Association of obesity and central fat distribution with carotid artery wall thickening in middle-aged women.
The association between obesity and atherosclerotic disease is controversial. In the present analysis, we evaluated whether common carotid intima-media thickness (IMT) and area, 2 markers of preclinical atherosclerosis, were increased in obese subjects. More than 5000 middle-aged women (n=5062; age, 30 to 69 years) living in the area of Naples, Southern Italy, were recruited for a prospective, currently ongoing study on the etiology of cardiovascular disease and cancer in the female population (the Progetto ATENA study). A subsample of 310 participants underwent high-resolution B-mode ultrasound examination, and the IMTs, intima-media areas, and lumen diameters of common carotid arteries were measured with a semiautomated computerized program. Subjects were divided into 3 groups on the basis of the recently published obesity guidelines for body mass index (BMI), a marker of general obesity, and tertiles of waist-to-hip ratio (WHR), a marker of regional obesity. Women with a BMI >/=30 kg/m(2) showed higher systolic and diastolic blood pressures, triglycerides, and fasting glucose and insulin, as well as lower high-density lipoprotein concentrations, than subjects with lower BMI. A gradual increase in common carotid IMT and intima-media area was observed when lean women (0.94+/-0.01 mm and 19.8+/-0.5 mm(2), respectively) were compared with overweight (0.98+/-0.01 mm and 21.0+/-0.4 mm(2)) and obese (1.02+/-0.02 mm and 22.6+/-0.8 mm(2), P<0.005 for linear trend) individuals. Similarly, women in the highest tertile of WHR (>0.85) had adverse risk factor profiles and thicker carotid intima-media complex than those in the first 2 tertiles (P<0.01 and P<0.05 for IMT and intima-media area, respectively). In multivariate analyses, BMI and WHR were significant predictors of carotid wall thickness, independently of other traditional and nontraditional cardiovascular risk factors (age, blood pressure, lipid abnormalities, fasting insulin). The present results indicate a graded and independent association between general and abdominal obesity-reflected by high BMI and WHR-and carotid artery wall thickening in a population of middle-aged women.


Autograft Substitutes: Conduits and Processed Nerve Allografts.
Manufactured conduits and allografts are viable alternatives to direct suture repair and nerve autograft. Manufactured tubes should have gaps less than 10 mm, and ideally should be considered as an aid to the coaptation. Processed nerve allograft has utility as a substitute for either conduit or autograft in sensory nerve repairs. There is also a growing body of evidence supporting their utility in major peripheral nerve repairs, gap repairs up to 70 mm in length, as an alternative source of tissue to bolster the diameter of a cable graft, and for the management of neuromas in non-reconstructable injuries.


Delayed postanoxic encephalopathy after strangulation. Serial neuroradiological and neurochemical studies.
A 13-year-old boy was the victim of attempted strangulation. His condition had returned to normal by the sixth day after the assault; however, from the seventh day, choreoathetosis, dystonia, and marked pseudobulbar paralysis developed in the boy. The computed tomographic scans and T2-weighted magnetic resonance images that were obtained at this time revealed low-density and high-signal intensities in the region of the bilateral putamen and caudate nucleus. These symptoms and the changes in his computed tomographic scans and magnetic resonance images subsided gradually during a 2-month period. Sequential analysis of the cerebrospinal fluid for gamma-aminobutyric acid and dopamine concentrations during his illness revealed reciprocal changes with normal recovery. Because of the delayed onset of neurological changes and the cerebrospinal fluid showing reversible symptoms, the delayed encephalopathy after strangulation had been related to the biochemical alterations that followed anoxia in the vulnerable basal ganglia.


[Interspecific interaction between Moina mongolica and Brachionus plicatilis].
In a laboratory experiment, Moina mongolica and Brachionus plicatilis were polycultured at four relatively inoculating densities, i.e., 0.06/0.30, 0.10/0.30, 0.30/0.30 and 0.60/0.30 (ind x ml(-1)/ind x ml(-1)), while M. mongolica monocultured at 0.06, 0.10, 0.30 and 0.60 ind x ml(-1) and B. plicatilis at 0.30 ind x ml(-1) were used as the control. Interspecific interference did exist between M. mongolica and B. plicatilis when these two species coexisted in a microcosm. In the polycultured microcosms, depressed population density of M. mongolica resulted from the coexistence of B. plicatilis, and M. mongolica maintained at extremely low density. In opposite, M. mongolica had negligibly negative influence on the population of B. plicatilis. Further experiment showed that the mortality of M. mongolica deprived of food for 120 h was 100%, while 90% of B. plicatilis survived after 144 h of food deprivation. The relatively strong capacity of B. plicatilis in tolerating starvation may be one of the important reasons for it wins the competition against M. mongolica.


Epilepsy and Ecstatic Experiences: The Role of the Insula.
Ecstatic epilepsy is a rare form of focal epilepsy in which the aura (beginning of the seizures) consists of a blissful state of mental clarity/feeling of certainty. Such a state has also been described as a "religious" or mystical experience. While this form of epilepsy has long been recognized as a temporal lobe epilepsy, we have accumulated evidence converging toward the location of the symptomatogenic zone in the dorsal anterior insula during the 10 last years. The neurocognitive hypothesis for the genesis of a mental clarity is the suppression of the interoceptive prediction errors and of the unexpected surprise associated with any incoming internal or external signal, usually processed by the dorsal anterior insula. This mimics a perfect prediction of the world and induces a feeling of certainty. The ecstatic epilepsy is thus an amazing model for the role of anterior insula in uncertainty and surprise.


Osteopathic manipulative treatment for postoperative pain.
Osteopathic manipulative treatment (OMT) is an important aspect of pain management and disease prevention. Advantages of OMT administered postoperatively include easy implementation and cost-effectiveness in terms of shortened hospital stays resulting from effective relief of acute pain. Patients who receive morphine preoperatively and OMT postoperatively tend to have less postoperative pain and require less intravenously administered morphine. In addition, OMT and relief of pain lead to decreased postoperative morbidity and mortality and increased patient satisfaction. Also, soft tissue manipulative techniques and thoracic pump techniques help to promote early ambulation and body movement.


Project Towards No Drug Abuse: generalizability to a general high school sample.
We examined the generalizability of a successful classroom-based prevention program developed for youth at alternative high schools (high risk) to youth at general high schools. A replication of a previously tested prevention program in a general high school population was conducted with 1-year follow-up data. Classrooms within each of three schools were randomly assigned to two conditions, classroom education or standard care control. Statistically significant effects on alcohol and illicit drug use were achieved in this population through a 1-year period following the program, although effects were not achieved on cigarette smoking and marijuana use. These results suggest that this program (Project Towards No Drug Abuse) has applicability to a wide range of older teens.


Single-balloon enteroscopy-assisted direct percutaneous endoscopic jejunostomy.
Direct percutaneous endoscopic jejunostomy (DPEJ) has emerged as a viable alternative for percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) in patients who cannot tolerate gastric feeding. Reportedly, DPEJ placement with regular endoscopes fails in up to one-third of cases. The aim of the current study was to assess the efficacy and safety of single-balloon enteroscopy (SBE)-assisted DPEJ. The DPEJ placement technique was comparable to conventional PEG placement. A total of 12 DPEJ procedures were performed in 11 patients (mean age 55 years [range 24-83 years]; seven males). SBE-assisted DPEJ was successful in 11 of the 12 procedures (92%). Post-procedural complications included gastroparesis and aspiration pneumonia in one case each. We conclude that SBE-assisted DPEJ placement seems a safe and successful approach for patients requiring jejunal enteral feeding.


A Theoretical Analysis of the Synergy of Amyloid and Tau in Alzheimer's Disease.
Amyloid plaques and Tau protein neurofibrillary tangles are considered the two most important pathogenic factors in Alzheimer's disease. The prevailing amyloid cascade hypothesis suggests that amyloid-β (Aβ) elevation induces downstream Tau hyperphosphorylation and aggregation, synaptic dysfunction, and neuronal loss that ultimately results in cognitive impairment. Alternatively, the dual-pathway hypothesis suggests that Aβ and abnormal Tau are two independent factors that exert synergistic effects on synaptic dysfunction and neuronal loss. We hypothesize that the intrinsic interaction of Aβ and Tau would better predict cognitive impairment. Herein, we propose an Aβ-Tau interactive model based on a review of the medical literature, mathematic modeling, and analysis of our clinicopathological data.


'We are nurses, they are doctors': barriers to nurses' roles in pain management following surgery in Jordan.
This study explored barriers to nurses' roles in pain management following surgery in Jordan. A qualitative approach using four focus group discussions (n = 4) was used. The total convenience sample of surgical wards nurses included 25 nurses. The analysis revealed two categories explaining the context and perceived barriers affecting nurses' roles in pain management. First were barriers within bedside nursing, comprising attention-seeking patients, 'buzzer obsession' and family interferences. Second were barriers within nursing, comprising lack of staff and 'nurses need pain relief before patients', and the perception of 'we are nurses, they are doctors.' Nurses' roles in managing patients' pain following surgery is hindered by contextually complex barriers identified by this research. Multidisciplinary actions are therefore urgently needed to address barriers to pain management at the nursing professional, ward culture and policy levels. Failure to do so might lead to more pain sufferers following surgery, and thus poor recovery.


[Peptic ulcer and Helicobacter pylori. Comments on the authors' cases].
The presence of Helicobacter was tested on a group with antral or duodenal ulcer with or without gastritis, versus a group without gastric or duodenal pathology. Furthermore an open trial was performed between omeprazole and colloidal bismuth subcitrate (CBS) on patients similarly affected by peptic disease. Although CBS did eliminate Helicobacter in more than a half of patients, what was not obtained by omeprazole, this result did not mean a better control of peptic disease: in fact the omeprazole was remarkably more active in our series on clinical and endoscopic ground, whether the Helicobacter was present or not, and further studies are required to assess the real significance of Helicobacter pylori in the above conditions.


Association of early-life exposure to household gas appliances and indoor nitrogen dioxide with cognition and attention behavior in preschoolers.
The authors investigated the association of early-life exposure to indoor air pollution with neuropsychological development in preschoolers and assessed whether this association differs by glutathione-S-transferase gene (GSTP1) polymorphisms. A prospective, population-based birth cohort was set up in Menorca, Spain, in 1997-1999 (n = 482). Children were assessed for cognitive functioning (McCarthy Scales of Children's Abilities) and attention-hyperactivity behaviors (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) at age 4 years. During the first 3 months of life, information about gas appliances at home and indoor nitrogen dioxide concentration was collected at each participant's home (n = 398, 83%). Genotyping was conducted for the GSTP1 coding variant Ile105Val. Use of gas appliances was inversely associated with cognitive outcomes (beta coefficient for general cognition = -5.10, 95% confidence interval (CI): -9.92, -0.28; odds ratio for inattention symptoms = 3.59, 95% CI: 1.14, 11.33), independent of social class and other confounders. Nitrogen dioxide concentrations were associated with cognitive function (a decrease of 0.27 point per 1 ppb, 95% CI: -0.48, -0.07) and inattention symptoms (odds ratio = 1.06, 95% CI: 1.01, 1.12). The deleterious effect of indoor pollution from gas appliances on neuropsychological outcomes was stronger in children with the GSTP1 Val-105 allele. Early-life exposure to air pollution from indoor gas appliances may be negatively associated with neuropsychological development through the first 4 years of life, particularly among genetically susceptible children.


Study of theThermo-/pH-Sensitivity of Stereo-Controlled Poly(N-isopropylacrylamide-co-IAM) Copolymers via RAFT Polymerization.
In this work, a smart copolymer, Poly(nipam-co-IAM) was synthesized by copolymerization of N-isopropylacrylamide (nipam) and itaconamic acid (IAM) through reversible addition-fragmentation chain-transfer (RAFT) polymerization. Poly(nipam-co-IAM) has been studied previously synthesized via radical polymerization without stereo-control, and this work used cumyl dithiobenzoate and Ytterbium(III) trifluoromethanesulfonate as RAFT and stereo-control agents, respectively. The stereo-control result in this work shows that tacticity affects the lower critical solution temperature (LCST) and/or the profile of phase separation of Poly(nipam-co-IAM). In the pH 7 and pH 10 buffer solutions, the P(nipam-co-IAM) copolymer solutions showed soluble⁻insoluble⁻soluble transitions, i.e., both LCST and upper critical solution temperature (UCST) transitions, which had not been found previously, and the insoluble to soluble transition (redissolved behavior) occurred at a relatively low temperature. The insoluble to soluble transition of P(nipam-co-IAM) in alkaline solution occurred at a temperature of less than 45 °C. However, the redissolved behavior of P(nipam-co-IAM) was found only in the pH 7 and pH 10 buffer solutions and this redissolved behavior was more prominent for the atactic copolymers than in the isotactic-rich ones. In addition, the LCST results under our experimental range of meso content did not show a significant difference between the isotactic-rich and the atactic P(nipam-co-IAM). Further study on the soluble-insoluble-soluble (S-I-S) transition and the application thereof for P(nipam-co-IAM) copolymers will be conducted.


Pharmacokinetics and Pharmacodynamics of Esomezol DR, a New Dual Delayed-Release Formulation of Esomeprazole 20 Mg or 40 Mg, in Healthy Subjects.
Esomeprazole, a proton pump inhibitor (PPI), is widely used to treat acid-related disorders, but it has short plasma half-life which can cause insufficient gastric acid suppression, such as nocturnal acid breakthrough. A new dual delayed-release (DR) formulation of esomeprazole (Esomezol DR), was developed to extend the duration of gastric acid suppression. This study aimed to evaluate the pharmacokinetics (PKs) and pharmacodynamics (PDs) of esomeprazole for the DR formulation compared to a conventional enteric-coated (EC) formulation (Nexium) in healthy male subjects. Two randomized, open-label, multiple-dose, two-way crossover studies with esomeprazole 20 mg and 40 mg were conducted. Subjects received the DR formulation or the EC formulation once daily for 7 days in each period with a 7-day washout. Serial blood samples were collected up to 24 hours after the 1st dose, and 24-hour intragastric pH was continuously monitored before the 1st dose as baseline and after the 1st and the 7th dose. In 20 mg and 40 mg dose groups, 38 and 44 subjects completed the study, respectively. The DR formulation exhibited the dual-release pattern of esomeprazole, resulting in more sustained plasma concentration-time profiles compared to the EC formulation. The systemic exposure of esomeprazole for the DR formulation was comparable to that for the EC formulation, showing the similar area under the plasma concentration-time curve. The 24-hour gastric acid suppression was also similar between the two formulations, while the inhibition during night-time (22:00-06:00) showed a better tendency in the DR formulation. The sustained exposure of esomeprazole in the DR formulation led to well-maintained and higher acid inhibition compared to the EC formulation, especially during the night-time. These results suggest that the DR formulation can be an alternative formulation to the conventional EC formulation, expecting the potential of relieving nocturnal acid-related symptoms.


The Nigerian I/CDC strain of Plasmodium ovale in chimpanzees.
The chimpanzee is the only animal host currently available that can support the development of the human malaria parasite Plasmodium ovale. Thirty-one infections with the Nigerian I/CDC strain were induced in splenectomized chimpanzees. Maximum parasite counts ranged from 1,240 to 127,224/microliters. Infections were transient and unpredictable. Anopheles stephensi, Anopheles gambiae, Anopheles freeborni, and Anopheles dirus mosquitoes were infected by feeding through parafilm membranes on heparinized blood containing gametocytes; each species supported development to sporozoites in the salivary glands. Mean oocyst counts per infected mosquito ranged from 1 to 85.1; 21.7% of infected lots of mosquitoes averaged > 20 oocysts per positive mosquito gut. One infection was induced via the bites of infected An. gambiae. The prepatent period was 16 days.


Corneal Evaluation in Patients With Parkinsonism on Long-Term Amantadine Therapy.
To evaluate the progression of corneal endothelial changes in patients with Parkinson disease (PD) on long-term oral amantadine therapy. A prospective comparative longitudinal observational study of 90 patients (180 eyes) with PD on more than 6 months of oral amantadine therapy, 30 amantadine naive patients with PD, and 30 healthy controls (age and gender matched). Corneal endothelial cell parameters (endothelial cell density, percentage hexagonality of the cells, and coefficient of variation) and corneal subbasal nerve fiber layer changes were studied over a follow-up period of 1 year. The amantadine patients with PD group had a statistically significant decrease in endothelial cell density (1.51% vs. 0.94% vs. 0.55%) (P = 0.04), decrease of percentage hexagonality of the cells (4.98% vs. 3.56% vs. 2.31%) (P = 0.01), and increase of coefficient of variation (6.12% vs. 4.80% vs. 3.30%) (P = 0.03) compared with amantadine naive patients with PD and controls, respectively. Analysis of changes in the patients with PD based on the daily dosage of amantadine showed greater change in endothelial parameters in patients who were on 400 mg amantadine. Long-term amantadine therapy seems to effect changes on corneal endothelium.


A case of minimal change disease treated successfully with mycophenolate mofetil in a patient with systemic lupus erythematosus.
The World Health Organization classifies lupus nephritis as class I to V or VI. However, a few cases of minimal change glomerulopathy have been reported in association with systemic lupus erythematosus (SLE). Mycophenolate mofetil has been shown to be effective for treatment of minimal change disease and lupus nephritis. A 24-year-old woman diagnosed with SLE five years prior to presentation complained of a mild generalized edema. The urinalysis showed microscopic hematuria and proteinuria. The assessed amount of total proteinuria was 1,618 mg/24 hours. A renal biopsy demonstrated diffuse fusion of the foot processes of podocytes on electron microscopy. Mycophenolate mofetil was started in addition to the maintenance medications of prednisolone 10 mg/day and hydroxychloroquine 400 mg/day. After six months of treatment, the microscopic hematuria and proteinuria resolved, and the total urine protein decreased to 100 mg/24 hours.


Physiological changes and alk gene instability in Pseudomonas oleovorans during induction and expression of alk genes.
The alk genes of Pseudomonas oleovorans, which is able to metabolize alkanes and alkenes, are organized in alkST and alkBFGHJKL clusters, in which the expression of alkBFGHJKL is positively regulated by AlkS. Growth of the wild-type strain GPo1 and P. oleovorans GPo12 alk recombinants on octane resulted in changes of cellular physiology and morphology. These changes, which included lower growth rates and a reduction of the number of CFU due to filamentation, were also seen when the cells were grown on aqueous medium, and the alk genes were induced with dicyclopropylketone, a gratuitous inducer of the alk genes. These effects were seen only for recombinants carrying both alkST and alkBFGHJKL operons. Deletion of parts of either alkB or alkJ, which encode two major Alk proteins located in the cytoplasmic membrane, modified but did not eliminate the effects described above, suggesting that they were due to induction and expression of several alk genes. Continuous growth of the cells in the presence of dicyclopropylketone for about 10 generations led to inactivation, but not elimination, of the alk genes. This resulted in a return of the recombinants to normal physiology and growth.


Experienced, recreational scuba divers in Australia continue to dive despite medical contraindications.
In Australia, a medical examination is required before undertaking a scuba diving course in order to screen for contraindications to diving. No further medical screening is required, and yet divers may develop diseases during their diving careers. This study aimed to survey experienced recreational scuba divers to determine the prevalence of diseases contraindicated in diving. A cross-sectional, postal survey was taken of divers belonging to scuba diving clubs across Australia. Three hundred forty-six divers returned completed questionnaires. Two hundred fifty-four (73.4%) were male, and 258 (74.6%) were aged 31 to 60 years. The mean years of diving equaled 10.6 +/- 9.18 years, and the mean number of dives undertaken was 414 +/- 740 dives. One hundred sixty-two (46.8%) divers were overweight, 45 (13.0%) divers required regular medication, and 39 (11.3%) divers smoked. Thirty-six (10.4%) divers reported a past or present history of asthma, and the same number reported hypertension or coronary heart disease. Eighty-six (24.9%) divers reported past or present psychological symptoms. Forty-two (12.1%) divers reported hearing difficulties, and 81 (23.4%) divers reported past or present tinnitus. Two divers had a past history of epilepsy, 2 had a history of pneumothorax, and I was diabetic. Experienced, recreational scuba divers continue to dive despite medical contraindications. This raises the questions: Did the divers fail to disclose these conditions at the initial examination, or did these conditions develop subsequently? Is the risk associated with these conditions clinically significant, and should screening examinations be undertaken at regular intervals? The high prevalence of hearing difficulties and tinnitus may be the result of aural barotrauma and requires further research.


Hepatocyte nuclear factor 1 and the glucocorticoid receptor synergistically activate transcription of the rat insulin-like growth factor binding protein-1 gene.
The insulin-like growth factor (IGF) binding proteins (IGFBPs) are a family of proteins that bind IGF-I and IGF-II and modulate their biological activities. IGFBP-1 is distinctive among the IGFBPs in its rapid regulation in response to metabolic and hormonal changes. The synthetic glucocorticoid, dexamethasone, increases IGFBP-1 mRNA abundance and gene transcription in rat liver and in H4-II-E rat hepatoma cells. A glucocorticoid response element (GRE) located at nucleotide (nt) -91/-77 is required for dexamethasone to stimulate rat IGFBP-1 promoter activity in transient transfection assays in H4-II-E cells. In addition to the GRE, three accessory regulatory sites [a putative hepatocyte nuclear factor-1 (HNF-1) site (nt -62/-50), an insulin-response element (nt -108/-99), and an upstream site (nt -252/-236)] are involved in dexamethasone stimulation under some, but not all, circumstances. The present study begins to address the mechanism by which transcription factors bound to the putative HNF-1 site act synergistically with the glucocorticoid receptor (GR) bound to the GRE. In gel shift assays, HNF-1alpha and HNF-1beta in H4-II-E extracts bind to the palindromic HNF-1 site. Both half-sites are required. Overexpression of HNF-1beta enhances dexamethasone-stimulated promoter activity. Both the HNF-1 site and the GRE must be intact for stimulation to occur. By contrast, overexpression of HNF-1alpha does not enhance dexamethasone-stimulated promoter activity, although, as also observed with overexpression of HNF-1beta, it inhibits basal promoter activity. Thus, the synergistic effects of HNF-1beta and the GR on dexamethasone-stimulated promoter activity require that they are bound to the HNF-1 site and the GRE, respectively, and may involve protein-protein interactions between the transcription factors, or between them and the basal transcription machinery or a steroid receptor coactivator. Synergy between the ubiquitously expressed GR and HNF-1, which is developmentally regulated and expressed in a limited number of tissues, provides a possible mechanism for tissue- and development-specific regulation of glucocorticoid action.


Restoration of X-ray and etoposide resistance, Ku-end binding activity and V(D) J recombination to the Chinese hamster sxi-3 mutant by a hamster Ku86 cDNA.
Ku is a heterodimeric protein composed of 86 and 70 kDa subunits that binds preferentially to the double-stranded ends of DNA. Recent molecular characterization of ionizing-radiation sensitive (IRs) mutants belonging to the XRCC5 complementation group demonstrated the involvement of Ku in DNA double-strand break (DSB) repair and lymphoid V(D)J recombination. Here, we describe the isolation of a full-length hamster cDNA encoding the large subunit of the Ku heterodimer and demonstrate that the stable expression of this cDNA can functionally restore IR, Ku DNA end-binding activity and V(D)J recombination proficiency in the Chinese hamster IRs sxi-3 mutant. Moreover, we also demonstrate that sxi-3 cells are hypersensitive to etoposide, a DNA topoisomerase II inhibitor, and that resistance to this drug was restored by the Ku86 cDNA. These experiments suggest that a defect in the large subunit of the heterodimeric Ku protein is the sole factor responsible for the known defects of sxi-3 cells and our data of further support the role of Ku in DNA DSB repair and V(D)J recombination.


Stuttering prevalence among patients at risk for velopharyngeal inadequacy: a preliminary investigation.
The purpose of the present investigation was to provide preliminary information concerning the prevalence of stuttering among patients manifesting structural abnormalities of the velopharyngeal complex. Certain theoretical considerations suggested, a priori, that the prevalence of stuttering might be higher among these patients, although unsubstantiated clinical impressions indicated that the opposite was true. A retrospective study of 534 patients uncovered one individual whose speech was characterized by stuttering. This prevalence rate of 1.87 per 1,000 did not differ significantly from the 7 per 1,000 prevalence rate that would be expected in the general population. However, the lack of statistical significance may have resulted from the small sample size. Additional information from other craniofacial centers is needed to address this issue adequately. The theoretical implications of these initial findings are explored.


Modulation of n-Type Units in Bipolar Host Materials toward High-Performance Phosphorescent OLEDs.
9'-Pyridinyl-9'H-9,3':6',9″-tercarbazole (PyCz) is a bipolar host material in phosphorescent organic light-emitting diodes (PhOLEDs). A second n-type unit, either pyridine or diphenylphosphine dioxide (DPPO), is introduced onto the pyridine ring of PyCz at para- or metasite to design and prepare four novel "dual n-type unit bipolar host" materials m-BPyCz, p-BPyCz, m-POPyCz, and p-POPyCz. The incorporation of the second n-type unit pulls down the lowest unoccupied molecular orbitals and facilitates electron injection and transportation, resulting in better charge-balancing ability. As a result, these dual n-type unit bipolar hosts exhibit higher efficiencies and slower efficiency roll-off in their blue and green PhOLEDs. In particular, m-POPyCz containing a bulky DPPO as the second n-type unit with a metalinking possesses the best charge-balancing state and generates a maximum external quantum efficiency (ηext) of 27.0% (corresponding to a current efficiency of 51.9 cd A-1 and a power efficiency of 46.5 lm W-1) in its sky-blue device and still remained at a high ηext of 23.6% even at the practical brightness of 1000 cd m-2. These results clearly demonstrate that the "dual n-type unit bipolar hosts" with an optimized substitution position and steric effect is a new and effective type of host materials for high-performance OLEDs.


Missing Value Imputation of Time-Series Air-Quality Data via Deep Neural Networks.
To prevent severe air pollution, it is important to analyze time-series air quality data, but this is often challenging as the time-series data is usually partially missing, especially when it is collected from multiple locations simultaneously. To solve this problem, various deep-learning-based missing value imputation models have been proposed. However, often they are barely interpretable, which makes it difficult to analyze the imputed data. Thus, we propose a novel deep learning-based imputation model that achieves high interpretability as well as shows great performance in missing value imputation for spatio-temporal data. We verify the effectiveness of our method through quantitative and qualitative results on a publicly available air-quality dataset.


Effect of sequential pretreatment combinations on the composition and enzymatic hydrolysis of hazelnut shells.
Hazelnut shells, a high lignin containing biomass, were subjected to individual and sequential liquid hot water (LHW), alkaline (AP) and dilute acid pretreatments (DAP). Among the single pretreatments, LHW demonstrated the highest cellulose recovery of 98.1%, DAP resulted in the highest hemicellulose solubilization of 56.0%, and AP of the highest lignin removal of 49.6%. Employing two-step pretreatment on hazelnut shells, in general, demonstrated an enhanced action of the second pretreatment; therefore, the sequence of the pretreatment methods had a significant impact on both substrate characteristics and enzymatic hydrolysis efficiency of biomass. In terms of delignification, AP-LHW achieved 60.7% lignin removal, while LHW-DAP showed the highest hemicellulose removal of 93.8% and DAP-LHW resulted in the highest cellulose recovery of 94.0%. Structural properties of raw and pretreated hazelnut shells were observed by FTIR. The maximum glucose recovery of 54.9% was observed in DAP-LHW pretreated samples. For this pretreatment combination, almost 1.8 MJ total energy was required to recover 10.2 g glucose. The findings indicated that complete removal of the physical barrier of lignin and hemicellulose might not be essential; partial relocation of lignin and alteration of cellulose structure may also be efficient in increasing the sugar recovery from the lignocellulosic biomass.


Trichostatin A, a histone deacetylase inhibitor, reduces lesion growth and hyperalgesia in experimentally induced endometriosis in mice.
The aim of this study was to evaluate the effect of trichostatin A (TSA) in a mouse model of endometriosis on serum tumour necrosis factor alpha (TNFalpha) levels, hotplate latency, lesion size and immunoreactivity to Trpv1, Pkcepsilon and Pgp9.5. We used 30 adult female mice, and endometriosis was induced by auto-transplanting pieces of uterus (ENDO) or fat (SHAM) to peritoneum in lower parts of the abdominal and pelvic cavity. Two weeks later, the ENDO group was further divided into two groups randomly: one received TSA treatments and the other received injections of dimethyl sulfoxide, as did the SHAM mice. Four weeks later, all mice were sacrificed. Response latency in hotplate test and serum TNFalpha levels were measured before the surgery, and before and after the treatment, along with the average lesion size and the immunoreactivity to Trpv1, Pkcepsilon and Pgp9.5, in both eutopic and ectopic endometrium and vaginal tissue. We found that mice receiving TSA had a significantly reduced average lesion size as compared with untreated mice, as well as a significant improvement in response to a noxious thermal stimulus. They also had a significantly lower immunoreactivity to Trpv1 in eutopic endometrium, to Pkcepsilon in ectopic endometrium and to Pgp9.5 in vagina. Endometriosis causes increased central sensitivity to noxious stimuli. Treatment with TSA significantly reduces lesion growth and may relieve pain symptoms in women with endometriosis, indicating that histone deacetylase inhibitors may be a promising therapeutic agent.


A comparison of the inhibitory effects of somatostatin-14, -25, and -28 on motility of the guinea pig ileum.
A number of studies have suggested that somatostatin-14 (SS-14) and somatostatin-28 (SS-28) exhibit a similar spectrum of biological activities but have different potencies. In the present study the effects of SS-14, SS-28, and somatostatin-25 on electrically induced contractions of the guinea pig ileum have been compared. All three peptides exhibited equipotent inhibitory effects. Inhibition was obtained at a threshold concentration less than 10(-10) M, with maximal inhibition at 10(-7) M and IC50 values of 6.0-6.5 X 10(-10) M. The N-terminal 14 amino acid fragment of SS-28 had no effect either on motility, when added alone, or on the actions of SS-28, suggesting that this region of the molecule is not critical for biological activity.


Fine Tuning of Chlorophyll Spectra by Protein-Induced Ring Deformation.
The ability to tune the light-absorption properties of chlorophylls by their protein environment is the key to the robustness and high efficiency of photosynthetic light-harvesting proteins. Unfortunately, the intricacy of the natural complexes makes it very difficult to identify and isolate specific protein-pigment interactions that underlie the spectral-tuning mechanisms. Herein we identify and demonstrate the tuning mechanism of chlorophyll spectra in type II water-soluble chlorophyll binding proteins from Brassicaceae (WSCPs). By comparing the molecular structures of two natural WSCPs we correlate a shift in the chlorophyll red absorption band with deformation of its tetrapyrrole macrocycle that is induced by changing the position of a nearby tryptophan residue. We show by a set of reciprocal point mutations that this change accounts for up to 2/3 of the observed spectral shift between the two natural variants.


Age-determined severity of anti-myeloperoxidase autoantibody-mediated glomerulonephritis in mice.
Anti-neutrophil cytoplasmic antibody associated vasculitis (AAV) is a typical disease of the elderly. In AAV, there is an age-specific increase in disease incidence with age being a predictor of disease outcome. In this study, we aimed to determine the contribution of age to the development of AAV employing a mouse model of anti-myeloperoxidase (MPO) antibody-mediated glomerulonephritis. Anti-MPO IgG and lipopolysaccharide (LPS)-mediated glomerulonephritis was induced in 3- and 18-month-old C57Bl6 mice. Clinical and pathological parameters of disease severity, alterations in the immune system and kidney specific changes in these mice were evaluated. Eighteen-month-old mice developed increased disease severity upon injection of anti-MPO IgG/LPS compared with 3-month-old mice. This was evidenced by increased albuminuria, more extensive glomerular capillary necrosis and increased glomerular neutrophil accumulation. Glomerular crescent formation was mild in both young and old mice. Old mice displayed higher plasma interleukin-6 levels as well as higher proportions of circulating neutrophils and activated monocytes compared with young mice. In addition, renal mRNA levels of inflammatory genes and endothelial adhesion molecules were higher in 18-month-old mice compared with 3-month-old mice. In conclusion, our results indicate that aged mice develop more severe clinical and pathological disease upon induction of anti-MPO IgG/LPS-mediated glomerulonephritis. These findings may be attributed to age-related changes in the immune system as well as in the kidney itself.


Caries prevalence and salivary and microbial conditions in 88-year-old Swedish dentate people.
As part of a comprehensive investigation of 88-year-old people, caries prevalence, stimulated salivary secretion rate, buffer capacity, and the prevalence of lactobacilli and mutans streptococci were studied in a subsample of 92 dentate subjects. The mean number of remaining teeth was 14.1 +/- 7.3. The DMFT was 25.2 +/- 3.0, and DF surfaces 38.3 +/- 22.7. Root caries experience was found in 85% of the subjects, with a mean root caries index of 36.6 +/- 28.5%. The men had significantly higher mean values of salivary secretion rate (2.0 +/- 1.3 ml/min) than the women (1.1 +/- 0.6 ml/min) (p < 0.001). The mean final pH of buffer capacity was 6.3 +/- 1.3. High counts of lactobacilli (> 10(5)) and mutans streptococci (> 10(6)) were found in 49% and 55% of the subjects, respectively, of whom most were denture wearers. The mean number of total mutans streptococci was higher in persons harboring both Streptococcus mutans and S. sobrinus than in subjects with only S. mutans.


Effect of three levels of vitamin D intake in preterm infants receiving high mineral-containing milk.
Very low-birth weight (VLBW) infants fed high-calcium and high-phosphorus (10.74 and 6.93 mmol/MJ; 180 and 90 mg/100 kcal, respectively) infant formulas were randomized to one of three levels of vitamin D intake to approximate 200, 400, and 800 IU/day. Sixty-two infants completed the study (24 to 29 days), with actual mean daily vitamin D intakes of 161, 361, and 766 IU, respectively. Outcomes were not different by group: gains in body weight, length and head circumference, serum calcium, magnesium, phosphorus, alkaline phosphatase, osteocalcin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and urine calcium:creatinine and magnesium:creatinine ratios. There were no radiographic fractures and/or rickets. A subset of 19 infants was followed between 173 and 380 days to determine descriptively if there was any delayed effect of earlier manipulation of vitamin D intake. They were fed standard infant formulas with a vitamin D content of 400 to 420 IU/L. No significant differences were present among the three groups, and data were combined. Serum 25-hydroxyvitamin D increased (p < 0.05), osteocalcin decreased (p < 0.05), and 1,25-dihydroxyvitamin D decreased (p = 0.06) at follow-up. Thus, for VLBZW infants fed high-calcium and high-phosphorus milk, an average daily vitamin D intake as low as 160 IU maintains normal and stable vitamin D status and normal physical growth, biochemical and hormonal indexes of bone mineral metabolism, and skeletal radiographs versus randomized infants receiving about 400 or 800 IU of vitamin D per day. On follow-up, vitamin D status remained normal for > or = 6 months while infants received < 400 IU of vitamin D per day.


Construction Path of Academic English Learning Environment in Colleges and Universities from the Perspective of Education Ecology.
This paper probes into the construction of academic English learning environment in colleges and universities from the perspective of educational ecology. This paper aims to construct academic English learning environment from the perspective of educational ecology by constructing a teaching community, organizing learning activities, using tool mediation, and optimizing the social and material environment. Understand the construction effect through a questionnaire survey. The results show that among the 1000 surveyed students' average satisfaction with the five elements of the learning environment, the teaching community is 4.6355, the learning community is 4.8963, the learning activity is 4.6987, the tool intermediary is 4.9258, and the social material environment is 4.2536, indicating that the students' satisfaction is high. From the perspective of educational ecology, the construction of academic English learning environment in colleges and universities can effectively optimize teaching and learning community and help to enhance students' motivation, cultivate learning interest, and improve practical ability. The construction effect is worthy of recognition.


[Anatomopathologic diagnosis of parasitosis in Congo].
In the part ten years, 9,650 anatomopathologic examinations have been carried out in the National Laboratory of Histopathology for Public Health in Brazzaville: 250 cases of parasitic infestation were diagnosed. In order of frequency were noted; 144 cases of bilharzia due to Schistosoma haematobium with 75 genito-urinary localisations and 51 appendicular cases, 31 cases of onchocercosis with a majority of subcutaneous nodules (17), 17 cases of digestive helminthiasis all locate in the ileo-caecal-appendix and discovered during systematic appendicular exploration, 13 cases of colitic or recto-sigmoidal amebiasis. These results point out 68 cases of appendicular parasitism. This should be in favour of more systematic anatomopathological examination of the ileo-caecal appendix both in tropical and in temperate regions.


Cognitive impairment and neuropsychiatric manifestations of neurobrucellosis.
This study aimed to reveal insight into the unclear areas of the diagnosis in neurobrucellosis and to decide the neuropsychiatric manifestations and cognitive impairment among patients with brucellosis. 82 patients with serologically confirmed brucellosis were included and divided into two groups according to the neuropsychiatric manifestations, the first group included 18 patients with neurobrucellosis and the second group included 64 patients with non-neurobrucellosis. Both groups were compared regarding the general symptoms and neurological symptoms and signs. Cognitive impairment in both groups was assessed by Montreal-Cognitive Assessment (MoCA), Wechsler Memory Scale-Revised (WMS-R), and forward and backward digital test. Also, depression and anxiety were assessed by Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). 18 (21.9%) patients were diagnosed as neurobrucellosis and 64 (78.1%) patients were diagnosed as non-neurobrucellosis. The mean age of the total patients was 34.91 ± 14.74, consisted of 45 males and 37. Most of the patients were living in rural areas 60 patients (74.4%). The most significantly higher neurological symptoms in neurobrucellosis patients were confusion and headache (P = 0.008 and P = 0.01, respectively). While the most significant higher neurological signs were loss of orientation (P = 0.009), muscle weakness (P = 0.04), neck rigidity (P < 0.05), pyramidal signs, and lost deep reflexes (P < 0.05). The neurobrucellosis patients had significantly impaired cognition in comparison with nonneurobrucellosis patients and more psychiatric signs like behavioral changes, anxiety, and depression (P < 0.001, P < 0.001, and P = 0.01, respectively). Patients with neuropsychiatric manifestations and cognitive impairment should be considered for neurobrucellosis and should receive proper therapy.


Characterization of the biophysical and motility properties of kinesin from the fungus Neurospora crassa.
Neurospora kinesin (Nkin) is a distant relative of the family of conventional kinesins, members of which have been identified in various animal species. As in its animal counterparts, Nkin most likely is an organelle motor. Because it is a functional homologue of the kinesin heavy chain of higher eukaryotes, its biophysical and motility properties were compared with those of other conventional kinesins. Purified Nkin behaves as a homodimeric complex composed of two subunits of a 105-kDa polypeptide. Based on its hydrodynamic properties (Stokes radius and sedimentation coefficient), Nkin is an elongated molecule, although it is more compact than its animal counterparts. A detailed comparison of the motility properties of Nkin with those of animal conventional kinesins reveals similarities and some intriguing differences. Nkin is less effective than other kinesins in the use of natural nucleoside triphosphates but responds to a selection of ATP analogues in a similar fashion as mammalian kinesin. Even in the presence of saturating concentrations of ATP, Nkin is significantly more sensitive to ADP or tripolyphosphate than other kinesins. Both the ATP-driven microtubule gliding activity and the microtubule-stimulated ATPase activity of Nkin obey Michaelis-Menten kinetics. Surprisingly, however, the Km values for both these activities are approximately an order of magnitude higher than those of other kinesins. Whether the low affinity for ATP suggested by these high Km values is related to the high rate of motility remains to be determined.


Fluoroscopic Percutaneous Fixation of Periacetabular Metastatic Cancer: The Tripod Technique.
There are an increasing number of patients who present with metastatic bone disease as the survival of patients with cancer improves in recent decades. The pelvis is the second most common site for skeletal metastases. Metastatic lesions in the pelvis can be largely divided into periacetabular lesions (Enneking zone II) and non-periacetabular lesions (zones I, III, and IV). Traditionally, patients with a symptomatic zone II lesion are treated with a cemented total hip arthroplasty (THA) using variations on the traditional Harrington method. These open surgeries are accompanied by many inherent risks. Both a prolonged recovery and wide range of potential complications may delay or interrupt the adjuvant radiation and systemic therapy. It was observed that the articular surface of the hip joint was often intact and that the femoral side was frequently not involved in these patients. A novel minimally invasive technique for hip joint preservation has recently been developed. Three large-bore cannulated screws are placed percutaneously under fluoroscopy in a tripod configuration to reinforce the mechanical axis of the acetabulum. Increased stability improves pain control and permits immediate weight bearing. When the disease progresses, this construct can be easily converted to a cemented THA using the tripod screws as rebar to support an acetabular cup, as part of a staged Harrington procedure. This approach is technically demanding. A detailed guide for the tripod technique should encompass indications, preoperative preparation, operating room settings, intraoperative fluoroscopic guidance, modifications, postoperative care, and subsequent conversion to a cemented THA, if needed.


Approximate solutions of two-way diffusion equations.
In this paper, a general and systematic scheme is formulated for finding approximate solutions of two-way diffusion equations. This expansion scheme is valid for arbitrary mean-free path and can be carried out to any desired accuracy. Its potential is demonstrated by constructing approximate solutions for two problems concerning the kinetics of an electron beam, and the accuracy is found to be very good even when only a few terms are included in the expansion. The approximate solutions found are compared with numerical calculations and previous analytical work in the literature.


The Sample Registration System: an innovative system for monitoring demographic dynamics.
"The International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) has been at the forefront of the development of longitudinal systems for demographic surveillance. The Demographic Surveillance System from the Matlab study area is internationally recognized as a unique source of accurate and complete demographic data for a large rural population within a developing setting. In this paper, an overview is presented of a second demographic surveillance system--the Sample Registration System (SRS)--which has been in operation for six years in two other areas of rural Bangladesh." Fertility and mortality rates for the period 1983-1988 are calculated from the SRS data.


Lung hyaluronan decreases during group B streptococcal pneumonia in neonatal piglets.
Neonatal Group B streptococcus (GBS) sepsis and pneumonia result in lung injury and remain a major cause of morbidity and mortality in the newborn. Increased lung hyaluronan (HA) content is an important component of the lung's early response to damage in diseases such as adult respiratory distress syndrome (ARDS), infant respiratory distress syndrome (IRDS), and bleomycin-induced fibrosis. It is known, however, that GBS virulence factors include specific secretory enzymes such as hyaluronidase, an enzyme which breaks down HA. We therefore hypothesized that in lobar GBS pneumonia, lung HA would be decreased compared with normal values, and that in lobar pneumonia with atelectasis, lung HA would be further decreased because of increased substrate availability. The right lower lobes (RLL) and left lower lobes (LLL) of anesthetized piglets 16 +/- 2 d old were each selectively inoculated with 1 x 10(9) colony-forming units (CFU) GBS via an endobronchial catheter (n = 7). The LLL was subsequently collapsed by endobronchial occlusion following 10 min of 100% O2. Control animals (n = 6) was anesthetized, instrumented, and ventilated without exposure to GBS. At 4 h, lungs were removed and HA extracted and assayed using a competitive inhibition assay. HA extracted from areas of lobar pneumonia was significantly decreased (27 +/- 6.6 micrograms/g wet lung, p < 0.005) when compared with control values of control piglets (51 +/- 19.6 micrograms/g wet lung). Atelectasis plus lobar pneumonia further decreased lung HA to 10 +/- 13.3 micrograms/g wet lung, p < 0.0001. We conclude that lobar GBS decreases lung HA and that this process is augmented by collapsed lung regions, and speculate that this departure from the usual early lung response to injury contributes to GBS invasion of lung parenchyma.


Treatment and follow-up of clinically nonfunctioning pituitary macroadenomas.
Although the majority of pituitary macroadenomas are clinically nonfunctioning, treatments as well as follow-up strategy for this condition lack evidence from randomized studies. We evaluated the evidence of treatment and follow-up strategies for clinically nonfunctioning adenomas. PubMed was searched for articles on nonfunctioning adenomas in November 2007, and references of selected articles were assessed for potentially relevant articles. All evidence for treatment and follow-up for nonfunctioning adenomas is based on observational studies. The most effective treatment is transsphenoidal surgery, indicated in patients with visual field defects. A wait-and-see approach may be considered in nonfunctioning macroadenomas not reaching to the optic chiasm. Some of these tumors ( approximately 10%) will show spontaneous regression, whereas in approximately 50% there will be progression within 5 yr observation. Postoperative radiotherapy should not be applied to all patients after surgery but can be considered in patients with large postoperative remnants of the tumor. During follow-up careful assessment and replacement of pituitary insufficiencies should be performed. Magnetic resonance imaging is advised with intervals of 1-3 yr and evaluation of visual fields when appropriate. Recurrence rates are reported to be 6-46% after transsphenoidal surgery, whereas after postoperative radiotherapy, recurrence rates of 0-36% are reported. Long-term sequelae of nonfunctioning macroadenomas are hypopituitarism, persistent visual field defects, and decreased quality of life. Whether nonfunctioning macroadenomas are associated with an increased mortality is still a matter of debate. Clinically nonfunctioning pituitary macroadenomas, although benign in nature, need individualized treatment and lifelong radiological and endocrinological follow-up.


Efficient and modular CRISPR-Cas9 vector system for Physcomitrella patens.
CRISPR-Cas9 has been shown to be a valuable tool in recent years, allowing researchers to precisely edit the genome using an RNA-guided nuclease to initiate double-strand breaks. Until recently, classical RAD51-mediated homologous recombination has been a powerful tool for gene targeting in the moss Physcomitrella patens. However, CRISPR-Cas9-mediated genome editing in P. patens was shown to be more efficient than traditional homologous recombination (Plant Biotechnology Journal, 15, 2017, 122). CRISPR-Cas9 provides the opportunity to efficiently edit the genome at multiple loci as well as integrate sequences at precise locations in the genome using a simple transient transformation. To fully take advantage of CRISPR-Cas9 genome editing in P. patens, here we describe the generation and use of a flexible and modular CRISPR-Cas9 vector system. Without the need for gene synthesis, this vector system enables editing of up to 12 loci simultaneously. Using this system, we generated multiple lines that had null alleles at four distant loci. We also found that targeting multiple sites within a single locus can produce larger deletions, but the success of this depends on individual protospacers. To take advantage of homology-directed repair, we developed modular vectors to rapidly generate DNA donor plasmids to efficiently introduce DNA sequences encoding for fluorescent proteins at the 5' and 3' ends of gene coding regions. With regard to homology-directed repair experiments, we found that if the protospacer sequence remains on the DNA donor plasmid, then Cas9 cleaves the plasmid target as well as the genomic target. This can reduce the efficiency of introducing sequences into the genome. Furthermore, to ensure the generation of a null allele near the Cas9 cleavage site, we generated a homology plasmid harboring a "stop codon cassette" with downstream near-effortless genotyping.


Changes of oxidative stress parameters in diabetic pregnancy.
The molecular aetiology of disturbed embryogenesis and other unfavourable outcomes in offspring of diabetic mothers is not fully understood. Experimental studies have suggested an involvement of radical oxygen species (ROS) in the teratological process. To investigate if maternal diabetes in humans is capable of inducing alterations in vascular oxidative stress parameters and whether such changes are associated with disturbances in foetal development. Seventy patients with pre-gestational diabetes (PGDM) were chosen for the study: 29 (41.4%) belonged to class B according to White, 15 (21.4%) to class C, 8 (11.4%) to class D, 3 (4.3%) to class F, 3 to class R and 12 (17.1%) to class F/R. In 20 (28.6%) patients from this group an unfavourable outcome was noted. All patients were subjected to intensive insulin therapy. Glycaemia was estimated by daily self-monitoring, and diurnal glucose profiles and glycated haemoglobin (HbA1c) concentrations were measured monthly. Oxidative stress was evaluated as changed superoxide dismutase, catalase and glutathione peroxidase activities as well as of malondialdehyde (MDA) and peroxides concentrations in maternal erythrocytes and blood serum. Prior to conception, the mean glycaemia in the group that had a planned pregnancy was 6.6mmol/l and HBA1c was 9.35%. Throughout the course of pregnancy, these parameters were maintained at a level of 6.7 mmol/l and 7.85%, respectively. The activity of all antioxidative enzymes was lower before than during pregnancy, and so was the concentration of MDA. The MDA concentrations were higher in patients with elevated glycaemia and with an unfavourable outcome. The investigated ROS, the glycaemia level, as well as the concentration of HBA1c did not show any significant differences between pregnancies with and without vascular complications. Patients with a favourable perinatal outcome presented a higher activity of antioxidant enzymes, than those with unfavourable outcome, throughout the whole course of pregnancy. The appearance of unfavourable perinatal outcomes in relation to parameters of oxidative stress was assessed by logistic regression. Both SOD and GPX activities, as well as peroxides' concentration, showed significant correlations (p < 0.005) with foetal complications. However, after mean glucose levels in the studied group were included into these analyses, this relationship was only evident with SOD and GPX activity (p < 0.0016). Oxidative stress is one of several important factors contributing to unfavourable outcome of human diabetic pregnancy.


Laparoscopic-Assisted Anorectoplasty for Rectovestibular Fistula: A Comparison Study with Anterior Sagittal Anorectoplasty.
Posterior or anterior sagittal anorectoplasty (ASARP) is the mainstream for correcting rectovestibular fistula (RVF). However, the intermediate RVF has the potential risk of wound complications when applying ASARP due to its high rectal pouch, long fistula tract, and difficulty separating the rectum and vagina. We developed laparoscopic-assisted anorectoplasty (LAARP) for surgical correction of RVF, which has acceptable preliminary outcomes. The purpose of this study is to evaluate the safety and efficacy of LAARP in comparison with ASARP for patients with RVF. Twenty-five patients with RVF who underwent LAARP between October 2017 and December 2020 were retrospectively reviewed. The outcomes were compared with 43 patients who underwent ASARP between April 2015 and August 2018. The age, weight at operation, sacral ratio, operative time, and postoperative hospital stay were evaluated. The results were assessed for complications, perineum appearance, and bowel function. The two groups were comparable in terms of demographics. The median operative time of the LAARP group was significantly longer than that of the ASARP group (113 vs. 95 minutes; p = 0.015). The mean length of the resected rectum in the LAARP group was also longer than that in the ASARP group (6.75 ± 5.07 vs. 3.31 ± 3.06 cm; p = 0.001). Compared with the LAARP group, complications in the ASARP group were more frequent (4.0 vs. 27.9%, p = 0.036). No intraoperative or postoperative wound-related complications occurred in the LAARP group. However, in the ASARP group, one patient had an intraoperative vaginal injury and four had postoperative anastomosis-related complications. The incidence of redo operation in the ASARP group was significantly higher than that in the LAARP group (p = 0.000). Cosmetic satisfaction was higher in the LAARP group (96.0 vs. 76.7%; p < 0.05). In terms of voluntary bowel movement, soiling, and constipation, the LAARP group had similar results compare with the ASARP group. The LAARP technique has shown several unique strengths in treating intermediate type RVF, including lower risks of complications, and minimal muscular injury, with a comparable bowel function.


Material transfer recording.
A material transfer technique for image recording is being developed that uses a focused laser beam to transfer ink from a substrate to a recording medium. No other processing is required; the recording is formed and developed merely by transfer and is instantly available for readout. This article relates some of the observed phenomena associated with transfer recording, discusses several test procedures directed toward the establishment of writing rate capabilities, presents the available test data, and offers suggested physical models to explain the observed transfer action.


The use of Tc-99m MDP bone scanning in the study of vascularized bone implants: concise communication.
The extent to which the nutrient artery alone is capable of maintaining bone growth in the immature animal was studied by excision and reimplantation of the upper tibia in two groups of puppies. In one group the reimplant was totally devascularized, and in a second group attempts were made to preserve the nutrient vessels to the reimplant. Technetium-99m methylene diphosphonate (Tc-99m MDP) was used to assess the effectiveness with which the nutrient circulation was maintained. With one exception the Tc-99m MDP scans proved to be reliable in indicating the potential for continued growth after reimplantation. It was found that the nutrient artery alone is capable of maintaining longitudinal bone growth in metaphyseal reimplants in immature animals. Complete devascularization results in cessation of growth. The Tc-99m MDP bone scan should prove of critical importance in the assessment of free vascularized transplants of immature bone.


Employment freeze management: an approach to attaining retrenchment goals.
This article describes a management philosophy for retrenchment and down-sizing within a major health care institution. The author focuses on an unique approach for reducing staff to attain retrenchment goals in light of ever decreasing operating budgets, increased cost containment and accountability, and increased demands for productivity enhancement and service in a competitive customer-oriented health care market.


Haemodynamic effects of change in position and respiration mode during a standard halothane anaesthesia in ponies.
The effects of change in position and respiration modes were studied in 5 experimental ponies during a standard halothane anaesthesia. A marked cardiovascular depression (decrease in mean arterial blood pressure, cardiac output, stroke volume and left ventricle work) occurred in recumbent, spontaneously breathing ponies. No significant differences were found between right and left lateral recumbency. The most pronounced cardiovascular depression was observed in the dorsal position. Sternal recumbency appeared to be slightly beneficial (higher systemic blood pressure and arterial oxygenation). Peripheral resistance tended to decrease in the lateral positions (peripheral vasodilatation) but increased slightly in dorsally recumbent ponies. The mean pulmonary artery pressure decreased significantly in the dorsal position. Pulmonary resistance increased slightly in the laterally and the sternally positioned ponies, suggesting a pulmonary vasoconstriction. On the other hand, pulmonary resistance decreased in dorsal recumbency. Arterial oxygenation decreased progressively during anaesthesia but remained always above standing control values. Hypoventilation (increase in arterial carbon dioxide to +/- 60 mm Hg) was observed in all positions. Controlled intermittent positive pressure ventilation (I.P.P.V.) induced a further decrease of all cardiovascular parameters although no significant differences in cardiac indexes were found regarding the spontaneous breathing protocol. In ventilated ponies the greatest cardiovascular depression was again observed in dorsal recumbency. Peripheral resistance increased slightly in the sternally positioned ponies. A gradual time-dependent increase in pulmonary resistance was observed. Apparently, the arterial oxygenation improved slightly in all positions (especially the sternal posture) when I.P.P.V. was applied.


Atrophic rhinitis caused by Pasteurella multocida type D: morphometric analysis.
In order to study the distribution and the extent of atrophy caused by Pasteurella multocida in the nasal conchae, experimental piglets were injected intramuscularly at seven days of age with either two or four 50% mouse lethal doses per kg body weight of P. multocida type D dermonecrotoxin. Experimental and control piglets were killed four, six and ten days postinjection. Serial transverse paraffin embedded sections of the noses were cut throughout the entire length of the nasal conchae. The area of the nasal ventral conchae was measured and the morphometric index of the nasal cavity was calculated. It was observed that P. multocida type D dermonecrotoxin induced severe atrophy of the nasal ventral conchae. This atrophy was present along the entire conchae. However, it was most severe at the level of the first and second premolar teeth.


Antibodies against acetaldehyde-modified epitopes: an elevated IgA response in alcoholics.
Several recent reports have shown that antibodies reactive with acetaldehyde (AcH)-modified epitopes are present in alcoholics. However, similar antibodies have also been found in patients with non-alcoholic liver disease and control subjects. In each of these studies total immunoglobulin binding to the AcH-modified proteins was measured, with no attempt being made to identify the classes of immunoglobulin involved. In the present study we employed an enzyme-linked immunosorbent assay (ELISA) to assess the classes of immunoglobulin involved in this response, using plasma samples from 97 alcoholics with varying degrees of liver disease, 35 patients with non-alcoholic liver disease and 33 control subjects. All three groups exhibited a large IgM response and a negligible IgG response. However, the alcoholics exhibited a significantly higher IgA response than either of the other groups. This suggests that the measurement of the IgA response to AcH-modified epitopes may be a specific marker of ethanol abuse.


Development of a Decision-Aid Form (DAF) for the stratification of care in a French comprehensive cancer center, a tool to support identification of care goals.
For cancer patients, life-threatening complications may be difficult to anticipate, which can lead to complex medical decision-making processes. Since 2015, the Gustave Roussy Cancer Center has used a Decision-Aid Form (DAF), which contains an estimated gradation of care in cases where patients' conditions worsen. In this study, we assessed the acceptability of the DAF and the predictive value of the proposed stratification of care with regard to care delivered and patient's outcomes. During a 5-month period, all patients who had been transferred from Site 1 to Site 2 of the hospital were prospectively included. A DAF was completed for 89.3% of the 206 patients included. Planned stratification of care was indicated in nearly all cases. The involvement of the palliative care team was indicated in only 29% of the DAF. The value of the WHO/ECOG Performance Status (PS) was limited. Finally, the field "information for patients and relatives" was infrequently completed. Although the possibility of transfer to the Intensive Care Unit was proposed for two-thirds of the patients, 76% of the 35 patients experiencing an acute event received only medical or palliative care. Overall, the level of therapeutic commitment suggested by the DAF was most often revised towards less aggressive care. The results of our study suggest that implementing an advanced stratification record is possible in a French cultural setting. To achieve complete cultural acceptance, our large integrated institutional program continues to play a key role in anticipating intent, tracing and sharing information with patients and their relatives.


A force for transformation.
Practice development resources are vital for nurse leaders wishing to bring changes in attitudes, practice and workplace culture to improve the patient experience. The Foundation of Nursing Studies (FoNS) provides nurse leaders with the support and resources to make such changes and this article sets out the main points of its new strategy for 2011/14.


Occurrence of Salmonella in Porcine Liver in Northern Ireland.
Pork livers from four pork processing plants in Northern Ireland were studied to assess their contamination by salmonellae. Additionally, aerobic plate counts (APC) and counts of Enterobacteriaceae were made. One hundred twenty livers were sampled immediately after evisceration and 110 sampled after being chilled overnight in the commercial premises. No salmonellae were detected. Geometric mean values for the APC were 1.6 × 104 and 3.1 × 105 CFU/g for fresh and chilled livers, respectively. Homologous geometric mean values for Enterobacteriaceae were 7.9 × 102 and 6.0 × 102 CFU/g, respectively.


CASTIN: a system for comprehensive analysis of cancer-stromal interactome.
Cancer microenvironment plays a vital role in cancer development and progression, and cancer-stromal interactions have been recognized as important targets for cancer therapy. However, identifying relevant and druggable cancer-stromal interactions is challenging due to the lack of quantitative methods to analyze whole cancer-stromal interactome. We present CASTIN (CAncer-STromal INteractome analysis), a novel framework for the evaluation of cancer-stromal interactome from RNA-Seq data using cancer xenograft models. For each ligand-receptor interaction which is derived from curated protein-protein interaction database, CASTIN summarizes gene expression profiles of cancer and stroma into three evaluation indices. These indices provide quantitative evaluation and comprehensive visualization of interactome, and thus enable to identify critical cancer-microenvironment interactions, which would be potential drug targets. We applied CASTIN to the dataset of pancreas ductal adenocarcinoma, and successfully characterized the individual cancer in terms of cancer-stromal relationships, and identified both well-known and less-characterized druggable interactions. CASTIN provides comprehensive view of cancer-stromal interactome and is useful to identify critical interactions which may serve as potential drug targets in cancer-microenvironment. CASTIN is available at: http://github.com/tmd-gpat/CASTIN .


Relationship between stress and pain in work-related upper extremity disorders: the hidden role of chronic multisymptom illnesses.
Pain and fatigue are commonly associated with work-related upper extremity disorders. Occasionally these symptoms persist beyond a reasonable healing period. One potential explanation for prolonged symptom expression is the concurrent development of a stress-mediated illness or CMI (Chronic Multi-Symptom Illness). In such a scenario, the chronic regional pain and other symptoms that the individual is experiencing would be attributable to the CMI rather than to tissue damage or a biomechanical dysfunction of the upper-extremity. This article critically reviews the case definitions of the new class of CMI disorders and evaluates the existing evidence supporting centrally mediated physiological changes (e.g., sensory hypervigilance, dysautonomia) that manifest as symptoms of pain and fatigue in some individuals experiencing chronic stressors. While explanations for prolonged pain and fatigue have historically focused on mechanisms involving peripheral pathology or psychiatric explanations, ample evidences support the role of altered Central Nervous System function in accounting for symptom manifestation in CMI. A model is presented that unites seemingly disparate findings across numerous investigations and provides a framework for understanding how genetics, triggering events, stressors, and early life events can affect CNS activity. Resultant symptom expression (e.g., pain and fatigue) from central dysregulation would be expected to occur in a subset of individuals in the population, including a subset of individuals with work-related upper extremity disorders. Thus when symptoms such as pain and fatigue persist beyond a reasonable period, consideration of CMI and associated assessment and interventions focused on central mechanisms may be worthwhile.


c-Yes response to growth factor activation.
Transmembrane receptors link the extracellular environment to the internal control elements of the cell. This signaling influences cell division, differentiation, survival, motility, adhesion, spreading and vesicular transport. Central to this signaling is the Src family of nonreceptor tyrosine kinases. The most studied kinase of this nine member family, c-Src, shares a similar structure, as well as a similar expression pattern to that of another Src family protein, c-Yes. Despite high conservation in sequence, molecular studies demonstrate that the functional domains of these kinases can contribute to specificity in signaling. At the cellular level, analysis of tight junction formation also serves as a model to differentiate c-Yes and c-Src signaling. Results suggest that c-Yes promotes formation of the tight junction by phosphorylating occludin, while c-Src signaling downregulates occludin formation in a Raf-1 dependent manner. In addition, pp62c-Yes knockout mice exhibit a specific physiological function phenotype that is distinct from c-src-/- mice. In these studies, c-yes-/- mice exhibit decreased transcytosis of pIgA from the blood to the bile, while c-src-/- mice exhibit deficits in osteoclasts function and bone resorption. Of particular interest in this review are receptor signals that specifically influence the actions of c-Yes. Growth factors that influence many Src family proteins include the PDGF-R, CSF-1 receptor and others. Since these receptors interact with various Src-family kinases, it is predicted that specific signaling is generated by differential recruitment to the cell membrane and/or differentiated interactions with substrates and binding partners. This review provides an overview of c-Yes interactions with specific receptor signaling pathways and how this interaction potentially influences the known physiological roles of c-Yes.


Clinical implications of a history of stealing on psychiatric disorders in children and adolescents.
To our knowledge, no case-control study has investigated the relationships between stealing, clinical implications, and psychiatric diagnosis among child and adolescent psychiatric patients with or without a history of stealing. Thus, the associations between child and adolescent psychiatric disorders and a history of stealing remain unclear. Therefore, the aim of the present study was to evaluate the relationships between stealing, clinical implications, and psychiatric diagnosis among child and adolescent psychiatric patients with or without a history of stealing. In this retrospective case-control study, the proportions of clinical implications among child and adolescent psychiatric patients with and without a history of stealing were compared. Data regarding age, sex, primary diagnosis, junior high school student or not, both father and mother are the caregivers or not, family history, abuse history, school refusal, depressive state, and obsessive-compulsive symptoms were retrieved from medical records. Participants consisted of Japanese junior high school students and younger patients (maximum age, 15 years) at the first consultation. All patients were examined and diagnosed by psychiatrists according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, or the Fifth Edition. Stealing was reported by the patients or caregivers to the psychiatrist, or the psychiatrist had inquired about a history of stealing at the first consultation. Among 1972 patients who consulted the clinic, at the first consultation, 56 (2.84%) had a history of stealing (cases), and 1916 (97.16%) did not (controls). Multivariate logistic regression analyses revealed that the proportions of males, junior high school students, abuse history, autism spectrum disorder (ASD), and conduct disorder were significantly higher, and the proportions of adjustment disorders and school refusal were significantly lower in cases than in controls. The multivariate adjusted odds ratio increased further when the two factors were considered together, such as ASD with abuse history and attention deficit-hyperactivity disorder (ADHD) with abuse history. Children with a history of stealing were more likely to be diagnosed with ASD or ADHD with abuse history. Child and adolescent psychiatric outpatients with a history of stealing were more likely to be older and male. Our study should be understood without prejudice because this study is reporting associations, not causality. Therefore, a prospective study to investigate causality among ADHD, ASD, abuse history, and stealing is needed. If ADHD and ASD with abuse history can be correlated to a history of stealing, interventions can be more effective by understanding the mechanisms underlying these connections.


Metabolism of human pluripotent stem cells and differentiated cells for regenerative therapy: a focus on cardiomyocytes.
Pluripotent stem cells (PSCs) exhibit promising application in regenerative therapy, drug discovery, and disease modeling. While several protocols for differentiating somatic cells from PSCs exist, their use is limited by contamination of residual undifferentiated PSCs and immaturity of differentiated somatic cells.The metabolism of PSCs differs greatly from that of somatic cells, and a distinct feature is required to sustain the distinct properties of PSCs. To date, several studies have reported on the importance of metabolism in PSCs and their derivative cells. Here, we detail advancements in the field, with a focus on cardiac regenerative therapy.


Clinical experience with intracoronary tissue plasminogen activator: results of a multicenter registry. Intracoronary t-PA Registry Investigators.
Clinical experience with the use of intracoronary tissue plasminogen activator (t-PA) is limited. We therefore undertook this study to document current clinical usage of intracoronary t-PA during a 2-yr period in a multicenter registry. Intracoronary t-PA was utilized on 206 occasions in 198 patients (154 men and 44 women; mean age, 59 +/- 12 yr). The mean dose of intracoronary t-PA was 31 +/- 15 mg. Indications for use included acute myocardial infarction (MI) (n = 83), preexisting thrombus with (n = 49) or without (n = 41) percutaneous transluminal coronary angioplasty (PTCA), unstable angina (n = 14), abrupt vessel closure (n = 11), and post-PTCA "clean-up" (n = 8). The Thrombolysis in Myocardial Infarction (TIMI Phase I) criteria were used to assess perfusion and degree of thrombus formation. Overall, the mean TIMI flow grade increased from 1.2 +/- 1.1 before treatment to 2.3 +/- 1.0 after treatment (P < 0.0001); the mean TIMI thrombus grade decreased from 3.2 +/- 1.0 before treatment to 1.6 +/- 1.4 after treatment (P < 0.0001). Complications included bleeding (9.2%), MI (17.6%), need for coronary artery bypass grafting (CABG) (9.2%), need for repeat PTCA/atherectomy/stents (4.9%), and ventricular fibrillation (1.7%, all associated with opening totally occluded vessels). There were 14 subsequent in-hospital deaths: 13 of the patients who died had originally presented with MI; the other had experienced abrupt vessel closure during a PTCA procedure. Intracoronary t-PA appears to be effective in improving distal flow and decreasing thrombus burden; however, intracoronary delivery of t-PA has associated risks.(ABSTRACT TRUNCATED AT 250 WORDS)


Closed reduction guided by dynamic ultrasound in late-diagnosed hip dislocation.
The potential for dynamic ultrasound in the primary treatment of late-diagnosed congenital hip dislocation was assessed in 21 patients. The study showed that dynamic ultrasound was a useful technique in guiding closed reduction and for assessing the effects of positioning on the stability of children less than 2 years of age. In older children, however, this assessment was less reliable. Although dynamic ultrasound evaluation can be done without sedation, general anesthesia provides optimal conditions for such evaluation. The benefits of ultrasound are that it does not involve exposure to radiation, that the need for elaborate radiographic methods like arthrography and computed tomography is reduced, and that closed reduction is more reliably achieved when guided by direct visualization. Because a thorough knowledge of the dynamics of hip dislocation is essential, the ultrasound evaluation should be performed by orthopedic surgeons.


Phase fluctuation cancellation of anonymous microwave signal transmission in passive systems.
A phase fluctuation cancellation approach for anonymous microwave signal transmission over fiber link is proposed and demonstrated. Unlike most previous schemes that used for active systems, our proposal is suitable for passive systems by utilizing the optical signal feedback and electrical signal phase-locking. Experimental results show that phase drifts of 7.7-ps, 54-ps and 96-ps (RMS value) for 2.45-GHz signals could be reduced to 3.1-ps, 3.8-ps and 8.5-ps after 1-km, 10-km and 25-km SMF transmission over an eight-hour period, respectively. Overall system performance is limited by the coherent Rayleigh noise and could be further optimized.


A Sensitive Aptasensor Based on a Hemin/G-Quadruplex-Assisted Signal Amplification Strategy for Electrochemical Detection of Gastric Cancer Exosomes.
Emerging evidence indicates that exosomes derived from gastric cancer cells enhance tumor migration and invasion through the modulation of the tumor microenvironment. However, it remains a major problem to detect cancer-specific exosomes due to technical and biological challenges. Most of the methods reported could not achieve efficient detection of tumor-derived exosomes in the background of normal exosomes. Herein, a label-free electrochemical aptasensor is presented for specific detection of gastric cancer exosomes. This platform contains an anti-CD63 antibody modified gold electrode and a gastric cancer exosome specific aptamer. The aptamer is linked to a primer sequence that is complementary to a G-quadruplex circular template. The presence of target exosomes could trigger rolling circle amplification and produce multiple G-quadruplex units. This horseradish peroxidase mimicking DNAzyme could catalyze the reduction of H2 O2 and generate electrochemical signals. This aptasensor exhibits high selectivity and sensitivity toward gastric cancer exosomes with a detection limit of 9.54 × 102 mL-1 and a linear response range from 4.8 × 103 to 4.8 × 106 exosomes per milliliter. Therefore, this electrochemical aptasensor is expected to become a useful tool for the early diagnosis of gastric cancer.


Epitope mapping of the Syrian hamster prion protein utilizing chimeric and mutant genes in a vaccinia virus expression system.
The cellular prion protein (PrPc) is a host-encoded sialoglycoprotein bound to the external surface of the cell membrane by a glycosyl phosphatidylinositol anchor. A posttranslationally modified PrP isoform (PrPSc) is a component of the infectious particle causing scrapie and the other prion diseases. mAb have been raised against the protease-resistant core of Syrian hamster (SHa) PrPSc designated PrP 27-30. To map the epitopes within PrP reacting to these antibodies, we have expressed wild-type, chimeric mouse (Mo)/SHa and mutant MoPrP genes using recombinant vaccinia virus systems. The fidelity of the expression of recombinant PrPC was examined using vaccinia viruses expressing SHa-PrPC. It is full length, possesses Asn-linked carbohydrates and is attached to the external surface of the cell membrane by a glycosyl phosphatidylinositol anchor that is sensitive to cleavage by phosphatidylinositol-specific phospholipase C. We have tested 18 mAb for their ability to bind to chimeric prion proteins on immunoblots. Three distinct epitopes were identified that mapped to amino acid differences between SHa and MoPrP sequences. The first epitope, recognized by three of the antibodies tested, was defined by methionines at amino acids 108 and 111 in the mouse protein. The second epitope was dependent upon the presence of asparagines at positions 154 and 174 in MoPrP and was recognized by four of the antibodies tested. The third epitope mapped to a single amino acid substitution at residue 138 in MoPrP. mAb raised against SHaPrP 27-30 specific for this epitope are able to bind MoPrPC which has a single amino acid change (Ile to Met) at position 138. Eleven of the 18 antibodies tested mapped to this immunodominant epitope. It is located within a postulated amphipathic helix, a structure associated with immunodominant Ag. Inasmuch as PrPC, in its native form on the cell surface, is detected by the mAb 13A5 (a prototypic antibody of the immunodominant third epitope class), it is likely that this epitope is accessible in the native conformation of this protein.


The current status of syphilis prevention and control in Jiangsu province, China: A cross-sectional study.
To analyze the midterm evaluation data from the National Syphilis Prevention and Control Plan (2010-2020) and evaluate the current status of syphilis prevention and control in Jiangsu province, China. We collected data via (1) field surveys conducted in 2015 and (2) data recorded in existing syphilis surveillance systems. We conducted descriptive statistical analysis to evaluate the current landscape of syphilis control initiatives and their potential effect in syphilis control. The incidence of all cases of syphilis decreased from 2010 (32.3 per 100,000) to 2015 (30.1 per 100,000), with an annual growth of -1.17% (x2trend = -7.52, P<0.001) in Jiangsu province. The incidence of primary and secondary syphilis and congenital syphilis both decreased significantly from 2010 to 2015. The average awareness rate of syphilis knowledge among professional personnel was 95.4% (3781/3963). Rural residents had the lowest awareness rate (83.5%, 1875/2245) and commercial sex workers had the highest awareness rate (92.1%, 7804/8474) in 2015. Only 47.8% (33908/70894) of patients received provider-initiated syphilis counseling and testing (PISTC) services in sexually transmitted disease (STD) clinics, but 94.5% (87927/93020) of all syphilis patients received free testing for syphilis. Overall, 97.2% (9378/9648) of syphilis reported cases of syphilis at medical institutions were confirmed to be accurate, and 92.2% (5850/6345) of patients diagnosed with syphilis at medical institutions received treatment with penicillin. The syphilis incidence rate in Jiangsu has decreased in recent years, but remains at a high level. It is essential to promote PISTC services to improve knowledge of syphilis and rates of testing and treatment in Jiangsu province.


Expression pattern of CDK12 protein in gastric cancer and its positive correlation with CD8+ cell density and CCL12 expression.
Background: The aims of this study were to investigate the expression pattern of CDK12 protein in gastric cancer, and to analyze the correlations of CDK12 expression between CD8+ cell density and CCL12 expression. Methods: Eighty-six paired tumor and non-tumor samples were collected from patients who underwent radical surgery and had pathological confirmed gastric adenocarcinoma. Immunohistochemistry was used to assess CDK12 expression and CD8+ cell density. Expression of CDK12 and CCL21 mRNA was detected by quantitative reverse transcription-polymerase chain reaction. Results: CDK12 expression in gastric tumor tissues was significantly higher than it in paired non-tumor tissues (P<0.001). High expression of CDK12 was identified in 43 cases (50%), and it was significantly correlated with Lauren's classification (diffuse type) and number of metastatic lymph nodes (≥15). High CDK12 protein level indicated a relative poorer overall survival than patients with CKD12 low expression, while it was not identified as an independent prognostic factor. Median number of CD8+ cells in tumor tissues was 51 (range: 0-292). Number of CD8+ cells was positively correlated with CDK12 expression score in tumor tissues (r=0.243, P=0.024). Positive correlation was also found between CDK12 and CCL21 mRNA expression (r=0.419, P=0.017). Conclusion: High CDK12 expression was detected in gastric cancer which was correlated with malignant phenotypes and worse outcome. Positive correlations of CD8+ cell number and CCL21 mRNA expression with CDK12 level were identified.


RabbitMash: accelerating hash-based genome analysis on modern multi-core architectures.
Mash is a popular hash-based genome analysis toolkit with applications to important downstream analyses tasks such as clustering and assembly. However, Mash is currently not able to fully exploit the capabilities of modern multi-core architectures, which in turn leads to high runtimes for large-scale genomic datasets. We present RabbitMash, an efficient highly optimized implementation of Mash which can take full advantage of modern hardware including multi-threading, vectorization and fast I/O. We show that our approach achieves speedups of at least 1.3, 9.8, 8.5 and 4.4 compared to Mash for the operations sketch, dist, triangle and screen, respectively. Furthermore, RabbitMash is able to compute the all-versus-all distances of 100 321 genomes in <5 min on a 40-core workstation while Mash requires over 40 min. RabbitMash is available at https://github.com/ZekunYin/RabbitMash. Supplementary data are available at Bioinformatics online.


Improving Subnational Input-Output Analyses Using Regional Trade Data: A Case-Study and Comparison.
Environmentally extended input-output analysis (EE-IO) is widely used for evaluating environmental performance (i.e., footprint) at a national level. Many studies have extended their analyses to the subnational level to guide regional policies. One promising method is to embed nationally disaggregated input-output tables, e.g., nesting a provincial level table, into a global multiregional input-output table. However, a widely used approach to environmental assessment generally disaggregates the trade structure at the national level to the provincial level using the same proportions (proportionality assumption). This means that the subnational spatial heterogeneities on international trade are not fully captured. By calculating the Chinese provincial material footprint (MF) based on two approaches-the proportionality assumption and the actual customs statistics-in the same framework, we evaluate the quantitative differences when the proportionality assumption is addressed. By computing MF for 23 aggregated resources across 30 Chinese provinces, our results show for countries with large material flows like China, estimating subnational-level international trade by proportionality assumption may lead to significant differences in material flows at both the disaggregated and aggregated levels. An important follow-up question is whether these differences are also relevant for other footprints.


Adaptive immune response of Vgamma2Vdelta2+ T cells during mycobacterial infections.
To examine the role of T cell receptor (TCR) in gammadelta T cells in adaptive immunity, a macaque model was used to follow Vgamma2Vdelta2+ T cell responses to mycobacterial infections. These phosphoantigen-specific gammadelta T cells displayed major expansion during Mycobacterium bovis Bacille Calmette-Guérin (BCG) infection and a clear memory-type response after BCG reinfection. Primary and recall expansions of Vgamma2Vdelta2+ T cells were also seen during Mycobacterium tuberculosis infection of naive and BCG-vaccinated macaques, respectively. This capacity to rapidly expand coincided with a clearance of BCG bacteremia and immunity to fatal tuberculosis in BCG-vaccinated macaques. Thus, Vgamma2Vdelta2+ T cells may contribute to adaptive immunity to mycobacterial infections.


The usefulness of appetite and energy intake-based algorithms to assess treatment effect of a bacterial infection: An observational prospective study.
The diagnosis of infectious diseases and the duration of antibiotic therapies are generally based on empirical rules. Studies implicate that the use biological markers can be used as a reliable method to shorten antibiotic therapies. The return of appetite is a clinical aspect of recovery from an infection that may be used to guide antibiotic therapies. To compare changes in appetite and daily energy intake with changes in CRP-levels in patients recovering from an infection. Observational study using a consecutive sample of patients admitted to the unit for infectious diseases at a University Hospital in Sweden, February to April 2014. Energy intake, CRP-levels and appetite were recorded daily. Energy intake was calculated using estimated energy contents. Appetite was measured using a validated visual analogue scale. Changes in daily energy intakes, CRP-levels and appetite were analysed. 49 patients (51% men) were included in the analysis from the overall population of 256 patients. During the length of the stay (median 3 days) CRP-levels fell in 92% of the patients (p<0.001), daily energy intake increased in 73% (median intake +6381 kJ/day, p<0.001) and appetite increased in 55% of the patients (p = 0.181). VAS-estimations of appetite augmented in 55%, decreased in 41% and were equal in 5% of the patients (p = 0.181). There was a non-significant difference in the within-subject variances in daily energy intake between female and male patients but not in other subsets. We found a significantly increase in the daily energy intake but not in self-estimated appetite in patients recovering from an infection. We suggest measuring the daily energy intake as a complement to other biological and clinical markers among inpatients to assess treatment effect.


Elucidating the structure-activity relationships of the vasorelaxation and antioxidation properties of thionicotinic acid derivatives.
Nicotinic acid, known as vitamin B(3), is an effective lipid lowering drug and intense cutaneous vasodilator. This study reports the effect of 2-(1-adamantylthio)nicotinic acid (6) and its amide 7 and nitrile analog 8 on phenylephrine-induced contraction of rat thoracic aorta as well as antioxidative activity. It was found that the tested thionicotinic acid analogs 6-8 exerted maximal vasorelaxation in a dose-dependent manner, but their effects were less than acetylcholine (ACh)-induced nitric oxide (NO) vasorelaxation. The vasorelaxations were reduced, apparently, in both N(G)-nitro-L-arginine methyl ester (L-NAME) and indomethacin (INDO). Synergistic effects were observed in the presence of L-NAME plus INDO, leading to loss of vasorelaxation of both the ACh and the tested nicotinic acids. Complete loss of the vasorelaxation was noted under removal of endothelial cells. This infers that the vasorelaxations are mediated partially by endothelium-induced NO and prostacyclin. The thionicotinic acid analogs all exhibited antioxidant properties in both 2,2-diphenyl-1-picrylhydrazyl (DPPH) and superoxide dismutase (SOD) assays. Significantly, the thionicotinic acid 6 is the most potent vasorelaxant with ED(50) of 21.3 nM and is the most potent antioxidant (as discerned from DPPH assay). Molecular modeling was also used to provide mechanistic insights into the vasorelaxant and antioxidative activities. The findings reveal that the thionicotinic acid analogs are a novel class of vasorelaxant and antioxidant compounds which have potential to be further developed as promising therapeutics.


Hemophilia of orbit.
Hemophilic pseudotumor is an uncommon complication of factor VIII and IX deficiencies in the coagulation cascade and occurs in a wide spectrum of bones and soft tissues. We present a six-year-old boy with hemophilic pseudotumor localized in the right orbit. He showed a favorable response to radiation therapy after unsuccessful treatment with factor VIII replacement therapy with no recurrence till eight months. Radiotherapy in the treatment of pseudotumors in hemophiliacs should be strongly considered, particularly in severely affected patients who do not respond to conservative therapy.


Initial Experience with Endoscopic Ultrasound.
Since its introduction in early 1990s, endoscopic ultrasound (EUS) has become integral to the diagnosis and staging of various luminal, extraluminal gastrointestinal (GI) and certain non-GI lesions. There is no data on EUS experience in Bangladesh. The aim of this paper is to evaluate the initial recent experience and clinical impact of EUS. All EUS procedures data were recorded prospectively from July 2013 to December 2014. These included patients' demographics, referral details, provisional diagnosis, management plan before and after EUS & indications of procedures. EUS-FNA data recorded included details regarding site, number of passes and histological diagnosis. Two hundred & four EUS procedures were carried out over one and half years. Male female ratio was 1.4:1, mean age was 46.4 ± 20 years. Of these procedures 148 (72.5%) were referrals from physicians and 56 (27.5%) were from surgeons. Most common indications were pancreatobiliary pathologies, esophageal & gastric pathologies. Pancreatobiliary lesions (n = 165, 80.9%) included patients with (A) Benign pathologies: Microliths in Gall baldder (n = 6), Gall stones (n = 12), Biliary ascarrisis (n = 22), Choledocholithiasis (n = 42), Acute Pancreatitis (n = 9), Chronic Pancreatitis (n = 15), Pancreatic pseudocysts(n = 4) (B) Malignant Pathologies : GB Carcinoma (n = 4), Cholangiocarcinoma (n = 29), Ca- pancreas (n = 9), Periampullary carcinoma (n = 12). Esophageal lesion was 9.3% (n = 19) of total procedures. Forty seven percent (n = 9) of EUS procedures on esophagus were for staging of esophageal malignancy, 10. 5% (n = 2) for restaging or recurrence after chemoradiation and 21% (n = 4) for submucosal lesions. Fifteen EUS procedures were carried out for gastric lesions, seven were for staging of gastric carcinoma, four were for assessment of submucosal lesions (e.g. GIST, lipoma or external compression), 02 for assessment of polyps and two for gastric ulcers.In clinical impact & outcome study, changes in diagnosis, management, avoidance of investigations and usefulness of EUS were evaluated. Diagnosis was changed in 34.4% (64/186) & management was changed in 45%(92/204). Additional investigation was avoided in 57.8% (118/204). This is the first report of Bangladesh experience of EUS to date. EUS is safe, accurate, cost effective & very useful tool for diagnosis and management of G.I. disorders.