[The expression of RANTES interleukin 1beta and endotoxin in the effusion of secretory otitis media].
To study the protein expression of endotoxin, interleukin 1beta (IL-1beta) and regulated upon activation, normal T expressed and secreted (RANTES) in effusions of secretory otitis media and their roles in the pathogenesis of secretory otitis media. Seventy-two effusion samples were taken from 53 patients with secretory otitis media by tympanocentesis. After swabs they were taken for bacteria culture. Limulus amebocyte lysate (LAL) test was used to quantify the content of endotoxin, radioimmunoassay to analyze the level of IL-1beta and enzyme-linked immunosorbent assay (ELISA) to detect the concentration of RANTES. Endotoxin, IL-1beta and RANTES were detectable in 80.9%, 77.8% and 70.8% of middle ear effusion, with mean levels of (35.2 +/- 51.6) EU/ml, (1.10 +/- 0.84) microg/L and (0.52 +/- 0.43) microg/L respectively. All of them showed higher concentration in the mucoid-type effusions than those in the serous-type effusions (P<0.05). Higher levels of the endotoxin and RANTES (P<0.05) were found in longer course patients. The effusions with positive bacteria culture displayed more abundant endotoxin, IL-1beta and RANTES protein than those with negative culture. Significant correlations were found between endotoxin and IL-1beta (r = 0.74, P<0.01), also between IL-1beta and RANTES (r = 0.48, P<0.01). Endotoxin, IL-1beta and RANTES may take part in maintaining the inflammatory response in the tympanic cavity and stimulating mucin secretion. It indicates that they play an important role in the immune pathogenesis of secretory otitis media.


Renal Dysfunction Influences the Diagnostic and Prognostic Performance of High-Sensitivity Cardiac Troponin I.
Measures of cardiac troponin (cTn) may have lower specificity for myocardial infarction in patients with CKD. We examined the diagnostic accuracy of baseline and serial high-sensitivity cTnI (hs-cTnI) measurements for myocardial infarction and 30- and 180-day mortality according to renal function. hs-cTnI was measured (Abbott assay) using sex-specific 99th percentiles (women, 16 ng/L; men, 34 ng/L) in 1555 adults presenting to the emergency department with symptoms suggesting ischemia (NCT02060760). Myocardial infarction was adjudicated along universal definition classification. Renal function did not significantly affect sensitivity or negative predictive values. Specificity decreased with impaired renal function from 93%-95% with normal function (eGFR≥90 ml/min per 1.73 m2; n=722) to 57%-61% with severely impaired renal function (eGFR<30 ml/min per 1.73 m2; n=81) and 40%-41% on dialysis (n=78). Positive predictive values decreased with decreasing renal function from 51%-57% with normal function to 27%-42% with severely impaired function and 15%-32% on dialysis. Receiver operating characteristic curve areas trended lower at baseline and 3 hours with renal impairment. Mortality increased significantly with increasing hs-cTnI tertile (1.3%, 6.0%, and 10.4%, respectively). Patients with hs-cTnI concentration exceeding concentrations in the 99th percentiles had a mortality rate (11.7%) significantly higher than that of patients with concentrations between 99th percentile concentrations and limit of detection (6.2%) or below limit of detection (1.1%). Renal dysfunction and dialysis reduced the rule-in performance but not the rule-out performance of hs-cTnI for myocardial infarction, and mortality increased in patients with higher hs-cTnI concentrations and any level of renal dysfunction.


[Self-expanding cup CLS. 10 years results].
The CLS acetabular cup, is a hemispherical, self-expanding cementless cup. The CLS cup initial stability is achieved by expansion-shell. Secondary the bone, which grows on the surface of the titanium, over the durable stability. We report a retrospective study of 26 CLS cups. The mean follow-up was 134 months. Clinical results were evaluated by Merle d'Aubigne scale, witch revealed that 96% of the patients presented good or excellent results. Radiologically, 100% of cup showed stable fixation by bony without signs of aseptic loosening in all patients.


[The effect of calcium-regulating hormones on the renal transport of calcium in hypertension].
Enhanced and diminished calcemia following administration of parathormone and calcitonin in hypertensive patients, respectively, were found not to differ from relevant values in healthy subjects. Calciuretic effect of parathormone results from its action on the bone and renal calcium transport. Quantitatively, the effects on the bone and renal calcium transport. Quantitatively, the effects on the bone presenting as elevated calcemia and calcium filtration capacity, its excreted fraction and renal excretion prevail, being less pronounced in hypertensive patients. A direct renal effect of parathyroid hormone indicated by stimulation of calcium tubular reabsorption is weaker in hypertensive subjects. Calcitonin administration inhibits tubular calcium reabsorption in the less degree in hypertensive subjects. The disorders in calciuretic function of the kidney in hypertension are secondary to reduced kidney sensitivity to the action of calcium regulating hormones.


Cationic Moieties in Polystyrene Gels Swollen with d-Limonene Improved Transdermal Delivery System.
d-limonene, a terpene and natural compound, has been found to be an excellent penetration enhancer for transdermal drug delivery (TDD). It hence has been incorporated within various transdermal formulations. Herein, we report the application of polystyrene gel swollen with d-limonene and its derivatives for TDD. Poly(styrene-co-divinylbenzene) (PS gel), poly(styrene-co-divinylbenzene-co-4-vinylpyridine) (PS-4VP) gel and poly(styrene-co-divinylbenzene-co-(vinylbenzyl) trimethylammonium chloride) (PS-VBAC gel) were employed as chemical gels to improve the stability of the TDD substrates. The drug permeation properties from the PS gels swollen in limonene were examined, regarding the effect of its network density as well as their rheological properties. The lowest density of the network showed the highest steady flux of the permeation at 43.7 ± 0.3 μg/cm². FT-IR spectra were confirmed for PS-4VP and PS-VBAC, bearing cationic moieties and they could control the release of ibuprofen by the electrostatic interaction at the interface of organogel and skin. The steady state flux of skin permeation got low values from 55.2 ± 0.8 to 11.6 ± 2.0 μg/cm², when the cationic moieties were increased. Moreover, the chemical network of PS gel swollen in limonene showed high mechanical stability illustrated by elastic modulus (G') of about 98 kPa for 10% cross-linked PS gel. The developed PS gels swollen in limonene show highly promising results, suggesting their possible application in TDD.


Serum fructosamine measurement: a new diagnostic approach to renal glucosuria in dogs.
Measurement of serum fructosamine, 1-amino-1-deoxyfructose, is commonly used in diagnosing and monitoring hyperglycaemic disorders, such as diabetes mellitus in dogs. Serum fructosamine indicates long-term serum glucose concentrations and replaces serial serum glucose measurements. This study investigates the clinical usefulness of serum fructosamine in differentiating conditions other than diabetes mellitus characterised by glucosuria. Four dogs presented with glucosuria all had serum fructosamine concentrations within or close to the reference range (313 micromol 1(-1), 291 micromol 1(-1), 348 micromol 1(-1), 262 micromol 1(-1) reference range: 250 to 320 micromol 1(-1) indicating that a single serum fructosamine measurement is a simple and efficient way of verifying concurrent persistent normoglycaemia. Therefore, serum fructosamine is a useful parameter not only in diabetic patients, bu also in differentiating conditions in dogs characterised by glucosuria without hyperglycaemia, such as primary renal glucosuria and the Fanconi syndrome. To distinguish between primary renal glucosuria and the Fanconi syndrome, measurement of the amino acid concentration in urine was performed.


Stressful life experiences and risk of relapse of breast cancer: observational cohort study.
To confirm, using an observational cohort design, the relation between severely stressful life experiences and relapse of breast cancer found in a previous case-control study. Prospective follow up for five years of a cohort of women newly diagnosed as having breast cancer, collecting data on stressful life experiences, depression, and biological prognostic factors. NHS breast clinic, London; 1991-9. A consecutive series of women aged under 60 newly diagnosed as having a primary operable breast tumour. 202/222 (91%) eligible women participated in the first life experiences interview. 170 (77%) provided complete interview data either up to 5 years after diagnosis or to recurrence. Recurrence of disease. We controlled for biological prognostic factors (lymph node infiltration and tumour histology), and found no increased risk of recurrence in women who had had one or more severely stressful life experiences in the year before diagnosis compared with women who did not (hazard ratio 1.01, 95% confidence interval 0.58 to 1.74, P=0.99). Women who had had one or more severely stressful life experiences in the 5 years after diagnosis had a lower risk of recurrence (0.52, 0.29 to 0.95, P=0.03) than those who did not. These data do not confirm an earlier finding from a case-control study that severely stressful life experiences increase the risk of recurrence of breast cancer. Differences in case control and prospective methods may explain the contradictory results. We took the prospective study as the more robust, and the results suggest that women with breast cancer need not fear that stressful experiences will precipitate the return of their disease.


The cardiac beta2-adrenergic signalling a new role for the cPLA2.
The cardiac actions of catecholamines have long been attributed to the predominant beta(1)-AR subtype that couples to the classical Gs/AC/cAMP pathway. Recent research clearly indicates that cardiac beta(2)-ARs play a functional role in healthy heart and assume increasing importance in failing and aged heart. beta(2)-ARs are primarily coupled to an atypical compartmentalized cAMP pathway, regulated by phosphorylation and/or oligomerization of beta(2)-ARs, and under the control of additional beta(2)-AR/Gi-coupled lipidic pathways, the impact of which seems to vary depending on the animal species, the developmental and pathophysiological state. This review focuses, more especially, on one of the last identified beta(2)-AR/Gi pathway, namely the cPLA(2).


Haemophilus influenzae: an underrated cause of vulvovaginitis in young girls.
To establish the common pathogens associated with infective vulvovaginitis in young girls in the local population and to determine current management of this condition. A prospective laboratory based survey was carried out over 19 months. A questionnaire was then sent to local general practitioners and hospital doctors. One hundred and six swabs were received during the study period of which 43 (40.5%) yielded organisms recognised as causes of vulvovaginitis. The most common pathogen was group A beta haemolytic streptococcus (19), with Haemophilus influenzae the second most common (11). Candida was isolated on nine occasions. The users' questionnaire had an overall response rate of 52%. Forty one per cent of respondents nominated candida as the most common cause of this condition. Forty six per cent were aware that beta haemolytic streptococci caused juvenile vulvovaginitis, but only four (3.6%) knew that H influenzae was a possible pathogen. The most popular agent for empirical treatment of vulvovaginitis was topical clotrimazole cream, although 24 respondents (22%) prescribed antibiotics that are active against both group A beta haemolytic streptococci and H influenzae. Although H influenzae is the second most common infective cause of juvenile vulvovaginitis in the local population, most doctors managing these patients were unaware of its importance and may not be prescribing appropriate empirical treatment.


Passive treatment of acid mine drainage with high metal concentrations using dispersed alkaline substrate.
Passive treatment systems based on the dissolution of coarse calcite grains are widely used to remediate acid mine drainage (AMD). Unfortunately, they tolerate only low metal concentrations or acidity loads, because they are prone to passivation (loss of reactivity due to coating) and/or clogging (loss of permeability) by precipitates. To overcome these problems, a dispersed alkaline substrate (DAS) composed of a fine-grained alkaline reagent (calcite sand) mixed with a coarse inert matrix (wood chips) was developed. The small grains provide a large reactive surface and dissolve almost completely before the growing layer of precipitates passivates the substrate, whereas the dispersion of nuclei for precipitation on the inert surfaces retards clogging. Chemical and hydraulic performance of DAS was investigated in two laboratory columns fed at different flow rates with natural AMD of pH 2.3 to 3.5 and inflow net acidity 1350 to 2300 mg/L as CaCO(3). The DAS columns removed 900 to 1600 mg/L net acidity, 3 to 4.5 times more than conventional passive treatment systems. Regardless of the flow rate employed, Al, Fe(III), Cu, and Pb were virtually eliminated. Minor Zn, Ni, and Cd were removed at low flow rates. High acidity removal is possible because these metals accumulate intentionally in DAS, and their precipitation promotes further calcite dissolution. During 15 mo, DAS operated without clogging at 120 g acidity/m(2).d, four times the loading rate recommended for conventional passive systems; DAS may therefore be capable of treating AMD at sites where influent chemistry precludes the use of other passive systems.


Effect of amniotic membrane to reduce postlaminectomy epidural adhesion on a rat model.
Epidural fibrosis and adhesion are the main reasons for post-laminectomy sustained pain and functional disability. In this study, the authors investigate the effect of irradiated freeze-dried human amniotic membrane on reducing epidural adhesion after laminectomy on a rat model. A total of 20 rats were divided into two groups. The group A did not receive human amniotic membrane implantation after laminectomy and group B underwent human amniotic membrane implantation after laminectomy. Gross and microscopic findings were evaluated and compared at postoperative 1, 3 and 8 weeks. The amount of scar tissue and tenacity were reduced grossly in group of rats with human amniotic membrane implantation (group B). On a microscopic evaluation, there were less inflammatory cell infiltration and fibroblast proliferation in group B. This experimental study shows that implantation of irradiated freeze-dried human amniotic membrane reduce epidural fibrosis and adhesion after spinal laminectomy in a rat model.


Fine structure of the eggs of blowflies Aldrichina grahami and Chrysomya pacifica (Diptera: Calliphoridae).
We report here the fine structure of the eggs of blowflies Aldrichina grahami (Aldrich) and Chrysomya pacifica Kurahashi. For A. grahami, the plastron is wide and extends to almost the entire length of the eggs. The plastron near the micropyle is truncated. The polygonal patterns of chorionic sculpture bear a distinct swollen boundary. Regarding C. pacifica, the plastron is narrow and extends to almost the entire length of the eggs. The plastron near the micropyle bifurcates to a Y-shape, but the arms of the 'Y' are short. Information presented herein allows some distinctive features to differentiate among eggs of blowfly species.


Small interfering RNA efficiently suppresses adhesion molecule expression on pulmonary microvascular endothelium.
Background. Adhesion molecules are known to influence postoperative organ function, they are hardly involved in the inflammatory response following the ischemia-reperfusion injury. We sought to investigate the potency of small interfering RNAs to suppress adhesion molecule expression in human pulmonary microvascular endothelial cells. Methods. Human lung microvascular endothelial cells were transfected with specific siRNA followed by a stimulation of the cells with an inflammatory cytokine. Adhesion molecule expression was determined by FACS-analysis, and reduction of intracellular mRNA was determined by qRT-PCR. Furthermore, the attachment of isolated neutrophils on the endothelial layer was determined after siRNA transfection. Results. In summary, siRNA transfection significantly decreased the percentage positive cells in a single cocktail transfection of each adhesion molecule investigated. Adhering neutrophils were diminished as well. Conclusion. siRNA might be a promising tool for the effective suppression of adhesion molecule expression on pulmonary microvascular cells, potentially minimizing leukocyte-endothelial depending interactions of a pulmonary allograft.


[Anatomy of the interosseous and lumbrical muscles of the hand].
After anatomic dissections and cross section studies the authors gives detailed descriptions of the insertions of the dorsal and palmar interossei muscles and of the lumbrical muscles. For each anatomic structure the different terms used in the literature are recalled. The exact typographic relations of the interossei muscles at the level of the metacarpophalangeal and the proximal interphalangeal joints are described.


Truth or fiction: risk factors for childhood atopic dermatitis.
Atopic dermatitis is increasing in prevalence throughout the developed world, in parallel with asthma and hay fever. The reasons for the increase remain unclear. As a practical question, it is valuable to understand which interventions might decrease risk for childhood atopic disease. Prospective studies among infants and children are challenging to design and to execute. Fortunately, several large studies from Europe and the United States are better characterizing whether behavioral interventions such as breastfeeding, delayed introduction of solid foods, hydrolyzed protein infant formulas, or pets in the home might be protective or impart increased risk of developing atopic dermatitis. As this body of literature grows, physicians will be able to recommend behavioral interventions that can prevent atopic dermatitis in individuals and ideally decrease prevalence over the population.


Functional brain connectivity in resting-state fMRI using phase and magnitude data.
The output of BOLD fMRI consists of a pair of magnitude and phase components. While the magnitude data has been widely accepted for brain function analysis, we can also make use of the phase data (unwrapped) since this is a good representation of the internal magnetic field. In this work, we discuss the use of fMRI phase data for brain function analysis. The fMRI phase data taken from 100 subjects are preprocessed using standard SPM approaches. Group independent component analysis (ICA) is applied to the magnitude and phase data separately. We then compare the spatial patterns for both magnitude and phase data using an empirical spatial smoothing procedure. We also evaluate the magnitude and phase functional network connectivity (FC) matrices. We observed the positive/negative correlation-balanced functional connectivity in phase data, which is distinct from the positive correlation prevalence in magnitude data. The phase FC (pFC) structure is quite different from the magnitude FC (mFC) in functional clusters (on-diagonal blocks or cliques) and inter-cluster couplings (off-diagonal blocks). Methods since both the magnitude and phase data of the fMRI signals are generated from the same magnetic source, either can be useful for brain function analysis from different perspective (per different measurements). Herein, we report on making use of resting-state fMRI phase data for brain functional analysis in comparison with magnitude data. This exploration in phase fMRI may provide a new arena for more comprehensive brain function analysis.


Blautia-a new functional genus with potential probiotic properties?
Blautia is a genus of anaerobic bacteria with probiotic characteristics that occur widely in the feces and intestines of mammals. Based on phenotypic and phylogenetic analyses, some species in the genera Clostridium and Ruminococcus have been reclassified as Blautia, so to date, there are 20 new species with valid published names in this genus. An extensive body of research has recently focused on the probiotic effects of this genus, such as biological transformation and its ability to regulate host health and alleviate metabolic syndrome. This article reviews the origin and biological characteristics of Blautia and the factors that affect its abundance and discusses its role in host health, thus laying a theoretical foundation for the development of new functional microorganisms with probiotic properties.


Transatlantic comparison of the competence of surgeons at the start of their professional career.
Although the objective in European Union and North American surgical residency programmes is similar-to train competent surgeons-residents' working hours are different. It was hypothesized that practice-ready surgeons with more working hours would perform significantly better than those being educated within shorter working week curricula. At each test site, 21 practice-ready candidate surgeons were recruited. Twenty qualified Canadian and 19 qualified Dutch surgeons served as examiners. At both sites, three validated outcome instruments assessing multiple aspects of surgical competency were used. No significant differences were found in performance on the integrative and cognitive examination (Comprehensive Integrative Puzzle) or the technical skills test (Objective Structured Assessment of Technical Skill; OSATS). A significant difference in outcome was observed only on the Patient Assessment and Management Examination, which focuses on skills needed to manage patients with complex problems (P < 0.001). A significant interaction was observed between examiner and candidate origins for both task-specific OSATS checklist (P = 0.001) and OSATS global rating scale (P < 0.001) scores. Canadian residents, serving many more working hours, perform equivalently to Dutch residents when assessed on technical skills and cognitive knowledge, but outperformed Dutch residents in skills for patient management. Secondary analyses suggested that cultural differences influence the assessment process significantly.


[Traffic accidents in obstructive sleep apnea patients and effect of nasal CPAP treatment].
We studied the traffic accident rates and daytime sleepiness in obstructive sleep apnea syndrome (OSAS) patient, and evaluated the effectiveness of long-term nasal CPAP treatment. Traffic accidents were observed in 42% of 14 male OSAS patients (46 +/- 7 years old) and near-miss accidents were also observed in 64% during the past three years. Stanford Sleepiness Scale showed 4.7 +/- 1.0, suggesting marked excessive daytime sleepiness (EDS). During NCPAP treatment for 11 +/- 9 months, no traffic and near-miss accidents were reported. After NCPAP treatment, SSS decreased to 2.0 +/- 0.8, and the score of Uchida-Kraeplin test for the evaluation of working ability increased significantly. These results suggest the improvement of EDS and working ability following NCPAP treatment. We conclude that OSAS patients have the tendency of daytime sleepiness and high traffic accidents rates, and NCPAP treatment is effective to improve such problems.


Magnetic resonance images of 91 children with different causes of short stature: pituitary size reflects growth hormone secretion.
In order to validate an association between pituitary size and severity of growth hormone deficiency (GHD) we evaluated the magnetic resonance images (MRI) of 107 children with different causes of short stature. Ninety-one MRIs were evaluable (64 male, 27 female; age: 9.1 +/- 3.9 years). The levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3), and tests of GH stimulation and spontaneous secretion, led to the following subgroups: severe isolated GHD (SIGHD) (GH < 7 ng/ml) (n = 21); partial, isolated GHD (GH 7-10 ng/ml) (n = 22); multiple pituitary hormone deficiency (MPHD) (n = 13); neurosecretory dysfunction (n = 10); non-classifiable diagnosis (NC) (n = 13); idiopathic short stature (n = 9); and intra-uterine growth retardation (n = 3). Pituitary height (PHT) was measured and hypoplasia was assumed when PHT was < -2 SDS. An ectopic posterior pituitary with missing stalk and a hypoplastic anterior pituitary was present in 12 (57%) SIGHD cases, 12 (92%) MPHD cases and 1 patient from the NC group. An isolated hypoplastic anterior pituitary was observed in 15%-33% of the other groups. PHT (mm; mean, SD) in MPHD (1.7 +/- 0.5) was lower than in SIGHD (2.7 +/- 1.0, P < 0.05), with PHT of both groups being lower than in all the other groups (3.8 +/- 0.9, P < 0.0001). PHT SDS correlates with IGF-I SDS (r = 0.48, P < 0.0001), IGFBP-3 SDS (r = 0.46, P < 0.0001) and the highest peaks in tests of GH stimulation and GH spontaneous secretion (r = 0.36, P < 0.0001). In contrast to all the other groups, no correlation with age was observed in MPHD and SIGHD. Breech delivery was recorded in up to 26% of patients in all seven groups. Surprisingly, only 1 out of 23 patients with an ectopic posterior pituitary was born by breech delivery, suggesting that ectopia of the posterior lobe is not necessarily related to breech delivery. PHT is significantly correlated with GH secretion in several types of short stature. Patients with ectopic posterior pituitary, missing stalk and hypoplastic anterior pituitary either suffer from SIGHD or MPHD, and this anatomical defect is not necessarily related to breech delivery.


Development of metabotropic glutamate receptor-mediated synaptic inhibition.
Modulation of hippocampal CA3-CA1 synaptic transmission during metabotropic glutamate receptor (mGluR) activation was investigated in juvenile (postnatal day (P) 15-21) and young adult rats (P28-35). The mGluR agonist 1S,3R-aminocyclopentane-1,3-dicarboxylic acid (ACPD) depressed the EPSP slope more in young adults than juveniles. ACPD increased paired-pulse facilitation (PPF) at both ages. The group I mGluR antagonist (+)-alpha-methylcarboxyphenylglycine (MCPG) inhibited the ACPD-mediated depression of the EPSP slope and completely blocked the increase in PPF only in young adults. Minimal effects of MCPG on ACPD-dependent synaptic depression were observed in juveniles. These data suggest that presynaptic group I mGluR-mediated synaptic inhibition increases across late postnatal development. In addition, other mGluR subtypes, with the ability to depress presynaptic function, appear to be present in juveniles.


Socio-economic characteristics of artificial insemination donor (AID) couples compared with matched population controls.
Socio-economic characteristics like education, occupation and religion may play a role when choosing or refraining from treatment by artificial insemination by donor (AID). From a cohort of 189 AID-patients, the socio-economic characteristics were established from the notes and a questionnaire that was sent to all patients to complete the available data. The response rate to the questionnaire was 83.6% (158 women). Data were compared with population controls that were matched for age and region. AID patients in this study had significantly lower educational and/or occupational levels than matched population controls and were significantly more religious.


Enzymes and genes of microbial autotrophy.
Ribulose 1,5-bisphosphate carboxylase/oxygenase and phosphoribulokinase are enzymes which are unique to, and essential for, the operation of the Calvin cycle. Biochemical and genetic studies of these enzymes in autotrophic bacteria are providing information on the evolution of autotrophy, regulation of CO2 assimilation and on the prospects of increasing plant productivity.


[Phacotrabeculectomy in patients with cataract and chronic open angle glaucoma, and patients with cataract and pseudoexfoliation glaucoma].
To compare the results obtained after phacotrabeculectomy followed by implantation of an intracapsular lens in patients with cataract and chronic open angle glaucoma, and patients with cataract and pseudoexfoliation open angle glaucoma. The retrospective study covered 55 eyes with cataract and glaucoma. In 28 eyes, chronic open angle glaucoma was diagnosed, and in 27--pseudoexfoliation glaucoma. In all cases, phacoemulsification of the opacified lens was carried out, a foldable intraocular lens was implanted in the capsule, and the trabeculum was removed by means of a punch. Visual acuity, intraocular pressure and the ratio of applied anti-glaucoma drugs were subject to the assessment. The observation period was 12 months. Within the COAG patient group, the average visual acuity prior to the surgery was 0.2+/-0.24, and after one year from the surgery it increased to 0.82+/-0.22. For PEX glaucoma patients, the values were respectively 0.3+/-0.25 before the surgery and 0.75+/-0.29 a year after it. Considerable reduction of the intraocular pressure was also achieved: in the COAG patients--from 19.51+/-3.8 mm Hg to 16.6+/-1.6 mm Hg, and in PEX glaucoma patients--from 22.28+/-5.18 mm Hg to 17.6+/-2.33 mm Hg one year after the surgery. Also, the quantity of anti-glaucoma drugs applied in the study groups was significantly reduced. The anti-glaucoma drug ratio in the COAG patients dropped from 1.8 to 0 after the surgery, and in the PEX glaucoma patients--from 2.3 to 0.3. Phacotrabeculectomy is an efficient and safe surgical method, to be recommended for patients both with primary open angle glaucoma and with pseudoexfoliation glaucoma.


A crucial role for exopolysaccharide modification in bacterial biofilm formation, immune evasion, and virulence.
Biofilms play an important role in many chronic bacterial infections. Production of an extracellular mixture of sugar polymers called exopolysaccharide is characteristic and critical for biofilm formation. However, there is limited information about the mechanisms involved in the biosynthesis and modification of exopolysaccharide components and how these processes influence bacterial pathogenesis. Staphylococcus epidermidis is an important human pathogen that frequently causes persistent infections by biofilm formation on indwelling medical devices. It produces a poly-N-acetylglucosamine molecule that emerges as an exopolysaccharide component of many bacterial pathogens. Using a novel method based on size exclusion chromatography-mass spectrometry, we demonstrate that the surface-attached protein IcaB is responsible for deacetylation of the poly-N-acetylglucosamine molecule. Most likely due to the loss of its cationic character, non-deacetylated poly-acetylglucosamine in an isogenic icaB mutant strain was devoid of the ability to attach to the bacterial cell surface. Importantly, deacetylation of the polymer was essential for key virulence mechanisms of S. epidermidis, namely biofilm formation, colonization, and resistance to neutrophil phagocytosis and human antibacterial peptides. Furthermore, persistence of the icaB mutant strain was significantly impaired in a murine model of device-related infection. This is the first study to describe a mechanism of exopolysaccharide modification that is indispensable for the development of biofilm-associated human disease. Notably, this general virulence mechanism is likely similar for other pathogenic bacteria and constitutes an excellent target for therapeutic maneuvers aimed at combating biofilm-associated infection.


[Results of surgical treatment of patients with subhepatic cholestasis of non-tumor etiology].
There were studied the results, termed from 12 to 24 months, of operatively treated patients for subhepatic cholestasis of nontumoral etiology. The general clinical examination, ultrasonographic investigation were performed to the patients, as well as morphological changes estimation in hepatic fine-needle biopsies samples, biochemical indices and the state of systemic hepatic blood circulation. Application of complex staged operative interventions, added by hepatoregenerative operations, have had favored normalization of laboratory indices and structural hepatic changes as well as the hepatic blood supply improvement due to systolic inflow enhancement by 26% and microcirculatory bed blood circulation -- by 51%.


Intracranial Dural Arteriovenous Fistulas With Brainstem Engorgement: An Under-Recognized Entity in Diagnosis and Treatment.
Background: In rare circumstances, patients with intracranial (dural arteriovenous fistulas) DAVFs could be complicated with brainstem engorgement, which might lead to delayed or false diagnosis and subsequent improper management. Methods: On July 2th, 2019, a systematic search was conducted in the PubMed database for patients with intracranial DAVFs complicated with brainstem engorgement. Results: Sixty-eight articles reporting of 86 patients were included for final analysis. The patients were aged from 20 to 76 years (57.10 ± 12.90, n = 82). The female to male ratio was 0.68 (35:51). Thirty-three (40.2%, 33/82) patients were initially misdiagnosed as other diseases. The specific location distributions were cranio-cervical junction, cavernous sinus, superior petrosal sinus, transverse and/or sigmoid sinus, tentorium, and other sites in 27 (32.5%), 11 (13.2%), 9 (10.8%), 10 (12.0%), 21 (25.3%), and 5 (6.0%) patients, respectively. The Cognard classification of DAVFs were II, III, IV, and V in 9 (10.7%, 9/84), 1 (1.2%, 1/84), 1 (1.2%, 1/84), and 73 (86.9%, 73/84) patients. Eighteen (22%, 18/82) patients were demonstrated to have stenosis or occlusion of the draining system distal to the fistula points. The mean follow-up period was 7.86 (n = 74, range 0-60 months) months. Fifty-four (70.1%, 54/77) patients experienced a good recovery according to the mRS score. Conclusions: Intracranial DAVFs complicated with brainstem engorgement are rare entities. Initial misdiagnosis and delayed definite diagnosis are common in the past three decades. The treatment outcome is still unsatisfactory at present. Early awareness of this rare entity and efficiently utilizing the up to date investigations are of utmost importance.


The Effectiveness and Safety of Botulinum Toxin Injections for the Treatment of Congenital Muscular Torticollis.
Botulinum toxin have been used to treat congenital muscular torticollis for the last 25 years; however, few studies have been published with only limited cases and short-term follow-up. The aim of the present study is to systematically review the effectiveness and safety of botulinum toxin injections for congenital muscular torticollis by analyzing these relevant literatures. The authors searched PubMed, Web of Science, EMBASE, Cochrane Library, China Biology Medicine, for all articles about botulinum toxin injections for the congenital muscular torticollis. The MINORS evaluation tool was adopted to evaluate the quality of these studies. Meta-analysis calculations are made by R software 3.6.2. This study search involved strict inclusion criteria and targeted data collection. Ten studies were included, with a total of 411 patients, comprising 1 non-randomized experimental study and 9 cases or case series. The results of our meta-analysis of single rate showed that the overall effective rate of botulinum toxin for congenital muscular torticollis was 84% (95% confidence interval [CI] 67%-96%). After botulinum toxin treatment, the conversion rate to surgery was 9% (95% CI 4%-22%), and the adverse reaction rate was 1% (95% CI 0%-3%). The most common adverse reactions among these included studies involve injection site erythema and transient dysphagia. Current evidence shows that botulinum toxin injections for the treatment of congenital muscular torticollis is safe and effective, with few serious adverse reactions. Further well-designed, larger randomized trials are warranted.


Association of single nucleotide polymorphisms in adiponectin and its receptor genes with polycystic ovary syndrome.
To examine the possible association of adiponectin (ADIPOQ), adiponectin receptor (ADIPOR1/2) gene polymorphisms with polycystic ovary syndrome (PCOS) and their influence on insulin resistance in Japanese women with PCOS. Six single nucleotide polymorphisms (SNPs) in ADIPOQ and ADIPOR1/2 were genotyped in 59 infertile Japanese women with PCOS and 97 healthy Japanese controls. In addition, the association between the genotype and allele frequencies of these SNPs and the clinical phenotypes was analyzed in PCOS patients. There was no significant difference in the genotype and allele frequencies of the 6 SNPs between PCOS patients and controls. In the PCOS group, women with the GG genotype of 45T > G of ADIPOQ had a significantly higher score in the homeostasis model assessment for insulin resistance, fasting blood sugar and insulin level than those with other genotypes. Furthermore, a statistically significant difference in the genotype frequency of 45T > G polymorphism was observed between PCOS subjects with insulin resistance (n = 38) and controls (p = 0.011). The 6 SNPs of ADIPOQ and ADIPOR1/2 were not associated with a risk of PCOS. However, the 45T > G SNP in the ADIPOQ may be related to insulin resistance in Japanese women with PCOS.


A1/A2-Diamino-Substituted Pillar[5]arene-Based Acid-Base-Responsive Host-Guest System.
An acid-base-responsive supramolecular host-guest system based on a planarly chiral A1/A2-diamino-substituted pillar[5]arene (1)/imidazolium ion recognition motif was created. The pillar[4]arene[1]diaminobenzene 1 can bring an electron-deficient imidazolium cation into its cylindrically shaped cavity under neutral or basic conditions and release it under acidic conditions.


Dissociation kinetics of bivalent ligand-immunoglobulin E aggregates in solution.
We study the dissociation of preformed bivalent ligand-bivalent receptor aggregates in solution, where the ligand is a symmetric bivalent hapten with two identical 2,4-dinitrophenyl (DNP) groups and the receptor is a fluorescein-labeled monoclonal anti-DNP IgE. We promote dissociation in two ways: by the addition of high concentrations of a monovalent hapten that competes for IgE binding sites with the bivalent hapten and by the addition of high concentrations of unlabeled IgE that binds almost all ligand binding sites that dissociate from labeled IgE. We investigate both theoretically and experimentally the two types of dissociation and find them to be quite different. Theory predicts that their kinetics will depend differently on the fundamental rate constants that characterize binding and aggregation. Using monovalent ligand to promote dissociation, we find that the fraction of labeled IgE sites bound to bivalent ligand decays with a slow and fast component. The fast decay corresponds to the dissociation of a singly bound DNP hapten. The interpretation of the slow decay depends on the detailed way in which ligand-receptor aggregates break up. We show that one possible explanation of these data is that small stable rings form before the addition of monovalent ligand. Other possible explanations are also presented.


[The Japanese version of the Calgary Depression Scale for Schizophrenics (JCDSS)].
Depressive features are clearly recognized within the context of schizophrenia, and clarification of the comorbidity has important clinical implications particularly when choosing the best neuroleptics for treatment. However, in some cases, it is difficult to clearly distinguish between depressive symptoms, negative symptoms and extrapyramidal side-effects. Conventionally, the Zung's Self-Rating Depression Scale or Hamilton's Depression Rating Scale has been used as an evaluation scale of depressive symptoms. However, as these scales are designed for assessment of depression in non-psychotic populations, they do not necessarily distinguish depressed from non-depressed psychotic subjects. Recently, Addington et al. developed a new depression scale, the Calgary Depression Scale for Schizophrenics(CDSS), which was designed for the assessment of depression in schizophrenia. CDSS is a nine item structured interview scale, in which each item has a four point measure, each point anchored by descriptors. It has been tested, and it has been shown that there is no overlap with negative or extrapyramidal symptoms. Therefore, for its clinical application, we prepared the Japanese-language version(JCDSS).


Lessons learned from clinical phenotypes in early psoriatic arthritis: the real-world Dutch south west Early Psoriatic ARthritis study.
Objective: This paper describes the baseline demographics, clinical characteristics, and patient-reported outcomes (PROs) according to clinical phenotype of patients with early psoriatic arthritis (PsA) for the purpose of creating a decision support system for daily clinical practice.Method: Patients with newly diagnosed PsA were included in the Dutch south west Early Psoriatic ARthritis (DEPAR) study. No classification criteria were applied, to ensure collection of real-world data on demographics, medication, clinical characteristics, and PROs. An IT infrastructure facilitated data collection.Results: We described 527 patients, categorized according to the clinical phenotype stated by the rheumatologist at the time of diagnosis, namely monoarthritis (15%), oligoarthritis (40%), polyarthritis (23%), enthesitis (10%), axial disease (2%), and dactylitis (10%). Overall psoriasis severity was mild and 83 patients (16%) had no psoriasis. Short-term sick leave (> 1 day per 4 weeks) was 17% and long-term sick leave (> 4 weeks) was 4%. The group with phenotype enthesitis reported the longest duration of complaints, had the highest fatigue scores, and contained the highest percentage of patients with a Hospital Anxiety and Depression Scale (HADS) anxiety score ≥ 8 and depression score ≥ 8.Conclusion: PsA patients presenting at outpatient clinics in the Netherlands had a mild degree of psoriasis, with impairment of quality of life and work productivity. Most patients presented with phenotype oligoarthritis. Those presenting with phenotype enthesitis more often reported scores suggestive of an anxiety or depression disorder and fatigue. It is important for attending rheumatologists to be aware of these differences when assessing patients with PsA.


ESWL and gallstone dissolution with MTBE via a naso-vesicular catheter.
Endoscopic placement of a naso-vesicular catheter was successful in 90% (45/50) of patients with cholecystolithiasis. The first 7 patients were treated by MTBE dissolution alone. Dissolution was discontinued after a maximum of 14 days, as only two patients were rendered stone free. In one patient, 3 tiny pigment stones were sucked out through the catheter, and in another inoperable patient a pigtail endoprosthesis was finally inserted into the gallbladder. In the remaining 36 patients, combined ESWL and MTBE dissolution therapy was carried out. Treatment was broken off by one patient after one week, and interrupted in another due to catheter dislodgement. After an average of 10 days with 1-9 ESWL sessions (average: 3) complete stone clearance was achieved in 60% (20/34) of patients. Fourteen of the patients who completed treatment, and the one with catheter dislodgement still have sludge in the gallbladder, which is being treated with oral bile acids. The procedure-related complication rate was 10% (3 pancreatitis, 1 cystic duct perforation and 1 guidewire impaction). The mortality rate was zero. There was no evident complication due to either ESWL or MTBE dissolution.


Effect of heparin on oestradiol-induced cell growth and proliferation in the uterus of ovariectomized rats.
The aim of this study was to examine the role of heparin in the realization of oestradiol (OE2) effects in the uterus. Ovariectomized rats were treated with a single injection of OE2 dipropionate (10 micrograms/rat, i.m.) along with injections of heparin (in doses of 0.4 mg/rat, i.m.). OE2 effects in the uterus were determined by measuring mitotic indices, proliferating cell nuclear antigen (PCNA)-labelling indices, DNA content, and volumes of cells, nuclei and nucleoli in luminal and glandular epithelia and stromal cells of the endometrium 24, 36 and 48 h after the injection of OE2. Heparin treatment inhibited the OE2-stimulated increase in mitotic activity and DNA content of the uterine structures, whereas OE2-induced increases in cell, nucleus and nucleolus volumes in all uterine structures tested at all the times were greatly augmented by heparin. The OE2-induced increase in PCNA-labelling index in all the cell types had a tendency to increase as the result of heparin action. In the absence of OE2, heparin had no effect on any of the uterine parameters. The effect of heparin is probably realized via changes in the mechanism of oestrogen action in the uterus. Heparin probably prevents passage of the cells from the G1- to the S-phase of the cell cycle and prolongation of the G1-phase with consequent accumulation of the cells in this phase of the cell cycle. This probably leads to reduction of mitotic activity. Furthermore, cells in G1-phase probably prolong their biosynthetic processes causing enlargement of the cell, nucleus and nucleolus volumes.


Differences in immunoregulatory T cell circuits between diphenylhydantoin-related and spontaneously occurring systemic lupus erythematosus.
We studied T cell surface markers, concanavalin A-induced, and spontaneously expanded suppressor cell function and the functions of postthymic precursor (Tar) cells in 3 patients with diphenylhydantoin (DPH)-related systemic lupus erythematosus (SLE). The findings were compared with those in 6 patients with spontaneously occurring SLE, 3 with active and 3 with inactive disease as well as with those in 3 normal volunteers. All 4 groups were age and sex matched. Findings were also compared to studies made in a group of 32 untreated idiopathic SLE patients and 32 normal controls. All T cell markers and immunoregulatory functions were normal in the DPH-treated SLE patients whereas all groups of patients with spontaneously occurring SLE had low numbers of t gamma cells, and Tar cells, and decreased concanavalin-A and spontaneously expended suppressor, human feedback inhibition and generation of suppression functions. Since consanguineous relatives of patients with spontaneously occurring SLE have been shown to have decreased suppressor cell function and patients with long-inactive spontaneous SLE continue to have defects in their T cell circuits, our findings may indicate that, in patients who develop SLE upon DPH intake the lupus diathesis uncovered by the drug probably resides in a site of immunoregulation different from that involved in spontaneously occurring lupus.


Extended electrochemical windows made accessible by room temperature ionic liquid/organic solvent electrolyte systems.
The electrochemical windows of acetonitrile solutions doped with 0.1 M concentrations of several ionic liquids were examined by cyclic voltammetry at gold and platinum microelectrodes. These results were compared with those observed in the commonly used 0.1 M tetrabutylammonium perchlorate/acetonitrile system as well as with neat ionic liquids. The use of a trifluorotris(pentafluoroethyl)phosphate-based ionic liquid, specifically, as supporting electrolyte in acetonitrile solutions affords a wider anodic window, which is attributed to the high stability of the anionic component of these intrinsically conductive and thermally robust compounds.


Inhibition of SF3b1 by pladienolide B evokes cycle arrest, apoptosis induction and p73 splicing in human cervical carcinoma cells.
Pladienolide B is a potent cancer cell growth inhibitor that targets the SF3b1 subunit of the spliceosome. There is considerable interest in the compound as a tool to study SF3b1 function in cancer. However, so far little information is available on the molecular mechanism of SF3b1 eliciting apoptosis in cancer cells. Here, we investigated the molecular mechanism of SF3b1 eliciting apoptosis in human cervical carcinoma cells. We demonstrated that inhibition of SF3b1 by pladienolide B inhibited proliferation of HeLa cells at low nanomolar concentrations in a dose- and time-dependent manner. It also induced G2/M phase arrest and significant rise of apoptotic cells. Moreover, it is indicated that inhibition of SF3b1 by pladienolide B induced Tap73/ΔNp73 expression and consequently down-regulated Bax/Bcl-2 ratio, cytochrome c release and caspase-3 expression. Thus, our results showed that SF3b1 plays a pivotal role in cycle arrest, apoptosis induction, and p73 splicing in human cervical carcinoma cells, suggesting that SF3b1 could be used as a potential candidate for cervical cancer therapy.


Modeling General and Specific Abilities: Evaluation of Bifactor Models for the WJ-III.
The present study examined issues related to structural modeling of abilities by the use of simulated data as well as analysis of the standardization data from the Woodcock-Johnson-III. In both cases, results were evaluated with cross-validation. Simulation results showed that cross-validation with an independent data set was more successful in identifying the model that was used to generate test scores than were several fit indices. Analysis of the Woodcock-Johnson-III standardization data with cross-validation showed that bifactor models provided better fit than hierarchical or correlated factor models. This was true considering both fit indices and cross-validation. General and specific factors shared a considerable amount of variance as evaluated by using the bifactor models to partition variance. The results of the present study suggest that there is a certain degree of ambiguity in determining the exact amount of covariance in test performance accounted for by general and specific factors. This calls in to question the practice of adjusting or controlling for general abilities when evaluating measures of specific abilities. Evidence for the validity of a construct should not be limited to factor analysis of tests purported to measure that construct.


Microwave-assisted sample preparation for rapid and sensitive analysis of H. pylori lipid A applicable to a single colony.
The lipid A of Gram-negative bacteria plays a major role in the pathogenesis of bacterial infections. Lipid A diversity is observed both in the number and length of fatty-acid side chains and in the presence of terminal phosphate residues and associated modifications. In this report, we describe a new sample preparation method based on microwave-assisted enzymatic digestion and detergent-free mild hydrolysis, in conjunction with a MALDI-time-of-flight (TOF)/TOF analysis, to determine the structures of lipid A from Helicobacter pylori. The total time for sample preparation and mass spectrometric analysis is within 2 h and applicable to profiling the lipid A structures from dried bacterial cells on as little as 1 microg. The reliability of the technique was further demonstrated through the analysis of the lipid A from bacterial cells of different H. pylori strains. The phosphorylation and acylation patterns of lipid A could be elucidated using material from a single colony. Furthermore, we found unusual heptaacyl lipid A species present in H. pylori mutant that have not been previously reported, although the abundance was relatively low. The present study provides the first characterization of the lipid A component from a single bacterial colony sample by mass spectrometry.


Obstetrician-gynecologists' knowledge of sickle cell disease screening and management.
Although obstetrician/gynecologists (OB/GYNs) play an important role in sickle cell disease (SCD) screening and patient care, there is little information on knowledge of SCD or sickle cell trait (SCT) or related practices in this provider group. Our objective was to assess SCD screening and prenatal management practices among OB/GYNs. Twelve hundred Fellows and Junior Fellows of the American College of Obstetricians and Gynecologists (the College)a were invited to complete a mailed survey, of which half (n = 600) belonged to the Collaborative Ambulatory Research Network.b Participants answered questions regarding appropriate target patient groups for prenatal SCD screening, folic acid requirements, practice behaviors and adequacy of their medical school and residency training. A total of 338 CARN members (56.3%) and 165 non-CARN members (27.5%) returned a survey. Of the 503 responders, 382 provided obstetric services and were included in the analyses. Forty percent of these respondents (n = 153) reported seeing at least 1 patient with SCD in the last year. Of these, 97.4% reported regularly screening people of African descent for SCD or SCT, whereas 52.9% reported regularly screening people of Mediterranean descent and 30.1% reported regularly screening people of Asian descent. Only 56.2% knew the correct recommended daily dose of folic acid for pregnant women with SCD. The proportion of respondents that rated training on SCD screening, assessment and treatment as barely adequate or inadequate ranged from 19.7% to 39.3%. The practice of many OB/GYNs who care for patients with SCD are not consistent with the College Practice Guidelines on the screening of certain target groups and on folic acid supplementation. There may be an opportunity to improve this knowledge gap through enhanced medical education.


High-Selectivity Bandpass Filter with Controllable Attenuation Based on Graphene Nanoplates.
A high-selectivity band pass filter with controllable attenuation based on graphene nanoplates is proposed in this paper. Graphene with controllable resistance has a good uniform attenuation effect to electric field intensity. The filter utilizes quarter wavelength stepped impedance resonators and mixed electromagnetic coupling to have compact circuits and high performance. The graphene nanoplates are loaded on the microstrip resonator to reduce the electric field intensity, which results in a flat attenuation in the passband. In addition, the filter has two transmission zeros, which lead to a strong selectivity. Finally, a high-selectivity bandpass filter with controllable attenuation is formed. By changing the bias voltage of graphene, a controllable attenuation of 1.64-11.13 dB can be achieved in the working passband centered at 1.36 GHz. In order to validate the concept, the prototype is fabricated and measured. The measurement results are in good agreement with the simulation results. The proposed high-selectivity bandpass filter with controllable attenuation based on graphene nanoplates has widely potential in reconfigurable wireless communication systems and radar systems due to its high integration and versatility.


Low growth temperature effects a differential inhibition of photosynthesis in spring and winter wheat.
In vivo room temperature chlorophyll a fluorescence coupled with CO(2) and O(2) exchange was measured to determine photosynthetic limitation(s) for spring and winter wheat (Triticum aestivum L.) grown at cold-hardening temperatures (5 degrees C/5 degrees C, day/night). Plants of comparable physiological stage, but grown at nonhardening temperatures (20 degrees C/16 degrees C, day/night) were used in comparison. Winter wheat cultivars grown at 5 degrees C had light-saturated rates of CO(2) exchange and apparent photon yields for CO(2) exchange and O(2) evolution that were equal to or greater than those of winter cultivars grown at 20 degrees C. In contrast, spring wheat cultivars grown at 5 degrees C showed 35% lower apparent photon yields for CO(2) exchange and 25% lower light-saturated rates of CO(2) exchange compared to 20 degrees C grown controls. The lower CO(2) exchange capacity is not associated with a lower efficiency of photosystem II activity measured as either the apparent photon yield for O(2) evolution, the ratio of variable to maximal fluorescence, or the level of reduced primary quinone electron acceptor maintained at steady-state photosynthesis, and is most likely associated with carbon metabolism. The lower CO(2) exchange capacity of the spring cultivars developed following long-term exposure to low temperature and did not occur following over-night exposure of nonhardened plants to 5 degrees C.


An interpretation of transference.
This paper offers an interpretation of the concept of transference. It begins with a re-examination of Socrates's therapeutic intent and Plato's revisions of psychological theory in the light of Socrates's failure. In particular, Plato devised an account of a structured psyche, a theory of fantasy, and a complex 'object-relations' theory, to explain dynamic interactions between psyche and social world. It is argued that these revisions embody a recognition of the phenomenon of transference, i.e. the psyche's characteristic activity of creating a meaningful world in which to live. Freud's early conception of transference--as a transfer of psychological content across space and time--is criticised on the ground that it assumes that the world is already given, independent of any psychic activity. Freud's later conception of transference as a repetition is then explored in the light of the psyche's ability to create artefacts. It is argued that neurotic transference is the unconscious attempt to create an idosyncratic polis, an idiopolis, in which to live. The resolution of the transference occurs because the analyst is made a citizen of the idiopolis, has learned the idiolect, and can speak in that idiolect of the fundamental conflicts within the idiopolis and their dynamic basis. A neurotic world cannot survive this internal recognition.


Sexually assaultive male juveniles: a follow-up.
The purpose of this study was to investigate the adult outcome of a group of male juveniles who committed sexual assault. Nineteen sexually assaultive male juveniles and a comparison group of 58 violent juveniles were studied over an 8-year period through use of criminal records and clinical interviews. Although in adolescence the two groups were similarly violent, on follow-up those who had committed sexual assault were significantly more likely to commit adult sexual offenses. They also committed significantly more violent nonsexual offenses. Childhood sexual abuse, especially by females, was associated with adult sexual offenses. Sexually assaultive delinquents are at particularly high risk for subsequent violence. Hence, special efforts must be made to treat these delinquents in adolescence. Prevention of violent sexual behavior must include improved methods of detecting sexual abuse, especially that perpetrated by older females.


[Immunodeficiency with thymoma (Good's syndrome) similar to sino-bronchial syndrome].
A 58-year-old man was admitted to our hospital because of recurrent pulmonary infections that began three years previously. Laboratory data showed hypogammaglobulinemia and a chest computed tomogram showed diffuse bilateral micronodular shadows and an anterior mediastinal tumor. Immunodeficiency with thymoma (Good's syndrome) was diagnosed. After undergoing a thymectomy, he received intravenous gamma-globulin injections once a month for prophylaxis. Good's syndrome occurs rarely in Japan. A solid tumor-like shadow is not necessarily observed in routine chest X-ray studies, and hypogammaglobulinemia is one sign of this syndrome. The hypogammaglobulinemia of Good's syndrome should be carefully differentiated from that of other immunodeficiency diseases such as common variable immunodeficiency, the acquired immunodeficiency syndrome, chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and multiple myeloma (non-secretory type).


Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease.
The objective of this study was to find the predictors and generate a prediction score of resistance to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD). Patients diagnosed as having KD were sampled when they received initial high-dose IVIG treatment (2 g/kg dose) within 9 days of illness (n = 320). These patients were divided into 2 groups: the resistance (n = 41) and the responder (n = 279). The following data were obtained and compared between resistance and responder: age, sex, illness days at initial treatment, and laboratory data. Multivariate logistic regression analysis identified age, illness days, platelet count, alanine aminotransferase (ALT), and C-reactive protein (CRP) as significant predictors for resistance to IVIG. We generated prediction score assigning 1 point for (1) infants less than 6 months old, (2) before 4 days of illness, (3) platelet count <or= 30 x 10(10)/L, (4) CRP >or= 8 mg/dL, as well as 2 points for (5) ALT >or= 80 IU/L. Using a cut-off point of 3 and more with this prediction score, we could identify the IVIG-resistant group with 78% sensitivity and 76% specificity. Resistance to IVIG treatment can be predicted using age, illness days, platelet count, ALT, and CRP. Randomized, multicenter clinical trials are necessary to create a new strategy to treat these high-risk patients.


Knudsen torque: a rotational mechanism driven by thermal force.
Thermally induced mechanical loading has been shown to have significant effects on micro- and nano-objects immersed in a gas with a nonuniform temperature field. While the majority of existing studies and related applications focus on forces, we investigate the torque, and thus the rotational motion, produced by such a mechanism. Our study has found that a torque can be induced if the configuration of the system is asymmetric. In addition, both the magnitude and the direction of the torque depend highly on the system configuration, indicating the possibility of manipulating the rotational motion via geometrical design. Based on this feature, two types of rotational micromotor that are of practical importance, namely pendulum motor and unidirectional motor, are designed. The magnitude of the torque at Kn=0.5 can reach to around 2nN×μm for a rectangular microbeam with a length of 100μm.


Cancer in adolescents and young adults: National incidence and characteristics in Japan.
Adolescents and young adults (AYA) with cancer are confronted with unique challenges in areas of paramount concern within their age group, such as fertility, education, career, and delayed and long-term effects of treatment. However, the extent and depth of the problem has never been examined in the Japanese population. The aim of this study was to describe the status of cancer patients in the AYA population, using data from the hospital-based cancer registry (HBCR). Patients included in the HBCR from January 2011 to December 2014 were included in this study to evaluate the incidence and cancer distribution trends among AYA. The total number and the proportion of AYA (15-39 years of age) stratified by sex, age, and cancer type were obtained. The incidence of age-specific cancer among AYA was also calculated. We identified 30,394 male (35.1%) and 56,100 female (64.9%) cancer patients in the population, which collectively constituted about 3% of all invasive cancer cases. The incidence of cancer in AYA was estimated as 86.2 per 100,000 per year, and increased with age. The most affected population was women between 35 and 39 years of age (35%). Breast cancer was the most common type of cancer, followed by cervical, uterine, and thyroid cancers. A substantial number of AYA are diagnosed with cancer every year. The distribution of cancer types in AYA was dependent on age and sex. These diversities in cancer types can inform researchers and policy makers to fine-tune their studies and policies.


The Impact of Preoperative Breast Magnetic Resonance Imaging on Surgical Management in Symptomatic Patients With Invasive Lobular Carcinoma.
Due to an insidious proliferative pattern, invasive lobular breast cancer (ILC) often fails to form a defined radiological or palpable lesion and accurate diagnosis remains challenging. This study aimed to determine the value of preoperative magnetic resonance imaging (MRI) for ILC and its impact on surgical outcomes. Consecutive symptomatic patients diagnosed with ILC in a tertiary centre over a 9-year period were reviewed. The time from diagnosis until surgery, initial type of surgery/index operation (breast-conserving surgery [BCS]/mastectomy) and the rates of reoperation (re-excision/completion mastectomy) were recorded. Patients were grouped into those who received conventional imaging and preoperative MRI (MR+) and those who received conventional imaging alone (MR-). There were 218 cases of ILC, and 32.1% (n = 70) had preoperative MRI. Time from diagnosis to surgery was longer in the MR+ than the MR- group (32.5 vs 21.1 days, P < .001) even when adjusting for age and breast density. Initial BCS was performed on 71.4% (n = 50) of MR+ patients and 72.3% (n = 107) of the MR- group. While the rate of completion mastectomy following initial BCS was higher in the MR+ group (30.0%, n = 15 vs 14.0%, n = 15; χ2 = 5.63; P = .018), this association was not maintained in multivariable analysis. No difference was recorded in overall (initial and completion) mastectomy rate between the MR+ and MR- group (50.0%, n = 35 vs 37.8%, n = 56; χ2 = 2.89; P = .089). Margin re-excision following BCS was comparable between groups (8.0%, n =4, vs 9.3%, n = 10; χ2 = 0.076, P = .783) despite the selection bias for borderline conservable cases in the MR+ group. The rate of usage of MRI for ILC cases declined over the study period. While MRI was associated with minor delays in treatment and did not reduce overall rates of margin re-excision or completion mastectomy, it altered the choice of surgical procedure in almost a quarter of MR+ cases. The benefit of preoperative breast MRI appears to be confined to select (younger, dense breast, borderline conservable) cases in symptomatic ILC.


The Onik method of automated percutaneous lumbar diskectomy (A.P.L.D.). Criteria of selection, technique, and evaluation of results.
The Onik method of automated percutaneous lumbar diskectomy is a new type of percutaneous surgery for the treatment of herniated lumbar disk. Candidates for this procedure should be carefully evaluated on the basis of precise clinical criteria and instrumental diagnosis. The goal is to select patients in whom excellent results can be achieved, recognizing the limitations as well as the merits of the technique. The surgical approach is described and the potential difficulties are discussed, since this technique must be performed with precision and without trauma in order to obtain good results. The clinical results of 500 patients treated by the Onik method of automated percutaneous lumbar diskectomy are reported. The follow-up period ranged from 6 months to 2 1/2 years. The patients were divided into three groups according to the strength of the indication for A.P.L.D.; the quality of the result is reported for each group.


Combinatorial coding of Drosophila muscle shape by Collier and Nautilus.
The diversity of Drosophila muscles correlates with the expression of combinations of identity transcription factors (iTFs) in muscle progenitors. Here, we address the question of when and how a combinatorial code is translated into muscle specific properties, by studying the roles of the Collier and Nautilus iTFs that are expressed in partly overlapping subsets of muscle progenitors. We show that the three dorso-lateral (DL) progenitors which express Nautilus and Collier are specified in a fixed temporal sequence and that each expresses additionally other, distinct iTFs. Removal of Collier leads to changes in expression of some of these iTFs and mis-orientation of several DL muscles, including the dorsal acute DA3 muscle which adopts a DA2 morphology. Detailed analysis of this transformation revealed the existence of two steps in the attachment of elongating muscles to specific tendon cells: transient attachment to alternate tendon cells, followed by a resolution step selecting the final sites. The multiple cases of triangular-shaped muscles observed in col mutant embryos indicate that transient binding of elongating muscle to exploratory sites could be a general feature of the developing musculature. In nau mutants, the DA3 muscle randomly adopts the attachment sites of the DA3 or DO5 muscles that derive from the same progenitor, resulting in a DA3, DO5-like or bifid DA3-DO5 orientation. In addition, nau mutant embryos display thinner muscle fibres. Together, our data show that the sequence of expression and combinatorial activities of Col and Nau control the pattern and morphology of DL muscles.


The Development of a Daily Comprehensive and Multidisciplinary Health Care Leadership Huddle.
Consistent and concise communication in a large health care organization that is geographically dispersed is a challenge. Issues often are not addressed with the appropriate individuals in the most timely and effective manner, which results in patient flow disruptions, service gaps, and provider and administrator frustration. This report describes the development of a daily leadership huddle with regional leadership and middle management to inform of daily operations, safety, quality, and service concerns, in order to allow for quicker action and issue resolution. Huddles have proven effective in organizations of similar size, but few organizations have attempted a multisite daily huddle. To ensure their success, key steps must be taken during the formation of daily leadership huddles, including buy-in from leaders and stakeholders at multiple levels. In our organization, the huddles have proven to be a forum for effective communication, quicker issue resolution, and an increased sense of camaraderie.


Predicting black light trap catch and flight activity of Acrosternum hilare (Hemiptera: Pentatomidae) adults.
A regression model was developed to predict the flight activity of Acrosternum hilare (Say) using data on the number of adults collected in a single black light trap located in Painter, VA, in the 18-yr period from 1990 to 2007. Eighteen initial weather variables, including cumulative precipitation over different time periods, mean monthly precipitation (PJA) and days below freezing (DFJA) from January to April, and mean monthly temperatures from December to April were tested in developing the regression model. Mixed (backward and forward) stepwise regression analysis showed that a two-variable model using PJA and DFJA was adequate for predicting the seasonal mean weekly number of A. hilare adults in the trap. Validation of the model using five independent black light trap data sets resulted in a strong correlation (r = 0.98) between observed and predicted mean weekly number of A. hilare adults caught in traps. Three peaks in flights of A. hilare adults were observed when mean trap catch was plotted over time for the 18-yr period. Peaks occurred at 319, 892, and 1,331 degree days (DD) from 1 January. Based on known developmental rates, the first peak was attributed to overwintered adults, the second to first-generation adults, and the third to a second generation of adults. This research suggests that A. hilare undergoes two complete generations in Virginia. Cumulative trap catch estimated from the 18-yr mean trap catch showed that 10, 50, and 90% of the total seasonal catch should occur by 153, 501, and 1,066 DD.


Upper respiratory tract secretions: pathophysiology.
Nasal fluid is a heterogeneous substance. It consists largely of a secretory product derived from the 100,000 small seromucous glands. The anterior part of the nose has a relatively high secretory capacity, but this does not seem to be caused by secretion from the 200 anterior serous glands. Compared to sputum, nasal secretion has a lower viscosity, but comparable spinability; it has a lower dry weight, and content of sulphate, sugars and most proteins, but a comparable level of albumin. Watery rhinorrhoea is mainly reflex-mediated. Watery, but not purulent nasal discharge can be reduced by the cholinoceptor antagonist, ipratropium, administered in a dose which matches the degree of the symptoms. It seems likely that the nose, in some respects, can serve as a model for the analysis of airway secretions, but a comparative study of nasal and of bronchial secretions sampled in an identical way is warranted.


The development of sequence-tagged sites for human chromosome 4.
As part of our efforts to construct a high-resolution physical map of human chromosome 4, we developed a systematic approach for efficiently generating large numbers of chromosome-specific sequence-tagged sites (STSs). In this paper, we describe how rate-limiting steps in our STS development were identified and overcome, and detail our current development strategy. We present information for 822 new human chromosome 4-specific STSs, including PCR amplification conditions and subchromosomal localization data, obtained by analysis of the STS with somatic cell hybrids containing different portions of human chromosome 4. Although most STSs presented here were developed from anonymous clones whose sequences were determined in this laboratory, several STSs were developed for genes and other DNA sequences that were previously mapped to chromosome 4. Our data indicate that the availability of DNA sequence for an STS locus, in addition to the sequences of the two PCR oligonucleotides, significantly increases the transfer of that STS by allowing investigators to select new oligonucleotides best suited to the standard conditions used in their laboratories.


Dose-dependent pharmacokinetics and hepatobiliary transport of bromophenol blue in the beagle.
The pharmacokinetic profile of bromophenol blue (I) in the plasma, urine, and bile of beagle dogs was determined after intravenous administration of 5-, 20-, and 30-mg/kg doses. In addition, two competitors, probenecid and phenylbutazone, were interacted with I in vivo and with I and rat liver cytoplasmic protein fractions Y and Z in vitro as a means of elucidating the mechanism of intrahepatic transport of I. Compound I was determined spectrophotometrically at 587 nm. In plasma, I displayed apparent first-order dose-dependent kinetics. The percentage of I bound to plasma proteins was approximately 92.5% over the dose range studied. Consecutive injections of equal doses of I produced statistically different terminal half-lives (p less than 0.05), suggesting the possibility of a saturable uptake process. In the presence of each competitor, the disposition of I was altered significantly (p less than 0.05): phenylbutazone displaced I from plasma protein, while probenecid decreased the binding of I to liver proteins in the Z-fraction. The Z-fraction bound a larger amount of I than the Y-fraction, suggesting a larger binding capacity. Under no circumstances was the binding of I to the Y-fraction altered. Cumulative biliary excretion data showed that the elimination of I in bile accounted for 92-99% of the dose delivered. The biliary excretion sigma- plots displayed no dose dependency, suggesting that the dose-dependent plasma half-life is due to a dose-dependent liver uptake (as opposed to elimination) process.


An overview of biogenic metallic nanoparticles for water treatment and purification: the state of the art.
The environment is fundamental to human existence, and protecting it from dangerous contaminants should be a top priority for all stakeholders. Reducing garbage output has helped, but as the world's population grows, more waste will be generated. Tons of waste inadvertently and advertently received by environmental matrixes adversely affect the sustainable environment. The pollution caused by these activities affects the environment and human health. Conventional remediation processes ranging from chemical, physical, and biological procedures use macroaggregated materials and microorganisms to degrade or remove pollutants. Undesirable limitations of expensiveness, disposal challenges, maintenance, and formation of secondary contaminants abound. Additionally, multiple stages of treatments to remove different contaminants are time-consuming. The need to avoid these limitations and shift towards sustainable approaches brought up nanotechnology options. Currently, nanomaterials are being used for environmental rejuvenation that involves the total degradation of pollutants without secondary pollution. As nanoparticles are primed with vast and modifiable reactive sites for adsorption, photocatalysis, and disinfection, they are more useful in remediating pollutants. Review articles on metallic nanoparticles usually focus on chemically synthesized ones, with a particular focus on their adsorption capacity and toxicities. Therefore, this review evaluates the current status of biogenic metallic nanoparticles for water treatment and purification.


[Meta-analysis of the research findings concerning functional relationships of explanatory variables to hope].
The purpose of the study was to meta-analyze the relationships of major concepts, which were made by synthesizing similar explanatory variables into more comprehensive concepts, to hope. The relevant researches from Jan 1980 to Dec 2003, performed in adults or adult patients, were collected. Using the SAS program, meta-analysis were done with the input data of the number of subjects, the correlation coefficients provided from most of the studies or a few transformed correlation coefficients from F value. In order to get the analysis to be done in homogeneous status of the data regarding each relationship of each major concept to hope (p>0.05), heterogeneous data were eliminated in repeating Q-test. The major variable regarding relationship to self/transcendental being/life (spiritual wellbeing & self esteem) and social support (social support & family support) have very large positive effects on hope (D=1.72, D=1.27). The negative effect of the variable regarding captive state(uncertainty in illness, perceived unhealthiness status, & fatigue) and positive effect of coping (approach coping) on hope are in the level between moderate to large (D=-0.61, D=0.78). All the effects of the major concepts on hope were verified as significant statistically(p=.000). The Fail-Safe numbers showed the significant effects of the three major concepts except coping on hope were reliable. The results can be a guide to advance hope theory for nursing.


The 2015 Clinical Guidelines for the Treatment and Prevention of Opportunistic Infections in HIV-Infected Koreans: Guidelines for Opportunistic Infections.
The Committee for Clinical Guidelines for the Treatment and Prevention of Opportunistic Infections of the Korean Society for AIDS was founded in 2011. The first edition of the Korean guidelines was published in 2012. The guideline recommendations contain important information for physicians working with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in the clinical field. It has become necessary to revise the guidelines due to new data in this field. These guidelines aim to provide up-to-date, comprehensive information regarding the treatment and prevention of opportunistic infections in HIV-infected Koreans. These guidelines deal with several common opportunistic infections, including pneumocystis pneumonia, tuberculosis, cryptococcal meningitis, etc. A brief summary of the revised guidelines is provided below. Recommendations are rated using the same system used in the previous guidelines.


[Effects of acupuncture at different acupoints on behaviors in depression model rats].
To observe therapeutic effects of acupuncture at different acupoints on depression. Seventy adult male rats with similar Open-Field score were randomly divided into a normal control group, a model group, a blank control group, a drug treatment group, an acupuncture group I ["Baihui" (GV 20), "Shenting" (GV 24)], II ]"Neiguan" (PC 6), "Sanyinjiao" (SP 6)], and III ("Baihui", "Shenting", "Neiguan" and 'Sanyinjiao"), 10 rats in each group. Separation feeding, long term unpredictability and medium stimulation stress techniques were applied to develop depression model rats. Changes of behaviors were investigated with Open-Field method and sucrose consumption trial. Compared with the normal control group, the score for the behavior and the consumption of sucrose reduced in the depression model group; compared with the blank control group, the score for the behavior and the consumption of sucrose increased in all the treatment groups during treatment. There was no significant difference among the acupuncture groups in the increase of behavior scores 21 days after treatment (P > 0.05), and there were significant differences in the increase of consumption of sucrose in the acupuncture group I and the increase of score for vertical movement in the acupuncture group III 14 days after treatment (P < 0.05, P < 0.01). Acupuncture can change the behavior abnormality induced by separation feeding, long term unpredictability and medium degree stimulation depression model rats and different acupoint selection is a factor in acuounture treatment.


The influence of Tribenoside on expression and deposition of epidermal laminins in HaCaT cells.
Tribenoside has been used clinically for hemorrhoidal disease associated with coagulation, inflammation, and wounds. However, the pharmacological mechanism of tribenoside activity has never been clear. In this study we examined whether tribenoside affected expression and deposition of laminins that are required for reconstruction of basement membranes (BMs) during wound healing in hemorrhoidal disease. HaCaT cells, which are derived from human epidermis, were treated in growth media supplemented with tribenoside. Reverse transcriptase-polymerase chain reaction (RT-PCR) using primers specific for laminin chains showed that HaCaT cells constitutively expressed laminin alpha3, alpha5, beta1, beta3, gamma1, and gamma2 chains. Tribenoside treatment of HaCaT cells did not induce expression of other laminin chains. We also quantified the expression of laminin chains in tribenoside-treated cells using real-time PCR. The expression level of laminin alpha3, beta1, beta3, gamma1, and gamma2 chains was not affected. In contrast, the expression of laminin alpha5 in the tribenoside-treated cells was four times higher than that of control cells. Immunocytochemistry also showed that tribenoside accelerated the focal deposition of laminin-332 (alpha3, beta3, gamma2). These results suggest that tribenoside interacts with epidermal cells and regulates the expression and localization of laminins to help reconstruct BMs in wound healing of hemorrhoids.


Psychotic depression.
The presence of delusions or hallucinations in major depressive disorder indicates a severe form of that disorder. Compared with patients with nonpsychotic depression, those with psychotic depression have depressive symptoms that are individually more severe. They also are more likely to have hypothalamic-pituitary-adrenal axis hyperactivity and increased ventricular-to-brain ratios. The short- and long-term outcomes for such patients are poor. Findings that this prognostic disadvantage may be permanent and that psychotic features recur at high rates in subsequent episodes indicate that these symptoms in major depressive disorder have a lifelong significance. Although monotherapy with antidepressants may be effective, recovery is more rapid when antidepressants are combined with antipsychotics. Electroconvulsive therapy is particularly effective for psychotic depression. The importance of combination therapy for prophylaxis is unknown.


Anterior Cruciate Ligament Reconstruction in Young Females: A Systematic Review of Patellar Tendon Versus Hamstring Tendon Autografts.
A systematic review was performed to compare patellar tendon-bone (BTB) and hamstring tendon (HS) autografts following anterior cruciate ligament reconstruction in young females, young patients, or females. One study compared BTB and HS in young females and found a lower rate of graft failure with BTB (P<.02). Of the 11 studies that made this comparison in females, 1 reported decreased laxity in females with BTB (P=.035). Of 4 studies comparing autografts in young patients, 1 reported a decreased rate of graft failure with BTB (P=.036). Further studies making this comparison specifically in young females are warranted. [Orthopedics. 2019; 42(3):e295-e304.].


Evaluation of Selenium Supplementation in Acute Ischemic Stroke Outcome: An Outcome Assessor Blind, Randomized, Placebo-Controlled, Feasibility Study.
Selenium is a trace element that protects against cellular damage by oxygen radicals through selenoproteins. Ischemic stroke is associated with the generation of oxygen free radicals resulting in a condition of oxidative stress. The present study aimed to evaluate the effect of selenium supplementation on short-term and long-term acute ischemic stroke outcomes. This was a randomized, parallel, outcome assessor blind, placebo-controlled feasibility study on ischemic stroke patients admitted in Bou-Ali Sina Hospital, Sari, Iran (2015-2017). Inclusion criteria were adults with accepted ischemic stroke by neuroimaging during the last 72h with a volume of at least one-third of MCA territory. The primary outcome was the short-term outcome measuring with the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) on day 7. The participants (44 patients) were randomized into two groups (22 in each group), one receiving intravenous selenium selenite for 5 days, and the other 40 cc normal saline as a placebo. A total of 40 ischemic stroke patients (18 females, 22 males) with mean age of 68.2 ± 10 years were investigated. Selenium supplementation improved short-term outcome, 15.7% by using NIHSS (66% vs 42%, RR = 0.85 with CI = 0.54-1.35; NNT = 10; 95% CI = 5.15- 2.53, P = 0.51) and 46.3% by using mRS (57% vs 12%, RR = 0.52 with CI = 0.31-0.88; NNT = 3; 95% CI = 1.49 -7.59, P = 0.01). The long-term outcome did not change significantly by considering Barthel index >75 after 3 months in comparison to comparator group (33.3% vs 29.4%, RR = 1.13 with CI = 0.40-3.16; NNT = 26; 95% CI = 2.77 -3.54, P = 0.81]. Selenium selenite supplementation in acute ischemic stroke can improve short-term outcome but cannot influence the long-term outcome.


Theoretical investigation of the ground and low-lying excited states of gallium and indium silicides, GaSi and InSi.
The electronic structure and the bonding of 13 electronic states of the diatomic gallium silicide (GaSi) and indium silicide (InSi) have been studied by multireference configuration interaction and coupled clusters methods in conjunction with the basis set (aug-)cc-pwCVQZ(-PP). Potential energy curves have been constructed for all states. Binding energies, spectroscopic parameters, and dipole moments have been calculated. Moreover, the bonding in the different states is analyzed. The potential energy curves of the two molecules, GaSi and InSi, are similar. The binding energies and the bond distances of the ground states of the molecules, X (4)Sigma(-), are D(e)=56.2 kcal/mol (GaSi) and 51.9 kcal/mol (InSi) and R(e)=2.406 A (GaSi) and 2.603 A (InSi). The first excited state a (2)Sigma(-) is calculated at 17 kcal/mol above the ground state in both molecules.


Primer modification improves rapid and sensitive in vitro and field-deployable assays for detection of high plains virus variants.
A high consequence pathogen, High plains virus (HPV) causes considerable damage to wheat if the crop is infected during early stages of development. Methods for the early, accurate, and sensitive detection of HPV in plant tissues are needed for the management of disease outbreaks and reservoir hosts. In this study, the effectiveness of five methods-real-time SYBR green and TaqMan reverse transcription-quantitative PCR (RT-qPCR), endpoint RT-PCR, RT-helicase dependent amplification (RT-HDA) and the Razor Ex BioDetection System (Razor Ex)-for the broad-range detection of HPV variants was evaluated. Specific PCR primer sets and probes were designed to target the HPV nucleoprotein gene. Primer set HPV6F and HPV4R, which amplifies a product of 96 bp, was validated in silico against published sequences and in vitro against an inclusivity panel of infected plant samples and an exclusivity panel of near-neighbor viruses. The primers were modified by adding a customized 22 nucleotide long tail at the 5' terminus, raising the primers' melting temperature (Tm; ca. 10°C) to make them compatible with RT-HDA (required optimal Tm = 68°C), in which the use of primers lacking such tails gave no amplification. All of the methods allowed the detection of as little as 1 fg of either plasmid DNA carrying the target gene sequence or of infected plant samples. The described in vitro and in-field assays are accurate, rapid, sensitive, and useful for pathogen detection and disease diagnosis, microbial quantification, and certification and breeding programs, as well as for biosecurity and microbial forensics applications.


Effectiveness of Bortezomib in a Patient With Acute Rejection Associated With an Elevation of Donor-Specific HLA Antibodies After Small-Bowel Transplantation: Case Report.
A significant association between donor-specific antibody (DSA) and graft rejection has recently been documented. However, confirmed strategy has not been established for DSA-associated rejection after intestinal transplantation (ITx). A 20-year-old male patient with chronic intestinal obstruction caused by hypoganglionosis of the entire intestine underwent cadaveric donor ITx with grafting performed on 232 cm of the small intestine, cecum, and a part of the ascending colon. On post-operative day (POD) 14, a histological evaluation showed an acute rejection of indeterminate grade. The patient had severe acute rejection on POD 16, which prompted us to administer bolus steroids and polyclonal anti-thymocyte antibody, along with baseline maintenance immunosuppression. The histopathological findings of the graft indicated typical acute cellular rejection, although C4d was positive. We then detected donor-specific HLA antibody. The patient initially responded well to the therapy and showed decreased histological rejection signs. However, the refractory low-grade rejection persisted in the graft. During this period, the patient showed increased levels of DSA, and we speculated that the persistent rejection was associated with DSA; thus, bortezomib was administered at this stage as a salvage therapy. This rejection was thereafter successfully controlled without severe adverse effect. Twenty-three months after ITx, the patient is currently alive with complete enteral autonomy. A case of acute graft rejection followed by a marked elevation of DSA is presented. In this particular case, a modified treatment protocol using bortezomib in addition to the typical immunosuppressive agents was effective.


Sleep is Inversely Associated with Sedentary Time among Youth with Obesity.
Objective: Pathways underlying the sleep-obesity relationship in youth are poorly understood. In this study, we examined associations of sleep with sedentary time and moderate-to-vigorous physical activity (MVPA) among youth, stratified by weight category (obesity versus no obesity). A sub-aim examined whether controlling for screen time changed the sleep-sedentary time association. Methods: Methods entailed secondary analysis of baseline data collected June-August 2014-2017 during a school-based healthy weight management trial in Minneapolis/St. Paul, Minnesota. Participants (N = 114) were 8-to-12 years old with BMI ≥ 75th percentile, most of whom were members of racial/ethnic minority groups (57%) or from households receiving economic assistance (55%). Mean nightly sleep duration and daily screen time were measured by survey, MVPA and sedentary time by accelerometer, and height and weight by research staff. Multivariate linear regression examined associations of sleep with sedentary time and MVPA. Results: Sleep was inversely associated with hours of sedentary time (β = -1.34 [-2.11, -0.58] p = .001) and percent of time spent sedentary (β = -2.92 [-4.83, -1.01], p = .004), for youth with obesity only. The association was unchanged by screen time. Sleep was not significantly associated with MVPA in total sample or stratified models. Conclusions: Associations among sleep, activity levels, and obesity may differ based upon movement type (sedentary time vs MVPA) and weight category (obesity vs no obesity).


Nucleofugality in oxygen and nitrogen derived pseudohalides in Menshutkin reactions: the importance of the intrinsic barrier.
In order to study the nucleofugality of polyatomic anionic leaving groups derived from oxygen and nitrogen, a contingent of 19 methylating agents consisting of amines or alcohols activated with carbonyl or sulfonyl substituents has been examined via ab initio calculations. We have calculated gas phase activation energies for alkylation of ammonia, and methyl cation affinities. We find that polyatomic anionic leaving groups derived from nitrogen will have higher activation energies for Menshutkin (SN2) alkylation even when they have similar methyl cation affinities. This inherent deficit in the nucleofugality of nitrogen-derived leaving groups appears to be a result of the way bond cleavage is synchronized with bond formation to the incoming ammonia nucleophile. The nitrogen leaving groups showed greater dissociation from the methyl fragment than oxygen leaving groups relative to the length of the forming carbon-nitrogen bond. Additionally the second sulfonyl group present in a sulfonimide appears to be less effective at activating nitrogen due to a preference for tetrahedral geometries at the departing nitrogen in the transition states involving leaving sulfonamide groups. Optimal delocalization of electron density is therefore frustrated due to the geometry of the leaving group.


[Total hip alloplasty. The long-term economical consequences].
A cost-effectiveness analysis concerning total hip arthroplasty was undertaken in 1984. The analysis included 86 patients submitted to operation in Odense and Svendborg Hospitals. After a follow-up period of five years, revision had proved necessary in one patient but no re-operations were undertaken on account of deep infection or aseptic loosening of the implants. The annual accumulated netto cost of total hip arthroplasty including the costs of readmission was calculated to be approximately 23,000 Danish crowns (2,000 pounds). This must be compared with a lasting marked improvement in the quality of life resulting from operation.


Metabolic syndrome prevalence in different affective temperament profiles in bipolar-I disorder.
Temperament originates in the brain structure, and individual differences are attributable to neural and physiological function differences. It has been suggested that temperament is associated with metabolic syndrome (MetS) markers, which may be partly mediated by lifestyle and socioeconomic status. Therefore, we aim to compare MetS prevalence between different affective temperamental profiles for each season in bipolar patients. Twenty-six bipolar type-I patients of a specialized outpatient mood disorder unit were evaluated for MetS according to new definition proposed by the International Diabetes Federation in the four seasons of a year. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego - autoquestionnaire version (TEMPS-A). The proportions of MetS were 19.2, 23.1, 34.6, and 38.5% in the summer, fall, spring, and winter, respectively. Only depressive temperament scores were higher (p = 0.002) during the winter in patients with MetS. These data suggest that depressive temperament profiles may predispose an individual to the development of MetS in the winter.


Sucrose Metabolism in Netted Muskmelon Fruit during Development.
Sugar content and composition are major criteria used in judging the quality of netted muskmelon (Cucumis melo L. var reticulatus) fruit. Sugar composition and four enzymes of sucrose metabolism were determined in ;Magnum 45' muskmelon fruit at 10-day intervals beginning 10 days after pollination (DAP) until full-slip (35 DAP). Sugar content increased in both outer (green) mesocarp and inner (orange) mesocarp between 20 and 30 DAP. The major proportion of total increase in sugar was attributed to sucrose accumulation. The large increase in sucrose relative to glucose and fructose was accompanied by a dramatic decrease in acid invertase activity, which was highest in both tissues at 10 and 20 DAP, and increases in sucrose phosphate synthase (SPS) and sucrose synthase activities. The green tissue had a lower proportion of total sugar as sucrose, greater invertase activity, and less SPS activity than the orange tissue. Changes in relative sucrose content were highly correlated with changes in enzyme activity. The results strongly suggest that increases in the proportion of sucrose found in melon fruit were associated with a decline in acid invertase activity and an increase in SPS activity approximately 10 days before full-slip. Therefore, these enzymes apparently play a key role in determining sugar composition and the quality of muskmelon fruit.


The incidence of concha bullosa and the correlation with nasal septal deviation.
To analyse the incidence of concha bullosa and any aetiological correlation with nasal septal deviation. Paranasal sinus computerised tomography (CT) scans were made of 143 consecutive patients with sinonasal symptoms. Patients with altered anatomy (iatrogenic or pathological) were excluded and the remaining CT scans were analysed for the pneumatisation of the middle turbinate, septal deviation and the correlation between them. Sixty-three percent of patients had some types of septal deviation and 35% had unilateral or bilateral concha bullosa. Septal deviation was present in 9 out of 13 patients (69.2%) with large unilateral or dominant concha bullosa, 10 out of 24 (41.7%) with medium unilateral or dominant concha bullosa, and 12 out of 30 (40%) with small concha bullosa. There was a clear link between the presence of a unilateral concha, or a dominant concha (in bilateral concha), and the presence of nasal septal deviation (P <0.009). After the assessment of various sizes and shape of concha bullosa and the form of nasal septal deviation away from the dominant concha, we suggest that deviation is an indirect result of the presence of the concha. This hypothesis can be proved by reference to the laws of physics.