Phaeobacter porticola sp. nov., an antibiotic-producing bacterium isolated from a sea harbour.
Three heterotrophic, aerobic, brown-pigmented strains, designated P97T, P100 and P104, were isolated from a harbour in the southern North Sea. Phylogenetic analysis of 16S rRNA gene sequences revealed that the isolates are affiliated to the genus Phaeobacter. In silico DNA-DNA hybridization of the genome of strain P97T against those of existing type species indicated that P97T represents a novel species within the genus Phaeobacter, with Phaeobacter inhibens T5T as the closest described organism (29.6 % DNA-DNA relatedness) followed by P. gallaeciensis CIP 105210T (26.4 %). DNA-DNA hybridization demonstrated that the three new strains belong to the same species. The new isolates inhibited Pseudoalteromonas tunicata DSM 14096T, and were Gram-stain-negative, catalase- and oxidase-positive, chemo-organoheterotrophic and motile. Growth occurred at pH 6.5-9.5 (optimum 7.0-8.0) and at 4-30 °C (optimum 20-28 °C). The strains required NaCl for growth. The salinity range was 0.5-6.0 % (w/v) NaCl for P97T and P100, and 0.5-5.0 % for P104, lower than values described for Phaeobacter gallaeciensis and Phaeobacter inhibens. The optimum NaCl concentration for strains P97T and P104 was 2.0-4.0 %, and for P100 was 2.0-3.0 %. Fatty acids (>1 %) comprised 18 : 1ω7c, 16 : 0, 18 : 1 ω7c 11-methyl, 18 : 0, 12 :1, 18 : 2ω7c,12, 10 : 0 3-OH and 12 : 0 3-OH. Polar lipids were phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, an aminolipid, one unknown lipid and one additional unknown lipid in strain P97T. The major respiratory quinone was Q10. Based on phylogenetic and phenotypic differences, the strains represent a novel species in the genus Phaeobacter, for which the name Phaeobacter porticola sp. nov. is proposed. The type strain is P97T (=DSM 103148T=LMG 29594T).


Neoadjuvant chemotherapy and radical surgery in locally advanced cervical cancer. Prognostic factors for response and survival.
Between January 1986 and September 1988, 75 patients with locally advanced cervical carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stages IB-III) received three courses of neoadjuvant chemotherapy (NAC), including cisplatin, bleomycin, and methotrexate (PBM). Fifteen percent of patients achieved a complete response (CR) and 68% a partial response (PR). Pretreatment characteristics were analyzed for response to NAC. Significantly lower response rates were found in patients with tumor size more than 5 cm in diameter and bilateral parametrial involvement to the pelvic side wall. None of the biological parameters studied was related to chemoresponsiveness. Patients achieving CR or PR had a significantly improved 3-year survival rate compared with those who did not respond. After NAC, radical surgery was possible in all responding patients. The median number of lymph nodes removed was 60. A lower than expected incidence of lymph node metastases was detected. None of the clinical and pathologic features considered was significantly correlated with the lymph node status. Twelve of the 62 operated patients had disease recurrence. Pathologic parametrial involvement and cervical infiltration equal to or deeper than 5 mm were found to be significant prognostic factors for recurrence. A 3-year, disease-free survival of 89%, 73%, and 43% for Stage IB-IIA, IIB, and III, respectively, was found. Among the operated patients these rates increased to 100%, 81%, and 66% for Stage IB-IIA, IIB, and III, respectively. A prospective randomized trial comparing NAC and surgery with radiotherapy alone is in progress.


Heterogeneity of Genetic Admixture Determines SLE Susceptibility in Mexican.
Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory disorder for which Major Histocompatibility Complex (MHC) genes are well identified as risk factors. SLE patients present different clinical phenotypes, which are partly explained by admixture patterns variation among Mexicans. Population genetic has insight into the high genetic variability of Mexicans, mainly described through HLA gene studies with anthropological and biomedical importance. A prospective, case-control study was performed. In this study, we recruited 146 SLE patients, and 234 healthy individuals were included as a control group; both groups were admixed Mexicans from Mexico City. The HLA typing methods were based on Next Generation Sequencing and Sequence-Based Typing (SBT). The data analysis was performed with population genetic programs and statistical packages. The admixture estimations based on HLA-B and -DRB1 revealed that SLE patients have a higher Southwestern European ancestry proportion (48 ± 8%) than healthy individuals (30 ± 7%). In contrast, Mexican Native American components are diminished in SLE patients (44 ± 1%) and augmented in Healthy individuals (63 ± 4%). HLA alleles and haplotypes' frequency analysis found variants previously described in SLE patients from Mexico City. Moreover, a conserved extended haplotype that confers risk to develop SLE was found, the HLA-A∗29:02∼C∗16:01∼B∗44:03∼DRB1∗07:01∼DQB1∗02:02, pC = 0.02, OR = 1.41. Consistent with the admixture estimations, the origin of all risk alleles and haplotypes found in this study are European, while the protection alleles are Mexican Native American. The analysis of genetic distances supported that the SLE patient group is closer to the Southwestern European parental populace and farthest from Mexican Native Americans than healthy individuals. Heterogeneity of genetic admixture determines SLE susceptibility and protection in Mexicans. HLA sequencing is helpful to determine susceptibility alleles and haplotypes restricted to some populations.


Agenesis of internal jugular vein a cause for concern.
Internal jugular vein is one of the major contributors to the venous drainage from the intracranial structures. Neck dissections which necessitates ligation of internal jugular vein leads to significant alteration of cerebrospinal fluid pressures in the range of three times for unilateral ligation to five times in cases of bilateral ligation. Agenesis of internal jugular vein merits concern prior to central venous cannulation and ligation during radical neck dissection for metastatic nodes in head and neck cancers.


Isolation and characterization of polycyclic aromatic hydrocarbon-degrading bacteria with tolerance to hypoxic environments.
Hypoxic conditions are considerably different from aerobic and anaerobic conditions, and they are widely distributed in natural environments. Many pollutants, including polycyclic aromatic hydrocarbons (PAHs), tend to accumulate in hypoxic environments. However, PAH biodegradation under hypoxic conditions is poorly understood compared with that under obligate aerobic and obligate anaerobic conditions. In the present study, PAH-degrading bacteria were enriched, and their biodegradation rates were tested using a hypoxic station with an 8% oxygen concentration. PAH-degrading bacteria collected from sediments in low-oxygen environments were enriched using phenanthrene (Phe) or pyrene (Pyr) as the sole carbon and energy source. Individual bacterial colonies showing the ability to degrade Phe or Pyr were isolated and identified by 16S rDNA gene sequencing. Morphological and physiological characterizations of the isolated bacterial colonies were performed. The isolated bacteria were observed by scanning electron microscopy (SEM) and were identified as Pseudomonas sp., Klebsiella sp., Bacillus sp., and Comamonas sp. Phylogenetic tree of the isolated PAH-degrading bacteria was also constructed. The biodegradation ability of these bacteria was tested at an initial Phe or Pyr concentration of 50 mg L-1. The biodegradation kinetics were best fit by a first-order rate model and presented regression coefficients (r2) that varied from 0.7728 to 0.9725 (P < 0.05). The half-lives of the PAHs varied from 2.99 to 3.65 d for Phe and increased to 60.3-82.5 d for Pyr. These half-lives were much shorter than those observed under anaerobic conditions but were similar to those observed under aerobic conditions.


Substrate filtering by the active site crossover loop in UCHL3 revealed by sortagging and gain-of-function mutations.
Determining how deubiquitinating enzymes discriminate between ubiquitin-conjugated substrates is critical to understand their function. Through application of a novel protein cleavage and tagging technique, sortagging, we show that human UCHL3 and the Plasmodium falciparum homologue, members of the ubiquitin C-terminal hydrolase family, use a unique active site crossover loop to restrict access of bulky ubiquitin adducts to the active site. Although it provides connectivity for critical active site residues in UCHL3, physical integrity of the crossover loop is dispensable for catalysis. By enlarging the active site crossover loop, we have constructed gain-of-function mutants that can accept substrates that the parent enzyme cannot, including ubiquitin chains of various linkages.


Apigenin in combination with Akt inhibition significantly enhances thyrotropin-stimulated radioiodide accumulation in thyroid cells.
Selectively increased radioiodine accumulation in thyroid cells by thyrotropin (TSH) allows targeted treatment of thyroid cancer. However, the extent of TSH-stimulated radioiodine accumulation in some thyroid tumors is not sufficient to confer therapeutic efficacy. Hence, it is of clinical importance to identify novel strategies to selectively further enhance TSH-stimulated thyroidal radioiodine accumulation. PCCl3 rat thyroid cells, PCCl3 cells overexpressing BRAF(V600E), or primary cultured tumor cells from a thyroid cancer mouse model, under TSH stimulation were treated with various reagents for 24 hours. Cells were then subjected to radioactive iodide uptake, kinetics, efflux assays, and protein extraction followed by Western blotting against selected antibodies. We previously reported that Akt inhibition increased radioiodine accumulation in thyroid cells under chronic TSH stimulation. Here, we identified Apigenin, a plant-derived flavonoid, as a reagent to further enhance the iodide influx rate increased by Akt inhibition in thyroid cells under acute TSH stimulation. Akt inhibition is permissive for Apigenin's action, as Apigenin alone had little effect. This action of Apigenin requires p38 MAPK activity but not PKC-δ. The increase in radioiodide accumulation by Apigenin with Akt inhibition was also observed in thyroid cells expressing BRAF(V600E) and in primary cultured thyroid tumor cells from TRβ(PV/PV) mice. Taken together, Apigenin may serve as a dietary supplement in combination with Akt inhibitors to enhance therapeutic efficacy of radioiodine for thyroid cancer.


PIM1 polymorphism and PIM1 expression as predisposing factors of esophageal squamous cell carcinoma in the Asian population.
Our study aimed to identify the association between a PIM1 polymorphism and PIM1 expression levels with clinicopathological features of esophageal squamous cell carcinoma (ESCC). A total of 168 patients with ESCC were recruited as the case group, and 180 healthy individuals were included as the control group. Polymerase chain reaction-direct sequencing was employed to analyze all genotypes containing the PIM1 -1 882 A>T mutation. Immunohistochemistry was used to detect PIM1 expression. The distributions of genotype AA and allele A of PIM1 -1 882 A>T were higher in the case group than in the control group (both P<0.05). AT + TT carriers had a lower risk of ESCC than AA carriers (P<0.05). PIM1 polymorphism was related to the invasion depth, degree of differentiation, and lymphatic metastasis of ESCC (P<0.05). PIM1 expression was associated with lymphatic metastasis of ESCC and PIM1 polymorphism (both P<0.05). PIM1 -1 882 A>T and the overexpression of PIM1 were associated with the clinicopathological features of ESCC, and PIM1 -1 882 A>T may help to reduce the risk of ESCC in the Asian population.


Skin grafting options at the Burn and Reconstructive Surgery Department of the Faculty Hospital in Bratislava.
Replacement of devastated or severely damaged skin presents a key problem in the treatment of extensive deep burns in humans. The skin is an organ serving many functions, which can be replaced with skin transplants or temporary skin replacements only up to a certain extent. At the Burn and Reconstructive Surgery Department of the Faculty Hospital in Bratislava, located in Ruzinov, we have been concerned with the problem of skin replacement since its establishment in 1987. In this article we review skin replacement options and our experience with indications and use of various types of skin substitutes, mainly of biological origin, such as allotransplants, xenotransplants and amnion.


[Inflammatory pseudotumor of the spleen as an incidental asymptomatic finding in a 44-year-old patient].
In the era of routinely used ultrasound techniques intrasplenic tumors are diagnosed more frequently. Usually these findings are not combined with specific symptoms. However, large cysts can lead to malfunctions of nearly located organs by displacing. Etiopathogenetic findings in our region are mainly non parasitic, epithelial and traumatic cysts or tumors of the spleen. We describe a large splenic mass of a 44 years old female patient. Pathological dignity remained unclear after using sonographic, radiological and clinical techniques. After uncomplicated total splenectomy the histopathological diagnosis revealed a benign, pseudoinflammatory tumor of the spleen. Inflammatory pseudotumors are a benign response to an unknown cause. It must be a main objective of preoperative diagnostics to distinguish them from malignant processes.


Simultaneous detection and differentiation of Staphylococcus species in blood cultures using fluorescence in situ hybridization.
To develop a new protocol for the simultaneous detection and differentiation of Staphylococcus aureus and coagulase-negative staphylococci (CoNS) in blood cultures using fluorescence in situ hybridization (FISH), without cultivation and biotyping. Oligonucleotide probes were used to target the variable regions of the 16S rRNA of S. aureus and CoNS, the probes were labeled with fluorochrome Cy3 (red signal) and fluorescein isothiocyanate (green signal), respectively. It is not possible to design one probe that will hybridize to all CoNS species. Therefore, in this study two differentially labeled probes (STA and SAU) were mixed and used to detect and differentiate S. aureus from CoNS rapidly in a single smear. Samples of 189 positive blood cultures with Gram-positive cocci in clusters and 11 Gram-positive cocci in chains or pairs were included. The FISH assay showed 91.8% sensitivity and 100% specificity for S. aureus and 100% sensitivity and 93.3% specificity for CoNS when hybridized with STA and SAU probes. Meanwhile, the assay showed 91.8% sensitivity and 100% specificity for S. aureus and 100% sensitivity and 90% specificity for CoNS, when hybridized with the SAU probe only. Our data showed that the FISH technique was suitable for the simultaneous detection and differentiation of Staphylococcus sp. in blood cultures.


Reduction in gastroenteritis in United States children and correlation with early rotavirus vaccine uptake from national medical claims databases.
We sought to estimate rotavirus disease reduction among children in hospital and office settings in the 4 US regions following rotavirus vaccine introduction and to estimate vaccine uptake. Two national third-party payer medical claims databases were used to examine the number of visits for gastroenteritis per annual nongastroenteritis visits among children aged <5 years during July 2003 to June 2008 in hospital and office settings. The gastroenteritis burden attributable to rotavirus was computed as the excess of all gastroenteritis visits during rotavirus seasons above the baseline of visits during nonrotavirus periods. Rotavirus vaccine uptake was estimated by comparing claims for rotavirus vaccine with those for diphtheria-tetanus-acellular pertussis vaccines. In the South, Northeast, and Midwest, the typical winter-spring gastroenteritis peak due to rotavirus was markedly dampened in 2007-2008. Compared with the mean for 3 prevaccine seasons, the excess gastroenteritis visits that occurred during the 2007-2008 rotavirus season was reduced by >90% among infants in all care settings in 3 regions and by >70% among children aged 1 to 4 years. In the West, disease reductions were lower (53%-63% reduction among hospitalized infants). At the onset of the 2007-2008 season, coverage with > or =1 rotavirus vaccine dose was an estimated 57% among infants, 17% among children aged 1 year, and 0 among those aged 2 to 4 years. The rotavirus burden in 2007-2008 was markedly reduced in all US regions and exceeded that explained by only direct protection of the youngest vaccinated children.


Genome-wide association study of ear tip barrenness in waxy maize.
Ear tip-barrenness (ETB), which results from aborted kernels or infertile florets at the ear tip, is an undesirable factor affecting the yield and quality of waxy maize. To uncover the genetic basis of ETB, a genome-wide association study (GWAS) was conducted using the genotype with 27,354 SNPs and phenotype with three environments. Five SNPs that distributed on chromosomes 1, 3 and 6, were identified to be significantly associated with ETB based on the threshold of false discovery rate (FDR) at 0.05. Among these significant loci, three SNPs were clustered together and colocalized with genomic regions previously reported. The average length of ETB decreased almost linearly from the inbred lines containing no favorable alleles across the three loci (1.75 cm) to those with one (1.18 cm), two (0.94 cm) and three (0.65 cm) favorable alleles. Moreover, three important genes, Zm00001d030028, Zm00001d041510 and Zm00001d038676 were predicted for three significant QTLs, respectively. These results promote the understanding genetic basis for ETB and will be useful for breeding waxy maize varieties with high-quality and high-yield.


Buzzwords in medical education: what they are, what they mean, and what we are doing about them at the University of Kentucky College of Medicine.
This article defines common buzzwords used to describe innovations in teaching medical students. As background for outlining the innovative educational programs in place at the University of Kentucky College of Medicine, the dual, or bimodal, missions of the College and their historical antecedents are presented. Definitions of important educational outcomes, or standards of achievement expected from University of Kentucky College of Medicine graduates, including professionalism, active learning, evidence-based medicine, and cultural diversity are given. In addition, their relevance to the development of medical professionals is outlined, and examples of where and how these standards are introduced in the Kentucky Medical Curriculum are presented. Similarly, definitions and examples of educational methods or pedagogies used to teach our medical students are discussed including the use of problem-based learning, computer-based instruction, standardized patients, and performance-based assessment.


Development and characterization of six new human papillary thyroid carcinoma cell lines.
Cell lines are a widely used tool in cancer research. However, despite the relatively high incidence of papillary thyroid carcinoma (PTC), there are only four PTC cell lines available for international research audience. The objective of this study was to establish and characterize new PTC cell lines that represent primary tumor biology. Surgical specimens were obtained to generate PTC cell lines. Short tandem repeat profiling was used to confirm the uniqueness of the cell lines against databases of known cell lines and mutations were assessed using Sequenom. The expression of thyroid-specific genes was examined using real-time PCR. Tumorigenicity was determined using an orthotopic thyroid xenograft tumor mouse model. Six PTC cell lines (five conventional PTCs and one follicular variant of PTC) were generated and found to be unique when compared by short tandem repeat profiling against databases of all existing cell lines. The five conventional PTC cell lines carry the BRAF V600E mutation and the follicular variant of PTC cell line had an NRAS mutation. Five of the six cell lines had a mutation in the promoter of the human telomerase reverse transcriptase gene. None of the cell lines have RET/PTC rearrangements. Three cell lines were tumorigenic in the orthotopic thyroid xenograft tumor mouse model. These five characterized conventional PTC cell lines and the unique follicular variant of PTC cell line should be valuable reagents for thyroid cancer research. The three tumorigenic cell lines can be used for in vivo testing of targeted therapeutic and novel agents.


Preventing Sexual Violence Through Bystander Intervention: Attitudes, Behaviors, Missed Opportunities, and Barriers to Intervention Among Australian University Students.
The concept of bystander intervention is gaining popularity in universities as a mechanism to prevent sexual violence. Prior research has focused on correlates of bystanders' intentions to intervene and intervention behaviors in situations where there is a risk of sexual violence. The current study builds on this literature by exploring the nature of missed opportunities, including perceived barriers to intervention. In all, 380 Australian undergraduate university students completed an online survey. Measures included a rape myth acceptance scale, bystander intentions to intervene, actual intervention behaviors, missed opportunities for intervention, and perceived barriers for missed opportunities. Promisingly, students reported high levels of intentions to intervene in situations where there was a risk of sexual violence and reported relatively few missed opportunities to do so when these situations did occur. Intervention behaviors varied by important demographic characteristics such as gender, age, attitudes toward sexual violence, and the nature of the situation. Younger female students, with lower levels of rape myth acceptance, who had previously engaged in bystander intervention behaviors were more likely to report intentions to intervene in future risky situations, and female international students reported fewer missed opportunities for intervention. The most common barrier to intervention for identified missed opportunities was a failure to recognize situations as having a potential risk for sexual violence, and students were most likely to intervene in situations when the opportunity to help a friend in distress arose. This study provides some preliminary empirical evidence about bystander intervention against sexual violence among Australian university students, and identifies unique contexts for intervention and what current barriers to intervention may be.


Mic1-3 knockout of Toxoplasma gondii is a successful vaccine against chronic and congenital toxoplasmosis in mice.
We evaluated a new vaccine, Mic1-3KO, against both chronic and congenital toxoplasmosis in mice. Mic1-3KO is a mutant strain of Toxoplasma gondii RH that lacks the mic1 and mic3 genes. OF1 mice were vaccinated with Mic1-3KO tachyzoites and challenged orally with T. gondii (strain 76K). Immune responses and protection against chronic infection (cyst load in brain tissue) and congenital infection (maternofetal transmission, survival, body weight, and chronic infection in pups) were evaluated. Mic1-3KO induced a strong humoral and cellular T helper (Th) 1 response and conferred highly significant protection against chronic infection (>96% reduction in cysts in brain tissue). Fewer infected fetuses were observed in vaccinated dams that were infected during pregnancy than in nonvaccinated infected dams (4.6% vs. 33.3%). All pups born to vaccinated infected dams survived and had the same weight as those born to nonvaccinated uninfected dams. Furthermore, they had significantly fewer cysts in brain tissue (>91%) than pups from nonvaccinated infected dams. During pregnancy, protection against congenital disease was associated with a cellular Th1 response regulated by interleukin-10. One month after delivery, vaccinated infected dams had >96% fewer cysts in their brain tissue than nonvaccinated infected dams. Mic1-3KO is an effective vaccine against chronic and congenital toxoplasmosis.


Diabetes mellitus and bilateral cataracts in a kitten.
An 18-week-old male domestic long-hair kitten was presented with a history of polyuria and polydipsia for several weeks. The general condition was unremarkable, but the kitten was considerably smaller than expected for the age and showed cataracts in both eyes. Serum glucose concentrations were persistently elevated and based on clinical findings and an elevated serum fructosamine concentration, a diagnosis of diabetes mellitus was established. Diabetes mellitus is not commonly diagnosed in young kittens, nor are cataracts recognised as a frequent feature of this disease in cats. The cataracts progressed in spite of the insulin therapy and the kitten was euthanised 10 weeks after referral. Histopathological examination of the pancreas revealed few and small islets of Langerhans compared to the examination of pancreas from a healthy kitten of the same age. Histopathological changes in the eyes included cataracts affecting both cortex and nucleus.


When being 'tired of living' plays an important role in a request for euthanasia or physician-assisted suicide: patient characteristics and the physician's decision.
In the Netherlands physicians are allowed to grant requests for euthanasia or physician-assisted suicide (EAS) if they meet several requirements of due care. According to jurisprudence, a physician is not allowed to end the life of a patient whose request for EAS is based on being 'tired of living', because such a request falls outside the medical domain. Our previous studies have shown that in spite of this, such requests are made approximately 400 times a year. To learn more about patients who request EAS because they are tired of living, and about factors that influence the decision of the physician. Questionnaires (n=4842) completed by general practitioners (n=3994). According to the physicians, 17% of patients who requested EAS were 'tired of living'. Of 139 patients in whose request for EAS being tired of living played a major role, 47% suffered from cancer, 25% suffered from another severe disease and 28% had no severe disease. In all three groups the same three symptoms occurred most frequently, 'feeling bad', 'tired', and 'not active'. Each of these symptoms occurred in more than half of the patients in each group. Most of the requests from patients with cancer were granted, but those from patients who had some other severe disease, or no severe disease at all, were refused. Factors that were related to granting a request were: the presence of unbearable and hopeless suffering, the absence of alternatives, and the absence of depressive symptoms. Being tired of living can play a major role in requests for EAS, both in the absence and the presence of a severe disease. The high occurrence of symptoms in the absence of a classifiable severe disease implies that physical symptoms are prevalent in this group of patients, leaving the legal requirement for EAS of 'a medical cause' open to interpretation in the more complex medical practice.


Congenital malformations in the newborn--a prospective study.
In a prospective study of 4098 births the incidence of congenital malformations was 1.464 per 100 births. Major malformations were seen in 1.1% births and minor malformations in 0.4% births. Patterns of congenital anomalies included multiple anomalies (37.68%), CNS malformations (13.33%), alimentary tract anomalies (6.66%), cardiovascular malformations (8.99%), genitourinary malformation (6.66%), limb anomalies (13.33%), and anomalies of skin and appendages (13.33%). Factors like maternal age, hormone testing and drug ingestion during pregnancy, radiation exposure and maternal infections were identified as possible risk factors for congenital malformations in the newborn.


Is Endovascular Aneurysm Repair a Relative Contraindication for Patients with Preoperative Renal Dysfunction?
Whether endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) is a relative contraindication in patients with preoperative renal dysfunction (Pre-RD), remains controversial because the contrast medium may induce nephrotoxicity. In this study 1658 patients were treated at ten Japanese medical centers between January 2005 and March 2011 (Open surgery (OS) vs. EVAR: n = 1270 vs. n = 388). They were retrospectively analyzed. Multiple logistic regression analysis (MLRA) with pre- and intra-operative variables was applied to all patients. The endpoints induced onset of new dialysis and postoperative renal dysfunction (Post-RD), were defined as a 50% decrease or more from the preoperative estimated glomerular filtration rate (eGFR) level. Early mortality, Post-RD, incidence of new dialysis in all patients were 1.6% (OS: EVAR = 1.9%:0.8%), 6% (OS: EVAR = 8%:2.3%) and 1.4% (OS: EVAR = 1.5%:1.0%) respectively. MLRA identified operation time, clamp of renal artery as risk factors for Post-RD, and operation time and Pre-eGFR level as risk factors for new dialysis. Although Post-RD was more frequently observed in the OS group, MLRA showed that the choice of OS or EVAR was not a risk factor for Post-RD and new dialysis. It was strongly suggested that using contrast medium during EVAR is not a contraindication to AAA repair in patients with Pre-RD. (This article is a translation of J Jpn Coll Angiol 2014; 54: 13-18.).


[Experimental studies of the significance of the renin-angiotensin system in the retina. A review].
BACKGROUND Many peptides now identified in the brain were previously thought of as exclusively peripheral hormones. Among those, the renin-angiotensin system (RAS) is not only found to be of great importance in peripheral vasomotor and electrolyte homeostasis but also acts as neurotransmitter or modulator in the central nervous system. Here we review a number of experiments performed by us pointing to a modulation effect of the RAS unrelated to its vasoactive mechanisms. The biochemical basis as well as the different methods employed will be described in detail. METHODS RAS enzyme activity within the different ocular structures were determined by means of fluorimetric measurements. Possible neurophysiological effects of the RAS on retinal function were established through electroretinographic in-vitro and in-vivo recordings. Immunocytochemical staining was employed to morphologically identify possible sites involved. RESULTS The performed fluorimetric measurements revealed highest Angiotensin-Converting Enzyme (ACE) activity within the neuroretina. Electroretinographic experiments have shown that variation in angiotensin-II activity is followed by reversible, dose-dependent effects on inner retinal signals. Clear evidence was found by immunohistochemistry that there is a discrete subpopulation of angiotensin-positive cells in the inner retina. CONCLUSIONS These findings demonstrate that the Renin-Angiotensin-System has neuronal sources and is physiologically active in the mammalian retina not purely related to vasoactive mechanisms. The RAS effector hormone angiotensin-II might therefore be a putative neurotransmitter in a subpopulation of retinal neurons. Reported side-effects of vasoactive substances, such as ACE-inhibitors on the visual function might be explained hereby.


Molecular HIV Clustering Among Individuals with Mpox and HIV Co-Morbidity in New York State, Excluding New York City.
The 2022 global mpox outbreak created an opportunity to test the utility of molecular HIV surveillance (MHS) to identify high-risk transmission networks. Individuals diagnosed with mpox in New York State (NYS) outside New York City-[Rest of State (ROS)] were matched to the NYS HIV and sexually transmitted infection registries. The demographic characteristics of individuals diagnosed with mpox in ROS mirror national trends. HIV-mpox comorbid individuals were more likely to be included in HIV molecular clusters compared to persons living with diagnosed HIV in ROS overall, men who have sex with men (MSM) in ROS, and age-adjusted MSM (to match individuals with mpox diagnosis) in ROS. For the 3-year 0.5% clusters, which are used to define national priority clusters, the HIV-mpox comorbid individuals clustered 2.4 times more frequently than the age/risk-adjusted control group. This study supports the use of HIV MHS to identify populations for priority public health interventions.


Effectiveness of Cross-Linked Acellular Dermal Matrix to Correct Post-Traumatic Enophthalmos.
The use of an acellular dermal matrix is rarely reported in orbital wall fracture reconstruction. This study aimed to share the author's experience with the cross-linked acellular dermal matrix as an allograft material for enophthalmos correction. In this retrospective study, the author evaluated the medical records and 3-dimensional facial computed tomography scans of patients with enophthalmos caused by neglected orbital fractures between May 2021 and June 2022. Facial computed tomography scans confirmed the clinical diagnosis of enophthalmos. A single surgeon performed all surgical operations. In all patients, the author accessed the orbital floor via subciliary incision while approaching the medial wall with a retrocaruncular incision. After fully exposing the lesion, the author used a 1.0-mm-thick cross-linked acellular dermal matrix (ADM) (MegaDerm; L&C Bio, South Korea). After trimming the cross-linked ADM to a proper size, the author implanted the ADM into the lesion. During May 2021 and June 2022, 3 cases of enophthalmos were successfully corrected with cross-linked ADM at the author's hospital. All patients were improved clinically and radiologically. This is the first study to show the effectiveness of cross-linked ADM for the correction of enophthalmos.


The back-deposition of dissolved Mn2+ to MnO2 cathodes for stable cycling in aqueous zinc batteries.
The Mn2+ dissolution of MnO2 cathode materials causes rapid capacity decay in aqueous zinc batteries. We herein show that the dissolved Mn2+ can be deposited back to the cathode with the aid of a suitable conductive agent. The active material is thus retained for energy storage, and this MnO2/Mn2+ redox process also provides capacity. In the Mn2+ free ZnSO4 electrolyte, MnO2 delivers 325 mA h g-1 capacity at 0.1 A g-1, and 90.4% capacity retention is achieved after 3000 cycles at 5 A g-1. Our work demonstrates an effective strategy to realize stable cycling of MnO2 cathodes in aqueous zinc batteries without Mn2+ additives.


Maternal intention and actual behavior in infant feeding at one month postpartum.
Five-hundred and ninety-one mothers completed a follow-up questionnaire at one month postpartum. The total breastfeeding rate declined from 83.4% before discharge to 50.8% at one month. One-hundred and fifty-three (25.9%) mothers exclusively breastfed, 147 (24.9%) mothers mixed fed, and 291 (49.2%) mothers formula fed their babies at that time. Among the mothers who initially intended to exclusively breastfeed, 39.3% changed to formula feeding, while 7.1% of the mothers who intended to mix feeding and 4.8% of the mothers who intended to formula feed changed to exclusive breastfeeding at one month postpartum. Nine percent of the breastfeeding mothers weaned within the 1st week, 9.2% weaned between the 1st and 2nd week, 8.4% weaned between the 2nd and 3rd week, while another 14.8% weaned between the 3rd and 4th week. Milk insufficiency, maternal tiredness, not knowing whether the infant had enough to eat and breast problems were the four major reasons for changing feeding method from breastfeeding to formula feeding. Positive breastfeeding attitude, non-employment and husband's approval of breastfeeding was negatively associated with changing feeding behavior from breastfeeding to formula feeding within one month postpartum. In conclusion, successful breastfeeding not only depends on factors related to the mother, but also on her environment. Education regarding breastfeeding should be provided to the entire family including the mother and father. The workplace needs to be more accommodating to breastfeeding mothers, so that they can continue breastfeeding after returning to work.


Digital Innovation: Transition to Practice Using Apple Clips to Teach Nursing Leadership.
Nurse educators are challenged to offer high-impact learning opportunities integrating technology to engage the current generation of students. An innovative learning assignment was created using app technology to replace a traditional assignment in a nursing leadership course. Students were assigned to create a digital video depicting a difficult situation in practice using the Clips app by Apple. The assignment used situation, background, assessment, and recommendation (SBAR) for structure and incorporated evidence-based practices. Students were surveyed to gain insight into the effectiveness and student satisfaction of the assignment. Students overwhelmingly supported the assignment as an innovative way to learn leadership, identifying creativity and having fun while learning as something not experienced in their other nursing courses. A digital assignment offers an opportunity to imagine learning assignments in nursing education that capture student attention in a non-traditional method reflecting the impact of technology on nursing education. [J Nurs Educ. 2020;59(5):283-286.].


Lipid-rich tapetosomes in Brassica tapetum are composed of oleosin-coated oil droplets and vesicles, both assembled in and then detached from the endoplasmic reticulum.
Tapetosomes are abundant organelles in tapetum cells of floral anthers in Brassicaceae species. They contain triacylglycerols (TAGs), the amphipathic protein oleosins and putative vesicles and play a predominant role in pollen-coat formation. Here we report the biogenesis and structures of tapetosomes in Brassica. Immunofluorescence confocal microscopy revealed that during early anther development, the endoplasmic reticulum (ER) luminal protein calreticulin existed as a network in tapetum cells, which contained no oleosins. Subsequently, oleosins appeared together with calreticulin in the ER network, which possessed centers with a higher ratio of oleosin to calreticulin. Finally, the ER network largely disappeared, and solitary tapetosomes containing oleosins and calreticulin became abundant. Transmission electron microscopy also revealed a close association between a maturing tapetosome and numerous ER cisternae. Mature, solitary tapetosomes were isolated and found to contain oleosins, calreticulin and the ER luminal binding protein (BiP). Isolated tapetosomes were treated with sodium carbonate and subfractionated by centrifugation. Two morphologically distinct constituents were isolated: low-density oil droplets, which contained oleosins and TAGs, and relatively high-density cisternae-like vesicles, which possessed calreticulin and BiP. Thus, tapetosomes are composed of oleosin-coated oil droplets and vesicles, both of which are assembled in and then detached from the ER. The structure and biogenesis of tapetosomes are unique among eukaryotic organelles. After tapetum cells lyzed, oleosins but not calreticulin and BiP of tapetosomes were transferred to the pollen surface.


Murine and human cathepsin B exhibit similar properties: possible implications for drug discovery.
Validation of drug targets and subsequent preclinical studies are usually carried out on animal disease models, with mouse being the most commonly used. However, results from mouse models cannot always be directly related to human disease. Major discrepancies between the properties of murine and human variants were observed during the evaluation of compounds targeting cathepsins S and K. It is important, therefore, to know whether similar differences exist between murine and human cathepsin B. Thus, both enzymes were expressed and biochemically characterized. The enzymes exhibited similar biochemical properties, indicating that cathepsin B transgenic mouse models could be useful for studying its role in human pathologies.


Investigation on the Transformation of Absorbed Oxygen at ZnO {101̅0} Surface Based on a Novel Thermal Pulse Method and Density Functional Theory Simulation.
Absorbed oxygen plays a key role in gas sensing process of ZnO nanomaterials. In this work, the transformation of absorbed oxygen on ZnO (101̅0) and its effects on gas sensing properties to ethanol are studied by a novel thermal pulse method and density functional theory (DFT) simulation. Thermal pulse results reveal that the absorbed O2 molecule dissociates into two individual oxygen adatoms by extracting electrons from ZnO surface layers when temperature is above 443 K. The temperature at which absorbed O2 molecule begins to dissociate is the lowest working temperature for gas sensing. DFT simulation demonstrates the dissociation process of O2 at ZnO (101̅0) surface, and the activation energy (Ea) of dissociation is calculated to be 351.71 kJ/mol, which suggests that the absorbed O2 molecule is not likely to dissociate at room temperature. The reactions between ethanol and absorbed O2 molecule, as well as reactions between ethanol and O adatom, are also simulated. The results indicate that ethanol cannot react with absorbed O2 molecule, while it can be oxidized by O adatom to acetaldehyde and then to acetic acid spontaneously. Mulliken charge analysis suggests electrons extracted by O adatom return to ZnO after the oxidation of ethanol.


Black PRAISE: engaging Black congregations to strengthen critical awareness of HIV affecting Black Canadian communities.
In Canada, HIV disproportionately affects Black communities. Though Black faith leaders play an influential role engaging Black communities around social care and social justice, their response to HIV has been somewhat muted. Black PRAISE is a novel intervention for Black churches to strengthen congregants' critical awareness of HIV affecting Black communities. A multi-stakeholder team developed and tested the intervention in 2016 - 17 among six churches in the province of Ontario, where more than half of Black Canadians reside, using a community-based participatory approach. Specifically, the intervention aimed to strengthen how congregants understand HIV among Black communities and reduce their level of stigma toward people living with HIV. We addressed critical awareness among the participating congregations through (i) disseminating a booklet with validated information that promoted critical health literacy related to HIV; (ii) enabling pastors to deliver a sermon on love, compassion and social justice; and (iii) developing and screening a short film that featured Black Canadians discussing their experiences of HIV-related stigma. We assessed changes in knowledge and stigma by surveying congregants (N = 173) at baseline and two follow-ups using validated instruments and other measures. Through Black PRAISE, congregants significantly increased their HIV-related knowledge; moreover, exposure to all the intervention components was associated with a significantly reduced level of stigma. A likely strategic outcome of Black PRAISE is that churches are empowered to help strengthen Black people's community-based response to HIV and join efforts to eliminate the structural conditions that increase Black people's vulnerability to HIV.


Hyperautofluorescent macular ring in a series of patients with enhanced S-cone syndrome.
The authors describe fundus autofluorescence (AF) and spectral-domain optical coherence tomography (SD-OCT) findings in three patients with enhanced S-cone syndrome and their correlation around the hyperautofluorescent ring border. Patients had AF imaging in combination with SD-OCT line-scans through the fovea, at the posterior pole, and at a temporal locus centered on the ring border. All eyes demonstrated a macular ring of high-intensity AF. The inner segment ellipsoid band showed thinning and disorganization toward the ring border, where it was lost.


Modular system for the construction of zinc-finger libraries and proteins.
Engineered zinc-finger transcription factors (ZF-TF) are powerful tools to modulate the expression of specific genes. Complex libraries of ZF-TF can be delivered into cells to scan the genome for genes responsible for a particular phenotype or to select the most effective ZF-TF to regulate an individual gene. In both cases, the construction of highly representative and unbiased libraries is critical. In this protocol, we describe a user-friendly ZF technology suitable for the creation of complex libraries and the construction of customized ZF-TFs. The new technology described here simplifies the building of ZF libraries, avoids PCR-introduced bias and ensures equal representation of every module. We also describe the construction of a customized ZF-TF that can be transferred to a number of expression vectors. This protocol can be completed in 9-11 d.


Complete genomic screen in late-onset familial Alzheimer's disease.
Alzheimer's disease (AD) is a complex genetic disorder. Linkage analysis has helped unravel a portion of the genetic component of AD by identifying four loci that play a role in the genetics of AD (amyloid precursor protein, presenilin 1, presenilin 2, and apolipoprotein E). These loci account for approximately 50% of the genetic etiology of AD. A total genomic screen is an efficient way to identify additional genetic effects in AD. A series of multiplex late-onset (>60 years) AD families were ascertained (NINDS-ADRDA diagnostic criteria) and sampled. A subset (n = 16) of the largest families (52 affecteds with DNA, 83 unaffecteds with DNA) were used to rapidly screen the genome (n = 280 markers) for additional major genetic effects. Critical values for regional follow-up were p < or =0.05 for SimIBD or sibpair analysis and/or a LOD score > or = 1.00. Fifteen regions warranted initial follow-up based on these criteria. An additional screening set was used (n = 38 families, 89 affecteds with DNA, 216 unaffecteds with DNA) for the follow-up analysis. These analyses revealed four regions of continued interest on chromosomes 4, 6, 12, and 20. Chromosome 12 presented the strongest results. Peak two point "affecteds only" LOD scores were 1.3, 1.6, 2.7, and 2.2 and (affected relative pair SimIBD) p values were 0.04, 0.03, 0.14, and 0.04 for D12S373, D12S1057, D12S1042, and D12S390, respectively. These markers span approximately 30 cm near the centromeric region of chromosome 12. Sibpair analysis resulted in two point Maximum Lod Score (MLS) results of 0.4, 1.2, 3.2, and 1.0 for the above markers. Multipoint MLS analysis supported these findings. Saturation mapping of all available markers in the chromosome 12 region as well as further investigation of the regions on 4, 6, and 20 is ongoing with candidate gene analysis to follow.


High Burden of HBV-Infection and Atypical HBV Strains among HIV-infected Cameroonians.
To investigate the prevalence and genotypic profile of overt and occult hepatitis-B infection (OBI) among HIV-infected individuals in Cameroon. 212 HIV-infected Cameroonians, aged 37.6 [IQR: 32.6-46.6] followed-up at the University Health Centre in Yaoundé, were tested for HBsAg, anti-HBs, anti-HBc IgG/IgM, HBV-DNA and anti-HCV IgG. HBV positive cases were tested for Hepatitis Delta virus (HDV) using anti-HDV IgG and HDV-RNA. Liver function was assessed by alanine and aspartate aminotransaminases. OBI was defined as negative-HBsAg and detectable HBV-DNA. In occult or overt HBVinfected participants, HBV reverse transcriptase (RT)/surface (S) sequences were analyzed for drug resistance, immuneescape mutants, and phylogeny. Overall, 78.3% (166/212) participants had past/ongoing HBV-exposure, with 39.1% (83/212) carrying "HBcAbpositive alone". Prevalence of overt HBV (positive-HBsAg) was 11.8% (25/212), prevalence of HBV and HDV was respectively 6.9% (12/175) and 12% (3/25). Phylogeny of HBV-RT/S revealed the co-circulation of genotypes A and E. All HBV-coinfected participants harbored HBV strains with at least one immune-escape mutation. Of note, one HBV variant carried the vaccine-escape mutation G145R that hinders HBsAg neutralization by antibodies. For the first time, a novel 9 aa-deletion (s115-s123), located in the HBsAg "a" determinant, was found concomitantly with OBI. A stop codon in the S region (associated with increased risk of hepatocellular carcinoma) was found in six cases. High prevalence of overt/occult HBV-infection and circulating atypical strains highlight the importance of HBV-surveillance among HIV-infected Cameroonians and strategies to detect OBI in highly endemic countries.


Enhanced water absorption of wheat gluten by hydrothermal treatment followed by microbial transglutaminase reaction.
The water absorption of wheat gluten plays an important role in the weight, volume and form ratio of the breads. In this paper, hydrothermal treatment and microbial transglutaminase (MTGase) modification were combined to improve the water absorption ratio (WAR) of wheat gluten. To understand the increases in WAR, the changes in MTGase reaction after gluten hydrothermal treatment were also investigated. The sole hydrothermal treatment improved the WAR of gluten. The gluten treated at 100 degrees C for 30 min exhibited the highest WAR value (2.03 g g(-1) gluten) while the WAR of the control without hydrothermal treatment was 1.5 g g(-1) gluten. When gluten was exposed to 90 degrees C for 30 min followed by incubation with MTGase for 5 h, its WAR reached 2.48 g g(-1) gluten. In contrast to control gluten, the surface hydrophobicity of the gluten preheated at 90 degrees C for 30 min increased and fluctuated in a different way during the following MTGase reaction. Meantime, the trend in the amount of soluble protein of preheated gluten was also changed in the progress of MTGase reaction. Hydrothermal treatment followed by MTGase reaction is an efficient approach to improve the WAR of wheat gluten. The analysis of catalytic process, including determination of ammonia, gluten surface hydrophobicity, soluble protein and SDS-PAGE, suggested that hydrothermal pretreatment accelerated the cross-linking reaction and may alter the ratio of gluten deamidation catalysed by MTGase, which induced an increase in the WAR.


Synthesis and application of the first radioligand targeting the allosteric binding pocket of chemokine receptor CXCR3.
Strategies for the identification of allosteric modulators of chemokine receptors largely rely on various cell-based functional assays. Radioligand binding assays are typically not available for allosteric binding sites. We synthesized, purified, and applied the first tritium-labeled allosteric modulator of the human chemokine receptor CXCR3 (RAMX3, [(3) H]N-{1-[3-(4-ethoxyphenyl)-4-oxo-3,4-dihydropyrido[2,3-d]pyrimidin-2-yl]ethyl}-2-[4-fluoro-3-(trifluoromethyl)phenyl]-N-[(1-methylpiperidin-4-yl)methyl]acetamide). RAMX3 is chemically derived from 8-azaquinazolinone-type allosteric modulators and binds to the CXCR3 receptor with a K(d) value of 1.08 nM (specific activity: 80.4 Ci mmol(-1) ). Radioligand displacement assays showed potent negative cooperativity between RAMX3 and chemokine CXCL11, providing a basis for the use of RAMX3 to investigate other potential allosteric modulators. Additionally, the synthesis and characterization of a number of other full and truncated 8-azaquinazoline analogues were used to validate the binding properties of RAMX3. We demonstrate that RAMX3 can be efficiently used to facilitate the discovery and characterization of small molecules as allosteric modulators of the CXCR3 receptor.


A checklist of marine bryozoan taxa in Scottish sea regions.
Contemporary and historical bryozoan records were compiled to provide a comprehensive checklist of species in Scottish waters. The checklist comprises 218 species in 58 families, with representatives from each of the extant bryozoan orders. The fauna was relatively sparse compared to other regions for which bryozoan checklists were available e.g. New Zealand and Australia. Six non-indigenous bryozoan species from the Scottish seas region were included in the checklist. Baseline information on species distributions, such as that presented in this checklist, can be used to monitor and manage the impact of human activities on the marine environment, and ultimately preserve marine biodiversity.


Host B7-1 and B7-2 costimulatory molecules contribute to the eradication of B7-1-transfected P815 tumor cells via a CD8+ T cell-dependent mechanism.
B7-1 (CD80)-transfected P815 tumor cells were previously shown to elicit tumor-eradicating immunity that leads to the regression of B7-1+ P815 tumors after transient growth in normal syngeneic (DBA/2) mice. Here, we show that not only the B7-1 molecule but also the B7-2 (CD86) molecule contributed to the eradication of B7-1+ P815 tumors. The B7-1 molecule that contributed to the eradication of B7-1+ P815 tumors was expressed not only on the tumor cells but also on host APCs, including MAC-1+ cells. The B7-2 molecule that contributed to the eradication of B7-1+ P815 tumors was expressed only on host APCs, such as B220+ cells, and not on the tumor cells. In spite of the fact that B7-expressing host APCs contributed to the eradication of B7-1+ P815 tumors, only CD8+ T cells without help from CD4+ T cells were important for tumor eradication. Taken together, these findings indicate that in addition to the ability of B7-1-transfected tumor cells to stimulate CD8+ T cell-mediated tumor-eradicating immunity directly, such tumor cells can also stimulate CD8+ T cell-mediated tumor-eradicating immunity indirectly as a result of cross-priming through B7-expressing host APCs.


[Usefulness of antibiotics in the treatment of bronchial asthma].
The efficacy and safety of antibiotics in the treatment of asthma are not unequivocal. Among various antibiotics, macrolides play the main role in the therapy of bronchial asthma. Macrolides are useful in the treatment of asthma not only because of their antimicrobial activity. The mechanism of action of macrolides in improving asthma and reducing airway responsiveness is evaluated especially due to their activity in non-infectious asthma. Macrolides may not only enhance the host defense system through increased cytokine synthesis, but also exhibit anti-inflammatory activity mediated by anti-inflammatory cytokines. The steroid-sparing effect of macrolide antibiotics has been postulated to contribute to their beneficial actions in the treatment of asthma. Macrolides may be useful in the treatment of patients with steroid-dependent asthma, probably because they inhibit eosinophilic inflammation. It has also been suggested that the effect of macrolides on bronchial hyperresponsiveness is mediated by their inhibitory action on superoxide production and chemotaxis of polymorphonuclear neutrophils and the mixed lymphocyte reactions. In spite of these suggestions, the mechanism of action of macrolides in asthmatic syndrome is not clear. Only well-designed and conducted clinical studies are capable of assessing the efficacy and safety of immunosuppressive macrolides in the treatment of asthma.


[Anaphylactic shock].
The anaphylactic shock is a life-threatening reaction produced by the release of pharmacologically active substances (histamine, leukotriene...) by most cells and basophils. The release of these mediators may be immunologically mediated (anaphylactic reaction a typical immediate hypersensitivity reaction mediated by IgE) or not (anaphylactic reaction when not mediated by an antigen-antibody process). These mediators in turn specific end-organ responses in the cardio-vascular system, (vasodilatation, change in inotropy, increased capillary permeability), the respiratory system (bronchospasm upper airway oedema) and the skin (urticaria). Because of its etiology (mainly drugs, contrast media and colloids) the treatment of anaphylactic or anaphylactic reactions must be prophylactic. When it occurs, its cure is based upon adrenaline and fluid loading and eventually bronchodilators.


Regeneration of sulfur-fouled bimetallic Pd-based catalysts.
Pd-based catalysts provide efficient and selective reduction of several drinking water contaminants, but their long-term application requires effective treatments for catalyst regeneration following fouling by constituents in natural waters. This studytested alumina-supported Pd-Cu and Pd-In bimetallic catalysts for nitrate reduction with H2 after sulfide fouling and oxidative regeneration procedures. Both catalysts were severely deactivated after treatment with microM levels of sulfide. Regeneration was attempted with dissolved oxygen, hydrogen peroxide, sodium hypochlorite, and heated air. Only sodium hypochlorite and heated air were effective regenerants, specifically restoring nitrate reduction rates for a Pd-In/gamma-Al2O3 catalyst from 20% to between 39 and 60% of original levels. Results from ICP-MS revealed that sodium hypochlorite caused dissolution of Cu from the Pd-Cu catalyst but that the Pd-In catalyst was chemically stable over a range of sulfide fouling and oxidative regenerative conditions. Analysis byXPS indicated that PdS and In2S3 complexes form during sulfide fouling, where sulfur is present as S2-, and that regeneration with sodium hypochlorite converts a portion of the S2- to S6+, with a corresponding increase in reduction rates. These results indicate that Pd-In catalysts show exceptional promise for being robust under fouling and regeneration conditions that may occur when treating natural waters.


Concentration dependent effects of calcium blockade on vessel diameter and microvascular macromolecular clearance.
The dose-dependents effects of topically applied verapamil (a calcium entry blocker) on vessel diameter and macromolecular clearance (as an index of permeability) were investigated in the hamster cheek pouch. Verapamil at concentrations between 10(-10)M and 10(-7)M produced a gradual and parallel increase in both vessel diameter and in macromolecular clearance. At concentrations between 10(-7)M and 10(-5)M verapamil greatly increased macromolecular transport, but only modestly increased vessel diameter. Our data indicate that low doses of verapamil influence microvascular transport by modulation of flow and associated changes in microvascular pressure, while doses of verapamil greater than or equal to 10(-7)M produce a more direct effect on microvascular permselectivity.


I don't care why you do it, just don't! Reactions to negative and positive organizational deviance partly depend on the desire for tightness of prevention-focused employees.
Tightness-Looseness (T-L) at the individual level has only begun to receive attention from researchers. Specifically in the organizational context, this is a so far unexplored construct. The study offers first insights into the mechanisms that can trigger individuals' desire for tightness and the consequences it can have on organizational behaviors. We, therefore, investigated the mediating role of the desire for tightness on the relationship between work regulatory prevention focus and emotional responses to both negative and positive (i.e., pro-social) deviant organizational behaviors. We tested our prediction through a mediational model with a sample of 788 Italian employees (58.6% females, Mage = 35.09). Our findings supported the hypothesized model showing that regardless of the motivation underpinning the norm-violating behavior, employees with a prevention focus are more desirous of tightness and exhibit hostile reactions toward deviance. Given its importance in understanding employees' behaviors and intentions, which inevitably reflect on the organization's functionality, the impact of the T-L individual-level dimension in organizations is undoubtedly worthy of deeper investigation.


A new method used in laparoscopic hysterectomy for uterine manipulation: uterine rein technique.
The aim of this study is to define a new method of manipulating the uterus during laparoscopic hysterectomy. A total laparoscopic hysterectomy (TLH) with the newly defined technique was performed in 29 patients between July 2016 and July 2017. In this new technique, the uterus was bound from uterine corpus and fundus like a bridle with polyester tape, to allow abdominal manipulation. The technique was successfully performed at the first attempt in 93.1% of cases. It was repeated in two cases (6.9%) since the polyester tape departed away from the uterus at the first attempt. The mean application time was 11.2 min. The vaginal manipulator was not required in any of the cases. There were no intraoperative complications. In conclusion, this method has the advantages of not requiring any vaginal manipulator, reducing the number of people required during operation, permitting a near maximum manipulation of the uterus in all three dimensions, and giving the control of these manipulations directly to the surgeon. On the other hand, the technique also has some inadequacies which should be discussed and improved on in the future. Impact of statement What is already known on this subject? In a laparoscopic hysterectomy, manipulation of the uterus is essential for anatomical dissection of the regions and completion of the operation without complications. An ideal uterine manipulator is defined as inexpensive, as convenient, fast and suitable for injecting solutions, removing the need for an assistant and most importantly offering the most suitable range of motion. In this study, we describe a new and different technique (rein technique) allowing the abdominal manipulation of the uterus in a laparoscopic hysterectomy and discuss the advantages and disadvantages of this method. What do the results of this study add? The procedure was easily accomplished in most patients. We did not need to use an extra uterine manipulator in any of the cases. What are the implications of these findings for clinical practice and/or further research? In conclusion, the rein technique of uterine manipulation is effective and safe.


Draft Genome Sequence of Clostridium cochlearium Strain AGROS13, Isolated from a Sheep Dairy Farm in New Zealand.
We report the draft genome sequence of a new Clostridium cochlearium strain, AGROS13, which was isolated from a sheep dairy farm environment in New Zealand. The genome is 2.7 Mbp, with a GC content of 28.2%. The genome sequence was found to be closely related to that of Clostridium cochlearium ATCC 17787. The new strain harbors a biosynthetic gene cluster coding for an unknown sactipeptide.


A new method for toilet training developmentally disabled children.
20 profoundly retarded children (4 to 12 yr.) were trained, using a variety of relaxation and tension activities designed to help them differentiate and gain control of the toileting musculature. Operant techniques were used to reinforce appropriate urination. The post-training scores of the experimental and control groups differed significantly for both accidental and appropriate urination.


[The medical responsibility of an allergist].
The professional civil responsibility of an allergy physician should be restored to the more general framework of medical responsibility. This is at present the objective of considerable public debate. From now on it is known that the developments at present and to come for the most part go beyond the strict requirement of the juridical process. They take up fully a real choice of society. What place do we wish to give to physicians in the future? What new outlines relating to care should be adopted? What must be done for the victims of medical accidents? These are the fundamental questions that we ask ourselves today. The choices that apply, influence, must persuade our society, its made of action and the relationships between the various' components. It must be said that the stakes are enormous. It must also be said that all of this will not be achieved without clashes.


How Structural Defects Affect the Mechanical and Electrical Properties of Single Molecular Wires.
We report how individual defects affect single graphene nanoribbons by scanning tunneling and atomic force microscopy pulling experiments simultaneously accessing their electrical and mechanical properties. The on-surface polymerization of the graphene nanoribbons is controlled by cooperative effects as theoretically suggested. Further, we find, with the help of atomistic simulations, that defects substantially vary the molecule-substrate coupling and drastically increase the flexibility of the graphene nanoribbons while keeping their desirable electronic properties intact.


EEG delta band as a marker of brain damage in aphasic patients after recovery of language.
In this study spectral delta percentage was used to assess both brain dysfunction/inhibition and functional linguistic impairment during different phases of word processing. To this aim, EEG delta amplitude was measured in 17 chronic non-fluent aphasic patients while engaged in three linguistic tasks: Orthographic, Phonological and Semantic. Average mapping of aphasics' structural lesion showed core damage in the left cortical-subcortical perisylvian areas. Delta amplitude was overall significantly higher in aphasics with respect to matched controls, a result in line with the view that diaschisis/cortical inhibition persists to some extent also in the chronic phase. Analysis of regions of interest revealed a peak of delta activity in left perilesional EEG sites, posterior to the core damage where residual suffering tissue probably projects its dysfunctional activity. Time course of word processing showed in patients greater delta percentage/inhibition in the first interval after word offset in correspondence of which verbal working memory is engaged. The significant interaction including group and task factors points to greater left posterior inhibition in aphasics across all tasks and left vs. right anterior relative disinhibition only during the Phonological task, whereas controls showed greater left vs. right disinhibition at anterior sites in all tasks. Delta band, in addition to its ability to reflect structural damage, was effective in the assessment of functional impairment as well as of linguistic reorganization of aphasics at hemispheric level with a spatial scalp distribution consistent with lesion map.


Ocular surface evaluation in eyes with chronic glaucoma on long term topical antiglaucoma therapy.
To evaluate ocular surface changes and its correlation with the central corneal subbasal nerve fibre layer in chronic glaucoma patients. A prospective comparative study of ocular surface evaluation was performed in 50 eyes of 25 patients using two or more antiglaucoma medications for at least 6mo and 50 eyes of 25 normal subjects without any ocular problems as controls. The study parameters evaluated included visual acuity, intraocular pressure, ocular surface evaluation parameters [fluorescein break-up time (FTBUT), Schirmer's I test, ocular surface staining scores and ocular surface disease index score (OSDI)], central corneal sensation (Cochet Bonnett aesthesiometer), central subbasal nerve fiber layer density (SBNFLD) by confocal microscopy. The mean values in the glaucoma cases and control groups respectively were as follows: OSDI score (35.89±16.07/6.02±3.84; P=0.001), Schirmer's I test score (7.63±2.64 mm/12.86±1.93 mm; P=0.001), FTBUT (9.44±2.76s/11.8±1.88s; P=0.001), corneal (5.7±2.33/ 1.1±0.58; P=0.001) and conjunctival staining score (5.06±1.94/0.84±0.46; P=0.001), corneal sensitivity (4.68±0.44/5.07±0.37; P=0.076), mean subbasal nerve fiber number (3.58±0.99/5.40±1.70; P=0.001), SBNFL length (1101.44±287.56 µm/1963.70±562.56 µm; P=0.001) and density (6883.94±1798.03 µm/mm2/12 273.15±3516.04 µm/mm2; P=0.001). Dry eye severity of level 2 and 3 was seen in 66% of glaucoma group. Corneal (R2=0.86) and conjunctival staining (R2=0.71) and OSDI score (R2=0.67) showed statistically significant negative correlation with central corneal SBNFLD while FTBUT (R2=0.84), corneal sensitivity (R2=0.52) showed positive correlation to central corneal SBNFLD in the long term topical antiglaucoma medication group. Ocular surface changes and antiglaucoma therapy induced dry eye is found to be associated with decreased SBNFLD in eyes on long term topical antiglaucoma medications.


Living-Donor Liver Transplant Follow-Up: A SingleCenter Experience.
Liver transplant is a definite treatment of decompensated liver disease. Because of the shortage of livers from deceased donors, living-donor liver transplant is becoming more common. Here, we analyzed our clinical experience in the follow-up care of these patients. Liver transplant recipients seen at the Sindh Institute of Urology and Transplantation (Karachi, Pakistan) were included in this analysis. Baseline characteristics and follow-up events were recorded. Our study population included 76 liver transplant patients registered at our clinic. Median age was 42 years, with 62 patients (81.6%) being males. The most common indication of transplant was hepatitis C virus-related cirrhosis (42 patients; 55%), followed by hepatitis B-hepatitis D virus coinfection (8 patients; 10.5%). Anastomotic biliary stricture developed in 16 patients (21.1%),which required biliary stenting. Biliary leak developed in 5 patients (6.6%), and renal cell carcinoma developed in 1 patient. Two recipients died due to hepatitis C virus-related fibrosing cholestasis hepatitis and pulmonary com plications. Posttransplant diabetes mellitus developed in 36 (47.1%), hypertension in 17 (38.6%), and dyslipidemia in 19 patients (25%). Of 42 patients with hepatitis C virus infection, 26 were treated with pegylated interferon and ribavirin, of which 65.3% achieved sustained virologic response at 24 weeks. The other 16 patients received sofosbuvir com - bined with ribavirin for 24 weeks. A sustained virologic response at 12 weeks was achieved in 5 patients, with not yet determined results in the remaining patients. Seven patients were lost to follow-up. Hepatitis C-related cirrhosis was the most common indication for liver transplant, and infection recurrence was observed in our patients. Biliary anastomotic stricture formation was the most prevalent complication after transplant. As liver transplants are becoming more widely available for Pakistani patients at home and abroad, gastroenterologists and trainees in our country should be sensitized, educated, and skilled in the posttransplant care of these patients.


[Report of a case of leiomyoma of the kidney].
The authors report a case of leiomyoma of the renal capsule. Although leiomyoma is a frequent tumour in the uterus, leiomyomas of the urinary tract are very rarely reported in the literature. This tumour has an excellent prognosis. In rare cases, the diagnosis may be suggested by CT scan, but histological examination confirms the diagnosis of benign tumour.


The Transition of Medical Students Through Residency: Effects on Physical Activity and Other Lifestyle-Related Behaviors.
Little is known about lifestyle choices and preventive healthcare-seeking behaviors during the transition from medical school graduation to residency training, a period characterized by increased rates of stress and lack of free time due to demanding working conditions. All of these issues are likely to affect physical activity (PA) level. This study explored the evolution of PA and other lifestyle behaviors during this transition. A cross-sectional study and a cohort study were conducted with medical students (2010) and physicians before and after the first year of residency (2013 and 2014). A self-administered questionnaire assessed PA, health and lifestyle behaviors. From a sample of 420 medical students and 478 residents, 74% comply with current PA guidelines. PA decreased by 16% during residency. Low levels of PA were found among (i) females and in respondents who reported (ii) poor self-perceived health and (iii) unhealthy body weight (P < .05). Low PA level was also significantly associated with poor mental health in first-year residents. The transition has a negative effect on physicians' PA level that may affect physicians' own health and patient care. Medical programs should encourage residents to engage in PA to assure physicians' personal and mental health.


Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users.
Domestic fuel combustion from cooking and heating, to which about 3 billion people worldwide are exposed, is associated with increased lung cancer risk. Lung cancer incidence in Xuanwei is the highest in China, and the attributable risk of lung cancer from unvented smoky coal burning is greater than 90%. To evaluate any lung cancer mortality reduction after changing from unvented stoves to portable stoves, we used lifetime smoky coal users in a retrospective cohort of all farmers born during 1917-1951 and residing in Xuanwei in 1976. Of the 42,422 enrolled farmers, 4054 lifetime smoky coal users changed to portable stoves, 4364 did not change, and 1074 died of lung cancer. Lung cancer morality associated with stove change was assessed by product-limit survival curves and multivariate Cox regression models. Both men (P<0.0001) and women (P<0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change. Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.46-0.82) and female participants (HR=0.41, 95% CI=0.29-0.57). Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries.


[Efficacy of first-line afatinib versus chemotherapy in EGFR mutation positive pulmonary adenocarcinoma].
Therapy of patients with advanced NSCLC has lately changed due to the algorithm based on the presence or absence of oncogenic mutations. There is an agreement nowadays that in the presence of activating EGFR mutations, the administration of EGFR TKI (gefitinib, erlotinib, afatinib) is the most efficacious initial treatment. Unlike the first-generation TKIs, afatinib is a new, irreversible ErbB blocker, selectively and effectively blocking signals from the ErbB family receptors. Afatinib's marketing authorization is based on a large, randomized, phase III clinical trial, LUX-Lung 3, where patients in the control arm were treated with the best available chemotherapy (pemetrexed/cisplatin combination). Primary endpoint was progression-free survival (PFS). Patients with common EGFR mutations showed a PFS of 13.6 months when treated with afatinib, while treatment in the control arm resulted in a PFS of 6.9 months. Overall survival (OS) was 31.6 and 28.2 months, respectively. LUX-Lung 3 has been followed by the LUX-Lung 6 trial, comparing afatinib treatment to traditional chemotherapy (gemcitabine/cisplatin) in Asian patients with NSCLC harboring EGFR mutations. This clinical trial has also proved benefit of afatinib: PFS was 11.0 months in the afatinib arm and 5.6 months in the control arm by independent reviewer, while OS was 23.6 months and 23.5 months, respectively. Similarity of the OS values in both trials is explained by the cross-over treatment. When further analyzing OS data, a statistically significant difference between the afatinib and the control arm was seen in the EGFR exon 19 del subgroup (LUX-Lung 3: 33.3 vs. 21.1 months, LUX-Lung 6: 31.4 vs. 18.4 months, respectively).


Driving to Childhood Cancer Hub Hospitals: A Study on Hospital Accessibility in Japan.
In 2013, 15 childhood cancer hub hospitals in Japan were designated to provide quality medical treatment and care. The present study assessed hospital accessibility by investigating travel times and distances from patient residences. A total of 37,309 residence/hospital pairs were generated using the addresses of 15 hub hospitals that were designated in 2019 and local government offices in 2014. Using the Google Directions Application Programming Interface (API), travel times and distances were calculated on the assumption that each patient would arrive by driving to the hospitals by 10 am on Wednesday, November 6, 2019. Thus, after identifying the nearest hospital for each residence and deriving adjusted estimated travel times (AETT), the data were summarized according to the regional block using weighted population descriptive statistics for children under 15 years of age in 2015. The cumulative distribution functions of the weighted mean of AETT were also plotted. Childhood cancer patients could access the nearest hub hospital by traveling approximately 1.78 hours (AETT, range: 0.1 to 41.8) and 91.86 km (range: 1.0 to 1438.0). Moreover, a total of 94.5% of patients had the nearest hub hospital within their own regional block. The cumulative distribution functions of AETT indicated that many children in three blocks with multiple hub hospitals have shorter travel times and better hospital accessibility than those in other blocks. Although feasibility is ultimately dependent on each patient's condition and situation, child cancer patients on average can likely complete hospital visits from home and return within a single day. However, this is likely not the case for children who live at considerable distances from hub hospitals. We found regional differences in travel times and distances, depending on whether a given block contained multiple hub hospitals.


Effect of valine and the herbicide sulfometuron methyl on acetolactate synthase activity in nuclear and plasmid-borne sulphometuron methyl resistant Saccharomyces cerevisiae strains.
Acetolactate synthase (ALS) specific activity was evaluated in isogenic lines of Saccharomyces cerevisiae carrying the wild-type ILV2 gene or mutations in this gene for resistance to the herbicide sulfometuron methyl (SM). Statistical comparisons were made between two nuclear alleles and among five alleles borne on a YE chimaeric plasmid transformed into a strain carrying a 1.5-kilobase deletion in the nuclear ILV2 gene. Decreased ALS activity of plasmid-borne SM-resistant mutations was shown not to be caused by copy number effects. ALS-specific activity in strains carrying the wild-type ILV2 allele exhibited strong feedback inhibition by valine and was sensitive to SM. All nuclear and plasmid-borne SM-resistance alleles resulted in ALS-specific activity highly resistant to SM and resistant to valine feedback inhibition.


Prevalence of Human Herpesvirus-8 and BK Polyoma Virus Infections in End-stage Renal Disease and the Influence of Renal Transplantation.
Viral infections lead to significant morbidity and mortality in kidney transplant recipients. We evaluated 49 kidney transplant recipients for human herpesvirus 8 (HHV-8) and BK polyomavirus infections in conjunction with data obtained from 43 donors. The seroprevalence of HHV-8 was 6.9% in donors and 12.2% in recipients. HHV-8 DNA was detected below the limit of quantification (<5000 copies/mL) in a recipient with HHV-8 seropositivity at the pretransplant period and was undetectable at month 3 after transplantation. Transient viruria with BK polyomavirus was recorded in 10.2% of recipients without viremia. Multiple factors contribute to viral reactivation, particularly immunosuppressive treatment. Reduction in maintenance immunosuppression seems beneficial in terms of viral reactivation. At our center, routine use of valganciclovir for antiviral prophylaxis may be effective for the prevention of HHV-8 reactivation.


Drought-Tolerant Plant Growth-Promoting Rhizobacteria Associated with Foxtail Millet in a Semi-arid Agroecosystem and Their Potential in Alleviating Drought Stress.
The application of plant growth promoting rhizobacteria (PGPR) to agro-ecosystems is considered to have the potential for improving plant growth in extreme environments featured by water shortage. Herein, we isolated bacterial strains from foxtail millet (Setaria italica L.), a drought-tolerant crop cultivated in semiarid regions in the northeast of China. Four isolates were initially selected for their ability to produce ACC deaminase as well as drought tolerance. The isolates were identified as Pseudomonas fluorescens, Enterobacter hormaechei, and Pseudomonas migulae on the basis of 16S rRNA sequence analysis. All of these drought-tolerant isolates were able to produce EPS (exopolysaccharide). Inoculation with these strains stimulated seed germination and seedling growth under drought stress. Pseudomonas fluorescens DR7 showed the highest level of ACC deaminase and EPS-producing activity. DR7 could efficiently colonize the root adhering soil, increased soil moisture, and enhance the root adhering soil/root tissue ratio. These results suggest drought tolerant PGPR from foxtail millet could enhance plant growth under drought stress conditions and serve as effective bioinoculants to sustain agricultural production in arid regions.


A case of acyclovir neurotoxicity presenting with atypical cerebrospinal fluid findings.
An 82-year-old man with a history of end-stage renal disease presented with progressively worsening confusion and somnolence for the past 4-5 days. The patient was diagnosed with herpes zoster by his primary care physician 5 days ago and was started on a course of valacyclovir 1 g three times a day (dose not adjusted for renal impairment).A lumbar puncture was performed and cerebrospinal fluid (CSF) studies revealed 37 white blood cells (WBCs)/hpf (100% monocytes), protein 64 mg/dL and glucose 52 mg/dL. He was started on ceftriaxone, ampicillin and acyclovir. MRI of the brain was done and was unremarkable. Acyclovir-induced encephalopathy was high on differential, but his CSF findings were concerning for viral encephalitis. Nonetheless, all antimicrobials were discontinued and he was scheduled for a 5-hour dialysis session. The very next day, he showed immense improvement and eventually recovered completely. CSF PCR tests for both herpes simplex virus and varicella zoster virus came back negative.


New challenges in toxicology of new psychoactive substances exemplified by fatal cases after UR-144 and UR-144 with pentedrone administration determined by LC-ESI-MS-MS in blood samples.
The topic of this paper relates to the study of cases involving the use of new psychoactive substances (NPS) from the classes of synthetic cannabinoids and cathinones, analyzed from multiple viewpoints including clinical and medico-legal perspectives. The paper investigates three fatal cases in which UR-144 and UR-144 with pentedrone identified in the bodies of victims during post-mortem examinations were responsible for the tragic consequences and proved to be the indirect cause of death. The victims were men aged 16, 22 and 40 years who used drugs, for example they smoked marijuana or its substitutes in the form of synthetic cannabinoids. In addition, all of them had behavioural problems. On account of emotional imbalance attributable probably to the presence of UR-144 (in one case) and a mixture of UR-144 and pentedrone (in the other two cases), two men committed suicide by jumping from a height and hanging, and one man had fatal accidental poisoning with pentedrone which was used to enhance the effect of previously used UR-144. The presence of UR-144 and pentedrone in the post-mortem material was analyzed by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS-MS). The results of toxicological tests were analyzed with a focus on possible tragic side effects caused by the presence of UR-144 and UR-144 with pentedrone in the body.


Fibroblast Growth Factor 21 Mimetics for Treating Atherosclerosis.
Fibroblast growth factor 21 (FGF21) is an atypical member of the FGF family. Acting in an endocrine fashion, it increases glucose uptake, modulates lipid metabolism, and sensitizes insulin response in metabolically active organs, including the liver and adipose tissue. Emerging evidence shows a strong correlation between circulating FGF21 levels and the incidence and severity of atherosclerosis. Animal studies have demonstrated a beneficial role of FGF21 in protecting against aberrant lipid profile, while recent development in FGF21 mimetics has provided further insight into the lipid-lowering effects of FGF21 signaling. The present review summarizes the physiological roles of FGF21, and discusses major breakthroughs and limitations of FGF21 mimetic-based therapeutic strategies for treating atherosclerosis.


Binocular locus of brain hemisphere reversal of time information effect in schizophrenia.
Investigated brain hemisphere laterality of time information among 60 schizophrenics and 60 nonschizophrenics. Duration estimation of a single dark dot presented to the left, center and right visual fields was studied with respect to an auditory warning signal of variable duration. Three conclusions were drawn: First, the relation between posterior and prior time information was shown to be that of inverse variation, and this relation was intact among schizophrenics. Second, time information was lateralized toward the left hemisphere among nonschizophrenics and toward the right hemisphere among schizophrenics, which indicates hemispheric reversal of time information as a characteristic of schizophrenia. Third, such hemispheric reversal of time information was confined to binocular, therefore, bilateral, stimulus input.


Suhuang Antitussive Capsule Ameliorates Corticosteroid Insensitivity in Cough Variant Asthma Guinea Pigs by Inhibiting p38 MAPK Signal Pathway.
The CVA guinea pig model was successfully established by use of ovalbumin (OVA) sensitization and cigarette smoke (CS) exposure. The guinea pigs were divided into 6 groups: a control group, an OVA model group, an OVA + CS model group, a Suhuang treatment group, a BUD treatment group, and a combination (Suhuang and BUD) treatment group. The effects of the treatment were determined by measuring lung function (RI/Cydn) and cough symptoms (coughs number/cough latency) as outcome criteria. The levels of inflammatory cytokines in bronchoalveolar lavage fluid (BALF) were determined by ELISA. Lung tissues were stained by hematoxylin and eosin (H&E). The expressions of GR/total p38 MAPK/p-p38 MAPK were detected by Western blot. The MKP-1 mRNA levels were detected by RT-PCR. Combination treatment significantly decreased RI/coughs numbers and increased Cydn/cough latency. Significantly, the results indicated that combination treatment decreased injury to pulmonary tissues. Results also revealed that levels of inflammatory cytokines were reduced in all treatment groups but most markedly in the combination treatment group. Moreover, Suhuang treatment significantly ameliorated corticosteroid insensitivity by improving the expression of glucocorticoid receptors (GR). The expressions of total p38 MAPK and p-p38 MAPK in lung tissue were significantly inhibited in the Suhuang and combination treatment groups. The MKP-1 mRNA levels in Suhuang and combination treatment groups were also increased significantly. Suhuang was effective for reversing corticosteroid insensitivity by regulating the p38 MAPK signal pathway, and combining BUD and Suhuang treatment showed synergistic interactions in CVA guinea pigs. Our findings showed that this combination therapy might be a promising therapeutic agent for CVA and also clarified its underlying mechanism of action, providing a theoretical basis for clinical combination treatment with Suhuang and BUD in CVA patients.


Effect of spatial resolution on SPECT quantification values.
The effect of spatial resolution on quantification by single photon emission computed tomography (SPECT) was studied using a rotating gamma camera and 99mTc. Using phantoms with hot and cold regions, experiments were performed to ascertain relationships between the source and the SPECT image, and to compare them with theoretic calculations. According to the results, the SPECT value represented the true radioactivity when the objects' sizes were 2.5 times larger than full width at half maximum (FWHM) for hot regions. For cold regions, there were errors of approximately 20% for the true value, even in the case of such large sizes. In addition, sizes at half maximum images corresponded to true object sizes when hot region sizes were larger than 1.4 x FWHM. The relationship between absolute radioactivity and total SPECT value was linear when the threshold level was zero. Knowing the effect of spatial resolution is a necessity in clinical SPECT studies.


A Case Report: Insulinoma in a Military Pilot Detected by 68Ga-Dotatate PET/CT.
A 37-year-old active duty male Air Force instructor pilot, with no prior medical history, was found unresponsive at his home after awakening with symptoms of altered mental status when the Emergency Medical Service (EMS) was called. The patient was found to be hypoglycemic with a glucose of 37 mg/dL. The patient recovered after administration of a dextrose bolus. Further investigation revealed that over the last several years, the patient exhibited symptoms of lightheadedness and tremors if fasted greater than 3 hours. Further clinical workup strongly suggested the presence of a neuroendocrine tumor. Initial imaging studies to include a multiphasic dedicated pancreatic computed tomography (CT) scan did not demonstrate a pancreatic lesion. However, the utilization of an innovative new nuclear medicine imaging modality, a 68Ga-Dotatate PET/CT, clearly demonstrated a 19 × 16 mm lesion of the distal pancreatic tail, which guided surgical resection. He underwent a robotic-assisted laparoscopic distal pancreatectomy, pathologically characterized as an insulinoma. The patient's symptoms immediately resolved with no recurrence over the next 6 months. The pilot was granted a waiver, returning him to his flying duties. The 68Ga-Dotatate PET/CT enabled the identification of an otherwise occult pancreatic neuroendocrine tumor ultimately leading to this patient's definitive cure and the salvage of this military asset's aviation career.


[Selective defect on interferon secretion associated with impaired natural killing activity (author's transl)].
A 4-year-old boy suffering from repeated, severe bacterial (staphylococcus, pneumococcus, klebsiella, moraxella) and viral (adenovirus) infections did not show any deficiency of either humoral, cellular or non-specific immunity when investigated by classical immunological tests. In contrast, a profound defect of interferon secretion was found in leucocyte cultures induced by mitomycin-treated Raji lymphoblastoid cells or soluble antigens. This was associated with a profound impairment of non-specific "natural" killer (NK) cytotoxic activity of peripheral leucocytes tested in a 4 hour-chromium release assay against K 562 target cells. Addition of leucocyte interferon in culture increased the cytotoxic potential of the patient's leucocytes. Intramuscular administration of interferon completely (but transiently) reversed the NK defect in vivo. The expression of HLA-A and B on the membrane of platelets was diminished, whereas the expression of HLA-A, B and la antigens on the membrane of lymphocytes was normal. This observation indicates that an apparently primitive defect of interferon secretion may result in a special type of immune deficiency with complex biological consequences, some of which can be reversed by interferon therapy.


Dehydration of an ethanol/water azeotrope by novel organic-inorganic hybrid membranes based on quaternized chitosan and tetraethoxysilane.
To control swelling of quaternized chitosan (q-Chito) membranes, mixtures of q-Chito as an organic component and tetraethoxysilane (TEOS) as an inorganic component were prepared using the sol-gel reaction, and novel q-Chito/TEOS hybrid membranes were formed. In the separation of an ethanol/water azeotrope by pervaporation, the effect of TEOS content on the water/ethanol selectivity of q-Chito/TEOS hybrid membranes was investigated. Hybrid membranes containing up to 45 mol % TEOS exhibited higher water/ethanol selectivity than the q-Chito membrane. This resulted from depressed swelling of the membranes by formation of a cross-linked structure. However, introduction of excess TEOS led to greater swelling of the hybrid membranes. Therefore, the water/ethanol selectivity of the hybrid membranes containing more than 45 mol % TEOS was lower than that of the q-Chito membrane. The relationship between the structure of q-Chito/TEOS hybrid membranes and their permeation and separation characteristics during pervaporation of an ethanol/water azeotrope is discussed in detail.


An Audit on the Appropriateness of Coronary Computed Tomography Angiography Referrals in a Tertiary Cardiac Center.
In response to growing concerns regarding the overuse of coronary computed tomography angiography (CCTA) in the clinical setting, multiple societies, including the American College of Cardiology Foundation, have jointly published revised criteria regarding the appropriate use of this imaging modality. However, previous research indicates significant discrepancies in the rate of adherence to these guidelines. To assess the appropriateness of CCTA referrals in a tertiary cardiac center in Bahrain. This retrospective clinical audit examined the records of patients referred to CCTA between the April 1, 2015 and December 31, 2015 in Mohammed bin Khalifa Cardiac Center. Using information from medical records, each case was meticulously audited against guidelines to categorize it as appropriate, inappropriate, or uncertain. Of the 234 records examined, 176 (75.2%) were appropriate, 47 (20.1%) were uncertain, and 11 (4.7%) were inappropriate. About 74.4% of all referrals were to investigate coronary artery disease (CAD). The most common indication that was deemed appropriate was the detection of CAD in the setting of suspected ischemic equivalent in patients with an intermediate pretest probability of CAD (65.9%). Most referrals deemed inappropriate were requested to detect CAD in asymptomatic patients at low or intermediate risk of CAD (63.6%). This audit demonstrates a relatively low rate of inappropriate CCTA referrals, indicating the appropriate and efficient use of this resource in the Mohammed bin Khalifa Cardiac Center. Agreement on and reclassification of "uncertain" cases by guideline authorities would facilitate a deeper understanding of referral appropriateness.


HSPA12B overexpression induces cisplatin resistance in non-small-cell lung cancer by regulating the PI3K/Akt/NF-κB signaling pathway.
Although cisplatin (CDDP) is widely used for non-small-cell lung cancer (NSCLC) treatment, resistance remains a major problem that restricts its efficacy. Therefore, identification of drugs that reverse or prevent resistance to CDDP in NSCLC has been a focus of a number of studies. The results of the present study revealed the effect of heat shock protein family A member 12B (HSPA12B) overexpression on chemoresistance in A549 cells in vitro. The effect of HSPA12B overexpression on chemoresistance in mice bearing A549 xenografted tumors was then determined via stable HSPA12B transfection. Finally, the effects of HSPA12B overexpression on the phosphorylation of protein kinase B (Akt) and nuclear factor-κB inhibitor α (IκBα), and the expression of the anti-apoptotic protein B-cell lymphoma 2 (Bcl-2) and the pro-apoptotic protein cleaved caspase-3 were determined by western blot analysis. The results demonstrated that HSPA12B overexpression increased resistance to CDDP in NSCLC cells in vivo and in vitro by promoting cell growth and inhibiting CDDP-induced apoptosis. Mechanistically, this effect was mediated by the upregulation of phosphorylated (p-)Akt, p-IκBα and Bcl-2 and the downregulation of cleaved caspase-3. Therefore, the present study provides useful information pertaining to the identification and targeting of a CDDP-resistant population, and the development of potential therapeutics to improve the current treatment modalities in NSCLC.


[Evaluation of clinical practice in pulmonology: tuberculosis].
The management of patients affected by tuberculosis raises issues including epidemiology, the identification and treatment of disease or infection, infection control measures, BCG vaccination and national and international strategies against the disease. BCG vaccination is controversial because of its undesirable effects and the conflicting evidence from trials. It provides partial but undeniable protection; 50% against all forms and 80% against the most severe forms, particularly in children. Vaccination strategies (generalised, selective or not at all) provide different cost/benefits depending on the population involved and its prior vaccination history. This variation in response does not outweigh the ethical and pragmatic considerations underlying the current approach of universal vaccination. The directly observed therapy, short course (DOTS) strategy has been well evaluated notwithstanding the huge potential scope of its global implementation. A more effective vaccine is one of the possible solutions for eliminating tuberculosis. DOTS could be usefully implemented in France as part of a strategy to eliminate the disease. BCG vaccination and elements of DOTS are effective interventions for the management of TB.