Reproductive failure due to the entrapment of oocytes in luteinized follicles of the little bulldog bat (Noctilio albiventris).
The reproductive tracts of 112 female little bulldog bats collected around the onset of a breeding season in the Cauca Valley of Colombia were examined histologically. Of the 88 females with luteinizing/luteinized follicles or new CL, 72 carried tubal ova or uterine blastocysts and 16 were non-pregnant. In 14 of the latter follicle rupture had apparently failed to occur, and the oocyte or a collapsed zona pellucida was found within a luteinizing or luteinized follicle. These structures appeared to be functional because most of the affected bats demonstrated preferential stimulation of the ipsilateral oviduct and/or uterine horn. Two of these animals also had a second, older luteinized follicle which contained the remnants of an oocyte. None of these 14 bats exhibited the uterine modifications thought to be associated with a previous pregnancy or had prominent mammary glands. Such reproductive features were, in contrast, frequently demonstrated by other females in the population. These observations suggest that the luteinization of unruptured follicles may have occurred in prepubertal members of the population and reflect immaturity of the hypothalamo-pituitary -ovarian axis in these individuals.


[Quantitative chemical analyses on the material gained by vitrectomy (author's transl)].
The material gained by vitrectomy from 13 eyes suffering from different pathological changes of the vitreous body was analysed in relation to the concentrations of protein, lactic acid and glycogen, and standardized by means of a special method. The concentration of protein was found to have increased in cases of intravitreal haemorrhage, shrinkage of the vitreous body after complete spontaneous resorption of intravitreal haemorrhage, and in a case of intravitreal membranes following endophthalmitis; in cases of subvitreal haemorrhage the protein content was approximately normal. The concentrations of lactic acid and glycogen were examined to find out if anaerobic glycolysis could be proved in cases of ischaemic retinopathy. Only one case showed an increased concentration of lactic acid while in three cases there was a reduced content of glycogen. In these three cases the possibility of anaerobic glycolysis could not be excluded, because in rabbits a rapid excretion rate of increased lactic acid concentrations via retinal vessels has been reported.


Metastatic disease to the pancreas: an imaging challenge.
Metastatic lesions of the pancreas are uncommon, accounting for approximately 2% of pancreatic malignancies. Many tumours involve the pancreas secondarily and may manifest with different clinical and imaging characteristics. Although many patients have widespread disease, isolated metastases can be found. Surgical management is associated with improved survival in these cases. The experience of the pancreatic surgery unit and imaging department of our hospital in many patients presenting with pancreatic metastases is presented, and a review of the recent literature is undertaken. Main Messages • The early recognition of secondary pancreatic tumours on US, CT and MRI is extremely important. • Pancreatic metastases may mimic primary pancreatic adenocarcinoma or induce acute pancreatitis. • Most pancreatic metastases are discovered on a CT examination performed for follow-up.


An audit of the diagnostic usefulness of PRL and TSH responses to domperidone and high resolution magnetic resonance imaging of the pituitary in the evaluation of hyperprolactinaemia.
The usefulness of dynamic tests of PRL release in determining underlying pathology in hyperprolactinaemic patients is not well recognized by endocrinologists, only 15% of whom routinely perform such tests. High resolution pituitary magnetic resonance imaging (MRI) has become more widely available during the past 5 years and is now generally regarded as the pituitary imaging method of choice. Since few prolactinoma patients are now submitted to surgery, it is important to ascertain the usefulness of these techniques in suggesting a pathological diagnosis. A 3 year retrospective audit of the information derived from measurement of PRL and TSH responses to the dopamine antagonist domperidone and from high resolution pituitary MRI in patients being investigated for hyperprolactinemia in regional endocrine unit. Eighty-four patients (10 male, 74 female) whose investigation of hyperprolactinaemia included a domperidone test and high resolution pituitary MRI. Patients who had domperidone tests performed after pituitary surgery or who did not have pituitary MRI were excluded from the analysis. PRL and TSH were measured basally and at 30 and 60 minutes following domperidone (10 mg i.v.) and gadolinium-enhanced pituitary MRI was performed in all patients. 20 patients had a normal PRL response to domperidone (defined as PRL30/PRL0 > 3) and this group included five patients in whom hyperprolactinaemia was not sustained. Pituitary MRI showed evidence of a microadenoma in only two patients, imaging being unequivocally normal in the majority. Sixty-four patients had an abnormal PRL response to domperidone and 18 of these had a macrolesion (nine prolactinomas, nine other tumours). Pituitary MRI was performed in the remaining 46 patients with abnormal PRL response to domperidone and suggested microadenoma in 29 (63%), identified other structural abnormalities in six cases but was entirely normal in 11 cases. Neither the basal PRL level nor the TSH response could refine the diagnosis further because of overlap between the various subgroups. The majority of patients with a normal dynamic response of PRL to domperidone had a normal or near normal pituitary MRI scan. In the two cases where an abnormality was detected it could have been an incidental microadenoma or cyst, thus suggesting that pituitary scanning could normally be omitted in patients whose PRL response to domperidone is normal (24% of our total). The group of patients with an abnormal dynamic response of PRL to domperidone was not generally amenable to further diagnostic refinement by considering the degree of hyperprolactinaemia or the TSH response to domperidone because of overlap of these parameters between the diagnostic subgroups. Therefore any degree of hyperprolactinaemia associated with a blunted PRL response to domperidone warrants pituitary imaging.


Lineage Specification from Prostate Progenitor Cells Requires Gata3-Dependent Mitotic Spindle Orientation.
During prostate development, basal and luminal cell lineages are generated through symmetric and asymmetric divisions of bipotent basal cells. However, the extent to which spindle orientation controls division symmetry or cell fate, and the upstream factors regulating this process, are still elusive. We report that GATA3 is expressed in both prostate basal progenitor and luminal cells and that loss of GATA3 leads to a mislocalization of PRKCZ, resulting in mitotic spindle randomization during progenitor cell division. Inherently proliferative intermediate progenitor cells accumulate, leading to an expansion of the luminal compartment. These defects ultimately result in a loss of tissue polarity and defective branching morphogenesis. We further show that disrupting the interaction between PRKCZ and PARD6B is sufficient to recapitulate the spindle and cell lineage phenotypes. Collectively, these results identify a critical role for GATA3 in prostate lineage specification, and further highlight the importance of regulating spindle orientation for hierarchical cell lineage organization.


Head and neck manifestations in HIV infection.
Diseases of the head and neck often are the first sign of Human Immunodeficiency Virus (HIV) infection. As current treatment increases the survival time of HIV-positive patients, the physician may encounter patients with a greater variety and number of diseases related to the primary HIV infection. Some entities are harbingers of HIV infection, such as Kaposi's sarcoma and parotid cystic enlargement. Other manifestations, such as Mycobacterium avium complex infection, may be used to determine the stage of HIV infection. The advent of highly active anti-retroviral therapy (HAART) has transformed the prevalence of HIV-associated head and neck disease. This article reviews the clinical presentations and treatments of common and uncommon head and neck manifestations in HIV infection. Accurate assessment of these conditions may allow the physician to identify HIV infection in previously undiagnosed patients, and, as a result, provide more timely treatment.


Brief cognitive assessment and prediction of functional outcome in stroke.
To evaluate the ability to predict outcome with a brief measure of cognitive ability, we tested consecutive admissions who received inpatient rehabilitation for stroke with the Repeatable Battery for Assessment of Neuropsychological Symptoms (RBANS). Six months later, 34 discharged patients were contacted by telephone and were interviewed using a battery of functional outcome and quality of life measures. Multiple regression analysis showed that inpatient RBANS indexes predicted cognitive disability 6 months later. The present findings support the use of cognitive evaluations of patients with acute stroke to assist with prediction of outcome to be used in treatment planning.


Satisfaction with nursing care in drug users: the evolution of a scale.
To identify the degree of satisfaction with nursing care, the significant variables and contribute to the evolution of the scale. Descriptive, correlational, cross study, with 180 drug users. Data collected using the scale called "Satisfaction of users with the Nursing Health Center26", between February and December 2012 in three treatment units in the region of Lisbon and Vale do Tejo, Portugal. Users indicated 83.3% satisfaction. The dimension "Information individualization" was the most marked (98.5%). The more stability in the programs, abstinence from stimulants and benzodiazepines and more nursing interventions, the greater the satisfaction. Better working conditions, specializing in mental health, younger ages and less experience of nurses also contributed to satisfaction. Four items of the scale were extracted, assuming new SUCECS22 designation. Satisfaction was high, influenced by structural variables of users, nurses and working conditions. The scale has proved suitable for assessment in this population.


Pseudomonas aeruginosa keratitis in leukopenic rabbits.
To study the role of the host inflammatory response in Pseudomonas aeruginosa keratitis, rabbits were made leukopenic with intravenous injections of cyclophosphamide and dexamethasone. Twenty-four hr later, keratitis was initiated in all rabbits with an intrastromal injection of 1,000 log phase P. aeruginosa strain 27853. Slit lamp examination of eyes showed that leukopenic rabbits had significantly less (P < 0.0001) ocular pathology at 16, 22, and 27 hr postinfection. The number of viable bacteria recovered from corneas of leukopenic rabbits was the same as the number recovered from nonleukopenic rabbits (P = 0.95). These results suggest that the host inflammatory response significantly contributes to the overall ocular pathology associated with P. aeruginosa keratitis, but does not influence the survival of the infecting organism in the cornea at the height of the infection.


Advances in radiation detection technologies for responders.
The Department of Homeland Security is supporting the development of a large number of standards for first responders. In the area of detection of radioactive and nuclear materials, four new standards (ANSI N42.32, N42.33, N42.34, and N42.35) and their corresponding test and evaluation protocols were developed to meet Department of Homeland Security needs. Testing of the standards and protocols was carried out at the National Institute of Standards and Technology, Oak Ridge National Laboratory, Pacific Northwest National Laboratory, Los Alamos National Laboratory, and Lawrence Livermore National Laboratory.


Tongmai Yangxin pill reduces myocardial no-reflow by regulating apoptosis and activating PI3K/Akt/eNOS pathway.
Tongmai Yangxin pill (TMYX) is derived from the Zhigancao decoction recorded in Shang han lun by Zhang Zhongjing during the Han dynasty and was further improved by Professor Ruan Shiyi, a cardiovascular expert at Tianjin University of Traditional Chinese Medicine. TMYX is used for the clinical treatment of chest pain, heartache, and qi-yin-deficiency coronary heart disease and can improve vascular endothelial function in patients with angina pectoris or coronary heart disease by up-regulating nitric oxide activity and then regulating vascular tension. Whether TMYX can further improve myocardial no-reflow by up-regulating NO activity and then dilating blood vessels remains unclear. This study aimed to reveal whether TMYX can further improve myocardial NR by up-regulating NO activity and then dilating blood vessels. The mechanism underlying PI3K/Akt/eNOS pathway activation and apoptosis regulation is also explored. The left anterior descending coronary arteries of healthy adult male SD rats were ligated to establish a NR model. The rats were assigned to 14 groups: control, sham, NR, TMYX (4.0 g/kg), sodium nitroprusside (SNP), Tongxinluo capsule (TXL), PI3K blocker (LY), TMYX + LY, SNP + LY, TXL + LY, eNOS blocker (L-NAME), TMYX + L-NAME, SNP + L-NAME, and TXL + L-NAME groups. Cardiac function was measured through echocardiography. Thioflavin S, Evans Blue, and TTC staining were adopted to evaluate NR and ischemic areas. Cell inflammation degree and edema were assessed by hematoxylin-eosin staining. Automated biochemical analyzer and kit were used to detect the activities of myocardial oxidants, including reactive oxygen species, super oxide dismutase, malonaldehyde, and NO. The expression levels of genes and proteins in the PI3K/Akt/eNOS signaling pathway and apoptosis were detected via real-time fluorescence quantitative PCR and Western blot analysis, respectively. A microvascular tension sensor was adopted to detect coronary artery diastolic function in vitro. TMYX reduced NR and ischemic areas; suppressed LV-mass; enhanced EF, FS, LVOT peak, and LVSV; and improved cardiac structure and function. Moreover, it decreased creatine kinase (CK), CK-MB, and lactic dehydrogenase activities. TMYX increased NO and super oxide dismutase activities; inhibited malonaldehyde activity; reduced muscle fiber swelling and inflammatory cell infiltration; and improved vasodilation in vitro. In the NR myocardium, TMYX stimulated myocardial PI3K activities and PI3K (Tyr458) phosphorylation and enhanced Akt activities and Akt phosphorylation at Tyr315. TMYX increased the activities of eNOS and the phosphorylation of eNOS at Ser1177 in the NR myocardium and attenuated cardiomyocyte apoptosis by increasing the expression of Bcl-2 and decreasing that of caspase-3 and Bax. All these effects of TMYX were abolished by the specific inhibitors of PI3K (LY) and eNOS (L-NAME). TMYX attenuates myocardial NR after ischemia and reperfusion by activating the PI3K/Akt/eNOS pathway and regulating apoptosis, further up-regulating NO activity and relaxing coronary microvessels.


Describing precisely what nurses do.
Numerous important papers written by nurses and other scientists to improve nursing practice are not read by many nurses because two of the common ways authors use to describe what nurses do obscures the applicability of studies to nurses in general. Interventions (aka, procedures, skills, tasks) used and populations studied, including diseases, are less robust indicators of research results than are tests of nursing theory. Further, some of these important papers are not stored in or retrieved by accessing the Cumulative Index of Nursing and Allied Health Literature database. We believe many research papers by nurses and those who study nursing would benefit from an explicit rather than implicit test of nursing theory and we advise authors use Henderson's theoretical textbook because of its link to research and expert opinion professional literature. Significant papers should be reversely cited in her textbook to place them in the context of the knowledge of nursing she recorded for much of the 20th century.


Transcriptional Time Course After Rotator Cuff Tear.
Rotator cuff (RC) tears are prevalent in the population above the age of 60. The disease progression leads to muscle atrophy, fibrosis, and fatty infiltration in the chronic state, which is not improved with intervention or surgical repair. This highlights the need to better understand the underlying dysfunction in muscle after RC tendon tear. Contemporary studies aimed at understanding muscle pathobiology after RC tear have considered transcriptional data in mice, rats and sheep models at 2-3 time points (1 to 16 weeks post injury). However, none of these studies observed a transition or resurgence of gene expression after the initial acute time points. In this study, we collected rabbit supraspinatus muscle tissue with high temporal resolution (1, 2, 4, 8, and 16 weeks) post-tenotomy (n = 6/group), to determine if unique, time-dependent transcriptional changes occur. RNA sequencing and analyses were performed to identify a transcriptional timeline of RC muscle changes and related morphological sequelae. At 1-week post-tenotomy, the greatest number of differentially expressed genes was observed (1,069 up/873 down) which decreases through 2 (170/133), 4 (86/41), and 8 weeks (16/18), followed by a resurgence and transition of expression at 16 weeks (1,421/293), a behavior which previously has not been captured or reported. Broadly, 1-week post-tenotomy is an acute time point with expected immune system responses, catabolism, and changes in energy metabolism, which continues into 2 weeks with less intensity and greater contribution from mitochondrial effects. Expression shifts at 4 weeks post-tenotomy to fatty acid oxidation, lipolysis, and general upregulation of adipogenesis related genes. The effects of previous weeks' transcriptional dysfunction present themselves at 8 weeks post-tenotomy with enriched DNA damage binding, aggresome activity, extracellular matrix-receptor changes, and significant expression of genes known to induce apoptosis. At 16 weeks post-tenotomy, there is a range of enriched pathways including extracellular matrix constituent binding, mitophagy, neuronal activity, immune response, and more, highlighting the chaotic nature of this time point and possibility of a chronic classification. Transcriptional activity correlated significantly with histological changes and were enriched for biologically relevant pathways such as lipid metabolism. These data provide platform for understanding the biological mechanisms of chronic muscle degeneration after RC tears.


Risk of ischaemic heart diseases and stroke in behçet disease: A systematic review and meta-analysis.
Behçet disease (BD) is a systemic vasculitis. In addition to the mucocutaneous lesions, the vascular injury of pathophysiology in BD is theoretically correlated with cardiovascular diseases. This study aimed to elucidate the association of BD with ischaemic heart diseases (IHDs) and stroke. A systematic search of PubMed, Embase, Web of Science and Cochrane Library databases was performed for all relevant observational studies from database inception until 10 July 2021. No language restriction was applied. A random-effects model was used for meta-analysis. A total of six observational studies consisting of three cohort studies, two cross-sectional studies and one study with both study designs were adopted in the meta-analysis. The numbers of patients with BD and healthy controls were 9,813 and 41,802, respectively. The pooled analysis demonstrated no significant association between BD and IHD. By contrast, we found that patients with BD had a significantly higher risk of stroke (adjusted hazard ratio, 2.083; 95% confidence interval, 1.339-3.240; p = 0.001) than healthy controls. We observed substantial heterogeneity across studies in few meta-analyses, but no significant publication bias was detected in any of the meta-analyses. BD was significantly associated with stroke but not IHD. Physicians should be aware of possible vascular and neurological complications during care of patients with BD.


Systematic structure-property investigations and ion-sensing studies of pyridine-derivatized donor/acceptor tetrakis(arylethynyl)benzenes.
Nine structural isomers of a tetrakis(arylethynyl)benzene chromophore functionalized with dibutylaniline and pyridine units as respective donors and acceptors have been synthesized and their steady-state spectroscopic parameters investigated. The effects of small structural variations on the electronic absorption and emission spectra have been explored in evaluation of their potential as optical materials components. These structural variations have predictable consequences and thus allow fine-tuning of the optoelectronic properties for specialized applications. Strong solvatochromism is also displayed. Their response to protonation and metal ion complexation caused dynamic shifts in the emission spectra, providing evidence for a stepwise intramolecular charge-transfer switching phenomenon manifested by either hypsochromic or bathochromic shifts in the fluorescence lambda max. These shifts are believed to correlate strongly to the relative energies of the fluorophore's HOMO and LUMO levels. The complete array of compounds represents an interesting set of candidates for fluorescent sensing device components.


Challenges in the diagnosis of acute pulmonary embolism.
The state of the art of diagnostic evaluation of hemodynamically stable patients with suspected acute pulmonary embolism was reviewed. Diagnostic evaluation should begin with clinical assessment using a validated prediction rule in combination with measurement of D-dimer when appropriate. Imaging should follow only when necessary. Although with 4-slice computed tomography (CT) and 16-slice CT, the sensitivity for detection of pulmonary embolism was increased by combining CT angiography with CT venography, it is not known whether CT venography increases the sensitivity of 64-slice CT angiography. Methods to reduce the radiation exposure of CT venography include imaging only the proximal leg veins (excluding the pelvis) and obtaining discontinuous images. Compression ultrasound can be used instead. In young women, radiation of the breasts produces the greatest risk of radiation-induced cancer. It may be that scintigraphy is the imaging test of choice in such patients, but this pathway should be tested prospectively. A patient-specific approach to the diagnosis of pulmonary embolism can be taken safely in hemodynamically stable patients to increase efficiency and decrease cost and exposure to radiation.


IPSS is lower in hypertensive patients treated with angiotensin-II receptor blocker: posthoc analyses of a lower urinary tract symptoms population.
The existence of Angiotensin-II (Ang-II) receptors in the bladder wall and the pronounced contractile effect of Ang-II on the human detrusor muscle have been well established. Studies have presented the role of Ang-II as a mediator in smooth muscle growth and collagen production in the bladder with outlet obstruction. We investigated the associations between male lower urinary tract symptoms (LUTS) and hypertension (HT), and examined whether the medications used for HT treatment, particularly Ang-II receptor blockers (ARBs) influence LUTS. Among 4,298 men with LUTS who were nominated to participate in a Japanese study using the International Prostate Symptom Score (IPSS) to gain information on the effects and the safety of silodosin, a total of 3,790 men for whom a baseline IPSS was available were sub-analyzed. We analyzed the influence of HT treatment on IPSSs. HT was the most common comorbidity (1,122 men, 29.6%), and 769 men (20.3%) were receiving some kinds of medication for the treatment. We found that the IPSS was lower in patients being treated for HT with ARB than in hypertensive patients who were not receiving any medication (16.8 ± 6.8 vs. 18.3 ± 6.6, P < 0.01). The baseline I-PSS in patients treated for HT with angiotensin converting enzyme inhibitor (ACE-I), calcium channel blocker (CCB), and normotensive patients were 18.3, 19.6, and 18.1, respectively. The IPSS is lower in patients with HT treated with ARB. Other drugs for HT, including ACE-I and CCB, did not improve the IPSS.


Impact of order and load knowledge on trunk kinematics during repeated lifting tasks.
To determine if lifting random unknown weights is more detrimental than lifting sequences of unknown weights and to investigate whether load knowledge impacts the effect of lifting random box weights. Much research has investigated lifting under known load conditions, but few studies have investigated unknown loads, especially when presented in random order. There has been some documentation of alteration in trunk mechanics when there is an overestimation of the unknown load. Ten men and 10 women performed three lifting tasks: random unknown, random known, and same weight. A lumbar motion monitor was used to collect kinematic data, and Borg's Rating of Perceived Exertion (RPE) and a task risk rating were also assessed. Both presentation order and load knowledge impacted trunk kinematics during repeated lifting tasks. However, these differences were relatively low in magnitude. Furthermore, kinematic response and perceived risk and exertion for these conditions varied between genders. Lifting random unknown loads appears to alter kinematic responses, particularly for men. Women attempt to modify the effect of random unknown loads by changing the lifting style through alterations in upper limb motions (e.g., drag box toward them prior to lifting). However, a need remains for a more comprehensive biomechanical investigation (e.g., spine loading) into the effects of random unknown loads because many of the effect sizes were small. Small kinematic adaptations resulting from tasks involving unknown and random loads may be mediated by the use of visual cues, order of presentation, or a change in lifting style.


An Undecimated Wavelet-based Method for Cochlear Implant Speech Processing.
A cochlear implant is an implanted electronic device used to provide a sensation of hearing to a person who is hard of hearing. The cochlear implant is often referred to as a bionic ear. This paper presents an undecimated wavelet-based speech coding strategy for cochlear implants, which gives a novel speech processing strategy. The undecimated wavelet packet transform (UWPT) is computed like the wavelet packet transform except that it does not down-sample the output at each level. The speech data used for the current study consists of 30 consonants, sampled at 16 kbps. The performance of our proposed UWPT method was compared to that of infinite impulse response (IIR) filter in terms of mean opinion score (MOS), short-time objective intelligibility (STOI) measure and segmental signal-to-noise ratio (SNR). Undecimated wavelet had better segmental SNR in about 96% of the input speech data. The MOS of the proposed method was twice in comparison with that of the IIR filter-bank. The statistical analysis revealed that the UWT-based N-of-M strategy significantly improved the MOS, STOI and segmental SNR (P < 0.001) compared with what obtained with the IIR filter-bank based strategies. The advantage of UWPT is that it is shift-invariant which gives a dense approximation to continuous wavelet transform. Thus, the information loss is minimal and that is why the UWPT performance was better than that of traditional filter-bank strategies in speech recognition tests. Results showed that the UWPT could be a promising method for speech coding in cochlear implants, although its computational complexity is higher than that of traditional filter-banks.


RNA Cloaking by Reversible Acylation.
We describe a selective and mild chemical approach for controlling RNA hybridization, folding, and enzyme interactions. Reaction of RNAs in aqueous buffer with an azide-substituted acylating agent (100-200 mm) yields several 2'-OH acylations per RNA strand in as little as 10 min. This poly-acylated ("cloaked") RNA is strongly blocked from hybridization with complementary nucleic acids, from cleavage by RNA-processing enzymes, and from folding into active aptamer structures. Importantly, treatment with a water-soluble phosphine triggers a Staudinger reduction of the azide groups, resulting in spontaneous loss of acyl groups ("uncloaking"). This fully restores RNA folding and biochemical activity.


[Traumatic duodenal hematoma (author's transl)].
Two cases of duodenal hematoma secondary to abdominal trauma in children are reported. The latent periods between trauma and the onset of symptoms were two and fifteen days. X-ray studies were conclusive for diagnosis. Pancreatic signs were mild in one case. Both cases were treated surgically, draining the fluid collection extramucosally. The authors advise surgical treatment whenever associated lesions need to be ruled out and when obstruction persists after the first days.


Clinical roles and applications of progesterone in reproductive medicine: an overview.
The physiologic and clinical value of progesterone is undisputed and a cornerstone of human reproduction. Better understanding of the exact dynamics and effects of endogenous progesterone secretion, as well as its therapeutic actions, is critical to ensure optimal clinical results in artificial reproduction technology, and to enhance chances of successfully completing pregnancy. Novel progesterone-based drugs and administration regimens will provide clinicians with greater options to make the management and treatment of infertile couples less burdensome and more successful.


Multiplex reconstruction with partial information.
A multiplex is a collection of network layers, each representing a specific type of edges. This appears to be a genuine representation of many real-world systems. However, due to a variety of potential factors, such as limited budget and equipment, or physical impossibility, multiplex data can be difficult to observe directly. Often, only partial information on the layer structure of the system is available, whereas the remaining information is in the form of a single-layer network. In this work we face the problem of reconstructing the hidden multiplex structure of an aggregated network from partial information. We propose an algorithm that leverages the layerwise community structure that can be learned from partial observations to reconstruct the ground-truth topology of the unobserved part of the multiplex. The algorithm is characterized by a computational time that grows linearly with the network size. We perform a systematic study of reconstruction problems for both synthetic and real-world multiplex networks. We show that the ability of the proposed method to solve the reconstruction problem is affected by the heterogeneity of the individual layers and the similarity among the layers. On real-world networks, we observe that the accuracy of the reconstruction saturates quickly as the amount of available information increases. In genetic interaction and scientific collaboration multiplexes, for example, we find that 10% of ground-truth information yields 70% accuracy, while 30% information allows for more than 90% accuracy.


Advanced fabrication and characterization of epitaxial ferroelectric thin films and multilayers.
Understanding the behavior of ferroelectrics on the nanoscale level requires the production of materials of the highest quality and advanced characterization techniques for probing the fascinating properties of these systems with reduced dimensions. Here we give an overview of our recent achievements in this area, which includes the detailed study of the suppression of ferroelectricity in PbTiO3 thin films, the fabrication of PbTiO3/SrTiO3 superlattices in which ferroelectricity shows some surprising behavior, and finally the manipulation of nanoscale ferroelectric domains using the atomic force microscope which leads to the precise analysis of domain wall creep and roughness in Pb(Zr,Ti)O3 thin films.


Effect of cabbage cultivars with varying levels of resistance to aphids on the performance of the parasitoid, Aphidius colemani (Hymenoptera: Braconidae).
The effect of aphid resistance in plant cultivars on parasitism of Myzus persicae (Sulzer) and Brevicoryne brassicae (Linnaeus) by Aphidius colemani Viereck was investigated under laboratory conditions using three cultivars of common cabbage, Brassica oleracea var. capitata. Significantly greater aphid populations were found on cv. Derby Day (green-leaved, susceptible to both aphid species), regardless of the presence or absence of parasitoids, compared with cv. Minicole (green-leaved, partially resistant with antibiosis factors for B. brassicae) or cv. Ruby Ball (red-leaved, partially resistant with antixenosis factors for B. brassicae). Minicole had the greatest proportion of parasitized aphids and Derby Day the least. A significantly lower percentage of emerged parasitoids were recorded on Minicole for both aphid species compared with Derby Day and Ruby Ball. The implication of the results are discussed in relation to the integrated control of aphids.


Effects of prolonged waking-auditory stimulation on electroencephalogram synchronization and cortical coherence during subsequent slow-wave sleep.
Evidence suggests that sleep homeostasis is not only dependent on duration of previous wakefulness but also on experience- and/or use-dependent processes. Such homeostatic mechanisms are reflected by selective increases in the duration of a sleep stage, modifications to electrophysiological-metabolic brain patterns in specific sleep states, and/or reactivation to neuronal ensembles in subsequent sleep periods. Use-dependent sleep changes, apparently different from those changes caused by memory consolidation processes, are thought to reflect neuronal restoration processes after the sustained exposure to stimulation during the preceding wakefulness. In the present study, we investigated changes in the brain electrical activity pattern during human sleep after 6 hr of continuous auditory stimulation during previous wakefulness. Poststimulation nights showed a widespread increase of spectral power within the alpha (8-12 Hz) and sleep spindle (12-15 Hz) frequency range during slow-wave sleep (SWS) compared with the baseline night. This effect was mainly attributable to an enhanced EEG amplitude rather than an increase of oscillations, except for temporal (within alpha and sleep spindles) and parietal regions (within sleep spindles) in which both parameters contributed equally to the increase of spectral energy. Power increments were accompanied by a strengthening of the coherence between fronto-temporal cortical regions within a broad frequency range during SWS but to the detriment of the coherence between temporal and parieto-occipital areas, suggesting underlying compensatory mechanisms between temporal and other cortical regions. In both cases, coherence was built up progressively across the night, although no changes were observed within each SWS period. No electrophysiological changes were found in rapid eye movement sleep. These results point to SWS as a critical brain period for correcting the cortical synaptic imbalance produced by the predominant use of specific neuronal populations during the preceding wakefulness, as well as for synaptic reorganization after prolonged exposure to a novel sensory experience.


Effect of neuroprotective N-methyl-D-aspartate antagonists on increased intracranial pressure: studies in the rat acute subdural hematoma model.
Glutamate antagonists are the most powerful neuroprotective drugs in laboratory studies of focal cerebral ischemia. Because the majority of clinical conditions in which focal brain ischemia occurs are associated with high intracranial pressure (ICP), we have used the rat acute subdural hematoma model to evaluate the effects of three glutamate N-methyl-D-aspartate antagonists, MK-801, CGS 19755 (SELFOTEL), D-CPP-ene, and mannitol, upon ICP and also upon the volume of ischemic brain damage. Only mannitol produced a significant reduction in ICP and improved cerebral perfusion pressure. The three glutamate antagonists did not significantly affect ICP or cerebral perfusion pressure, but they were associated with a significantly smaller zone of focal brain damage, when compared to the mannitol and saline groups. N-methyl-D-aspartate antagonists do not increase ICP or jeopardize cerebral perfusion pressure when administered under anesthesia with a controlled PaCO2 level. Further studies in humans are indicated.


Understanding the neurobiology of comorbidity in anxiety disorders.
Anxiety and depression are common disorders that frequently co-exist. Both disorders show good response to antidepressants, especially the selective serotonin reuptake inhibitors. Some suggest that these disorders are variants of the same underlying brain pathology. This review examines the similarities and differences between anxiety and depression in terms of the known neurobiological etiologic mechanisms as well as their biological underpinnings and response to treatment. Sufficient and significant differences between these disorders support the view that they are independent entities. Shared abnormalities in the 5HT1A receptor function, for example, may help explain some of the comorbidity.


Effect of food intake on pharmacokinetics of oral artemisinin in healthy Vietnamese subjects.
The influence of food intake on the pharmacokinetics of artemisinin was studied with six healthy Vietnamese male subjects. In a crossover study, artemisinin capsules (500 mg) were administered with and without food after an overnight fast. Plasma samples were obtained up to 24 h after intake of each drug. Measurement of artemisinin concentrations was performed by high-performance liquid chromatography with electrochemical detection. Tolerance was evaluated according to subjective and objective findings, including repeated physical examinations, routine blood investigations, and electrocardiograms. Pharmacokinetics were analyzed with a noncompartmental method and with a one-compartment model. This model had either zero-order or first-order input. No statistically significant differences were found between the results of the two experimental conditions. Specifically, there were no consistent differences in parameters most likely to be affected by food intake, including absorption profile, absorption rate, bioavailability (f) (as reflected in area under the concentration time curve [AUC]), and drug clearance. Some mean +/- standard deviation parameters after food were as follows: maximum concentration of drug in serum (Cmax), 443 +/- 224 microg x liter(-1); time to Cmax, 1.78 +/- 1.2 h; AUC, 2,092 +/- 1,441 ng x ml(-1) x h, apparent clearance/f, 321 +/- 167 liter x h(-1); mean residence time, 4.42 +/- 1.31 h; and time at which half of the terminal value was reached, 0.97 +/- 0.68 h. The total amount of artemisinin excreted in urine was less than 1% of the dose. We conclude that food intake has no major effect on artemisinin pharmacokinetics. In addition, we conclude tentatively that artemisinin is cleared by the liver, that this clearance does not depend on liver blood flow (i.e., that artemisinin is a so-called low-clearance drug), and that absorption of the drug is not affected by food intake.


Photochemistry of diketones: observation of a triplet state-oxygen adduct.
The presence of triplet state-oxygen adducts (a species previously proposed but never observed in a direct manner) is readily observed following laser flash photolysis studies of 2,2'-thenil. We report on the kinetic and spectroscopic parameters characteristic of this transient adduct.


Sulfonothioated meso-Methyl BODIPY Shows Enhanced Uncaging Efficiency and Releases H2Sn.
meso-Methyl BODIPY photocages stand out for their absorption properties and easy chromophore derivatization. However, their low uncaging efficiencies often hinder applications requiring release of protected substrates in high amounts. In this study, we demonstrate that the sulfonothioated BODIPY group photocleaves a sulfonylthio group from the meso-methyl position with a 10-fold higher quantum yield than the most efficient leaving groups studied to date. Photocleavage, observed in solution and in cells, is accompanied by the spatiotemporally controlled photorelease of H2Sn. For this reason, sulfonothioated BODIPY may be applied in cell signaling, redox homeostasis, and metabolic regulation studies.


Folate supplementation and neural tube defects: a review of a public health issue.
Folate deficiency is one of today's most common vitamin deficiencies in women. Women who consume a low level of folate during pregnancy are at risk for poor pregnancy outcomes including neural tube defects (NTD). However, other factors such as heredity, social class, maternal age, birth order, maternal diet, length of time between pregnancies, maternal zinc deficiency, use of anticonvulsant drugs, abnormal homocysteine metabolism and the use of oral contraceptives, have also been implicated as causes of NTD. Animal studies have shown that fetuses are highly dependent on the folate status of the mother. In addition, several retrospective and prospective human studies have provided evidence that folate lowers the incidence of NTD.


A window on the physiopathogenesis of seizures in patients with cortical dysplasia.
Cortical dysplasia is found in many cases of intractable epilepsy. Dr. Avoli reports that dysplastic cortex--removed from human brains during seizure surgery--shows abnormal excitability in vitro.


The short mRNA isoform of the immunoglobulin superfamily, member 1 gene encodes an intracellular glycoprotein.
Mutations in the immunoglobulin superfamily, member 1 gene (IGSF1/Igsf1) cause an X-linked form of central hypothyroidism. The canonical form of IGSF1 is a transmembrane glycoprotein with 12 immunoglobulin (Ig) loops. The protein is co-translationally cleaved into two sub-domains. The carboxyl-terminal domain (CTD), which contains the last 7 Ig loops, is trafficked to the plasma membrane. Most pathogenic mutations in IGSF1 map to the portion of the gene encoding the CTD. IGSF1/Igsf1 encodes a variety of transcripts. A little studied, but abundant splice variant encodes a truncated form of the protein, predicted to contain the first 2 Ig loops of the full-length IGSF1. The protein (hereafter referred to as IGSF1 isoform 2 or IGSF1-2) is likely retained in most individuals with IGSF1 mutations. Here, we characterized basic biochemical properties of the protein as a foray into understanding its potential function. IGSF1-2, like the IGSF1-CTD, is a glycoprotein. In both mouse and rat, the protein is N-glycosylated at a single asparagine residue in the first Ig loop. Contrary to earlier predictions, neither the murine nor rat IGSF1-2 is secreted from heterologous or homologous cells. In addition, neither protein associates with the plasma membrane. Rather, IGSF1-2 appears to be retained in the endoplasmic reticulum. Whether the protein plays intracellular functions or is trafficked through the secretory pathway under certain physiologic or pathophysiologic conditions has yet to be determined.


Roshan's telemedicine: expanding the frontier of quality healthcare through mobile technology.
The article highlights the power of mobile technology in expanding access to quality healthcare by telling the story of the first successful operation by Afghan doctors to separate conjoined twins at The French Medical Institute for Mothers and Children (FMIC) in Kabul, Afghanistan's capital. Roshan, Afghanistan's leading telecommunications provider, set up the telemedicine link in 2007, connecting three hospitals in Kandahar, Bamiyan and Badakhshan Provinces to FMIC in Kabul, and all three to one of the best and most modern hospitals in the region: The Aga Khan University Hospital in Karachi, Pakistan.


Single Unit Cell Bismuth Tungstate Layers Realizing Robust Solar CO2 Reduction to Methanol.
Solar CO2 reduction into hydrocarbons helps to solve the global warming and energy crisis. However, conventional semiconductors usually suffer from low photoactivity and poor photostability. Here, atomically-thin oxide-based semiconductors are proposed as excellent platforms to overcome this drawback. As a prototype, single-unit-cell Bi2WO6 layers are first synthesized by virtue of a lamellar Bi-oleate intermediate. The single-unit-cell thickness allows 3-times larger CO2 adsorption capacity and higher photoabsorption than bulk Bi2WO6. Also, the increased conductivity, verified by density functional theory calculations and temperature-dependent resistivities, favors fast carrier transport. The carrier lifetime increased from 14.7 to 83.2 ns, revealed by time-resolved fluorescence spectroscopy, which accounts for the improved electron-hole separation efficacy. As a result, the single-unit-cell Bi2WO6 layers achieve a methanol formation rate of 75 μmol g(-1) h(-1), 125-times higher than that of bulk Bi2WO6. The catalytic activity of the single-unit-cell layers proceeds without deactivation even after 2 days. This work will shed light on designing efficient and robust photoreduction CO2 catalysts.


Magnetic resonance imaging of musculoskeletal lesions: comparison of three fat-saturation pulse sequences.
Fat-saturation (FS) pulse sequences can improve the detection of musculoskeletal lesions. We prospectively compared contrast-enhanced T1-weighted FS spin-echo (SE) images, T2-weighted FS fast spin-echo (FSE) images and inversion recovery (IR) FSE images to determine if any of these three pulse sequences is superior for depicting bone marrow and soft tissue lesions. T1-weighted FS-SE images (400-680/10-20 [TR/TE]) after intravenous injection of gadolinium-diethylenetriaminepentaacetic acid (DTPA), T2-weighted FS-FSE (2400-4200/96-112) and IR-FSE (3700-6000/12-14/170 [TR/TE/TI]) images were obtained with a 1.5-T magnet system in 35 patients. The visibility, margination and extent of 37 bone marrow and 67 soft tissue lesions, image uniformity, susceptibility and motion artefacts were qualitatively analysed by four radiologists. The number and size of lesions detected, the mean lesion signal-to-noise ration (S/N) and contrast-to-noise ratio (C/N) were also statistically compared. More bone and soft-tissue lesions were detected on the IR-FSE and T2-weighted FS-FSE than the T1-weighted FS-SE images. The IR-FSE images were significantly better than the T2-weighted FS-FSE and T1-weighted FS-SE images for bone marrow lesions conspicuity (P < 0.01). The soft-tissue lesions were also more conspicuous on the IR-FSE and T2-weighted FS-FSE images than on the T1-weighted FS-SE images (P < 0.005). The lesion extent and image quality were similar on all three sequences while motion artefacts were most severe on the IR-FSE and least severe on the T1-weighted FS-SE images (P < 0.001). Fat saturation was maximal on the IR-FSE images, resulting in a significantly higher mean C/N of bone marrow lesions. The mean C/N of soft-tissue lesions was higher on the T2-weighted FS-FSE images although the differences were not significant. The T2-weighted FS-FSE and IR-FSE sequences are superior to the contrast-enhanced T1-weighted FS-SE sequence for depicting musculoskeletal lesions. Bone marrow lesion conspicuity is greater on the IR-FSE images, with comparable scan time and image quality but more motion artifacts.


Increased aortic NADPH oxidase activity in rats with genetically high angiotensin-converting enzyme levels.
In humans and rats, angiotensin I-converting enzyme activity is significantly determined by a gene polymorphism. Homozygous Brown Norway rats have higher plasma angiotensin I-converting enzyme activity and circulating angiotensin II (Ang II) levels than Lewis rats. Because Ang II induces NAD(P)H oxidase activation, we hypothesized here that Brown Norway rats have higher vascular NAD(P)H oxidase activity and superoxide anion production than Lewis rats. Homozygous Brown Norway (n=15) and Lewis (n=13) male rats were used. Plasma angiotensin I-converting enzyme activity (by fluorimetry), Ang II levels (by high-performance liquid chromatography and radioimmunoassay), and aortic NAD(P)H oxidase activity, as well as superoxide anion production (by chemiluminescence with lucigenin) were measured. Plasma angiotensin I-converting enzyme activity and Ang II levels were 100% higher in Brown Norway rats than in Lewis rats (P<0.05). Aortic angiotensin I- converting enzyme, but not Ang II, was elevated (P<0.05). Aortic superoxide anion production and NAD(P)H oxidase activity were 300% and 260% higher in Brown Norway than in Lewis rats, respectively (P<0.05), which was not observed in Brown Norway rats treated with candesartan (10 mg/kg per day for 7 days). Endothelial NO synthase activity in the aorta from Brown Norway rats was significantly lower than in Lewis rats. However, inducible NO synthase activity and both endothelial NO synthase and inducible NO synthase mRNA and protein levels were similar in both genotypes. In summary, Brown Norway rats have higher vascular NAD(P)H oxidase activity and superoxide anion production than Lewis rats, suggesting the presence of a higher level of vascular oxidative stress in rats with genetically higher angiotensin I-converting enzyme levels. This effect is mediated through the angiotensin I receptor.


Discovery of novel aldose reductase inhibitors characterized by an alkoxy-substituted phenylacetic acid core.
In continuation of our effort aimed towards the development of novel aldose reductase inhibitors, several phenylacetic acids bearing an alkoxy substituent in position 3 or 4, respectively, were prepared and screened. The latter represent formal ring opening products of the cyclohexylmethyloxyphenylacetic acids IIa and IIb, recently elaborated in our group. Out of these series, compounds 4aa and 4ba characterized by an n-heptyloxy subunit turned out to be the most potent inhibitors. Based on these unexpected results, we suggest that such an alkyl side chain acts as a useful surrogate for the 4-bromo-2-fluorobenzyl residue often found in potent aldose reductase inhibitors.


Bilateral central serous chorioretinopathy in a patient treated with systemic cortico-steroids for non-Hodgkin lymphoma.
To describe the concomitant occurrence of systemic cortico-steroid treatment and the development of bilateral central serous chorioretinopathy (CSC), which promptly regressed after the reduction of the drug dosage, up to its scheduled withdrawal. Case report. A 46-year-old white male, with a history of monolateral CSC, had a non-Hodgkin lymphoma on his right cheek. Soon after surgical excision of the tumoral lesion, he received a standard post-operative regimen of decreasing intramuscular betamethasone for 25 days, followed by 10 day's withdrawal, then cycles of intravenous cyclophosphamide and vincristine, followed by 7-day oral prednisone, repeated monthly for three months. Fluorescein angiographies at the end of the first oral cortico-steroid cycle and before starting the second, documented the occurrence of bilateral CSC and its regression, which were chronologically related respectively to the cortico-steroid administration and withdrawal. This case further demonstrates that systemic cortico-steroids can be responsible for the occurrence of CSC. The patient's history should always be checked for any previous CSC episodes. In these subjects, periodical ophthalmoscopic examination is essential to discover early or asymptomatic steroid-related CSC patterns, to prevent complications of the disease.


Thermoregulatory responses to exercise at a fixed rate of heat production are not altered by acute hypoxia.
This study sought to assess the within-subject influence of acute hypoxia on exercise-induced changes in core temperature and sweating. Eight participants [1.75 (0.06) m, 70.2 (6.8) kg, 25 (4) yr, 54 (8) ml·kg-1·min-1] completed 45 min of cycling, once in normoxia (NORM; [Formula: see text] = 0.21) and twice in hypoxia (HYP1/HYP2; [Formula: see text]= 0.13) at 34.4(0.2)°C, 46(3)% RH. These trials were designed to elicit 1) two distinctly different %V̇o2peak [NORM: 45 (8)% and HYP1: 62 (7)%] at the same heat production (Hprod) [NORM: 6.7 (0.6) W/kg and HYP1: 7.0 (0.5) W/kg]; and 2) the same %V̇o2peak [NORM: 45 (8)% and HYP2: 48 (5)%] with different Hprod [NORM: 6.7 (0.6) W/kg and HYP2: 5.5 (0.6) W/kg]. At a fixed %V̇o2peak, changes in rectal temperature (ΔTre) and changes in esophageal temperature (ΔTes) were greater at end-exercise in NORM [ΔTre: 0.76 (0.19)°C; ΔTes: 0.64 (0.22)°C] compared with HYP2 [ΔTre: 0.56 (0.22)°C, P < 0.01; ΔTes: 0.42 (0.21)°C, P < 0.01]. As a result of a greater Hprod (P < 0.01) in normoxia, and therefore evaporative heat balance requirements, to maintain a similar %V̇o2peak compared with hypoxia, mean local sweat rates (LSR) from the forearm, upper back, and forehead were greater (all P < 0.01) in NORM [1.10 (0.20) mg·cm-2·min-1] compared with HYP2 [0.71 (0.19) mg·cm-2·min-1]. However, at a fixed Hprod, ΔTre [0.75 (0.24)°C; P = 0.77] and ΔTes [0.63 (0.29)°C; P = 0.69] were not different in HYP1, compared with NORM. Likewise, mean LSR [1.11 (0.20) mg·cm-2·min-1] was not different (P = 0.84) in HYP1 compared with NORM. These data demonstrate, using a within-subjects design, that hypoxia does not independently influence thermoregulatory responses. Additionally, further evidence is provided to support that metabolic heat production, irrespective of %V̇o2peak, determines changes in core temperature and sweating during exercise.NEW & NOTEWORTHY Using a within-subject design, hypoxia does not independently alter core temperature and sweating during exercise at a fixed rate of heat production. These findings also further contribute to the development of a methodological framework for assessing differences in thermoregulatory responses to exercise between various populations and individuals. Using the combined environmental stressors of heat and hypoxia we conclusively demonstrate that exercise intensity relative to aerobic capacity (i.e., %V̇o2max) does not influence changes in thermoregulatory responses.


Structure and predissociation of the 3psigma(u)D (3)Sigma(u) (+) Rydberg state of N(2): first extreme-ultraviolet and new near-infrared observations, with coupled-channels analysis.
The 3psigma(u)D (3)Sigma(u) (+) Rydberg state of N(2) is studied experimentally using two high-resolution spectroscopic techniques. First, the forbidden D (3)Sigma(u) (+)-X (1)Sigma(g) (+) transition is observed for the first time via the (0,0) band of (14)N(2) and the (1,0) band of (15)N(2), using 1 extreme-ultraviolet +1 ultraviolet two-photon-ionization laser spectroscopy. Second, the Rydberg-Rydberg transition D (3)Sigma(u) (+)-E (3)Sigma(g) (+) is studied using near-infrared diode-laser photoabsorption spectroscopy, thus extending the previous measurements of Kanamori et al. [J. Chem. Phys. 95, 80 (1991)], to higher transition energies, and thereby revealing the (2,2) and (3,3) bands. The combined results show that the D(v=0-3) levels exhibit rapidly increasing rotational predissociation as v increases, spanning nearly four orders of magnitude. The D-state level structure and rotational predissociation signature are explained by means of a coupled-channels model which considers the electrostatically coupled (3)Pi(u) Rydberg-valence manifold, together with a pure-precession L-uncoupling rotational interaction between the 3psigma(u)D (3)Sigma(u) (+) and 3ppi(u)G (3)Pi(u) Rydberg p-complex components.


Treatment adherence and blood pressure control in older individuals with hypertension.
Non-adherence to treatment has been identified as the main cause of uncontrolled blood pressure (BP), and may represent a greater risk in older individuals. The aim of this study was to evaluate and compare the rate of adherence to hypertension treatment using different methods, to estimate the BP control rate, and to observe if there is an association between BP control and adherence. Treatment adherence was evaluated in older patients with hypertension, followed by the public primary health care, through four methods, including the Morisky-Green test (reference), the Attitude regarding the Medication Intake questionnaire (AMI), an evaluation of adherence by the nurse in the office (Nurse Adherence Evaluation - NAE), and at home (Home Adherence Evaluation - HAE). Salt intake was estimated by 24-hour sodium urinary excretion. BP control was assessed by the awake ambulatory blood pressure monitoring. Concordance between the Morisky-Green test and AMI (Kappa=0.27) or NAE (Kappa=0.05) was poor. There was a moderate concordance between the Morisky-Green test and HAE. Eighty percent had controlled BP, including 42% with white-coat effect. The group with lower salt excretion informed to avoid salt intake more times (p<0.001) and had better medication adherence (p<0.001) than the higher salt excretion group. The evaluated tests did not show a good concordance to the Morisky-Green test. Adherence to hypertension treatment was low; however, there was a high rate of BP control when subjects with the white-coat effect were included in the analysis.


Sturge-Weber syndrome with bilateral intracranial calcification.
Four children affected by Sturge-Weber syndrome and demonstrating bilateral intracranial calcification are described, bringing up to 21 the number of similar reported cases. The frequency of bilateral hemisphere involvement in this syndrome is not known, but it might be as high as 15%. If present, neurosurgical intervention is, in our opinion, contraindicated.


Comparison of the Microarray-Based Assay, the Real-Time PCR Assay, and the Bidirectional Sequencing Method for CYP2C19 Genotyping.
Cytochrome P450 2C19 (CYP2C19) is a clinically important enzyme that metabolizes a wide variety of drugs. Recently, some new genetic assays designed to identify the CYP2C19 genotype were introduced. We compared the abilities of the microarray-based Verigene CYP2C19 Test (Nanosphere, USA) and the AccuPower Real-time PCR CYP (*2,*3,*17) assay (Bioneer, Korea) with the ability of the bidirectional sequencing method for the detection of CYP2C19 genotypes in 78 whole blood samples. Among 78 specimens, 28 were *1/*1, 1 was *1/*17, 27 were *1/*2, 10 were *1/*3, 8 were *2/*2, 1 was *3/*3, and 3 were *2/*3. In the initial test, five samples (6.4%) in the Verigene assay and two samples (2.4%) in the AccuPower assay failed to generate definite results. All retests with both assays generated definitive results. In both assays, the results of CYP2C19 genotyping showed 100% final concordance with those obtained by the direct sequencing method. These two assays could be useful for the identification of CYP2C19 genotypes in clinical laboratories.


Raman-markers of X-ray radiation damage of proteins.
Despite their high relevance, the mechanisms of X-ray radiation damage on protein structure yet have to be completely established. Here, we used Raman microspectrophotometry to follow X-ray-induced chemical modifications on the structure of the model protein bovine pancreatic ribonuclease (RNase A). The combination of dose-dependent Raman spectra and ultrahigh resolution (eight structures solved using data collected between 0.85 and 1.17 Å resolution on the same single crystal) allowed direct observation of several radiation damage events, including covalent bond breakages and formation of radicals. Our results are relevant for analytical photodamage detection and provide implications for a detailed understanding of the mechanisms of photoproduct formation.


Direct interaction of the U1 snRNP-A protein with the upstream efficiency element of the SV40 late polyadenylation signal.
An integral component of the splicing machinery, the U1 snRNP, is here implicated in the efficient polyadenylation of SV40 late mRNAs. This occurs as a result of an interaction between U1 snRNP-A protein and the upstream efficiency element (USE) of the polyadenylation signal. UV cross-linking and immunoprecipitation demonstrate that this interaction can occur while U1 snRNP-A protein is simultaneously bound to U1 RNA as part of the snRNP. The target RNA of the first RRM (RRM1) has been shown previously to be the second stem-loop of U1 RNA. We have found that a target for the second RRM (RRM2) is within the AUUUGURA motifs of the USE of the SV40 late polyadenylation signal. RNA substrates containing the wild-type USE efficiently bind to U1 snRNP-A protein, whereas substrates fail to bind when motifs of the USE were replaced by linker sequences. The addition of an oligoribonucleotide containing a USE motif to an in vitro polyadenylation reaction inhibits polyadenylation of a substrate representing the SV40 late polyadenylation signal, whereas a mutant oligoribonucleotide, a nonspecific oligoribonucleotide, and an oligoribonucleotide containing the U1 RNA-binding site had much reduced or no inhibitory effects. In addition, antibodies to bacterially produced, purified U1 snRNP-A protein specifically inhibit in vitro polyadenylation of the SV40 late substrate. These data suggest that the U1 snRNP-A protein performs an important role in polyadenylation through interaction with the USE. Because this interaction can occur when U1 snRNP-A protein is part of the U1 snRNP, our data provide evidence to support a link between the processes of splicing and polyadenylation, as suggested by the exon definition model.


Correlation between rotation thrombelastometry ROTEM analysis and standard haemostatic parameters during liver transplantation.
The determination of the correlations between simultaneously performed rotation thrombelastometry ROTEM analysis and standard haemostatic analysis during liver transplantations is indispensable for performing an adequate perioperative haemostatic monitoring. Perioperative haemostatic monitoring was performed to 30 patients undergoing orthotopic liver transplantation (13 male (42%) and 17 female (58%), age: (mean +/- SD; 21 +/- 17 years). Standard coagulation parameters (PT, APTT, FIB) were assessed chronometrically on STA-Compact Analyzer (Diagnostica Stago - La Roche), rotation thrombelastometry analyses - on ROTEM analyzer (Petapharm GmbH) and platelets (PLT) - on Cell Dyn 3700 (Abbott Diagnostica), MAPSS technology. A protocol was successfully developed for the implementation of perioperative haemostatic control during orthotopic liver transplantations, performing parallel thrombelastometric and standard haemostatic analyses. Significant correlation was established between PT(INR) and EXTEM_CFT ( r = 0.834; p < 0.001) and between APTT and INTEM_CFT (r = 0.707; p < 0.001) in the preoperative period (R1). The correlation was reduced to insignificant during the intraoperative periods (R2-R5) and two hours postoperatively (R6). Significant correlation was determined between PLT/INTEM and between FIB/MCF_FIBTEM during all perioperative periods (R1 -R6). The correlations found in the present study suggest to perform the haemoststic liver transplantation monitoring through a parallel systematic analysis of both standard and rotation thrombelastometry parameters and confirm the ROTEM method as preferable and highly informative.


Synchronous lymph node and liver metastasis in a well differentiated gastric endocrine tumour type I.
Gastric endocrine tumours constitute less than 1% of all (neuro-)endocrine tumours and less than 2% of all gastrointestinal malignancies. They are classified into three groups: well-differentiated endocrine tumours, well-differentiated endocrine carcinoma, poorly-differentiated endocrine carcinoma. We report the rare case of a patient with a metastasising gastric endocrine tumour that histologically revealed all signs of a well-differentiated endocrine tumour.


Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh.
Bangladesh's maternal mortality and neonatal mortality remain unacceptably high. We assessed the availability and quality of emergency obstetric care (EmOC) and emergency newborn care (EmNC) services at health facilities in Bangladesh. We randomly sampled 50 rural villages and 50 urban neighborhoods throughout Bangladesh and interviewed the director of eight and nine health facilities nearest to each sampled area. We categorized health facilities into different quality levels (high, moderate, low, and substandard) based on staffing, availability of a phone or ambulance, and signal functions (six categories for EmOC and four categories for EmNC). We interviewed the directors of 875 health facilities. Approximately 28% of health facilities did not have a skilled birth attendant on call 24 hours per day. The least commonly performed EmOC signal function was administration of anticonvulsants (67%). The quality of EmOC services was high in 33% and moderate in 52% of the health facilities. The least common EmNC signal function was kangaroo mother care (7%). The quality of EmNC was high in 2% and moderate in 33% of the health facilities. Approximately one-third of health facilities lack 24-hour availability of skilled birth attendants, increasing the risk of peripartum complications. Most health facilities offered moderate to high quality services for EmOC and low to substandard quality for EmNC.


Metal-Insulator-Metal-Based Plasmonic Metamaterial Absorbers at Visible and Infrared Wavelengths: A Review.
Electromagnetic wave absorbers have been investigated for many years with the aim of achieving high absorbance and tunability of both the absorption wavelength and the operation mode by geometrical control, small and thin absorber volume, and simple fabrication. There is particular interest in metal-insulator-metal-based plasmonic metamaterial absorbers (MIM-PMAs) due to their complete fulfillment of these demands. MIM-PMAs consist of top periodic micropatches, a middle dielectric layer, and a bottom reflector layer to generate strong localized surface plasmon resonance at absorption wavelengths. In particular, in the visible and infrared (IR) wavelength regions, a wide range of applications is expected, such as solar cells, refractive index sensors, optical camouflage, cloaking, optical switches, color pixels, thermal IR sensors, IR microscopy and gas sensing. The promising properties of MIM-PMAs are attributed to the simple plasmonic resonance localized at the top micropatch resonators formed by the MIMs. Here, various types of MIM-PMAs are reviewed in terms of their historical background, basic physics, operation mode design, and future challenges to clarify their underlying basic design principles and introduce various applications. The principles presented in this review paper can be applied to other wavelength regions such as the ultraviolet, terahertz, and microwave regions.


Synthesis of a p-type semiconducting phenothiazine exfoliatable layered crystal.
Phenothiazine (PTZ) crystals are grown by a physical vapor transport method in a horizontal tube furnace. The resulting disk-type PTZ single crystals have a layered structure, which can be mechanically exfoliated into stacked individual layers to exhibit various colors depending on the thickness. The PTZ single-crystal field-effect transistor (FET) devices exhibit a p-type semiconducting property with 3.03 × 10(-6) S/cm electrical conductivity, 1.15 × 10(-4) cm(2)/(V s) carrier mobility, and a 10(4) on/off ratio.


Dispersal of invasive Phytolacca americana seeds by birds in an urban garden in China.
Although seed dispersal is a key process determining the regeneration and spread of invasive plant populations, few studies have explicitly addressed the link between dispersal vector behavior and seedling recruitment to gain insight into the invasion process within an urban garden context. We evaluated the role of bird vectors in the dispersal of pokeweed (Phytolacca americana), a North American herb that is invasive in urban gardens in China. Fruiting P. americana attracted both generalist and specialist bird species that fed on and dispersed its seeds. The generalist species Pycnonotus sinensis and Urocissa erythrorhyncha were the most frequent dispersers. Seedling numbers of P. americana were strongly associated with the perching behavior of frugivorous birds. If newly recruited bird species use seedling-safe perching sites, the P. americana will regenerate faster, which would enhance its invasive potential. Based on our observations, we conclude that the 2 main bird vectors, P. sinensis and U. erythrorhyncha, provide potential effective dispersal agents for P. americana. Our results highlight the role of native birds in seed dispersal of invasive plants in urban gardens.


Increasing the speed of frequency-domain, homodyne thermoreflectance imaging.
Charge coupled device (CCD)-based thermoreflectance imaging using a "4-bucket" lock-in imaging algorithm is a well-established, powerful method for obtaining high spatial and thermal resolution two-dimensional thermal maps of optoelectronic, electronic, and micro-electro-mechanical systems devices. However, the technique is relatively slow, limiting broad commercial adoption. In this work, we examine the underlying limit on the image acquisition speed using the conventional "4-bucket" algorithm and show that the straightforward extension to an n-bucket technique by faster sampling does not address the underlying statistical bias in the data analysis and hence does not reduce the image acquisition time. Instead, we develop a modified "enhanced n-bucket" algorithm that halves the image acquisition time for every doubling of the number of buckets. We derive detailed statistical models of the algorithms and confirm both the models and the resulting speed enhancement experimentally, resulting in a practical means of significantly enhancing the speed and utility of CCD-based frequency domain, homodyne thermoreflectance imaging.


Allosteric Modulation of Membrane Proteins by Small Low-Affinity Ligands.
Membrane proteins may respond to a variety of ligands under an applied external stimulus. These ligands include small low-affinity molecules that account for functional effects in the mM range. Understanding the modulation of protein function by low-affinity ligands requires characterizing their atomic-level interactions under dilution, challenging the current resolution of theoretical and experimental routines. Part of the problem derives from the fact that small low-affinity ligands may interact with multiple sites of a membrane protein in a highly degenerate manner to a degree that it is better conceived as a partition phenomenon, hard to track at the molecular interface of the protein. Looking for new developments in the field, we rely on the classic two-state Boltzmann model to devise a novel theoretical description of the allosteric modulation mechanism of membrane proteins in the presence of small low-affinity ligands and external stimuli. Free energy stability of the partition process and its energetic influence on the protein coupling with the external stimulus are quantified. The outcome is a simple formulation that allows the description of the equilibrium shifts of the protein in terms of the grand-canonical partition function of the ligand at dilute concentrations. The model's predictions of the spatial distribution and response probability shift across a variety of ligand concentrations, and thermodynamic conjugates can be directly compared to macroscopic measurements, making it especially useful to interpret experimental data at the atomic level. Illustration and discussion of the theory is shown in the context of general anesthetics and voltage-gated channels for which structural data are available.


Health information exchange for patients with intellectual disabilities: a general practice perspective.
Inadequate health information exchange (HIE) between patients with intellectual disabilities (ID), their carers, and GPs may lead to ineffective treatment and poor treatment compliance. Factors influencing HIE are largely unexplored in previous research. To provide insight into the perceived HIE facilitators of GPs and general practice assistants, and the barriers in GP consultations for patients with ID. An interview-based study with GPs (n = 19) and general practice assistants (n = 11) in the Netherlands. Semi-structured interviews were conducted on topics relating to stages during and around GP consultation. Transcripts were coded and analysed using framework analysis. The main themes were impaired medical history taking and clinical decision making, and fragile patient follow-up. Factors negatively influencing HIE related to patient communication skills and professional carers' actions in preparing the consultation and in collecting, recording, and sharing information. HIE barriers resulted in risk of delay in diagnosis and treatment, misdiagnosis, unnecessary tests, and ineffective treatment regimens. HIE facilitators were described in terms of GP adjustments in communication, planning of consultations, and efforts to compensate for fragile follow-up situations. Inadequate HIE should be seen as a chain of events leading to less effective consultations, substandard treatment, and insufficient patient follow-up. The results indicate a mismatch between GPs' expectations about professional carers' competencies, responsibilities, and roles in HIE and the setting in which professional carers operate. Further research should focus on how daily GP practice can be attuned to the practicalities of HIE with patients with ID and their professional carers.


Acceptance of psychology teaching in paediatric dentistry by undergraduate dental students.
By means of a questionnaire, 4 cohorts of undergraduate students (n = 144) were asked before and after the clinical course in paediatric dentistry about their acceptance of the teaching of psychological aspects in dentistry. A generally very high interest was found for psychology as well as for child-related psychology. The teaching of this topic by means of lectures was thought to be useful, but other didactic means were demanded to supplement teaching. For many of the aspects taught, more information was requested. Moreover, teaching of aspects not taught in the lectures was also requested. The more obvious the practical relevance of each topic appeared, the greater was the students' interest. Psychology was thought to be useful as an aid to paediatric treatment. However, interest dropped after the completion of the paediatric dentistry course. It is concluded that undergraduate dental students have no particular inclination towards the treatment of children but rather a need for guidelines to avoid potential problems in dealing with this demanding group of patients.


Maternal HIV-1 DNA load and mother-to-child transmission.
While many factors contribute to mother-to-child transmission (MTCT) of HIV-1, maternal plasma HIV-1 RNA viral load (RNA-VL) has been consistently found as the main risk factor, including when antiretroviral prophylaxis was used to prevent MTCT. However the predictive value of RNA-VL is poor. A recent study of HIV-1-positive pregnant women who did not receive antiretroviral prophylaxis reported an association between HIV-1 DNA viral load (DNA-VL) and MTCT that was stronger than the association between RNA-VL and MTCT. We sought to determine if HIV-1 DNA-VL was independently associated with MTCT of HIV in a population of women who received zidovudine prophylaxis during pregnancy and whose infants received zidovudine after birth. Patients were 33 non-breastfeeding transmitting (TR) and 33 nontransmitting mothers (NTR) from Perinatal HIV Prevention Trial (PHPT-1), a multicenter clinical trial conducted in Thailand comparing zidovudine prophylaxis durations to prevent MTCT. TR and NTR mothers were matched according to baseline RNA-VL. Maternal peripheral blood mononuclear cell (PBMC)-associated HIV-1 DNA was extracted from whole blood, and DNA-VL was established by quantitative real-time polymerase chain reaction. We found that TR had a significantly higher cell-associated HIV-1 DNA viral load than did NTR. Median TR DNA-VL was 2.54 log(10) copies per microgram PBMC DNA, while it was 2.28 log(10) copies per microgram PBMC DNA in NTR (Wilcoxon p = 0.02). In summary, HIV-1 DNA viral load was associated with MTCT in a population of women who received antiretroviral prophylaxis during pregnancy, independently from RNA viral load.


Quality control study of the Italian Group of Cytometry on flow cytometry DNA content measurements: II. Factors affecting inter- and intralaboratory variability.
A multicentric national quality control study has been organized under the auspices of the Italian Group of Cytometry to find a possible influence of some procedural steps in DNA flow cytometry measurements on DNA index (DI) values and to identify the main parameters affecting the interlaboratory variability. To 40 participating laboratories we provided suspensions containing unknown mixture of different cell types: an homogeneous thymocyte population used to check instrument linearity; one mixture composed of two cell types characterized by DI = 1.00 and 1.10; and another composed of three different cell types with relative DIs of 1.00, 1.26, and 1.62, respectively. Possible effects due to staining protocols were studied, allowing the participants to stain cellular DNA according to the procedure routinely adopted in each laboratory, in addition to a standardized procedure with a fixed PI solution. As far as the influence of instrument linearity on DI values is concerned, we did not find any correlation with the DI variability observed, even if the use of a standardized staining protocol could lead to a sensible gain in interlaboratory DI reproducibility. Twenty-five of 40 (65%) laboratories were able to discriminate the near-diploid subpopulation, and a coefficient of variation of less than 4% was the minimum condition necessary to recognize the DI = 1.1 population. In samples containing two aneuploid subpopulations, 25 of 35 (71.4%) laboratories showed a high reproducibility with the standard staining protocol and 22 of 38 (57.9%) with the free staining protocol. However, a sensible improvement in interlaboratory reproducibility emerged with respect to the previous trial.


Aflatoxin control in maize by Trametes versicolor.
Aspergillus flavus is a well-known ubiquitous fungus able to contaminate both in pre- and postharvest period different feed and food commodities. During their growth, these fungi can synthesise aflatoxins, secondary metabolites highly hazardous for animal and human health. The requirement of products with low impact on the environment and on human health, able to control aflatoxin production, has increased. In this work the effect of the basidiomycete Trametes versicolor on the aflatoxin production by A. flavus both in vitro and in maize, was investigated. The goal was to propose an environmental loyal tool for a significant control of aflatoxin production, in order to obtain feedstuffs and feed with a high standard of quality and safety to enhance the wellbeing of dairy cows. The presence of T. versicolor, grown on sugar beet pulp, inhibited the production of aflatoxin B1 in maize by A. flavus. Furthermore, treatment of contaminated maize with culture filtrates of T. versicolor containing ligninolytic enzymes, showed a significant reduction of the content of aflatoxin B1.


Classification of breast cancer histology images using Convolutional Neural Networks.
Breast cancer is one of the main causes of cancer death worldwide. The diagnosis of biopsy tissue with hematoxylin and eosin stained images is non-trivial and specialists often disagree on the final diagnosis. Computer-aided Diagnosis systems contribute to reduce the cost and increase the efficiency of this process. Conventional classification approaches rely on feature extraction methods designed for a specific problem based on field-knowledge. To overcome the many difficulties of the feature-based approaches, deep learning methods are becoming important alternatives. A method for the classification of hematoxylin and eosin stained breast biopsy images using Convolutional Neural Networks (CNNs) is proposed. Images are classified in four classes, normal tissue, benign lesion, in situ carcinoma and invasive carcinoma, and in two classes, carcinoma and non-carcinoma. The architecture of the network is designed to retrieve information at different scales, including both nuclei and overall tissue organization. This design allows the extension of the proposed system to whole-slide histology images. The features extracted by the CNN are also used for training a Support Vector Machine classifier. Accuracies of 77.8% for four class and 83.3% for carcinoma/non-carcinoma are achieved. The sensitivity of our method for cancer cases is 95.6%.


Sum-difference theory of remembering and knowing: a two-dimensional signal-detection model.
In the remember-know paradigm for studying recognition memory, participants distinguish items whose presentations are episodically remembered from those that are merely familiar. A one-dimensional model postulates that remember responses are just high-confidence old judgments, but a meta-analysis of 373 experiments shows that the receiver operating characteristic (ROC) curves predicted by this model have the wrong slope. According to the new sum-difference Theory of remembering and knowing (STREAK), old items differ from new ones in both global and specific memory strength: The old-new judgment is based on a weighted sum of these dimensions, and the remember- know judgment is based on a weighted difference. STREAK accounts for the form of several novel kinds of ROC curves and for existing remember-know and item-recognition data.


Sleep fragmentation in mentally retarded people decreases with increasing daylength in spring.
We studied the sleep-wake behavior of mentally retarded people from late winter to early summer at 60 degrees N. During this time the daylength increased 8 h 51 min. The data were collected by observing the sleep-wake status of 293 subjects at 20-min intervals for five randomized 24h periods (= recording days). The intervals during which the individual recording days of the same order (1st, 2nd, etc.) were carried out, were called recording periods. Consequently, there were five recording periods, each containing 293 individual recording days. Even though there was overlap among the recording periods, the median daylength from one period to another increased approximately by 100 min. In the initial statistical analysis, the number of wake-sleep transitions was found to differ significantly among the five recording periods (Friedman test, p < 0.001). The mean ranks in the Friedman test suggested that the number of wake-sleep transitions was highest during the 1st and lowest during the 5th recording period. In further statistical analyses using a program for mixed effects regression analysis (MIXOR 2.0) it was found that the increase in daylength during the study period was associated with a simultaneous decrease of approximately 0.5 wake-sleep transitions in the whole study population (p < 0.001). The decrease in the number of wake-sleep transitions was significant only in the subgroups of subjects with a daylength change of more than 350 min between the 1st and 5th recording days (Wilcoxon tests, p < 0.005). This suggests that after a marked prolongation of the natural photoperiod, the reduction in sleep episodes was more probable than after smaller changes in daylength. It is concluded that the sleep of mentally retarded people living in a rehabilitation center at a northern latitude is more fragmented in winter than in early summer and that the change is related probably to the simultaneous increase in the length of the natural photoperiod. The sleep quality of persons living in institutional settings might be improved by increasing the intensity and/or duration of daily artificial light exposure during the darker seasons.


Urological manifestations of chronic schistosomal myeloradiculopathy.
To describe the clinical and urodynamic features of patients with chronic voiding dysfunction secondary to schistosomal myeloradiculopathy (SM), as the clinical involvement of the spinal cord is a well recognized complication of Schistosomiasis mansoni infection. We reviewed the records and urodynamic studies of 26 consecutive patients (17 males and nine females, aged 8-58 years) with chronic neurological and urinary symptoms secondary to SM. The voiding function history, radiological and urodynamic findings and therapeutic approaches were reviewed. Patients with and without upper urinary tract complications were compared in terms of age, duration of voiding dysfunction and urodynamic pattern. The most common urinary symptoms were difficulty in emptying the bladder (17 patients, 65%), urinary incontinence (14, 54%), and urgency and frequency (13, 50%). Laboratory and radiographic evaluation showed urinary tract infection in eight (30%) patients, bilateral hydronephrosis in five (19%) and bladder calculi in five (19%). Urodynamics showed detrusor overactivity with detrusor-external sphincter dyssynergia (DESD) in 14 patients (54%), detrusor arreflexia in six (23%), detrusor overactivity with no dyssynergia in four (15%), and detrusor underactivity in two (8%). Comparing patients with and without upper tract complications showed no differences in age and duration of urinary symptoms, but there was a significant association of detrusor overactivity with DESD and upper urinary tract complications (P = 0.04). Urological management consisted of antibiotics, clean intermittent catheterization, anticholinergic medication and stone removal, as appropriate. Conservative treatment failed in three patients and they required an injection with botulinum-A toxin into the detrusor (two) or ileocystoplasty (one). Patients with chronic SM behave clinically like those with other causes of spinal cord disease and neurogenic bladder dysfunction requiring lifelong surveillance. The severity of illness in these patients should re-emphasize the need for early recognition and treatment of this condition, to prevent or reverse the neurological deficits.


Methyltransferase 3 Mediated miRNA m6A Methylation Promotes Stress Granule Formation in the Early Stage of Acute Ischemic Stroke.
The modification of methyltransferase-like (METTL) enzymes plays important roles in various cellular responses by regulating microRNA expression. However, how m6A modification is involved in stress granule (SG) formation in the early stage of acute ischemic stroke by affecting the biogenesis processing of microRNAs remains unclear. Here, we established a middle cerebral artery occlusion (MCAO) model in rats and an oxygen-glucose deprivation/reperfusion (OGD/R) model in primary cortical neurons and PC12 cells to explore the potential mechanism between m6A modification and SG formation. The in vivo results showed that the level of infarction and apoptosis increased while SG formation decreased significantly within the ischemic cortex with improved reperfusion time after 2 h of ischemia. Consistent with the in vivo data, an inverse association between the apoptosis level and SG formation was observed in PC12 cells during the reperfusion period after 6 h of OGD stimulation. Both in vivo and in vitro results showed that the expression of METTL3 protein, m6A and miR-335 was significantly decreased with the reperfusion period. Overexpression of the METTL3 and METTL3 gene-knockdown in PC12 cells were achieved via plasmid transfection and CRISPR-Cas9 technology, respectively. Overexpression or knockdown of METTL3 in oxygen-glucose deprivation of PC12 cells resulted in functional maturation of miR-335, SG formation and apoptosis levels. In addition, we found that miR-335 enhanced SG formation through degradation of the mRNA of the eukaryotic translation termination factor (Erf1). In conclusion, we found that METTL3-mediated m6A methylation increases the maturation of miR-335, which promotes SG formation and reduces the apoptosis level of injury neurons and cells, and provides a potential therapeutic strategy for AIS.


Long-term visual outcome of dense bilateral congenital cataract.
Dense congenital cataracts often cause severe visual impairment. The results of long-term follow-up of dense bilateral congenital cataract in China have not been well documented. The purpose of this study was to evaluate the long-term visual function in children who underwent cataract extraction for dense bilateral congenital cataract in southern part of China. Medical records of children who underwent surgery of dense bilateral congenital cataract between January 1992 and December 2000 at Zhongshan Ophthalmic Center of Sun Yat-sen University were retroactively reviewed. In 38 children available for current follow-up, best corrected visual acuity (BCVA) and stereoscopic vision, as well as nystagmus, strabismus, and other complications, were evaluated. The mean follow-up period was 107.6 months (range 60 to 167 months). The mean age of cataract extraction and secondary intraocular lens implantation were 5.6 months (range 3 to 12 months) and 4.2 years (range 2.4 to 15 years), respectively. The mean BCVA was 0.25 in the better eye and 0.16 in the fellow eye. Stereoscopic vision was absent in all patients, and 3 children had simultaneous perception. Nystagmus was detected in all cases and strabismus in 35 cases. A high correlation was found between timing of cataract extraction and final BCVA of the better eye (r = -0.55, P = 0.00). A statistically significant difference was found in BCVA between post- and pre-treatment of amblyopia (t = 5.65, P = 0.00). Long-term visual function in children with dense bilateral congenital cataract was poor when cataract surgery was performed at age of 3 months or later. Earlier cataract surgery with adequate optical rehabilitation contributed to better visual outcome.


Follow-Up of Pulmonary Hypertension With Echocardiography.
Individual patient response to effective therapies for pulmonary hypertension (PAH) is variable and difficult to quantify. Consequently, management decisions regarding initiation and continuation of therapy are highly dependent on the results of investigations. Registry data show that changes in cardiac index, mean right atrial pressure, and mean pulmonary artery pressure have the greatest influence on survival. It is recognized that pulmonary artery pressure (PASP) responses to PAH-specific drugs are heterogeneous. However, follow-up testing is strongly focused on assessing changes in PASP and functional status (6-min walk). The goals of therapy, which should be highlighted in follow-up imaging, include not only reduction of PASP, decrease in pulmonary vascular resistance, and improvements in right ventricular function, cardiac output, and tricuspid regurgitation. This paper reviews the echocardiographic follow-up of pulmonary hypertension, and especially focuses on right ventricular function-a major determinant of outcome, for which reliable echocardiographic assessment has become more feasible.


Plasma kisspeptin levels in girls with premature thelarche.
Premature thelarche (PT) is defined as isolated breast development without secondary sex characteristics in girls below the age of eight. We aimed to determine whether the level of kisspeptin, which plays a role in the release of gonadotropins, is associated with PT. The patient group included children with PT aged 3-8 years (n=20) and the control group included healthy children in the same age range (n=20). Height standard deviation scores (HSDSs), bone maturation and growth velocity were evaluated in the two groups. Basal follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), and sex hormone-binding globulin (SHBG) levels were also measured in the two groups by immunochemiluminometric assay (ICMA). A gonadotropin-releasing hormone (GnRH) test was also conducted in the patient group and the peak levels of FSH and LH were determined. Kisspeptin levels were measured using enzyme immunoassay (EIA). No differences were found between the groups in terms of age, HSDS, annual growth rate and bone age. While the plasma basal FSH, LH and E2 levels in the patient and control groups did not show statistically significant differences, PRL levels were higher in the patient group (p<0.05). Peak LH response to GnRH test was at the prepubertal level (<5 ng/mL) in patients with PT. In the patient group, kisspeptin levels were significantly higher compared to the levels in the control group (2.96 ± 1.21 ng/dL vs. 1.19 ± 0.41 ng/dL, p<0.05), and kisspeptin levels showed a significant correlation with PRL, FSH, LH, and E2 levels (p<0.05). In this study, plasma kisspeptin levels were found to be higher in patients with PT and to show a positive correlation with increased PRL levels. Kisspeptin is one of the neuropeptides that plays a role in the onset of puberty. Our results support the hypothesis that PT may result from the temporary activation of central stimulants.


Modified MicroSecure Vitrification: A Safe, Simple and Highly Effective Cryopreservation Procedure for Human Blastocysts.
Clinical embryo vitrification evolved with the development of unique vitrification devices in the 21st century and with the misconception that ultra-rapid cooling in an "open" system (i.e., direct LN2 contact) was a necessity to optimize vitrification success. The dogma surrounding the importance of cooling rates led to unsafe practices subject to technical variation and to the creation of vitrification devices that disregarded important quality-control factors (e.g., ease of use, repeatability, reliability, labeling security, and storage safety). Understanding the quality-control flaws of other devices allowed for the development of a safe, secure, repeatable, and reliable µS-VTF method aimed to minimize intra- and inter-technician variation. Equally important, it combined the availability of two existing FDA-compliant devices: 1) a 0.3-mL ionomeric resin embryo straw with internalized, dual-colored, tamper-proof labeling with repeatable weld seal potential; and 2) shortened, commonly-used, 300-µm ID sterile flexipettes to directly load the embryo(s) in order to create a highly-effective global vitrification device. Like other aseptic, closed vitrification systems (e.g., High Security Vitrification (HSV), Rapid-i, and VitriSafe) effectively used in reproductive medicine, microSecure Vitrification (µS-VTF) has proven that it can achieve high post-warming survival and pregnancy outcomes with its attention to simplicity, and reduced technical variation. Although the 0.3-mL embryo straw containing an internal hydrophobic plug was commercially replaced with a standard semen straw possessing cotton-polyvinyl pyrrolidone (PVP) plugs, it maintained its ionomeric resin composition to ensure weld sealing. However, the cotton plugs can wick out the fluid-embryo contents of the flexipettes upon contact. A modified µS-VTF method was adapted to include an additional internal weld seal before the plug on the device loading side. The added technical step to the µS-VTF procedure has not affected its successful application, as high survival rates (> 95%) and pregnancy rates continue today.


Delayed hypersensitivity and systemic arthralgia following transurethral collagen injection for stress urinary incontinence.
During a prospective cohort study to determine the effectiveness of and adverse effects associated with transurethral collagen injection for treatment of stress urinary incontinence in women, we observed 3 cases of delayed allergic reaction at the skin test site associated with arthralgia. A total of 337 women with at least a 1-year history, physical findings and urodynamic abnormalities consistent with stress urinary incontinence, who required pads or protective clothing and who had no or only grade 1 cystocele were enrolled in this prospective cohort study. Adverse effects were documented by a third party at each followup. Delayed reaction at the skin test site occurred in 3 patients (0.9%), and was associated with arthralgias in 2. The incidence and systemic nature of this type of reaction suggest that gluteraldehyde cross-linked collagen injection is not as innocuous as previously believed. Patients should be counseled regarding the unknown long-term outcome of this complication. Before treatment clinicians should consider double skin testing.


Imaging diagnosis of post-ERCP focal pancreatitis mimicking pancreatic carcinoma by follow-up F-18 FDG PET/CT.
Pancreatitis is the most common complication of diagnostic or therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The incidence of clinical post-ERCP pancreatitis is about 5%. The authors describe a case of 60-year-old man who developed an unusual focal, instead of usual diffuse pancreatitis after diagnostic ERCP. F-18 FDG PET/CT in 3 days after ERCP detected focal FDG uptake because of pancreatitis, and the diagnosis was confirmed by spontaneous resolution of the lesion on 1-week follow-up PET/CT study.


Primary inoculation skin tuberculosis by accidental needle stick.
A 42-year-old female laboratory worker presented with a left index finger skin lesion after an accidental prick while handling samples of a cultural exam of Mycobacterium tuberculosis. Surgical excision was performed and pathology analysis revealed a dermic chronic inflammatory process with no granulomas. Later, a non-painful lymphadenopathy appeared in the left axilla as well as brownish indurated skin lesions in the lower limbs consistent with erythema nodosum. Fine needle aspiration biopsy of the lymph node revealed epithelioid granulomas, Langhans' multinucleated giant cells and the presence of acid-fast bacilli. Standard tuberculosis treatment resulted in regression of lesions and no relapses occurred in the 2-year follow-up period.