomical dissection along embryonic planes is a well-established principle of precision cancer surgery used routinely by the specialist colorectal surgeon. Therefore, the real question concerns the need for true central vascular ligation and associated extended (D3) lymphadenectomy or otherwise, particularly along the superior mesenteric vessels when performing a right colectomy. Whether this approach results in improved overall or disease-free survival remains unclear and its role remains controversial particularly given the potential for significant morbidity associated with a more extensive central vascular dissection. Current literature is limited by considerable bias, as well as inconsistent and variable terminology, and the results of established randomized trials are awaited. As a result of the current state of equipoise, various national guidelines have disparate recommendations as to when complete mesocolic excision should be performed if at all. This article aims to review the rationale for and technical aspects of complete mesocolic excision, summarize available short and long term outcome data and address current controversies.


The Anxious and Ambivalent Partisan: The Effect of Incidental Anxiety on Partisan Motivated Recall and Ambivalence.
Affective Intelligence Theory (AIT) asserts that anxiety reduces the effect of party identification on candidate preferences (Marcus, Neuman, and MacKuen 2000), but recent studies have raised doubts about this causal claim. Rather than functioning as a moderator of party identification, perhaps anxiety has a direct effect on preferences, or perhaps the relationship is reversed and preferences drive emotions (Ladd and Lenz 2008). Alternatively, Marcus et al.'s measure of anxiety may simply be capturing partisan ambivalence, so the posited relationship is spurious (Lavine, Johnston, and Steenbergen 2012). This paper addresses each of these questions by examining the effect of experimentally induced emotions on the types of considerations that came to mind when a national sample of adult Americans was asked what they liked and disliked about Barack Obama. By directly manipulating anxiety, this experiment avoids the causal ambiguity plaguing this debate and ascertains the true nature of the relationship between anxiety and ambivalence. Consistent with AIT, anxiety led respondents to recall more contemporary considerations, whereas enthusiasm brought to mind more long-standing considerations. Because the political context at the time of the study (fall 2013) was a very tumultuous time for the Obama administration, the increased accessibility of contemporary considerations led Democratic participants to experience more ambivalence in the anxiety condition. This effect was concentrated among those Democrats who were exposed to the most newspaper coverage.