Successful pulmonary administration of activated recombinant factor VII in diffuse alveolar hemorrhage.
Diffuse alveolar hemorrhage (DAH) is a serious pulmonary complication seen in patients with autoimmune disorders and patients treated with chemotherapy or after hematopoietic stem cell transplantation. The clinical management of DAH is complex and the condition has a high mortality rate. Tissue factor is expressed in the lung alveoli during inflammation and therefore pulmonary administration of human recombinant activated factor VIIa (rFVIIa) could be a rational treatment option. Six patients with acute, bronchoscopically confirmed DAH from a single intensive care unit university hospital center were included in the study of acute DAH in critically ill patients. The patients were treated with intrapulmonary administration of 50 microg/kg rFVIIa in 50 ml of sodium chloride by bronchoalveolar lavage (BAL) with 25 ml in each of the main bronchi, which was repeated after 24 hours in case of treatment failure. An excellent response, defined as complete and sustained hemostasis after a single dose of rFVIIa, was seen in three patients. A good response, meaning that sustained hemostasis was achieved by a repeated rFVIIa administration, was seen in the remaining three patients. In one of these patients, the BAL treatment was repeated twice; in another patient, the second dose of rFVIIa was administered by nebulizer after extubation after the initial BAL. The hemostatic effect was statistically significant (p = 0.031). The oxygenation capacity, as reflected by the PaO2/FiO2 (arterial oxygen pressure/inspiratory fractional oxygen content) ratio, increased significantly (p = 0.024) in all six patients following the local rFVIIa therapy. Symptomatic therapy of DAH after intrapulmonary administration of one or more doses of rFVIIa was found to have a good to excellent hemostatic effect in six consecutive patients with DAH. The intrapulmonary administration of rFVIIa seemed to have a high benefit-to-risk ratio. Larger series should confirm the safety of this approach.


Evidence of placental translation inhibition and endoplasmic reticulum stress in the etiology of human intrauterine growth restriction.
Unexplained intrauterine growth restriction of the fetus (IUGR) results from impaired placental development, frequently associated with maternal malperfusion. Some cases are complicated further by preeclampsia (PE+IUGR). Here, we provide the first evidence that placental protein synthesis inhibition and endoplasmic reticulum (ER) stress play key roles in IUGR pathophysiology. Increased phosphorylation of eukaryotic initiation factor 2alpha suggests suppression of translation initiation in IUGR placentas, with a further increase in PE+IUGR cases. Consequently, AKT levels were reduced at the protein, but not mRNA, level. Additionally, levels of other proteins in the AKT-mammalian target of rapamycin pathway were decreased, and there was associated dephosphorylation of 4E-binding protein 1 and activation of glycogen synthase kinase 3beta. Cyclin D1 and the eukaryotic initiation factor 2B epsilon subunit were also down-regulated, providing additional evidence for this placental phenotype. The central role of AKT signaling in placental growth regulation was confirmed in Akt1 null mice, which display IUGR. In addition, we demonstrated ultrastructural and molecular evidence of ER stress in human IUGR and PE+IUGR placentas, providing a potential mechanism for eukaryotic initiation factor 2alpha phosphorylation. In confirmation, induction of low-grade ER stress in trophoblast-like cell lines reduced cellular proliferation. PE+IUGR placentas showed elevated ER stress with the additional expression of the pro-apoptotic protein C/EBP-homologous protein/growth arrest and DNA damage 153. These findings may account for the increased microparticulate placental debris in the maternal circulation of these cases, leading to endothelial cell activation and impairing placental development.


Bruchid (Coleoptera: Bruchidae) ovicidal phenylbutanoid from Zingiber purpureum.
The larvicidal activity of the dichloromethane extract of Zingiber purpureum Roscoe (Zingiberaceae) rhizome against the second instar of Aedes aegypti (L.) (Diptera: Culicidae) is shown to be due to 4-(3',4'-dimethoxyphenyl)buta-1,3-diene. The diene also showed ovicidal activity against the bruchid Callosobruchus maculatus (F.) (Coleoptera: Bruchidae). Most of the eggs laid by bruchids on treated cowpea seeds were transparent, and very few of them contained developing embryos. The few larvae produced from these embryos were unable to penetrate the seed coat and enter the seed. Similar effects were seen when adults were exposed to the compound and then placed on untreated cowpea seeds, suggesting that a new type of maternally mediated ovicidal effect was involved. Coated and impregnated granular formulations of the extract were evaluated for use in the control of bruchid infestation of stored cowpea seeds. Coated granules showed activity similar to that of the crude extract but were found to lose activity rapidly. Impregnated granules were found to be less active than the crude extract.


The effects of experimental malnutrition on albumin metabolism and distribution in rabbits.
In order to determine the extent to which the concentration of albumin in plasma is maintained at the expense of the extravascular pool during protein-energy malnutrition, the rates of exchange between albumin in plasma (IA) and the extravascular pool (EA) and consequently the distribution of albumin between intravascular and extravascular pools (expressed as EA:IA) were measured in protein-energy-depleted and control rabbits. The fractional rates of synthesis (FSR) and catabolism (FCR), the concentration of albumin and the plasma volume (PV) were also measured. In animals in which protein-energy intake was reduced by 58% the concentration of albumin in plasma remained unchanged, whereas FCR decreased by 38% and FSR by 30%. No significant changes in EA:IA or PV were found. We conclude that albumin concentration during protein-energy depletion is not maintained at the expense of extravascular albumin, but by parallel changes in the rates of catabolism and synthesis.


[Surgical repair of Ebstein's disease (author's transl)].
In 1976 4 patients with Ebstein's disease underwent surgical repair. In one patient (22 yrs.) the tricuspid valve leaflets were suitable for reconstructive surgery using Hardys method in addition to De Vegas annuloplasty. In the other three cases (17, 29, 51 yrs. old) excision of the malformed tricuspid valve was necessary, and porcine heterografts of greatest possible diameter were implanted. Three patients improved considerably 9 months postoperatively. The fourth patient, a 51 years old woman, died 2 days postoperatively on cardiac failure. From our own results and based upon reports from the literature we conclude that reconstructive surgery of the tricuspid valve should be preferred to replacement. If valve replacement is necessary, bioprostheses ought to be used. At the age of 15 to 40 years, surgical repair seems to have the best prognosis in patients with Ebstein's malformation.


The Botrytis cinerea transglycosylase BcCrh4 is a cell death-inducing protein with cell death-promoting and -suppressing domains.
Botrytis cinerea is a necrotrophic fungal plant pathogen that causes grey mould and rot diseases in many crops. Here, we show that the B. cinerea BcCrh4 transglycosylase is secreted during plant infection and induces plant cell death and pattern-triggered immunity (PTI), fulfilling the characteristics of a cell death-inducing protein (CDIP). The CDIP activity of BcCrh4 is independent of the transglycosylase enzymatic activity, it takes place in the apoplast and does not involve the receptor-like kinases BAK1 and SOBIR1. During saprophytic growth, BcCrh4 is localized in the endoplasmic reticulum and in vacuoles, but during plant infection, it accumulates in infection cushions (ICs) and is then secreted to the apoplast. Two domains within the BcCrh4 protein determine the CDIP activities: a 20aa domain at the N' end activates intense cell death and PTI, while a stretch of 52aa in the middle of the protein induces a weaker response and suppresses the activity of the 20aa N' domain. Deletion of bccrh4 affected fungal development and IC formation in particular, resulting in reduced virulence. Collectively, our findings demonstrate that BcCrh4 is required for fungal development and pathogenicity, and hint at a dual mechanism that balances the virulence activity of this, and potentially other CDIPs.


'Modelling social exclusion in a diagnostically-mixed sample of people with severe mental illness'.
Social inclusion is an important indicator of recovery in individuals with severe mental illness. The Social Inclusion Questionnaire User Experience (SInQUE) is a new measure of social inclusion for mental health service users which assesses five domains (consumption, production, access to services, social integration and civil engagement). It has good psychometric properties and is acceptable to service users and mental health professionals. It is not clear whether individuals with different diagnostic conditions experience a similar reduction in social inclusion. (1) Investigate whether current social inclusion differs between diagnostic groups (people with schizophrenia/other psychotic disorders, common mental disorder or personality disorder); (2) Identify factors associated with lower social inclusion; (3) Examine associations between social inclusion and stigma, quality of life and loneliness. Mental health service users with psychotic disorder, personality disorder or common mental disorder, living in the community, completed the SInQUE, alongside other validated outcome measures. Multiple regression investigated associations. About 192 service users (55% with psychotic disorder; 26% with common mental disorder; 19% with personality disorder). Current social inclusion did not vary according to diagnosis, except for the sub-domain of productivity, where individuals with personality disorder were more socially included than the other two groups. Lower social inclusion was associated with older age (p = .008), lack of higher education (p < .001), more previous admissions (p = .005), severity of current symptoms and greater experienced stigma (p = .006) and anticipated stigma (p = .035). Greater social inclusion was associated with better quality of life (p < .001) and less loneliness (p < .001). Barriers to social inclusion in individuals with severe mental health problems include factors related to the illness, such as symptom severity and external factors, such as stigma and discrimination. Social inclusion is a recovery goal and should be routinely assessed. Increasing people's social inclusion benefits service users in terms of improved mental health, better quality of life and reduced loneliness.


Stepwise construction of Ag29 nanocluster-based hydrogen evolution electrocatalysts.
Although several silver-based nanoclusters have been controllably prepared and structurally determined, their electrochemical catalytic performances have been relatively unexplored (or showed relatively weak ability towards electro-catalysis). In this work, we accomplished the step-by-step enhancement of the electrocatalytic hydrogen evolution reaction (HER) efficiency based on an Ag29 cluster template. A combination of atomically precise operations, including the kernel alloying, ligand engineering, and surface activation, was exploited to produce a highly efficient Pt1Ag28-BTT-Mn(10) nano-catalyst towards HER, derived from both experimental characterization and theoretical modelling. The precision characteristic of the Ag29-based cluster system enables us to understanding the correlations between nanocluster structures and HER performances at the atomic level. Overall, the findings of this work will hopefully provide more opportunities for the customization of new cluster-based nano-catalysts with enhanced electrocatalytic capacities.


Epidermal growth factor receptor in glioblastoma.
Mutations in the epidermal growth factor receptor (EGFR) are commonly occurring in glioblastoma. Enhanced activation of EGFR can occur through a variety of different mechanisms, both ligand-dependent and ligand-independent. Numerous evidence has suggested that EGFR is overexpressed in most of primary glioblastomas and some of the secondary glioblastomas and is characteristic of more aggressive glioblastoma phenotypes. Additionally, recent studies have revealed that wild-type EGFR, and to a greater extent hyper-activating EGFR mutants induced a substantial upregulation of Fyn expression. Furthermore, it was determined that Fyn expression is upregulated across a panel of patient-derived glioblastoma stem cells (GSCs) relative to normal progenitor controls. Moreover, researchers are continuously involved in elucidation of novel mechanism linking EGFR EGFR-expressing glioblastoma. The present review highlights current aspects of EGFR receptor in glioblastoma and concludes that the concept of EGFR signaling and related receptors and associated factors is evolving, however, it needs detailed evaluation for future clinical applications in cancer patients.


Discovery of orbital-selective Cooper pairing in FeSe.
The superconductor iron selenide (FeSe) is of intense interest owing to its unusual nonmagnetic nematic state and potential for high-temperature superconductivity. But its Cooper pairing mechanism has not been determined. We used Bogoliubov quasiparticle interference imaging to determine the Fermi surface geometry of the electronic bands surrounding the Γ = (0, 0) and X = (π/aFe, 0) points of FeSe and to measure the corresponding superconducting energy gaps. We show that both gaps are extremely anisotropic but nodeless and that they exhibit gap maxima oriented orthogonally in momentum space. Moreover, by implementing a novel technique, we demonstrate that these gaps have opposite sign with respect to each other. This complex gap configuration reveals the existence of orbital-selective Cooper pairing that, in FeSe, is based preferentially on electrons from the d yz orbitals of the iron atoms.


Inducing prion protein shedding as a neuroprotective and regenerative approach in pathological conditions of the brain: from theory to facts.
In the last decades, the role of the prion protein (PrP) in neurodegenerative diseases has been intensively investigated, initially in prion diseases of humans (e.g., Creutzfeldt-Jakob disease) and animals (e.g., scrapie in sheep, chronic wasting disease in deer and elk, or "mad cow disease" in cattle). Templated misfolding of physiological cellular prion protein (PrPC) into an aggregation-prone isoform (termed PrP "Scrapie" (PrPSc)), self-replication and spreading of the latter inside the brain and to peripheral tissues, and the associated formation of infectious proteopathic seeds (termed "prions") are among the essential pathogenic mechanisms underlying this group of fatal and transmissible spongiform encephalopathies. Later, key roles of the correctly folded PrPC were identified in more common human brain diseases (such as Alzheimer's disease or Parkinson's disease) associated with the misfolding and/or accumulation of other proteins (such as amyloid-β, tau or α-synuclein, respectively). PrPC has also been linked with neuroprotective and regenerative functions, for instance in hypoxic/ischemic conditions such as stroke. However, despite a mixed "bouquet" of suggested functions, our understanding of pathological and, especially, physiological roles played by PrPC in the brain and beyond is certainly incomplete. Interactions with various other proteins at the cell surface or within intracellular compartments may account for the functional diversity linked with PrPC. Moreover, conserved endogenous proteolytic processing of PrPC generates several defined PrPC fragments, possibly holding intrinsic functions in physiological and pathological conditions, thus making the "true and complete biology" of this protein more complicated to be elucidated. Here, we focus on one of those released PrPC fragments, namely shed PrP (sPrP), generated by a membrane-proximate ADAM10-mediated cleavage event at the cell surface. Similar to other soluble PrPC fragments (such as the N1 fragment representing PrP's released N-terminal tail upon the major α-cleavage event) or experimentally employed recombinant PrP, sPrP is being suggested to act neuroprotective in Alzheimer's disease and other protein misfolding diseases. Several lines of evidence on extracellular PrPC (fragments) suggest that induction of PrPC release could be a future therapeutic option in various brain disorders. Our recent identification of a substrate-specific approach to stimulate the shedding by ADAM10, based on ligands binding to cell surface PrPC, may further set the stage for research into this direction.


A review of short bowel syndrome and palliation: a case report and medication guideline.
While patients with short bowel syndrome are not common in palliative care, they can present challenges for palliative care professionals. The case presented highlights a specific difficulty encountered. Many medications are poorly absorbed from a short bowel and alternative routes of administration need to be considered. A search was conducted to identify reviews, reports, and other articles from January 1960 to February 2004. MEDLINE, Cochrane Library, and CINAHL (Cumulative Index of Nursing and Allied Health Library) and MIMs (Medimedia Australia) databases were searched. A review of major textbooks was also conducted. Information on the site of absorption, time to peak plasma concentration, alternate routes, and pharmacokinetic information is summarized and presented in table form. This case report and review should assist practitioners with the palliative management of patients with short bowel syndrome.


Perception of teacher sexual misconduct by age of student.
This study explored whether student age influenced perceptions of teacher sexual misconduct. Participants (300 undergraduates) read scenarios depicting teacher sexual misconduct in which the student's age was varied (9, 12, 15), and then answered questions about their perceptions. Data were analyzed with 2 (respondent gender) 2 (cross-gender dyads) 3 (student age) MANOVAs. Experiences involving the youngest student were viewed as the most abusive, followed by the 12-year-old, and the 15-year-old. Gender differences were evident, with women viewing the experiences more negatively. Scenarios involving a male teacher/female student were viewed more negatively than a female teacher/male student dyad. These findings illustrate the importance of educating students and school personnel about teacher sexual misconduct.


Control of thermal emission by selective heating of periodic structures.
We predict that thermal emission can be controlled by selective heating of periodic structures. Previous studies on thermal emission modification via photonic crystals have been limited to uniform temperature. We consider frequency-dependent nonuniform absorption in a periodic structure and show that thermal emission peaks can be associated with specific locations in the structure. Consequently, local periodic heating allows control over which peaks appear in the thermal emission spectrum, as we demonstrate with calculations on two-component metallodielectric structures.


Meningiomas.
Meningiomas, the most common intracranial tumors, are dura-based tumors that occur in middle-aged or older adults and have a predilection for women and African Americans. They are almost always benign, but atypical and malignant forms exist. The optimal treatment for symptomatic tumors is complete surgical resection when feasible. Tumors in poor locations can have a higher rate of morbidity and often can be only partially removed. Radiation therapy should be used to treat lesions that are partially removed and lesions of higher grade, despite complete removal. Small lesions may be amenable to radiosurgery, which may obviate surgery in high-risk patients. For lesions that recur or grow despite surgery and radiation, the only option is systemic chemotherapy. No agent is optimal, but hydroxyurea is used most often. Newer approaches such as the use of inhibitors of somatostatin receptors or signal transduction pathways are under investigation.


Interleukin-1 potentiates the development of collagen-induced arthritis in mice.
1. The subcutaneous administration of recombinant human interleukin-1 beta (rhIL-1 beta) was found to induce an increased incidence and earlier onset of collagen-induced arthritis in mice. 2. The rhIL-1 beta had different effects, depending on when it was administered after collagen-immunization. 3. The effect of rhIL-1 beta may be due, in part, to augmentation of the immune response to type II collagen. 4. Interleukin-1-accelerated, collagen-induced arthritis will provide a useful model for investigating the role of interleukin-1 in the regulation of arthritic diseases, and the development of anti-arthritic therapeutics.


The Complete Chloroplast Genome Sequences of the Medicinal Plant Pogostemon cablin.
Pogostemon cablin, the natural source of patchouli alcohol, is an important herb in the Lamiaceae family. Here, we present the entire chloroplast genome of P. cablin. This genome, with 38.24% GC content, is 152,460 bp in length. The genome presents a typical quadripartite structure with two inverted repeats (each 25,417 bp in length), separated by one small and one large single-copy region (17,652 and 83,974 bp in length, respectively). The chloroplast genome encodes 127 genes, of which 107 genes are single-copy, including 79 protein-coding genes, four rRNA genes, and 24 tRNA genes. The genome structure, GC content, and codon usage of this chloroplast genome are similar to those of other species in the family, except that it encodes less protein-coding genes and tRNA genes. Phylogenetic analysis reveals that P. cablin diverged from the Scutellarioideae clade about 29.45 million years ago (Mya). Furthermore, most of the simple sequence repeats (SSRs) are short polyadenine or polythymine repeats that contribute to high AT content in the chloroplast genome. Complete sequences and annotation of P. cablin chloroplast genome will facilitate phylogenic, population and genetic engineering research investigations involving this particular species.


Diabetes in Kidney Transplantation.
Diabetes mellitus (DM) is one of the most common complications after kidney transplantation and is associated with unfavorable outcomes including death. DM can be present before transplant but post-transplant DM (PTDM) refers to diabetes that is diagnosed after solid organ transplantation. Despite its high prevalence, optimal treatment to prevent complications of PTDM is unknown. Medical therapy of pre-existent DM or PTDM after transplant is challenging because of frequent interactions between antidiabetic and immunosuppressive agents. There is also frequent need for medication dose adjustments due to residual kidney disease and a higher risk of medication side effects in patients treated with immunosuppressive agents. Sodium-glucose cotransporter 2 inhibitors have demonstrated a favorable cardio-renal profile in patients with DM without a transplant and hence hold great promise in this patient population although there is concern about the higher risk of urinary tract infections. The significant gaps in our understanding of the pathophysiology, diagnosis, and management of DM after kidney transplantation need to be urgently addressed.


The effects of hyperthermia on the immunomodulatory properties of human umbilical cord vein mesenchymal stem cells (MSCs).
Hyperthermia can modulate inflammation and the immune response. Based on the recruitment of mesenchymal stem cells (MSCs) to inflamed tissues and the immunomodulatory properties of these cells, the aim of this study was to examine the effects of hyperthermia on the immunomodulatory properties of MSCs in a mixed lymphocyte reaction (MLR). Passages 4-6 of human umbilical cord vein mesenchymal stem cells were co-cultured in a two-way MLR. Cells in the hyperthermia groups were incubated at 41 °C for 45 min. A colorimetric assay was employed to examine the effects of MSCs on cell proliferation. The levels of IL-4 and TNF-α proteins in the cell culture supernatant were measured, and non-adherent cells were used for RNA extraction, which was then used for cDNA synthesis. RT-PCR was utilised to assess levels of IL-10, IL-17A, IL-4, TNF-α, TGF-β1, FOX P3, IFN-γ, CXCL12 and β-actin mRNA expression. UCV-MSCs co-cultured in an MLR reduced lymphocyte proliferation at 37 °C, whereas hyperthermia attenuated this effect. Hyperthermia increased expression of IL-10, TGF-β1 and FOXP3 mRNAs in co-culture; however, no effects on IL-17A and IFN-γ were observed, and it reduced CXCL12 expression. In co-culture, IL-4 mRNA and protein increased at 37 °C, an effect that was reduced by hyperthermia. No considerable change in TNF-α mRNA expression was found in hyperthermia-treated cells. Hyperthermia increases cell proliferation of the peripheral blood mononuclear cells and modifies the cytokine profile in the presence of UCV-MSCs.


[A comparative study on treating femal stress urinary incontinence with TVT-Abbrevo and TVT-Obturator].
To compare the effectiveness and complications of TVT-Abbrevo (tension-free vaginal tape-Abbrevo) and TVT-Obturator (tension-free vaginal tape-obturator) for the treatment of female stress urinary incontinence (SUI). From Nov.2012 to Nov.2013, 117 patients suffering from SUI were treated with TVT-Abbrebo (n=79) or TVT-Obturator (n=38) procedure, the clinical efficacy and operation-correlated complications were observed. A total of 117 cases, 107 cases of urinary incontinence symptoms disappeared completely, 10 cases were improved. 72 cases (91.1%) were cured and 7 cases (8.9%) were improved in TVT-Abbrevo group; 35 cases (92.1%) were cured and 3 cases (7.9%) were improved in TVT-Obturator group. No significant differences could be found for the curing rates between two groups (P>0.05). Compared with the TVT-Obturator group, the TVT-Abbrevo group had less patients complaining of inner thigh pain at 24 h and 1 w after surgery (P<0.05). No significant differences were observed for the incidence of inner thigh pain at 1m and 1y after surgery between TVT-Abbrevo and TVT-Obturator group (P>0.05). No intraoperative complications such as blood vessel, nerve, bladder damage were recorded and no postoperative retropubic hematoma, tape adjustment and other complications occurred in two goups. No recurrence after 1 year follow-up. The study shows that TVT-Abbrevo procedure is safe and efficacy in treatment of SUI, and associated with low incidence of recent postoperative inner thigh pain.


Long-Acting Injectable Atypical Antipsychotic Use in Adolescents: An Observational Study.
Although second generation long-acting injectable antipsychotics (SG-LAIAs) have been approved and are widely used in adults, there is limited evidence for the use of long-acting formulations in children and adolescents. Thus, we systematically describe the off-label use of SG-LAIAs in clinical practice in adolescent inpatients. All individuals admitted to our Children and Adolescent Inpatient Psychiatry Unit receiving treatment with SG-LAIAs between January 2013 and June 2016 were reviewed. A retrospective analysis of medical records was conducted. Clinical diagnoses were established using DSM-5 criteria. Thirty individuals (53.3% female) out of a total of 1,148 admitted patients (2.6%) were identified. The mean age was 16.3 (SD = 1.3; range: 12.5-17.9).The main diagnoses were psychosis (70%) and disruptive behavior disorders (DBDs) (30%), although comorbidity was frequent (96.6%), especially drug use (55.2%, mostly cannabis). SG-LAIAs used were aripiprazole (40%), risperidone (36.7%), and paliperidone palmitate (23.3%), and the main reasons were a history of low compliance (90%) and/or poor insight (73.3%). A mean improvement of 31.7 (SD = 8.7) between admission and discharge was registered in the Children's Global Assessment Scale (CGAS); no differences were observed between different SG-LAIAs. Although they were generally well tolerated, 23.3% of patients reported mild short-term side effects, which were more frequent with risperidone than with aripiprazole (p = .014). Our clinical experience suggests that SG-LAIAs may be a safe treatment option during adolescence in inpatients with psychotic disorders, as well as with DBD. No differences were found in CGAS improvement scores between the three SGA-LAIAs used, although patients on risperidone reported more side effects than those on aripiprazole. Further research is needed so as to evaluate safety and effectiveness of SG-LAIAs in this population.


Spot sign on 90-second delayed computed tomography angiography improves sensitivity for hematoma expansion and mortality: prospective study.
The computed tomography angiography (CTA) spot sign is a validated biomarker for poor outcome and hematoma expansion in intracerebral hemorrhage. The spot sign has proven to be a dynamic entity, with multimodal imaging proving to be of additional value. We investigated whether the addition of a 90-second delayed CTA acquisition would capture additional intracerebral hemorrhage patients with the spot sign and increase the sensitivity of the spot sign. We prospectively enrolled consecutive intracerebral hemorrhage patients undergoing first pass and 90-second delayed CTA for 18 months at a single academic center. Univariate and multivariate logistic regression were performed to assess clinical and neuroimaging covariates for relationship with hematoma expansion and mortality. Sensitivity of the spot sign for hematoma expansion on first pass CTA was 55%, which increased to 64% if the spot sign was present on either CTA acquisition. In multivariate analysis the spot sign presence was associated with significant hematoma expansion: odds ratio, 17.7 (95% confidence interval, 3.7-84.2; P=0.0004), 8.3 (95% confidence interval, 2.0-33.4; P=0.004), and 12.0 (95% confidence interval, 2.9-50.5; P=0.0008) if present on first pass, delayed, or either CTA acquisition, respectively. Spot sign presence on either acquisitions was also significant for mortality. We demonstrate improved sensitivity for predicting hematoma expansion and poor outcome by adding a 90-second delayed CTA, which may enhance selection of patients who may benefit from hemostatic therapy.


Nephrotoxicity of CdCl2 and Cd-metallothionein in cultured rat kidney proximal tubules and LLC-PK1 cells.
Nephrotoxicity is the major adverse effect produced by chronic exposure to cadmium (Cd). This injury is thought to be caused by the Cd-metallothionein complex (CdMT). In intact animals, CdMT is more efficiently taken up by the proximal tubules than CdCl2 and results in more renal damage. However, the mechanism(s) by which CdMT produces renal injury is not yet understood completely. Therefore, we used cultured renal proximal tubular cells to study the nephrotoxicity of CdMT and CdCl2. Rat kidney proximal tubules were isolated by collagenase perfusion, followed by percoll isopycnic centrifugation. 14C-alpha-methylglucose uptake and lactate dehydrogenase leakage were used as indices of nephrotoxicity. Surprisingly, CdMT was less toxic than CdCl2 to the cultured rat proximal tubule cells, as well as to cultured LLC-PK1 cells (a pig kidney proximal tubular cell line). Consistent with these observations on nephrotoxicity, 109CdMT uptake into these cultured renal cells was much less than that of 109CdCl2. Transwell cultures of LLC-PK1 cells were also used to examine the toxicity and uptake of CdCl2 and CdMT following basolateral and apical exposure. Uptake of both CdCl2 and CdMT from basolateral exposure was higher than that from apical exposure. Again, more 109CdCl2 was taken up and more cytotoxicity was observed in the CdCl2- than CdMT-exposed cells. In summary, CdCl2 is more toxic than CdMT to cultured rat kidney proximal tubules as well as LLC-PK1 cells. This is in contradiction to the greater in vivo nephrotoxic effects of CdMT than CdCl2. Therefore, cultured renal cells do not appear to be an appropriate model to study the nephrotoxicity of CdMT; transport of CdMT into proximal tubular cells in vivo does not appear to be maintained in vitro.


Aspects of general linear modelling of migration.
"This paper investigates the application of general linear modelling principles to analysing migration flows between areas. Particular attention is paid to specifying the form of the regression and error components, and the nature of departures from Poisson randomness. Extensions to take account of spatial and temporal correlation are discussed as well as constrained estimation. The issue of specification bears on the testing of migration theories, and assessing the role migration plays in job and housing markets: the direction and significance of the effects of economic variates on migration depends on the specification of the statistical model. The application is in the context of migration in London and South East England in the 1970s and 1980s."


Colonic Lesions, Cytokine Profiles, and Gut Microbiota in Plasminogen-Deficient Mice.
Plasminogen-deficient (FVB/NPan-plg(tm1Jld), plg(tm1Jld)) mice, which are widely used as a wound-healing model, are prone to spontaneous rectal prolapses. The aims of this study were 1) to evaluate the fecal microbiome of plg(tm1Jld) mice for features that might contribute to the development of rectal prolapses and colonic inflammation and 2) to assess the relevance of the inflammatory phenotype to the variability in wound healing in this model. The (plgtm1Jld) mice exhibited delayed wound healing, and they could be divided into 3 distinct groups that differed according to the time until wound closure. Colonic lesions in plg(tm1Jld) mice, which were characterized by necrotizing ulcerations and cystically dilated glands, were restricted to the intermediate and distal parts of the colon. The cytokine profile was indicative of chronic tissue damage, but the genetic modification did not change the composition of the gut microbiota, and none of the clinical or biochemical parameters correlated with the gut microbiota composition.


Pore-Space Partition and Optimization for Propane-Selective High-Performance Propane/Propylene Separation.
The development of effective propane (C3H8)-selective adsorbents for the purification of propylene (C3H6) from C3H8/C3H6 mixture is a promising alternative to replace the energy-intensive cryogenic distillation. However, few materials possess the dual desirable features of propane selectivity and high uptake capacity. Here, we report a family of pore-space-partitioned crystalline porous materials (CPM) with remarkable C3H8 uptake capacity (up to 10.9 mmol/g) and the highly desirable yet uncommon C3H8 selectivity (up to 1.54 at 0.1 bar and 1.44 at 1 bar). The selectivity-capacity synergy endows them with record-performing C3H8/C3H6 separation potential (i.e., C3H6 recovered from the mixture). Moreover, these CPMs exhibit outstanding properties including high stability, low regeneration energy, and multimodular chemical and geometrical tunability within the same isoreticular framework. The high C3H8/C3H6 separation performance was further confirmed by the breakthrough experiments.


"Ways and channels for voice regarding perceptions of maternal health care services within the communities of the Makamba and Kayanza provinces in the Republic of Burundi: an exploratory study".
Increased availability of maternal health services alone does not lead to better outcomes for maternal health.The services need to be utilized first.One way to increase service utilization is to plan responsive health care services by taking into account the community's views or expressed needs. Burundi has a high maternal mortality ratio, and despite improvements in health infrastructure, skilled staff and the abolition of user fees for pregnant women,utilization of maternal health services remains low. Possible reasons for this include a lack of responsive healthcare services. An exploratory study was conducted in 2013 in two provinces of Burundi (Makamba and Kayanza), with the aim to collect the experiences of women and men with the maternal health services,their views regarding those services, channels used to express these experiences, and the providers' reaction. Semi-structured interviews were used to collect data from men and women and key informants, including community health workers, health committee members, health providers, local authorities, religious leaders and managers of non-governmental organizations. Data analysis was facilitated by MAXQDA 11 software. Negative experiences with maternal health services were reported and included poor staff behavior towards women and a lack of medicine. Health committees and suggestion boxes were introduced by the government to channel the community's views. However, they are not used by the community members, who prefer to use community health workers as intermediaries. Fear of expressing oneself linked to the post-war context of Burundi, social and gender norms, and religious norms limit the expression of community members' views, especially those of women. The limited appreciation of community health workers by the providers further hampers communication and acceptance of the community's views by health providers. In Burundi, the community voice to express views on maternal health services is encountering obstacles and needs to be strengthened,especially the women's voice. Community mobilization in the form of a mass immunization campaign day organized by women fora, and community empowerment using participatory approaches could contribute towards community voice strengthening.


Co-introduced functional CCR2 potentiates in vivo anti-lung cancer functionality mediated by T cells double gene-modified to express WT1-specific T-cell receptor.
Although gene-modification of T cells to express tumor-related antigen-specific T-cell receptor (TCR) or chimeric antigen receptor (CAR) has clinically proved promise, there still remains room to improve the clinical efficacy of re-directed T-cell based antitumor adoptive therapy. In order to achieve more objective clinical responses using ex vivo-expanded tumor-responsive T cells, the infused T cells need to show adequate localized infiltration into the tumor. Human lung cancer cells variously express a tumor antigen, Wilms' Tumor gene product 1 (WT1), and an inflammatory chemokine, CCL2. However, CCR2, the relevant receptor for CCL2, is rarely expressed on activated T-lymphocytes. A HLA-A2402(+) human lung cancer cell line, LK79, which expresses high amounts of both CCL2 and WT1 mRNA, was employed as a target. Normal CD8(+) T cells were retrovirally gene-modified to express both CCR2 and HLA-A*2402-restricted and WT1(235-243) nonapeptide-specific TCR as an effector. Anti-tumor functionality mediated by these effector cells against LK79 cells was assessed both in vitro and in vivo. Finally the impact of CCL2 on WT1 epitope-responsive TCR signaling mediated by the effector cells was studied. Introduced CCR2 was functionally validated using gene-modified Jurkat cells and human CD3(+) T cells both in vitro and in vivo. Double gene-modified CD3(+) T cells successfully demonstrated both CCL2-tropic tumor trafficking and cytocidal reactivity against LK79 cells in vitro and in vivo. CCL2 augmented the WT1 epitope-responsive TCR signaling shown by relevant luciferase production in double gene-modified Jurkat/MA cells to express luciferase and WT1-specific TCR, and CCL2 also dose-dependently augmented WT1 epitope-responsive IFN-γ production and CD107a expression mediated by these double gene-modified CD3(+) T cells. Introduction of the CCL2/CCR2 axis successfully potentiated in vivo anti-lung cancer reactivity mediated by CD8(+) T cells double gene-modified to express WT1-specific TCR and CCR2 not only via CCL2-tropic tumor trafficking, but also CCL2-enhanced WT1-responsiveness.


Effects of bone marrow mesenchymal stem cells transplantation on the recovery of neurological functions and the expression of Nogo-A, NgR, Rhoa, and ROCK in rats with experimentally-induced convalescent cerebral ischemia.
To investigate the effects of intravenous transplantation of bone marrow mesenchymal stem cells (BMSCs) on neurological function in rats with experimentally-induced convalescent cerebral ischemia and the expression of Nogo-A, NgR, Rhoa, and ROCK expression. BMSCs were isolated and cultured in vitro using the whole bone marrow adherent method. Eighty-one adult male Sprague-Dawley rats were divided at random into three groups: the sham-operated group, the cerebral ischemia group, and the BMSC treatment group (n=27 rats per group). In the latter two groups, the middle cerebral artery occlusion (MCAO) model was performed by the modified Zea Longa method. After MCAO, rats in the sham-operated and cerebral ischemic groups were injected with 1 mL of phosphate buffered saline (PBS) via the tail vein. In the BMSC-treatment group, 1 mL of the BMSC suspension (containing 3×106 BMSCs) was injected through the rats' femoral vein. At 12, 24, and 72 h after BMSC transplantation, modified neurological deficit scores (mNSS) were used to assess neurological function. TTC (2,3,5-triphenyl tetrazolium chloride) staining was used to measure the ischemic lesion volume, and the distribution of Nogo-A protein was observed by immunohistochemistry. The expressions of Nogo-A, NgR, Rhoa, and ROCK were detected by Western blot. At 72 h after BMSC transplantation, the mNSS scores were significantly lower in the BMSC treatment group than those in the cerebral ischemia group (7.50±0.55 vs. 8.67±0.52, P<0.01), and the ischemic lesions volume was significantly reduced. The expressions of Nogo-A, NgR, RhoA, and ROCK were significantly decreased compared with the controls (P<0.05). The transplantation of BMSCs can improve neurological function in rats after convalescent cerebral ischemia, and their therapeutic effect may be related to the downregulation of Nogo-A, NgR, RhoA, and ROCK expression.


Therapeutic Strategy of Targeting Astrocytes for Neuroprotection in Parkinson's Disease.
Parkinson's disease (PD) is one of common neurodegenerative diseases, which shows motor symptoms including tremor, bradykinesia, rigidity and postural instability. It also involves non-motor symptoms such as cognitive impairment, mental manifestation, autonomic disorder and sensory disturbance. Although treatments to improve the motor disability in PD are being assessed at present, the main challenge remains that is the development of neuroprotective or disease-modifying treatments. Therefore, it is desirable to find approaches that can inhibit the progression of dopaminergic neurodegeneration. Astrocytes are known to play an important role in the maintenance of the neuronal environment and exert neuroprotective effects. Additionally, astrocyte dysfunction increases the susceptibility of neurons to cytotoxicity. We have demonstrated neuroprotective approaches in parkinsonian models in various studies targeting astrocytes. In this article, we summarize the neuroprotective function of astrocytes in the brain, involvement of astrocyte dysfunction in neurodegeneration, and experimental approaches to dopaminergic neuroprotection. We review findings reported in several papers including our own studies. We also address target molecules and pivotal pathways in astrocytes for dopaminergic neuroprotection. The review discusses new promising therapeutic strategies to prevent dopaminergic neurodegeneration in PD.


Dietary and urinary risk factors for stones in idiopathic calcium stone formers compared with healthy subjects.
The high social-economic cost of nephrolithiasis wholly justifies the attempts to understand its mechanism and avoid recurrences. The influence of dietary habits and urinary risk factors has been evaluated, but the results were discrepant, probably because of differences in the methodologies used to compare patients and controls. The aim was to assess dietary and urinary risk factors for urinary stones by comparison between 108 calcium stone formers (SF) and 210 healthy subjects (HS). All subjects were recruited during the same 1 year period. Personal characteristics, dietary habits (evaluated through a food frequency questionnaire) and urinary biochemical parameters were collected. The high predominance of men in the SF group led us to focus on the 79 SF and the 96 HS men. A familial history of stones was reported more frequently in SF than in HS, 42.9% vs 17.6%, P<0.005. Body weight was higher in SF, 76.8+/-12.2 kg vs 72.8+/-9.6 kg, P=0.02; and calcium intake was lower in SF, 794.8+/-294.1 mg vs 943.6+/-345.4 mg, P<0.01. For urinary parameters, calcium and oxalate output were significantly higher in SF. Urinary urea, as a reflection of daily protein intake, and uric acid were also higher in SF. Urinary citrate excretion related to body weight was lower in SF. Calciuria was significantly correlated with urinary urea in both SF and HS, but the correlation was stronger for SF. Calciuria correlated significantly with natriuria only in HS. The main differences between SF and HS were that SF had a family history of stones, a higher body weight, a lower daily intake of calcium, and a higher urinary output of calcium and oxalate. These results underline the combined role of genetic and nutritional factors in the pathogenesis of urinary stone formation.


Pooling the ground: understanding and coordination in collective sense making.
Common ground is most often understood as the sum of mutually known beliefs, knowledge, and suppositions among the participants in a conversation. It explains why participants do not mention things that should be obvious to both. In some accounts of communication, reaching a mutual understanding, i.e., broadening the common ground, is posed as the ultimate goal of linguistic interactions. Yet, congruent with the more pragmatic views of linguistic behavior, in which language is treated as social coordination, understanding each other is not the purpose (or not the sole purpose) of linguistic interactions. This purpose is seen as at least twofold (e.g., Fusaroli et al., 2014): to maintain the systemic character of a conversing dyad and to organize it into a functional synergy in the face of tasks posed for a dyadic system as a whole. It seems that the notion of common ground is not sufficient to address the latter character of interaction. In situated communication, in which meaning is created in a distributed way in the very process of interaction, both common (sameness) and privileged (diversity) information must be pooled task-dependently across participants. In this paper, we analyze the definitions of common and privileged ground and propose a conceptual extension that may facilitate a theoretical account of agents that coordinate via linguistic communication. To illustrate the usefulness of this augmented framework, we apply it to one of the recurrent issues in psycholinguistic research, namely the problem of perspective-taking in dialog, and draw conclusions for the broader problem of audience design.


Therapeutic innovation.
The small but very focused meeting of 60 delegates from academia, small biopharmaceutical companies and large pharmaceutical companies aimed to give an overview of current R&D approaches in the cardiovascular disease area. Most of the new therapeutic approaches were presented by small biopharmaceutical companies and addressed disease targets in the vasculature for the following indications: thrombosis; atherosclerosis; restenosis; hyperlipidemia; and hypertension. Cardiac disease targets were addressed in the following indications: congestive heart failure (CHF); chronic angina; reperfusion injury; and atrial arrhythmia. The technologies presented included small molecule drugs, protein drugs and gene therapeutics as well as vaccines and an integrated target definition platform. The therapeutic approaches were complemented by the presentation of two innovative diagnostic products for thrombosis and stroke related brain injury.


3,4-Bis(4-bromo-phen-yl)-N-phenyl-maleimide.
In the title mol-ecule, C(22)H(13)Br(2)NO(2), the three benzene rings are arranged in a propeller-like fashion around the central malemide ring, making dihedral angles of 48.2 (4), 30.2 (4) and 34.8 (4)° with the malemide ring. The C-C single-bond lengths connecting benzene groups and maleimide are significantly shorter [C-C = 1.468 (9) and 1.478 (9) Å] than a typical Csp(3)-Csp(3) single bond, indicating partial conjugation between the benzene and the mal-eimide. A weak non-classical C-H⋯O hydrogen bond helps to stabilize the crystal structure.


Toward refined environmental scenarios for ecological risk assessment of down-the-drain chemicals in freshwater environments.
Current regulatory practice for chemical risk assessment suffers from the lack of realism in conventional frameworks. Despite significant advances in exposure and ecological effect modeling, the implementation of novel approaches as high-tier options for prospective regulatory risk assessment remains limited, particularly among general chemicals such as down-the-drain ingredients. While reviewing the current state of the art in environmental exposure and ecological effect modeling, we propose a scenario-based framework that enables a better integration of exposure and effect assessments in a tiered approach. Global- to catchment-scale spatially explicit exposure models can be used to identify areas of higher exposure and to generate ecologically relevant exposure information for input into effect models. Numerous examples of mechanistic ecological effect models demonstrate that it is technically feasible to extrapolate from individual-level effects to effects at higher levels of biological organization and from laboratory to environmental conditions. However, the data required to parameterize effect models that can embrace the complexity of ecosystems are large and require a targeted approach. Experimental efforts should, therefore, focus on vulnerable species and/or traits and ecological conditions of relevance. We outline key research needs to address the challenges that currently hinder the practical application of advanced model-based approaches to risk assessment of down-the-drain chemicals. Integr Environ Assess Manag 2017;13:233-248. © 2016 SETAC.


Onset of ADL and IADL limitation among Chinese middle-aged and older adults.
It is important to measure the prevalence and onset of limitations for older adults to take critical day-to-day activities in the population. However, too often, only very older people are covered, and too few activities are included in the studies. Using a nationally representative sample from 2011 to 2018 (N = 16, 381), this study characterizes the limitation pattern covering ADL and IADL activities among middle-aged and older adults in China. We use survival models to characterize the limitation transition. We find that half of the population become limited in activities including housekeeping, toileting, managing money, and cooking in their early 70s, followed by shopping, bathing, transferring and dressing in their late 70s, continence, and taking medications in their early 80s, and feeding in their early 90s. In addition, women show significantly younger age of limitation onsets for all activities except continence.


High-precision temperature determination of evaporating light-absorbing and non-light-absorbing droplets.
Models describing evaporation or condensation of a droplet have existed for over a century, and the temporal evolutions of droplet radius and temperature could be predicted. However, the accuracy of results was questionable, since the models contain free parameters and the means of accurate calibration were not available. In previous work (Hołyst et al. Soft Matter 2013, 9, 7766), a model with an efficacious parametrization in terms of the mean free path was proposed and calibrated with molecular dynamics numerical experiment. It was shown that it is essentially possible to determine reliably the temperature of a steadily evaporating/condensing homogeneous droplet relative to ambient temperature when the evolution of the droplet radius is known. The accuracy of such measurement can reach fractions of mK. In the case of an evaporating droplet of pure liquid, the (droplet) temperature is constant during the stationary stage of evaporation. In this paper, we show that, in many cases, it is also possible to determine the temporal evolution of droplet temperature from the evolution of the droplet radius if the droplet (initial) composition is known. We found the droplet radius evolution with high accuracy and obtained the evolution of droplet temperature (and composition) for droplets of (i) a two-component mixture of pure liquids; (ii) solutions of solid in liquid, one that is non-surface-active and another that is; and (iii) suspensions of non-light-absorbing and light-absorbing particles.


Gender differences in financial barriers to primary health care in New Zealand.
Gender differences in health status and use of health care services have been established in the developed world with less attention paid to gender differences in financial barriers to primary care. Such barriers represent potentially avoidable mortality and morbidity. To examine gender differences in financial barriers to New Zealand primary health care. Data from SoFIE-health, an add-on to Statistics New Zealand-led Survey of Family, Income and Employment (SoFIE), analysed using logistic regression, controlling for demographic, socioeconomic, health behaviour and health variables. Access to primary health care includes general practitioner and dental care and prescription drugs. Odds of deferring seeing their doctor(s), dentist and buying a prescription respectively at least once during preceding 12 months, because they could not afford the cost of a visit or prescription, were greater for women compared to men (Odds Ratio (OR) 1.82, 95% CI: 1.67-1.99; OR 2.05, 95% CI: 1.78-2.34; and OR 1.58, 95% CI: 1.47-1.71; respectively). Adjusting for demographic, socioeconomic, health behaviour and health status attenuated OR to 1.45 (1.31-1.61) for deferring medical visit, 1.47 (1.26-1.71) buying prescription, and 1.35 (1.24-1.46) for deferring dental visit, although confidence intervals still excluded the null. Gender significantly associated with reporting cost barriers to primary health care, regardless of individual deprivation or income levels, suggesting that primary health care policies targeting gender-specific factors are warranted. Policy measures to reduce co-payments may improve access to care for both women and men, and may have positive health implications.


Adverse effect of delayed pushing on postpartum blood loss in nulliparous women with epidural analgesia.
To test for an association between blood loss and time until pushing (TUP) after full cervical dilation in nulliparous women with epidural analgesia. A prospective cohort study was performed at the University Hospital of Zurich between October 2015 and November 2016. Included were 228 nulliparous women with singleton pregnancy, planned vaginal delivery after 36 completed weeks of gestation, epidural analgesia, and guided active pushing. TUP was defined as the interval between full cervical dilation and initiation of active pushing. The primary outcome measure was blood loss, assessed by the postpartum decrease in hemoglobin (ΔHb), estimated blood loss, and rate of ΔHb ≥30 g/L. Associations between TUP and primary and secondary maternal and neonatal delivery outcomes were assessed using Spearman correlation, Mann-Whitney U test, Kruskal-Wallis test, or Fisher exact test, as appropriate. Longer TUP correlated significantly with increased ΔHb (ρ=0.142, P=0.033) and higher rates of ΔHb ≥30 g/l (P=0.002). Composite adverse maternal and neonatal outcomes were unaffected. On the grounds of increased maternal blood loss, and in contrast to the current International Federation of Gynecology and Obstetrics (FIGO) guideline, delayed active pushing is not recommended in nulliparous women with epidural analgesia.


Retrospective Analysis of Sagittal Balance Parameters and Clinical Efficacy After Short-Segment Anterior Cervical Spine Surgery with Different Fusion Devices.
To compare the cervical sagittal balance parameters and clinical efficacy of three fusion devices after short-segment anterior cervical discectomy and fusion. Retrospectively analyzed 516 patients with cervical spondylosis who underwent surgery at our hospital from May 2013 to May 2019. All patients had complete data and were divided into three groups according to the selected fusion cage. Neck and upper limb pain were assessed by the visual analog scale (VAS) score. Neurological function was evaluated by the modified Japanese Orthopedics Society (mJOA) score. Also, the curvature of the cervical spine and the occurrence of dysphagia were observed. There were no significant differences in the general information, thoracic inlet angle, T1 slope, or surgical data among the groups (p>0.05). There were significant differences in the scores between pre- and postoperatively in the different groups (p<0.05). There were no significant differences in the C2-C7 Cobb angle or C2-C7 sagittal vertebral axis before the operation among the groups (p>0.05). There was a significant difference in the correction and loss of correction among the groups postoperatively and on follow-up (p>0.05). Dysphagia was less likely in the Zero-P VA fusion group than in the other two groups. Different fusion instruments can relieve the symptoms. In the Prodisc-C Vivo group, no significant improvement in cervical sagittal balance was achieved. A good effect on improving sagittal balance was observed in both the Zero-P VA fusion and Skyline anterior cervical titanium plate groups, but a better effect on preventing dysphagia was observed in the Zero-PVA fusion group.


Callosal Sensitivity to Short-Range Stimulus Orientation and Long-Range Stimulus Context Orientation: Tachistoscopic Evidence.
To study local-global relationships in interhemispheric interactions, tachistoscopically presented pairs of lines (1.15 degrees) were compared for their relative orientation by 48 neurotypical adults. Orientations of line stimuli (local aspect of the task) were vertical, horizontal, forward slash or backslash, as were those of the interstimulus axes. The latter created a global context that could influence line discrimination. Stimulus pairs were presented within a field (not requiring callosal participation for line orientation comparison) or one on each side of the visual field meridian (requiring callosal participation). The primary purpose of the design was to determine whether local or global violations of stimulus "homotopy" across the meridian would impose costs of interhemispheric integration. The rationale for this expectation is that the fiber projection of the corpus callosum is highly symmetric across the midsagittal plane (i.e., homotopic). The expected "callosal homotopy" effect was significantly upheld as a whole but broke down or became extravagant in certain specific conditions, with specific costs of interhemispheric integration varying from null to a highly significant 20-ms as a function of interactions of interstimulus and stimulus orientations. The corpus callosum seems to be particularly sensitive to local stimulus orientation in interaction with long-range stimulus context orientation.


Mechanism of 2-deoxy-D-glucose inhibition of cell-wall polysaccharide and glycoprotein biosyntheses in Saccharomyces cerevisiae.
The mechanism of inhibition by 2-deoxy-D-glucose of the synthesis of yeast wall polysaccharides and glycoproteins was investigated in Saccharomyces cerevisiae cells and protoplasts. The extent of the inhibition of mannan and glucan synthesis was found to be dependent on whether glucose or mannose was used as the carbon source in the medium. During growth on glucose, 2-deoxy-D-glucose inhibited more intensively mannan than glucan formation. Biosynthesis of wall glucan was strongly suppressed in mannose medium. Selective incorporation of 2-deoxy-D-glucose occurred into that polysaccharide, synthesis of which was more inhibited under given conditions. Suggestive evidence has been obtained that the decisive factor for the proportion of glucan and mannan in the walls is the direction of glucose 6-phosphate/mannose 6-phosphate interconversion dependent on the exogeneous hexose. No close correlation was found between the inhibition of mannan synthesis and the appearance of the mannan-protein enzymes invertase and acid phosphatase. Effect of 2-deoxy-D-glucose was therefore investigated on the parallel synthesis of protein, mannan and several extracellular and intracellular enzymes in protoplasts grown on glucose and mannose. The results obtained pointed out that the hindrance of the secretion of mannan-protein enzymes is of a complex nature and related more to the inhibition of synthesis of the protein moiety than to the inhibition of glycosylation. Synthesis of several enzymes was found to be a subject of a metabolic control by 2-deoxy-D-glucose or its metabolites.


Impact of managed care on healthcare delivery practices: the perception of healthcare administrators and clinical practitioners.
Managed care has introduced changes, such as cost effectiveness, access to care, and quality of care, to many components of the U.S. healthcare delivery system. These changes have affected how healthcare administrators and clinical practitioners perceive the impact of managed care on healthcare delivery practices. A survey was initiated to explore whether the perceptions of administrators differed from those of practitioners and to discover which organizational variables could explain the difference. A descriptive, cross-sectional survey design was used for the target population of administrators and practitioners in high, moderate, and low managed-care-penetration markets. Two investigator-developed instruments--the Managed Care Perceptions Inventory (MCPI) and the MCPI-Demographic--and an intact centralization of decision-making assessment subscale were used for data collection. Administrators had a statistically significant, more positive perception of the impact of managed care on healthcare delivery than did practitioners. When the distinction between administrator and practitioner was not used as a grouping factor, managed care market penetration, nonprofit status, and years in current employment position were factors that had statistically significant associations with a more positive perception of managed care. Based on these findings, both administrators and practitioners have a role in maintaining awareness regarding their perceptions and should work collaboratively to address issues of concern. Similarly, promoting trust and commitment at the organizational level is important. Recommendations for further research are also provided.


A scale-free network view of the UMLS to learn terminology translations.
The UMLS Metathesaurus belongs to the class of scale-free networks with few concept hubs possessing a large number of relationships. The hubs provide useful links between the concepts from disparate terminologies in the UMLS; however, they also exponentially increase the number of possible transitive cross-terminology paths. Towards the goal of using machine learning to rank cross-terminology translations, we propose a traversal algorithm that exploits the scale-free property of the UMLS to reduce the number of candidate translations. We characterize the concept hubs into "informational" and "noisy" concept hubs and provide an automated method to detect them. Using gold standard mappings from SNOMED-CT to ICD9CM, we found an average 20-fold reduction in the number of candidate mappings while achieving comparable recall and ranking results. A hub-driven traversal strategy provides a promising approach to generate high quality cross-terminology translations from the UMLS.


[Neurinoma arising from the first branch of the trigeminal nerve: a case report].
A case of a neurinoma arising from the first branch of the trigeminal nerve in a 40-year-old female is reported. The patient was admitted with the chief complaint of loss of Lt. visual acuity and mild hypoesthesia in the area of the first branch of the trigeminal nerve. A CT scan and MRI revealed a tumor extending through the superior orbital fissure into the orbita. Subtotal resection of the tumor was performed by a fronto-orbito-zigomatic approach and a histological diagnosis of neurinoma was made. Although the hypoesthesia remained, the visual acuity was markedly improved postoperatively. A neurinoma arising from the first branch of the trigeminal nerve is very rare. To our knowledge, including our case, only five cases which were described for clinical and diagnostic features and surgical management have been reported. There were three males and two females, and the age ranged from 1 to 57 years. Neurologically, all cases presented hypoesthesia in the area of the first branch of the trigeminal nerve and exophthalmus on admission. Visual disturbance was found in three cases. Radiologically, the enlargement of the superior orbital fissure was revealed in two cases. Angiography performed in three cases demonstrated the avascular mass. Three patients received CT scan and only the present case used MR imaging. Surgical resection was performed in all cases through various approaches. The fronto-orbito-zygomatic approach which was chosen in our case was useful for obtaining a sufficient operative view. As in our case, excellent outcome was achieved in three other cases due to successful tumor resection.


Multidrug-resistance-associated protein 1 (Mrp1) is probably not required for murine Th cell activation.
Previously, we have demonstrated that multidrug-resistance-associated protein 1 (Mrp1) represents an activation marker for murine Th1 cells and is constitutively expressed by Th2 cells. Using the inhibitor MK571, we and others also suggested that Mrp1 is necessary for Th cell activation. However, herein, we show that Mrp1-deficient Th cells can be differentiated to a similar extent to Th1 and Th2 cells in vitro and, upon re-stimulation, produce comparable amounts of IL-2, IFNgamma and IL-4. Mrp1-deficient mice are equally susceptible than wild-type mice to infection with the protozoan parasite Leishmania major, a well-respected model for in vivo Th1 and Th2 cell differentiation. Intriguingly, MK571 is able to completely block activation of Mrp1-deficient Th cells. Most likely, therefore, the molecule relevant for Th cell activation which is blocked by MK571 is different from Mrp1. While these results are compatible with our previously reported data on Mrp1 expression, they contradict our previous conclusions about Mrp1 function in murine Th1 cells as well as those published in a very recent report in this journal on human Th cells.


Survival protein anoctamin-6 controls multiple platelet responses including phospholipid scrambling, swelling, and protein cleavage.
Scott syndrome is a rare bleeding disorder, characterized by altered Ca(2+)-dependent platelet signaling with defective phosphatidylserine (PS) exposure and microparticle formation, and is linked to mutations in the ANO6 gene, encoding anoctamin (Ano)6. We investigated how the complex platelet phenotype of this syndrome is linked to defective expression of Anos or other ion channels. Mice were generated with heterozygous of homozygous deficiency in Ano6, Ano1, or Ca(2+)-dependent KCa3.1 Gardos channel. Platelets from these mice were extensively analyzed on molecular functions and compared with platelets from a patient with Scott syndrome. Deficiency in Ano1 or Gardos channel did not reduce platelet responses compared with control mice (P > 0.1). In 2 mouse strains, deficiency in Ano6 resulted in reduced viability with increased bleeding time to 28.6 min (control 6.4 min, P < 0.05). Platelets from the surviving Ano6-deficient mice resembled platelets from patients with Scott syndrome in: 1) normal collagen-induced aggregate formation (P > 0.05) with reduced PS exposure (-65 to 90%); 2) lowered Ca(2+)-dependent swelling (-80%) and membrane blebbing (-90%); 3) reduced calpain-dependent protein cleavage (-60%); and 4) moderately affected apoptosis-dependent PS exposure. In conclusion, mouse deficiency of Ano6 but not of other channels affects viability and phenocopies the complex changes in platelets from hemostatically impaired patients with Scott syndrome.


Microfluidic Immunoassay System for Rapid Detection and Semi-Quantitative Determination of a Potential Serum Biomarker Mesothelin.
Mesothelin (MSLN) is considered as a potential serological tumor biomarker for early diagnosis of pancreatic cancer. Nevertheless, low sensibility, high reagent consumption, and time costs of traditional detection methods limit their utility in clinical disease diagnoses. Here, we combined the immunoassay technique with microfluidic chips to develop a microfluidic immunoassay system (MIAS) that can be used for rapid semi-quantitative detection of serum MSLN levels. The MIAS was composed of 12 uniform structures, including 12 inlets, 12 reaction chambers, and one outlet allowing measurement of four samples with three repeats, simultaneously. A unique microarray cylinder was located at the end of each reaction chamber where immunoassay was performed to trap microspheres. A feasible interception efficiency (∼80%) was attained, with microspheres filling the reaction column. It has been demonstrated that fluorescence intensity is proportional to the MSLN concentration on the MIAS (R2 = 0.95). Subsequently, 16 clinical serum samples collected from Changhai Hospital, Shanghai were selected from eight patients with pancreatic cancers, four with pancreatitis, and four with other digestive system diseases (2 gastric cancer, 1 bile duct stricture, and 1 bile duct stones). MSLN levels for these samples were detected via MIAS. The results showed a significant correlation between MIAS and traditional enzyme-linked immunosorbent assay (ELISA), with the correlation coefficient, 0.93. The detection limit of MSLN fluorescence intensity and concentration was ∼6 a.u. and ∼20 pg/mL, respectively. The entire duration of analysis by MIAS decreased to ∼40 min compared to 2 h by ELISA. Statistical analysis of MIAS data revealed that MSLN was overexpressed in pancreatic cancer than in the others (P value = 0.0014). Moreover, the diagnostic accuracies of MSLN detected by MIAS and CA19-9 detected by ELISA in hospitals were 87.5 and 81.3%, respectively. MSLN is helpful for the early diagnosis of pancreatic cancer and other diseases, and it had a significant ability to discriminate between pancreatic and nonpancreatic cancers (P value = 0.0159). The results from this study show that MIAS has the potential to become a new serological tumor marker detection platform for rapid detection and semi-quantitative determination of MSLN and would have broad applications in early clinical diagnosis.


[Long-term efficacy of hepatitis B vaccine in newborn and revaccination study].
Two-hundred and sixty-nine newborns were followed up for 4 and 5 years after completion of vaccination (10 micrograms x 3). The anti-HBs positive rates remained 82.54% and 72.03%, respectively. The low-level titer (> or = 10-99 mIU/ml) made up 44.61%, and the medium-level titer (> or = 100-99mIU/ml) 32.34%. The highest titer was 857 mIU/ml. A 10 micrograms dose of hepatitis B vaccine was given to these children. The anti-HBs level went up greatly in the first month after revaccination, but started to drop in the third month, decreased rapidly in the sixth month, and in the twelveth month the level trended to restore the level before revaccination. This paper indicated that the home-made hepatitis B vaccine was effective. Revaccination was not necessary within 5-7 years after initial vaccination. Revaccination to children whose anti-HBs level was < 10mIU/ml was beneficial but the anti-HBs persistence was short.


Serous Cystic Neoplasm: Do We Have to Wait Till It Causes Trouble?
Serous cystic neoplasm (SCN) of the pancreas is considered a benign tumor with almost no malignant potential. Most surgeons agree that asymptomatic SCN requires only regular observation. However, several complexities and interference with organ preservation during the operation, may develop when a huge symptomatic tumor is treated with surgery. So, the purpose of this study is to develop a potential management plan based on a literature review and by describing three recent cases of SCN of the pancreas. We suggest that SCNs be responded to with a timely and appropriate surgical intervention - before they require clinical attention.


Effects of prolactin, progesterone and ovariectomy on metabolic activities and insulin receptors in the mammary gland and adipose tissue during extended lactation in the rat.
Prolactin implants prevented the decline in milk yield and the resumption of oestrous cycles which occurred between days 22 and 28 in untreated lactating rats. Ovariectomy and progesterone implants only partially prevented the decline in milk yield despite preventing the occurrence of oestrous cycles. All three treatments increased total RNA content of the mammary gland compared with controls. In untreated rats there were no changes in mammary DNA content or the number of insulin receptors whereas lipoprotein lipase (LPL) activity decreased significantly during the declining phase of lactation. In contrast, the number of insulin receptors, LPL activity and glucose incorporation into lipid increased in adipose tissue. Prolactin prevented the increase in insulin receptors and lipid synthesis and significantly decreased LPL activity in adipose tissue. Progesterone stimulated LPL activity in the mammary gland and also prevented the increase in lipid synthesis and insulin receptors in adipose tissue but was without effect on LPL activity whereas ovariectomy stimulated LPL activity in the mammary gland but prevented only the increase in the number of insulin receptors in adipose tissue. The results show that raising the serum prolactin concentration can prevent the decline in milk yield during extended lactation and whilst part of this effect may be due to a direct effect on the mammary gland and an indirect effect due to inhibition of oestrous cycles, prolactin may also produce part of its effect on milk synthesis by inhibiting competitive metabolic processes in tissues such as adipose tissue.


Synthesis of novel curcumin analogues and their evaluation as selective cyclooxygenase-1 (COX-1) inhibitors.
Curcumin, a major yellow pigment and active component of turmeric, has been shown to possess anti-inflammatory and anti-cancer activities. Recent studies have indicated that cyclooxygenase-1 (COX-1) plays an important role in inflammation and carcinogenesis. In order to find more selective COX-1 inhibitors a series of novel curcumin derivatives was synthesized and evaluated for their ability to inhibit this enzyme using in vitro inhibition assays for COX-1 and COX-2 by measuring PGE(2) production. All curcumin analogues showed a higher rate of COX-1 inhibition. The most potent curcumin compounds were (1E,6E)-1,7-di-(2,3,4-trimethoxyphenyl)-1,6-heptadien-3,5-dione (4) (COX-1: IC(50) = 0.06 microM, COX-2: IC(50) > 100 microM, selectivity index>1666) and (1E,6E)-methyl 4-[7-(4-methoxycarbonyl)phenyl]-3,5-dioxo-1,6-heptadienyl]benzoate (6) (COX-1: IC(50) = 0.05 microM, COX-2: IC(50) > 100 microM, selectivity index > 2000). Curcumin analogues therefore represent a novel class of highly selective COX-1 inhibitors and promising candidates for in vivo studies.


Role of aorto-angioplasty in hypertension caused by Takayasu's arteritis.
Sixteen patients with Takayasu's arteritis and a long-stenotic segment of the descending thoracic aorta and/or proximal and middle portion of the abdominal aorta, with or without renal artery stenosis, were treated by percutaneous transluminal aorto-angioplasty (PTAA). These patients might be subdivided into three groups: A. with normal renal artery, B. with severe renal artery stenosis or occlusion without treatment or with failure of dilatation, and C. with renal artery stenosis but relieved by percutaneous transluminal renal angioplasty (PTRA). It was found that the hypertension may be caused by the suprarenal aortic stenosis itself. PTAA has an excellent effect to normalize the blood pressure in Group A. The elevated blood pressure may also be decreased in various extent in the patient with severe renal artery stenosis after PTAA, but not to normal. An additional PTRA or other renal vesel reconstruction procedure is necessary in this group. No recurrence of the aorta stenosis was found by non-invasive examinations or aortography during the long-term follow-up. PTAA may be considered as the first choice for the aortic stenosis caused by Takayasu's arteritis.


[Etiology of posterior uveitis and panuveitis at the Central University Hospital in Monastir].
The authors conducted a retrospective analysis of 245 patients with posterior uveitis or panuveitis in order to determine their etiologies and collect some epidemiological data. A specific diagnosis was made in 80.4%. Behcet's disease (22.4%), toxoplasmosis (22%), and Vogt-Koyanagi-Harada syndrome (9%) were the most common causes of posterior uveitis or panuveitis. No case of confirmed sarcoïdosis was found in our series.


Measurement of coping and stress responses in women with breast cancer.
The development of the Responses to Stress Questionnaire-cancer version (RSQ-CV) to assess coping with and responses to the stress of breast cancer is described. The RSQ-CV was completed by 232 women with breast cancer near the time of their diagnosis. Confirmatory factor analyses verified a model that includes three voluntary coping factors (primary control engagement coping, secondary control engagement coping, disengagement coping) and two involuntary stress response factors (involuntary engagement, involuntary disengagement). Internal consistency reliability, and stability over 12 weeks for the five factors were adequate to excellent. Convergent and discriminant validity was examined through correlations with measures of intrusive thoughts, avoidance, and dimensions of perceived control. Significant correlations with symptoms of anxiety and depression are also reported. Applications of the RSQ-CV for research with breast cancer patients are discussed.


Salvage therapy with amprenavir, lopinavir and ritonavir is durably potent in HIV-infected patients in virological failure: 1-year results.
We report the results of the extended follow-up at one year of a randomized trial evaluating the virological efficacy of a salvage therapy combining lopinavir and amprenavir with either 200 or 400 mg/day ritonavir, along with optimized nucleoside reverse transcriptase inhibitors, in patients carrying multidrug-resistant isolates. The combination of amprenavir, lopinavir and ritonavir (400 mg/day) is durably potent, yielding a sustained virological response (HIV RNA < 50 copies) in 39% of cases.


Detecting Chirality in Molecules by Linearly Polarized Laser Fields.
A new scheme for enantiomer differentiation of chiral molecules using a pair of linearly polarized intense ultrashort laser pulses with skewed mutual polarization is presented. The technique relies on the fact that the off-diagonal anisotropic contributions to the electric polarizability tensor for two enantiomers have different signs. Exploiting this property, we are able to excite a coherent unidirectional rotation of two enantiomers with a π phase difference in the molecular electric dipole moment. The approach is robust and suitable for relatively high temperatures of molecular samples, making it applicable for selective chiral analysis of mixtures, and to chiral molecules with low barriers between enantiomers. As an illustration, we present nanosecond laser-driven dynamics of a tetratomic nonrigid chiral molecule with short-lived chirality. The ultrafast time scale of the proposed technique is well suited to study parity violation in molecular systems in short-lived chiral states.


Protective effects of S-sulfonated human gamma globulin against experimental infections in mice.
S-sulfonated gamma globulin (GGS), newly developed as a safe drug for intravenous use, was studied for its protective effects against some experimental infections in mice. Gamma globulin showed a good protective activity against infections due to Streptococcus pneumoniae and Escherichia coli and was moderately active against infections due to Staphylococcus aureus and Pseudomonas aeruginosa. In most cases, the potency of GGS was almost the same as that of original native gamma globulin. The duration of GGS activity in vivo was found to be comparable to that of native gamma globulin and much higher than that of pepsin-digested gamma globulin. In the control of infection due to E. coli, specific antibody was found to play a central role in the antibacterial action of GGS. When GGS was administered in combination with the antibiotics gentamicin and cefazolin for the control of infections due to S. pneumoniae or E. coli, a clear synergistic effect was observed.


Simplified total aortic arch replacement with an in situ stent graft fenestration technique for acute type A aortic dissection.
Total arch replacement combined with stented elephant trunk implantation in the descending aorta has successfully improved the outcomes of acute type A aortic dissection (AAAD). However, the optimal surgical strategy for the left subclavian artery (LSA) during the procedure remains a challenge. This study aimed to present our new technique of in situ stent graft fenestration to simplify the surgical procedure for suitable cases of AAAD. From August 2008 to December 2015, a total of 106 patients underwent simplified total aortic arch replacement with an in situ stent graft fenestration technique. The mean age of the patients was 50.71 ± 11.54 years (range, 24-78 years). Both perioperative variables and postoperative follow-up outcome of the procedure were assessed. The in-hospital mortality rate was 7.5%. The mean cardiopulmonary bypass time was 162.73 ± 68.49 minutes, cross-clamp time was 93.13 ± 22.29 minutes, and circulatory arrest time was 23.28 ± 5.56 minutes. Transient neurologic dysfunction was observed in five patients. No permanent neurologic dysfunction was observed, and no stroke or left arm ischemia occurred. During the follow-up period (mean, 43.4 ± 21.53 months), the survival rates of patients were 90.6%, 85.5%, and 78.8% at 1 year, 2 years, and 7 years, respectively. No stroke or left limb ischemia was observed. The LSA perfusion was well preserved in all surviving patients, and there was no endoleak or dissection around the LSA. All patients were free from reoperation. The in situ graft fenestration technique could simplify the procedure of LSA reconstruction during total arch replacement, provide a good surgical view for anastomosis and hemostasis, shorten the operation time, and yield satisfactory early and midterm results. It is a safe and effective alternative approach for suitable patients with AAAD. However, the long-term results of this technique need further evaluation.


Effect of Lactobacillus rhamnosus hsryfm 1301 on the Gut Microbiota and Lipid Metabolism in Rats Fed a High-Fat Diet.
Accumulating evidence indicates that lactic acid bacteria could improve host physiology and lipid metabolism. To investigate the effect of the gut microbiota on host lipid metabolism, a hyperlipidemic rat model was established by feeding rats a high-fat diet for 28 days, and the gut microbiota of the rats was analyzed using real-time PCR before and after administration of Lactobacillus rhamnosus hsryfm 1301 and its fermented milk for 28 days. The findings showed that the Lactobacillus spp., Bifidobacterium spp., Bacteroides spp., and Enterococcus spp. content in the hyperlipidemic rats gut was increased significantly (p < 0.05), while the Clostridium leptum and Enterobacter spp. content was decreased significantly after intervening with L. rhamnosus hrsyfm 1301 and its fermented milk for 28 days (p < 0.05). Furthermore, the lipid levels of the serum and the liver were decreased significantly (p < 0.05) and the fecal water content was increased significantly (p < 0.05) in the hyperlipidemic rats after the intervention, and hepatocyte fatty degeneration of liver tissues was also prevented. A positive correlation was observed between the Clostridium leptum content and the level of serum cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein, and a negative correlation was observed between the Enterobacter spp. content and the Lactobacillus spp. and Bifidobacterium spp. content in the hyperlipidemic rats gut. These results suggest that the gut microbiota and lipid metabolism of hyperlipidemic rats could be improved by supplementation with L. rhamnosus hsryfm 1301 and its fermented milk.


Ordered Mesoporous Electrodes for Sensing Applications.
Electrochemical sensors have become increasingly relevant in fields such as medicine, environmental monitoring, and industrial process control. Selectivity, specificity, sensitivity, signal reproducibility, and robustness are among the most important challenges for their development, especially when the target compound is present in low concentrations or in complex analytical matrices. In this context, electrode modification with Mesoporous Thin Films (MTFs) has aroused great interest in the past years. MTFs present high surface area, uniform pore distribution, and tunable pore size. Furthermore, they offer a wide variety of electrochemical signal modulation possibilities through molecular sieving, electrostatic or steric exclusion, and preconcentration effects which are due to mesopore confinement and surface functionalization. In order to fully exploit these advantages, it is central to develop reproducible routes for sensitive, selective, and robust MTF-modified electrodes. In addition, it is necessary to understand the complex mass and charge transport processes that take place through the film (particularly in the mesopores, pore surfaces, and interfaces) and on the electrode in order to design future intelligent and adaptive sensors. We present here an overview of MTFs applied to electrochemical sensing, in which we address their fabrication methods and the transport processes that are critical to the electrode response. We also summarize the current applications in biosensing and electroanalysis, as well as the challenges and opportunities brought by integrating MTF synthesis with electrode microfabrication, which is critical when moving from laboratory work to in situ sensing in the field of interest.


Quercetin suppresses the proliferation of multiple myeloma cells by down-regulating IQ motif-containing GTPase activating protein 1 expression and extracellular signal-regulated kinase activation.
The flavonoid quercetin has shown anti-tumor effects against a variety of solid tumors. However, its effects on multiple myeloma (MM) remain unclear. In this study we examined the proliferation of human myeloma cell lines U266, KM3 and RPMI8226 and MM derived cells from four patients with MM after quercetin treatment, and detected the expression of IQ motif-containing GTPase activating protein 1 (IQGAP1), a scaffold protein involved in mitogen-activated protein kinase (MAPK) signaling, by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. We found that quercetin inhibited the proliferation of MM cells in a dose- and time-dependent manner, accompanied by reduced IQGAP1 expression at mRNA and protein levels, and reduced extracellular signal-regulated kinase 1/2 (ERK1/2) activation. Furthermore, we found that quercetin inhibited the interaction between IQGAP1 and ERK1/2 in RPMI8226 cells. In summary, our results suggest that quercetin suppresses the proliferation of MM cells by down-regulating IQGAP1 expression and ERK activation, and has potential as a novel agent to target oncogenic kinase cascades for MM therapy.


A clinicoradiologic study of the shoulder in Apert syndrome.
To provide a comprehensive radiographic, clinical, and functional description of the shoulder in Apert syndrome. A cohort of 9 Apert syndrome patients (ages, 9-27 years) followed at a tertiary care facility was included in this prospective study. Patients were clinically assessed with physical examination and completion of 2 validated functional assessment tools, the Shoulder Pain and Disability Index (SPADI) and American Academy of Orthopaedic Surgeons Pediatric Outcomes Data Collection Instrument (AAOS PODCI). Radiographs were obtained of both shoulders, and standardized-protocol magnetic resonance imaging was performed on the dominant shoulder of all participants. All patients had some degree of functional impairment attributable to their shoulder pathologic abnormality. Physical examination consistently revealed reduced forward flexion and abduction. Radiographic findings were similar to previous reports, with pervasive osseous dysplasia of the shoulder joint. Medial humeral head hypoplasia was seen in 8 of 9 patients and greater tuberosity overgrowth in 7 of 9 patients. Magnetic resonance imaging of the shoulder, not previously performed in a cohort of Apert patients, allowed better delineation of abnormalities seen radiographically such as a central glenoid cleft seen in 8 of 9 patients. It also revealed a new finding of inferior glenoid inclination (7/9 patients) that has not been described in the literature. Very few soft tissue or degenerative abnormalities were demonstrated. The findings of this study confirm that patients with Apert syndrome are functionally impaired by their shoulder pathologic abnormality, which may have a similar clinical impact as the more well-described hand and foot anomalies. The global functioning of patients with Apert syndrome is equivalent to patients with juvenile rheumatoid arthritis. The shoulder range of motion in Apert patients is decreased, most significantly in flexion and abduction. Radiographs confirmed previous imaging findings of glenohumeral dysplasia. The novel magnetic resonance imaging component demonstrated consistent inferior glenoid inclination, which may be a significant factor in their shoulder impairment. Magnetic resonance imaging revealed no significant soft tissue or degenerative abnormalities to account for their clinical disability. These findings have potential relevance in the surgical and clinical management of these patients. Level IV.


The relationship of job performance to exercise adherence in a corporate fitness program.
An investigation of the relationship between exercise adherence and job performance was conducted over a six-month period among a group of white-collar workers (3,231) eligible to participate in a corporate fitness program. The study population was divided into four job categories - management (561), professional (1,265), clerical (1,078), and other (327) - and five exercise adherence groups - nonmember (1,090), nonexerciser (926), exercised less than one time per week (738), exercised one to two times per week (238), and exercised more than two times per week (239). Current job performance ratings were determined for all individuals. A strong association (p less than .01) was observed between above average performance and increasing adherence levels. An inverse relationship was demonstrated between poor performance and increasing adherences levels (p less than .0001). In each adherence group no differences in performance were noted when prior performance was compared with current performance. On the basis of these findings there appears to be a positive although probably noncausal relationship between exercise adherence in a corporate fitness program and above average job performance.


Effect of MMT concentration on tribological behavior of MMT/Epoxy nanocomposite.
Numerous studies have investigated the material properties of clay/polymer nanocomposites, such as their fracture toughness, elastic modulus, and hardness. However, only a few researchers have studied the tribological properties of clay/polymer nanocomposites. This study investigated the effect of the montmorillonite (MMT) concentration on the tribological behavior of MMT/epoxy nanocomposites. Wear tests were performed on MMT/epoxy nanocomposites with four different clay concentration levels to characterize the improvement in wear behavior due to the MMT concentration. In order to examine the tribological mechanism depending on the clay concentration level, SEM analysis was performed on the worn surfaces after the wear tests. The results showed that the friction coefficient of an MMT/epoxy nanocomposite with a low MMT concentration was larger than that of a nanocomposite with a high MMT concentration. It is believed that the phenomena occur due to the action of MMT as a reinforcement and lubricant material and reduce the wear rate with increasing MMT concentration.


Does zinc oxide nanoparticles potentiate the regenerative effect of platelet-rich fibrin in healing of critical bone defect in rabbits?
Many encouraging studies confirmed the ability of Zinc Oxide Nanoparticles (ZnONPs) in accelerating bone growth and mineralization. The use of Platelet Rich-Fibrin (PRF) as a sole filling material for large segmental bone defects remains questionable. The objectives are to investigate the regenerative efficacy of autologous Platelet Rich-Fibrin (PRF) and Zinc Oxide Nanoparticles (ZnONPs) in repairing large segmental bone ulnar defects in a randomized controlled study in rabbits using computed tomographic interpretations. A 12 mm critical size defect was surgically induced in the ulna of 30 rabbits (n = 10/ group). In the control group, the defect was left empty. In the PRF group, the defect is filled with PRF. In the PRF/ZnONPs group, the defect is filled with PRF that was inoculated with 0.1 ml of 0.2% ZnONPs. Radiologic healing capacity was evaluated at the first, second, and third postoperative months. Statistical analysis showed significant differences in the radiologic healing scores between the groups (P = 0.000-0.0001) at all-time points (P = 0.000-0.047) during the study. Rabbits in the PRF/ZnONPs group showed the highest appreciable bone quality and quantity followed by the PRF group with high quantity but low bone quality meanwhile, rabbits in the control group showed minimal quantity but medium bone quality. Interestingly, the addition of ZnONPs to PRF can accelerate the healing of ulnar critical-size defects in rabbits.


The Relationship between Selected Motor Ability Determinants and Anthropometric Characteristics in Adolescent Athletes from Various Sport.
The main purpose of this study was to examine the relationship between speed, lower extremities explosive power, simple, and complex responses in adolescent athletes from various disciplines. Thirty nine athletes of 16.5 years old, N = 13 sprinters and jumpers, N = 13 soccer players, and N = 13 judokas participated in the experiment. Pearson correlations, a one-way ANOVA and an independent t-test for establishing differences between those three groups of athletes was applied. Additionally the Ward method of hierarchical cluster analysis also was applied. The strong correlation occurred between complex responses and speed; 20 m from standing and 20 m flying start (r = 0.62 and r = 0.65 respectively). In other cases, no strong association was found. The substantial differences between groups occurred in the 20 m run from flying start (t = 5.92) and standing triple jump (t = 4.16). The study indicates that adolescent athletes may need to be assessed differently to a certain extent, including sport specialization.


Comparison of patients with enterococcal bacteremia due to strains with and without high-level resistance to gentamicin.
Patients with enterococcal bacteremia due to strains with and without high-level gentamicin resistance (HLGR; MIC, > 2,000 mg/L) were compared. Between 1986 and 1991, there were 178 episodes of enterococcal bacteremia: 47 and 131 episodes, respectively, due to enterococcal strains with and without HLGR. Sixty-two, 57, and 59 episodes, respectively, were in patients with transient bacteremia (a single positive blood culture), bacteremia (two or more positive blood cultures), and polymicrobial bacteremia. Nosocomial bacteremia accounted for 61.7% and 51.1% of episodes due to strains with and without HLGR, respectively. All isolates were strains of Enterococcus faecalis except for 13 strains of Enterococcus faecium, 4 of Enterococcus avium, and 3 of Enterococcus durans. Although the mortality was slightly higher among patients infected with strains with HLGR than among those infected with strains without HLGR (38.3% vs. 30.5%, respectively), there was no statistical difference. The mortality rate was adversely affected by old age (P < .01) and rapidly and ultimately fatal underlying conditions (P < .001). The addition of gentamicin to the treatment regimens had no effect on mortality.


[Alcohol and pancreatic diseases].
The epidemiological correlation between the incidence of acute and chronic pancreatitis and the amount of alcohol intake is well known. In contrast to alcoholic cirrhosis, there appears to be no threshold above which alcohol intake is associated with an increased risk to develop pancreatitis, but instead the risk increases with increasing consumption of alcohol in a logarithmic fashion. The incidence of alcoholic pancreatitis has continuously increased in recent decades and exceeds the combined incidence from all other causes. In very recent years, this increase appears to slow down. The pathophysiology of acute alcoholic pancreatitis is not known in detail. Alcohol may directly damage the acinar cell or the ductal epithelium. The pathogenesis of chronic pancreatitis involves an increase of protein concentration in pancreatic secretion leading to protein precipitations which may finally form calculi. The pancreas-stone-protected may play a crucial role in the lithogenic process. Little is currently known about the influence of alcohol on motility and pressure in biliary and pancreatic ducts. The course of alcoholic pancreatitis is more progressive and severe compared with nonalcoholic pancreatitis and markedly depends on discontinuation of alcohol consumption. The incidence of pancreatic carcinoma has continuously increased during the last 20 years in industrialized countries. Although diagnosis has been improved, long-term survival continues to be dismal. Several epidemiological studies have shown that there is no major correlation between alcohol consumption and the risk to develop pancreatic carcinoma.