Esophageal cancer awareness in Bomet district, Kenya.
Esophageal cancer is the most common malignancy in Western Kenya and patients present with advanced disease. To determine baseline level of knowledge of esophageal cancer in Bomet District in order to develop targeted and effective educational classes. A questionnaire with twelve questions testing knowledge about esophageal cancer and eight questions aimed at determining barriers to healthcare was conducted out of Tenwek Hospital from June to July 2010. Eighty-one questionnaires were completed. 33% thought that cancer is a virus and 35% thought that it is contagious. 47% did not think that family history is a risk factor. 79% accurately claimed dysphagia as the most common symptom for esophageal cancer. 40% thought that herbal therapy is the optimal treatment for esophageal cancer. Cost and fear of diagnosis were cited as the most significant barriers to healthcare. Most participants had a monthly income of less than 3000 Kenyan schillings (37.5 US dollars); for 37% of participants, the cost of transport to the hospital represented a third of their monthly income. The questionnaire provided population-specific information on cancer knowledge and aided in targeting barriers to healthcare access. These factors will be incorporated into the cancer education outreach program of Tenwek Hospital.


Case report: A rare case of pulmonary mucormycosis caused by Lichtheimia ramosa in pediatric acute lymphoblastic leukemia and review of Lichtheimia infections in leukemia.
Mucormycosis caused by Lichtheimia ramosa is an emerging and uncommon opportunistic infection in patients with hematological malignancies, with high mortality rates. Herein, we first report a case of pulmonary mucormycosis with Lichtheimia ramosa in a 3-year-old girl recently diagnosed with B-cell acute lymphoblastic leukemia. The diagnosis was made using computerized tomography of the lung, metagenomic next-generation sequencing (mNGS) of blood and sputum specimens, and microscopic examination to detect the development of Lichtheimia ramosa on the surgical specimen. She was effectively treated after receiving prompt treatment with amphotericin B and posaconazole, followed by aggressive surgical debridement. In our case, the fungal isolates were identified as Lichtheimia ramosa using mNGS, which assisted clinicians in quickly and accurately diagnosing and initiating early intensive treatment. This case also indicated the importance of strong clinical suspicion, as well as aggressive antifungal therapy combined with surgical debridement of affected tissues.


Design and analysis of factorial clinical trials: The impact of one treatment's effectiveness on the statistical power and required sample size of the other.
Factorial allow for the simultaneous evaluation of more than one treatment, by randomizing patients to their possible combinations, including control. However, the statistical power of one treatment can be influenced by the effectiveness of the other, a matter that has not been widely recognized. In this paper, we evaluate the relationship between the observed effectiveness of one treatment and the implied power for a second treatment in the same trial, under a range of conditions. We provide analytic and numerical solutions for a binary outcome, under the additive, multiplicative, and odds ratio scales for treatment interaction. We demonstrate how the minimum required sample size for a trial depends on the two treatment effects. Relevant factors include the event rate in the control group, sample size, treatment effect sizes, and Type-I error rate thresholds. We show that that power for one treatment decreases as a function of the observed effectiveness of the other treatment if there is no multiplicative interaction. A similar pattern is observed with the odds ratio scale at low control rates, but at high control rates, power may increase if the first treatment is moderately more effective than its planned value. When treatments do not interact additively, power may either increase or decrease, depending on the control event rate. We also determine where the maximum power occurs for the second treatment. We illustrate these ideas with data from two actual factorial trials. These results can benefit investigators in planning the analysis of factorial clinical trials, in particular, to alert them to the potential for losses in power when one observed treatment effect differs from its originally postulated value. Updating the power calculation and modifying the associated required sample size can then ensure sufficient power for both treatments.


Gene expression profiles and pathway enrichment analysis to identification of differentially expressed gene and signaling pathways in epithelial ovarian cancer based on high-throughput RNA-seq data.
Epithelial ovarian cancer (EOC) can be considered as a stressful and challenging disease among all women in the world, which has been associated with a poor prognosis and its molecular pathogenesis has remained unclear. In recent years, RNA Sequencing (RNA-seq) has become a functional and amazing technology for profiling gene expression. In the present study, RNA-seq raw data from Sequence Read Archive (SRA) of six tumor and normal ovarian sample was extracted, and then analysis and statistical interpretation was done with Linux and R Packages from the open-source Bioconductor. Gene Ontology (GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were applied for the identification of key genes and pathways involved in EOC. We identified 1091 Differential Expression Genes (DEGs) which have been reported in various studies of ovarian cancer as well as other types of cancer. Among them, 333 genes were up-regulated and 273 genes were down-regulated. In addition, Differentially Expressed Genes (DEGs) including RPL41, ALDH3A2, ERBB2, MIEN1, RBM25, ATF4, UPF2, DDIT3, HOXB8 and IL17D as well as Ribosome and Glycolysis/Gluconeogenesis pathway have had the potentiality to be used as targets for EOC diagnosis and treatment. In this study, unlike that of any other studies on various cancers, ALDH3A2 was most down-regulated gene in most KEGG pathways, and ATF4 was most up-regulated gene in leucine zipper domain binding term. In the other hand, RPL41 as a regulatory of cellular ATF4 level was up-regulated in many term and pathways and augmentation of ATF4 could justify the increase of RPL41 in the EOC. Pivotal pathways and significant genes, which were identified in the present study, can be used for adaptation of different EOC study. However, further molecular biological experiments and computational processes are required to confirm the function of the identified genes associated with EOC.


[Treatment of posterior-communicating wide-necked aneurysms with endovascular stent and Guglielmi detachable coils].
To summarize our clinical experience in treating posterior-communicating wide-necked aneurysms using endovascular stent and Guglielmi detachable coils (GDCs). The coronary stents were implanted across the neck of 32 posterior-communication wide-necked aneurysms. Microcatheters were introduced into the aneurysm sac through stent mesh, GDCs were used to embolize aneurysms. All operations were successful. Total occlusion was achieved in 26 patients, over 90% in 4, 60 - 70% in 2. The patients were perfectly recovered with patency of the parent arteries. Endovascular therapy combined with stent implatation and GDC placement is a valid approach to the treatment of posterior-communication wide-necked aneurysms.


Transfusion triggers in orthotopic liver transplantation: a comparison of the thromboelastometry analyzer, the thromboelastogram, and conventional coagulation tests.
The Thromboelastogram (TEG; Haemoscope Corporation, Niles, IL) and the ROTEM thromboelastometry analyzer (Pentapharm GmbH, Munich, Germany) are coagulation monitors that measure the viscoelastic changes accompanying whole-blood coagulation generation and lysis. It is not clear whether TEG and ROTEM transfusion algorithms suggest similar blood component intervention. This study aims to report the extent to which administration of platelets, fresh frozen plasma, and cryoprecipitate would be indicated using protocol-dictated interventions by the Rotem, TEG, and conventional coagulation screens during orthotopic liver transplantation (OLT). Prospective observational study. University hospital. Twenty patients undergoing orthotopic liver transplantation. Coagulation was managed with native TEG protocols. Additional samples for kaolin TEG, kaolin heparinase TEG, Rotem in-TEM, Rotem hep-TEM, Rotem fib-TEM, full blood count, prothrombin time, and Clauss fibrinogen assays were taken at 5 fixed operative stages. Results were reviewed and protocol-indicated interventions recorded. There was moderate agreement between Clauss fibrinogen and Rotem fib-TEM assays about fulfilling fibrinogen transfusion criteria (kappa = 0.42, p < or = 0.05). Agreement between TEG and Rotem to transfuse platelets was fair (Rotem in-TEM/native heparinase TEG, kappa = 0.33, Rotem in-TEM/kaolin heparinase TEG, kappa = 0.28). There was moderate agreement between Rotem in-TEM and prothrombin time (kappa = 0.42), and poor agreement between other tests about the point to administer fresh frozen plasma. Transfusion practice is likely to differ according to the method of coagulation monitoring used. A prospective case-matched study using the viscoelastic tests used in this study would be beneficial in determining the optimal therapy. Rotem fib-TEM monitoring may improve hemostasis management.


Migration of bisphenol A from can coatings to liquid infant formula during storage at room temperature.
Information on migration of bisphenol A (BPA) from can coatings to foods during storage at room temperature is very limited, and the conclusions from the available studies are not always consistent. To investigate the effect of storage time on BPA migration from can coatings to liquid infant formula at room temperature, samples of 21 canned liquid infant formula products from different cans but the same lot as those analyzed for BPA previously were analyzed for BPA again after storage at room temperature for 10 months. Additional migration of BPA from can coatings to liquid formula during the 10-month storage period at room temperature was observed for 9 of the 21 products, with increases in BPA levels ranging from 29.8 to 110%. Significant differences between the 2007 and 2008 results (P = 0.026) were observed for only one brand of product, which had the lowest BPA levels in the 2007 survey. The BPA levels in the milk-based formula products analyzed in 2008 (mean, 6.8 ng/g) were significantly higher (P = 0.00023) than those in the milk-based formula products analyzed in 2007 (mean, 5.0 ng/g), whereas the differences in BPA levels between the soya-based formula products analyzed in 2008 (mean, 5.3 ng/g) and those analyzed in 2007 (mean, 5.8 ng/g) were not significant (P = 0.097). No obvious correlation between the product expiration date and the level of BPA migration from can coatings was observed.


[Effects of Nutrient Inputs on Changes of Phosphorus Forms and Phytoplankton Growth in Taihu Lake].
In order to determine the effects of nutrient inputs on changes of phosphorus forms and phytoplankton growth in large shallow lakes, an enrichment bioassay was conducted using surface lake water collected from the Meiliang Bay of Taihu Lake in spring. The concentration of different phosphorus forms, phytoplankton biomass (chlorophyll a) and alkaline phosphatase activity (APA) was analyzed after the addition of different concentrations of inorganic nutrients. The results showed that the phytoplankton biomass increased significantly with the addition of phosphorus (P), but with no primary effect from nitrogen (N), which suggested the phytoplankton growth was mainly limited by P. The maximum growth rate and the highest concentration of chlorophyll both occurred in the SRP 0.015 mg x L(-1) treatment. Nitrate addition could improve the bioavailability of phosphorus, accelerate the phosphorus cycling process and promote the growth of APA. There was an induction-repression mechanism resulting in a negative relationship between APA and orthophosphate concentration. The APA was obviously stimulated under PO4(3-) -P ≤ 0.025 mg x L(-1). This paper researches the transformation and cycling process of phosphorus in water and the induction-repression mechanism between the APA and orthophosphate concentration. The result can help to reveal the compensation path of nutrients in algae growth process and provide a theoretical basis for the further reveal of the mechanism of algae outbreaks.


Species-Specific Outcome in the Competition for Nitrogen Between Invasive and Native Tree Seedlings.
The outcome of competition for nitrogen (N) between native and invasive tree species is a major concern when considering increasing anthropogenic N deposition. Our study investigated whether three native (i.e., Fagus sylvatica, Quercus robur, and Pinus sylvestris) and two invasive woody species (i.e., Prunus serotina and Robinia pseudoacacia) showed different responses regarding morphological and physiological parameters (i.e., biomass and growth indices, inorganic vs. organic N acquisition strategies, and N allocation to N pools) depending on the identity of the competing species, and whether these responses were mediated by soil N availability. In a greenhouse experiment, tree seedlings were planted either single or in native-invasive competition at low and high soil N availability. We measured inorganic and organic N acquisition using 15N labeling, total biomass, growth indices, as well as total soluble amino acid-N and protein-N levels in the leaves and fine roots of the seedlings. Our results indicate that invasive species have a competitive advantage via high growth rates, whereas native species could avoid competition with invasives via their higher organic N acquisition suggesting a better access to organic soil N sources. Moreover, native species responded to competition with distinct species- and parameter-specific strategies that were partly mediated by soil N availability. Native tree seedlings in general showed a stronger response to invasive P. serotina than R. pseudoacacia, and their strategies to cope with competition reflect the different species' life history strategies and physiological traits. Considering the responses of native and invasive species, our results suggest that specifically Q. robur seedlings have a competitive advantage over those of R. pseudoacacia but not P. serotina. Furthermore, native and invasive species show stronger responses to higher soil N availability under competition compared to when growing single. In conclusion, our study provides insights into the potential for niche differentiation between native and invasive species by using different N forms available in the soil, the combined effects of increased soil N availability and competition on tree seedling N nutrition, as well as the species-specific nature of competition between native and invasive tree seedlings which could be relevant for forest management strategies.


[Protective effects of Angelica sinensis polysaccharide on immunological liver injury induced by concanavalin A in mice].
To investigate the protective effects of Angelica sinensis polysaccharide on immunological liver injury induced by concanavalin A (ConA). Sixty NIH mice were randomly divided into 6 groups as normal group, model group, biphenyl group, Angelica sinensis polysaccharide high does group, Angelica sinensis polysaccharide middle dose group and Angelica sinensis polysaccharide low dose group. Immunological liver injury in mice was induced by ConA (20 mg/kg) by injection via tail vein, the control group received saline alone. In the treatment groups, each group was administrated via gavage daily. The control group was given equal volume of saline. Liver index, thymus index and spleen index, contents of serum ALT, AST, TB and NO in serum and TNF-alpha, IL-1beta, ITN-gamma in liver homogenate were measured. Angelica sinensis polysaccharide remarkably increased the levels of liver index, thymus index and spleen index, decreased the contents ALT, AST, TB and NO levels in serum, and TNF-alpha, IL-1beta, ITN-gamma in liver homogenate (P < 0.05). Angelica simesis polysaccharide haride can obviously protect immunological injury liver in mice and between the dose range of 30-120 mg/kg in a dose-dependent manner. Its mechanism may be relate to inhibiting T lymphocyte activity and ITN-gamma, TNF-alpha, IL-1beta, NO release.


Concise asymmetric synthesis of a (1R,2S)-1-amino- 2-vinylcyclopropanecarboxylic acid-derived sulfonamide and ethyl ester.
The development and demonstration of short, robust and chromatography-free sequences for the preparation of a (1R,2S)-1-amino-2-vinylcyclopropane-carboxylic acid-derived sulfonamide and ethyl ester in ≥99% ee are described. Both compounds are common building blocks in multiple preparations of potent HCV NS3 protease inhibitors. The robustness of the asymmetric cyclopropanation of (E)-N-benzylideneglycine ethyl ester under phase transfer catalysis conditions is significantly improved based on a detailed mechanistic investigation that included an analysis of the catalyst decomposition pathway, a postulated model for the stereo-selectivity that was guided by calculations and rigorous quality control of the starting materials and reagents. Wet milling has been demonstrated to dramatically accelerate this phase transfer reaction. A bench stable benzylidene-protected primary 1-amino-2-vinylcyclopropane amide intermediate was isolated and its reliable enantiomeric enrichment was achieved by a controlled crystallization process. A chemical resolution procedure was identified using di-p-toluoyl-(D)-tartaric acid to access (1R,2S)-1-amino-2-vinyl-cyclopropanecarboxylic ester in high ee.


A biochemical genomics screen for substrates of Ste20p kinase enables the in silico prediction of novel substrates.
The Ste20/PAK family is involved in many cellular processes, including the regulation of actin-based cytoskeletal dynamics and the activation of MAPK signaling pathways. Despite its numerous roles, few of its substrates have been identified. To better characterize the roles of the yeast Ste20p kinase, we developed an in vitro biochemical genomics screen to identify its substrates. When applied to 539 purified yeast proteins, the screen reported 14 targets of Ste20p phosphorylation. We used the data resulting from our screen to build an in silico predictor to identify Ste20p substrates on a proteome-wide basis. Since kinase-substrate specificity is often mediated by additional binding events at sites distal to the phosphorylation site, the predictor uses the presence/absence of multiple sequence motifs to evaluate potential substrates. Statistical validation estimates a threefold improvement in substrate recovery over random predictions, despite the lack of a single dominant motif that can characterize Ste20p phosphorylation. The set of predicted substrates significantly overrepresents elements of the genetic and physical interaction networks surrounding Ste20p, suggesting that some of the predicted substrates are in vivo targets. We validated this combined experimental and computational approach for identifying kinase substrates by confirming the in vitro phosphorylation of polarisome components Bni1p and Bud6p, thus suggesting a mechanism by which Ste20p effects polarized growth.


Evaluation of multi-terminology super-concepts for information retrieval.
Following a recent change in the indexing policy for French quality controlled health gateway CISMeF, multiple terminologies are now being used for indexing in addition to MeSH®. To evaluate precision and recall of super-concepts for information retrieval in a multi-terminology paradigm compared to MeSH-only. We evaluate the relevance of resources retrieved by multi-terminology super-concepts and MeSH-only super-concepts queries. Recall was 8-14% higher for multi-terminology super-concepts compared to MeSH only super-concepts. Precision decreased from 0.66 for MeSH only super-concepts to 0.61 for multi-terminology super-concepts. Retrieval performance was found to vary significantly depending on the super-concepts (p<10-4) and indexing methods (manual vs automatic; p<0.004). A multi-terminology paradigm contributes to increase recall but lowers precision. Automated tools for indexing are not accurate enough to allow a very precise information retrieval.


Formation of Nb(C,N) Carbonitride in Cast Austenitic Heat-Resistant Steel during Directional Solidification under Different Withdraw Rates.
It is recognized recently that primary "Chinese-script" Nb(C,N) carbonitride is critical to the development of cast austenitic heat-resistant steels for ultra-high temperature applications. In this paper, the precipitation behavior of Nb(C,N) carbonitride in a novel creep and fatigue resistant steel was investigated by the use of the liquid metal cooling directional solidification (LMC-DS) method under different withdraw rates. Thermodynamic calculations were also performed to aid in the understanding of the solidification behavior. Microstructural characterization and thermodynamic calculation agreed that the alloy solidified in the path of primary austenite, eutectic Nb(C,N) carbonitride, and secondary ferrite, regardless of the withdraw rate. However, the primary and secondary dendrite arm spacing decreased significantly with an increase in the withdraw rate, and a quantitative relationship was established. Furthermore, the eutectic reaction range increased at a higher withdraw rate, due to the rapid increase of the solid phase fraction and the accumulation of solutes in the interdendritic liquid phase. This gave rise to a decline in the interlamellar spacing of primary Nb(C,N) carbonitride sheets and rods for the higher withdraw rate. Therefore, a fine "Chinese-script" Nb(C,N) carbonitride in this type of alloys can be achieved through increasing the withdraw rate or the cooling rate during casting.


Tuberous breast correction by fat grafting.
Tuberous breast is a rare malformation that has negative physical and psychological impacts during puberty. A range of surgical techniques has been used to correct breast shape and volume in this context, including a combination of skin plasty and mammary gland remodeling, as well as prostheses and locoregional flaps. The authors have used fat grafting as a complementary technique to correct tuberous breasts since 1998. The authors discuss application of their lipomodeling technique for correction of tuberous breast deformity. The charts of tuberous breast patients treated consecutively over an 11-year period (n = 31) solely with fat grafting (ie, without using an implant) were retrospectively reviewed. Each breast deformation was graded according to the Grolleau classification. The number of sessions and the mean transfer of fat volume by lipomodeling session were recorded. Patient and surgeon satisfaction were evaluated. Of the 31 patients in this series, 18 had bilateral formations and 13 had unilateral malformations. The mean patient age was 23 years, and the mean body mass index was 21.9. A single session (mean transfer volume, 158 mL; range, 90-253 mL) was required in 14 (45%) cases. A second session (mean transfer volume, 226 mL; range, 100-316 mL) was necessary in the remaining 55% of cases. Mean follow-up period after the last fat transfer session was 6.5 years (range, 1.5-11 years). Patients were very satisfied in 94% of cases (n = 29) and satisfied in 6% (n = 2). The surgical team rated 94% of cases as being successful or very successful. No complications were observed. One patient developed hypertrophy of the treated breast following weight gain and thus required breast reduction. Imaging performed preoperatively and 1 year postoperatively did not reveal any anomalies other than oil cysts. Fat grafting is a reliable technique that produces excellent results and high levels of patient satisfaction for the treatment of tuberous breast. The aesthetic outcome is natural, implant free, and long lasting. 4.


The effect of melatonin administration on circulating plasma luteinizing hormone concentration in castrated White Leghorn roosters.
Melatonin (MLT) has a significant role in mammalian reproduction, with little or no effect in birds. In the present study we studied the role of MLT in regulation of luteinizing hormone (LH) secretion in castrated White Leghorn (WL) roosters. In Experiment 1, castrated WL roosters (n = 30) were divided into three groups, and each group (n = 10) was subdivided into two subgroups (n = 5). Birds in one subgroup received an injection of MLT at 5 mg (MLT-5), 20 mg (MLT-20), or 80 mg (MLT-80)/kg BW. Birds in the second subgroup were vehicle-injected and served as controls. Each dose of MLT was administered on a separate day at 1100 h. Blood was sampled 30 min before and 10, 30, 60, and 120 min after MLT or vehicle administration. Ten minutes after MLT administration, a significant reduction in plasma LH was observed in the MLT-20 and -80 groups, i.e., 70.3 +/- 8.3% and 62.2 +/- 4.1% of control values, respectively. In the MLT-80 group, plasma LH further declined to 42.1 +/- 9.7% of control values 60 min after injection. In Experiment 2, 18 castrated WL roosters were divided into three groups of six birds each. Two groups were injected with 80 mg MLT/kg BW at the beginning of the experiment; the second group received an additional dose of 80 mg MLT/ kg BW 140 min after the first injection. The third group was injected twice (as in second group) with vehicle and served as control. Blood was sampled 30 min before and 30, 60, 120, 170, 200, and 240 min after injection. Repeated MLT injection maintained low levels of plasma LH level until the end of the experiment. In Experiment 3, 10 castrated WL roosters were divided into two groups (n = 5). The first group was injected daily, for 10 d, with 80 mg MLT/kg BW, the second group was vehicle-treated and served as a control. At Day 3, there was a significant reduction in plasma LH level in the MLT-treated group, which continued for 7 d. This study demonstrates that, in birds, MLT suppresses LH secretion in a dose- and a time-related manner.


Age-related differences in serum gonadotropin (FSH and LH), salivary testosterone, and 17-beta estradiol levels among Ache Amerindian males of Paraguay.
Age-related differences in serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), salivary testosterone, and 17-beta estradiol levels are reported for Ache Amerindian males (n = 17; mean age, 37.1 +/- 14.2 SD) of Paraguay in order to explore population variation in patterns of male reproductive senescence in a foraging/agricultural community. Hormone associations were examined to test various hypotheses for age-related differences in hypothalamic-pituitary function. Significant increases in FSH (r = 0.75, P < 0.0005) and LH (r = 0.65, P < 0.01) were noted in association with aging. No significant correlation was observed between morning or evening testosterone and age. Morning and evening estradiol levels were associated with morning and evening testosterone, respectively (morning, r = 0.53, P = 0.05; evening, r = 0.63, P = 0.02). Evening estradiol was also positively associated with LH (r = 0.66, P = 0.02), suggesting testicular production to be an important source of circulating estradiol. Morning estradiol tended to rise with age, but was not significant (r = 0.39, P = 0.15). Anthropometric measurements of height, weight, body mass index, and fat percent did not change significantly with age. In contrast to testosterone, age-related differences in gonadotropin levels may be independent of energetic status, less variant, and more universal among male populations. Implications for gonadotropin function and aging on human male reproductive senescence and life histories are discussed.


Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.
This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA). Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22-28 weeks) and very low birth weight (401-1500 g) who were born at network centers between January 1, 2003, and December 31, 2007. Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at <or=12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified. Although the majority of infants with GAs of >or=24 weeks survive, high rates of morbidity among survivors continue to be observed.


Rapid Assessment of Avoidable Blindness in India.
Rapid assessment of avoidable blindness provides valid estimates in a short period of time to assess the magnitude and causes of avoidable blindness. The study determined magnitude and causes of avoidable blindness in India in 2007 among the 50+ population. Sixteen randomly selected districts where blindness surveys were undertaken 7 to 10 years earlier were identified for a follow up survey. Stratified cluster sampling was used and 25 clusters (20 rural and 5 urban) were randomly picked in each district.. After a random start, 100 individuals aged 50+ were enumerated and examined sequentially in each cluster. All those with presenting vision <6/18 were dilated and examined by an ophthalmologist. 42722 individuals aged > = 50 years were enumerated, and 94.7% examined. Based on presenting vision,, 4.4% (95% Confidence Interval[CI]: 4.1,4.8) were severely visually impaired (vision<6/60 to 3/60 in the better eye) and 3.6% (95% CI: 3.3,3.9) were blind (vision<3/60 in the better eye). Prevalence of low vision (<6/18 to 6/60 in the better eye) was 16.8% (95% CI: 16.0,17.5). Prevalence of blindness and severe visual impairment (<6/60 in the better eye) was higher among rural residents (8.2%; 95% CI: 7.9,8.6) compared to urban (7.1%; 95% CI: 5.0, 9.2), among females (9.2%; 95% CI: 8.6,9.8) compared to males (6.5%; 95% CI: 6.0,7.1) and people above 70 years (20.6%; 95% CI: 19.1,22.0) compared to people aged 50-54 years (1.3%; 95% CI: 1.1,1.6). Of all blindness, 88.2% was avoidable. of which 81.9% was due to cataract and 7.1% to uncorrected refractive errors/uncorrected aphakia. Cataract and refractive errors are major causes of blindness and low vision and control strategies should prioritize them. Most blindness and low vision burden is avoidable.


Influenza Vaccine Effectiveness and Waning Effect in Hospitalized Older Adults. Valencia Region, Spain, 2018/2019 Season.
Influenza vaccination is annually recommended for specific populations at risk, such as older adults. We estimated the 2018/2019 influenza vaccine effectiveness (IVE) overall, by influenza subtype, type of vaccine, and by time elapsed since vaccination among subjects 65 years old or over in a multicenter prospective study in the Valencia Hospital Surveillance Network for the Study of Influenza and other Respiratory Viruses (VAHNSI, Spain). Information about potential confounders was obtained from clinical registries and/or by interviewing patients and vaccination details were only ascertained by registries. A test-negative design was performed in order to estimate IVE. As a result, IVE was estimated at 46% (95% confidence interval (CI): (16%, 66%)), 41% (95% CI: (-34%, 74%)), and 45% (95% CI: (7%, 67%)) against overall influenza, A(H1N1)pdm09 and A(H3N2), respectively. An intra-seasonal not relevant waning effect was detected. The IVE for the adjuvanted vaccine in ≥75 years old was 45% (2%, 69%) and for the non-adjuvanted vaccine in 65-74 years old was 59% (-16%, 86%). Thus, our data revealed moderate vaccine effectiveness against influenza A(H3N2) and not significant against A(H1N1)pdm09. Significant protection was conferred by the adjuvanted vaccine to patients ≥75 years old. Moreover, an intra-seasonal not relevant waning effect was detected, and a not significant IVE decreasing trend was observed over time.


[Urinary TGF-beta1 excretion in children with renal cysts].
Autosomal dominant polycystic disease is characterised by abnormal polycystin, protein, which is a component of basement membrane and extracellular matrix. Transforming growth factor (TGF-beta1) is a cytokine, which takes part in development of renal tubule epithelium and stimulates the synthesis of extracellular matrix proteins. The aim of work was the assessment of TGF-beta1 concentration in children with renal polycystic disease. The examined group (I) consisted of 33 children aged (median 14.7 years, range 4.0-17.9): A--11 children with solitary cyst, B--22 with polycystic renal disease. Control group (C) consisted of 20 healthy children at the same age. The concentration of urinary TGF-b1 was measured using immunoenzymatic ELISA method. The results showed that mean concentration of urinary TGF-beta 1 (121.9 +/- 168 pg/mg cr.) was lower than in group B, in which it was 207.2 +/- 361 pg/mg cr. However the difference was not statistically significant (p>0.05). In both subgroups (A and B) urinary excretion of TGF-beta1 was higher than in control group (C) (p<0.05). In 4 (36%) children from group A and 8 (36%) from group B the urinary concentration of TGF-beta 1 was below the sensitivity of the method. No correlation between TGF-beta 1 and children's age, urinary osmolality and GRF according to Schwartz was found. It was a positive correlation between urinary TGF-betal concentration and total diameter of renal cysts. TGF-betal takes part in renal cyst formation and increased urinary excretion of TGF-b1 in proportion to the dimension of renal cysts may be an evidence of that fact.


Cultivation of Podospora anserina on soybean hulls results in an efficient enzyme cocktail for plant biomass hydrolysis.
The coprophilic ascomycete fungus Podospora anserina was cultivated on three different plant biomasses, i.e. cotton seed hulls (CSH), soybean hulls (SBH) and acid-pretreated wheat straw (WS) for four days, and the potential of the produced enzyme mixtures was compared in the enzymatic saccharification of the corresponding lignocellulose feedstocks. The enzyme cocktail P. anserina produced after three days of growth on SBH showed superior capacity to release reducing sugars from all tested plant biomass feedstocks compared to the enzyme mixtures from CSH and WS cultures. Detailed proteomics analysis of the culture supernatants revealed that SBH contained the most diverse set of enzymes targeted on plant cell wall polymers and was particularly abundant in xylan, mannan and pectin acting enzymes. The importance of lytic polysaccharide monooxygenases (LPMOs) in plant biomass deconstruction was supported by identification of 20 out of 33 AA9 LPMOs in the SBH cultures. The results highlight the suitability of P. anserina as a source of plant cell wall degrading enzymes for biotechnological applications and the importance of selecting the most optimal substrate for the production of enzyme mixtures.


The efficacy of a hyaluronate/carboxymethylcellulose membrane in prevention of postoperative adhesion in a rat uterine horn model.
The current study was designed to investigate the efficacy of a hyaluronate/carboxymethylcellulose membrane for the prevention of post-operative adhesion in a rat uterine horn model. This is a prospective double-blinded controlled study. Nineteen injured uterine horns were treated with a hyaluronate/carboxymethylcellulose membrane as a barrier and 19 injured uterine horns without any treatment served as a control group. Two weeks later, second look laparotomies were performed in order to assess the degree of the adhesion. Total adhesion scores, histopathological analysis of inflammation process and vascularization of adhesions were compared with control group. P values of 5% or less were considered statistically significant. Animals treated with a hyaluronate/carboxymethylcellulose membrane had significantly reduced post-surgical adhesion scores when compared with control group. In histopathological examination, there was less vascularization in the treatment group. The types and extent of inflammation were similar in two groups. Clinically and histopathologically, a hyaluronate/carboxymethylcellulose membrane is effective in reducing postoperative adhesion formation in the rat uterine horn model.


The role of pelvic lymphadenectomy in non-muscle invasive bladder cancer.
We evaluated whether the extent of lymphadenectomy at the time of radical cystectomy for non-muscle invasive bladder cancer (NMIBC) impacts recurrence free survival. We conducted an IRB approved retrospective analysis of patients with clinical NMIBC who underwent radical cystectomy from 1990-2010. Patients were stratified based on extent of lymph node dissection using total lymph node yield as a surrogate indicator of lymph node dissection extent, with cut off analyses performed at 0, 8, 10, and 20 nodes removed. Analyses of recurrence free survival (RFS) were performed using log-rank analysis and multivariate Cox regression. One hundred and ninety-six patients with NMIBC met the inclusion criteria for this study, with no differences in RFS detected in those who had ≥ 10 nodes compared to < 10 nodes removed (p = 0.63). Upon multivariate analysis, ≥ 10 nodes removed (HR 1.00; p = 0.99) was not significantly associated with decreased RFS, while high grade tumor (HR 3.22; p = 0.05) and positive margin status (HR 3.87; p = 0.04) were. The median number of nodes removed was 8 (range 0-45), with no difference in RFS using this as a cut off point (p = 0.19). The removal of ≥ 20 nodes did not predict worse survival compared to < 20 nodes removed (p = 0.07). Although the extent of lymphadenectomy has been associated with improved survival in patients undergoing radical cystectomy for muscle invasive bladder cancer, we were unable to detect an impact of lymph node dissection extent on RFS in patients with NMIBC. This finding emphasizes that when determining extent of lymph node dissection in radical cystectomy, one size does not fit all.


Mono- vs. bi-metallic assembly on a bulky bis(imino)terpyridine framework: a combined experimental and theoretical study.
The bis(imino)terpyridine ligands, 6,6''-{(2,6-i-Pr2C6H3)N=CR}2-2,2':6',2''-C15H9N3 (R = H L1, Me L2), have been prepared in high yield from the condensation reaction of the corresponding carbonyl compound with two equivalents of 2,6-diisopropylaniline. The molecular structure of L2 reveals a transoid relationship between the imino and pyridyl nitrogen groups throughout the ligand framework. Treatment of aldimine-containing L1 with one equivalent or an excess of MX2 in n-BuOH at 110 degrees C gives the mononuclear five-coordinate complexes, [(L1)MX2] (M = Fe, X = Cl 1a; M = Ni, X = Br 1b; M = Zn, X = Cl 1c), in which the metal centre occupies the terpyridine cavity and the imino groups pendant. Conversely, reaction of ketimine-containing L2 with excess MX2 in n-BuOH at 110 degrees C affords the binuclear complexes, [(L2)M2X4] (M = Fe, X = Cl 3a; M = Ni, X = Br 3b; M = Zn, X = Cl 3c), in which one metal centre occupies a bidentate pyridylimine cavity while the other a tridentate bipyridylimine cavity. 1H NMR studies on diamagnetic 3c suggests a fluxional process is operational at ambient temperature in which the central pyridine ring undergoes an exchange between metal coordination. Under less forcing conditions (room temperature in dichloromethane), the monometallic counterpart of 1b [(L2)NiBr2] (2b) has been isolated which can be converted to 3b by addition of one equivalent of (DME)NiBr2 (DME = 1,2-dimethoxyethane) in n-BuOH at 110 degrees C. Quantum mechanical calculations (DFT) have been performed on [(L1)ZnCl2] and [(L2)ZnCl2] for different monometallic conformations and show that 1a is the energetically preferred structure for L1 while there is evidence for dynamic behaviour in L2-containing species leading to bimetallic formation. Single-crystal X-ray diffraction studies have been performed on 1a, 1b, 1c, 2b, 3a, 3b(H2O) and 3c.


The effects of adiponectin and leptin on changes in bone mineral density.
We tested the hypothesis that low leptin and high adiponectin levels are associated with higher rates of bone mineral density (BMD) loss among 3,075 men and women, aged 70-79, from the Health Aging and Body Composition Study. Results suggest that adiponectin, but not leptin, is a risk factor for bone loss in women. Adiponectin and leptin are hormones secreted by adipose cells that may impact BMD. Few studies have evaluated the longitudinal association of leptin and adiponectin levels with rates of BMD change. Hip and whole-body areal BMD (aBMD) were measured five times using dual-energy X-ray absorptiometry over 10 years (average follow-up time, 7.95 ± 1.92 years). Trabecular lumbar spine volumetric BMD (vBMD) was measured using quantitative computed topography at baseline and year 6 in the Pittsburgh cohort only. Random slope and intercept models were used to account for within person correlation as a result of repeated measures of hip and whole-body aBMD. Linear regression was used to model changes in spine trabecular vBMD. Among women, the annualized rate of hip aBMD loss in the highest tertile of adiponectin was -0.67% (95% CI -0.77, -0.58) compared to [-0.43% (95% CI -0.51, -0.35)] in the lowest tertile (p trend = 0.019) after adjusting for age, race, BMI, diabetes, baseline hip aBMD, and weight change. In men, hip aBMD loss was greatest in the high adiponectin group (tertile 3), however this association was not significant (p trend = 0.148). After adjusting for weight change in women, the association between higher leptin and lower hip aBMD loss was attenuated and no longer significant (p trend = 0.134). Leptin and adiponectin levels were not associated with whole-body aBMD or trabecular lumbar spine vBMD loss. Adiponectin was associated with increased hip aBMD loss in women only, supporting evidence that adiponectin may have an important role in bone health.


A Facile Molding Method of Continuous Fiber-Reinforced Thermoplastic Composites and Its Mechanical Property.
The mechanical properties of continuous fiber-reinforced thermoplastic (C-FRTP) composites are commonly lower than those of continuous fiber-reinforced thermosetting plastic (C-FRP) composites. We have developed a new molding method for C-FRTP. In this study, pre-impregnated materials were successfully prepared by polymer solution impregnation method and, finally, C-FRTP was fabricated. The viscosity of the thermoplastic matrix was decreased to approximately 3dPa×s, the same level of epoxy, and the fiber volume fraction was increased from approximately 45 to 60%. The cross-section of specimens were polished by an ion milling system and impregnation condition was investigated by scanning electron microscopy (SEM). The micrographs suggested that thermoplastic polymer was impregnated to every corner of the fiber, and no void was found on the cross-section. It revealed that void-free composites with perfect mechanical properties can be manufactured with this new molding method. All specimens were submitted to a mechanical measuring equipment, and the mechanical properties of the composite specimens were investigated. Mechanical analysis revealed that tensile property and flexural property of C-FRTP were enhanced up to the same level with C-FRP.


Main Diagnostic Pitfalls in Reading the Sacroiliac Joints on MRI.
Magnetic resonance imaging of the sacroiliac joints is now frequently performed to help identify patients with early axial spondyloarthritis. However, differential diagnoses exist and should be recognized. The aim of this article is to review the most frequent differential diagnoses that may mimic inflammatory sacroiliitis in clinical practice.


[The relationship of beta-fibrinogen gene polymorphisms and ischaemic cardiocerebral vascular disease].
To analyze the frequency of beta-fibrinogen (beta-Fg) gene -455G/A, -148C/T and 448G/A polymorphism, fibrinogen molecular reactivity and their association with plasma fibrinogen levels in health adults, myocardial infarction and cerebral infarction disease. The beta-Fg gene -455G/A, -148C/T and 448G/A polymorphisms were analyzed by restriction fragment length polymorphism (RFLP). Fibrinogen molecular reactivity was analyzed for the conversion kinetics of fibrinogen into fibrin by a computer assistant procedure. Plasma fibrinogen levels were determined by Clauss method. The frequencies of -455A, -148T, 448A allele in health adults were 0.185, 0.194 and 0.192, in myocardial infarction disease 0.295, 0.318 and 0.307, in cerebral infarction disease 0.177, 0.193 and 0.182, respectively. The frequencies of -455A, -148T, 448A alleles in myocardial infarction disease were apparently higher than that of health adults. There were close linkage between -455G, -148C and 448G or -455A, -148T and 448A, the correspondence was over 98%. There are no differences in the plasma fibrinogen levels of the three polymorphisms in two genotype groups. The fibrinogen molecular reactivity was significantly increased in cardiocerebral vascular disease and related with plasma fibrinogen level. The three polymorphisms loci are strong linkage disequilibrium. There are no significant differences in the plasma fibrinogen levels of the three polymorphisms in two genotype groups. The frequencies of -455A, -148T, 448A alleles in myocardial infarction disease were apparently higher than that of health adults. It suggest that there was no association between beta-Fg gene -455G/A, -148C/T and 448G/A polymorphisms and plasma fibrinogen levels, but did in myocardial infarction disease. The fibrinogen molecular reactivity was significantly increased in cardiocerebral vascular disease and related with plasma fibrinogen level.


Recreational nitrous oxide abuse-induced vitamin B12 deficiency in a patient presenting with hyperpigmentation of the skin.
Vitamin B12 deficiency causes skin hyperpigmentation, subacute combined degeneration of the spinal cord, and megaloblastic anemia. Although vitamin B12 deficiency rarely occurs in well-nourished, healthy, young people, nitrous oxide (N2O) intoxication is an important cause of vitamin B12 deficiency in this cohort. N2O, a colorless gas used as an anesthetic since the late 19th century because of its euphoric and analgesic qualities, is now used as a recreational drug and is available via the Internet and at clubs. Here, we describe the case of a 29-year-old woman presenting with skin hyperpigmentation as her only initial symptom after N2O abuse for approximately 2 years. N2O intoxication-induced vitamin B12 deficiency was diagnosed based on the skin pigmentation that had manifested over the dorsa of her fingers, toes, and trunk, coupled with myeloneuropathy of the posterior and lateral columns, a low serum vitamin B12 level, an elevated serum homocysteine level, and the N2O exposure revealed while establishing the patient's history. Symptoms improved significantly with vitamin B12 treatment. We recommend that dermatologists consider N2O intoxication-induced vitamin B12 deficiency as a potential cause of skin hyperpigmentation and myeloneuropathy of the posterior and lateral columns in young, otherwise healthy patients. Failure to recognize this presentation may result in inappropriate treatment, thus affecting patients' clinical outcomes.


Allelic variants in durum wheat (Triticum turgidum L. var. durum) DREB genes conferring tolerance to abiotic stresses.
To identify potential and useful markers able to discriminate promising lines of durum wheat (Triticum turgidum L. var durum) tolerant to salt and drought stresses, nucleotide sequences of Dehydration-Responsive-Element Binding Factor (DREB) genes were used to design primers probed with High Resolution Melting technology for the identification of allelic variants. DREB1, DREB2, DREB3, DREB4 and DREB5 conserved regions corresponding to EREBP/AP2 domain and containing the conserved core sequence (5'-TACCGACAT-3'), the protein site directly involved in DNA recognition, were analyzed. The validated primers were probed on four lines of durum wheat differentially tolerant to salt and drought stresses treated with solutions containing different salt concentrations. Some SNPs mutations were identified in the highly tolerant durum cultivar Jennah Khetifa treated with the maximum salt concentration (1.5 M). The SNPs mutations identified were non-synonymous (nsSNPs) causing changes in peptide sequences. These concerned amino acid residues directly involved in the maintenance of protein geometry, the recognition of the specific cis-element, and the contacts between the protein and DNA. A validation of the found SNPs was carried out by analyzing the regressions between DREBs SNPs allelic variants and some morpho-physiological characters in a RIL population, deriving from a cross between the two durum wheat genotypes utilized for SNPs detection, grown under contrasting environments. Several phenotypical characters have been assessed in the progeny across all the localities evaluating the different performances under different stress levels and related with SNPs occurrence. Significant relations between SNPs variants and morpho-physiological characteristics were found in the progeny growth in very severe drought environments, suggesting a role of the identified SNPs in conferring a superior capability to adverse stress conditions and, at the same time, the key role of these genes in empowering salt tolerance.


Efficacy of baked milk oral immunotherapy in baked milk-reactive allergic patients.
Patients with IgE-mediated cow's milk allergy who are nonreactive to baked milk (BM) can be desensitized with BM to promote tolerance to unheated milk (UM). We sought to test whether patients who are BM reactive can progress in BM oral immunotherapy (OIT) and become desensitized to UM as well. Fifteen patients (>4 years) who previously failed to complete our milk OIT program were enrolled into the BM OIT protocol. A dose of BM (180 °C for 30 minutes) which was less than the eliciting dose was increased 50% monthly while under medical supervision until the primary outcome dose of 1.3 g/d BM protein was achieved. Basophil reactivity and milk protein-specific IgE binding were analyzed at the first round of BM OIT therapy (T0) and at 12 months of BM treatment. In terms of the primary outcome, only 3 (21%) of 14 patients tolerated the 1.3 g/d BM dose. Although some patients initially progressed in BM OIT, 8 of 11 failed because of IgE-mediated reactions. Three did not complete the program because of non-IgE-mediated factors. An increase in challenge threshold to UM was noted in patients continuing until 12 months (P = .003), including those among whom reactions precluded continuation in the program. Patients (n = 3) who successfully reached maintenance had decreased milk-specific IgE reactivity. Furthermore, the mean difference at T0 between induced HM and UM percentages of CD203c expression was significantly lower in patients who successfully completed BM OIT than in those who did not (-11% vs 4.4%, P = .0002), which is consistent with their decreased clinical reactivity to BM. Although use of hypoallergenic BM in OIT is a promising therapy, care must be taken before its administration in BM-reactive patients because of the risk for anaphylaxis and only limited increase in challenge threshold attained.


Development and validation of cuproptosis-associated prognostic signatures in WHO 2/3 glioma.
WHO 2/3 glioma is a common intracranial tumor that seriously affects the quality of life and survival time of patients. Previous studies have shown that the tricarboxylic acid (TCA) cycle is closely related to the occurrence and development of glioma, while recent studies have shown that cuproptosis, a novel programmed death pathway, is closely related to the inhibition of the TCA cycle. In our study, eight of ten cuproptosis-related genes (CRGs) were found to be differentially expressed between normal and WHO 2/3 glioma tissues. Through the LASSO algorithm, the cuproptosis-associated risk signatures (CARSs) were constructed, which can effectively predict the prognosis of WHO 2/3 glioma patients and are closely related to clinicopathological features. We analyzed the relationship between risk score and immune cell infiltration through Xcell, ssGSEA, TIMER database, and immune checkpoint molecules. In addition, the relationship between risk score and chemotherapeutic drug sensitivity was also investigated. The prognosis-related independent risk factors FDX1 and CDKN2A identified from CARSs are considered potential prognostic biomarkers for WHO 2/3 glioma. The clinical prognosis model based on cuproptosis is expected to provide an effective reference for the diagnosis and treatment of clinical WHO 2/3 glioma patients.


Serum Untargeted Metabolism Reveals the Mechanism of L. plantarum ZDY2013 in Alleviating Kidney Injury Induced by High-Salt Diet.
A high-salt diet (HSD) is one of the key risk factors for hypertension and kidney injury. In this study, a HSD C57BL/6J mice model was established with 4% NaCl, and then different concentrations of Lactobacillus plantarum ZDY2013 were intragastrically administered for 2 weeks to alleviate HSD-induced renal injury. For the study, 16S rRNA gene sequencing, non-targeted metabonomics, real-time fluorescent quantitative PCR, and Masson's staining were used to investigate the mechanism of L. plantarum ZDY2013 in alleviating renal damage. Results showed that HSD caused intestinal inflammation and changed the intestinal permeability of mice, disrupted the balance of intestinal flora, and increased toxic metabolites (tetrahydrocorticosteron (THB), 3-methyhistidine (3-MH), creatinine, urea, and L-kynurenine), resulting in serious kidney damage. Interestingly, L. plantarum ZDY2013 contributed to reconstructing the intestinal flora of mice by increasing the level of Lactobacillus and Bifidobacterium and decreasing that of Prevotella and Bacteroides. Moreover, the reconstructed intestinal microbiota significantly changed the concentration of the metabolites of hosts through metabolic pathways, including TCA cycle, ABC transport, purine metabolism, and histidine metabolism. The content of uremic toxins such as L-kynurenine, creatinine, and urea in the serum of mice was found to be decreased by L. plantarum ZDY2013, which resulted in renal injury alleviation. Our data suggest that L. plantarum ZDY2013 can indeed improve chronic kidney injury by regulating intestinal flora, strengthening the intestinal barrier, limiting inflammatory response, and reducing uremic toxins.


Small-Molecule Inhibition of UBE2T/FANCL-Mediated Ubiquitylation in the Fanconi Anemia Pathway.
The Fanconi anemia pathway orchestrates the repair of DNA interstrand cross-links and stalled replication forks. A key step in this pathway is UBE2T and FANCL-dependent monoubiquitylation of the FANCD2-FANCI complex. The Fanconi anemia pathway represents an attractive therapeutic target, because activation of this pathway has been linked to chemotherapy resistance in several cancers. However, to date, very few selective inhibitors of ubiquitin conjugation pathways are known. By using a high-throughput screen-compatible assay, we have identified a small-molecule inhibitor of UBE2T/FANCL-mediated FANCD2 monoubiquitylation that sensitizes cells to the DNA cross-linking agent, carboplatin.


Aggressive vs nonaggressive therapy for metastatic NSCLC.
Clinicians tend to underestimate potential modest benefits of chemotherapy. They are often reluctant to refer patients for chemotherapy, perhaps because they expect the side effects to outweigh any perceived benefits. However, patients are much more ready to accept chemotherapy, even when the likely benefits are small. Quality of life, change in performance status, and relief of tumor-related symptoms are important additional parameters of treatment assessment. Taking account of these other factors will help clinicians balance quality and quantity of life in patients with metastatic non-small cell lung cancer.


[Biliary excretion of mezlocillin].
2 g of mezlocillin were given at different time intervals (1/4, 1/2, 1, 2, 4, 10, 14, 18 hours) to patients in whom endoscopic retrograde cholangiography (ERC) was scheduled for antibiotic prophylaxis. Prior to the instillation of the contrast medium 5 ml of bile were aspirated and the concentration of the antibiotic determined via agar diffusion in comparison to the serum level. Serum levels reached a peak of 105 micrograms/ml whereas bile levels reached a mean level of 4000 micrograms/ml. In patients with intact liver function mezlocillin is concentrated to a factor of 40 within bile. Complete elimination in serum occurs after 4 to 5 hours, in bile after 18 to 24 hours.


Symplastic growth and symplasmic transport.
IN CURRENT USAGE, THE ADJECTIVE SYMPLASTIC HAS TWO DIFFERENT MEANINGS: in the term, symplastic growth, as defined by Priestley; and in discussions of transport through the symplast, as defined by Münch. To avoid confusion, it is recommended that symplastic be reserved to characterize growth deformation, that symplasmic be used to refer to transport through the symplasm, and apoplasmic, to refer to the apoplasm.


A simple and powerful flow cytometric method for the simultaneous determination of multiple parameters at G protein-coupled receptor subtypes.
The quantification of pharmacological parameters at G protein-coupled receptors (GPCRs) is indispensable in drug research but costly and time-consuming when conventional methods are sequentially applied. With neuropeptide Y (NPY) Y(1), Y(2), and Y(5) receptors as model systems, a homogenous flow cytometric method for the simultaneous determination of the affinity, selectivity, and activity of GPCR ligands was developed. Mixtures of cells expressing the receptors of interest and cyanine-labeled NPY as a universal fluorescent Y(1), Y(2), and Y(5) receptor agonist were used. Calcium mobilization was measured in different channels with the aid of fluo-4 and fura red. A combination of dye-loaded HEL-Y(1) and CHO-Y(2)-Galpha(qi5) cells with unloaded HEC-1B-Y(5) cells allowed the simultaneous determination of Y(1), Y(2), and Y(5) receptor selectivity preceded by the Y(1) and Y(2) receptor-mediated response with one and the same sample. The data are in good agreement with those determined by radioligand binding and spectrofluorimetry. The convenient, robust, and inexpensive multiparametric procedure offers a broad range of applications in the pharmacological characterization of GPCR ligands.


[Progress of endoscopic screening and differentiation of colorectal polyps].
The incidence of colorectal cancer is rising year by year, thus screening of neoplastic colorectal polyps is very important for the prevention and treatment of colorectal cancer. In recent years, endoscopic techniques have advanced dramatically, such as high definition endoscopy, magnified endoscopy, conventional or virtual chromoendoscopy. Some of these technologies not only can improve the adenoma detection rate, but also may help to enable real-time endoscopic diagnosis and thereby guide decisions about endoscopic resection. The second generation colon capsule endoscopy provides a new and relative reliable noninvasive tool for colorectal diseases screening and diagnosis. This article aims to provide a comprehensive review of advanced imaging techniques available for the detection and differentiation of colorectal polyps.


Conditional independence as a statistical assessment of evidence integration processes.
Intuitively, combining multiple sources of evidence should lead to more accurate decisions than considering single sources of evidence individually. In practice, however, the proper computation may be difficult, or may require additional data that are inaccessible. Here, based on the concept of conditional independence, we consider expressions that can serve either as recipes for integrating evidence based on limited data, or as statistical benchmarks for characterizing evidence integration processes. Consider three events, A, B, and C. We find that, if A and B are conditionally independent with respect to C, then the probability that C occurs given that both A and B are known, PC|A,B, can be easily calculated without the need to measure the full three-way dependency between A, B, and C. This simplified approach can be used in two general ways: to generate predictions by combining multiple (conditionally independent) sources of evidence, or to test whether separate sources of evidence are functionally independent of each other. These applications are demonstrated with four computer-simulated examples, which include detecting a disease based on repeated diagnostic testing, inferring biological age based on multiple biomarkers of aging, discriminating two spatial locations based on multiple cue stimuli (multisensory integration), and examining how behavioral performance in a visual search task depends on selection histories. Besides providing a sound prescription for predicting outcomes, this methodology may be useful for analyzing experimental data of many types.


Screening of Korean forest plants for rat lens aldose reductase inhibition.
Naturally occurring substances which can prevent and treat diabetic complications were sought by examining ethanol extracts prepared from Korean forest plants for their inhibitory effects on rat lens aldose reductase activity in vitro. Among the plants examined, Acer ginnala, Illicium religiosum and Cornus macrophylla exerted the most strong inhibitory activity on aldose reductase.


Early intervention in patients at ultra high risk of psychosis: benefits and risks.
Prediction of transition to psychosis in the prodromal phase of schizophrenia has raised interest in intervention prior to the onset of frank psychosis. The aim of this review was to examine whether interventions in the prodromal phase have a favourable benefit/risk ratio. A literature search in PubMed, EMBASE and PsycINFO was performed. Three randomized clinical trials with antipsychotic medication and/or cognitive behavioural therapy as clinical intervention suggested a positive effect at the end of treatment, but no significant differences were found at the end of follow-up periods from 1 to 4 years. Naturalistic studies present a hypothesis about a possible preventive effect of antidepressive medication. The results of eight other studies are more difficult to interpret. Side-effects of antipsychotic medication and non-adherence with medication are essential problems. At the present time, the data concerning the benefits and risks do not justify prodromal intervention as standard clinical practice.


Combined treatment with interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha up-regulates the expression of HLA class I determinants in Burkitt lymphoma lines.
Cell lines derived from Epstein-Barr virus (EBV)-positive and EBV-negative Burkitt lymphoma (BL) have a low or defective expression of polymorphic HLA class I determinants compared to EBV-transformed lymphoblastoid cell lines (LCL) of normal B cell origin and are resistant to lysis by cytotoxic T lymphocytes (CTL) specific for the corresponding determinants (M. G. Masucci, S. Torsteinsdottir, J. Colombani, C. Brautbar, E. Klein, and G. Klein, Proc. Natl. Acad. Sci. USA 84, 4567, 1987; S. Torsteinsdottir, C. Brautbar, E. Klein, G. Klein, and M. G. Masucci, Int. J. Cancer, 41, 913, 1988). In order to investigate whether this phenotypic trait of the tumor cells can be modulated by agents known to enhance HLA class I antigen expression, pairs of LCL and BL lines were cultured in the presence of recombinant human interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha. Three low HLA A11 expressor EBV-negative BL lines, DG 75, BL 28, and BL 41, reacted significantly stronger with the anti-HLA A11 monoclonal antibody (Mab) AUF 5.13 after combined treatment with 500 U/ml IFN-gamma and 500 U/ml TNF-alpha. Reactivity with the AUF 5.13 and with other anti-polymorphic class I Mab's was up-regulated also in in vitro EBV-converted sublines of BL 28 and BL 41. The increment of antigen expression depended on the baseline expression in untreated cells. It was largest for the low expressor lines and decreased proportionally to the level of up-regulation induced by EBV conversion. Up-regulation of HLA A11 was accompanied by induction of sensitivity to HLA A11-specific CTLs in BL 28 and its converted subline E95A BL28 while BL 41 and E95A BL 41 remained resistant. The treatment did not affect significantly HLA A11 expression of two EBV-carrying, low HLA A11 expressor BL lines, WW-1-BL and WW-2-BL, and of the EBV-carrying BL 72 line that had a high spontaneous expression. The results suggest that the down-regulation of class I antigen expression is reversible in some but not all BL lines.


Streptococcus bovis infections in pigeons.
Streptococcus bovis infection was diagnosed in pigeons from 20 lofts submitted for post mortem investigation. Clinical signs were very variable and ranged from hyperacute death to chronic lameness with arthritis. Lesions were generally unspecific except for single cases of muscle necrosis with purulent myositis. Histological examinations demonstrated the septicaemic nature of the infections. Intravenous inoculations of S. bovis resulted in prostration, long lasting loss of weight and polyuria. Microscopically purulent hepatitis and nephritis were the most characteristic lesions. After oral inoculation no clinical signs were seen.


Unstable angina: 1985 update.
Since 1978 there have been dramatic advances in the understanding of the pathophysiologic features of unstable angina pectoris and in the availability of new therapies of proven efficacy. Coronary artery spasm has been shown to be an important mechanism of acute myocardial ischemia in patients with unstable angina, and coronary thrombosis has been established as an early event in the development of acute myocardial infarction and, possibly, sudden death. Intravenous nitrates and oral calcium antagonists have been made available and are now widely used. Acetylsalicylic acid has been shown to be of benefit. Improved techniques of myocardial preservation and the introduction of percutaneous transluminal coronary angioplasty have modified the surgical management of coronary artery disease.


Refractive index of plant cell walls.
Air was replaced with media of higher refractive indices by vacuum infiltration in leaves of cucumber, blackeye pea, tomato, and string bean plants, and reflectance of noninfiltrated and infiltrated leaves was spectrophotometrically measured. Infiltrated leaves reflected less light than noninfiltrated leaves over the 500-2500-nm wavelength interval because cell wall-air interfaces were partly eliminated. Minimal reflectance should occur when the average refractive index of plant cell walls was matched by the infiltrating fluid. Although refractive indices that resulted in minimal reflectance differed among the four plant genera, an average value of 1.425 approximates the refractive index of plant cell walls for the four plant genera.


Sodium valproate in the treatment of behavioral disturbance in dementia.
Management of the behavioral complications of dementia, including agitation and aggression, presents a tremendous challenge to families and caregivers of afflicted patients. Most previous pharmacotherapies have shown minimal efficacy and significant side effects. We report our initial, open-label experience using the anticonvulsant sodium valproate in four dementia patients with severe behavioral disturbance. The drug was well tolerated by all patients, with no side effects or laboratory abnormalities, during 1- to 3-month trials. Two patients showed significant improvement in behavior, and a third had a transient response. Valproate may be a useful agent in the treatment of behavioral disturbance in dementia; controlled trials are needed to document its efficacy.


Honeybee (Apis mellifera) vision can discriminate between and recognise images of human faces.
Recognising individuals using facial cues is an important ability. There is evidence that the mammalian brain may have specialised neural circuitry for face recognition tasks, although some recent work questions these findings. Thus, to understand if recognising human faces does require species-specific neural processing, it is important to know if non-human animals might be able to solve this difficult spatial task. Honeybees (Apis mellifera) were tested to evaluate whether an animal with no evolutionary history for discriminating between humanoid faces may be able to learn this task. Using differential conditioning, individual bees were trained to visit target face stimuli and to avoid similar distractor stimuli from a standard face recognition test used in human psychology. Performance was evaluated in non-rewarded trials and bees discriminated the target face from a similar distractor with greater than 80% accuracy. When novel distractors were used, bees also demonstrated a high level of choices for the target face, indicating an ability for face recognition. When the stimuli were rotated by 180 degrees there was a large drop in performance, indicating a possible disruption to configural type visual processing.


Care of older adult populations diagnosed with Helicobacter pylori: a review of current literature.
Helicobacter pylori has been linked to development of peptic ulcers and increases the risk of developing gastric carcinoma. Currently, about half of the world's population is infected with H. pylori, many of whom are older adults. Older adult populations often have multiple comorbidities that may mask dyspeptic signs and symptoms. The role of H. pylori and infective signs vary by age, and the confusing symptoms in older adult populations may delay detection and treatment of H. pylori. In addition, time of detection and appropriate treatment is paramount to prevent gastric pathology. Clinicians need to recognize and understand the importance of risk factors, screening, detection, and treatment of H. pylori, particularly in older adults. Earlier detection and more aggressive, proactive clinical recognition of dyspeptic signs and symptoms may lead to earlier screening and diagnosis of H. pylori in older adult populations and help decrease the frequency of gastric metaplasia.


The health of the workers in a rapidly developing country: effects of occupational exposure to noise and heat.
Occupational hygiene and safety have not been high on the agenda of industrial management in developing countries for a variety of reasons. This cross-sectional study was undertaken to assess the exposure to noise and heat, and to study the level of occupational hygiene practiced, at a foundry in a rapidly developing country (Dubai, United Arab Emirates). Audiometry, muscle cramps and visual acuity were measured in workers at a foundry and compared with the results from workers at a soft-drink bottling plant. Thermal stress, relative humidity, ventilation, illumination and noise levels were measured at different work units at the foundry and at the soft-drink bottling factory. Thermal stress index was high while relative humidity and ventilation were low at the foundry compared with the bottling plant. Noise levels were also high at the foundry, exceeding 90 dB at almost all work units except the fabrication workshop. Mild or moderate visual defects were observed among 31% of foundry workers, compared with 19% of the bottling plant workers.Muscle cramps were reported by 30% of all workers at the foundry, compared with 5% at the bottling plant. Visual disability was the highest among furnace operators and fabricators. Mean hearing disability was 8.69 +/- 1.08% among foundry workers, compared with 4.56 +/- 0.82% among bottling plant workers. The high thermal stress, noise levels and exposure to non-ionizing radiations at the foundry might have contributed to the higher frequency of muscle cramps and the greater hearing and visual disabilities, respectively, among these workers. Non-use of personal protective equipment and poor occupational hygiene and safety measures were also seen to affect eye and ear health adversely among the workers at the foundry.


Telemedicine for clinical psychology in the Highlands of Scotland.
Telemedicine may be useful in the delivery of clinical psychology services in the Highlands of Scotland, where geographical size and sociodemographic factors can hinder service delivery. The Highlands have a population of 210,000 at a density of approximately 8 people/km2, one of the lowest in the European Union. Despite a general lack of formal evaluation of telemedicine, especially in mental health, descriptive studies and patient satisfaction reports give grounds for optimism. There are several current applications of telemedicine in the Highlands, including cognitive-behavioural therapy, a comparative evaluation of neuropsychological assessments, and the treatment of children and their families. The projects are being formally evaluated and early results are encouraging.


Effects of Nutrition Education with Intervention Mapping on Cardiovascular Disease Risk Factors in Women with Borderline Dyslipidemia: Analysis According to Menopausal Status.
Menopause causes hormonal, physical, and psychological changes that are associated with an increase in risk of cardiovascular disease (CVD). This study examined the effects of medical nutrition therapy (MNT) on CVD risk factors in pre- and post-menopausal women with borderline dyslipidemia in Korea. In total, 76 participants were divided into the MNT and control groups. MNT was performed for 12 weeks using intervention mapping with consideration of weight, blood lipid levels, and dietary assessment results. Anthropometric and biochemical measurements and dietary intake were analyzed. The dietary energy and cholesterol intake, waist circumference (WC), blood triacylglycerol and very-low-density lipoprotein cholesterol levels, and atherogenic index (AI) of the pre-menopausal MNT group decreased significantly after the intervention. Moreover, dietary cholesterol intake, WC, waist-to-hip ratio, body fat percentage, total blood cholesterol, low-density lipoprotein to high-density lipoprotein ratio, and AI decreased significantly in the post-menopausal MNT group after the intervention. MNT for 12 weeks is effective in decreasing risk factors associated with CVD in Korean women with borderline dyslipidemia, and the effects differ between pre- and post-menopausal women.


Acupuncture for patients with functional dyspepsia: study protocol of a randomised controlled trial.
Whether acupuncture is efficacious for patients with functional dyspepsia is still controversial. So we designed a randomised controlled trial to settle the problem. We designed a multicentre, two-arm, sham-controlled clinical trial. 200 participants with functional dyspepsia will be randomly assigned to the true acupuncture (TA) group and sham acupuncture (SA) group in a 1:1 ratio. Participants in the TA group will receive acupuncture at points selected according to syndrome differentiation. Participants in the sham acupuncture group will receive penetrations at sham points. Participants in both groups will receive 20 sessions of electroacupuncture in 4 weeks, five times continuously with a 2 day rest in a week. The primary outcome is the proportion of patients reporting the absence of dyspeptic symptoms at 16 weeks after inclusion. The secondary outcome includes a Short-Form Leeds Dyspepsia Questionnaire, the Chinese version of the 36-Item Short Form Survey, the Chinese version of the Nepean dyspepsia index, etc. The study protocol has been approved by the institutional review boards and ethics committees of the first affiliated hospital of Chengdu University of TCM, the first affiliated hospital of Hunan University of TCM and Chongqing Medical University, respectively (from April to August 2012). The results of this trial will be disseminated in a peer-reviewed journal and presented at international congresses. ClinicalTrials.gov NCT01671670.


[Peristomal laparocele: particular indications for the use of prosthetic materials].
The authors report the case of a female patient suffering from colic neoplasm and a vast peristomal laparocele, the long-term outcome of a rectal amputation that the patient underwent at a young age. After colic resection, a vast area of surgical mesh in dacron was modelled and positioned in a retromuscular scat, thus allowing the hernia pathology to be resolved relatively simply, owing to its particular location-in correspondence with a preternatural anus-until not long ago this would have represented an absolute contraindication to the use of prosthetic materials. A precise surgical approach, marked by a scrupulous respect for aseptic conditions, is essential in these circumstances owing to the persistent risk of septic complications.


Quis Custodiet Ipsos Custodes (Who Controls the Controllers)? Two Decades of Studies on HDAC9.
Understanding how an epigenetic regulator drives different cellular responses can be a tricky task. Very often, their activities are modulated by large multiprotein complexes, the composition of which is context- and time-dependent. As a consequence, experiments aimed to unveil the functions of an epigenetic regulator can provide different outcomes and conclusions, depending on the circumstances. HDAC9 (histone deacetylase), an epigenetic regulator that influences different differentiating and adaptive responses, makes no exception. Since its discovery, different phenotypes and/or dysfunctions have been observed after the artificial manipulation of its expression. The cells and the microenvironment use multiple strategies to control and monitor HDAC9 activities. To date, some of the genes under HDAC9 control have been identified. However, the exact mechanisms through which HDAC9 can achieve all the different tasks so far described, remain mysterious. Whether it can assemble into different multiprotein complexes and how the cells modulate these complexes is not clearly defined. In summary, despite several cellular responses are known to be affected by HDAC9, many aspects of its network of interactions still remain to be defined.


A comprehensive review on emerging trends in industrial wastewater research.
Rapid industrialization is one of the intricate factors that is linked to the depletion of water resources and increased generation of wastewater. Due to various obstructions and impediments, such as ineffective treatment solutions, exorbitant prices, lack of basic amenities, insufficient financial assistance, and technical expertise, sustainable treatment of industrial effluents has become an onerous process in most parts of the world. The majority of current treatment solutions are conventional and outdated, and thus fall short to remove all the contaminants efficiently from the industrial wastewater. Moreover, poorly treated or untreated industrial effluents are indiscriminately dumped into water bodies such as lakes, ponds, and rivers, causing substantial health hazards to humans and animals and serious threats to the aquatic ecosystem. Thus, there is a need for highly efficient, cost-effective, and sustainable technologies for the treatment of industrial wastewater. Employment of microbial technologies such as microbial fuel cells and microalgal technologies, treatment of wastewater can be coupled with the production of bioelectricity and valuable biomass, respectively. Moreover, with nanofiltration and biochar technologies, the efficiency of the overall treatment procedure can be increased to a greater extent. The present review aims to highlight opportunities and challenges associated with some of the emerging trends in industrial wastewater research.


Role of surface protein SasG in biofilm formation by Staphylococcus aureus.
The SasG surface protein of Staphylococcus aureus has been shown to promote the formation of biofilm. SasG comprises an N-terminal A domain and repeated B domains. Here we demonstrate that SasG is involved in the accumulation phase of biofilm, a process that requires a physiological concentration of Zn(2+). The B domains, but not the A domain, are required. Purified recombinant B domain protein can form dimers in vitro in a Zn(2+)-dependent fashion. Furthermore, the protein can bind to cells that have B domains anchored to their surface and block biofilm formation. The full-length SasG protein exposed on the cell surface is processed within the B domains to a limited degree, resulting in cleaved proteins of various lengths being released into the supernatant. Some of the released molecules associate with the surface-exposed B domains that remain attached to the cell. Studies using inhibitors and mutants failed to identify any protease that could cause the observed cleavage within the B domains. Extensively purified recombinant B domain protein is very labile, and we propose that cleavage occurs spontaneously at labile peptide bonds and that this is necessary for biofilm formation.


Heritabilities and genetic correlations for postweaning growth and feed intake of beef bulls and steers.
Data from studies conducted at Miles City, MT and Lethbridge, AB were pooled to evaluate genetic and environmental variation in feed intake (MEI), growth rate (ADG), MEI-to-gain ratio (M/G), final weight (FWT), and fat thickness (FAT). A total of 124 sires with an average of 4.25 progeny each were represented in the data. Restricted maximum likelihood methods were used to estimate within and between paternal half-sib estimates of variance and covariance. Heritabilities and genetic, phenotypic, and environmental correlations with inference to populations at 365 d of age were calculated from the estimates. Heritabilities were as follows: ADG, .38 +/- .16; MEI, .45 +/- .17; M/G, .26 +/- .15; FWT .25 +/- .15; and FAT .52 +/- .17. The genetic correlation of MEI with ADG was large (.73 +/- .13) and antagonistic to genetic improvement of M/G through selection for ADG. Efficient genetic improvement in M/G was found to depend on using either MEI or an indicator of composition of gain as selection criteria in addition to ADG. Selection to improve M/G using an index that included FWT and FAT, in addition to MEI and ADG, resulted in greater predicted response in ADG and lesser predicted response in MEI than the index of ADG and MEI alone.


Wave field reconstruction and phase imaging by electron diffractive imaging.
In electron diffractive imaging, the phase image of a sample is reconstructed from its diffraction intensity through iterative calculations. The principle of this method is based on the Fourier transform relation between the real-space wave field transmitted by the sample and its Fraunhofer diffraction wave field. Since Gerchberg's experimental work in 1972, various advancements have been achieved, which have substantially improved the quality of the reconstructed phase images and extended the applicable range of the method. In this review article, the principle of diffractive imaging, various experimental processes using electron beams and application to specific samples are explained in detail.


Ruthenium-catalyzed insertion of adjacent diol carbon atoms into C-C bonds: Entry to type II polyketides.
Current catalytic processes involving carbon-carbon bond activation rely on π-unsaturated coupling partners. Exploiting the concept of transfer hydrogenative coupling, we report a ruthenium(0)-catalyzed cycloaddition of benzocyclobutenones that functionalizes two adjacent saturated diol carbon-hydrogen bonds. These regio- and diastereoselective processes enable convergent construction of type II polyketide substructures.


Plasma catecholamines in Buerger's disease: effects of cigarette smoking and surgical sympathectomy.
to study the influence of tobacco exposure and sympathectomy on basal sympathoadrenal function of patients with Buerger's disease. plasma catecholamines were measured before and after smoking, in patients with Buerger's disease (n=13), in patients with Buerger's disease submitted to surgical bilateral lumbar sympathectomy (n=13), and in healthy volunteers (n=16). venous blood samples were collected before and 2h after smoking one cigarette (0.9mg nicotine). Plasma concentrations (pg/ml) of dihydroxiphenylalanine (pL-DOPA), noradrenalin (pNA), adrenalin (pAD) and 3,4-dihydroxiphenylacetic acid (pDOPAC) were determined. Buerger's patients have low basal plasma catecholamines compared to volunteers: pNA (501 (196-927) vs 1858 (968-3663)) and pAD (71 (31-109) vs 193 (116-334)). Sympathectomy increased pL-DOPA, pAD and pDOPAC, but not pNA. After smoking, pNA only decreased in volunteers (1858 (968-3663) vs 1064 (535-2393)). In Buerger+sympathectomy group, smoking lowered pAD (700 (58-3379) vs 278 (54-429)). in Buerger's disease there is an impairment of sympathoadrenal function with an altered peripheral adrenergic response to cigarette smoking. Patients submitted to sympathectomy have high pAD, but this benefit is reversed after smoking. This might be clinically relevant given the association between cigarette smoking and the manifestations of Buerger's disease and the controversy on the effectiveness of sympathectomy in the management of the disease.


Diastolic stress echocardiography detects coronary artery disease in patients with asymptomatic type II diabetes.
Diabetes mellitus is considered as an equivalent of coronary artery disease (CAD). Aim of the study was to investigate whether in asymptomatic patients with type II diabetes, diastolic stress echocardiography may represent an alternative tool for the detection of CAD. The study population consisted of 105 patients with diabetes mellitus (age 61+/-9 years, 26% female, duration of diabetes 37+/-14 months). We performed an exercise stress test, followed by an echo-study and a single-positron emission tomography. Coronary angiography was performed within 1 month. Coronary angiography revealed a coronary artery stenosis of at least 70% in 72 patients (69%, CAD group), while the remaining formed the non-CAD group. Exercise induced an increase of both E/E' lateral and septal ratios as well as their average in the CAD group and on the contrary a decrease of these ratios in the non-CAD group. Receiver operating curve analysis for discrimination between patients with and without obstructive CAD showed an optimal cut-off value of -0.0708 for the exercise-induced change of E/E' average (area under curve 0.892, P<0.001). Sensitivities of scintigraphy and of diastolic stress echocardiography for detection of CAD were 75.0 and 93.1%, respectively; specificity was 78.8% for both methods. In asymptomatic patients, sensitivities of scintigraphy and diastolic stress echocardiography were 76.9 and 92.3%; specificity of both was 80%. In patients with type II diabetes, diastolic stress echocardiography, by means of E/E' ratio exercise-induced changes, can be used for the diagnosis and severity of CAD and for the detection of occult myocardial ischemia.


CD45 cell surface antigens are linked to stimulation of early human myeloid progenitor cells by interleukin 3 (IL-3), granulocyte/macrophage colony-stimulating factor (GM-CSF), a GM-CSF/IL-3 fusion protein, and mast cell growth factor (a c-kit ligand).
CD45 antigens are protein tyrosine phosphatases. A possible link was evaluated between expression of CD45 antigens on human myeloid progenitor cells (MPC) (colony-forming unit-granulocyte/macrophage [CFU-GM], burst-forming unit-erythroid [BFU-E], and colony-forming unit-granulocyte/erythroid/macrophage/megakaryocyte [CFU-GEMM]) and regulation of MPC by colony-stimulating factors (CSF) (interleukin 3 [IL-3], GM-CSF, G-CSF, M-CSF, and erythropoietin [Epo]), a GM-CSF/IL-3 fusion protein, and mast cell growth factor (MGF; a c-kit ligand). Treatment of cells with antisense oligodeoxynucleotides (oligos) to exons 1 and 2, but not 4, 5, or 6, of the CD45 gene, or with monoclonal anti-CD45, significantly decreased CFU-GM colony formation stimulated with GM-CSF, IL-3, fusion protein, and GM-CSF + MGF, but not with G-CSF or M-CSF. It also decreased GM-CSF, IL-3, fusion protein, and MGF-enhanced Epo-dependent BFU-E and CFU-GEMM colony formation, but had little or no effect on BFU-E or CFU-GEMM colony formation stimulated by Epo alone. Similar results were obtained with unseparated or purified (greater than or equal to one of two cells being a MPC) bone marrow cells. Sorted populations of CD343+ HLA-DR+ marrow cells composed of 90% MPC were used to demonstrate capping of CD45 after crosslinking protocols. Also, a decreased percent of CD45+ cells and CD45 antigen density was noted after treatment of column-separated CD34+ cells with antisense oligos to exon 1 of the CD45 gene. These results demonstrate that CD45 cell surface antigens are linked to stimulation of early human MPC by IL-3, GM-CSF, a GM-CSF/IL-3 fusion protein, and MGF.


A thiocyanato-bridged copper(I) cubane complex and its application in palladium-catalyzed Sonogashira coupling of aryl halides.
Reaction of copper(I) thiocyanate with 1,1'-bis(di-tert-butylphosphino) ferrocene (dtbpf) in a 2:1 molar ratio in DCM-MeOH (50:50 V/V) afforded a tetranuclear copper(I) complex [Cu4(μ3-SCN)4(κ(1)-P,P-dtbpf)2] (1) with a cubane-like structure. Complex 1 was shown to be an efficient catalyst in comparison to CuI in the Sonogashira reaction. The coupling products were obtained in high yields by using Pd loadings of 0.2 mol% as well as complex-1 of 0.1 mol%.


Searching for anti-glioma activity. Ribonucleoside analogues with modifications in nucleobase and sugar moieties.
Several ribonucleoside analogues with modifications in the nucleobase and sugar moiety have been screened for anti-glioma activity in the T98G glioma cell line using cervical (HeLa) cell line as reference human malignant cells, and lung fibroblast (MCR-5) cell line as non-cancerous reference cells. Among the investigated compounds, ribonucleosides containing 6-chloropurine (3), 7-guanine (5) and a pyrrolopyrimidine (18) as nucleobases, show promising anti-glioma activity with good selectivity indices, and can be considered as lead structures for further anti-cancer studies.


Vibrational circular dichroism of Delta-SAPR-8-tetrakis[(+)-heptafluorobutyrylcamphorato]lanthanide(III) complexes with an encapsulated alkali metal ion.
The vibrational circular dichroism (VCD) spectra for Delta-M[Ln((+)-hfbc)(4)] (M(I) = Na, K, Rb, Cs; Ln(III) = La, Eu; abbreviated as M-Ln) and Delta-Cs[Yb((+)-hfbc)(4)] (Cs-Yb) were observed in CDCl(3) solutions. The VCD signs and/or intensities are mostly different from those of the Delta-tris(beta-diketonato) transition-metal complexes. The M-Ln complexes give the strong VCD peak(s) near 1550 cm(-1). These VCD patterns are different from each lanthanide(III) complex, but their intensities change with variation of the alkali metal ion. A positive-negative couplet VCD near 1550 cm(-1) for the Delta-M-La complexes is observed similarly for the Delta-tris(beta-diketonato) complexes, confirming the assignment to the Delta absolute configuration based on the exciton CD. The density functional theory calculated VCD for the two peaks at 1650 and 1550 cm(-1) reproduces the relative intensity and signs of the observed ones for the Delta-M-La(III) complexes.


Pertussis in early infancy: disease burden and preventive strategies.
Severe pertussis disease in early infancy remains a significant problem, both in developed countries with long-standing pertussis immunization programs and in poor countries. We review current understanding of the disease burden and potential prevention strategies. Even with intensive care support, infants with pertussis pneumonia still die, so prevention is the key. The source of pertussis in infants under 3 months of age is often not clear, but in countries with high childhood immunization coverage, the sources are usually adults. Strategies to protect these infants may be indirect (timely primary immunization and boosters for older children and adults) and direct (mother during pregnancy or infant soon after birth). 'Cocooning' by immunizing all potential adult contacts is probably the most effective indirect strategy but needs funding and programmatic support for successful implementation. Maternal immunization is attractive but unproven and has significant practical hurdles. The evidence on immunization at birth is conflicting and impact, including interference with response to other infant vaccines, is unclear. Adult booster immunization, either universal or targeted (mothers during pregnancy or 'cocoon'), would probably be effective but is challenging to implement. If shown to be safe and effective, immunization at birth has significant practical advantages. Different strategies (alone or combined) may be needed in different settings.


Anti-α4 Integrin Antibody Blocks Monocyte/Macrophage Traffic to the Heart and Decreases Cardiac Pathology in a SIV Infection Model of AIDS.
Cardiovascular disease (CVD), myocarditis and fibrosis are comorbidities of HIV(+) individuals on durable antiretroviral therapy (ART). Although mechanisms for these vary, monocytes/macrophages are increasingly demonstrated to be key players. We directly blocked monocyte/macrophage traffic to the heart in an SIV model of AIDS using an anti-alpha-4 integrin antibody (natalizumab). Nineteen Rhesus macaques were SIVmac251 infected and CD8-lymphocyte depleted for the development of rapid AIDS. Ten animals received natalizumab once a week, for 3 weeks, and were sacrificed 1 week later. Six animals began treatment at the time of infection (early) and the remaining 4 began treatment 28 days post-infection (late), a time point we have previously established when significant cardiac inflammation occurs. Nine animals were untreated controls; of these, 3 were sacrificed early and 6 were sacrificed late. At necropsy, we found decreased SIV-associated cardiac pathology in late natalizumab-treated animals, compared to untreated controls. Early and late treatment resulted in significant reductions in numbers of CD163(+) and CD68(+) macrophages in cardiac tissues, compared to untreated controls, and a trend in decreasing numbers of newly recruited MAC387(+) and BrdU(+) (recruited) monocytes/macrophages. In late treated animals, decreased macrophage numbers in cardiac tissues correlated with decreased fibrosis. Early and late treatment resulted in decreased cardiomyocyte damage. These data demonstrate a role for macrophages in the development of cardiac inflammation and fibrosis, and suggest that blocking monocyte/macrophage traffic to the heart can alleviate HIV- and SIV-associated myocarditis and fibrosis. They underscore the importance of targeting macrophage activation and traffic as an adjunctive therapy in HIV infection.


Affordable dispersion mitigation with an analog electrical filter.
A new method for dispersion mitigation is presented for low-cost and simple networks. The method does not require dispersion-compensating fibers, special optical filters, coherent detection, or external modulation. It can work in a direct modulation scheme and with a standard optical detector. The disadvantage of this method is the requirement to operate in the weak modulation regime of the signal. In this regime, the dispersive channel can be regarded as linear in the power domain, and not only in the field domain, so that the effects of dispersion can be reduced with a proper electronic filter. Since electronic filters are usually considerably cheaper than coherent optical solutions, this solution can be implemented in low-cost networks, where dispersion is a more severe problem than noise. We show that by adding the filter to a low-noise on-off keying (OOK) system it is possible to transmit data at bit rates of 50 Gb/s to distances at least sixfold larger than its OOK limit (6 km in this case), i.e., 40 km and beyond.


Baby STRENGTH: Eat, Sleep, Console for Infants With Neonatal Abstinence Syndrome.
Traditional medication-based management of neonatal abstinence syndrome (NAS) results in long hospitalizations. Nonpharmacologic treatment and using the Eat, Sleep, Console (ESC) model of care have been shown to decrease lengths of stay (LOSs). To determine whether using the ESC model of care to treat infants with opioid withdrawal resulted in decreased LOSs and number of infants receiving morphine when compared with traditional medication management. Retrospective medical review for all patients admitted for NAS 12 months before and 12 months after implementing the ESC model of care. Data collected from electronic health records included demographic data, maternal history, infant LOS, infants receiving morphine, and birth weight/weight on day of life (DOL) 5. Univariate analysis was used to control for demographic data/risk factors. A 2-samples t test was used to compare average LOSs. Chi-square test was used to detect differences in the number of infants receiving morphine. Data were analyzed using SAS 9.4 software. LOS decreased from mean of 17.7 days to a mean of 5.9 days (P < .0001). The number of infants receiving morphine decreased from 20 (58.9%) to 1 (2.7%) (P < .0001). No statistically significant difference was noted in the percentage of weight loss on DOL 5. Data showed an increase in breastfeeding rates from 41.18% to 64.86% (P = .0456). The ESC model of care decreased infant LOS and the number of morphine doses administered for opioid withdrawal symptoms. Maternal breastfeeding rates increased. More research is needed to determine long-term neurodevelopmental outcomes of infants managed using ESC principles.