Access to Health Care for Pregnant Arabic-Speaking Refugee Women and Mothers in Germany.
Refugee women often encounter multiple barriers when accessing ante-, peri-, and postnatal care. The aim of this study was to investigate how premigration experiences, conceptions about pregnancy and childbirth, health literacy, and language skills influence access to health care, experiences of health care, and childbirth. A total of 12 semi-structured interviews with refugee women from Iraq, Syria, and Palestine were conducted in the city of Dresden. Content analysis was applied using Levesque's access model as a framework. Results indicate that conceptions of pregnancy and childbirth and premigration experiences influence women's behaviors and experiences of pregnancy and childbirth. They contribute to barriers in accessing health care and lead to negative health outcomes. In view of limited health literacy, poor language skills, lack of information, and missing translators, female relatives in countries of origin remain an important source of information. Improved access to services for refugee women is needed.


Tailoring the Porosity in Iron Phosphosulfide Nanosheets to Improve the Performance of Photocatalytic Hydrogen Evolution.
Metal sulfide photocatalysts are typically required during water splitting to produce hydrogen. However, the rapid recombination of photogenerated electron-hole pairs in these highly unstable photocatalysts has restricted hydrogen production to small-scale batch reactions. In this work, porous transition-metal thiophosphites were used to enable continuous long-term hydrogen production through photocatalysis. A wide bandgap (2.04 eV) was essential for generating hydrogen at a rate of 305.6 μmol h-1 g-1 , 180 % faster than nonporous FePS3 nanosheets. More importantly, the high in-plane stiffness of these approximately 7 nm thick porous FePS3 nanosheets ensured structural stability during 56 h of continuous photocatalysis reactions. The reaction results with D2 O instead of H2 O indicated that hydrogen mainly came from H2 O. Furthermore, a sacrificial reagent (triethylamine) was photodegraded into diethylamine and acetaldehyde through a monoelectronic oxidation process, as indicated by HPLC and LC-MS. This synthesis strategy reported for FePS3 porous nanosheets paves a new pathway for designing other dianion-based inorganic nanocrystals for hydrogen energy applications.


The role of endoscopic biliary stents in palliative care.
This article reviews the role of endoscopic biliary stents in palliative care. In particular it focuses on the indications for stents, and recognition and management of possible complications. These issues are illustrated with three case reports.


Changes in self-concept during pulmonary rehabilitation, Part 1.
The purpose of this two-part study was to describe changes in self-concept during and after a formal pulmonary rehabilitation program. A 20-item semantic meaning differential scale was administered to 37 patients with severe chronic obstructive pulmonary disease who were participating in a multidisciplinary pulmonary rehabilitation program. Patients were asked to evaluate their past, present, and future selves on program admission, on program discharge, and 2 to 6 months after home discharge. Mean total self-concept score for the present self significantly increased between program admission and home discharge 3 weeks later (mean change 31.32 +/- 22.04, p less than 0.0001). No significant declines in self-concept were found 2 to 6 months after home discharge (p = 0.39). Men showed a significantly higher change in total self-concept score than women during the 3-week program (p = 0.03). However, the men's change score dropped significantly after home discharge (p = 0.02), suggesting a need for more intensive follow-up care than with women. The self-concept tool in this study provided an easy way to monitor subjective changes in psychologic status.


Age, growth and mortality of Clarias gariepinus (Siluriformes: Clariidae) in the Mid-Cross River-Floodplain ecosystem, Nigeria.
Clarias gariepinus is a threatened highly prized species used for some elite ceremonies by the local communities. Artisanal fishers take advantage of this species annual breeding migration from the lower Cross River to the floodplain lakes in Mid-Cross River during the rainy season, and some migrant stocks are not able to spawn. Since there is a lack of information on this species population dynamics in the Mid-Cross area, this study aimed to evaluate the age, growth and mortality to support the development of effective management plans. For this, monthly overnight gill net catches (from 6 to 72mm mesh sizes) were developed between March 2005 and February 2007. Growth parameters were determined using the FiSAT II length-frequency distribution. A total of 1 421 fish were collected during the survey. The asymptotic growth (L(infinity)) was 80.24cm, growth rate (K) was 0.49/year while the longevity was 6.12 years. The annual instantaneous rate of total mortality (Z) was 2.54/year and the natural mortality (M) was 0.88. Fishing mortality (1.66/year) was higher than the biological reference points (F(opt) = 0.83 and F(limit) = 1.11) and the exploitation rate (0.66) was higher than the predicted value (E(max) = 0.64) indicating that C. gariepinus was over exploited in the Mid-Cross River-Floodplain ecosystem. Some recommended immediate management actions are to strengthen the ban of ichthyocide fishing, closure of the floodplain lakes for most of the year, restricted access to the migratory path of the fish during the flood period and vocational training to the fishers. In order to recover and maintain a sustainable harvest, I suggest that a multi-sector stakeholder group should be formed with governmental agents, community leaders, fishers, fisheries scientists and non-governmental organizations. These short and long term measures, if carefully applied, will facilitate recovery of the fishery.


Utilization of phosphorus and certain other minerals from swine waste and broiler litter.
Two trials were conducted with 15 wethers surgically equipped with duodenal and ileal cannulas to study the utilization of P, Ca, Mg, Cu, Fe and Zn from swine waste and broiler litter. For each trial, animals were fed a low-P basal diet until serum inorganic P averaged 5.5 mg/dl; then they were allotted at random to the following 50% DM ensiled diets: low-P basal, basal + swine waste, basal + broiler litter, basal + dicalcium phosphate and basal + soybean meal. Each trial consisted of a 7-d preliminary period, a 7-d collection of feces and urine and 6-d sampling of duodenal and ileal digesta and feces. Apparent P absorption was not different (P greater than .05) between sheep fed waste-supplemented diets (37%) and those fed the conventionally supplemented diets (28%). Phosphorus absorption, calculated by difference, tended (P less than .1) to be higher from the waste supplements (59%) than from dicalcium phosphate and soybean meal (37%). Less (P less than .05) Ca was absorbed from the waste diets (.62 g/d) than from the conventional diets (1.28 g/d). More (P less than .05) Cu (mg/d) was absorbed from the waste diets, but no difference was found when absorption was expressed as percentage of intake. Broiler litter and swine waste were good sources of available P and Mg for ruminants.


Neurological features and management of Wilson disease in children: an evaluation of 12 cases.
Wilson's disease is an autosomal recessive disorder of copper metabolism which leads to copper overload in different tissues of the body. The aim of this study was to present the neurologic features of Wilson's disease and to assess the clinical course of neurological findings in children receiving anti-copper treatment. Twelve children with a diagnosis of Wilson's disease and findings of central nervous system involvement who were followed up in the Department of Pediatric Neurology and Pediatric Gastroenterology of the School of Medicine at Erciyes University were enrolled in the study. The study cases consisted of five boys (42%) and seven girls (58%). The mean age at the time of diagnosis was 9.9±3.4 years (5-15 years). The mean duration of follow-up was 49.0±36.4 months (15-128 months). Neurological findings at presentation included headache in seven cases (58%), tremor in seven cases (58%), dystonia in three cases (25%), ataxia in two cases (17%), dizziness in two cases (17%), numbness in the hands and acute weakness in one case (8%) and syncope in one case (8%). Headache, dizziness, syncope, numbness in hands and acute weakness symptoms resolved completely within six months after receiving treatment. Movement disorders either decreased or remained stable in seven of the eight cases. However, one patient developed progressively worsening dystonia despite to all treatments. Wilson's disease can be manifested with signs and symptoms of central nervous system in the childhood. Wilson's disease should be considered in all children presenting with movement disorders. A complete neurological assessment should be carried out in all cases with Wilson's disease.


[Covered osteosynthesis through cannulated screws in medial Garden type I and II femoral neck fractures].
Fracture of the femoral neck is a common problem in elderly patients. In these patients with concomitant illness and medical complications the hip fracture is then often the reason for a long-term institutionalization with serious implications for the outcome. While the treatment of displaced femoral neck fractures Garden's stage III and IV is quite clear, the procedure for impacted or undisplaced fractures Garden's stage I or II is still the subject of controversy. In a retrospective study was shown that conservative treatment of impacted or undisplaced femoral neck fractures is associated with a high complication rate of 30-40%. When these femoral neck fractures were broken down according to Garden's classification the complication rate in cases of Garden's stage II was found to be 1.5 times that in femoral neck fractures in Garden's stage I. With a P-value less than 0.05 this difference was statistically significant (Wilcoxon test). Because of these major problems associated with conservative treatment we changed our current algorithm. Covered internal fixation with cancellous screws is now considered to be indicated for all impacted or undisplaced femoral neck fractures. Between 1990 und 1992, 53 patients (42 female, 11 male) with femoral neck fracture in Garden's stage I (24 patients) or II (29 patients) were treated in our Department of Traumatology with 6.5 mm cancellous screws. In all case early mobilization and weight-bearing were allowed. In this prospective study the average follow-up was 14.3 +/- 2.1 months (range 8-20 months).(ABSTRACT TRUNCATED AT 250 WORDS)


A simple carbon dioxide injection system for photosynthetic studies.
A simple carbon dioxide injection system has been developed for the maintenance of CO(2) concentrations in semiclosed cuvette systems suitable for photosynthesis and gaseous pollutant studies. The device injects small volumes of pure carbon dioxide into the cuvette in response to a signal from an infrared gas analyzer.


Plant transposable elements: their role in evolution.
Transposable elements (TE) are natural constituents of plant genomes. However, their presence only becomes apparent if they become dislodged from their resident positions in the genome and transpose into another gene, thereby inducing a mutation. Such TE-induced mutations are somatically unstable because they revert to wild type and hence reconstitute the expression of the mutated gene. The frequent somatic excision of the TE results in a variegated phenotype. Since this instability is inherited in a Mendelian manner the variegated phenotype is nuclear determined. By this criterion TE have been shown to occur in more than 30 species belonging to different families and genera. Many questions arise when dealing with TE: their structure and functions, and the biological significance of the activity of elements in the differentiation of a normal plant or in the evolution of plant genes.


Hydrogenated amorphous silicon photodiodes for optical addressing of spatial light modulators.
We discuss the use of hydrogenated amorphous silicon (a-Si:H) photodiodes as photosensors in high-performance optically addressed spatial light modulators (OASLM's). To find the performance limitations that result from the photodiode exclusively, a pseudo-OASLM is constructed; it is composed of an a-Si:H photodiode in series with a discrete capacitor and resistor to simulate an electrically ideal liquid-crystal modulator. The a-Si:H photodiode conduction regimes are identified, and the maximum and minimum frame rates that may be attained with an a-Si:H photodiode-driven OASLM are determined to be ~ 100 kHz and ~ 0 Hz, respectively. Optimum performance is obtained when the photodiode capacitance is equal to the light modulator capacitance.


Porokeratosis: a differential diagnosis to consider in benign lichenoid keratosis.
Porokeratosis is a disorder of keratinization with many clinical variants. The histological hallmark feature of porokeratosis is a cornoid lamella. Other accompanying features include lichenoid inflammation, atrophy towards the centre of the lesion, dermal cytoid bodies, and adjacent lichenoid changes. Lichenoid keratosis is a benign cutaneous condition, thought to largely represent a degenerating seborrheic keratosis or solar lentigo. The classical histologic appearances are characterized by parakeratosis, epidermal acanthosis, and a dense band of lichenoid lymphocytic infiltrate. Since a lichenoid inflammatory reaction pattern can be seen in porokeratosis it has the potential to be misdiagnosed as a lichenoid keratosis if the cornoid lamella is not identified or missed due to sampling selection. We critically review 104 cases of benign lichenoid keratosis to establish whether any of these cases had features to support a diagnosis of porokeratosis. With 9.6% of cases considered for re-classification, we review clues to reaching this histologic diagnosis.


New feature announcement.
SPATIAL AND POLARIZATION DYNAMICS OF SEMICONDUCTOR LASERS: Special Joint Issue of the Journal of the Optical Society of America B and Optics Express Feature announcement.


Is there a role for intensive therapy in breast cancer?
With reference to survival, polychemotherapy has been demonstrated to be statistically significantly more effective than monochemotherapy both in the adjuvant setting and in the metastatic situation. Breast cancer demonstrates a dose-response relationship. Chemotherapy used in the conventional dose range should be given with adequate dose-intensity both in the adjuvant setting and for metastatic patients. More dose-intensive combinations are almost always associated with a higher response rate in patients' metastatic disease, but these results have seldom been translated into an improved survival. For marrow requiring high-dose therapy, repeated phase II studies have demonstrated the possibility of a survival tail, which may be due to stage migration and patient selection. At present we have at least 13 ongoing phase III studies in the adjuvant setting and at least 5 ongoing studies in the metastatic situation. These studies will give a definite answer on whether marrow-supported high-dose therapy is better than conventional therapy or if alternative approaches using tailored therapy will result in an equivalent outcome. In the future we must make better use of the present arsenal of drugs and examine the marked inter-individual variations in pharmacokinetic profiles for the drugs. We have to tailor the therapy to the tumour biological profile, in both the primary tumour and metastases with appreciation of heterogeneity and tumour progression. Based on these prerequisites, therapy can be either dose-intensive or in some instances continuous using lower doses.


The vitamin K-dependent carboxylase generates γ-carboxylated glutamates by using CO2 to facilitate glutamate deprotonation in a concerted mechanism that drives catalysis.
The γ-glutamyl carboxylase converts Glu to carboxylated Glu (Gla) to activate a large number of vitamin K-dependent proteins with diverse functions, and this broad physiological impact makes it critical to understand the mechanism of carboxylation. Gla formation is thought to occur in two independent steps (i.e. Glu deprotonation to form a carbanion that then reacts with CO(2)), based on previous studies showing unresponsiveness of Glu deprotonation to CO(2). However, our recent studies on the kinetic properties of a variant enzyme (H160A) showing impaired Glu deprotonation prompted a reevaluation of this model. Glu deprotonation monitored by tritium release from the glutamyl γ-carbon was dependent upon CO(2), and a proportional increase in both tritium release and Gla formation occurred over a range of CO(2) concentrations. This discrepancy with the earlier studies using microsomes is probably due to the known accessibility of microsomal carboxylase to water, which reprotonates the carbanion. In contrast, tritium incorporation experiments with purified carboxylase showed very little carbanion reprotonation and consequently revealed the dependence of Glu deprotonation on CO(2). Cyanide stimulated Glu deprotonation and carbanion reprotonation to the same extent in wild type enzyme but not in the H160A variant. Glu deprotonation that depends upon CO(2) but that also occurs when water or cyanide are present strongly suggests a concerted mechanism facilitated by His-160 in which an electrophile accepts the negative charge on the developing carbanion. This revised mechanism provides important insight into how the carboxylase catalyzes the reaction by avoiding the formation of a high energy discrete carbanion.


Free fibula and corticocancellous bone grafting for salvage of a war-injured forearm.
The treatment of a complex forearm injury inflicted by a wartime mine explosion is presented in this study. Apart from the soft tissue damage, a 4-part fracture of the radius and loss of 19 cm of the ulnar diaphysis were present along with lesions of the median and ulnar nerves. The radial pulse was intact. The first formal treatment of the wounding consisted of extensive soft tissue and bone debridement and external fixation of radius with an additional intramedullary K-wire. After wound closure was obtained, a free vascular fibula grafting of the ulna and corticocancellous bone grafting of the radius were performed. Bone union of both the radius and ulna was subsequently achieved and 9 years after the injury, the patient has full flexion and extension of the elbow, full pronation and 70% of supination. Motion of the wrist is limited because of an ulnar plus variant of the distal radioulnar joint. Hand function is still limited by chronic low-moderate median nerve palsy, but the ulnar nerve has recovered completely. The patient is able to pinch, has full finger extension and can make a fist. He is satisfied that he made the correct decision in not having an initial amputation for his injury.


Mineralogy of Bioprecipitate Evolution over Induction Times Mediated by Halophilic Bacteria under Various Mg/Ca Molar Ratios.
In microbial mineralization experiments, the induction time of mineral precipitation is ambiguous, and this may lead to difficulties in reproducing and confirming the test results. To explore the link between induction time and microbially mediated carbonate precipitation, we report here the mineralogy and morphology of carbonate precipitates induced by the halophilic Halomonas utahensis WMS2 bacterium in media with various Mg/Ca molar ratios over a range of induction times. The results show that the biominerals are formed in an alkaline environment affected by ammonia secreted by H. utahensis WMS2 bacteria. The content of dissolved inorganic carbon increased as a result of carbonic anhydrase catalyzing the hydration of carbon dioxide to release bicarbonate and carbonate ions. The X-ray diffraction (XRD) results show that the phase of mineral precipitated gradually changes from an unstable Mg-rich calcite to metastable monohydrocalcite and then to stable hydromagnesite with an increase in the Mg2+ ion concentration and induction time. The scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and Fourier transform infrared spectroscopy (FTIR) results show that minerals mostly change from single particles/crystallites to aggregations under the action of the microorganisms at different Mg2+ ion concentrations and induction times. Our experiments demonstrate that the carbonate minerals produced in the presence of microbes change significantly with the induction time, in addition to the influence of the hydrochemical factors; this indicates that the induction time is significant in determining the mineralogy of biominerals.


Kadsura heteroclita stem ethanol extract protects against carbon tetrachloride-induced liver injury in mice via suppression of oxidative stress, inflammation, and apoptosis.
Kadsura heteroclita stem (KHS) is a well-known hepatoprotective Tujia ethnomedicine (folk named Xuetong), has long been used for the prevention and treatment of hepatitis and liver diseases. To explore the protective effects of KHS against carbon tetrachloride (CCl4)-induced liver injury and the underlying mechanism, particularly antioxidative, anti-inflammatory, and anti-apoptotic potentials. The acute toxicity of KHS was measured by the method of maximum tolerated dose (MTD). Liver injury in mice was induced by intraperitoneal injection of 25% carbon tetrachloride (olive oil solubilization) 2 times every week. After modeling, mice in KHS groups were treated with KHS at 100, 200, 400 mg/kg/d, mice in positive control group were treated with bifendate (30 mg/kg/d), and mice in normal and model groups were given ultrapure water. After 4 weeks of treatment, blood of mice was taken from the orbital venous plexus before mice euthanized, the liver, spleen, and thymus of mice were weighed by dissecting the abdominal cavity after mice euthanized. Moreover, the liver of mice was selected for histological examination. The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities in mice serum were measured using the automatic biochemical analyzer. The levels of superoxide dismutase (SOD), myeloperoxidase (MPO), malondialdehyde (MDA), glutathione peroxidase (GPX-2), tumor necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), Bcl-2-associated X (Bax), B-cell lymphoma-2 (Bcl-2), Caspase-3, and Caspase-8 in mice liver were measured by Elisa kits. Furthermore, the protein expression of Bcl-2 and Bax in mice liver tissue was detected by Western blot. The MTD of KHS was determined to be 26 g/kg in both sexes of mice. Treatment with KHS dose-dependently protected the liver and other main organs against CCl4-induced liver injury in mice. The ALT and AST levels in mice liver were significantly reduced after treatment with KHS at the dose of 100, 200, and 400 mg/kg. In addition, the liver histopathological analyses revealed that KHS markedly alleviated inflammatory cell infiltration, hepatic fibrosis, hepatocyte ballooning, necrosis and severe apoptosis of hepatocytes induced by CCl4. Further assay indicated that KHS significantly suppressed the production of MDA and MPO, while markedly increased the level of SOD and GPx-2. The TNF-α and IL-6 level in mice liver tissue were decreased by KHS, whereas the IL-10 level was increased. KHS also inhibited hepatocyte apoptosis by significantly reducing the expression of Bax, Caspase-3, Caspase-8, as well as increasing the expression of Bcl-2. Besides, the Western blot results strongly demonstrated that KHS inhibited hepatocyte apoptosis, as evidenced by reducing the expression of Bax protein and increasing the expression of Bcl-2 protein in liver injury tissues. This research firstly clarified that KHS has a significant protective effect against CCl4-induced liver injury, which might be closely related to alleviating oxidative stress, reducing inflammatory response, and inhibiting hepatocyte apoptosis.


Effect of ferric carboxymaltose on serum phosphate and C-terminal FGF23 levels in non-dialysis chronic kidney disease patients: post-hoc analysis of a prospective study.
Some parenteral iron therapies have been found to be associated with hypophosphatemia. The mechanism of the decrease in serum phosphate is unknown. The aim of this study is to examine the effect of IV ferric carboxymaltose(FCM) on phosphate metabolism and FGF23 levels in patients with chronic kidney disease(CKD). This is a post-hoc analysis of a prospective study carried out in 47 non-dialysis CKD patients with iron-deficiency anaemia who received a single 1000 mg injection of FCM. Markers of mineral metabolism (calcium, phosphate, 1,25-dihydroxyvitamin D, PTH and FGF23[c-terminal]) were measured prior to FCM administration and at week 3 and week 12 after FCM administration. Based on the measured levels of serum phosphate at week 3, patiens were classified as hypophosphatemic or non-hypophosphatemic. Serum phosphate levels decreased significantly three weeks after FCM administration and remained at lower levels at week 12 (4.24 ± 0.84 vs 3.69 ± 1.10 vs 3.83 ± 0.68 mg/dL, respectively, p < 0.0001. Serum calcium, PTH and 1,25-dihydroxyvitamin D did not change over the course of the study. Serum FGF23 decreased significantly from 442(44.9-4079.2) at baseline to 340(68.5-2603.3) at week 3 and 191.6(51.3-2465.9) RU/mL at week 12, p < 0.0001. Twelve patients were non-hypophosphatemic and 35 hypophosphatemic. FGF23 levels decreased in both groups, whereas no changes were documented in any of the other mineral parameters. In non-dialysis CKD patients, FCM induces reduction in serum phosphate levels that persists for three months. FCM causes a significant decrease in FGF23 levels without changes to other bone metabolism parameters.


Inflammatory cytokine production in interferon-gamma-primed mice, challenged with lipopolysaccharide. Inhibition by SK&F 86002 and interleukin-1 beta-converting enzyme inhibitor.
Mice challenged with lipopolysaccharide (LPS) produce variable serum levels of pro-inflammatory cytokines, and particularly low levels of interleukin-1 beta (IL-1 beta). Interferon-gamma (IFN-gamma) has been shown to be an important mediator of bacteria-induced hypersensitivity to LPS in mice. In the present study, we show that mice pretreated with IFN-gamma exhibit an enhanced capacity to produce serum IL-1 beta, IL-1 alpha, tumour necrosis factor (TNF-alpha) as well as IL-6 in response to LPS. Priming with intraperitoneal (i.p.) injection of 15 mg rat recombinant IFN-gamma, 18 hours prior to the i.p. LPS (300 mg) challenge resulted in a 4-fold increase in the LPS-stimulated release of IL-1 beta and a 2- to 7-fold increase in the release of IL-1 alpha, TNF-alpha, as well as IL-6 into the serum. LPS induced a concentration-dependent increase in the release of IL-1 beta in isolated peritoneal macrophages from IFN-gamma-primed mice whereas macrophages from unprimed mice released minute amounts of IL-1 beta. In addition, nigericin markedly enhanced the release of IL-1 beta in unprimed mice but not in macrophages from IFN-gamma primed mice. The cytokine synthesis inhibitor SK&F 86002, administered per os (100 mg/kg), 1 hour prior to LPS challenge, strongly inhibited the rise in serum levels of the four cytokines. Furthermore, treatment with the IL-1 beta converting enzyme (ICE) specific reversible inhibitor YVAD-CHO resulted in a sharp dose- and time-dependent inhibition of IL-1 beta secretion in the serum, whereas the other cytokines were not affected. In conclusion, IFN-gamma priming strongly potentiates the release of proinflammatory cytokines in the serum of mice as compared to LPS stimulation alone, and provides therefore a useful way to test the in vivo potency and selectivity of cytokine synthesis inhibitors.


Relapse of prostate cancer from the viewpoint of total gland volume kinetics theory.
In many cases of prostate cancer, changes of prostate volume were measured very frequently after castration by means of transrectal ultrasound. For short-term observations, a factor called as "reduction time (tau [τ])," which means the time required for the volume of "effective portion" (volume responded to castration) to be reduced to one-tenth of its original value, correlated very well with patients' prognosis. For long-term observations for relapse, changes of prostate volume could be divided clearly into two types, namely, "metastatic progressive type" with metastasis without volume increase and "local progressive type" with remarkable volume increase without metastasis. "τ" in the "local progressive type" was far shorter than that in the "metastatic progressive type." Much longer survival was obtained when the patient belonged to the "local progressive type," than to the "metastatic progressive type." Thus, "τ" was the most important and the most reliable factor to predict the prognosis. Based upon these observations, a schematic analysis of prostate cancer relapse was shown.


Notch signaling during chondrogenesis of human bone marrow stem cells.
Notch signaling is an important mechanism involved in early development which helps to determine the differentiation and fate of cells destined to form different tissues in the body. Its role in the differentiation of adult stem cells, such as those found in bone marrow is much less clear. As there is great interest in the potential of human bone marrow stem cells (hMSC) as a source of cells for the repair of articular cartilage and other tissues, it is important to understand if Notch signaling promotes or suppresses differentiation. Using primary human bone marrow stem cells (hMSC) in 3D cell aggregate culture a new study has investigated the expression of the canonical Notch pathway genes during chondrogenesis and showed that the Notch ligand, Jagged1 (JAG1) sharply increased in expression peaking early in differentiation. A Notch target gene, HEY1, was also expressed with a temporal profile, which closely followed the expression of JAG1 and this preceded the rise in type II collagen expression that characterized chondrogenesis. The JAG1 mediated Notch signaling was shown with a Notch inhibitor (DAPT) to be necessary for chondrogenesis, as inhibition days 0-14, or just days 0-5, blocked chondrogenesis, whereas Notch inhibition days 5-14 did not. In further experiments Notch signaling was shown to be critical for full chondrogenesis, as adenoviral hJAG1 transduction of hMSCs, which caused continuous expression of JAG1 and sustained Notch signaling, completely blocked chondrogenesis. In these cultures there was inhibited production of extracellular matrix and failure to differentiate was interpreted as the retention of the hMSC in a pre-chondrogenic state. The results in this study thus showed that JAG1 mediated Notch signaling in hMSC was necessary to initiate chondrogenesis, but must be switched off for chondrogenesis to proceed and it will be important to establish if this is a mechanism common to all chondrocyte differentiation.


Clinical profile of acute paraphenylenediamine intoxication in Egypt.
Orientation to paraphenylenediamine (PPD) acute systemic intoxication in Egypt has been increased over the last decade. The aim of this study was to provide more insight into the clinical profile of acute PPD intoxication with reviewing the possible underlying mechanisms. Our study was retrospective. It was conducted over 7 years (2001-2008) on 25 cases with acute PPD intoxication admitted to the Poison Control Center Ain Shams University Hospitals, Cairo, Egypt. The mean age of the cases was 35.34 +/- 10.5 years; the male to female ratio was 18:7. Cervicofacial and laryngeal edema was the dominating presenting manifestation in 72% of the cases, 100% of the cases developed rhabdomyolysis, 80% had impaired renal functions, elevated liver transaminases were detected in 76% of cases, 75% showed hyperkalemia and 16% died due to ventricular arrhythmia. In conclusion, PPD causes serious multisystem toxicity and its selling to the public should be officially restricted.


Serological Protection 5-6 Years Post Vaccination Against Yellow Fever in African Infants Vaccinated in Routine Programmes.
Introduction: Although effective live attenuated yellow fever (YF) vaccines have been available for over 9 decades sporadic outbreaks continue to occur in endemic regions. These may be linked to several factors including epidemiological factors such as vector and intermediate host distribution or vaccine coverage and efficacy. The World Health Organization's research priorities include gathering systematic evidence around the potential need for booster vaccination with YF vaccine whether this follows full or fractional doses in children. Knowledge on the longevity of response to YF vaccine and the implications of this response needs to be consolidated to guide future vaccination policy. Methods: We measured anti-YF IgG by microneutralization assay in a group of 481 African infants who had received YF vaccine as part of routine EPI programmes, to explore serological protection from YF 5-6 years post YF vaccination, as well as the effect of co variates. Findings: Notably, 22.2% of the cohort had undetectable antibody concentrations, with another 7.5% revealing concentrations below the threshold of seropositivity of 0.5 IU/mL. Sex, season, country and time since vaccination did not affect the longevity of antibody concentration or having antibody concentrations above a defined threshold. Conclusion: Roughly 30% of children in this cohort did not demonstrate anti-yellow fever antibody concentrations above the defined threshold of protection, with 20% having no demonstrable antibody. Knowledge on the longevity of response to YF vaccine and the implications needs to be consolidated to guide future vaccination policy.


Antitumor Anesthetic Strategy in the Perioperatory Period of the Oncological Patient: A Review.
The stress response triggered by the surgical aggression and the transient immunosuppression produced by anesthetic agents stimulate the inadvertent dispersion of neoplastic cells and, paradoxically, tumor progression during the perioperative period. Anesthetic agents and techniques, in relation to metastatic development, are investigated for their impact on long-term survival. Scientific evidence indicates that inhaled anesthetics and opioids benefit immunosuppression, cell proliferation, and angiogenesis, providing the ideal microenvironment for tumor progression. The likely benefit of reducing their use, or even replacing them as much as possible with anesthetic techniques that protect patients from the metastatic process, is still being investigated. The possibility of using "immunoprotective" or "antitumor" anesthetic techniques would represent a turning point in clinical practice. Through understanding of pharmacological mechanisms of anesthetics and their effects on tumor cells, new perioperative approaches emerge with the aim of halting and controlling metastatic development. Epidural anesthesia and propofol have been shown to maintain immune activity and reduce catecholaminergic and inflammatory responses, considering the protective techniques against tumor spread. The current data generate hypotheses about the influence of anesthesia on metastatic development, although prospective trials that determinate causality are necessary to make changes in clinical practice.


Characterisation of the spectrum and genetic dependence of collateral mutations induced by translesion DNA synthesis.
Translesion DNA synthesis (TLS) is a fundamental damage bypass pathway that utilises specialised polymerases with relaxed template specificity to achieve replication through damaged DNA. Misinsertions by low fidelity TLS polymerases may introduce additional mutations on undamaged DNA near the original lesion site, which we termed collateral mutations. In this study, we used whole genome sequencing datasets of chicken DT40 and several human cell lines to obtain evidence for collateral mutagenesis in higher eukaryotes. We found that cisplatin and UVC radiation frequently induce close mutation pairs within 25 base pairs that consist of an adduct-associated primary and a downstream collateral mutation, and genetically linked their formation to TLS activity involving PCNA ubiquitylation and polymerase κ. PCNA ubiquitylation was also indispensable for close mutation pairs observed amongst spontaneously arising base substitutions in cell lines with disrupted homologous recombination. Collateral mutation pairs were also found in melanoma genomes with evidence of UV exposure. We showed that collateral mutations frequently copy the upstream base, and extracted a base substitution signature that describes collateral mutagenesis in the presented dataset regardless of the primary mutagenic process. Using this mutation signature, we showed that collateral mutagenesis creates approximately 10-20% of non-paired substitutions as well, underscoring the importance of the process.


Energy and structure of inertial range turbulence deduced from an evolution of fluid impulse.
We explore numerically a very simple idea that may provide a material explanation for inertial range turbulence. We base a Lagrangian model of viscous incompressible fluid flow on an evolving ensemble of vortex doublet sheets. Initially these are randomly oriented and randomly distributed within a disk in two-dimensional space. These sheets are then actively transported (in two dimensions) according to the Oseledets equation of motion for fluid impulse. The mutual interaction of these sheets, and their diffusion, establishes a velocity fluctuation field. In a specific sense this evolution is self-affine, and we exploit this property to calculate standard statistical measures for the fluctuation field. We determine from this simple model the second-order structure function and the energy spectrum of inertial range turbulence.


Influence of cytostatic treatment on the coagulation system and fibrinolysis in patients with non-Hodgkin's lymphomas and acute leukemias.
Cytostatic therapy is known to aggravate tumor-induced coagulopathy. Therefore, we have studied the effect of different chemotherapeutic regimens on the activation of coagulation and fibrinolysis in patients with non-Hodgkin's lymphomas or acute leukemias. In non-Hodgkin's lymphoma patients treated with an aggressive protocol (COL-BLAM) and in leukemia patients (TAD-9) fibrinopeptide A, prothrombin fragment (F1 + 2) and thrombin antithrombin III complexes (TAT) increased (Tables 4 and 6), while D-dimer did not deviate significantly. The ratio D-dimer/TAT consequently showed a significant decrease, indicating increased formation of thrombin after release of procoagulant factors, which is not paralleled by an activation of fibrinolysis. Both these groups were also characterized by an increase in uric acid and in C-reactive protein and plasminogen-activator inhibitor, two acute-phase reactants. In contrast, patients with non-Hodgkin's lymphomas treated with a less aggressive protocol (COP) showed no significant changes in hemostatic variables, uric acid, or acute-phase reactants. The release of procoagulant factors relates to the cytostatic sensitivity of the tumor and to a high tumor-cell destruction. Our results further emphasize the need for large-scale studies on antithrombotic prophylaxis in patients undergoing cytostatic treatment.


Basal cell adenoma in a relatively rare site.
Basal cell adenoma (BCA) of the salivary glands is an uncommon type of monomorphic adenoma. Its most frequent location is the parotid gland. It usually appears as a firm and mobile slow-growing mass. Histologically, it is seen as nests of isomorphic cells and interlaced trabeculae with a prominent basal membrane. There is also slack, hyaline stroma with absence of a myxoid or chondroid component. We describe a case of BCA of palatal minor salivary glands, a rare site for its occurrence. We also briefly review the literature on the same.


Microleakage of composite restorations bonded with three new dentin bonding agents.
This report evaluates the impact of two dentin bonding techniques on microleakage of Class V restorations bonded with three new dentin bonding systems. Forty-eight extracted human premolar and molar teeth were randomly assigned to four groups for bonding with EBS Bonding System (ESPE, Seefeld, Germany); Syntac Single-Component (Ivoclar-Vivadent, Schaan, Liechtenstein); Scotchbond 1 (3M Dental Products, St. Paul, Minnesota); and a control, Prime and Bond 2.1 (Dentsply, DeTrey, Konstanz, Germany). Cavities were cut in both the buccal and lingual surfaces. The coronal half of each preparation was in enamel, and the gingival half was in cementum or dentin. The cavities were restored with composite after the application of dentin bonding agents, using two different drying techniques for each material. The teeth were stored in distilled water for 6 days at 37 degrees C and then thermocycled. The restorations were examined microscopically for leakage, using Procion brilliant red as a marker. All groups showed microleakage at both the enamel and dentin margins. At the gingival margin, there was no significant difference between any of the experimental materials and the control for either wet bonding (Kruskal-Wallis: p = .8920) or dry bonding (Kruskal-Wallis: p .9973); or between the two techniques for each material (Mann-Whitney U in all cases p > .05). Scanning electron microscopic examination confirmed that the zones of microleakage, as indicated by dye penetration, were principally resincohesive failures within the collagen-rich hybrid layer. Three water-based bonding agents were unable to prevent microleakage at either the enamel or dentin margins of Class V cavities regardless of which bonding technique was employed. All systems behaved equally.


Catalytic hairpin assembly mediated liposome-encoded magnetic beads for signal amplification of peroxide test strip based point-of-care testing of ricin.
Herein, we propose a new peroxide test strip (PTS) based point-of-care testing (POCT) method to detect ricin B-chain qualitatively and quantitatively by using catalytic hairpin assembly (CHA) mediated liposome-encoded magnetic beads for signal amplification. The sensitivity of this PTS based POCT method was improved significantly because it combined CHA signal amplification and liposome-based signal amplification.


Bacteria-triggered systemic immunity in barley is associated with WRKY and ETHYLENE RESPONSIVE FACTORs but not with salicylic acid.
Leaf-to-leaf systemic immune signaling known as systemic acquired resistance is poorly understood in monocotyledonous plants. Here, we characterize systemic immunity in barley (Hordeum vulgare) triggered after primary leaf infection with either Pseudomonas syringae pathovar japonica (Psj) or Xanthomonas translucens pathovar cerealis (Xtc). Both pathogens induced resistance in systemic, uninfected leaves against a subsequent challenge infection with Xtc. In contrast to systemic acquired resistance in Arabidopsis (Arabidopsis thaliana), systemic immunity in barley was not associated with NONEXPRESSOR OF PATHOGENESIS-RELATED GENES1 or the local or systemic accumulation of salicylic acid. Instead, we documented a moderate local but not systemic induction of abscisic acid after infection of leaves with Psj. In contrast to salicylic acid or its functional analog benzothiadiazole, local applications of the jasmonic acid methyl ester or abscisic acid triggered systemic immunity to Xtc. RNA sequencing analysis of local and systemic transcript accumulation revealed unique gene expression changes in response to both Psj and Xtc and a clear separation of local from systemic responses. The systemic response appeared relatively modest, and quantitative reverse transcription-polymerase chain reaction associated systemic immunity with the local and systemic induction of two WRKY and two ETHYLENE RESPONSIVE FACTOR (ERF)-like transcription factors. Systemic immunity against Xtc was further associated with transcriptional changes after a secondary/systemic Xtc challenge infection; these changes were dependent on the primary treatment. Taken together, bacteria-induced systemic immunity in barley may be mediated in part by WRKY and ERF-like transcription factors, possibly facilitating transcriptional reprogramming to potentiate immunity.


A novel DNA damage recognition protein in Schizosaccharomyces pombe.
Toxic and mutagenic O6-alkylguanine adducts in DNA are repaired by O6-alkylguanine-DNA alkyltransferases (MGMT) by transfer of the alkyl group to a cysteine residue in the active site. Comparisons in silico of prokaryotes and lower eukaryotes reveal the presence of a group of proteins [alkyltransferase-like (ATL) proteins] showing amino acid sequence similarity to MGMT, but where the cysteine at the putative active site is replaced by tryptophan. To examine whether ATL proteins play a role in the biological effects of alkylating agents, we inactivated the gene, referred to as atl1+, in Schizosaccharomyces pombe, an organism that does not possess a functional MGMT homologue. The mutants are substantially more susceptible to the toxic effects of the methylating agents, N-methyl-N-nitrosourea, N-methyl-N'nitro-N-nitrosoguanidine and methyl methanesulfonate and longer chain alkylating agents including N-ethyl-N-nitrosourea, ethyl methanesulfonate, N-propyl-N-nitrosourea and N-butyl-N-nitrosourea. Purified Atl1 protein does not transfer methyl groups from O6-methylguanine in [3H]-methylated DNA but reversibly inhibits methyl transfer by human MGMT. Atl1 binds to short single-stranded oligonucleotides containing O6-methyl, -benzyl, -4-bromothenyl or -hydroxyethyl-guanine but does not remove the alkyl group or base and does not cleave the oligonucleotide in the region of the lesion. This suggests that Atl1 acts by binding to O6-alkylguanine lesions and signalling them for processing by other DNA repair pathways. This is the first report describing an activity that protects S.pombe against the toxic effects of O6-alkylguanine adducts and the biological function of a family of proteins that is widely found in prokaryotes and lower eukaryotes.


Follicle size and oocyte diameter in relation to developmental competence of buffalo oocytes in vitro.
Follicular size, oocyte morphology and diameter were investigated for their possible relationship with in vitro developmental competence of buffalo oocytes. Cumulus oocytes complexes (COCs), aspirated from small (<3 mm), medium (3-8 mm) and large (>8 mm) follicles of normal ovaries and cystic ovarian follicles of abattoir-derived ovaries, were graded for their morphological appearance and were cultured to assess their developmental competence. The influence of cystic follicles on maturational competence of COCs recovered from co-existing follicles of cystic ovaries was studied. The mean diameter of oocytes from follicles of different size were examined, and the influence of oocyte diameter--(i) <126 microm; (ii) 127-144 microm; (iii) 145-162 microm; and (iv) >163 microm--on in vitro maturation, cleavage and embryo yield was studied. Results suggested that increased fertilization, cleavage and embryo development were significantly (P<0.05) higher in COCs aspirated from large follicles, followed by medium and small-sized normal follicles, and the presence of cystic follicles had no significant (P<0.05) effect on the maturation competence of the COCs recovered from co-existing follicles. The mean diameter of the buffalo oocyte obtained from normal ovaries was found to be 146.4 microm and the rate of blastocyst production in vitro was significantly higher (P<0.05) in oocytes with diameters greater than 145 microm. In conclusion, the larger the size of the follicles and oocytes, the greater the developmental competence in vitro of buffalo oocytes.


Toxic effects of subacute inhalation exposure to trichloroethylene on serum lipid profile, glucose and biochemical parameters in Sprague-Dawley rats.
The current study evaluated the inhalation toxicity of trichloroethylene (TCE) at 0, 10, 100, 250 and 400 ppm in Sprague-Dawley rats for 10 day period, because the subacute inhalation toxicity of TCE on serum lipid profile, glucose and some biochemical parameters has not been previously reported. TCE vapors were generated using the dynamic generation system based on evaporation method in the exposure chamber. On the basis of the results, mean serum low-density lipoprotein (LDL) and albumin (ALB) decreased significantly in all the groups exposed to TCE compared with the control group (p < .005), but there was a significant increase for parameters: fasting blood glucose (FBG) and alkaline phosphatase (ALP) (p < .005). Rats exposed to 400 ppm TCE showed a significant decrease in serum cholesterol (CHOL) and protein (Pr) compared with the control group (p < .005). A negative relationship was found between triglycerides (TG), very low density lipoprotein (VLDL), CHOL, LDL, Pr, ALB and urea levels and the subacute exposure to concentrations of TCE (R2 = -0.26, p < .05), but there was a direct correlation for parameters FBG, ALP and alanine aminotransferase (ALT) (R2 = 0.42, p < .05). In conclusion, studies with Sprague-Dawley rats demonstrated that subacute inhalation exposure to TCE (≥ 100 PPM) is associated with biochemical and lipotoxicity in the form of decreased serum ALB and LDL and raised ALP and glucose levels. The present study also provides additional evidence relating to decreased serum CHOL and Pr after subacute inhalation exposure to 400 ppm TCE.


The social and structural determinants of sexual and reproductive health and rights in migrants and refugees: a systematic review of reviews.
The sexual and reproductive health and rights (SRHR) of migrants and refugees present important public health challenges. Social and structural determinants affect both the general health and SRHR of migrants, but the drivers of SRHR among migrant and refugee populations remain understudied. To identify upstream social and structural determinants of SRHR health of migrants and refugees reported in systematic reviews. We conducted a systematic review of reviews. We studied 3 aspects of SRHR: sexually transmitted infections, sexual violence and unintended pregnancy in migrants and refugees. We used an inductive approach to synthesize emerging themes, summarized them in a narrative format and made an adapted version of Dahlgren and Whitehead's social determinants of health (SDH) model. We included 12 systematic reviews, of which 10 were related to sexually transmitted infections, 4 to sexual violence and 2 to unintended pregnancy. We identified 6 themes that operate at 4 different levels in an adapted version of the Dahlgren and Whitehead SDH model: economic crisis and hostile discourse on migration; limited legal entitlements, rights and administrative barriers; inadequate resources and financial constraints; poor living and working conditions; cultural and linguistic barriers; and stigma and discrimination based on migration status, gender, sex and ethnicity. This review provides evidence of how upstream social and structural determinants undermine the SRHR of refugees and migrants. Unless these are addressed in policy-making and planning, the health of migrants and refugees is at risk.


Spline functions: an alternative representation of aspheric surfaces.
This paper offers an alternative to current practice in the specification of aspheric optical surfaces. Spline functions, a numerical analog of a flexible draftsman's curve, are used to represent a rotationally symmetric aspheric surface. We develop the interpolation formulas pertinent to ray tracing and apply an optimization procedure to design a simple Schmidt system as an illustration. We conclude by showing that the new formulation seems to be more compatible with the optimization process than the usual polynomial aspheric.


Combined carotid and coronary surgery.
A retrospective review of 40 consecutive patients undergoing combined coronary artery bypass grafting (CABG) and unilateral carotid endarterectomy (CEA) was carried out to determine the stroke rate for the procedure. Patients presenting with severe coronary artery disease judged to be at risk of imminent myocardial infarction, who had signs of cerebral ischaemia (70%) or asymptomatic carotid bruits (30%), were investigated for extracranial carotid vascular disease. Patients with severe stenotic carotid lesions associated with high risk coronary artery disease underwent combined CEA/CABG. Three patients had a previous contralateral CEA. The average age of the patients was 62 years, and there were 31 males and nine females. CEA was completed prior to CABG under the same general anaesthetic. There were 24 CEAs on the left and 16 on the right. Six patients suffered a postoperative cerebral ischaemic event (15.4%): a reversible ischaemic neurological deficit in three (7.7%), a transient ischaemic cerebral event in two (5.1%), and a permanent stroke occurred in one (2.6%). Two deaths occurred and both were cardiac related. Combined CEA/CABG in patients with stenotic lesions of the coronary and extra-cranial carotid vascular systems who are at risk of cerebral or myocardial infarction, can be performed with a permanent stroke rate within the published range for either CEA or CABG alone and with a mortality of 5%.


Phagocytosis of heat-killed blastospores of Candida albicans by human monocyte beta-glucan receptors.
Candida albicans is an opportunistic human pathogen with a cell wall that is qualitatively similar in carbohydrate composition to zymosan. Monolayers of human peripheral blood monocytes ingested 2.5 x 10(6)-2.5 x 10(7) heat-killed C. albicans blastospores in a dose-related manner. The percentage of monocytes ingesting at least one C. albicans reached a near plateau level of 68 +/- 6% (mean +/- SD, n = 3) when 2.5 x 10(7) particles per ml were incubated with monocytes for 30 min. Pretreatment of monocytes with 10 ng/ml to 100 micrograms/ml of soluble yeast beta-glucan inhibited C. albicans ingestion in a dose-dependent manner without affecting Fc-mediated ingestion of IgG-coated sheep erythrocytes (EsIgG). Pretreatment of monocytes with 100 micrograms/ml of soluble yeast beta-glucan inhibited the ingestion of 1 or more C. albicans by 80 +/- 11% (mean +/- SD, n = 4), with 50% inhibition occurring with approximately 7 micrograms/ml of soluble beta-glucan. Incubation of monocytes with 100 micrograms/ml to 1000 micrograms/ml of soluble yeast mannan resulted in no significant inhibition of C. albicans ingestion. The pretreatment of monolayers of monocytes for 30 min with 1 microgram/ml to 50 micrograms/ml of affinity-purified trypsin resulted in a dose-dependent inhibition of C. albicans ingestion with 10 micrograms/ml of trypsin inhibiting the percentage of monocytes ingesting 1 or more organisms by 71 +/- 6%. The inhibitory effects of soluble yeast beta-glucan and trypsin pretreatment on the ingestion of heat-killed C. albicans are comparable to the inhibitory effect of these agents on monocyte phagocytosis of zymosan and glucan particles. This relationship indicates that C. albicans contain a ligand that is recognized by the monocyte beta-glucan receptor of human monocytes.


Analytical solutions of the Frankenhaeuser-Huxley equations I: minimal model for backpropagation of action potentials in sparsely excitable dendrites.
Hodgkin and Huxley's ionic theory of the nerve impulse embodies principles, applicable also to the impulses in vertebrate nerve fibers, as demonstrated by Bernhard Frankenhaeuser and Andrew Huxley 40 years ago. Frankenhaeuser and Huxley reformulated the classical Hodgkin-Huxley equations, in terms of electrodiffusion theory, and computed action potentials specifically for saltatory conduction in myelinated axons. In this paper, we obtain analytical solutions to the most difficult nonlinear partial differential equations in classical neurophysiology. We solve analytically the Frankenhaeuser-Huxley equations pertaining to a model of sparsely excitable, nonlinear dendrites with clusters of transiently activating, TTX-sensitive Na(+) channels, discretely distributed as point sources of inward current along a continuous (non-segmented) leaky cable structure. Each cluster or hot-spot, corresponding to a mesoscopic level description of Na(+) ion channels, includes known cumulative inactivation kinetics observed at the microscopic level. In such a third-order system, the 'recovery' variable is an electrogenic sodium-pump imbedded in the passive membrane, and the system is stabilized by the presence of a large leak conductance mediated by a composite number of ligand-gated channels permeable to monovalent cations Na(+) and K(+). In order to reproduce antidromic propagation and attenuation of action potentials, a nonlinear integral equation must be solved (in the presence of suprathreshold input, and a constant-field equation of electrodiffusion at each hot-spot with membrane gates controlling the flow of current). A perturbative expansion of the non-dimensional membrane potential (Phi) is used to obtain time-dependent analytical solutions, involving a voltage-dependent Na(+) activation (micro) and a state-dependent inactivation (eta) gating variables. It is shown that action potentials attenuate in amplitude in accordance with experimental findings, and that the spatial density distribution of transient Na(+) channels along a long dendrite contributes significantly to their discharge patterns. A major significance of the analytical modeling, in contrast to the computational modeling of backpropagating action potentials, is the provision of a continuous description of the voltage as a function of position, allowing for greater feasibility in developing large-scale biophysical neural networks, without the need for ad hoc computational modeling.


Avoiding complications in the care of fractures of the tibia.
Tibial fractures are the most common long-bone fractures. Orthopaedic surgeons, regardless of their subspecialty, often must treat these injuries, which range from low-energy, minimally displaced fractures to limb-threatening injuries with neurologic and vascular damage and significant damage to the soft-tissue envelope. Tibial shaft fractures are often prone to complications, such as apex-anterior and valgus malalignments after nailing of the fractures in the proximal one third of the tibia, infection after open fractures, and aseptic nonunions. Understanding the common complications will aid in preventing them and will allow recognition and provide treatment strategies when such problems occur.


Quantitative estimation of Newcastle disease virus antibody levels in chickens and turkeys by ELISA.
A quantitative single-well ELISA for estimation of Newcastle disease (ND) virus antibodies in chickens and turkeys was developed using purified antigen from PMV-1/Chicken/Ulster 2C/71. The test was standardised using sera from 20-week-old chickens or 20- 30-week-old turkeys. Absorbance values for negative sera in chickens increased with the age of the birds but overall was lower than the cut-off for the test. ND haemagglutination inhibition (HI) positive field sera were always positive by ELISA and the mean was significantly higher than that of the negative population. Standard antisera to four of seven of the other PMV serotypes (including PMV-3) gave positive reactions in ELISA and three were also positive at low level by PMV-1 HI test. Absorbance values remained negative in turkeys given two inoculations of PMV-3 vaccine in spite of good PMV-3 HI responses. Doubling dilutions of chicken and turkey sera were tested by ELISA and end-point titres calculated. Standard curves relating ELISA titre and absorbance of each sample at 1/100 dilution were constructed and used to determine titres of test samples from single well absorbance values. A significant positive correlation between ELISA titre and HI titre for chicken and turkey sera was demonstrated. Sensitivity of the test was investigated using birds experimentally infected with PMV-1/Chicken/Ulster 2C/71 or a pigeon PMV-1 isolate. Seroconversion was detected at the same time by ELISA and HI. In experiments to estimate the ELISA titre required to protect birds against virulent ND, five groups of chickens were vaccinated twice with one of four commercial ND vaccines (three inactivated; one live) on two occasions and challenged with a virulent ND strain (PMV-1/ Chicken/Antrim/73). Two of the groups vaccinated with inactivated vaccines were protected against challenge. In another group also given inactivated vaccine, clinical signs were seen in one bird and ELISA proved a better indicator of immune status than HI. In the groups given living vaccine, no signs of ND were seen and ELISA indicated a much higher level of vaccinal antibody than HI test. In turkeys given two inoculations with inactivated vaccine, antibody levels were boosted to acceptable levels by ELISA and HI indicating that vaccinal antibody levels were adequate.


[Objective vocal evaluation of dysphonia by simultaneous measurement of acoustic and aerodynamic parameters with the EVA device].
Authors present the analysis of the voice in 88 normal subjects and 159 dysphonic patients by simultaneously measurements of Jitter (acoustical short-term indicator of aperiodicity) and "Glottal Leakage" (aerodynamic parameter calculated by the ratio of Oral Airflow and Intensity). All the measurements were performed, with EVA apparatus, on the most stable part of a steady-state vowel /a/. The reference method was the rating by a jury along a global perceptual scale. Statistical tests confirm that Jitter and "Glottal Leakage" are relevant to evaluate the quality of the voice. Discriminant analysis allows to find out a fairly-good rate of discrimination of 63.1% (Randomly rating would have been 25%) The authors conclude on the interest of such a protocol and present suggestions to improve it by taking in count phénomena during the vocal attack and middle-term variations.


Expanding coping goodness-of-fit: religious coping, health locus of control, and depressed affect in heart failure patients.
The goodness-of-fit coping hypothesis posits that problem-focused (PF) coping is particularly helpful under high controllability conditions, while emotion-focused (EF) coping is more helpful in low controllability situations. However, little research has examined whether the goodness-of-fit hypothesis applies to religious coping, a distinct set of coping resources and efforts. Further, little goodness-of-fit research has been conducted in the context of life-threatening illness. We tested coping goodness-of-fit for PF and EF as well as religious coping resources and strategies in 202 congestive heart failure (CHF) patients. Multiple regression analyses examined the extent to which each type of coping, health locus of control (HLOC) regarding their CHF, and their interactions related to subsequent depressed affect. Neither religious coping efforts nor religious resources were related to depressed affect. However, when examined in conjunction with internal HLOC, active coping and organized religious commitment were related to less depression for those higher in internal HLOC, while daily spiritual experience was related to less depression for those lower in HLOC. These results partially support the goodness-of-fit hypothesis and indicate a need to consider the perceived controllability of situations when examining the associations of religious coping resources and activities on depressive symptoms in the context of illness.


Si-H and Si-Si activation at Pt: synthesis and reactivity of neutral and cationic silyl complexes.
Reactions of [Pt(PEt(3))(3)] (1) with the silanes HSiPh(3), HSiPh(2)Me and HSi(OEt)(3) led to the products of oxidative addition, cis-[Pt(H)(SiPh(3))(PEt(3))(2)] (2), cis-[Pt(H)(SiPh(2)Me)(PEt(3))(2)] (3), cis-[Pt(H){Si(OEt)(3)}(PEt(3))(2)] (cis-4) and trans-[Pt(H){Si(OEt)(3)}(PEt(3))(2)] (trans-4). The complexes cis-4 and trans-4 can also be generated by hydrogenolysis of (EtO)(3)SiSi(OEt)(3) in the presence of 1. Furthermore, the silyl compounds cis-4 and trans-4 react with B(C(6)F(5))(3) and CH(3)CN by hydride abstraction to give the cationic silyl complex trans-[Pt{Si(OEt)(3)}(NCCH(3))(PEt(3))(2)][HB(C(6)F(5))(3)] (8). In addition, the reactivity of the complexes cis-4, trans-4 and 8 towards alkenes and CO was studied using NMR experiments.


Pierre Robin syndrome: mandibular growth during the first year of life.
Micrognathia and glossoptosis may cause severe respiratory and feeding difficulties in newborns with Pierre Robin syndrome. The growth of the mandible is alleged to more or less "catch up" during the first year of life. We could not objectify such a catch-up growth using the noninvasive and harmless measurement of the jaw index. The jaw index is defined as alveolar overjet x maxillary arch/mandibular arch. The alveolar overjet is the frontodorsal distance between the most anterior points of the upper and lower alveolar arches, whereas the maxillary arch is measured from the left tragus to the right tragus via the subnasal point, and the mandibular arch is measured from the left to the right tragus via the pogonion point. The growth of the mandible in 7 Pierre Robin patients was found to be proportionately similar to that observed in healthy control subjects age 0 months (N = 100), 6 months (N = 42), and 1 year (N = 32).


Late contralateral hyperhidrosis in lateral medullary infarcts.
This study describes unilateral increases of sweating reactions observed in the months after contralateral medullary infarct; evaluation of sympathetic cutaneous response may help to explain sweating disorders. After the discovery of the clinical phenomenon in one case, patients admitted between 1990 and 1993 were systematically evaluated clinically and electrophysiologically. In a group of five patients presenting with lateral or dorsal medullary lesions, two exhibited an increase of contralateral sweating reactions that appeared 6 to 8 months after stroke, were elicited by effort and exposure to heat and stress, and were more severe over the forehead, face, and upper trunk. In one case, this was clinically associated with an absence of sweating on the side of the lesion. During the late phase after stroke, in three patients presenting with lateral medullary lesions, electrophysiological evaluation revealed significant asymmetry of the sympathetic skin response, which was higher on the side contralateral to the lesion than on the ipsilateral side. In one patient, no response could be elicited by stimulations applied on the side of the lesion. Contralateral hyperhidrosis can be observed in the late phase after lateral medullary infarct and is likely due to lesion of the sympathetic pathway passing through the lateral medulla, which inhibits sudomotor neurons. Evaluation of sympathetic skin response may help to explain such clinical disorders.


High-Resolution CT Change over Time in Patients with Idiopathic Pulmonary Fibrosis on Antifibrotic Treatment.
Antifibrotic treatment slows down functional decline and disease progression in idiopathic pulmonary fibrosis (IPF). High-resolution computed tomography (HRCT) is useful to diagnose IPF; however, little is known about whether and to what extent HRCT changes reflect functional changes during antifibrotic therapy. The aim of this study was, therefore, to assess HRCT change over time after 1 year of treatment and to evaluate whether these changes correlate with functional decline over the same period of time. Sixty-eight IPF patients on antifibrotic treatment (i.e., pirfenidone or nintedanib) were functionally categorized as stable or progressors based on whether (or not) they had a decline in forced vital capacity (FVC) >5% predicted/year, and their HRCT were scored blindly and independently by two expert thoracic radiologists at treatment initiation (HRCT1) and after 1 year of treatment (HRCT2). Ground glass opacities (Alveolar Score, AS), reticulations (Interstitial Score, IS) and honeycombing (HC) were quantified and correlated with FVC decline between HRCT1 and HRCT2. At treatment initiation, HRCT scores were similar in both stable patients and progressors. After one year of treatment, in the entire population, AS and HC increased significantly, while IS did not. However, when stratified by the rate of functional decline, in stable patients, HC increased significantly while AS and IS did not. On the other hand, among progressors AS and HC increased significantly whereas IS did not. In the entire population, the combined score of fibrosis (IS + HC) correlated significantly with FVC decline. In conclusion, IPF patients on antifibrotic treatment exhibit different patterns of HRCT change over time based on their rate of functional decline. HRCT data should be integrated to lung function data when assessing response to antifibrotic treatment in patients with IPF.


Quantitative approaches to functional MRI: applications in epilepsy.
The application of functional magnetic resonance imaging (fMRI) to elucidation of seizures and epilepsy has been built primarily upon a framework derived from cortical responses to periodic sensory (and cognitive) stimuli. This analytical approach relies upon assumptions that may be less applicable to the problem of seizure origination. Because of the heterogeneous and complex nature of seizures, a number of quantitative methodologies have been derived to understand fMRI changes that are associated with epileptiform neural activity. Separated broadly, these can be divided into those making some set of assumptions about the form of the MRI signal response to neural activation (the general linear model), and those that are data driven. It is likely that a combination of methodologies, where data driven methods are "informed" by knowledge of the underlying neurobiological process will provide the greatest insight into the underlying neurobiological basis of seizure origination.


Bone morphogenetic protein-2 (BMP-2) inhibits muscle development and promotes cartilage formation in chick limb bud cultures.
Bone morphogenetic proteins (BMPs) induce ectopic cartilage and bone when implanted intramuscularly in adult rats. Expression data suggest that BMPs signal skeletal development in embryos. An important question is which cells are targets of BMP signaling in adult and embryonic tissues. Here, we examined the effect of BMP-2 on micromass cultures of chick limb bud mesenchyme. We report that BMP-2 promotes formation of cartilage and simultaneously inhibits development of muscle cells. To follow the fate of presumptive muscle cells, we replaced chick somites with quail somites at the wing level and made micromass cultures from the chimeric wings. In untreated cultures, quail cells formed muscle but not cartilage. In BMP-2-treated cultures, quail cells disappeared altogether. This suggests that BMP-2 may simultaneously promote cartilage differentiation and reduce the presumptive myogenic cell populations in regions of skeletal development.


Comprehensive management of disseminated breast cancer.
The management of patients with metastatic breast cancer is best achieved by the judicious use of local and systemic measures that palliate symptoms and improve overall quality of life. When two treatment approaches are known to be equally efficacious, the less toxic should be used. When disease is limited to one or two sites and the patient has an indolent form of the disease, the patient's symptoms are often best palliated with the use of surgery or radiotherapy alone. When multiple sites of disease are evident or the disease is progressing more rapidly, systemic therapy is preferred, and local therapies should be added when the patient is clearly refractory to systemic therapy or when the disease site is unlikely to be adequately palliated with systemic therapy. The use of any of these therapies, including chemotherapy, has a relatively small effect on the median survival of patients with metastatic breast cancer. However, improvements in quality of life are usually greatest with regimens inducing the highest response rates, even when these regimens are associated with greater toxicity. The characteristics of patients likely to respond to endocrine therapy are well defined; in these patients endocrine therapy should be used as the first form of systemic therapy. Among endocrine therapies, the least toxic is used first. The selection of patients for chemotherapy is largely a process of exclusion. When chemotherapy is used, there are a number of different strategies for sequencing chemotherapy that appear to be equally efficacious. In general, patients should be treated with standard doses of drug combinations for a period in excess of 3 months. When used inappropriately, especially in asymptomatic patients, these therapies may actually compromise the patient's quality of life. The use of surgery, radiation therapy, and systemic therapy should be integrated with various types of psychosupport services, especially peer support groups. Patients who want to try new forms of therapy should do so early in the course of the disease when these therapies are most likely to be effective and the patient has the least to lose if the therapy proves ineffective. This is especially true because the use of the most effective regimens at a time when the patient is asymptomatic may mean that the patient is resistant to most or all therapies of proven value when most in need of palliation.


Long-term day-case treatment of peripheral neuromuscular disease with intravenous immunoglobulin: the practice of a regional day-case service in Preston, Lancashire.
Neuromuscular disease is one of the most common indications for the use of intravenous immuno-globulin (IVIG). We describe practical aspects of IVIG administration and dosing in long-term treatment, as well as the setting up of a day-case service in a regional neurology unit to provide a streamlined patient experience. An audit of the safety of IVIG administration and patient satisfaction during implementation supported the fact that this is a relatively safe treatment. Standardised assessment methods have been used both to monitor treatment effect and to provide the necessary outcome measures for Department of Health (DOH) monitoring of IVIG use.


Perspectives of contraceptive choices for men.
Apart from condoms and vasectomy, which have several limitations of their own, no other methods of contraception are available to men. Various chemical, hormonal, vas based and herbal contraceptives have been examined and few of them have reached the stage of clinical testing. Promising leads have been obtained from testosterone buciclate/undecanoate, alone or in combination with levonorgestrel butanoate or cyproterone acetate, RISUG, an injectable intravasal contraceptive and a few herbal products, particularly the seed products of Carica papaya. It is feasible that an ideal male contraceptive, that meets out all the essential criteria will be made available to the community in the near future.


[Accessory scrotum with lipoma: a case report].
A newborn male infant was referred to our clinic because of anomalies of external genitalia. The infant was born at term after a normal pregnancy and delivery, and was appropriate for gestational age. A tumor mass covered with scrotum-like skin on its tip was noticed in the right side of perineum between the scrotum and anus. The raphe, which ran along the midline at the penis and the normal scrotum, circumscribed the right side of this structure. Both testes had descended into the scrotum. The condition was associated with incomplete penoscrotal transposition. There was no other urological anomaly including lower urinary tract. Histological findings of the tumor indicated perineal lipoma, and the scrotum-like portion was diagnosed as an accessory scrotum. Thirty-one report cases of the accessory scrotum including our own were reviewed and discussed.


Short- and long-term outcomes of laparoscopic complete mesocolic excision for colon cancer in the elderly: A retrospective cohort study.
Laparoscopic complete mesorectal excision (CME) can be used for the treatment of colon cancer. This study was designed to assess short-term and long-term outcomes of laparoscopic CME in elderly colon cancer patients. We retrospectively reviewed colon cancer patients who underwent laparoscopic CME at a single medical center between January 2014 and January 2019. Short-term surgical outcomes and long-term survival outcomes were analyzed, including overall survival (OS) and disease-free survival (DFS). A total of 152 patients were included in the study, of which 54 were classified as elderly group (≥70 years) and 98 were classified as younger group (<70 years). The elderly group had more Charlson comorbidity index (CCI) scores >3. The short-term results of the two groups were similar. The overall complication and major complication rates were comparable between the two groups. The 5-year OS rates of the elderly and younger groups were 67% and 71%, respectively (p=0.846). The 5-year DFS rates in the elderly and younger groups were 59% and 62%, respectively (p=0.995). Compared with younger patients, laparoscopic CME in elderly colon cancer patients can achieve similar short-term and long-term outcomes. For elderly colon cancer patients, age is not a contraindication to laparoscopic CME.


Combined use of hydroxypropyl-β-cyclodextrin and ionic liquids for the simultaneous enantioseparation of four azole antifungals by CE and a study of the synergistic effect.
A CE method employing a dual system of hydroxypropyl-β-cyclodextrin (HP-β-CD) and ionic liquids (ILs) has been developed for the simultaneous enantioseparation of four azole antifungals for the first time. In this study, three different types of ILs were employed as modifiers and among them dodecyl trimethyl ammonium chloride was found to be the most effective. The effects of the concentration, cations, and anions of ILs on the enantioseparation were investigated. With the developed dual system, all the enantiomers were well separated in resolutions of 3.8, 3.5, 2.8, and 2.5 for miconazole, econazole, ketoconazole, and itraconazole, respectively. The interactions between dodecyl trimethyl ammonium chloride and HP-β-CD were also studied using a neutral polyacrylamide coated capillary and (1) H NMR spectroscopy to further explore the synergistic effect involved. It was found that ILs improved the enantioseparation not only by changing the EOF, but also by interactions with HP-β-CD that could change its ability of forming inclusion complex with the enantiomers.


The influence of abutment disconnections on peri-implant marginal bone: A systematic review.
To assess the failure rate of dental implants and prosthetic restoration, complications and marginal bone loss (MBL) of implants restored with an immediate definitive abutment at the time of the implant placement, and implants that were evaluated according to a standard prosthetic protocol (SPP), which includes multiple abutment changes. This systematic review followed the guidelines of the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). An electronic search with no date or language restriction was run in January 2018 in the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, and complemented with a manual search. Randomised clinical trials with at least a 12-month follow-up evaluating the use of a definitive abutment and a SPP were included. The Cochrane Collaboration Risk of Bias tool was used to evaluate the included studies. The outcome measures were: implant and prosthetic failure; aesthetics; complications; and peri-implant MBL. The results were pooled using a random-effect model with mean differences (MDs) for continuous outcomes and risk ratio for dichotomous outcomes with a 95% confidence interval (CI). The search identified a total of 714 studies. After the screening process five studies were included in the analysis. The five studies included had a limited sample size, a short follow-up period, and four studies were considered at high risk of bias. The meta-analysis revealed that five studies using an immediate definitive abutment over a 12- to 18-month follow-up resulted in lower MBL, with a MD of -0.32 mm (95% CI -0.45 to -0.19: P < 0.0000). At the end of a 3-year follow-up two studies showed a MD of -0.33 mm (95% CI -0.63 to -0.03: P = 0.03, which also favours the definitive abutment group. Regarding implant failure rate, complications, and probing depth, no significant difference was found between the groups. Within the limitations of this meta-analysis, reducing the number of abutment changes contributes to statistically significant lower MBL. However, the clinical significance of this reduction in bone loss should be interpreted with caution. A high implant success rate was reported by all studies for both control and test groups.


Antimicrobial Resistance Profiling of Gallibacterium anatis from Layers Reveals High Number of Multiresistant Strains and Substantial Variability Even Between Isolates from the Same Organ.
In this investigation, data on antimicrobial resistance (AMR) profiles of 213 Gallibacterium anatis isolates were determined from 93 laying hens originating from 39 flocks. Each flock was sampled three times during its life time for the presence of G. anatis. The broth microdilution method was applied comprising 21 antimicrobial substances. Multidrug resistance was found in 96.2% of the G. anatis isolates. Most of the isolates were resistant to tetracycline (89.2%), tylosin (94.8%), enrofloxacin (58.2%), nalidixic acid (77.4%), and sulfamethoxazole (77.0%). Resistance against antimicrobial substances increased significantly with the age of birds. A total of 99 different AMR profiles were detected. On flock level, different AMR profiles were found in 71.8% of the flocks independent of the sampling time point. On bird level, identical AMR profiles were mostly found in isolates originating from the same organ of a single bird, but 22 such paired isolates differed in their AMR profile. Variations of AMR profiles were found within isolates from a single bird, but from different organs. Isolates from systemic organs were significantly more resistant to different antimicrobial substances compared to isolates from the reproductive tract. No influence could be found in regard to an increase of resistance and applied antibiotic treatment.


Effect of erythromycin on D-galactose absorption and sucrase activity in rabbit jejunum.
Erythromycin, an antibiotic used in the treatment of infectious diseases, produces gastrointestinal side effects such as diarrhea. The mechanisms by which erythromycin produces these effects are not known. However, erythromycin has been shown to increase gastrointestinal motor activity and to inhibit intestinal neutral amino acid absorption. Both effects could contribute to the gastrointestinal side effects observed. Because the intestinal systems of amino acid and sugar transport present similar characteristics, the aim of the present work was to determine whether erythromycin also alters D-galactose absorption and sucrase activity in rabbit jejunum. The results show that erythromycin diminishes intestinal D-galactose absorption. This effect seems to be due to an action mainly located on the Na(+)-dependent sugar transport of the mucosal border of the intestinal epithelium. Erythromycin also inhibits the Na(+)-K+ ATPase activity of the enterocyte, which might explain the inhibition of the D-galactose Na(+)-dependent transport. However, a direct action of the erythromycin molecule on the Na(+)-dependent carrier cannot be excluded. Erythromycin did not alter sucrase activity.


Preprocessing Methods for Ambulatory HRV Analysis Based on HRV Distribution, Variability and Characteristics (DVC).
Thanks to wearable devices joint with AI algorithms, it is possible to record and analyse physiological parameters such as heart rate variability (HRV) in ambulatory environments. The main downside to such setups is the bad quality of recorded data due to movement, noises, and data losses. These errors may considerably alter HRV analysis and should therefore be addressed beforehand, especially if used for medical diagnosis. One widely used method to handle such problems is interpolation, but this approach does not preserve the time dependence of the signal. In this study, we propose a new method for HRV processing including filtering and iterative data imputation using a Gaussian distribution. The particularity of the method is that many physiological aspects are taken into consideration, such as HRV distribution, RR variability, and normal boundaries, as well as time series characteristics. We study the effect of this method on classification using a random forest classifier (RF) and compare it to other data imputation methods including linear, shape-preserving piecewise cubic Hermite (pchip), and spline interpolation in a case study on stress. Features from reconstructed HRV signals of 67 healthy subjects using all four methods were analysed and separately classified by a random forest algorithm to detect stress against relaxation. The proposed method reached a stable F1 score of 61% even with a high percentage of missing data, whereas other interpolation methods reached approximately 54% F1 score for a low percentage of missing data, and the performance drops to about 44% when the percentage is increased. This suggests that our method gives better results for stress classification, especially on signals with a high percentage of missing data.


Ultrastructure and localization of E proteins in cultured neuron cells infected with Japanese encephalitis virus.
A unique structure and in situ localization of E proteins were demonstrated in cultured neurons infected with neurovirulent and aneurovirulent strains of local Japanese encephalitis virus (JEV). Dilated rough endoplasmic reticulum (rER) containing smooth membrane structures (SMS) was continuous with the outer membrane of the nuclear envelope. These membranes were found to be connected to unique dense bodies, membrane vesicle structures (MVS). The de novo formation of SMS, annulate lamellae, and the appearance of MVS indicated proliferation of the membranous system in response to JEV infection. E proteins were possibly assembled in the virions in the nuclear envelope or rER or on the plasma membrane. The interconnections between MVS, rER, and the nuclear envelope and immunogold labeling of E proteins on the MVS provided strong evidence that MVS serve as a reservoir of JEV components during virus assembly.


Late radiation damage to the rat femur and the NSD formula.
The extraction of 86Rb chloride, the red blood cell volume and the mineral content in the rat femur have been studied 7 months after local X-irradiation. Doses were given as 3, 6 and 9 fractions over three weeks. The total doses used were based on NSD value of 1450 and 1900 on the basis of the results from our previous single dose irradiation studies. The reduction in the extraction of 86Rb chloride was statistically significant for all fractionation schemes and at both NSD levels. In the whole femur, with bone marrow, the extraction was reduced by 33% to 46%. In the hard bone the reduction was less only 18% to 38%. There was no significant difference between the fractionation schemes used at each NSD level. The red blood cell volume was significantly reduced in the whole femur, with bone marrow, with no difference between the fractionation schemes. However, there was no change in the hard bone. The dry bone weight was reduced by 3 to 6% with no significant difference between the different fractionation schemes. The dose levels predicted by the NSD formula produced approximately the same damage to the rat femur 7 months after the irradiation when the dry weight and the extraction of 86Rb chloride were used as end points for the evaluation of the severity of late radiation damage.


Climate Change Impacts on Plant Phenology: Grapevine (Vitis vinifera) Bud Break in Wintertime in Southern Italy.
The effects of global warming on plants are not limited to the exacerbation of summer stresses; they could also induce dormancy dysfunctions. In January 2020, a bud break was observed in an old poly-varietal vineyard. Meteorological data elaboration of the 1951-2020 period confirmed the general climatic warming of the area and highlighted the particular high temperatures of the last winter. Phenological records appeared to be significantly correlated to wood hydration and starch reserve consumption, demonstrating a systemic response of the plant to the warm conditions. The eight cultivars, identified by single-nucleotide polymorphism (SNP) profiles and ampelographic description, grown in this vineyard showed different behaviors. Among them, the neglected Sprino, Baresana, Bianco Palmento, and Uva Gerusalemme, as well as the interspecific hybrid Seyve Villard 12.375, appeared to be the most interesting. Among the adaptation strategies to climate changes, the cultivar selection should be considered a priority, as it reduces the inputs required for the plant management over the entire life cycle of the vineyard. Hot Mediterranean areas, such as Salento, are a battlefront against the climate change impacts, and, thus, they represent a precious source of biodiversity for viticulture.


Impaired fibrinolytic compensation for hypercoagulability in obese patients with type 2 diabetes: association with increased plasminogen activator inhibitor-1.
In patients with type 2 diabetes, fibrinolysis is considered impaired by increased plasma concentrations of plasminogen activator inhibitor (PAI)-1. However, several investigators found both coagulation and fibrinolysis to be activated in these patients. We further characterized the balance between coagulation and fibrinolysis in lean and obese patients with type 2 diabetes. We studied 112 type 2 diabetic patients (66 lean, 46 obese) and 69 age-matched healthy subjects (46 lean, 23 obese). We measured plasma concentrations of fibrinogen and prothrombin F1+2 (F1+2) as indicating coagulation activity and plasmin-antiplasmin complex (PAP) and D dimer as indicating fibrinolytic activity. Plasma PAI-1 concentrations also were determined. Plasma concentrations of F1+2, PAP, D dimer, and PAI-1 were higher in diabetic patients than in control subjects. Plasma fibrinogen and F1+2 were similar between lean and obese diabetic patients, but plasma PAP and D dimer were significantly lower in obese than lean diabetic patients (P <.0001, P =.0194, respectively). By multivariate analysis, plasma PAI-1 and body mass index (BMI) were independent factors in diabetic patients predicting PAP, while BMI and glycosylated hemoglobin (HbA(1c)) independently predicted D dimer. Plasma PAI-1 concentrations were significantly higher in obese than lean diabetic patients (P <.0001). In conclusions, both coagulation and fibrinolytic systems are enhanced in lean and obese type 2 diabetic patients compared with healthy subjects. Although the degree of activation of coagulation was similar between lean and obese diabetic patients, the fibrinolytic activity was lower in obese than lean patients. Fibrinolytic compensation for hypercoagulation is incomplete in obese patients with type 2 diabetes, partly because of elevated PAI-1 in the blood.


Endodontic approach in a replanted tooth with an immature root apex and chronic apical periodontitis: a case report.
This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.


[Survival and pulmonary hemodynamics in patients with sequelae of pulmonary tuberculosis who received home oxygen therapy].
We studied the relationship between survival and pulmonary hemodynamics in patients with sequelae of pulmonary tuberculosis. We also studied the effect of home oxygen therapy (HOT) on pulmonary hemodynamics in those patients. The subjects were 59 patients who were treated with HOT after right-heart catheterization. Blood gases and pulmonary hemodynamics were measured twice: while the patients breathed air and after they had inhaled pure oxygen. In 11 patients, right-heart catheterization done before and after HOT was begun. Before HOT was begun, 49 patients were given the diagnosis of pulmonary hypertension, but the difference in survival between those who had and those who did not have pulmonary hypertension was not statistically significant. Mean pulmonary artery pressure fell by more than 5 mmHg after inhalation of pure oxygen in 5 patients (responders), but survival did not differ between responders and non-responders. Blood-gas volumes and pulmonary hemodynamics did not differ between those who died within 2 years after right-heart catheterization and those who lived for more than 5 years. Pulmonary arterial resistance and mean pulmonary artery pressure decreased significantly after HOT was begun. HOT can reduce mean pulmonary artery pressure in patients with sequelae of pulmonary tuberculosis, but survival on HOT is not related to the presence of pulmonary hypertension or to the effect of pure oxygen on mean pulmonary artery pressure.


Optical Metric Assessed Engineered Tissues Over a Range of Viability States.
Many conventional methods to assess engineered tissue morphology and viability are destructive techniques with limited utility for tissue constructs intended for implantation in patients. Sterile label-free optical molecular imaging methods analyzed tissue endogenous fluorophores without staining, noninvasively and quantitatively assessing engineered tissue, in lieu of destructive assessment methods. The objective of this study is to further investigate label-free optical metrics and their correlation with destructive methods. Tissue-engineered constructs (n = 33 constructs) fabricated with primary human oral keratinocytes (n = 10 patients) under control, thermal stress, and rapamycin treatment manufacturing conditions exhibited a range of tissue viability states, as evaluated by quantitative histology scoring, WST-1 assay, Ki-67 immunostaining imaging, and label-free optical molecular imaging methods. Both histology sections of fixed tissues and cross-sectioned label-free optical images of living tissues provided quantitative spatially selective information on local tissue morphology, but optical methods noninvasively characterized both local tissue morphology and cellular viability at the same living tissue site. Furthermore, optical metrics noninvasively assessed living tissue viability with a statistical significance consistent with the destructive tissue assays WST-1 and histology. Over the range of cell viability states created experimentally, optical metrics noninvasively and quantitatively characterized living tissue viability and correlated with the destructive WST-1 tissue assay. By providing, under sterile conditions, noninvasive metrics that were comparable with conventional destructive tissue assays, label-free optical molecular imaging has the potential to monitor and assess engineered tissue construct viability before surgical implantation.


Bioavailability of oestradiol from the Alora (0.1 mg/day) oestradiol matrix transdermal delivery system compared with Estraderm (0.1 mg/day).
This open-label, randomised, two-way crossover study compared the steady-state bioavailability of oestradiol administered by way of a new oestradiol matrix transdermal delivery system (Alora 0.1 mg/day) with that of Estraderm (0.1 mg/day) in 24 subjects. Serum oestradiol, oestrone and oestrone sulphate concentrations were determined by measurement of blood samples. Mean SD pre-dosing, nonadjusted oestradiol levels for Alora (71.9 27.0 pg/ml) were substantially higher than those for Estraderm (26.7 9.7 pg/ml), while peak oestradiol concentrations were comparable. Consequently, fluctuations in steady-state levels were substantially smaller for Alora than for Estraderm; the fluctuation index values (\[C- C ])/ max min C ) were significantly lower for Alora (0.97 0.23) than av for Estraderm (1.68 0.45). Oestradiol levels remained constant over the dosing interval with Alora but decreased significantly after 48 hours with Estraderm. The bioavailability of oestradiol with Alora was 127 56% that of Estraderm. Oestrone and oestrone sulphate data showed the same qualitative and quantitative differences between the two systems. Both systems were well tolerated. In summary, Alora delivered more oestradiol to the systemic circulation with greater consistency and over a longer time than did Estraderm.