The direct cost of care for psoriasis and psoriatic arthritis in the United States.
Relatively little information is available in the literature concerning the cost of psoriasis in the United States, and much of that information is out of date. The present analyses estimate the direct cost of medical care for psoriasis (including psoriatic arthritis) from a societal perspective among adults in the United States. The costs of hospitalizations, outpatient and physician office visits, prescription and over-the-counter (OTC) medications, and medical procedures were estimated from the literature, analysis of publicly available health databases (Health and Nutrition Examination Survey, National Hospital Discharge Survey, Medicare Public Use Files, National Ambulatory Medical Care Survey, and the National Hospital Ambulatory Medical Care Survey), and analysis of privately available health databases (United Health Care/Diversified Pharmaceutical Services, the Medstat Group diagnosis-related group guide, and the National Disease and Therapeutic Index). Costs were expressed as of 1997 by using Medicare and health maintenance organization reimbursement rates and wholesale drug costs. Costs of OTC medications were derived by adjusting a previous estimate in the literature for inflation in over-the-counter drugs and population increases. The cost of illness for the approximately 1.4 million individuals with clinically significant disease is substantial-approximately $30.5 million for hospitalizations, $86.6 million for outpatient physician visits, $27.4 million for photochemotherapy, $147.9 million for dermatologic prescription drugs, and $357.2 million for OTC drugs, for a total direct cost of $649.6 million. Cost estimates from this study are substantially less than those found in previous studies ($1.09 billion and $4.32 billion after adjustment of estimates in the literature for medical inflation and population increases). This appears to be principally a result of decreases in hospitalization rates since 1979 and the valuation methodology per unit of medical services (with prior studies using "list" prices and the current study using reimbursement rates).


Comparison of methods of skeletal fixation for severely injured digits.
Our objective is to compare the results of three different methods of osteosynthesis used in severely injured digits, namely the K-wire group, the K-wire & Wire-loop group and the Plate & Screws group. The results of 38 patients with 50 severely injured fingers managed between 1994 and 2000 were reviewed. Majority of them had serious injury caused by electric-saw and Zone III was the most common level of injury using Biemer's classification. Using the scoring system of Nakamura and Tamai, excellent and good results were obtained in 59.5% of the patients. The rate of bony complications was different among the three methods of osteosynthesis though the final functional outcomes were comparable. The rate of bony complications in this series was 20.4%, which included non-union (7), migration of K-wires (2) and infection (1). All occurred in K-wire and K-wire & Wire-loop groups. Plate & Screws, therefore, is the preferred method of bony fixation if further operation for non-union is to be avoided. This is more so for the proximal injuries.


Identification of centrolobol as the platyphylloside metabolite responsible for the observed effect on in vitro digestibility of hay.
Syntheses of the metabolites from platyphylloside, a phenol causing digestibility inhibition in rumen fluid, have been performed to identify the active metabolite. 1,7-Bis(4'-hydroxyphenyl)-3-heptanone (3-platyphyllone), racemic, and the two enantiomers of 1,7-bis(4'-hydroxyphenyl)-3-heptanol (centrolobol) and 1,7-bis(4-hydroxyphenyl)heptane (platyphyllane) were synthesized and tested regarding digestibility inhibition in vitro in cow rumen fluid. All compounds tested induced a decreased digestion. Centrolobol was found to be the metabolite causing the observed effect, and (R)-centrolobol was found to be the enantiomer formed in the rumen liquor in vitro.


COPD, airflow limitation and chronic bronchitis in farmers: a systematic review and meta-analysis.
The current definition of chronic obstructive pulmonary disease (COPD) associates persistent airflow limitation and chronic respiratory symptoms. Agricultural work has been associated with an increased risk of developing COPD, but the prevalence and definition of the disease vary greatly between studies. This meta-analysis aimed to assess the association between agricultural work and COPD using the most widely used definitions of the disease. Inclusion criteria were: (1) design: cross-sectional or longitudinal, (2) groups: at least one group of farmers and a control group of non-farmers, (3) outcome: prevalence or unadjusted OR of COPD, airflow limitation and/or chronic bronchitis, (4) study subjects: groups of exposed subjects comprising ≥30 individuals and with a mean age ≥40 years and (5) language: English and French language, full-length, original publications in peer-reviewed journals. In total, 22 manuscripts were included in the meta-analysis. Eight studies assessed only the prevalence of airflow limitation, nine assessed only the prevalence of chronic bronchitis and four assessed the prevalence of both these parameters. Only one assessed the prevalence of COPD according to its current definition, and this study also provided the prevalence of airflow limitation. Ten studies showed a positive association between farming exposure and airflow limitation or chronic bronchitis, and 12 showed no association (OR (95% CI)=1.77 (1.50 to 2.08), p<0.001). Cattle, swine, poultry and crop farming were associated with either airflow limitation or chronic bronchitis. Although some features of COPD are associated with some agricultural work, well-designed studies with appropriate diagnostic criteria should be conducted to draw strong conclusions about the relationship between COPD and farming.


Fertility and Economic Development: Quantile Regression Evidence on the Inverse J-shaped Pattern.
This paper analyses empirically the relationship between economic development and fertility. Through a new sample selection and quantile regression, it investigates whether there is an inverse J-shaped pattern between these two variables, and, if so, whether it depends on development and fertility levels. Our results confirm that the inverse J-shaped pattern exists, but only when a certain level of economic development is attained. Results also suggest an innovative finding: the J-shape depends not only on the development but also on the fertility level. The higher the fertility rate, the higher the GDP per capita needed to reverse fertility decline, and the faster the negative and positive segments of the J-shape fall and grow.


Effects of lactate administration on mitochondrial enzyme activity and monocarboxylate transporters in mouse skeletal muscle.
Growing evidence shows that lactate is not merely an intermediate metabolite, but also a potential signaling molecule. However, whether daily lactate administration induces physiological adaptations in skeletal muscle remains to be elucidated. In this study, we first investigated the effects of daily lactate administration (equivalent to 1 g/kg of body weight) for 3 weeks on mitochondrial adaptations in skeletal muscle. We demonstrated that 3-week lactate administration increased mitochondrial enzyme activity (citrate synthase, 3-hydroxyacyl CoA dehydrogenase, and cytochrome c oxidase) in the plantaris muscle, but not in the soleus muscle. MCT1 and MCT4 protein contents were not different after 3-week lactate administration. Next, we examined whether lactate administration enhances training-induced adaptations in skeletal muscle. Lactate administration prior to endurance exercise training (treadmill running, 20 m/min, 60 min/day), which increased blood lactate concentration during exercise, enhanced training-induced mitochondrial enzyme activity in the skeletal muscle after 3 weeks. MCT protein content and blood lactate removal were not different after 3-week lactate administration with exercise training compared to exercise training alone. In a single bout experiment, lactate administration did not change the phosphorylation state of AMPK, ACC, p38 MAPK, and CaMKII in skeletal muscle. Our results suggest that lactate can be a key factor for exercise-induced mitochondrial adaptations, and that the efficacy of high-intensity training is, at least partly, attributed to elevated blood lactate concentration.


Microbial hydroxylation of (+/-)- and (-)-(2Z,4E)-5-(1',2'-epoxy-2',6',6'-trimethylcyclohexyl)-3-methyl-2,4-pentadienoic acid into (+/-)- and (-)-xanthoxin acid by Cunninghamella echinulata.
Microbial hydroxylation of (+/-)-(2Z,4E)-5-(1',2'-epoxy-2',6',6'-trimethylcyclohexyl)-3-methyl-2,4-pentadienoic acid (3a) with Cercospora cruenta, a fungus producing (+)-abscisic acid, gave a four-stereoisomeric mixture consisting of (+)- and (-)-xanthoxin acid (4a), and (+)- and (-)-epi-xanthoxin acid (5a) by an HPLC analysis with a chiral column. Screening of the microorganisms capable of oxidizing (+/-)-3a showed that Cunninghamella echinulata stereoselectively oxidized (+/-)-3a to xanthoxin acid (4a) with the some degree of enantioselectivity as (-)-3a to (-)-4a.


Anticipating knowledge to inform species management: predicting spatially explicit habitat suitability of a colonial vulture spreading its range.
The knowledge of both potential distribution and habitat suitability is fundamental in spreading species to inform in advance management and conservation planning. After a severe decline in the past decades, the griffon vulture (Gyps fulvus) is now spreading its breeding range towards the northwest in Spain and Europe. Because of its key ecological function, anticipated spatial knowledge is required to inform appropriately both vulture and ecosystem management. Here we used maximum entropy (Maxent) models to determine the habitat suitability of potential and current breeding distribution of the griffon vulture using presence-only data (N = 124 colonies) in north-western Spain. The most relevant ecological factors shaping this habitat suitability were also identified. The resulting model had a high predictive performance and was able to predict species' historical distribution. 7.5% (approximately 1,850 km(2)) of the study area resulted to be suitable breeding habitat, most of which (approximately 70%) is already occupied by the species. Cliff availability and livestock density, especially of sheep and goats, around 10 km of the colonies were the fundamental factors determining breeding habitat suitability for this species. Griffon vultures could still spread 50-60 km towards the west, increasing their breeding range in 1,782 km(2). According to our results, 7.22% of the area suitable for griffon vulture will be affected by wind farms, so our results could help to better plan wind farm locations. The approach here developed could be useful to inform management of reintroductions and recovery programmes currently being implemented for both the griffon vulture and other threatened vulture species.


Visceral leishmaniasis with cardiac involvement in a dog: a case report.
A dog presented with cutaneous nodules, enlarged lymph nodes and oedema in limbs, face and abdomen. The diagnosis of visceral leishmaniasis was established by identification of Leishmania amastigotes within macrophages from skin and popliteal lymph node biopsies. At necropsy, lesions were found in different organs, but it was particularly striking to observe large areas of pallor in the myocardium. Histological examination revealed an intense chronic inflammatory reaction in many organs, and numerous macrophages were found to contain amastigote forms of Leishmania. The inflammatory reaction was especially severe in the heart, where large areas of the myocardium appeared infiltrated with huge numbers of mononuclear immune cells, causing cardiac muscle atrophy and degeneration. Despite the severe inflammation, the number of parasitized macrophages was low in the myocardium, as revealed by immunohistochemical staining of Leishmania amastigotes. Because cardiac involvement is not usually described in this condition, this dog represents a very rare case of canine visceral leishmaniasis with affection of the myocardium.


A comparison of straight- and curved-path walking tests among mobility-limited older adults.
Habitual gait speed (HGS) and the figure-of-8 walking test (F8WT) are measures of walking ability that have been associated with mobility outcomes and disability among older adults. Our objective was to contrast the physiologic, health, and behavioral attributes underlying performance of these two walking tests among older adults with mobility limitations. HGS and F8WT were the primary outcomes. HGS was measured as time needed to walk a 4-m straight course at usual pace from standstill position. F8WT was measured as time to walk in a figure-of-8 pattern at self-selected usual pace from standstill position. Separate multivariable linear regression models were constructed that predicted walking performance. Independent variables included physiologic, cognitive-behavioral health attributes, and demographic information. Of 430 participants, 414 completed both walking tests. Participants were 67.7% female, had a mean age of 76.5 ± 7.0 years and a mean of 4.1 ± 2.0 chronic conditions. Mean HGS was 0.94 ± 0.23 m/s and mean F8WT was 8.80 ± 2.90 seconds. Within separate multivariable linear regression models (HGS: R (2) = .46, p model < .001; F8WT: R (2) = .47, p model < .001), attributes statistically significant within both models included: trunk extension endurance, ankle range of motion, leg press velocity at peak power, executive function, and sensory loss. Cognitive and physiologic attributes uniquely associated with F8WT were cognitive processing speed and self-efficacy, and reaction time and heel-to-floor time. Pain and peak leg press strength were associated with only HGS. Both HGS and F8WT are useful tests of walking performance. Factors uniquely associated with F8WT suggest that it may be well suited for use among older adult patients with balance problems or at risk for falls.


Characterization of methylated bovine serum albumin-induced allergic inflammation in rats.
An air pouch type allergic inflammation in rats was induced using an insoluble cationic protein, methylated bovine serum albumin (MeBSA), as an antigen. Changes in vascular permeability, local tissue edema, histamine contents in the pouch fluid, and number of infiltrated leukocytes and chemotactic activity in the pouch fluid were analyzed during an 8-hour period after injecting the antigen solution into the air pouch of the immunized and nonimmunized rats. Vascular permeability during the first 30-min interval in the immunized rats was higher than that in the nonimmunized rats, reflecting a higher histamine level in the pouch fluid. However, both the increase in vascular permeability and histamine level in the immunized rats in this period were much lower than those induced by a soluble, noncationic antigen, azobenzenearsonate-conjugated acetyl bovine serum albumin. In the MeBSA-induced allergic inflammation model, a second peak of vascular permeability was induced at 2 h, and local tissue edema formation became apparent at 2 h, reaching a plateau at 4 h. A prominent increase in leukocyte infiltration, especially neutrophils, into the pouch fluid was induced at 4 h in accordance with an increase in chemotactic activity in the pouch fluid. These observations indicate that the acute phase of MeBSA-induced allergic inflammation is characterized by a weak anaphylactic response and a prominent neutrophil infiltration.


The influence of heroin dose and route of administration on the severity of the opiate withdrawal syndrome.
To determine the relationship between severity of opiate withdrawal and prior heroin dose and route of administration (smoking versus intravenous injection). Retrospective analysis of withdrawal data and assessment of associations with baseline variables including heroin dose, route of administration, duration of use, concomitant use of cocaine, severity of opiate dependence, previous treatment, sex or age. Psychiatric inpatient unit specialized in withdrawal treatments. Twenty-two opiate addicts injecting or smoking heroin who were abruptly withdrawn after admission. Daily assessment of withdrawal severity with the Opiate Withdrawal Scale (OWS) during the first week after drug cessation. Severity and duration of withdrawal symptoms were greater in injectors compared to smokers (with comparable doses) and also in patients with higher heroin dose. Heroin dose and route of administration were related significantly to total and maximum withdrawal scores and together accounted for about 50% of variance. Similar levels of total withdrawal distress were associated with approximately five times higher heroin consumption in chasers than in injectors. The impact of heroin dose and route of administration on withdrawal severity is marked. The influence of the route of administration on withdrawal severity might be due to differences in bioavailability.


Developments in making patients' orthodontic choices better.
Orthodontics is an unusual speciality as out-patient treatment requires patients to attend services regularly for two to three years. Contact with services is even longer for some patients referred as children, with their parent or carer, and ultimately finishing treatment as autonomous adults. Treatment success is highly dependent on patient co-operation. It is vital for patients to have as good an understanding as possible of what treatment entails, and whether or not it aligns with their expectations, before and during treatment. This article reviews evidence of the effectiveness of orthodontic information to enable patient involvement in treatment regimens. It critiques the current provision of information with reference to research from the decision and behaviour sciences about how people make sense of information when making treatment decisions. Orthodontists provide a lot of verbal and written information about the 'facts' of treatment. This type of information is unlikely to facilitate patients' decisions about, or adherence with, treatments. There is a paucity of evidence describing how: (1) patients make sense of orthodontic problems and treatments, (2) parents manage decision making about their child's treatment, and (3) variation in information needs across the lifespan and treatment experience. We identified a set of questions to help service providers think critically about the effectiveness of their information provision. Further empirical research is needed to provide evidence to ensure the information included within orthodontic leaflets is relevant to patients and can be assimilated into their existing representations of the problem and treatment.


Integration of Horizontal and Vertical Microfluidic Modules for Core-Shell Droplet Generation and Chemical Application.
This paper presents a method for utilizing three-dimensional microfluidic channels fully to realize multiple functions in a single device. The final device structure was achieved by combining three independent modules that consisted of horizontal and vertical channels. The device allowed for the one-step generation of water-in-oil-in-water droplets without the need for partial treatment of the polydimethylsiloxane channel surface using separate modules for generating water-in-oil droplets on the horizontal plane and oil-in-water droplets on the vertical plane. The second vertically structured module provided an efficient flow for the generation of highly wettable liquid droplets, and tuning of the first horizontally structured module enabled different modes of inner-core encapsulation within the oil shell. The successful integration of the vertical and horizontal channels for core-shell droplet generation and the chemical synthesis of a metal complex within the droplets were evaluated. The proposed approach of integrating independent modules will expand and enhance the functions of microfluidic platforms.


Towards spontaneous heterolysis of the homonuclear P-P bond in diphosphines: the case of diazaphospholeniumtriphospholides.
Computational studies on a series of polyphospholyl-substituted N-heterocyclic phosphines (CH)(2)(NR)(2) P-P(n)(CH)(5-n) (R=Me, n=1-5) disclosed that increasing formal replacement of CH units in the phosphole ring by phosphorus atoms is associated with an increase in P-P distances and charge separation, and a decrease in covalent bond orders. Altogether, these trends imply that the CH versus P substitution enhances ionic P-P bond polarization in these compounds. Experimental verification of this hypothesis was obtained for the triphospholyl diazaphospholenes (CR)(2)(NR')(2)P-P(3)(CtBu)(2) (8a: R=H, R'=tBu; 8b: R=Me, R'=Mesityl [Mes]), which were prepared through metathesis reactions from suitable precursors and identified by solution and solid-state NMR data and a single-crystal X-ray diffraction study of 8a. Analysis of J(PP) coupling patterns suggested that both species are characterized by the absence of a strong covalent P-P bond connecting both rings. This interpretation was confirmed by the finding of a unique P-P distance of 2.79 A for crystalline 8 a, and further supported by computational studies, which led to the conclusion that both species are better described as diazaphospholenium-triphospholide contact ion pairs rather than covalent molecules. Variable-temperature (VT) NMR spectra of 8b showed a collapse of J(PP) couplings between atoms in different rings, which indicates scrambling of the diazaphospholenium and triphospholide units between different molecules in solution, and further substantiates the proposed view on the molecular structure.


[Sexual and physical abuse during early childhood or adolescence and later drug addiction].
Sexual or physical abuse of children are discussed as possible causes or risk-factors for psychiatric disorders like posttraumatic stress disorder, alcohol and drug addiction. The aim of this study was to identify possible differences between sexually or physically abused and non-abused patients with polytoxic drug abuse. 100 patients with polytoxic drug abuse were interviewed during their therapy about a history of sexual abuse prior to the age of sixteen. Using different questionnaires we tried to find possible differences between drug users being sexually abused or not and risk factors for later drug addiction. 70% of the female and 56% of the male drug users had been sexually abused as children, 40% of the male and 50% of the female participants had a history of severe sexual abuse with sexual intercourse. In over 50% friends or relatives were the perpetrators committed the crime, in no case the parents had. More than 40% showed also a history of physical abuse. Significantly more drug users than alcohol abusers had a sexual trauma. Especially severe sexual abuse was associated with abuse of hard illegal drugs. Furthermore, we could find significantly more symptoms such as autoaggressive and suicidal behaviour, social isolation, reduced emotional binding to others, tendency to be persistently victimized, prostitution and violence against others in the group of sexually abused. Many of these symptoms are not only characteristic of addiction, but can be found also in other psychiatric diseases such as borderline and eating disorder. In conclusion, we could not find a significant correlation between sexual abuse and later drug addiction. 80% of the drug users themselves did not relate the fact of being sexually abused as child to later drug abuse. However, there seems to be a positive correlation between sexual abuse and a more severe addiction to illegal drugs as well as higher rates of symptoms with a negative course of the disease. For this group of patients with an unfavourable prognosis special therapeutic concepts are needed.


Does pelvic venous congestion syndrome exist and can it be treated?
Chronic pelvic pain (CPP) is a common and costly health problem in gynecology. Operative pathological findings are often absent. In some women with CPP, pelvic venous congestion has been reported; however, this observation has also been made in asymptomatic women. Thus, it is not clear whether pelvic venous congestion causes CPP and, if it does, whether it is a direct or indirect cause. Venography and non-invasive imaging methods are used for the diagnosis, but scoring systems have not been validated. The current mainstay of treatment is venography-controlled embolization, which is less invasive than surgical interventions. However, the only evidence on effectiveness comes from uncontrolled case series. A systematic review of causation evidence is needed to prove whether pelvic venous congestion causes CPP and whether embolization treatment is effective. In addition, if causation is established, good-quality primary randomized controlled trials on embolization may be required.


Differential bore sheath breast biopsy--a pilot study of a new technique.
The increasing requirement for core biopsy in the diagnosis of early breast disease puts additional demands on radiologists' time and expertise. We present a new approach to percutaneous breast biopsy of impalpable lesions with core biopsy and simultaneous hook wire localization. The technique allows accurate localization of breast lesions and is unique in that it facilitates simultaneous hook wire localization. Percutaneous biopsy by this method was accurate in 9 of 11 patients.


Dynamic Stacking Pathway of Perylene Dimers in Aromatic and Nonaromatic Solvents.
Using molecular dynamics simulations, we elucidate in detail the dynamics of the π-π stacking process of a perylene bisimide (PBI) dimer solvated in toluene. Our calculations show that the transition from the open (unstacked) to the stacked configuration is hindered by a small free energy barrier of approximately 1kBT in toluene but not in the nonaromatic solvent hexane. A similar effect is observed tor two non-covalently linked monomers. The origin of this barrier is traced back to π-π interactions between perylene and the aromatic solvent which are very similar in nature to those between two PBI monomers. The stacking process proceeds in three phases via two well-defined transition states: (i) in the first phase, the two PBI molecules share part of their respective solvation shells forming the first transition state. Further approach needs to squeeze out the shared solvent layer, thus creating the energy barrier. (ii) After removal of the separating solvent, the two PBIs form a second transition state with one monomer located at a random position in the other's solvation shell. (iii) Finally, the two PBIs slide on top of each other into their final stacked position.


Sex-associated differences in the antibody-dependent cellular cytotoxicity antibody response to measles vaccines.
In some countries, excessive non-measles-related mortality has been observed among female recipients of high-titer measles vaccines. We determined if differences in the immune response to measles vaccines underlie the excessive female mortality by measuring the measles virus (MV)-specific antibody-dependent cellular cytotoxicity (ADCC) antibody response in 65 3-year-old Gambian children immunized with Edmonston-Zagreb medium-titer (EZ) or Schwarz standard vaccines during infancy. Among the 20 females and 22 males with undetectable anti-MV antibodies at the time of immunization, females had significantly lower ADCC than males (median cytotoxicities of 1/100 serum dilutions = 8.4 and 12%, respectively; P = 0.04). This sex-associated difference was present only among the six female and seven male recipients of EZ vaccine (median cytotoxicities = 5.1 and 19.0%, respectively; P = 0.02). There were no significant sex-associated differences in neutralizing antibody activity. Decreased ADCC antibody activity may contribute to the lower survival rate observed in females receiving high-titer measles vaccination.


In utero exposure to diesel exhaust increased accessory reproductive gland weight and serum testosterone concentration in male mice.
The effects of in utero exposure to diesel exhaust (DE) on the male mouse reproductive system were examined. Pregnant ICR mice inhaled DE at soot concentrations of 0.3, 1.0, or 3.0 mg DEP/m3 or clean air as the control, for 2-16 days postcoitum. On postnatal day (PND) 28, the weights of the testes and accessory glands and testosterone concentration in serum were significantly higher in the DE-exposed male pups. Testosterone concentration correlated significantly (P<0.01) with the expression levels of steroidogenic enzyme mRNAs, weights of the testes and male reproductive accessory glands, and daily sperm production. These findings indicate that very early stage mouse embryo exposure to DE leads to endocrine disruption after birth and acceleration of male puberty.


Jealousy, Gender, and Culture of Honor: A Study in Portugal and Brazil.
The purpose of this study was to examine whether gender and culture of honor were associated with the type of infidelity (sexual or emotional) that affected our subjects more. Samples of 192 Portuguese university students (119 women and 73 men) and 415 Brazilian university students (214 men and 201 women) participated in this research. Participants responded to six dilemmas reflecting a type of infidelity (sexual or emotional), a gender scale, and a culture of honor scale. The results of both samples are compatible with the cultural theses about jealousy. Both men and women were more affected by emotional infidelity. In addition, it was found that the relationship between the sex of the participants and the type of infidelity that induced stress in them was affected by sociocultural variables, such as culture of honor, masculinity, and femininity. Some differences in the response patterns in the case of an infidelity, in both samples (Portuguese and Brazilian), are shown and discussed.


Through-knee amputation is a feasible alternative to above-knee amputation.
Through-knee amputation (TKA) is a rare amputation performed in <2% of all major lower extremity amputations in the United States. Despite biomechanical benefits and improved rehabilitation compared with above-knee amputation (AKA), TKA has largely been abandoned by vascular surgeons because of concerns for poor wound healing. The purpose of this study was to evaluate surgical outcomes of TKA. The American College of Surgeons National Surgical Quality Improvement Program between 2005 and 2012 was queried using Current Procedural Terminology codes indicating AKA and TKA. Baseline characteristics were reviewed, and logistic regression analysis was performed to identify predictors of 30-day mortality. Propensity score matching was used to balance comorbidities between AKA and TKA. Operative variables and postoperative complications were compared between the groups. A total of 7469 AKA and 251 TKA patients were identified among 15,932 major lower extremity amputations. Baseline characteristics were examined. White race, chronic obstructive pulmonary disease, dyspnea, emergent operation, steroid use, myocardial infarction, congestive heart failure, high American Society of Anesthesiologists score, old age, preoperative sepsis or septic shock, and dialysis dependency were associated with increased 30-day mortality. Independent lifestyle and smoking (within 1 year) were protective against early death. Baseline comorbidities were not statistically significant after 1:1 propensity score matching. Operative outcomes were similar in both groups (AKA vs TKA). Wound infection (7.2% vs 11.2%; P = .16), dehiscence rate (1.2% vs 0.8%; P = 1.0), and 30-day mortality (9.6% vs 11.2%; P = .66) were comparable. Other outcome parameters, including cardiopulmonary and genitourinary complications, were similar except for a higher likelihood of return to the operating room in the TKA group (27.9% vs 12.4%; P < .01). Postoperative mortality was not associated with TKA (P = .77) or reoperation (P = .42), but it was associated with the patients' physiologic conditions (dyspnea, sepsis, emergent operation, high American Society of Anesthesiologists score, and dependent lifestyle). Predictors of reoperation were contaminated wound (hazard ratio [HR], 2.19; confidence interval [CI], 1.17-3.23; P = .015), sepsis or septic shock (HR, 2.63; CI, 1.37-5.05; P = .004), chronic obstructive pulmonary disease (HR, 2.81; CI, 1.23-6.42; P = .014), and wound infection (HR, 4.91; CI, 2.06-11.70; P < .001). Presence of peripheral vascular disease was not associated with post-TKA reoperation (P = .073). TKA demonstrated similar postoperative morbidity and mortality compared with AKA. Wound infection and risk of dehiscence were equivalent. TKA did demonstrate a higher rate of reoperation; however, neither TKA nor reoperation predicted postoperative mortality. Patients in stable physiologic condition without active infection can safely undergo elective TKA to maximize rehabilitation potential.


Tumor necrosis factor and interleukin-1 activities in free lung cells after single and repeated inhalation of bacterial endotoxin.
Bacterial endotoxins (lipopolysaccharides), important components of many organic dusts, are known to induce macrophages to produce the inflammatory mediators interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-alpha). To investigate the role of these mediators in the early inflammatory responses in the lung, guinea pigs were exposed to an aerosol of bacterial endotoxin. A bronchoalveolar lavage (BAL) was then performed, and TNF-alpha and IL-1 in lysed BAL cells and in the supernatants from BAL cell cultures were studied. The effect of single and repeated LPS inhalation exposures on the activities of TNF and IL-1 was studied, as was the effect of LPS added to the cell culture medium. A single inhalation exposure to LPS caused an increase in the TNF-alpha and IL-1 activities in cell lysate and in the cell culture supernatant. After a second inhalation exposure, cell-associated and extracellular TNF-alpha activity could not be detected, whereas IL-1 activity was markedly enhanced. IL-1 activity was increased when LPS was added to the cell culture medium with or without a prior inhalation exposure. In contrast, TNF-alpha activity was not affected after a second exposure.


[A successful case of more than 5 years of disease free survival in hepatocellular carcinoma with tumor thrombus to the right main branch of portal vein after repeated hepatic resection following transhepatic arterial embolization (TAE)].
A case is a male in his 50's. He received hepatic resections twice for hepatocellular carcinoma. Recurrence was pointed out in the residual liver with tumor thrombus to the right branch of the portal vein. The serum level of AFP was 648 ng/ml. We performed transhepatic arterial embolization (TAE) with Epi-ADM, CDDP, Lipiodol and spongel through the right hepatic artery before re-hepatectomy. Posterior segmentectomy with an extraction of portal vein thrombus was performed. Pathological findings showed complete necrosis not only in the main tumor but in the portal vein thrombus also. He is alive for more than 5 years without recurrence after surgeries following pre-operative TAE.


Lack of relationship between systemic exposure for the component drug of the fluorouracil, epirubicin, and 4-hydroxycyclophosphamide regimen in breast cancer patients.
The aim of this study was to investigate the covariance between the pharmacokinetics of the three components of the FEC regimen, epirubicin (EPI), fluorouracil (5-FU), and the cyclophosphamide (CP) metabolite 4-hydroxycyclophosphamide (4-OHCP), in breast cancer patients. Data from 21 women were collected over a total of 35 cycles. 5-FU (300 to 600 mg/m2) and CP (300 to 600 mg/m2) were administered as bolus injections, whereas EPI (15 to 60 mg/m2) was administered either as a bolus injection or as an infusion. The pharmacokinetics of the component drugs were monitored using a limited sampling scheme. Population pharmacokinetic models for each of the three drugs were developed using the program NONMEM. The data for 5-FU were best described by a one-compartment model with nonlinear elimination, where the maximal rate of elimination (Vmax) and the concentration at which the elimination was half-maximal (Km) were 105 mg/L.h and 27 mg/L, respectively. EPI concentration-time profiles showed a triexponential decline, with a mean terminal half-life of 24 hours and a clearance (CL) of 59 L/h. The elimination of 4-OHCP was monoexponential, with a mean half-life of 7 hours. The interindividual coefficients of variation (CVs) in CL were 30%, 22%, and 41% for 5-FU, EPI, and 4-OHCP, respectively. The corresponding values for intrapatient course-to-course variability in CL were 11%, 8%, and 27%. No significant correlation in any of the pharmacokinetic parameters between the drugs was found. Individualization of dosing of the FEC regimen using therapeutic drug monitoring and attempts to find concentration-response relationships may be successful, but requires that the exposure of all three drugs is considered simultaneously.


Preliminary effect of proximal femoral nail antirotation on emergency treatment of senile patients with intertrochanteric fracture.
To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA). From September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 hours after injury. There were 10 type I fractures, 19 type II and 6 type III according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists (ASA), there were 9 grade I, 14 grade II, 8 grade III, and 4 grade IV. The duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2-4 days after operation (mean 3.5 days). Hospital stay was 4-7 days (mean 5.3 days). Full weight bearing time was 10-14 weeks (mean 12.8 weeks). During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15-18 weeks (mean 16.6 weeks). No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had trochanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%. The emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation, less blood loss, shorter length of stay, less complications, and the preliminary clinical effect is satisfactory.


Theileria parva: influence of vector, parasite and host relationships on the epidemiology of theileriosis in southern Africa.
The protozoan parasite Theileria parva, transmitted by the ixodid tick Rhipicephalus appendiculatus, is the cause of East Coast fever (ECF) and the related syndromes of Corridor disease and January disease in cattle of eastern, central and southern Africa. It is likely that buffalo (syncerus caffer) are the natural host of T. parva. In eastern and southern Africa, there exists both buffalo-adapted and cattle-adapted T. parva. Disease caused by buffalo-adapted parasites is called Corridor disease, and that caused by cattle-adapted parasites is termed East Coast fever. In eastern Africa, it has been shown experimentally that buffalo-adapted T. parva can, after serial passage in cattle, become adapted to cattle, in which it can then be maintained and cause ECF. This adaptation has been termed transformation. The transformation of buffalo-adapted T. parva to a cattle-adapted parasite has not been reported in southern Africa, and ECF, eradicated from South Africa, Swaziland and southern Mozambique by 1960, has not reappeared in the subcontinent. This paper discusses the possible reasons for this, and hypothesizes that vector population dynamics and the susceptibility of the vector population to infection with T. parva are among the most important factors which influence the expression of ECF as a disease entity, and the likelihood of transformation occurring. It also considers the possibility that disappearance of ECF from southern Africa resulted from the extinction, as a result of vigorous control measures and unfavourable climatic conditions, of non-diapausing populations of R. appendiculatus that may have been introduced from eastern Africa with cattle imported in 1901.


Developmental regulation of elastin synthesis.
The regulation of elastin production has been evaluated and compared in two systems in the developing sheep: nuchal ligament and lung. Absolute rates of production in explant culture were estimated by immunoprecipitation of newly synthesized elastin and determination of precursor pool specific activities. Lung elastin production increased about 2.5-fold while nuchal ligament production increased about 9-fold during the latter half of gestation. In comparison, the activities of elastin messenger RNA(mRNAE) of these tissues were determined in a cell-free system by immunoprecipitation. The increases in mRNAE activity largely paralleled the rises in elastin production, suggesting that elastin synthesis in these tissues is regulated, at least in part, by the availability of translationally active mRNAE.


Tailoring conductive network nanostructures of ZIF-derived cobalt-decorated N-doped graphene/carbon nanotubes for microwave absorption applications.
Confronted with microwave pollution issues, there is an urgent need for microwave absorption materials that possess optimal combinations of dielectric loss and magnetic loss properties. While a variety of studies focus on the components, the construction of nanostructure is rarely studied, which is of equivalent significance to microwave absorber design. In this work, Co-ZIF-67 was adopted as self-template to grow N-doped graphene/carbon nanotube interlinked conductive networks in-situ under a one-step carbonization process with tailored microwave absorption properties. Diverse microwave absorption performance could be achieved by directly adjusting the proportions among ingredients and the calcination temperature, obtaining a maximum value of reflection loss of -65.45 dB at 17.5 GHz with a sample thickness of just 1.5 mm. The effective absorption bandwidth could be tailored from 3.75 to 18 GHz among different thickness as required. The nanostructures had an apparent impact on the corresponding microwave absorption performance, in which the N-doped carbon-based conductive networks, ferromagnetic cobalt atoms, and interfaces among heterostructure strengthened the dipolar polarization and conductivity loss, magnetic loss, and interfacial polarization, respectively. This synthesis strategy offers a promising pathway for integrating nanostructures and functions, catering to requirements for designing and optimizing prospective microwave absorbers.


Factors affecting participation in group intervention in patients after adjuvant treatment for early-study breast cancer.
According to studies of patients with cancer, support groups can help in three areas: 1) improve mood; 2) introduce new, adaptive ways of handling potentially difficult situations; and 3) impart strategies for managing stress. Nevertheless, the decrease in the quality of life of cancer patients or survivors does not always translate into their utilization of available psychosocial services. The aim of the current study was to explore the factors affecting the decision of patients with breast cancer to participate in group intervention based on an enhancing-resilience approach. One hundred eighty-nine patients who were diagnosed with early-stage breast cancer at a tertiary hospital and had completed adjuvant therapy at least three months previously were asked to enroll in the study with or without group intervention. One hundred and one (53.4%) completed the battery of psychological questionnaires, of whom 56 agreed to participate in the intervention. Sociodemographic and medical data were collected for all 189 subjects from the medical files. No significant differences in sociodemographic or medical data were found between intervention-group participants (N = 56) and non-participants (N = 133). Group participants reported significantly higher levels of psychological pathology. Subjects who completed the questionnaires but did not participate in the intervention reported significantly higher levels of positive cognitive emotion regulation and flexibility than participants. Low participation in group interventions may be more strongly associated with psychological characteristics than sociodemographic and medical factors. It seems that patients know to perceive whether their personal resources are inadequate for facing a life-threatening illness. Like individual therapy, group interventions should be more sensitive to perceived individual needs and to the art of tailoring suitable contents according individual needs.


Cutaneous mastocytosis, problems of clinical diagnosis of four cases.
Mastocytosis is a rare disease characterized by a pathological increased of mast cells in one or more tissues, particularly in the skin, bone marrow, liver, spleen, lymph nodes and gastrointestinal tract. Cutaneous mastocytosis represents over 90% of cases found with predilection in children. The aim of the paper was to summarize the authors' clinical, histopathological and immunohistochemical observations on patients with cutaneous mastocytosis. We present four cases of cutaneous mastocytosis, sporadic form, customized by clinical presentation and age of onset: two installed in the neonatal period, a case with onset in infancy and another in adulthood. For the assessment of the severity and the effectiveness of the treatment, we used SCORMA Index. We performed in each patient histopathological examination of the skin (Hematoxylin-Eosin and Giemsa stains), the dosage of mediators (serum tryptase level, serum histamine levels, urinary histamine metabolites) and the balance of expansion (complete blood cell count, liver biological investigations, abdominal ultrasound, skeletal radiography, chest radiography). For the adult with mastocytosis, we performed abdominal scanner and cytological study of the bone marrow. Following investigations carried out in each case, we mentioned the diagnosis of cutaneous mastocytosis, and also excluded several diseases confounded by clinically and histologically aspect. Considering the fact that the balance expansion was negative, we excluded the diagnosis of systemic mastocytosis. The presence of anemia and protein energetic malnutrition in children with mastocytosis involves carrying out balance extension for the exclusion of a systemic form of the disease. Histopathological examination of the skin using special stains, the dosage of mediators (serum tryptase level, serum histamine levels, urinary histamine metabolites) and balance expansion establish the diagnosis of cutaneous mastocytosis and also exclude many confusions because of the clinical presentation.


[Effects of extracellular K+ concentration on the ERG c-wave].
The effects of K+ concentration in the perfusate on ERG were examined in bullfrog neural retina-retinal pigment epithelium-choroid preparations. In the range of K+ concentration between 1.0 and 6.0 mM, an increase in K+ concentration caused a decline in the b-wave amplitude, while leaving the b-wave peak latency almost unchanged. An increase in K+ concentration in the range between 1.0 and 3.0 mM enhanced the c-wave amplitude, while an increase in K+ concentration in the range between 4.0 and 6.0 mM diminished it. An increase in K+ concentration tended to shorten the time course of the c-wave. These results suggest that variations in the K+ concentration in tissue fluid may partially account for the marked inter- and intra-individual variations of the c-wave.


Association between consumption of fruits and vegetables with suicidal ideation.
To investigate the association between fruit and vegetable (F&V) intake with suicidal ideation. Cross-sectional study using a Korean Community Health Survey. F&V consumers were defined as individuals who had consumed fruits or vegetables more than once per day. Multivariable logistic regression models were used to identify factors associated with suicidal ideation including F&V consumption and to estimate the prevalence of having suicidal ideation after consideration of potential confounders. 221 081 Korea adults (nationally representative). Approximately 55 % of participants were F&V consumers. They were more likely to be young, be women, attain high educational levels, be married and be healthier physically and psychologically than the F&V non-consumers. Non-consumers had an increased risk for suicidal ideation than consumers even when potential confounders were considered, and this trend was more remarkable with vegetable intake. F&V intake is associated with low risk for suicidal ideation.


Phytochemicals and bioactivities of Anemone raddeana Regel: a review.
Anemone raddeana, usually called as'"Toujian Liang" in China, is an Anemone herb belonging to the Ranunculaceae family. Until now there are in total 67 of chemical components identified including triterpenoids, steroids, lactones, fats and oils, saccharide and alkaloids. A broad spectrum of pharmacological activity of A. raddeana compounds have been reported, such as antitumor, antimicrobial, anti-inflammatory, sedative and analgesic activites, as well as anti-convulsant and anti-histamine effects. In view of this, we initiated this short review to present the phytochemical and pharmacological profile of A. raddeana to support future studies in this discipline.


Social media and schizophrenia: An update on clinical applications.
Social media has redesigned the landscape of human interaction, and data obtained through these platforms are promising for schizophrenia diagnosis and management. Recent research shows mounting evidence that machine learning analysis of social media content is capable of not only differentiating schizophrenia patients from healthy controls, but also predicting conversion to psychosis and symptom exacerbations. Novel platforms such as Horyzons show promise for improving social functioning and providing timely access to therapeutic resources. Social media is also a considerable means to assess and lessen the stigma surrounding schizophrenia. Herein, the relevant literature pertaining to social media and its clinical applications in schizophrenia over the past five years are summarized, followed by a discussion centered on user feedback to highlight future directions. Social media provides valuable contributions to a multifaceted digital phenotype that may improve schizophrenia care in the near future.


Gram-negative bacterial toe web infection - a systematic review.
Gram-negative bacterial toe web infection (GNBTWI) is a frequent therapeutic challenge in clinical practice with high recurrence rates and frequent need of systemic drugs. The aim of this systematic review was to provide an updated overview and evidence-based data on pathogens, risk factors and treatment of GNBTWI along with promoting a consistent international terminology. This systematic review is based on a search in PubMed database for English and German articles published between 1980 and 2016. A total of seven articles were considered appropriate for inclusion in this review regarding to treatment and outcome. Throughout the medical literature, a variety of terms for bacterial toe web infections is used. Only few data on the incidence of GNBTWI were published. GNBTWI has been shown to have a significant male predominance. Pseudomonas aeruginosa is the most commonly identified organism beside a high mixed infection rate. We identified the following predisposing factors: interdigital tinea, occlusion and humidity, history of self-medication with antifungals, antibiotics and glucocorticosteroids. As for treatment, debridement of macerated skin lesions and the hyperkeratotic rim showed good response in three published cases. Bacteriological workup of swabs including an antibiogram is recommended for identification of the proper topical and systemic therapy. Autosensitization dermatitis and frequent recurrences are common complications of GNBTWI. Despite the fact, that GNBTWI is an accepted disease entity, scarce data on GNBTWI exist in the medical literature. Randomized controlled trials are missing although needed for evidence-based therapy. To facilitate communication and exchange of updates of GNBTWI, we promote the suggested terminology for bacterial toe web diseases.


Gonadotropin-releasing hormone-stimulated phosphoinositide hydrolysis in the anterior pituitary. Modulation by protein kinase C but not by cyclic nucleotides.
Gonadotropin-releasing hormone (GnRH) produces a rapid and concentration-dependent hydrolysis of polyphosphoinositides in rat anterior pituitary cells in culture. Evaluation of the action of the decapeptide by measurement of [3H]-inositol phosphates and of prelabeled phosphoinositides demonstrated an effect on phosphatidylinositol-4,5-bis-phosphate and phosphatidylinositol-4-phosphate earlier than on phosphatidylinositol. The receptor antagonist [D-pGlu1,D-Phe2,D-Trp3,6]-luteinizing hormone-releasing hormone blocked the effect of GnRH on [3H]-inositol phosphate production. Protein kinase C activators attenuated GnRH-induced phosphoinositide hydrolysis, while neither cyclic AMP analogs nor cyclic GMP analogs were effective. These results indicate that phosphoinositide hydrolysis represents an important postreceptor transducing mechanism for GnRH action at the gonadotroph and that protein kinase C (but not cyclic nucleotides) may exert a negative feedback control on GnRH receptor-coupling mechanisms.


Food Cravings and Eating: The Role of Experiential Avoidance.
Food cravings have been associated with problematic eating behaviors, such as emotional eating. Late adolescence is an important developmental period to examine this association, as late adolescents have greater independence in food choices as well as potentially higher demands during a transitional period of their lives. Mechanisms underlying the association between food cravings and problematic eating remain unclear. This study examined whether experiential avoidance (EA) may be one possible mechanism mediating the association between higher levels of food cravings and problematic eating behaviors. Late adolescents (n = 174) completed measures assessing EA, food cravings, and three problematic eating behaviors: emotional eating, cognitive restraint, and uncontrolled eating. Height and weight were measured objectively to calculate body mass index (BMI). Food cravings were positively associated with emotional eating and mediated by EA. EA also significantly mediated the association between greater cognitive restraint and greater food cravings. No significant mediation was detected for food cravings and uncontrolled eating. Future research may consider EA as a treatment target in intervention strategies for late adolescents seeking to decrease emotional or restrained eating behaviors.


Efficacy of preconception care of diabetic women in a community setting.
To determine the impact of informal preconception care of diabetic women on first-trimester glycemia control in a community setting. Forty-five women with pregestational diabetes underwent a standardized interview regarding their preconception care prior to the index pregnancy. Patients under 14 weeks' gestation had their glycosylated hemoglobin measured; it was used as an index of first-trimester glycemic control. Variables related to glycemic control were analyzed with reference to glycosylated hemoglobin results. Despite a high incidence of counseling and frequent preconception visits, the mean first-trimester glycosylated hemoglobin (+/- SD) was high (10.7 +/- 2.0), and the majority of pregnancies were unplanned. Informal and noncentralized preconception care was not effective in preventing first-trimester hyperglycemia in this group of diabetic women. A high rate of unplanned pregnancy and lack of structured preconception care were prevalent and possibly etiologic.


Targeting the Gut Mucosal Immune System Using Nanomaterials.
The gastrointestinal (GI) tract is one the biggest mucosal surface in the body and one of the primary targets for the delivery of therapeutics, including immunotherapies. GI diseases, including, e.g., inflammatory bowel disease and intestinal infections such as cholera, pose a significant public health burden and are on the rise. Many of these diseases involve inflammatory processes that can be targeted by immune modulatory therapeutics. However, nonspecific targeting of inflammation systemically can lead to significant side effects. This can be avoided by locally targeting therapeutics to the GI tract and its mucosal immune system. In this review, we discuss nanomaterial-based strategies targeting the GI mucosal immune system, including gut-associated lymphoid tissues, tissue resident immune cells, as well as GI lymph nodes, to modulate GI inflammation and disease outcomes, as well as take advantage of some of the primary mechanisms of GI immunity such as oral tolerance.


[INBORN ERRORS OF FATTY ACID METABOLISM (REVIEW)].
The review summarizes the current knowledge about inborn errors of fatty acid metabolism (disorders of carnitine transport and mitochondrial fatty acid oxidation), characterized by high mortality, predominant damage of the central nervous system, heart, liver and skeletal muscles. The article presents the main clinical genetic features of diseases this group. After the introduction of newborn screening using the tandem mass-spectrometry (MS/MS), early identification of fatty acid metabolism defects became possible. Using of MS/MS method is promising for mass newborn screening. Early identification and accordingly timely initiated treatment prevents unfavorable outcome. Moreover, a specified medical-genetic diagnosis allows further prenatal diagnosis of pathology in subsequent pregnancies.


Upper-limb joint kinetics expression during wheelchair propulsion.
In the wheelchair propulsion literature, it is common to report upper-limb (UL) joint kinetics to express shoulder, elbow, and wrist loads. Choosing the appropriate kinetic resolution coordinate system (CS) for UL joint forces and moments has become a laboratory-specific process. The differences that arise during interpretation may hinder a clear and broad understanding of UL joint kinetics during wheelchair propulsion. This article addresses the inconsistency of kinetic reporting in the wheelchair literature that examines the pain and injury experienced by manual wheelchair users. To highlight the variety of reporting methods in wheelchair propulsion, this article surveys peer-reviewed, published articles reporting wrist-, elbow-, or shoulder-joint intersegmental forces and moments calculated from inverse dynamics during wheelchair propulsion. To correct this inconsistency, researchers may need to standardize kinetic reporting methods to achieve a cohesive comprehension of wheelchair biomechanics. This article is provided to open discussion on the anatomical and clinical relevance of currently employed CSs and other available options, with the additional goal of providing an initial recommendation for kinetic representation during wheelchair propulsion.


Laboratory simulation of diffuse reflectivity from a cloudy planetary atmosphere.
For the first time measurements in the multiple scattering regime of the diffuse reflectivity as a function of single scattering albedo have been made in a geometry that may be simulated by a plane parallel atmosphere of large optical depth. A comparison between the measurements and a theoretical computation of the diffuse reflectivity is presented. The measurements are within 1% agreement with the theoretical calculations for two different sizes of scattering particles which are larger than and smaller than the wavelength of the incident light, corresponding to the Mie and Rayleigh regimes, respectively.


Cannabis profiling based on its elemental composition--is it possible?
Elemental composition of 85 cannabis samples was established using GF AAS and ICP OES methods. The robustness of the method was determined by analyzing eight independently prepared replicates from a single cannabis plant. The accuracy of the method was established by analyzing four plant certified reference material samples. The ability of discriminant analysis using elemental compositions to distinguish between fiber cannabis samples collected from four different regions of Poland was evaluated. Then, a classification model was developed that correctly classified selected samples of known origin. Cannabis samples confiscated by law enforcement agencies have also been subjected to discriminant analysis. A classification model has been developed for four locations in Poland (Białystok, Kościerzyna, the environs of Skarżysko Kamienna, and Bydgoszcz), to help determine where samples of unknown origin could have been grown.


Characterizing heterogeneous molecular biology database systems.
Molecular biology data are distributed among multiple databases. Although containing related data, these databases are often isolated and are characterized by various degrees of heterogeneity: they usually represent different views (schemas) of the scientific domain and are implemented using different data management systems. Currently, several systems support managing data in heterogeneous molecular biology databases. Lack of clear criteria for characterizing such systems precludes comprehensive evaluations of these systems or determining their relationships in terms of shared goals and facilities. In this paper, we propose criteria that would facilitate characterizing, evaluating, and comparing heterogeneous molecular biology database systems.


Calculation of conversion coefficients for clinical photon spectra using the MCNP code.
In this work, the MCNP4B code has been employed to calculate conversion coefficients from air kerma to the ambient dose equivalent, H*(10)/Ka, for monoenergetic photon energies from 10 keV to 50 MeV, assuming the kerma approximation. Also estimated are the H*(10)/Ka for photon beams produced by linear accelerators, such as Clinac-4 and Clinac-2500, after transmission through primary barriers of radiotherapy treatment rooms. The results for the conversion coefficients for monoenergetic photon energies, with statistical uncertainty <2%, are compared with those in ICRP publication 74 and good agreements were obtained. The conversion coefficients calculated for real clinic spectra transmitted through walls of concrete of 1, 1.5 and 2 m thick, are in the range of 1.06-1.12 Sv Gy(-1).


Does your fall prevention program drive clinical decision making?
There is a significant amount of information available that outlines the negative impacts of falls in the aging population on both the individual's quality of life and the economics of health care delivery throughout the continuum.


Screening for biologically active metabolites with endosymbiotic bacilli isolated from arthropods.
Endosymbiotic bacteria from the genus Bacillus were isolated from different compartments of the gut of various members of insects (Hexapoda) and millipedes (Diplopoda). They were grown in submerged culture and investigated by biological assays and HPLC-diode array analysis regarding their production of bioactive metabolites, which were isolated and determined in structure. Known compounds and yet unknown derivatives from the primary metabolism were detected, as well as antibacterially and antifungally acting peptide antibiotics.


Effects of endurance training on the breathing pattern of professional cyclists.
The aim of this longitudinal study was to clarify the changes induced by endurance training on the breathing pattern of 13 professional cyclists (age+/-SD: 24+/-2 years; VO(2 max) approximately 75 ml x kg(-1) x min(-1)) during the three periods (rest, precompetition, and competition) of a sports season. Both the volume and the intensity of training were quantified during these periods. In each session (corresponding to each of the three periods) all subjects performed (1) a pulmonary function test (to measure forced vital capacity [FVC], peak expiratory flow [PEF], and maximal voluntary ventilation [MVV]), and (2) a ramp test until exhaustion on a cycle ergometer (workload increases of 25 W x min(-1)). The following variables were recorded every 100 W until the end of the tests: pulmonary ventilation (VE, in l x min(-1) BTPS), tidal volume (VT, inl BTPS), breathing frequency (f(b), in breaths x min(-1)), ventilatory equivalents for oxygen (VE x VO(2)(-1)) and carbon dioxide (VE x VCO(2)(-1)), inspiratory (TI) and expiratory (TE) times (s), ratio of TI to total respiratory duration or inspiratory "duty cycle" (TI/TTOT, and mean inspiratory flow rate (VT)/TI), in l x s(-1)). The results showed no changes in any of these variables (p>0.05) between the three periods of study, despite significant changes in training loads (i.e., increases in the volume and/or intensity of training throughout the season). These findings suggest that endurance conditioning does not alter the breathing pattern of professional cyclists during an incremental exercise test.


The kinetics of the cytologic and rhinomanometric changes in the nose after challenge with allergen.
The objective of these experiments was to study the dynamics of the cytologic and rhinomanometric nasal reaction after allergen challenge. For this purpose a micro-suction system was developed to repetitively and atraumatically collect nasal secretions. Outside of the pollen season, four patients allergic to grass pollen were challenged with phosphate buffered saline (PBS) and, two weeks later, with grass pollen. Six control subjects were challenged with PBS only. Repetitive nasal secretion samplings over three days and rhinomanometry (PAR) were performed. Analysis of samplings taken before allergen challenge proved the atraumatic character of the micro-suction and provocation methods. Coupling the obtained dynamic data of nasal cytology and PAR, the following observations could be made: 1) Higher number of eosinophils in patients in the absence of antigen, compared to controls, suggesting a constitutional characteristic of atopy. 2) A close temporal association between cytological and clinical events occurring during the late phase of the allergic reaction. Nasal obstruction seems to be correlated with the influx of eosinophils rather than with their absolute concentration.


Brugada syndrome in childhood: a potential fatal arrhythmia not always recognised by paediatricians. A case report and review of the literature.
We report on a youngster followed by his paediatrician from birth until 14 years of age for premature beats, most likely of ventricular origin. The sudden death of his sister provoked a re-assessment of his electrocardiograms (ECG), resulting in the diagnosis of Brugada syndrome and the subsequent implantation of a cardioverter defibrillator. This syndrome is a well known entity in adult cardiology, first described by Brugada and Brugada in 1992. It is considered to be the second most common cause of death in young adults after road traffic accidents. In children, however, the Brugada syndrome is not well known and we believe to be certainly underdiagnosed.


Evaluation of spermiation indices with multiple sperm collections in endangered sterlet (Acipenser ruthenus).
This study investigated the effects of multiple collections of sperm on endangered sterlet (Acipenser ruthenus) sperm functional parameters [spermatozoa motility and curvilinear velocity (VCL)] as well as on protein concentration and osmolality of seminal plasma. The average sperm volume and mean spermatozoa concentration per male were significantly altered with multiple collections. On the other hand, no significant effect of multiple collections on protein concentration of seminal plasma was observed. In all experimental groups, moderate impact of sequential collection on osmolality (p < 0.05) of seminal plasma was observed. Ninety to 100% of motile spermatozoa were observed at 15 s after activation, with an average VCL of 181.12 ± 19.10 μm/s. After 90 s, average VCL decreased to 130 ± 26 μm/s. Motility was maintained for up to 4 min. The maximum percentage of motile spermatozoa was observed after the third collection of sperm. The spermatozoa VCL increased significantly with subsequent collections. The results of this study provide new data on the effects of multiple collections on quantitative and qualitative parameters of sperm in sterlet. The data confirmed that the sequential stripping has no negative effect on the percentage of motility and spermatozoa velocity. This should be beneficial for the development of sterlet aquaculture programs.


A descriptive study of the perceptions of workplace violence and safety strategies of nurses working in level I trauma centers.
Workplace violence is a significant occupational hazard in health care. As the largest group of employees in health care, nurses are particularly vulnerable to workplace violence, with those who work in emergency departments being especially at risk. The purpose of this research was to study the phenomenon of workplace violence by interviewing emergency nurses who had experienced violence while on duty. A descriptive study approached the issue of workplace violence from the perspective of 8 registered nurses from 2 level I trauma centers who volunteered to be interviewed. Cross-case comparison of the interview responses was used to analyze the data from verbatim transcripts. Emergency nurses identified specific experiences of violence at work. Inadequate safety measures and vulnerability were the 2 themes that were consistently verbalized through out the interviews. The emergency nurses who were interviewed discussed their experiences with patients, family members, and others who exhibited violent and aggressive behavior. They identified safety measures that they believed were inadequate and discussed their feelings of vulnerability because of violent incidents at work. Further research with larger samples could confirm specific safety problems in emergency departments that must be addressed to provide a safer workplace for emergency nurses, their colleagues, and their patients.


A hidden household danger: Television.
Today, at least 1 television (TV) is owned in most households, and watching TV has become a significant part of daily life. Time spent in front of the TV has increased as its popularity has grown, which may pose a danger to children. The aim of the present study was to draw attention to cases of TV tip-over-related pediatric injuries. Cases of TV tip-over injuries of pediatric patients admitted to the Emergency Department of Kayseri Training and Research Hospital recorded between June 1, 2011 and December 31, 2013 were included. Data were prospectively collected, including age and gender of patient, part(s) of the body affected, Glasgow Coma Scale score, TV screen size and brand, and whether the patient was hospitalized in the general ward or the intensive care unit (ICU). There were 53 pediatric patients enrolled in the study, including 30 males (56.6%) and 23 females (43.4%). Eight patients (17%) had a fracture somewhere in the body, whereas 45 patients (83%) had no fracture. Of patients with a fracture, 3 (2 males, 1 female) were treated in the general ward and 3 (male) in the intensive care unit. One male patient died. An increasing number of individuals present to emergency services with injuries sustained by TV toppling. Cases of injury, permanent disability, and even death associated with falling TVs suggest that awareness of the danger should be increased, as it may affect children in particular.


Quantification of shape and cell polarity reveals a novel mechanism underlying malformations resulting from related FGF mutations during facial morphogenesis.
Fibroblast growth factor (FGF) signaling mutations are a frequent contributor to craniofacial malformations including midfacial anomalies and craniosynostosis. FGF signaling has been shown to control cellular mechanisms that contribute to facial morphogenesis and growth such as proliferation, survival, migration and differentiation. We hypothesized that FGF signaling not only controls the magnitude of growth during facial morphogenesis but also regulates the direction of growth via cell polarity. To test this idea, we infected migrating neural crest cells of chicken embryos with replication-competent avian sarcoma virus expressing either FgfR2(C278F), a receptor mutation found in Crouzon syndrome or the ligand Fgf8. Treated embryos exhibited craniofacial malformations resembling facial dysmorphologies in craniosynostosis syndrome. Consistent with our hypothesis, ectopic activation of FGF signaling resulted in decreased cell proliferation, increased expression of the Sprouty class of FGF signaling inhibitors, and repressed phosphorylation of ERK/MAPK. Furthermore, quantification of cell polarity in facial mesenchymal cells showed that while orientation of the Golgi body matches the direction of facial prominence outgrowth in normal cells, in FGF-treated embryos this direction is randomized, consistent with aberrant growth that we observed. Together, these data demonstrate that FGF signaling regulates cell proliferation and cell polarity and that these cell processes contribute to facial morphogenesis.


Novel familial cases of ICCA (infantile convulsions with paroxysmal choreoathetosis) syndrome.
Epilepsy and paroxysmal dyskinesia are two episodic cerebral disorders that can share a common genetic basis. Rare families with infantile seizures and paroxysmal dyskinesia [predominantly paroxysmal kinesigenic dyskinesia (PKD)], co-inherited as a single autosomal dominant trait, have been described (infantile convulsions with paroxysmal choreoathetosis; ICCA syndrome) and a disease gene has been mapped at chromosome 16p12-q12 (ICCA region). We report the clinical picture of seven previously unreported families with ICCA syndrome. The identification of novel ICCA families should contribute to better knowledge regarding the clinical manifestations of ICCA syndrome as well as the search for the underlying genetic defect(s).


Uncombable hair (pili trianguli et canaliculi): evidence for dominant inheritance with complete penetrance based on scanning electron microscopy.
Uncombable or spun-glass hair (pili trianguli et canaliculi) is an uncommon condition in which the hair is "unmanageable" and has a distinct appearance on scanning electron microscopy. The hair is usually grossly abnormal in infancy and childhood, but may become normal later in life. Although dominant inheritance has been observed, most cases have been sporadic. Both recessive and dominant transmission with incomplete penetrance have been suggested as modes of inheritance. We report the occurrence of this condition in a young girl, her brother, and her father. Although the proposita and her brother had characteristically uncombable hair, their father appeared normal and denied any history of hair abnormality. However, the characteristic hair morphology was observed on scanning electron microscopy in all 3 relatives, documenting dominant transmission and complete penetrance of the gene in this family.


A Case Report of Sequential Use of a Yeast-CEA Therapeutic Cancer Vaccine and Anti-PD-L1 Inhibitor in Metastatic Medullary Thyroid Cancer.
Medullary thyroid cancer (MTC) accounts for ~4% of all thyroid malignancies. MTC derives from the neural crest and secretes calcitonin (CTN) and carcinoembryonic antigen (CEA). Unlike differentiated thyroid cancer, MTC does not uptake iodine and I-131 RAI (radioactive iodine) treatment is ineffective. Patients with metastatic disease are candidates for FDA-approved agents with either vandetanib or cabozantinib; however, adverse effects limit their use. There are ongoing trials exploring the role of less toxic immunotherapies in patients with MTC. We present a 61-year-old male with the diagnosis of MTC and persistent local recurrence despite multiple surgeries. He was started on sunitinib, but ultimately its use was limited by toxicity. He then presented to the National Cancer Institute (NCI) and was enrolled on a clinical trial with heat-killed yeast-CEA vaccine (NCT01856920) and his calcitonin doubling time improved in 3 months. He then came off vaccine for elective surgery. After surgery, his calcitonin was rising and he enrolled on a phase I trial of avelumab, a programmed death-ligand 1 (PD-L1) inhibitor (NCT01772004). Thereafter, his calcitonin decreased > 40% on 5 consecutive evaluations. His tumor was subsequently found to express PD-L1. CEA-specific T cells were increased following vaccination, and a number of potential immune-enhancing changes were noted in the peripheral immunome over the course of sequential immunotherapy treatment. Although calcitonin declines do not always directly correlate with clinical responses, this response is noteworthy and highlights the potential for immunotherapy or sequential immunotherapy in metastatic or unresectable MTC.


The impact of marginal lung function on outcomes in the era of minimally invasive thoracic surgery.
The effect of marginal lung function on outcomes after lung resection has traditionally been studied in the context of open thoracic surgery. Its impact on postoperative outcomes in the era of minimally invasive lung resection is unclear. In this retrospective cohort study, we included adult patients who underwent minimally invasive lung resection at our institution between January 2017 and May 2020 for known malignancy or lung nodule. Marginal lung function was defined as pre-operative forced expiratory volume in 1 second (FEV1) and/or diffusion lung capacity of carbon monoxide <60% of predicted. Our outcomes included a composite outcome of pulmonary morbidity and/or 30- and 90-day mortality, and hospital length of stay. We used multivariable logistic and Poisson regression models to identify associations with outcomes, and Kaplan-Meier and Cox models to estimate survival. Of 300 patients, 88 (29%) had marginal lung function. Patients in the marginal group were more likely to be female (69% vs. 56%; P=0.028), and more likely to have: hypertension (HTN) (83% vs. 71%; P=0.028), chronic obstructive pulmonary disease (COPD) (38% vs. 12%; P<0.001), interstitial lung disease (ILD) (9% vs. 3%; P<0.019), and ischemic heart disease (28% vs. 18%; P=0.033). Patients were similar in terms of age (68±8 vs. 68±10 years; P=0.932), and other comorbidities. Anatomic lung resection comprised 56.8% of the marginal group vs. 74% in the non-marginal group (P=0.003). The most common complication was prolonged air leak (18.2% vs. 11.8%; P=0.479). Marginal lung function had a trend toward increased composite respiratory complications (22.7% vs. 15.1%; P=0.112) and 90-day mortality (5.7% vs. 4.2%; P=0.591), although they did not reach statistical significance. There was a statistically significant 1-day average increase in length of stay in the marginal lung function cohort (4.6 vs. 3.4 days; P<0.015) with a stronger association with diffusion lung capacity of carbon monoxide than FEV1. Survival was similar (marginal function HR =1.0; P=0.994). In the era of minimally invasive thoracic surgery, lung resection in patients with marginal lung function may be considered in select patients. These findings aid in the selection consideration and counseling of this patient population.


Barriers and Facilitators to Mental Health Help-Seeking among Young Adults in Saudi Arabia: A Qualitative Study.
While young Saudi adults are reportedly prone to experiencing a variety of mental health problems, they tend to delay seeking mental health support. Therefore, this study aimed to explore the barriers and facilitators of seeking mental health support among young adults in Saudi Arabia. A qualitative research design was implemented using semi-structured interviews with 12 young adult participants in Saudi Arabia, recruited through social media platforms, and the interviews were then analyzed using thematic analysis. Two major themes emerged: barriers that impede the process of mental health help-seeking and facilitators that assist individuals in seeking mental health support. The barriers included public stigma and lack of awareness, unprofessional mental health practitioners, lack of accessibility to services and information, unsupportive families, intrapersonal dilemmas, and misconceptions based on religious beliefs. Facilitators of help-seeking included increasing societal and family awareness, promoting the accessibility of services, enhancing sources of external support, personal motivation to change, and online therapy. The findings of this study emphasize the importance of promoting mental health literacy among the Saudi public, particularly with regard to young adults and their unique mental health needs. Exploring facilitators and barriers may also assist mental health providers in developing tailored mental health campaigns and interventions directed at young adults.


Adverse events to antituberculosis therapy: influence of HIV and antiretroviral drugs.
This study investigated whether serious adverse events (SAEs) during antituberculosis therapy occur more frequently in HIV co-infected patients in a South African population. A retrospective analysis examined incidences of hepatotoxicity, peripheral neuropathy, severe arthralgia, persistent vomiting and severe rash in 400 patients treated for tuberculosis in a community clinic. A total of 141 patients were co-infected with HIV, among whom only 16.3% were receiving antiretrovirals. Details of SAEs were ascertainable in 331/400 patients, and occurred in 26.7% of HIV-infected and 13.3% of HIV-uninfected individuals (P = 0.003). The excess was attributable to increased peripheral neuropathy (8.3% and 1.9%, respectively, P = 0.009) and persistent vomiting (13.3% and 3.3%, P = 0.001). SAE occurrence was not related to antiretroviral use, although median CD4 counts were lower in those experiencing side-effects (130 and 259 cells/microL, P = 0.008). The treatment completion did not differ significantly between the two groups (76.6% and 84.2%, P = 0.08).


Effects of transcranial ultrasound and intravenous microbubbles on blood brain barrier permeability in a large animal model.
We sought to determine whether transtemporal-applied 1-MHz ultrasound-induced microbubble destruction may be a safe method of transiently altering blood brain barrier (BBB) permeability for drug delivery in a large animal model. Endothelial cells are an integral component of the BBB but also prevent passage of potentially therapeutic drugs. Ultrasound-mediated destruction (UMD) of microbubbles has been shown to disrupt this barrier in small animals when ultrasound is delivered through bone windows. However, the effects of temporal bone attenuation and scattering in a large animal may limit the clinical application of such a technique. Twenty-four pigs were studied. One-MHz pulsed-wave ultrasound at 2.0 W/cm(2) (20% duty cycle) across the temporal bone was applied for 30 min after intravenous injections of either albumin-coated perfluorocarbon microbubble (PESDA, 8 pigs), lipid-encapsulated perfluorocarbon microbubbles (LEMB, 8 pigs) or ultrasound alone (8 pigs). BBB leak was quantified at 30 and 120 min after insonation using Evans blue. Serial magnetic resonance imaging (MRI) was performed in nine of the pigs (3 for each group) to quantify Gadolinium leak within the parenchyma. Peak negative pressures decreased ten-fold when ultrasound was transmitted across the pig temporal bone. Despite this, spectrophotometric analysis showed that both IV LEMB and PESDA combined with transtemporal ultrasound resulted in a significant increase in Evans blue extravasation across BBB of the treated side at 30 min after insonation (p < 0.001; compared with ultrasound alone) but not at 120 min. There was significant retention of Gadolinium within the insonified parenchyma at 60 and 90 min after insonation, but not at 120 min. Oxygen saturation and arterial pressures were not changed after any microbubble injection. Intravenous microbubbles, combined with transtemporal ultrasound, can transiently increase BBB permeability in a large animal. This induced opening of BBB is reversible and may be a safe noninvasive method of achieving drug or gene delivery across the BBB.


Availability, price and affordability of asthma medicines in five Indian states.
States of Haryana, Karnataka, Maharashtra and Rajasthan, and Chennai (capital of Tamil Nadu State), India. To assess the availability, price and affordability of beclomethasone and salbutamol inhalers in five Indian states using a standardised methodology. Data on the availability and price of two essential medicines for asthma, beclomethasone (50 microg/dose) and salbutamol (0.1 mg/dose) inhalers, were collated from five medicine price studies on essential medicines. Beclomethasone and salbutamol inhalers were available in 25% and 30% of public facilities in Rajasthan State only. The procurement price for beclomethasone and salbutamol was respectively 0.74 and 0.56 times the international reference price (IRP). The availability of beclomethasone inhalers was poor in the private sector (10-65%) in four states. The availability of salbutamol inhalers ranged from 20% to 95% as an innovator brand and 83% to 100% as the generic. The price of beclomethasone was 0.87-1.49 times the IRP, while salbutamol cost 0.82-1.12 times the IRP. Purchasing one inhaler each of salbutamol and beclomethasone cost between 1.6 and 2.3 days' wages for the lowest paid government worker. Eighty per cent of the population earn less than this wage. Essential inhalation medicines for asthma were not available in the public sector where low-income populations receive treatment. Steroid inhalers were not readily available in the private sector. Essential inhalation medicines for asthma are not affordable for the majority of the population.


Insights on exposure-induced disease susceptibility: an interview with Jaclyn Goodrich.
In this interview, Dr Jaclyn Goodrich speaks with Storm Johnson, Commissioning Editor for Epigenomics, on her work to date on environmental epigenetics and the impact of toxic exposures on susceptible populations. Jaclyn Goodrich is a research assistant professor of environmental health sciences at the University of Michigan School of Public Health (Ann Arbor, MI, USA). She obtained a doctorate in toxicology and completed postdoctoral training in environmental epigenomics at the University of Michigan. The overarching goal of her current research program is to identify environmental factors that modify the epigenome and increase risk for disease throughout the life course. She primarily conducts epidemiological studies to investigate the impact of toxic exposures on susceptible populations including children and occupationally exposed workers. She has coauthored more than 70 publications and is an active member of the Society of Toxicology and the Environmental Mutagenesis and Genomics Society.


Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19.
To determine the incidence, mortality, stage, and recovery of acute kidney injury (AKI) in COVID-19 patients and further analyze the effect of patient demographics and comorbidities on AKI incidence. Our study looked at 1545 charts of patients over 18 years old who presented to BronxCare Hospital in NY with a positive SARS-CoV-2 PCR test. Using the KDIGO criteria, any patient presenting with a creatinine of 1.5 times the baseline or that had an increase in creatinine of 0.3mg/dL in 48 hours was diagnosed with AKI. Pregnant patients, patients with end-stage renal disease (ESRD), and patients with a history of renal transplant were excluded. The incidence of AKI in COVID-19 patients was 39% (608), and the mortality rate was 58.2% (354). Of the 254 survivors, 74.8% recovered. Moreover, 42.6% (259) of patients with AKI were admitted to the ICU. Twenty-six of our patients received hemodialysis during admission. There was a statistically significant association between AKI and age, race, hypertension (HTN), diabetes mellitus (DM), hepatitis C (HCV), congestive heart failure (CHF), CKD, patient outcome, and days spent in the hospital. Of the 608 patients with AKI, 294 (48.4%), 185 (30.4%) and 129 (21.2%) had AKI stage 1, 2 and 3, respectively. Early resource planning is necessary when admitting COVID-19 patients. Nephrology should be consulted early, and measures should be in place to optimize outpatient follow-up in the nephrology clinic. Lastly, the use of nephrotoxic agents should be carefully considered and, if possible, avoided from the time of admission in patients with COVID-19.


Repeated administration of recombinant human insulin-like growth factor-I in patients after gastric surgery. Effect on metabolic and hormonal patterns.
The primary objective of this investigation was to evaluate the anticatabolic effects of repeated subcutaneous administration of recombinant human insulin-like growth factor-I (rhlGF-I) in patients after gastric surgery. The anabolic and protein-sparing effects of growth hormone are primarily mediated by IGF-I. Malnutrition and catabolic states result in increasing blood levels of growth hormone and decreasing levels of IGF-I. Experimental data showed that exogenous IGF-I could attenuate or reverse catabolism. After giving their written informed consent, 38 male and female patients undergoing gastrectomy (age 40-75 years, body mass index 17-30 kg/m2) were treated with 80 micrograms/kg body weight rhlGF-I or placebo in a prospective, randomized, double-blind study for 5 consecutive days. Patients received a standardized total parenteral nutritional regimen with 3 g/kg body weight glucose and 0.1 g/kg body weight nitrogen. Nitrogen balance and 3-methylhistidine excretion were measured daily. Hormone profiles (IGF-I, IGFBP1, IGFBP3, cortisol, insulin, glucagon, triiodothyronine [T3], levothyroxine [T4], and thyroxine-binding globulin) were taken.


Repurposing fed-batch media and feeds for highly productive CHO perfusion processes.
Perfusion is a cell culture mode that is gaining popularity for the manufacture of monoclonal antibodies and their derivatives. The cell culture media supporting perfusion culture need to support higher cell densities than those used in fed-batch culture. Therefore, when switching from a fed-batch to a perfusion mode, a new medium need to be developed which supports high cell densities, high productivity, and favorable product quality. We have developed a method for deriving perfusion culture media based on existing fed-batch media and feeds. We show that we can obtain culture media that successfully support perfusion cultures in a single-use rocking bioreactor system at cell-specific perfusion rates below 25 pL-1 cell-1 day-1 . High productivities and favorable product quality are also achievable.


Determination of the phytochemical composition of Jingning fang and the in vivo pharmacokinetics of its metabolites in rat plasma by UPLC-MS/MS.
Jingning fang (JNF) is an effective Traditional Chinese Medicine (TCM) which is used for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). To clarify the bioactive constituents of JNF, a Thermo Q Exactive™ Plus Orbitrap™ mass spectrometer was used in this study. More than 127 chemical compounds were isolated and identified tentatively in the JNF extract, while 42 prototype constituents with 4 potential metabolites were identified tentatively in rat plasma. A method for simultaneous determination of polygalaxanthone III (PAIII), sibiricose A5 (A5), sibiricose A6 (A6), 3, 6'-disinapoyl sucrose (3,6'-DISS), tenuifoliside C (TEC), tenuifolin B (TNB), verbascoside (VCE), heterophyllin B (HEB) and schisandrin (SCH) in rat was developed and validated using polydatin (PLN) and psoralen (PSN) as internal standards. All calibration curves proved favorable linearity (R2≥0.9923) in linear ranges. The lower limit of quantification (LLOQ) was 2.5ng/mL for PAIII, A5, 3, 6'-DISS, TNB, VCE, HEB and SCH, 1.0ng/mL for A6 and TEC, respectively. Intra-day and inter-day precisions didn't exceed 14.0% for all the analytes. Extraction recoveries and matrix effects of analytes and IS were acceptable. The validated method has been successfully applied to the pharmacokinetics (PK) studies of the nine compounds in JNF. These findings are useful for predicting the bioactive components of JNF, and will aid in optimizing dose regimens of the drug.


Intradural iatrogenic epidermoid cyst at cauda equina: A case report.
Spinal epidermoid accounts for <1% of all primary spinal cord tumors. They occur due to the invagination of epidermal elements into the neural tube during the embryonic period. Even more infrequent are spinal epidermoid cysts that occur without attendant spinal dysraphism (e.g., as occurs with the iatrogenic inoculation of epithelial cells in the subarachnoid space following a lumbar puncture). A 38-year-old female with a history of epidural spinal blocks at L2-3 for two previous pregnancies presented with low back pain, right lower extremity weakness (4/5 level), hyporeflexia, and tingling/ numbness in the right L3-5 distribution. The lumbar MR demonstrated an intradural extramedullary lesion at the L2-L3 level that compressed the cauda equina/nerve roots. MR findings were compatible with an epidermoid cyst, this was histologically confirmed following a microsurgical L2-3 laminectomy for lesion resection. Pathologically, the lesion demonstrated a keratinized stratified squamous epithelium with keratin content without cutaneous attachments, thus confirming the diagnosis of an epidermoid cyst. Postoperatively, her sensory complains improved and her motor strength fully recovered to the 5/5 level. Patients with spinal epidermoid cysts typically present with underlying spinal dysraphism, but only rarely do iatrogenic cases arise. Here, we presented a patient who developed a spinal lumbar epidermoid cyst in a female patient after undergoing spinal epidural anesthesia during pregnancy. Notably, this was successfully treated a with decompressive laminectomy and microsurgical resection.


Increased extracellular dopamine in the nucleus accumbens of the rat elicited by a conditional stimulus for food: an electrochemical study.
Stearate-modified graphite paste electrodes were implanted chronically into dopamine terminal regions in the nucleus accumbens or caudate nucleus of the rat. Reverse dialysis was used to demonstrate a selective response of these electrodes to dopamine, but not 3,4-dihydroxyphenylacetic acid or ascorbic acid. In a separate behavioural experiment, a significant increase in the chronoamperometric response was observed during presentation of a conditional stimulus predictive of food, and the electrochemical response remained elevated during and following consumption of the meal. Similar trends were observed from electrodes in the caudate nucleus. These data confirm the activation of mesolimbic dopamine neurons by incentive stimuli predictive of food and possibly by consumption of food. Together with other recent data on sex- and thirst-related increases in dopamine levels in the nucleus accumbens, these findings are consistent with a role for the nucleus accumbens as an interface between motivation and activation of the motor system.


Electrically driven monolithic subwavelength plasmonic interconnect circuits.
In the post-Moore era, an electrically driven monolithic optoelectronic integrated circuit (OEIC) fabricated from a single material is pursued globally to enable the construction of wafer-scale compact computing systems with powerful processing capabilities and low-power consumption. We report a monolithic plasmonic interconnect circuit (PIC) consisting of a photovoltaic (PV) cascading detector, Au-strip waveguides, and electrically driven surface plasmon polariton (SPP) sources. These components are fabricated from carbon nanotubes (CNTs) via a CMOS (complementary metal-oxide semiconductor)-compatible doping-free technique in the same feature size, which can be reduced to deep-subwavelength scale (~λ/7 to λ/95, λ = 1340 nm) compared with the 14-nm technique node. An OEIC could potentially be configured as a repeater for data transport because of its "photovoltaic" operation mode to transform SPP energy directly into electricity to drive subsequent electronic circuits. Moreover, chip-scale throughput capability has also been demonstrated by fabricating a 20 × 20 PIC array on a 10 mm × 10 mm wafer. Tailoring photonics for monolithic integration with electronics beyond the diffraction limit opens a new era of chip-level nanoscale electronic-photonic systems, introducing a new path to innovate toward much faster, smaller, and cheaper computing frameworks.