Microstructure, texture and colour development during crust formation on whole muscle chicken fillets.
1. The development of crust during a 22-min period was evaluated in an oven, and in previously cooked-in-bag products (no crust) placed in an oven for 10 min. The oven-roasted products started to develop a thin (2-4 μm) crust layer after 4 min. At that point, the colour of the fillets turned white but no browning was observed. As roasting time increased, crust thickness and shear force increased, the product turned brown and eventually black at certain spots. 2. Light microscopy revealed the shrinking of muscle fibres close to the surface, as they also lost water. At a certain point, tears between the different layers started to appear. The inner muscle fibres also progressively shrank and the spaces between them increased. Microscopy of cook-in-bag products revealed no crust formation during heating. Upon moving to the oven, crust started to form but was much faster compared with the other products. 3. Cook-in-the-bag samples showed a higher rate of cook loss during the first 12 min (to internal 70°C) compared with oven heating. This could have been due to the fast heating rate in water and/or no crust formation. 4. White colour was fully formed on water-cooked fillets within 2 min (L* = 83), while it was gradually forming on oven-roasted samples (max L* of 79 after 12 min). 5. Shear force measurements showed an increase in both treatments up to 18 min, with a decrease thereafter (when dry crust started to crack).


Oral desensitization for milk allergy in children: state of the art.
The purpose of this review is to research current evidence on cow's milk oral immunotherapy for the treatment of cow's milk allergy (CMA). The specific, active treatment for IgE-mediated food allergy included CMA, which is currently being investigated in human trials. Allergen-specific approaches include oral, sublingual and epicutaneous immunotherapy. Reports on oral immunotherapy (OIT) for the treatment of milk allergy have been more extensive and carried out mostly with native proteins. The aim of OIT with cow's milk is the achievement of desensitization or tolerance by patients suffering from CMA. Desensitization state can be achieved by approximately 36-92% of the children treated with specific immunotherapy; the rate of permanent tolerance is unknown. Longer duration of desensitization may result in permanent tolerance. The possibility of adverse events or reactions during OIT is quite frequent. Side-effects have been reported by patients in all published studies. OIT as an active treatment for CMA represents an emerging reality. Before this treatment can be used in clinical practice, additional studies are needed. Currently, many issues remain unanswered: severity and type of food allergy responsive to specific immunotherapy, degree of protection, 'shared schedules' of desensitization(s) in research settings and well established risk-to-benefit ratio. However the field of specific, active treatment of food allergy is poised for clinically important advances.


Protein composition of whole and parotid saliva in healthy and periodontitis subjects. Determination of cystatins, albumin, amylase and IgA.
Cystatins are physiological inhibitors of cysteine proteinases and they are widely distributed in human tissues and body fluids including saliva. We previously reported an increased cystatin activity in whole saliva of gingivitis and periodontitis subjects. Based on this result we decided to investigate the type and origin of cystatins involved in this increased cystatin activity by collecting both whole and parotid saliva of 25 healthy and 30 periodontitis subjects. Saliva samples were quantified for cystatins S and C by enzyme-linked immunosorbent assay and cystatin activities were measured toward papain. Besides, three other salivary proteins were determined: the plasma protein albumin, the typical parotid derived amylase and the salivary immunoglobulin IgA. The present investigation shows that levels of total protein and cystatin activity as well as the levels of glandular derived proteins amylase and cystatin C were significantly higher in whole and parotid saliva of subjects with periodontitis than in healthy controls. Cystatin S, the major salivary cystatin, however was higher in the whole saliva of the healthy group. Whole saliva concentrations of albumin and IgA, originating from sources other than the glandular cells, were not different between healthy and periodontitis subjects and were also not correlated with the typical salivary gland proteins. In conclusion, this study provides additional evidence that the human salivary glands may respond to an inflammatory disease of the oral cavity, periodontitis, by enhanced synthesis of some acinar proteins.


HIV sinusitis: rationale for a treatment algorithm.
Over 12 million individuals worldwide are infected with the human immunodeficiency virus (HIV). Up to 60% of these persons may suffer from disease of the paranasal sinuses. Numerous differences exist between sinusitis in HIV and non-HIV infected patients. Some of the differences include HIV sinusitis pathogenesis, bacteriology, and management. This paper addresses these issues so that physicians may adequately prevent, diagnose, and treat persons suffering from HIV sinus infection.


Group sequential design for randomized trials using "first hitting time" model.
Group sequential design (GSD) has become a popular choice in recent clinical trials as it improves trial efficiency by providing options for early termination. The implementation of traditional tests for survival analysis (eg, the log-rank test and the Cox proportional hazard (PH) model) in the GSD setting has been widely discussed. The PH assumption is required for conventional (sequential) design, it is, however, often violated in practice. As an alternative, some generalized tests have been proposed (eg, the Max-Combo test) and their efficacies have been established. In this article, we explore the application of a more flexible, "first hitting time" based threshold regression (TR) model to GSD. TR assumes that subjects' health status is a latent (unobservable) process, and the clinical event of interest occurs when the latent health process hits a pre-specified boundary. The simulation results supported our findings that, in most cases, this comparable new method can successfully control type I error while providing higher early stopping opportunities in the sequential design, even when non-proportional hazard presents.


Non-esterified fatty acid concentrations are independently associated with hepatic steatosis in obese subjects.
We tested the hypothesis that NEFA concentrations are higher in obese subjects with fatty liver than in obese subjects without fatty liver. We recruited 22 obese (BMI>30 kg/m(2)) men aged 42-64 years, in whom liver fat was assessed by ultrasound and classified into categories of no, mild to moderate and severe fatty liver by two independent radiologists. Regional and visceral abdominal fat were assessed by dual-energy X-ray absorptiometry and magnetic resonance imaging, and endogenous glucose production, whole-body glucose disposal during an insulin clamp, and NEFA concentrations were measured, along with NEFA suppression (percent (%) suppression and insulin sensitivity index for NEFA during an OGTT). Seven subjects had no evidence of fatty liver, nine had mild or moderate fatty liver and six had severe fatty liver. The amount of visceral fat was not associated with the degree of fatty liver. Whole-body glucose disposal was inversely associated with fatty liver (38.4, 26.5 and 23.9 mumol kg(-1) min(-1) for the groups with no fatty liver, mild to moderate fatty liver and severe fatty liver, respectively, p=0.004). NEFA suppression during the OGTT was decreased (62.5, 50.8 and 41%, p=0.03, for no, mild to moderate, and severe fatty liver, respectively) and the insulin sensitivity index for NEFA was decreased (0.80, 0.40 and 0.34, p<0.0001). Regression modelling suggested that NEFA concentrations were associated with fatty liver independently of whole-body glucose production and disposal measurements. In obese men, NEFA concentrations during an OGTT are associated with fatty liver independently of classic measures of insulin sensitivity determined by the hyperinsulinaemic clamp. The contribution to this association by factors regulating NEFA concentrations requires further study.


Submicrometer particle detector and size analyzer.
A new instrument is described for measuring concentrations of submicrometer particulates with diameters ranging from 0.005 to 1.0 microm and concentrations as low as 750 particles per cm3 at small diameters and 25 particles per cm3 at the larger diameters. Developed by the Bureau of Mines, the instrument is capable of obtaining size distributions of the sampled particulates using an electrical mobility classification which requires voltages of less than 1000 V over the entire size range. The instrument is normally operated by 115 V ac, but it contains an internal rechargeable battery pack for up to 25 h of continuous dc operation. It has been designed primarily as an incipient fire detector, but can be used as a suspended particulate monitor and size analyzer or as a laboratory instrument for studying combustion aerosols. Representative data are presented, indicating potential uses of the instrument.


[Protective Effect of Acupuncture Serum Derived from Acute Convulsion Rats on Cultured Hip-pocampal Neurons with Seizure-like Discharges by Regulating Expression of Endoplasmic Reticulum Stress-inducible Molecular Chaperones].
To observe the effect of acupuncture serum on the number of apoptosis of the cultured hippocampal neurons with seizure-like discharges and the expression levels of endoplasmic reticulum stress-inducible molecular chaperones glucose-regulated protein 78 (GRP 78), C/EBP homologous protein (CHOP) and cysteine protease protein-12(Caspase-12), so as to reveal its protective mechanism on seizure-induced injury of hippocampal neurons. A regular primary culture of neurons derived from the hippocampus of the newly-born SD rats was conducted for 10 days, then these cultured neurons that displayed seizure-like discharges in Mg2+-free medium were divided into normal extracellular fluid (medium) group (normal), Mg2+-free medium group, acupuncture serum group and non-acupuncture serum group (n=30). Blood examples were taken from pentylenetetrazol (i.p.i.) -induced acute convulsion adult SD rats underwent manual acupuncture stimulation of "Baihui" (GV 20) and "Dazhui" (GV 14, once daily for 7 days) to prepare acupuncture serum. Hippocampal neuronal cultures were prepared from hip-pocampal tissue isolated from 24 h-old SD rats. The isolated neurons were incubated normally in Dulbecco's Modified Eagle Me-dium (DMEM)/Nutrient Mixture F 12(1:1) for 10 days, followed by exposure to the extracellular fluid {composed of NaCl, KCl, CaCl2, MgCl2, HEPES[4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid], D-glucose and aminoethanoic acid (pH 7.3)} for 3 h and returned to normal culture for normal group, by exposure to Mg2+-free extracellular fluid (to induce seizure-like discharges) for 3 h and returned to normal culture for Mg2+-free medium group, by exposure to Mg2+-free extracellular fluid for 3 h and returned to a regular culture medium[DMEM/F 12(1:1)] plus acupuncture serum (9:1) for acupuncture serum group, and by exposure to Mg2+-free extracellular fluid for 3 h and returned to DMEM/F 12(1:1) plus non-acupuncture serum (9:1) for non-acupuncture serum group. The cell apoptosis was assessed at 2, 12 and 48 h after application of acupuncture serum or non-acupuncture serum by using TUNEL method and the expression levels of GRP 78, CHOP and Caspase-12 proteins of the cultured cells at the 3 time-points detected using Western blot. The number of apoptotic hippocampal neurons was significantly higher in the Mg2+-free medium group than in the normal medium group at 2, 12 and 48 h (P<0.01), and considerably decreased in the acupuncture serum group (but not in the non-acupuncture serum group) relevant to the Mg2+-free medium group at the same time-points after application of acupuncture serum (P<0.05, P<0.01). The expression levels of GRP 78 protein at 2 h, CHOP and Caspase-12 proteins at 2, 12 and 48 h were significantly up-regulated in the Mg2+-free medium group relavant to the normal me-dium group (P<0.05, P<0.01). After application of acupuncture serum to the culture medium, the expression levels of GRP 78 protein at the three time-points were significantly increased in comparison with the Mg2+-free medium group (P<0.01,P<0.05), while those of CHOP at 12 and 48 h, and Caspase-12 at the three time-points were notably down-regulated (P<0.05,P<0.01). No significant differences were found between the non-acupuncture serum and Mg2+-free medium groups in the expression levels of GRP 78, CHOP and Caspase-12 proteins at the three time-points (P>0.05). Acupuncture serum can significantly reduce apoptosis of the cultured hippocampal neurons, which may be related to its effects in increasing the expression of GRP 78 protein and down-regulating the expression of CHOP and Caspase-12 proteins, suggesting an important role of acupuncture serum in maintaining the stability of the neuronal endoplasmic reticulum.


Myoelectric alterations after voluntary induced high - and low - frequency fatigue.
The aim of the study was to find whether voluntary induced high- and low-frequency peripheral fatigue exhibit specific alteration in surface EMG signal (SEMG) during evoked and maximum voluntary contractions. Ten male students of physical education performed 60 s long stretch-shortening cycle (SSC) exercise with maximal intensity and 30 s long concentric (CON) exercise with maximal intensity. To verify voluntary induced peripheral fatigue, knee torques during low- (T20) and high-frequency electrical stimulation (T100) of relaxed vastus lateralis muscle (VL) were obtained. Contractile properties of the VL were measured with passive twitch and maximal voluntary knee extension test (MVC). Changes in M-waves and SEMG during MVC test were used to evaluate the differences in myoelectrical signals. T100/T20 ratio decreased by 10.9 ± 8.4 % (p < 0.01) after the SSC exercise and increased by 35.9 ± 17.5 % (p < 0.001) after the CON exercise. Significant SEMG changes were observed only after the CON exercise where peak to peak time of the M-waves increased by 9.2 ± 13.3 % (p < 0.06), SEMG amplitude during MVC increased by 32.9 ± 21.6 % (p < 0.001) and SEMG power spectrum median frequency decreased by 11.0 ± 10.5 % (p < 0.05). It is concluded that high frequency fatigue wasn't reflected in SEMG, however the SEMG changes after the CON seemed to reflect metabolic changes due to acidosis. Key pointsThe SSC exercise induced high-frequency fatigue which was not reflected in any SEMG change.The CON exercise induced dominantly low-frequency fatigue where only SEMG during MVC changedMuscle fibre membrane excitability was not changed due to low- and high-frequency fatigue but mainly reflected metabolic changes.Changes in muscle compound action potential did not follow those changes seen after electrically elicited HF and LF fatigue.


Bone mineral density around femoral stems. DXA measurements in 22 porous-coated implants after 5 years.
In this cross-sectional study the bone mineral density (BMD) close to proximal porous-coated femur stems was measured by DXA 4.5-6 years after the stem implantation and compared to the contralateral non-operated femur in 22 cases. Measuring areas were defined by Gruen's method. The average precision error varied according to the zone assessed and ranged from 2.2 to 4.9 percent. The median BMD values of the operated femur were in 5 of 7 areas lower than those of the contralateral side. The largest differences were noted in the calcar region and the greater trochanteric region (21 and 20 percent, respectively). No correlation was found between the femoral BMD differences and the stem diameter.


Anemia or other comorbidities? using machine learning to reveal deeper insights into the drivers of acute coronary syndromes in hospital admitted patients.
Acute coronary syndromes (ACS) are a leading cause of deaths worldwide, yet the diagnosis and treatment of this group of diseases represent a significant challenge for clinicians. The epidemiology of ACS is extremely complex and the relationship between ACS and patient risk factors is typically non-linear and highly variable across patient lifespan. Here, we aim to uncover deeper insights into the factors that shape ACS outcomes in hospitals across four Arabian Gulf countries. Further, because anemia is one of the most observed comorbidities, we explored its role in the prognosis of most prevalent ACS in-hospital outcomes (mortality, heart failure, and bleeding) in the region. We used a robust multi-algorithm interpretable machine learning (ML) pipeline, and 20 relevant risk factors to fit predictive models to 4,044 patients presenting with ACS between 2012 and 2013. We found that in-hospital heart failure followed by anemia was the most important predictor of mortality. However, anemia was the first most important predictor for both in-hospital heart failure, and bleeding. For all in-hospital outcome, anemia had remarkably non-linear relationships with both ACS outcomes and patients' baseline characteristics. With minimal statistical assumptions, our ML models had reasonable predictive performance (AUCs > 0.75) and substantially outperformed commonly used statistical and risk stratification methods. Moreover, our pipeline was able to elucidate ACS risk of individual patients based on their unique risk factors. Fully interpretable ML approaches are rarely used in clinical settings, particularly in the Middle East, but have the potential to improve clinicians' prognostic efforts and guide policymakers in reducing the health and economic burdens of ACS worldwide.


Soleus fascicle length changes are conserved between young and old adults at their preferred walking speed.
Older adults have been shown to naturally select a walking speed approximately 20% slower than younger adults. We explored the possibility that a reduction in preferred speed in older adults represents a strategy to preserve the mechanical function of the leg muscles. We examined this question in the soleus muscle in eight healthy young (25.8±3.5 years) and eight healthy older adults (66.1±2.3 years) who were paired so that their preferred speed differed by ∼20%. Soleus muscle fascicle lengths were recorded dynamically using ultrasound, together with simultaneous measurements of soleus EMG activity and ankle joint kinematics while (a) older adults walked on a treadmill at a speed 20% above their preferred speed (speeds matched to the preferred speed of young adults), and (b) young and older adults walked at their preferred treadmill speeds. Analyses of mean muscle fascicle length changes revealed that, at matched speeds, older adults had a statistically different soleus fascicle length pattern compared to young adults, where the muscle's stretch-shorten cycle during stance was diminished. However, older adults walking at their preferred speed exhibited a more pronounced stretch-shorten cycle that was not statistically different from young adults. Conserving muscle length patterns through a reduction in speed in older adults may represent a physiologically relevant modulation of muscle function that permits greater force and power production. Our findings offer a novel mechanical explanation for the slower walking speed in older adults, whereby a reduction in speed may permit muscles to function in a mechanically similar manner to that of younger adults.


Cocaine- and amphetamine-regulated transcript (CART) is expressed in several islet cell types during rat development.
Cocaine- and amphetamine-regulated transcript (CART) is an anorexigenic peptide widely expressed in the central and peripheral, including the enteric, nervous systems. CART is also expressed in pituitary endocrine cells, adrenomedullary cells, islet somatostatin cells, and in rat antral gastrin cells. We used immunocytochemistry (IHC) and in situ hybridization (ISH) to study CART expression in developing rat pancreas. We also examined co-expression of CART and islet hormones and developmental markers and the effect of CART on proliferation using clonal insulin cells (INS-1 832/13). A major portion of each of the islet cell types, except the ghrelin cells, expressed CART during a period before and around birth. Two weeks postnatally, CART expression was restricted to somatostatin cells. Pre- and early postnatally, many of the CART-expressing cells co-expressed cytokeratin 20 (CK20), a marker of duct cells and islet precursor cells, the trophic hormone gastrin, and a smaller subpopulation also harbored the proliferation marker Ki67. CART was also expressed in pancreatic nerve fibers, both sensory and autonomic, and in ganglion nerve cell bodies. Although highly expressed in the developing islets, CART did not affect proliferation of INS-1 cells. We have demonstrated that CART is expressed in several islet cell types during rat development but is restricted to somatostatin cells and neurons in the adult rat.


Long-Reads-Based Metagenomics in Clinical Diagnosis With a Special Focus on Fungal Infections.
Identification of the causative infectious agent is essential in the management of infectious diseases, with the ideal diagnostic method being rapid, accurate, and informative, while remaining cost-effective. Traditional diagnostic techniques rely on culturing and cell propagation to isolate and identify the causative pathogen. These techniques are limited by the ability and the time required to grow or propagate an agent in vitro and the facts that identification based on morphological traits are non-specific, insensitive, and reliant on technical expertise. The evolution of next-generation sequencing has revolutionized genomic studies to generate more data at a cheaper cost. These are divided into short- and long-read sequencing technologies, depending on the length of reads generated during sequencing runs. Long-read sequencing also called third-generation sequencing emerged commercially through the instruments released by Pacific Biosciences and Oxford Nanopore Technologies, although relying on different sequencing chemistries, with the first one being more accurate both platforms can generate ultra-long sequence reads. Long-read sequencing is capable of entirely spanning previously established genomic identification regions or potentially small whole genomes, drastically improving the accuracy of the identification of pathogens directly from clinical samples. Long-read sequencing may also provide additional important clinical information, such as antimicrobial resistance profiles and epidemiological data from a single sequencing run. While initial applications of long-read sequencing in clinical diagnosis showed that it could be a promising diagnostic technique, it also has highlighted the need for further optimization. In this review, we show the potential long-read sequencing has in clinical diagnosis of fungal infections and discuss the pros and cons of its implementation.


Psychometric properties of a modified version of the Roland-Morris disability questionnaire (M-RMDQ).
Chronic pain can be associated with limitations in patient function. Assessment of pain-related limitations is one of the important outcome domains that should be considered when designing chronic pain clinical trials. Although a validated instrument for the assessment of pain-related disability in Iranian chronic low back pain (CLBP) patients exists, to date there is no psychometrically sound instrument to measure pain-related physical disability amongst Iranian chronic pain patients suffering from pain in other parts of their bodies. Six hundred chronic pain patients completed the Modified version of the Roland-Morris disability questionnaire (M-RMDQ) in addition to questionnaires on demographic variables, pain intensity and depression. Internal consistency, test-retest reliability, and concurrent and predictive validity were calculated for the M-RMDQ. Internal consistency of the M-RMDQ items was acceptable (Cronbach's alpha=0.88). Test-retest reliability with a mean 36-day interval between assessments in 76 chronic pain patients was high (ICC=0.90). Concurrent validity was confirmed via significant correlations between the scores of M-RMDQ, depression and pain intensity. Predictive validity of the M-RMDQ was confirmed as it successfully differentiated pain clinic chronic pain patients from the non-pain clinic chronic pain population. The M-RMDQ has adequate reliability and validity and can be used as a sound measure of physical disability associated with chronic pain among the Iranian population.


The Blood Glucose Monitoring Communication questionnaire: an instrument to measure affect specific to blood glucose monitoring.
The aim of this study was to present the psychometric properties of a new tool for evaluating affective response to blood glucose monitoring (BGM) in youths with type 1 diabetes and their parents. Study participants included 153 youths with type 1 diabetes and their parents. Each youth and parent completed the Blood Glucose Monitoring Communication (BGMC) questionnaire, Diabetes Family Conflict Scale, and Pediatric Quality of Life Inventory. Statistical analyses evaluated the psychometric properties of the BGMC questionnaires and their association with glycemic outcomes. Youth and parent BGMC questionnaires had acceptable internal consistency (youth, alpha = 0.77; parent, alpha = 0.82) and 1-year test-retest reliability (youth, r = 0.60; parent, r = 0.80). Higher BGMC questionnaire scores (indicating more negative affect) showed a strong association with higher levels of diabetes-specific family conflict (youth, r = 0.33; parent, r = 0.44) and poorer health-related psychosocial quality of life (youth, r = -0.50; parent, r = -0.42). Higher BGMC questionnaire scores were also associated with poorer glycemic control (youth, r = 0.28; parent, r = 0.20), even when the effects of diabetes-specific family conflict and psychosocial quality of life were controlled. Youths with BGMC questionnaire scores in the upper quartile had A1c values 1 percentage point higher (9.1%) than youths with scores in the lowest quartile (8.0%). The BGMC questionnaires have strong psychometric properties and are convenient measures of affect specific to BGM. Further, BGM affect is associated with glycemic outcomes and may provide a unique contribution to factors associated with glycemic control in youths.


Phytoremediation of oilfield sludge after prepared bed bioremediation treatment.
A field-scale experiment was carried out to compare the effectiveness of five plant species in the remediation of oily sludge. Alfalfa, tall fescue, and soybean substantially increased the removal rate of oil and grease (O&G) after 120 days of remediation. Of these, soybean treatment showed the highest removal rate of 34.2% compared with only 13.7% in the unplanted control plot. In addition to assisting with phytoremediation, soybean can also be used for energy production, for example in the production of biodiesel. Furthermore, microbial counts and community level physiological profiling using Biolog sole carbon source utilization tests were used to investigate the effect of plants on the microbial community of oily sludge. Plants selectively increased microbial counts in the rhizosphere and O&G concentrations of the sludge were negatively correlated with counts of TPH (total petroleum hydrocarbon) degraders. The acute biotoxicity of the sludge was also tested by the bacterial luminescence method and alfalfa treatments decreased the biological toxicity of the sludge compared with the unplanted control.


Human sensitivity to gravity (on the problem of gravipreferendum).
Experiments were carried out in a centrifuge with an arm of 7.25 m, the cabin being equipped with a self-contained system of control. During an exposure to head-to-feet accelerations (+gz) of 2 g and an onset rate of 0.1 g s-1 the test subject controlled the centrifugation himself and selected the acceleration values he was instructed to attain. The subjects were shown to be capable of assessing integrally the value of accelerations and estimating it with an error of 0.1-0.12 g. During an exposure to chest-to-back accelerations (+gx) limited to a value of 12 g and a gradient of 0.3 g s-1 the ability to select actively the rate of an acceleration increase was studied. Repeated centrifugations resulted in the formation and strengthening of the skill of maintaining a physiologically optimal rate of an acceleration increase. Onset rates were determined for every level of acceleration. When calculated as a mean, physiologically optimal values of the onset rate for 12 g were 0.16-0.18 g s-1. The findings give insight into important properties of the physiological structure of "gravipreferendum", which is the capability of man to differentiate between gravity levels and to select actively optimal rates of an increase in acceleration.


A Case Report of Vitiligo Induced by Alexandrite Hair Removal Laser.
Vitiligo is one of the disorders where we usually see Koebner lesions. Lasers target a chromophore in the skin to deliver their energy. Their effect is theoretically considered as injury and may induce Koebner lesions in vitiligo patients. Few cases were reported with the different kinds of laser, including laser hair removal (LHR). No cases have ever been reported of vitiligo lesions induced by Alexandrite LHR. Here we present a case report of a young female patient who had never had vitiligo until she received a 755-nm LHR treatment. These vitiligo lesions were completely treated with NB-UVB with no recurrence until 4 years later when she received another 755-nm LHR treatment session with a different machine, which lead to new vitiligo patches only on the areas that received the laser.


Clustering and coupled gating modulate the activity in KcsA, a potassium channel model.
Different patterns of channel activity have been detected by patch clamping excised membrane patches from reconstituted giant liposomes containing purified KcsA, a potassium channel from prokaryotes. The more frequent pattern has a characteristic low channel opening probability and exhibits many other features reported for KcsA reconstituted into planar lipid bilayers, including a moderate voltage dependence, blockade by Na(+), and a strict dependence on acidic pH for channel opening. The predominant gating event in this low channel opening probability pattern corresponds to the positive coupling of two KcsA channels. However, other activity patterns have been detected as well, which are characterized by a high channel opening probability (HOP patterns), positive coupling of mostly five concerted channels, and profound changes in other KcsA features, including a different voltage dependence, channel opening at neutral pH, and lack of Na(+) blockade. The above functional diversity occurs correlatively to the heterogeneous supramolecular assembly of KcsA into clusters. Clustering of KcsA depends on protein concentration and occurs both in detergent solution and more markedly in reconstituted membranes, including giant liposomes, where some of the clusters are large enough (up to micrometer size) to be observed by confocal microscopy. As in the allosteric conformational spread responses observed in receptor clustering (Bray, D. and Duke, T. (2004) Annu. Rev. Biophys. Biomol. Struct. 33, 53-73) our tenet is that physical clustering of KcsA channels is behind the observed multiple coupled gating and diverse functional responses.


Potential Effect of CD271 on Human Mesenchymal Stromal Cell Proliferation and Differentiation.
The Low-Affinity Nerve Growth Factor Receptor (LNGFR), also known as CD271, is a member of the tumor necrosis factor receptor superfamily. The CD271 cell surface marker defines a subset of multipotential mesenchymal stromal cells and may be used to isolate and enrich cells derived from bone marrow aspirate. In this study, we compare the proliferative and differentiation potentials of CD271+ and CD271- mesenchymal stromal cells. Mesenchymal stromal cells were isolated from bone marrow aspirate and adipose tissue by plastic adherence and positive selection. The proliferation and differentiation potentials of CD271+ and CD271- mesenchymal stromal cells were assessed by inducing osteogenic, adipogenic and chondrogenic in vitro differentiation. Compared to CD271+, CD271- mesenchymal stromal cells showed a lower proliferation rate and a decreased ability to give rise to osteocytes, adipocytes and chondrocytes. Furthermore, we observed that CD271+ mesenchymal stromal cells isolated from adipose tissue displayed a higher efficiency of proliferation and trilineage differentiation compared to CD271+ mesenchymal stromal cells isolated from bone marrow samples, although the CD271 expression levels were comparable. In conclusion, these data show that both the presence of CD271 antigen and the source of mesenchymal stromal cells represent important factors in determining the ability of the cells to proliferate and differentiate.


Synergistic aerobic and anaerobic infections.
Encapsulation affects the virulence and survival of anaerobic bacteria and their protection from phagocytosis. More encapsulated Bacteroides strains and anaerobic and facultative gram-positive cocci are isolated from patients with clinical infections than from healthy people. The pathogenicity of Bacteroides, Fusobacterium, Clostridium, and cocci isolates was demonstrated by their ability to induce subcutaneous abscesses in mice. Encapsulated Bacteroides, Fusobacterium, and cocci isolates generally induced abscesses, whereas nonencapsulated organisms did not. When strains that had fewer than 1% encapsulated organisms were inoculated with other viable or nonviable encapsulated bacteria, many survived in the abscesses and became heavily encapsulated. These strains were then able to induce abscesses when injected alone. Encapsulated Bacteroides species and anaerobic cocci induced bacteremia and translocation and increased the mortality in infected animals more often than did nonencapsulated forms of the same strain. In studies of selective antimicrobial therapy and quantitative cultures of abscesses, it was determined that possession of a capsule generally made Bacteroides species more important in mixed infections than their aerobic counterparts. In vivo synergy was seen between encapsulated Bacteroides species and all tested aerobic bacteria and most anaerobic and facultative gram-positive cocci as well as between most of these cocci and Pseudomonas aeruginosa or Staphylococcus aureus. It is concluded that encapsulated anaerobic bacteria have an important pathogenic role in polymicrobial infections.


Heme reactivity is uncoupled from quaternary structure in gel-encapsulated hemoglobin: a resonance Raman spectroscopic study.
Encapsulation of hemoglobin (Hb) in silica gel preserves structure and function but greatly slows protein motion, thereby providing access to intermediates along the allosteric pathway that are inaccessible in solution. Resonance Raman (RR) spectroscopy with visible and ultraviolet laser excitation provides probes of heme reactivity and of key tertiary and quaternary contacts. These probes were monitored in gels after deoxygenation of oxyHb and after CO binding to deoxyHb, which initiate conformational change in the R-T and T-R directions, respectively. The spectra establish that quaternary structure change in the gel takes a week or more but that the evolution of heme reactivity, as monitored by the Fe-histidine stretching vibration, ν(FeHis), is completed within two days, and is therefore uncoupled from the quaternary structure. Within each quaternary structure, the evolving ν(FeHis) frequencies span the full range of values between those previously associated with the high- and low-affinity end states, R and T. This result supports the tertiary two-state (TTS) model, in which the Hb subunits can adopt high- and low-affinity tertiary structures, r and t, within each quaternary state. The spectra also reveal different tertiary pathways, involving the breaking and reformation of E and F interhelical contacts in the R-T direction but not the T-R direction. In the latter, tertiary motions are restricted by the T quaternary contacts.


Are There Differences in Experts' and Lay Assessors' Attractiveness Judgments of Non-Professional Men's Dance/Gait Movements?
Research on attractiveness assessments of men's dance has shown that raters derive and integrate information about male mating-related qualities into their attractiveness assessments, but prior studies have focused on lay assessors (i.e., individuals with no professional dance background) rather than dance experts. We recruited male and female Russian dance experts (n = 23) to judge gender-neutral, featureless virtual characters, animated with motion-captured dance movements and gaits of British men, and compared their dance assessments to those from a group of Russian male and female lay assessors (n = 73). The dance experts provided higher dance and gait attractiveness judgments than the lay assessors. Both groups judged the gait movements to be of higher attractiveness than the dance movements. Differences in attractiveness assessments between experts and lay assessors were larger for the male judges than for the female judges. In an additional survey, the dance experts (versus lay assessors) placed greater emphasis on the importance of dance-related capacities and skills. We discuss our findings with reference to past research on dance/gait attractiveness as assessed by lay judges and the role of expertise in assessing body movement.


DNA microarray analysis of chromosomal susceptibility regions to identify candidate genes for allergic disease: a pilot study.
To examine whether DNA microarray analysis of chromosomal susceptibility regions for allergy can help to identify candidate genes. Nasal biopsies were obtained from 23 patients with allergic rhinitis and 12 healthy controls. RNA was extracted from the biopsies and pooled into three patient and three control pools. These were then analysed in duplicate with DNA microarrays containing 12626 genes. Candidate genes were further examined in nasal biopsies (real-time polymerase chain reaction) and blood samples (single nucleotide polymorphisms) from other patients with allergic rhinitis and from controls. A total of 37 differentially expressed genes were identified according to criteria involving both the size and consistency of the gene expression levels. The chromosomal location of these genes was compared with the chromosomal susceptibility regions for allergic disease. Using a statistical method, five genes were identified in these regions, including serine protease inhibitor, Kazal type, 5 (SPINK5) and HLA-DRB2. The relevance of these genes was examined in other patients with allergic rhinitis and in controls; none of the genes were differentially expressed in nasal biopsies. Moreover, no association between allergic rhinitis and SPINK5 polymorphisms was found, at either the genotype or haplotype level. DNA microarray analysis of chromosomal susceptibility regions did not lead to identification of candidate genes that could be validated in a new material. However, because gene polymorphisms may cause differential gene expression, further studies, including validation data, are needed to examine this approach.


CHRM3 is a novel prognostic factor of poor prognosis in patients with endometrial carcinoma.
Endometrial carcinoma is the most common gynecologic malignancy. Searching for a new molecule to more accurately predict survival of patients and act as therapy target is urgent. CHRM3 is a major player in many kinds of cancer. The expression level and prognostic value of CHRM3 in endometrial carcinoma remain unclear. In this study, we assayed the expression of CHRM3 in 257 endometrial carcinoma patients by immunohistochemistry. The results showed that CHRM3 expression level was closely correlated with the FIGO stage, vascular invasion and lymphatic metastasis. Although CHRM3 was highly expressed in advanced endometrial carcinoma, multivariate Cox proportional hazards regression analysis showed that CHRM3 expression was not an independent prognostic factor for endometrial carcinoma. Furthermore, to evaluate the prognostic efficiency of CHRM3 in endometrial carcinoma, we compared the sensitivity and specificity of CHRM3 in endometrial carcinoma prognosis by logistic regression. The result showed that CHRM3 combining with other clinicopathological risk factors was a stronger prognostic model than clinicopathological risk factor alone or combination of risk factors. Thus, CHRM3 potentially offers a clinical value in target therapy for endometrial carcinoma patients.


Implications of policy and management decisions on access, quality, and the type of services for the elderly in the United States.
America has no conscious overall health policy. What we have is a system which encourages doctors to perform medical procedures on people, especially in hospitals, and which places little or no emphasis on a person's responsibility for his or her own health. There is no incentive whatsoever for doctors, except in HMOs, to provide the elderly with primary care or consultations on preventative health care. there is no reimbursement under Medicare for this type of service, and a financial disincentive exists for the doctor in that a healthier patient is less likely to use a physician's services. In addition, because there is inadequate funding for home health care and supportive services for families of the elderly who are experiencing problems functioning in their daily living, many people who could be kept out of nursing homes with proper support go into nursing homes, where they generally, after depletion of their assets, have their nursing home care covered by the Medicaid program. Because of the lack of recognition by the Medicare program of the major role of social and mental health factors on the health of the elderly, and the lack of reimbursement or other funding for services which treat the social, mental, and spiritual aspects of the person, the elderly are often inappropriately and expensively treated for physical symptoms; their other needs and problems are ignored, even though in many cases the treatment of the underlying problem would remove or ameliorate the physical symptom and expedite the recovery. Recommended changes in the health care system which will be of particular benefit to the elderly are by providing primary and preventative health care, providing alternatives to hospitalization and nursing home care wherever possible, discouraging unnecessary surgery and medication, providing for contributions to Medicare based on income of the elderly so that the poor and the rich are treated more equitably, decreasing the complexity of the Medicare reimbursement process, mandating geriatric education for health care professionals, developing public awareness concerning the quality of extended life and promoting public information programs designed to promote a new and positive image of aging in America.


A pilot study of the therapeutic efficacy and mechanism of artesunate in the MRL/lpr murine model of systemic lupus erythematosus.
Recent evidence indicates that artesunate has immunomodulatory properties that might be useful for treating autoimmune disease. In this study, we conducted a pilot study and explored the effect and mechanism of artesunate on the treatment of systemic lupus erythematosus using an MRL/lpr murine model. MRL/lpr mice were divided into control, cyclophosphamide (CTX) and artesunate treatment groups. Blood was collected to measure serum levels of creatinine, antinuclear antibody (ANA) and anti-double-stranded DNA (anti-dsDNA) antibody. Twenty-four-hour urine was collected to measure levels of proteinuria. The concentration of monocyte chemotactic protein-1 (MCP-1) in serum and urine was measured. The expression of MCP-1 in kidney was detected by Western blot and immunohistochemistry assay, respectively. The expression of B cell activating factor (BAFF) in spleen was determined by real time-PCR and immunoblotting. We found that artesunate significantly increased the survival rate, body weight and blood leukocyte counts, and reduced the serum levels of ANA and anti-dsDNA antibody titer, 24 h urinary protein, and serum creatinine. Our results indicated that artesunate could decrease MCP-1, major pro-inflammation cytokine, in serum, urine and kidney. We also found that the level of BAFF, the major B cell activation factor, was decreased in artesunate treated MRL/lpr mice. Its efficacy was comparable with that of CTX in this study. Taken together, we have demonstrated that artesunate can inhibit the progression of disease and reverse the pathologic lesion of lupus nephritis.


Increased ultrafine particles and carbon monoxide concentrations are associated with asthma exacerbation among urban children.
Increased air pollutant concentrations have been linked to several asthma-related outcomes in children, including respiratory symptoms, medication use, and hospital visits. However, few studies have examined effects of ultrafine particles in a pediatric population. Our primary objective was to examine the effects of ambient concentrations of ultrafine particles on asthma exacerbation among urban children and determine whether consistent treatment with inhaled corticosteroids could attenuate these effects. We also explored the relationship between asthma exacerbation and ambient concentrations of accumulation mode particles, fine particles (≤2.5 micrograms [μm]; PM2.5), carbon monoxide, sulfur dioxide, and ozone. We hypothesized that increased 1-7 day concentrations of ultrafine particles and other pollutants would be associated with increases in the relative odds of an asthma exacerbation, but that this increase in risk would be attenuated among children receiving school-based corticosteroid therapy. We conducted a pilot study using data from 3 to 10 year-old children participating in the School-Based Asthma Therapy trial. Using a time-stratified case-crossover design and conditional logistic regression, we estimated the relative odds of a pediatric asthma visit treated with prednisone (n=96 visits among 74 children) associated with increased pollutant concentrations in the previous 7 days. We re-ran these analyses separately for children receiving medications through the school-based intervention and children in a usual care control group. Interquartile range increases in ultrafine particles and carbon monoxide concentrations in the previous 7 days were associated with increases in the relative odds of a pediatric asthma visit, with the largest increases observed for 4-day mean ultrafine particles (interquartile range=2088p/cm(3); OR=1.27; 95% CI=0.90-1.79) and 7-day mean carbon monoxide (interquartile range=0.17ppm; OR=1.63; 95% CI=1.03-2.59). Relative odds estimates were larger among children receiving school-based inhaled corticosteroid treatment. We observed no such associations with accumulation mode particles, black carbon, fine particles (≤2.5μm), or sulfur dioxide. Ozone concentrations were inversely associated with the relative odds of a pediatric asthma visit. These findings suggest a response to markers of traffic pollution among urban asthmatic children. Effects were strongest among children receiving preventive medications through school, suggesting that this group of children was particularly sensitive to environmental triggers. Medication adherence alone may be insufficient to protect the most vulnerable from environmental asthma triggers. However, further research is necessary to confirm this finding.


Investigation of the viscous heating artefact arising from the use of thermocouples in a focused ultrasound field.
Accurate temperature measurements in therapeutic ultrasound fields are necessary for understanding damage mechanisms, verification of thermal modelling and calibration of non-invasive clinical thermometry. However, artefactual heating, primarily due to viscous forces which result from motion relative to the surrounding tissue, occurs when metal thermocouples are used in an ultrasound field. The magnitude and time dependence of this artefact has been characterized by comparison with novel thin-film thermocouples (TFTs) at 1-2 cm focal depths in fresh degassed ex vivo bovine liver. High-intensity focused ultrasound exposures (1.7 MHz; free-field spatial-peak temporal-average intensities 40-600 W cm(-2)) were used. Subtraction of the TFT data from that obtained for other thermocouples yielded the time dependence of the viscous heating artefact. This was found to be intensity independent up to 600 W cm(-2) (below the threshold for cavitation and lesion formation) and remained significant at radial distances out to the first side lobe in the focal plane. The contribution of viscous heating to cooling was also found to be significant for at least 5 s after the end of insonation. The ratio of viscous artefact to absorptive heating after 5 s was: 1.76 +/- 0.07 for a fine-wire, 0.45 +/- 0.07 and 1.93 +/- 0.07 for two different sheathed-wires and 0.24 +/- 0.07 for a needle thermocouple.


Hoechst 33342 efflux identifies a subpopulation of cytogenetically normal CD34(+)CD38(-) progenitor cells from patients with acute myeloid leukemia.
Efflux of Hoechst 33342 from normal hematopoietic cells identifies a "side population" (SP(+)) of negatively staining cells that, in the mouse, are largely CD34(-) and are enriched for primitive progenitors. To further characterize human SP(+) cells, blood or bone marrow from 16 patients with acute myeloid leukemia (AML) was analyzed for their presence, immunophenotype, and cytogenetic and functional properties, and for the relation between SP phenotype and multidrug resistance-1 (MDR-1) expression. The mean percentages of SP(+) and MDR(+) cells was 8.1% (range, 0.5%-29.9%) and 12.8% (range, 0%-54.8%), respectively, with no correlation between the 2 values. The percentages of SP(+) cells that were CD34(+)CD38(-), CD34(+)CD38(+), or CD34(-) were 12% (range, 0.4%-50%), 25% (range, 0.5%-96%), and 63% (range, 4%-99%). Cytogenetically abnormal cells were always detected in the SP(-)CD34(+)CD38(-) and SP(+)CD34(-) fractions, and abnormal colonies (CFC), long-term culture-initiating cells (LTC-IC), and nonobese diabetic-severe combined immunodeficiency (NOD/SCID) mouse leukemia-IC were detected in the former fraction. No progenitors were detected among SP(+)CD34(-) cells in any of these assays from 9 of 10 samples. In contrast, exclusively normal cells were detected in the SP(+)CD34(+)CD38(-) fraction from 9 of 15 samples, and CFC, LTC-IC, and multilineage engraftment in NOD/SCID mice from this subpopulation were also cytogenetically normal in 6 of 8, 6 of 7, and 2 of 2 cases studied, respectively. In contrast to murine studies, primitive progenitors are enriched among SP(+)CD34(+)CD38(-) cells from patients with AML. The molecular basis for Hoechst dye efflux is uncertain because it does not appear to be related to MDR-1 expression. (Blood. 2001;97:3882-3889)


Mechanism of enhanced sensitivity of mutated β-adrenergic-like octopamine receptor to amitraz in honeybee Apis mellifera: An insight from MD simulations.
Amitraz is one of the critical acaricides/insecticides for effective control of pest infestation of Varroa destructor mite, a devastating parasite of Apis mellifera, because of its low toxicity to honeybees. Previous assays verified that a typical G protein-coupled receptor, β-adrenergic-like octopamine receptor (Octβ2R), is the unique target of amitraz, but the honeybee Octβ2R resists to amitraz. However, the underlying molecular mechanism of the enhanced sensitivity or toxicity of amitraz to mutated honeybee Octβ2RE208V/I335T/I350V is not fully understood. Here, molecular dynamics simulations are employed to explore the implied mechanism of the enhanced sensitivity to amitraz in mutant honeybee Octβ2R. We found that amitraz binding stabilized the structure of Octβ2R, particularly the intracellular loop 3 associated with the Octβ2R signaling. Then, it was further demonstrated that both mutations and ligand binding resulted in a more rigid and compact amitraz binding site, as well as the outward movement of the transmembrane helix 6, which was a prerequisite for G protein coupling and activation. Moreover, mutations were found to promote the binding between Octβ2R and amitraz. Finally, community analysis illuminated that mutations and amitraz strengthened the residue-residue communication within the transmembrane domain, which might facilitate the allosteric signal propagation and activation of Octβ2R. Our results unveiled structural determinants of improved sensitivity in the Octβ2R-amitraz complex and may contribute to further structure-based drug design for safer and less toxic selective insecticides. © 2022 Society of Chemical Industry.


A mechanical plant defense defines the opening of a phenological window for gall induction by Asphondylia aucubae (Cecidomyiidae: Diptera).
Many insect herbivores can only use hosts during a specific phenological stage, i.e., a phenological window. Previous studies have primarily examined the effects of these windows on insect herbivores, but relatively little is known about the mechanisms controlling the phenological windows. In most gall insect systems, phenological windows have been attributed to the short duration of physiologically active plant tissues that induce gall formation (reactive plant tissue). In the fruit gall midge, Asphondylia aucubae Yukawa and Ohsaki, and the host plant (i.e., Aucuba japonica) system, the disappearance of reactive plant tissue closes the phenological window, but its presence does not define the opening of the window. The hard endocarp of the fruit covers most potential oviposition sites just before the midge emergence season, but decreases in proportional cover during the emergence season. We experimentally manipulated the timing of oviposition relative to fruit development. Midges that emerged earliest and attacked fruits during their earliest developmental stages were unable to oviposit because of intact, hard endocarps, whereas their counterparts that emerged later could oviposit more readily through cracks in the endocarp. We noted possible oviposition avoidance behavior and the necessity of more frequent (repeated) ovipositor insertions to intensively stimulate the decreased reactive tissues during the latter half of the emergence season. Overall, our results indicated that the fragmentation of the defensive, hard endocarp of the host plant defines the opening of the phenological window in this plant-herbivore system.


Mineralization of developing mouse calvaria as revealed by Raman microspectroscopy.
Raman microspectroscopy is a nondestructive vibrational spectroscopic technique that permits the study of organic and mineral species at micron resolution, offers the ability to work with hydrated and dehydrated specimens in vivo or in vitro, and requires minimal specimen preparation. We used Raman microspectroscopy to determine the composition of the mineral environments present in mouse calvaria, the flat bones that comprise the top of the skull. We have acquired Raman transects (lines of point spectra) from mouse calvaria during a developmental time course ranging from embryonic day 13.5 (E13.5; 6 days before birth) to 6 months of age. Exploratory factor analysis (FA) reveals the presence of a variety of apatitic mineral environments throughout the tissue series. The earliest mineral is observed in the fetal day 15.5 (F15.5) mice and is identified as a carbonated apatite. The presence of a heterogeneous mineralized tissue in the postnatal specimens suggests that ionic incorporation and crystal perfection in the lattice yary as the mouse develops. This variation is indicative of the presence of both recently deposited mineral and more matured remodeled mineral. Band area ratios reveal that the mineral/matrix ratio initially increases, reaches a plateau, and then increases again. The carbonate/phosphate band area ratio remains constant from F18.5 to postnatal day 3 (PN3) and then increases with age. Insights into the chemical species, the degree of mineralization, and the multiple mineral environments that are present in normal calvarial tissue will enable us to better understand both normal and abnormal mineralization processes.


[Death after ST-elevation myocardial infarction in patients treated with fibrinolytic therapy, angioplasty, or conventional therapy. A post-mortem study to verify cardiac rupture as a cause of death].
Experimental clinical observations suggest that fibrinolysis (FL) in acute myocardial infarction, even though reducing global mortality, is associated with an increasing incidence of death in the first 24-48 h. The responsible mechanism is not yet known, although available evidence supports heart rupture as the possible cause. We studied 154 patients at autopsy who died of cardiac causes from January 1, 1994 to December 31, 2005 among a cohort of 2260 patients who were admitted for ST-elevation myocardial infarction. They were divided into three therapeutic groups-- FL, coronary angioplasty (PTCA) and conventional therapy (CT)--in order to assess the incidence of cardiac rupture and compare it with the other causes of cardiac death. Of the 896 patients (39.7%) who were treated with FL, 57 (6.4%) died; of the 804 (35.6%) treated with PTCA, 40 (5.05%) died, and of the 560 (24.7%) treated with CT, 57 (10.2%) died (p < 0.05 in the two first groups vs CT). We studied at autopsy 154 patients (mortality 6.7%). The mean admission delay was 5.05 h in the FL group, 7.04 h in the PTCA group, and 7.05 h in the CT group. Cardiac death occurred on average after 13 h in the FL group, after 15 h in the PTCA group, and after 19 h in the CT group. The cause of death was due to cardiac rupture in 56 patients (36.5%), to shock in 55 patients (35.7%), to electromechanical dissociation in 29 patients (18.8%), and to cardiac failure in 14 patients (9%). In the FL and PTCA groups, cardiac rupture was the major, and also the earliest (10 e 12 h, respectively), cause of death, whereas in the CT group cardiac shock (13 h) was the major cause of death. Anterior myocardial infarction (n = 104, 65%) was more prevalent in deceased patients, whereas inferior myocardial infarction was found in the other 50 cases (35%). Cardiac rupture was more prevalent in anterior myocardial infarction. In the FL and PTCA groups, histological examination showed unusual hemorrhagic infiltration in the necrotic areas with presence of leukocytes. Our study shows that cardiac rupture is the major cause of death in patients with ST-elevation myocardial infarction treated with FL and PTCA, suggesting that mechanical and lythic reperfusion injury, in coagulative necrosis, may represent a further cause of cardiac rupture that occurs early or within the first hours.


[Diagnostic management in paediatric blunt abdominal trauma - a systematic review with metaanalysis].
The objective of this systematic review was to investigate the diagnostic management in paediatric blunt abdominal injuries. A literature research was performed using following sources: MEDLINE, Embase and Cochrane. Where it was possible a meta-analysis was performed. Furthermore the level of evidence for all publications was assigned. Indicators for intraabdominal injury (IAI) were elevated liver transaminases, abnormal abdominal examinations, low systolic blood pressure, reduced haematocrit and microhematuria. Detecting IAI with focused assessment with sonography for trauma (FAST) had an overall sensitivity of 56.5 %, a specificity of 94.68 %, a positive likelihood ratio of 10.63 and a negative likelihood ratio of 0.46. The accuracy was 84.02 %. Among haemodynamically unstable children the sensitivity and specificity were 100 %. The overall prevalence of IAI and negative CT was 0.19 %. The NPV of abdominal CT for diagnosing IAI was 99.8 %. The laparotomy rate in patients with isolated intraperitoneal fluid (IIF) in one location was 3.48 % and 56.52 % in patients with IIF in more than one location. FAST as an isolated tool in the diagnostics after blunt abdominal injury is very uncertain, because of the modest sensitivity. Discharging children after blunt abdominal trauma with a negative abdominal CT scan seems to be safe. When IIF is detected on CT scan, it depends on the number of locations involved. If IIF is found only in 1 location, IAI is uncommon, while IIF in two or more locations results in a high laparotomy rate.


Hydatid thrill: an explanation of the phenomenon.
The hydatid thrill is a rare but pathognomic sign of hydatid disease. The physical basis of the thrill was studied in two patients with the disease. The thrill occurs when a mother cyst packed with unruptured daughter cysts is gently percussed. The consistency of the wall of the daughter cyst and the tension of the fluid inside it are responsible for making the cysts vibrate and produce the sensation of a thrill. Free fluid from ruptured daughter cysts dampens the vibrations. It is extremely rare for a mother cyst to have all the daughter cysts in an intact condition.


A Characterization Study of the Patients Visiting Hospital due to Laryngopharyngeal Reflux Suspicion: A Prospective Case-Control Study.
This study aimed to explore the characteristics of laryngopharyngeal reflux (LPR) and the association between LPR and allergic rhinitis (AR). In this prospective case-control study, a total of 102 patients with suspected LPR who visited the Department of Otolaryngology Head and Neck Surgery, Heping Hospital Affiliated to Changzhi Medical College, between June 2019 and June 2021 were consecutively included. They were divided into the LPR-positive group and the LPR-negative group according to 24-h Dx-pH monitoring. The influencing factors of LPR, including the scores for AR (SFAR) and AR prevalence, were compared between the two groups. The total SFAR and scores in items 1, 3, 4, and 5 of the LPR-positive group were significantly higher than those of the LPR-negative group (p < 0.05). The prevalence of AR in the LPR-positive group was 60%, which was significantly higher than that in the LPR-negative group (36.54%) (p < 0.05). After excluding confounding factors, AR was positively correlated with the incidence of LPR, and the incidence of LPR with AR was 2.372 times that of non-AR. Receiver operating characteristic curve results show that AR has the highest predictive value for LPR, and the area of AR under the curve is was 0.617. The SFAR and incidence of AR are high in patients with positive LPR, and AR may be a risk factor for LPR. The results of this study may deepen our understanding of the occurrence of LPR.


Palladium diselenolenes: a new group of near-infrared lumophores.
We describe the photochemical characteristics of two phosphorescent palladium diselenolenes [Pd(2)(Se(2)C(8)H(12))(2)(PBu(3))(2)] (1) and [Pd(2)(Se(2)C(8)H(12))(2)(PPh(3))(2)] (2) which, to the best of our knowledge, are the first reported examples of luminescent Pd-Se compounds. Both compounds exhibit broadband near-infrared phosphorescence in the solid state, with lambda(max) of 717 nm for 1 and 792 nm for 2 at 298 K, and 752 nm for 1 and 785 nm for 2 at 77 K. No phosphorescence was detected for either compound when they were dissolved in nitrogen-purged acetonitrile or toluene solution at 298 K but they do phosphoresce at 77 K in organic glasses with emission quantum yields of 0.12 (+/-0.01) for 1 and 0.13 (+/-0.01) for 2 in an ethanol/diethylether/toluene (1:2:1) (EDT) glass. Emission lifetimes at 77 K are the same whether in the solid state or in an organic glass with first order fit lifetimes of tau = 18.8 (+/-0.7) micros and 11.5 (+/-0.3) micros for 1 and 2, respectively. Combination of these lifetimes with quantum yields gives radiative lifetimes of 151 (+/-13) micros and 86 (+/-7) micros for compounds 1 and 2, respectively, at 77 K in EDT glass. At 77 K solid state quantum yields are estimated to be of the same order of magnitude as those in glasses, and these decrease by a factor of about 3-5 in going from 77 to 298 K. In the solid state at 298 K emission lifetimes are 1.83 (+/-0.02) micros and 7.0 (+/-0.3) micros for 1 and 2, respectively. We could detect no transients by nanosecond flash photolysis which could be assigned to the triplet state in room temperature solution, and no emission assignable to singlet oxygen across the wavelength range 1200-1350 nm upon 550 nm excitation of either 1 or 2 in acetonitrile solution. We estimate the quantum yield of singlet oxygen formation to be less than about 5 x 10(-4), which is also an upper limit for the yield of triplet states of any significant lifetime in fluid solution. Density functional theory (DFT) calculations of the S(0) to S(1) and T(1) transitions show a shift in molecular orbital character from one with significant -ene pi involvement but very little P involvement in the ground-state to one with less -ene pi but greater P involvement in the excited states; there is also a significant shift in the distribution of involvement of atomic orbitals on the four Se atoms.


The Biomechanical Mechanism of Upper Airway Collapse in OSAHS Patients Using Clinical Monitoring Data during Natural Sleep.
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep disorder characterized by repeated pharyngeal collapse with partial or complete obstruction of the upper airway. This study investigates the biomechanics of upper airway collapse of OSASH patients during natural sleep. Computerized tomography (CT) scans and data obtained from a device installed on OSASH patients, which is comprised of micro pressure sensors and temperature sensors, are used to develop a pseudo three-dimensional (3D) finite element (FE) model of the upper airway. With consideration of the gravity effect on the soft palate while patients are in a supine position, a fluid-solid coupling analysis is performed using the FE model for the two respiratory modes, eupnea and apnea. The results of this study show that the FE simulations can provide a satisfactory representation of a patient's actual respiratory physiological processes during natural sleep. The one-way valve effect of the soft palate is one of the important mechanical factors causing upper airway collapse. The monitoring data and FE simulation results obtained in this study provide a comprehensive understanding of the occurrence of OSAHS and a theoretical basis for the individualized treatment of patients. The study demonstrates that biomechanical simulation is a powerful supplementation to clinical monitoring and evaluation.


Baikalsky State Nature Biosphere Reserve and its buffer zone: floristic data.
Baikalsky State Nature Biosphere Reserve is situated in the central part of the Khamar-Daban Range (Southern Baikal, Siberia), in three administrative districts of Republic of Buryatia (i.e. Kabansky District, Dzhidinsky District and Selenginsky District), Russia. In general, this territory has been relatively well studied by botanists, but until now there was no detailed information about the flora of the Reserve with precise geographic localities. Moreover, some records in the Baikalsky Reserve's flora were published without references to documenting herbarium specimens. The dataset contains 39,238 unique occurrences of 875 taxa (854 species, 14 subspecies, five varieties and two species aggregates) from the Baikalsky Reserve and its buffer zone. All the data were acquired during the field studies by the author in 2009-2021, when 152 taxa (17.3% of all the taxa included into the dataset) were first recorded by the author from the study area. Herbarium vouchers are preserved in the Moscow University Herbarium (MW). This dataset is the first attempt at creating a database of vascular plants of the Baikalsky Reserve and its buffer zone, based on modern research. These data will provide the background for the updated check-list of the Baikalsky Reserve's flora.


The association of PBX1 polymorphisms with overweight/obesity and metabolic alterations in the Korean population.
Pre-B-cell leukemia transcription factor 1 (PBX1), which is located on chromosome 1q23, was recently reported to be associated with type 2 diabetes mellitus. We examined whether single nucleotide polymorphisms (SNPs) of the PBX1 gene are associated with overweight/obesity in a Korean population. We genotyped 66 SNPs in the PBX1 gene and investigated their association with clinical phenotypes found in 214 overweight/obese subjects and 160 control subjects using the Affymetrix Targeted Genotyping chip array. Seven SNPs (g.+75186C>T, g.+78350C>A, g.+80646C>T, g.+138004C>T, g.+185219G>A, g.+191272A>C, and g.+265317T>A) were associated with the risk of obesity in three models (codominant, dominant, and recessive) (P=0.007-0.05). Haplotype 1 (CAC) and 3 (TAC) of block 3 and haplotype 2 (GGAAT) of block 10 were also strongly associated with the risk of obesity. In the control group, subjects that had homozygote for the major allele for both g.+185219G>A and g.+191272A>C showed lower high density lipoprotein-cholesterol (HDL-C) level compared to those possessing the minor allele, suggesting that the association between the homozygote for the major allele for both g.+185219G>A and g.+191272A>C and HDL-C is attributable to the increased risk of obesity. This study suggests that the PBX1 gene is a possible risk factor in overweight/obese patients.


Mismatch repair gene mutation analysis and colonoscopy surveillance in Chinese Lynch syndrome families.
Lynch syndrome (or HNPCC) is a colorectal cancer syndrome caused by germline mutations in either one of the DNA mismatch repair (MMR) genes hMLH1, hMSH2, hMSH6 or hPMS2. Mutations in hMLH1 and hMSH2 are most prevalent. Here we aimed to determine the cancer risk of MMR gene mutation carriers and, in addition, the efficacy of colonoscopy surveillance in Chinese Lynch syndrome family members with and without MMR gene mutations. A Lynch syndrome family registry encompassing 106 families in Northern China was recently established. Detailed pedigree data for each family were collected and hMLH1 and hMSH2 gene mutation analyses were performed. Germ-line mutations were identified in probands from 42 of these families, and additional genetic analyses were performed in each member of these 42 families to identify mutation and non-mutation carriers. Among the family members included, 180 received colonoscopy and the remaining cases were followed without colonoscopy. Overall 54.8 % of the Lynch syndrome family members carried MMR gene mutations, and these mutation carriers exhibited significantly higher colorectal cancer and other Lynch syndrome-associated cancer risks as compared to non-mutation carriers. The cumulative risk for all Lynch syndrome-related cancers at age 70 was 93.8 % for both hMLH1 and hMSH2 mutation carriers, and 81.7 % and 93.1 % for colorectal cancer at this age, respectively. Whereas 43 of 102 (42.2 %) mutation carriers exhibited significant colonoscopy findings, including 10 colorectal cancers, none of 78 non-mutation carriers exhibited significant findings, and no cancers were detected. In addition, in the mutation carriers, colonoscopy surveillance led to the detection of more early stage cancers than in the non-surveillance group (70.0 % versus 36.5 %, p < 0.01). In Lynch syndrome family members, we recommend pre-symptomatic MMR gene mutation analysis in order to identify high risk individuals for colonoscopy surveillance.


Overdentures. Principles and procedures.
Although advances in methods and improved materials have contributed to better treatment results, caries and periodontal problems still remain significant threats to overdenture service life. The prevention of caries and recurrent periodontal disease thus becomes a most important aspect of postinsertion care. Undoubtedly, there are a number of successful overdenture methods. This article outlines two treatment sequences previously described by Brewer and Morrow that continue to be effective (Fig. 23). Common to most overdenture techniques is that an overdenture may be the only treatment that permits retention using the patient's last few retainable teeth. A conservative approach to root preservation still is a valid and practical measure in preventative dentistry.


Magnetic Resonance Imaging of the Knee in the Presence of Bridging External Fixation: A Comparative Experimental Evaluation of Four External Fixators, Including Dolphix®.
Performing MR investigation on patients instrumented with external fixators is still controversial. The aim of this study is to evaluate the quality of MR imaging of the knee structures in the presence of bridging external fixators. Different cadaveric lower limbs were instrumented with the MR-conditional external fixators Hofmann III (Stryker, Kalamazoo, MI, USA), Large external Fixator (DePuy Synthes, Raynham, MA, USA), XtraFix (Zymmer, Warsaw, IN, USA) and a newer implant of Ketron Peek CA30 and ERGAL 7075 pins, Dolphix®, (Citieffe, Bologna, Italy). The specimens were MR scanned before and after the instrumentation. The images were subjectively judged by a pool of blinded radiologists and then quantitatively evaluated calculating signal intensity, signal to noise and contrast to noise in the five regions of interest. The area of distortion due to the presence of metallic pins was calculated. All the images were considered equally useful for diagnosis with no differences between devices (p > 0.05). Only few differences in the quantification of images have been detected between groups while the presence of metallic components was the main limit of the procedure. The mean length of the radius of the area of distortion of the pins were 53.17 ± 8.19 mm, 45.07 ± 4.33 mm, 17 ± 5.4 mm and 37.12 ± 10.17 mm per pins provided by Zimmer, Synthes, Citieffe and Stryker, respectively (p = 0.041). The implant of Ketron Peek CA30 and ERGAL 7075 pins showed the smallest distortion area.


Sepsis-Induced Adipokine Change with regard to Insulin Resistance.
Background. Assessment of white adipose tissue has changed in recent years, with WAT now being considered as an active endocrine organ, secreting a large number of bioactive mediators, so-called adipokines. Besides other functions, these adipokines are involved in inflammatory response thereby exhibiting predominantly proinflammatory or anti-inflammatory properties and contribute to insulin resistance. Methods. Comprehensive review of the literature of the role of adipokines relevant to critical care medicine using PubMed search. Results. Adiponectin-the prototype of an anti-inflammatory and insulin-sensitizing adipokine-is diminished in sepsis, while resistin-a protein with proinflammatory properties-is elevated. Plasminogen activator inhibitor-1, interleukin (IL)-1, IL-6, IL-8, and IL-10, and tumor-necrosis-factor-alpha mediate insulin resistance and are elevated in sepsis, while retinol-binding protein-4 concentrations are significantly reduced in sepsis. Chemerin displays potent anti-inflammatory and insulin-resistance properties, while monocyte chemotactic protein-1-increased in sepsis-contributes to macrophage infiltration in adipose tissue and insulin resistance. Conclusions. The expression of adipokines in humans is altered as well in obese as in septic patients with elevated levels of proinflammatory adipokines. Changes in adipokine levels in acute sepsis could contribute to insulin resistance. Consequently, in critically ill patients, these alterations underline a possible contribution of adipokines in the development of hyperglycemia.


Pharmacological management of benign prostatic hypertrophy with phosphodiesterase-5 inhibitors.
Benign prostatic hypertrophy (BPH) and its associated lower urinary-tract symptoms (LUTS) commonly result in a significant decrease in the quality of life (QOL) of aging men. Although several safe and effective medications are currently available for the management of this disease, newly emerging research has focused on the exploration of unconventional pharmacological therapy. In particular, multiple clinical trials published within the past two years have explored the use of phosphodiesterase-5 (PDE-5) inhibitors for the alleviation of LUTS secondary to BPH. Although this class of medication has traditionally been used in men with erectile dysfunction (ED), the preliminary results from these studies have offered promising evidence for use of PDE-5 inhibitors in BPH.


Discontinuation of preoperative clopidogrel is unnecessary in peripheral arterial surgery.
The optimal management of preoperative clopidogrel remains controversial, as vascular surgeons are increasingly encountering patients treated with clopidogrel as part of dual antiplatelet therapy. Current practice differs considerably, from cessation of the medication at least 5 days before surgery to proceeding with surgery without delay. The purpose of this prospective, nonrandomized, comparative study was to determine the effect of preoperative exposure to clopidogrel and aspirin on perioperative bleeding complications in patients undergoing open arterial surgery. Data were collected prospectively on 647 consecutive major arterial procedures from 2005 through mid-2012. Patients were classified into two groups: the clopidogrel group consisted of 305 procedures performed in 269 patients who were maintained, after obtaining informed consent, on dual clopidogrel and aspirin up to the time of surgery and the no-clopidogrel group consisted of 342 procedures completed in 298 patients who were taking neither medication together or were taking aspirin alone. The primary composite end point was reoperation for bleeding and bleeding-related death. Secondary end points included blood transfusion requirements, hematoma formation, the procedure duration, as well as hospital and intensive care unit length of stay. The patients taking clopidogrel had a higher cardiovascular risk profile and a higher prevalence of prior peripheral and coronary stents (P < .0001). Clopidogrel use was common across all operation categories: 59% of carotid endarterectomy patients (104 of 177), 43% of lower extremity bypass patients (147 of 344), and 43% of abdominal aortic bypass patients (54 of 126). The difference in the primary end point between the clopidogrel and no-clopidogrel groups was not statistically significant (0.65% and 0.3%, respectively; P =.55). No bleeding-related deaths were observed. Further analysis revealed a similar incidence of stable hematomas. Blood transfusions were mainly required by patients undergoing aortic surgery, at similar rates and volumes in the clopidogrel and no-clopidogrel groups: abdominal aortic bypass cohort (a mean of 1.6 units packed red blood cells needed in 72% vs a mean of 1.6 units in 69%, respectively; P =.76); lower extremity bypass cohort (a mean of 1.5 units needed in 15% vs 1.3 units needed in 11%; P < .004). The mean operative time and intensive care unit and hospital lengths of stay were not longer in clopidogrel recipients. Combined therapy with clopidogrel and aspirin up to the day of surgery is not associated with increased bleeding complications or transfusion requirements. Data from this study do not validate the perceived higher risk of perioperative bleeding in clopidogrel patients and do support the strategy of continued clopidogrel use in patients undergoing peripheral arterial surgery.


Effect of RNase on Zein Synthesis in Endosperms of brittle-2opaque-2 Maize Double Mutant.
Posttranscriptional degradation of zein mRNAs in Zea mays, presumably caused by high RNase activity, may be involved in reducing zein synthesis in the endosperms of zein-deficient mutants. Zein proteins prepared from mature endosperms of zein-deficient double mutants such as brittle-2;opaque-2 showed an almost complete blockage of the synthesis of two major zein components, Z1 and Z2. However, these two components were present prior to 12 days postpollination. The changes in quantity and quality of zein synthesis in these double mutants correlated well with the rising RNase levels in the developing endosperm. In addition to its effect on zein synthesis, high RNase activity also influenced the stability of rRNAs in the brittle-2;opaque-2 double mutant at the later stages of endosperm development. These results suggest that RNase played a role in regulating zein synthesis in developing zein-deficient mutant endosperms.


A patient preference and satisfaction study of ciclesonide nasal aerosol and mometasone furoate aqueous nasal spray in patients with perennial allergic rhinitis.
Patients' preference and satisfaction with their nasal allergy medications may be influenced by their sensory attributes. This study evaluates patient preference and satisfaction with ciclesonide hydrofluoroalkane nasal aerosol (CIC-HFA) compared with mometasone furoate aqueous nasal spray (MFNS). Symptomatic subjects with perennial allergic rhinitis (PAR) were randomized to CIC-HFA at 74 micrograms or MFNS at 200 micrograms q.d. in an open-label, two-period, crossover study. Subject preference was recorded as total preference score (TPS; average of 17 individual preference items) at the end of treatment period 2, and satisfaction was assessed with a 76-item, self-administered instrument at baseline and at the end of each 2-week treatment period. The primary assessments were TPS and regimen attributes composite satisfaction score composed of two of nine satisfaction subscales: sensory impact (including medication running out of the nose, medication running down the throat, and impact on smell and taste) and regimen management (comprised of issues relating to dosing and ability to remember to take medication). Two hundred ninety-four subjects completed the study. A total of 68.1% of subjects preferred CIC-HFA (p < 0.0001 versus MFNS), with a mean TPS of 68.3 versus 31.7 for the MFNS group. The regimen attributes composite satisfaction score significantly (p < 0.0001 for each treatment period) favored CIC-HFA versus MFNS at the end of treatment period 1 (85.5 vs 77.6) and treatment period 2 (83.0 versus 73.5), respectively. In this study, subjects reported higher preference for and satisfaction with CIC-HFA compared with MFNS, suggesting significant differences in patient perception of attributes in favor of CIC-HFA. Clinical trial registration URL and registration number: www.clinicaltrials.gov/ct2/show/NCT01401465.


[Exposure or cancer predisposition? Cytogenetic examination of head and neck squamous cancer patients]
Search of different biomarkers is one of the most important demands of the national cancer prevention programme. We examined the usefulness of bleomycin sensitivity assay, whether it serves as a biomarker of individual sensitivity and risk for head and neck cancer under our environmental conditions. The test is based on the measurement of the means of chromatid breaks induced by bleomycin in vitro in a single lymphocyte (break/cell=b/c). 156 head and neck cancer patients were matched not only with 295 healthy controls (146 non-smokers and 149 smokers), but also with 51 strong alcoholic and smoking patients with liver disease whose lifestyle did not differ from that of the cancer patients. The aberrant cell frequency of cancer patients (2.85%), alcoholics (2.82%) and healthy smokers (2.81%) was similar and higher (p<0.03) than the values of non-smoker controls (2.25%). Thus, the results of conventional chromosome analysis indicate the effect of exposure to mutagens, derived mainly from smoking. Mutagen sensitivity measured by the bleomycin assay was significantly higher in both the cancer- (1.13 b/c) and the alcoholic patients (1.29 b/c) compared with smoker (1.04 b/c) and non-smoker controls (0.98 b/c). The bleomycin sensitivity assay, therefore, seems to be the biomarker not only for the cancer, but also for a disease of the same aetiology such as alcohol-related liver disease. However, the method is not suitable for the assessment of individual cancer risk due to overlapping of b/c values with those of controls. The proportion of mutagen sensitive persons in the group of Hungarian controls is 42-49%, which is two-fold of those in the US and Western Europe. When we estimate the cancer risk, the results of bleomycin sensitivity assay are equivocal under our experimental conditions, and they must be applied cautiously even in combination with the results of chromosome analysis.


Anorexia in oesophageal carcinoma.
The influence of anorexia on nutritional status and tumour resectability was prospectively assessed in 50 patients with oesophageal carcinoma and severe dysphagia. Among the 21 patients in whom anorexia was present, objective measurement of clinical status demonstrated that malnutrition was present in 13 (62%) and resection of the tumour was possible only in five (24%). On the contrary, among the 29 patients without anorexia, malnutrition was only present in five (17%) and resection of the tumour was possible in 24 (82%). We conclude that anorexia is a main determinant of malnutrition and that it is related to the tumour development independently of dysphagia. In patients with oesophageal carcinoma, the clinical assessment of anorexia must be used for evaluating nutritional status before surgery. The presence of anorexia suggests a widespread tumour or a disseminated cancer and it might explain the poor nutritional effects of palliative intubation in non resectable tumour.


Skin changes and tumours after renal transplantation.
Skin involvement in chronic renal failure is characterised by a multitude of different aspects. Apart from the typical yellow-brown discolouration of the skin, most often patients complain of pruritus and xerosis cutis. A marked actinic elastosis is noticed. Dialysis treatment alters and partly aggravates these pre-existing skin conditions. When chronic renal failure leads to a kidney transplantation, some of the reversible skin pathology, e.g. pruritus, xeroderma, tends to ameliorate, but a high tendency to develop malignancies becomes prominent.


Fruit and Vegetable Consumption Behavior Among Asian Americans: A Thematic Analysis.
Consuming 5 or more cups of fruits and vegetables (F & V) per day or 400 g/day for adults is advocated by most health authorities and has short-term and long-term health benefits. There have been numerous studies examining dietary behaviors among different US populations; however, the literature on F & V consumption behavior among Asian Americans (AAs) is sparse. AAs constitute a diverse group and as their population continues to grow in the US; there is a greater need to examine the health practices of AAs and their constituent subgroups. The study aimed to conduct a thematic analysis based on a scoping review of the peer-reviewed published literature over the past 15 years targeting F & V consumption among AAs. The thematic analysis was organized around the prevalence, consequences, determinants, and interventions (n = 33). AAs consuming recommended servings of F & V ranged from 0.5% to 20%. Correlations between the consumption of F & V and Body Mass Index (BMI) and other chronic diseases were reported as negative and significant associations were noted between F & V intake and self-reported health. There was only 1 intervention that was conducted with this behavior in only 1 small subgroup of this target population. There is an urgent need to study F & V consumption behavior among different AA subgroups as well as to design culturally appropriate theory-based efficacious F & V promotion interventions for them.


Oral disodium cromoglycate treatment on irritable bowel syndrome: an open study on 101 subjects with diarrheic type.
Several studies on the usefulness of oral disodium cromoglycate (DSCG) in the treatment of systemic adverse reaction to foods have been performed, with less attention to gastroenterological symptoms. In the present study, we selected 101 patients with diarrheic-type irritable bowel syndrome which improved after an elimination diet and worsened after a challenge with specific food(s). All patients were then tested for 48 commercial alimentary antigens by skin prick test (SPT) and underwent 8 wk of oral DSCG (500 mg three times a day), and the results were evaluated by means of a semiquantitative subjective and objective score. We observed an improvement of the symptoms in 67% of the 74 SPT-positive patients, whereas only 41% of the 27 SPT-negative patients showed a positive response to DSCG (p less than 0.05). These data confirm the protective role of DSCG in food-dependent diarrheic-type irritable bowel syndrome with food allergy features.


Generating a Reproducible Model of Mid-Gestational Maternal Immune Activation using Poly(I:C) to Study Susceptibility and Resilience in Offspring.
Maternal immune activation (MIA) during pregnancy is consistently linked to increased risk of neurodevelopmental and neuropsychiatric disorders in offspring. Animal models of MIA are used to test causality, investigate mechanisms, and develop diagnostics and treatments for these disorders. Despite their widespread use, many MIA models suffer from a lack of reproducibility and almost all ignore two important aspects of this risk factor: (i) many offspring are resilient to MIA, and (ii) susceptible offspring can exhibit distinct combinations of phenotypes. To increase reproducibility and model both susceptibility and resilience to MIA, the baseline immunoreactivity (BIR) of female mice before pregnancy is used to predict which pregnancies will result in either resilient offspring or offspring with defined behavioral and molecular abnormalities after exposure to MIA. Here, a detailed method of inducing MIA via intraperitoneal (i.p.) injection of the double stranded RNA (dsRNA) viral mimic poly(I:C) at 12.5 days of gestation is provided. This method induces an acute inflammatory response in the dam, which results in perturbations in brain development in mice that map onto similarly impacted domains in human psychiatric and neurodevelopmental disorders (NDDs).


Clinical outcomes assessment in behavioral healthcare: searching for practical solutions.
Most quality management initiatives in behavioral healthcare have focused on adverse events, clinical processes, or cost variables. Considerably less attention has been paid to indices of clinical improvement, likely because of a lack of agreed-upon measures of improvement, a lack of availability of simple methods for data collection and analysis, and an inability to provide timely feedback regarding clinical improvement, among other reasons. A computerized system was designed to collect relevant psychiatric symptom ratings in a manner that allows for real-time feedback at the patient and clinician Levels regarding clinical improvement and for higher-level, administrative evaluation of overall clinic performance. The costs and benefits of this system are discussed.


Medical students' situational motivation to participate in simulation based team training is predicted by attitudes to patient safety.
Patient safety education, as well as the safety climate at clinical rotations, has an impact on students' attitudes. We explored medical students' self-reported motivation to participate in simulation-based teamwork training (SBTT), with the hypothesis that high scores in patient safety attitudes would promote motivation to SBTT and that intrinsic motivation would increase after training. In a prospective cohort study we explored Swedish medical students' attitudes to patient safety, their motivation to participate in SBTT and how motivation was affected by the training. The setting was an integrated SBTT course during the surgical semester that focused on non-technical skills and safe treatment of surgical emergencies. Data was collected using the Situational Motivation Scale (SIMS) and the Attitudes to Patient Safety Questionnaire (APSQ). We found a positive correlation between students' individual patient safety attitudes and self-reported motivation (identified regulation) to participate in SBTT. We also found that intrinsic motivation increased after training. Female students in our study scored higher than males regarding some of the APSQ sub-scores and the entire group scored higher or on par with comparable international samples. In order to enable safe practice and professionalism in healthcare, students' engagement in patient safety education is important. Our finding that students' patient safety attitudes show a positive correlation to motivation and that intrinsic motivation increases after training underpins patient safety climate and integrated teaching of patient safety issues at medical schools in order to help students develop the knowledge, skills and attitudes required for safe practice.


The Retinal Research Team at the Eye Foundation Hospital/UAB.
The trustees of the Eye Foundation, Inc. and the Eye Foundation Hospital constitute an independent institution, which is associated with the University of Alabama at Birmingham only in research and resident training. Clarence Blair is the Chairman of the Foundation Board. Harold Skalka, M.D., F.A.C.S., is the Chairman of the Department of Ophthalmology, and his offices are in the Eye Foundation Hospital building. With funds raised largely by Alston Callahan, M.D., F.A.C.S., Director of Development, and with the assistance of fellow trustees, the retina research department has been greatly expanded in the last few years. In this article, the seven prestigious retinal investigators are introduced and short summaries of their research aims are presented. All work toward a better understanding of clinical problems which baffle ophthalmologists, as macular degeneration and diabetic eye disease.


Construct validity of the Bender-Gestalt II: comparison with Wechsler Intelligence Scale for Children-III.
This study investigated the relationships of visuomotor constructs as measured by the Bender-Gestalt II with the subtests of the WISC-III. A factor analysis included the standardized Copy and Recall scores of the Bender-Gestalt II and subtest scores of the WISC-III. The Copy score was predicted to load on measures of visual and spatial thinking and the Recall score on a short-term memory factor. The results of a principal components analysis suggest a four-factor solution with the Bender-Gestalt II Copy score loading on a visual and spatial thinking factor primarily with WISC-III Perceptual Organization subtests. The Recall score loaded on a visual and spatial thinking factor as well as a short-term memory factor with the WISC-III Digit Span subtest. The results suggest the Bender-Gestalt II Copy subtest shared commonality with the visual and spatial tasks given the similarity in the visuomotor demands of each test and was less influenced by processing speed or cultural knowledge than other tests on the visual and spatial thinking factor. Also, results suggest Bender-Gestalt II Recall measures elements of both visual and spatial thinking as well as aspects of short-term memory and memory retrieval. Clinical guidelines for co-administration and underlying processing demands are discussed.


Assessing the effect of mortality change in an age group on the expectation of life at birth.
"This article compares four procedures in assessing the effect of the change in mortality conditions in an age group between two periods on the expectation of life at birth. The differences and similarities are pointed out. The outcome of applying the different approaches on the difference in the expectation of life at birth of the life tables of Sweden for the periods 1901-10 and 1936-40 is also discussed."


Sleep Instability Correlates with Attentional Impairment in Boys with Attention Deficit Hyperactivity Disorder.
Theoretical models of sleep and attention deficit hyperactivity disorder (ADHD) suggest that symptoms of ADHD are associated with daytime sleepiness, but it has received little support. The present study aimed at testing an alternative model involving the association of attentional instability with sleep instability, i.e., sleep stage transitions and arousals. Twelve ADHD and 15 healthy control (HC) boys aged between 8 and 12 years old underwent polysomnography recording and attentional testing. The microarousal index, the number of awakenings, and the number of stage shifts between stages 1, 2, 3, 4 and REM sleep throughout the night were computed as sleep stability parameters. Attentional functioning was assessed using the Continuous Performance Test-II. We found significantly higher sleep instability in ADHD compared to HC. Sleep arousals and stage transitions (micro arousal index, stage 4/3 and 2/4 transitions) in ADHD significantly correlated with lower attentional scores. No association whatsoever was found between sleep instability and attentional functioning in HC. The results show that sleep instability is associated with lower attentional performance in boys with ADHD, but not in HC. This could be compatible with a model according to which attention and sleep stability share a common neural substrate in ADHD.