Vaginal adenosis in a non-diethylstilbestrol-exposed 6-year-old patient.
Vaginal adenosis is rare, and it is defined as the presence of metaplastic cervical or endometrial epithelium within the vaginal wall. It is associated with in utero exposition to diethylstilbestrol and a high risk of vaginal carcinomas. A case of vaginal adenosis arising in a non-diethylstilbestrol-exposed 6-year-old patient is presented. Few cases have been described in children and adolescents, and since the withdrawal of diethylstilbestrol from the market, this condition is rarely described in the medical literature. However, it should be considered as a possible diagnosis in girls with persistent vaginal discharge.


Subcortical Brain Volumes Relate to Neurocognition in First-Episode Schizophrenia, Bipolar Disorder, Major Depression Disorder, and Healthy Controls.
To explore differences and similarities in relationships between subcortical structure volumes and neurocognition among the four subject groups, including first-episode schizophrenia (FES), bipolar disorder (BD), major depression disorder (MDD), and healthy controls (HCs). We presented findings from subcortical volumes and neurocognitive analyses of 244 subjects (109 patients with FES; 63 patients with BD, 30 patients with MDD, and 42 HCs). Using the FreeSurfer software, volumes of 16 selected subcortical structures were automatically segmented and analyzed for relationships with results from seven neurocognitive tests from the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) Cognitive Consensus Battery (MCCB). Larger left lateral ventricle volumes in FES and BD, reduced bilateral hippocampus and amygdala volumes in FES, and lower bilateral amygdala volumes in BD and MDD were presented compared with HCs, and both FES and BD had a lower bilateral amygdala volume than MDD; there were seven cognitive dimension, five cognitive dimension, and two cognitive dimension impairments in FES, BD, and MDD, respectively; significant relationships were found between subcortical volumes and neurocognition in FES and BD but not in MDD and HCs; besides age and years of education, some subcortical volumes can predict neurocognitive performances variance. The different degrees of subcortical volume lessening may contribute to the differences in cognitive impairment among the three psychiatric disorders.


Systemic signalling of environmental cues in Arabidopsis leaves.
Light intensity and atmospheric CO2 partial pressure are two environmental signals known to regulate stomatal numbers. It has previously been shown that if a mature Arabidopsis leaf is supplied with either elevated CO2 (750 ppm instead of ambient at 370 ppm) or reduced light levels (50 micromol m-2 s-1 instead of 250 micromol m-2 s-1), the young, developing leaves that are not receiving the treatment grow with a stomatal density as if they were exposed to the treatment. But the signal(s) that it is believed is generated in the mature leaves and transmitted to developing leaves are largely unknown. Photosynthetic rates of treated, mature Arabidopsis leaves increased in elevated CO2 and decreased when shaded, as would be expected. Similarly, the levels of sugars (glucose, fructose, and sucrose) in the treated mature leaves increased in elevated CO2 and decreased with shade treatment. The levels of sugar in developing leaves were also measured and it was found that they mirrored this result even though they were not receiving the shade or elevated CO2 treatment. To investigate the effect of these treatments on global gene expression patterns, transcriptomics analysis was carried out using Affymetrix, 22K, and ATH1 arrays. Total RNA was extracted from the developing leaves after the mature leaves had received either the ambient control treatment, the elevated CO2 treatment, or the shade treatment, or both elevated CO2 and shade treatments for 2, 4, 12, 24, 48, or 96 h. The experiment was replicated four times. Two other experiments were also conducted, one to compare and contrast gene expression in response to plants grown at elevated CO2 and the other to look at the effect of these treatments on the mature leaf. The data were analysed and 915 genes from the untreated, signalled leaves were identified as having expression levels affected by the shade treatment. These genes were then compared with those whose transcript abundance was affected by the shade treatment in the mature treated leaves (1181 genes) and with 220 putative 'stomatal signalling' genes previously identified from studies of the yoda mutant. The results of these experiments and how they relate to environmental signalling are discussed, as well as possible mechanisms for systemic signalling.


arrEYE: a customized platform for high-resolution copy number analysis of coding and noncoding regions of known and candidate retinal dystrophy genes and retinal noncoding RNAs.
Our goal was to design a customized microarray, arrEYE, for high-resolution copy number variant (CNV) analysis of known and candidate genes for inherited retinal dystrophy (iRD) and retina-expressed noncoding RNAs (ncRNAs). arrEYE contains probes for the full genomic region of 106 known iRD genes, including those implicated in retinitis pigmentosa (RP) (the most frequent iRD), cone-rod dystrophies, macular dystrophies, and an additional 60 candidate iRD genes and 196 ncRNAs. Eight CNVs in iRD genes identified by other techniques were used as positive controls. The test cohort consisted of 57 patients with autosomal dominant, X-linked, or simplex RP. In an RP patient, a novel heterozygous deletion of exons 7 and 8 of the HGSNAT gene was identified: c.634-408_820+338delinsAGAATATG, p.(Glu212Glyfs*2). A known variant was found on the second allele: c.1843G>A, p.(Ala615Thr). Furthermore, we expanded the allelic spectrum of USH2A and RCBTB1 with novel CNVs. The arrEYE platform revealed subtle single-exon to larger CNVs in iRD genes that could be characterized at the nucleotide level, facilitated by the high resolution of the platform. We report the first CNV in HGSNAT that, combined with another mutation, leads to RP, further supporting its recently identified role in nonsyndromic iRD.Genet Med 19 4, 457-466.


Comparative study of fourteen alkaloids from Uncaria rhynchophylla hooks and leaves using HPLC-diode array detection-atmospheric pressure chemical ionization/MS method.
The purpose of the study is to compare alkaloid profile of Uncaria rhynchophylla hooks and leaves. Ten oxindole alkaloids and four glycosidic indole alkaloids were identified using HPLC-diode array detection (DAD) or LC-atmospheric pressure chemical ionization (APCI)-MS method, and a HPLC-UV method for simultaneous quantification of major alkaloids was validated. The hooks are characterized by high levels of four oxindole alkaloids rhynchophylline (R), isorhynchophylline (IR), corynoxeine (C) and isocorynoxeine (IC), while the leaves contained high level of two glycosidic indole alkaloids vincoside lactam (VL) and strictosidine (S). The presented methods have proven its usefulness in chemical characterization of U. rhynchophylla hooks and leaves.


Report of the First Clinical Case of a Moroccan Kabuki Patient with a Novel MLL2 Mutation.
Kabuki syndrome (also known as Niikawa-Kuroki syndrome) is a rare autosomal disorder, characterized by an unusual face, short stature, skeletal, visceral and dermatoglyphic abnormalities, cardiac anomalies, mental retardation, and immunological defects. Point mutations and large intragenic deletions and duplications of the mixed lineage leukemia 2 (MLL2) and exons deletions of lysine demethylase 6A (-KDM6A) genes have been identified as its underlying causes. We report on the first description of a Moroccan Kabuki syndrome patient with typical facial features, developmental delay, finger pads, and other anomalies carrying a novel splice site mutation in the MLL2 gene that produces a truncated and likely pathogenetic form of MLL2 protein.


Laparoscopic surgery for cancer patients.
Laparoscopy is an effective tool for diagnosis and staging of malignancies. Laparoscopic resection of abdominal tumors has been performed rarely, with two exceptions: laparoscopic adrenalectomy and laparoscopic resection of colorectal cancer. One of the best applications of minimally invasive surgery is the use of laparoscopic techniques for palliation of abdominal cancer. Requiring thorough training and preparation of surgeons and mandating their strict credentialing will reduce the risk of complications from laparoscopic surgery.


Influence of captopril on glucose and fatty acid oxidation in human thrombocytes and mononuclear leucocytes.
Captopril (CAS 62571-86-2) may be beneficial for the treatment of diabetes because of its activating effect on peripheral glucose consumption besides its well known blood pressure degradation. The glucose oxidation has been found to be activated by captopril in thrombocytes and mononuclear leucocytes, cell types which are usually considered to be independent from insulin. Because the oxidation of pyruvate labelled in position C-1 but not of 2-14C-pyruvate and of 1-14C-acetate was enhanced, captopril most probably stimulated the pyruvate decarboxylation reaction. The metabolism of glucose labelled in positions 1 and 6 was equally activated by captopril indicating another step which may be affected by captopril.


Simultaneous quantification of plasma levels of 12 antimicrobial agents including carbapenem, anti-methicillin-resistant Staphylococcus aureus agent, quinolone and azole used in intensive care unit using UHPLC-MS/MS method.
Critically ill patients in intensive care unit (ICU) are susceptible to infectious diseases, thus empirical therapy is recommended. However, the therapeutic effect in ICU patients is difficult to predict due to fluctuation in pharmacokinetics because of various factors. This problem can be solved by developing personalized medicine through therapeutic drug monitoring. However, when different measurement systems are used for various drugs, measurements are complicated and time consuming in clinical practice. In this study, we aimed to develop an assay using ultra-high performance liquid chromatography coupled with tandem mass spectrometry for simultaneous quantification of 12 antimicrobial agents commonly used in ICU: doripenem, meropenem, linezolid, tedizolid, daptomycin, ciprofloxacin, levofloxacin, pazufloxacin, fluconazole, voriconazole, voriconazole N-oxide which is a major metabolite of voriconazole, and posaconazole. Plasma protein was precipitated by adding acetonitrile and 50% MeOH containing standard and labeled IS. The analytes were separated with an ACQUITY UHPLC CSH C18 column, under a gradient mobile phase consisting of water and acetonitrile containing 0.1% formic acid and 2 mM ammonium formate. The method fulfilled the criteria of US Food and Drug Administration for assay validation. The recovery rate was more than 84.8%. Matrix effect ranged from 79.1% to 119.3%. All the calibration curves showed good linearity (back calculation of calibrators: relative error ≤ 15%) over wide concentration ranges, which allowed determination of Cmax and Ctrough. Clinical applicability of the novel method was confirmed. We have developed an assay for simultaneous quantification of 12 antimicrobial agents using a small sample volume of 50 μL with a short assay time of 7 min. Our novel method may contribute to simultaneous calculation of pharmacokinetic and pharmacodynamic parameters.


Nucleoside triphosphate changes during the peripheral life-span of erythrocytes of adult rainbow trout (Salmo gairdneri).
Determinations of nucleoside triphosphates (NTP) were made on rainbow trout erythrocytes segregated into age classes following velocity sedimentation at unit gravity. The NTP content of young cells was lower than that of mature cells, whereas it was significantly higher in the oldest cell population. Thin-layer chromatography of erythrocyte cell extracts showed that both ATP and GTP were present and that the former dominated in all age groups. Potassium cyanide was significantly more effective than iodoacetate in lowering NTP levels in the cells of the young age class whereas in the oldest cells the reverse was true.


The fluorescence of resin-based composites: An analysis after ten years of aging.
The long-term preservation of fluorescence qualities of resin-based composite (RBC) restorations is an absolute condition for the implementation of the fluorescence-aided identification technique (FIT) in dentistry and forensic medicine. Therefore, this study assessed the fluorescence of 244 color shades of 16 commercially available RBC brands with a monochromator-based multimode microplate reader. The specimens were stored in the dark at room temperature and reassessed ten years after the initial investigation. The mean intensity of the fluorescence maxima decreased from (31,030±936) RFU to (22,027±632) RFU. Linear regression resulted in r2=0.972 and a slope=0.701±0.005. The fluorescence intensity of the tested RBCs dropped to about 70% of the initial intensity independent of the brand, color shade and initial fluorescence intensity. On the basis of this in vitro 10-year data set, we assume that in vivo RBC fluorescence is also suitable for the detection and differentiation of clinically aged RBC restorations by FIT.


Prayers in the clinic: how pediatric physicians respond.
Physicians and researchers have recently paid increased attention to prayer in physician-patient interactions. Research focuses more on attitudinal questions about whether physicians and/or patients think prayer is relevant than on actual data about when and how prayer comes up in the clinic and how physicians respond. We focus on pediatric physicians to investigate: 1) how prayer enters clinical contexts and 2) how physicians respond. We examined in-depth interviews with 30 academic pediatricians and pediatric oncologists. All of these physicians were employed by the most highly ranked hospitals according to US News and World Report. In close to 100% of cases when the subject of prayer came up in clinical contexts, it was patients and families who raised it. Patients and families mostly talked about prayer in response to a seriously ill or dying child. When it was raised, pediatric physicians responded to prayer by participating; accommodating but not participating; reframing; and directing families to other resources. Physicians wanted to respect patients and families around the topic of prayer. They negotiated between patient/family requests, the specific situation, and their own comfort levels to respond in one of four ways. Their four responses allowed researchers to generate hypotheses about the independent variables that influence how pediatric physicians respond to prayer. Asking how prayer actually came up in clinical situations rather than how patients and/or physicians thought it should be raised, better informs ongoing conversations about the significance of prayer in physician-patient interactions.


Deleterious effect of smoking and nasal septal deviation on mucociliary clearance and improvement after septoplasty.
To investigate the effect of septal deviation, septoplasty, and smoking upon nasal mucociliary clearance by using saccharine test. Included in this study were 40 patients (15 women and 25 men) who had septal deviation and septoplasty surgery performed between March and June 2006. Patients are classified into three groups: group I (n = 20) nonsmoking patients who had septoplasty surgery, group II (n = 20) smoking patients who had septoplasty surgery, and the control (n = 20) group. None of the control group has nasal breathing problem or smoking history. For determining preoperative and postoperative nasal mucociliary clearance (MCC) time, a saccharine test was performed on the patients 1 day before surgery and at the third month of postoperative control. Preoperative and postoperative nasal MCC time in patients of group I are statistically significantly lower than the group II (p < 0.01). Postoperative MCC time in group I and II is significantly decreased compared with preoperative MCC time, statistically (p < 0.01). Preoperative and postoperative MCC time of group I and group II is significantly higher than MCC time of the control group (p < 0.01). Nasal septal deviation and smoking deteriorates nasal MCC time and this result can be shown easily with the saccharine test. Properly performed septoplasty surgery decreases nasal MCC time during the late postoperative period but MCC times are still longer than normal. The saccharine test can be used for following up the effect of septoplasty upon nasal mucosa.


Outpatient invasive radiology procedures: a cost effective alternative.
Significant cost savings can be made when invasive radiology procedures are done on an outpatient basis, say the authors. They discuss the concepts of outpatient invasive procedures and the development of an outpatient program at the University of Cincinnati Hospital.


Effect of Wetting and Dewetting Dynamics on Atomic Force Microscopy Measurements.
Water bridge dynamics between an atomic force microscopy (AFM) tip and a flat substrate is studied by using a multibody dissipative particle dynamics (MDPD) model. First, the numerical model is validated by comparing the present results of droplet contact angles and liquid bridges with those reported in the literature. Then, the ability of MDPD to capture the meniscus shape and behavior for different operating conditions and geometric parameters is examined for both static and dynamic cases. Hence, several parametric studies and analyses of the AFM tip configuration and its operating conditions are reported. It is found that a critical capillary number of about 0.001 is calculated based on 5% change on the force measurements between the static and dynamic results. It is also demonstrated that the hysteresis behavior in the capillary force exerted on the AFM tip can be successfully predicted by using the MDPD model when the tip approaches or retracts from the substrate. Moreover, there is an excellent agreement in the results of breakup distance for different water bridge volumes between the predictions of the MDPD model and the theory. Also, the hysteresis of capillary force exerted on an AFM tip composed of multibody design is studied. The prediction on the transition of the capillary force vs distance between the AFM tip and the substrate is in good agreement with the experimental results. Therefore, we demonstrate a validated MDPD model which can successfully capture liquid bridge dynamics. This model can be used as a powerful design tool for meniscus manipulation technology, such as dip-pen nanolithography, as well as for studying dynamic, e.g., tapping mode AFM tip, interactions with a liquid bridge.


The neuroanatomy of Barentsia discreta (Entoprocta, Coloniales) reveals significant differences between bryozoan and entoproct nervous systems.
Entoprocta affinities within Lophotrochozoa remain unclear. In different studies, entoprocts are considered to be related to different groups, including Cycliophora, Bryozoa, Annelida, and Mollusca. The use of modern methods to study the neuroanatomy of Entoprocta should provide new information that may be useful for phylogenetic analysis. The anatomy of the nervous system in the colonial Barentsia discreta was studied using immunocytochemistry and transmission electron microscopy. The ganglion gives rise to several main nerves: paired lateral, aboral, and arcuate nerves, and three pairs of tentacular cords that branch out into tentacular nerves. The serotonergic nervous system includes paired esophageal perikarya and two large peripheral perikarya, each with a complex net of neurites. Each tentacle is innervated by one abfrontal and two laterofrontal neurite bundles. Sensory cells occur regularly along the abfrontal side of each tentacle. Star-like nerve cells are scattered in the epidermis of the calyx. The stalk is innervated by paired stalk nerves. The neuroanatomy of the colonial Barentsia discreta is generally similar to that of solitary entoprocts but differs in the anatomy and ultrastructure of the ganglion, the number of neurite bundles in the calyx, and the distribution of serotonin in the nerve elements. A comparison of the organization of the nervous system in the Entoprocta and Bryozoa reveals many differences in tentacle innervations, which may indicate that these groups may not be closely related. Our results can not support with any certainty the homology of nervous system elements in adult entoprocts and adult "basal mollusks".


DNA methylation: A source of random variation in natural populations.
Epigenetic processes (e.g., DNA methylation) have been proposed as potentially important evolutionary mechanisms. However, before drawing conclusions about their evolutionary relevance, we need to evaluate the independence of epigenetic variation from genetic variation, as well as the extent of methylation polymorphism in nature. We evaluated these in natural populations of a clonal fish, Chrosomus eos-neogaeus, for which genetically identical individuals may be found in distinct environments. A genomic survey confirms the genetic uniformity of individuals, whereas a substantial level of inter-individual variation results in DNA methylation. Survey of the methylation status of the CpG dinucleotides of a fragment of a retrotransposon confirmed a marked difference in epiallelic composition among tissues, as well as among individuals. This study provides further evidence of epigenetic variation in the absence of genetic variation and demonstrates that this process can be a source of random variation in natural populations.


Profiling neurotransmitter-evoked glial responses by RNA-sequencing analysis.
Fundamental properties of neurons and glia are distinctively different. Neurons are excitable cells that transmit information, whereas glia have long been considered as passive bystanders. Recently, the concept of tripartite synapse is proposed that glia are structurally and functionally incorporated into the synapse, the basic unit of information processing in the brains. It has then become intriguing how glia actively communicate with the presynaptic and postsynaptic compartments to influence the signal transmission. Here we present a thorough analysis at the transcriptional level on how glia respond to different types of neurotransmitters. Adult fly glia were purified from brains incubated with different types of neurotransmitters ex vivo. Subsequent RNA-sequencing analyses reveal distinct and overlapping patterns for these transcriptomes. Whereas Acetylcholine (ACh) and Glutamate (Glu) more vigorously activate glial gene expression, GABA retains its inhibitory effect. All neurotransmitters fail to trigger a significant change in the expression of their synthesis enzymes, yet Glu triggers increased expression of neurotransmitter receptors including its own and nAChRs. Expressions of transporters for GABA and Glutamate are under diverse controls from DA, GABA, and Glu, suggesting that the evoked intracellular pathways by these neurotransmitters are interconnected. Furthermore, changes in the expression of genes involved in calcium signaling also functionally predict the change in the glial activity. Finally, neurotransmitters also trigger a general metabolic suppression in glia except the DA, which upregulates a number of genes involved in transporting nutrients and amino acids. Our findings fundamentally dissect the transcriptional change in glia facing neuronal challenges; these results provide insights on how glia and neurons crosstalk in a synaptic context and underlie the mechanism of brain function and behavior.


A simple automated solid-phase extraction procedure for measurement of 25-hydroxyvitamin D3 and D2 by liquid chromatography-tandem mass spectrometry.
Measurement of 25-hydroxyvitamin D(3) (25OHD(3)) and D(2) (25OHD(2)) is challenging. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods have been described but they are often complex and difficult to automate. We have developed a simplified procedure involving an automated solid-phase extraction (SPE). Internal standard (hexadeuterated 25-hydroxyvitamin D(3)) was added to serum or plasma followed by protein precipitation with methanol. Following centrifugation, a robotic instrument (CTC PAL [Presearch] for ITSP SPE [MicroLiter Analytical Supplies, Inc]) performed a six-step SPE procedure and the purified samples were injected into the LC-MS/MS. Quantification of 25OHD(3) and 25OHD(2) was by electrospray ionization MS/MS in the multiple-reaction monitoring mode. The lower limit of quantitation was 4.0 nmol/L for 25OHD(3) and 7.5 nmol/L for 25OHD(2). Within- and between-assay precision was below 10% over the concentration range of 22.5-120 nmol/L for D(3) and 17.5-70 nmol/L for D(2) (n = 10). The calibration was linear up to 2500 nmol/L (r = 0.99). Recoveries ranged between 89% and 104% for both metabolites and no ion suppression was observed. The results obtained compared well (r = 0.96) with the IDS-OCTEIA 25-hydroxyvitamin D enzyme immunoassay for samples containing less than 125 nmol/L, at higher concentrations the immunodiagnostic system (IDS) method showed positive bias. Our simplified sample preparation and automated SPE method is suitable for the measurement of 25OHD(3) and D(2) in a routine laboratory environment. The system can process up to 300 samples per day with no cumbersome solvent evaporation step and minimal operator intervention.


Nonlinear response properties of combination-sensitive electrosensory neurons in the midbrain of Gymnarchus niloticus.
The jamming avoidance response of the weakly electric fish Gymnarchus niloticus relies on determining the sign of the frequency difference (Df) between the fish's own electric organ discharge (EOD) and that of a neighbor, which is achieved by comparing modulations in amplitude (AM) and phase (PM) that result from the summation of their EODs. These two stimulus features are processed in separate pathways that converge in the torus semicircularis on combination-sensitive neurons, many of which are selective for the sign of Df. We recorded extracellular single-unit responses to independent stimulation with AM and PM and combined AM-PM stimulation to determine how sign selectivity is established. Responses to AM and PM frequently summated nonlinearly, leading to sign-selective responses as a result of facilitation to the preferred sign of Df and/or suppression to the nonpreferred sign of Df. Facilitation typically occurred when responses to AM and PM were aligned, whereas suppression typically occurred when they were offset. By experimentally manipulating the degree of alignment between these two responses, we found that the summed response was dependent on their relative timing. In addition, we found a unique class of units that were sensitive to differences in amplitude between two body surfaces. This sensitivity rendered such units immune to the problem of orientation ambiguity, in which the sign selectivity of a single neuron reverses with changes in stimulus orientation. We discuss potential synaptic mechanisms for driving nonlinear responses in these and other combination-sensitive neurons.


Changes in work and health of Australians during the COVID-19 pandemic: a longitudinal cohort study.
Engagement in work is an important determinant of health. In response to the COVID-19 pandemic, public health measures imposed to reduce viral transmission resulted in large-scale loss of work during the early stages of the pandemic, contributing to declined mental and physical health. As the pandemic unfolded, the Australian economy began to recover and some people could return to work, whilst localised lockdowns resulted in further loss of work for others. The long-term health effects of work loss remain unexplored within the COVID-19 pandemic context, in addition to whether any health effects are persistent upon returning to work. A prospective longitudinal cohort study of 2603 participants across Australia monitored changes in health and work between March and December 2020, with participants completing surveys at baseline and 1, 3 and 6 months later. Outcomes described psychological distress, and mental and physical health. Linear mixed regression models examined associations between changes in health and experiences of work loss, and return to work, over time. Losing work during the early stages of the pandemic was associated with long-term poorer mental health, which began to recover over time as some returned to work. Physical health deteriorated over time, greater for people not working at baseline. Being out of work was associated with poorer mental health, but better physical health. These effects were larger for people that had recently lost work than for people with sustained work loss, and retaining employment played a protective role. Generally, returning to work resulted in poorer physical health and improvements in mental health, although this depended on the broader context of changes in work. Work cessation during the pandemic led to poor health outcomes and had long-lasting effects. Returning to work benefits mental health but may reduce physical activity in the short-term. We encourage the provision of accessible mental health supports and services immediately following loss of work, and for people with prolonged forms of work loss. Australian New Zealand Clinical Trials Registry: ACTRN12620000857909 .


Considerations for the design and technical setup of a human whole-body exposure chamber.
Exposures to air contaminants, such as chemical vapors and particulate matter, pose important health hazards at workplaces. Short-term experimental exposures to chemical vapors and particles in humans are a promising attempt to investigate acute effects of such hazards. However, a significant challenge in this field is the determination of effects of co-exposures to more than one chemical or mixtures of chemical vapors and/or particles. To overcome such a challenge, studies have to be conducted under standardized exposure characterization and real time measurements, if possible. A new exposure laboratory (ExpoLab) was installed at IPA, combining sophisticated engineering designs with new analytical techniques, to fulfill these requirements. Low-dose as well as high-dose exposure scenarios are achieved by means of a calibration-gas-generator. Exposure monitoring can be carried out with a high performance real time mass spectrometer and other suitable analyzers (e.g. gas chromatograph). Numerous automated security facilities guarantee the physical integrity of the volunteers, and the waste atmosphere is removed using either charcoal filtration or catalytic post-combustion. Measurements of sulfur hexafluoride, carbon dioxide, aniline and carbon black are presented to demonstrate the performance of the exposure unit with respect to the temporal and spatial stability of generated atmospheres. The variations of generated contents in the atmospheres at steady state are slightly higher than the measurement precision of the analyzers (the typical standard deviation of generated atmospheres is < 2%). The technical components of ExpoLab and its monitoring systems ensure high quality standards in validity and reliability of generating and measuring exposure atmospheres.


Hepatitis B envelope protein mutants in human hepatocellular carcinoma tissues.
Hepatitis B virus (HBV) envelope mutants in the region encoding the highly immunogenic major hydrophilic region (MHR) of surface antigen (HBsAg) have been associated with vaccine failure and chronic infection. To determine if these mutants are associated with the development of human hepatocellular carcinoma (HCC), we measured the frequency and nature of such mutants in 23 HBV-associated HCC and various control tissues by performing Southern blot analysis, the polymerase chain reaction (PCR) and direct sequencing. The HBV genome was present mainly in an integrated form and, in most of the samples, the envelope gene was intact. Amino acid substitutions, involving the MHR region in the HCC tissues, were analysed in 11 (61. 1%) of 18 patients with HCC. The mutation Gly145Arg, which has been reported to be associated with immunoevasion, was found in seven of the 18 HCC tissues. A significantly higher frequency of mutations was found in HCC tissues (11 of 18) than in the corresponding non-tumorous tissue of the same patients (one of eight), and in samples from patients with acute (one of 19) or chronic (three of 31) HBV infection (P < 0.001, Fisher's exact test). The accumulation of these envelope mutants in the HCC tissue suggests that such envelope protein mutations may play a role in the process of oncogenesis and that specific vaccines may need to be developed to prevent the occurrence of mutant HBV-associated HCC. Alternatively, the progressive accumulation of mutants in patients with acute hepatitis, chronic hepatitis and HCC may reflect the increased length of duration of HBV infection in these groups of liver lesions.


Clinical presentation of the lead-poisoned child on mental ability tests.
Current literature on effects of childhood lead poisoning and high blood lead level on psychological test performance was reviewed. A pathognomic configuration of mental ability test scores is described. A sample of 18 moderately to severely lead poisoned children was found to have a significantly higher frequency of this score configuration than either a comparison sample or the Black subsample of the original WISC-R standardization group. Implications for clinical practice and research are discussed.


Approaches for improving the stability of ketorolac in powder blends.
Methods for improving the stability of ketorolac powder blends under elevated humidity and temperature conditions were investigated. The approaches that were examined for potentially increasing the stability of ketorolac were varying the ketorolac salt form, altering the excipient ratios, and adding antioxidants or pH modifiers to the formulation. The ketorolac powder blends were stored for 3 months at 75% relative humidity (RH) and 40, 50, and 60 degrees C. The results showed that the salt form of ketorolac had a large impact on stability after 3 months of storage at 50 degrees C/75% RH. The calcium salt powder blend and the free acid powder blend exhibited only 0.2% and 0.5% drug loss, respectively, whereas the tromethamine salt powder blend showed a 10.2% drug loss. Varying the ratios of lactose, microcrystalline cellulose, and croscarmellose sodium in the powder blends of ketorolac tromethamine showed that croscarmellose sodium and microcrystalline cellulose destabilized ketorolac. Addition of propyl gallate (1% w:w) to ketorolac tromethamine powder blends increased the stability of the ketorolac significantly. Addition of pH modifiers caused a modest improvement in the stability of ketorolac.


Inkjet-Printed Electrodes on A4 Paper Substrates for Low-Cost, Disposable, and Flexible Asymmetric Supercapacitors.
Printed electronics is widely gaining much attention for compact and high-performance energy-storage devices because of the advancement of flexible electronics. The development of a low-cost current collector, selection, and utilization of the proper material deposition tool and improvement of the device energy density are major challenges for the existing flexible supercapacitors. In this paper, we have reported an inkjet-printed solid-state asymmetric supercapacitor on commercial A4 paper using a low-cost desktop printer (EPSON L130). The physical properties of all inks have been carefully optimized so that the developed inks are within the printable range, i.e., Fromm number of 4 < Z < 14 for all inks. The paper substrate is made conducting (sheet resistance ∼ 1.6 Ω/sq) by printing 40 layers of conducting graphene oxide (GO) ink on its surface. The developed conducting patterns on paper are further printed with a GO-MnO2 nanocomposite ink to make a positive electrode, and another such structure is printed with activated carbon ink to form a negative electrode. A combination of both of these electrodes is outlaid by fabricating an asymmetric supercapacitor. The assembled asymmetric supercapacitor with poly(vinyl alcohol) (PVA)-LiCl gel electrolyte shows a stable potential window of 0-2.0 V and exhibits outstanding flexibility, good cyclic stability, high rate capability, and high energy density. The fabricated paper-substrate-based flexible asymmetric supercapacitor also displays an excellent electrochemical performances, e.g., a maximum areal capacitance of 1.586 F/cm2 (1023 F/g) at a current density of 4 mA/cm2, highest energy density of 22 mWh/cm3 at a power density of 0.099 W/cm3, a capacity retention of 89.6% even after 9000 charge-discharge cycles, and a low charge-transfer resistance of 2.3 Ω. So, utilization of inkjet printing for the development of paper-based flexible electronics has a strong potential for embedding into the next generation low-cost, compact, and wearable energy-storage devices and other printed electronic applications.


Intramuscular cavernous haemangioma of the triceps.
A 16-year-old teenager presented himself with a swollen left elbow, with no associated vascular-nerve complications. The standard radiography was without abnormalities. The echography showed the presence of an oblong vascularized formation occupying the posterior part of the elbow. The magnetic resonance imaging (MRI) showed a hyper vascularized lesion developing at the expense of the brachial triceps muscle with an intermediate signal intensity on the sequences weighted in T1 and a hyper signal in T2. The anatomopathological study of the initial biopsy and of the tumor part concluded with a cavernous hemangioma. Although their origin is vascular, hemangiomas never metastasize and do not undergo malignant transformation. The treatment of symptomatic hemangioma consists of surgical excision.


[The methods of exploring obesity cutoffs for screening/diagnosing diabetes].
It is important to establish an appropriate obesity-cutoff method to identify people with diabetes or at high risk of the disease. Aside from restricted cubic splines and fractional polynomial model, the receiver operating characteristic curve is the most frequently one used to define these cutoffs. In this study, we explored the obesity cutoffs across different ethnic populations and evaluated the merits/demerits of different Methods by reviewing the currently used obesity cutoffs.


Hydrocarbon emissions from in-use commercial aircraft during airport operations.
The emissions of selected hydrocarbons from in-use commercial aircraft at a major airport in the United States were characterized using proton-transfer reaction mass spectrometry (PTR-MS) and tunable infrared differential absorption spectroscopy (TILDAS) to probe the composition of diluted exhaust plumes downwind. The emission indices for formaldehyde, acetaldehyde, benzene, and toluene, as well as other hydrocarbon species, were determined through analysis of 45 intercepted plumes identified as being associated with specific aircraft. As would have been predicted for high bypass turbine engines, the hydrocarbon emission index was greater in idle and taxiway acceleration plumes relative to approach and takeoff plumes. The opposite was seen in total NOy emission index, which increased from idle to takeoff. Within the idle plumes sampled in this study, the median emission index for formaldehyde was 1.1 g of HCHO per kg of fuel. For the subset of hydrocarbons measured in this work, the idle emissions levels relative to formaldehyde agree well with those of previous studies. The projected total unburned hydrocarbons (UHC) deduced from the range of in-use idle plumes analyzed in this work is greater than a plausible range of engine types using the defined idle condition (7% of rated engine thrust) in the International Civil Aviation Organization (ICAO) databank reference.


Comparison of climbing-specific strength and endurance between lead and boulder climbers.
Albeit differences in climbing-specific strength of the forearms have been demonstrated between lead and boulder climbers, little is known about the potential differences in force and power output of the upper body pulling-apparatus between disciplines. The aim of this study was to compare the climbing-specific upper-body strength and finger flexor endurance between lead and boulder climbers, as well as to examine the relative utilization of force when testing on a ledge hold compared to a jug hold. Sixteen boulder climbers (red-point climbing grade 17.9 ± 3.3) and fifteen lead climbers (red-point climbing grade 20.5 ± 3.5) performing on an advanced level volunteered for the study. Peak force, average force and rate of force development (RFD) were measured during an isometric pull-up, average velocity in dynamic pull-up, and finger flexor endurance in an intermittent test to fatigue. The isometric pull-up was performed on a ledge hold (high finger strength requirements) and on a jug hold (very low finger strength requirements). Boulder climbers demonstrated a higher maximal and explosive strength in all strength and power measurements (26.2-52.9%, ES = 0.90-1.12, p = 0.006-0.023), whereas the finger flexor endurance test showed no significant difference between the groups (p = 0.088). Both groups were able to utilize 57-69% of peak force, average force and RFD in the ledge condition compared to the jug condition, but the relative utilization was not different between the groups (p = 0.290-0.996). In conclusion, boulder climbers were stronger and more explosive compared to lead climbers, whereas no differences in finger flexor endurance were observed. Performing climbing-specific tests on a smaller hold appears to limit the force and power output equally between the two groups.


CELL DIVISION IN SPIROGYRA. I. MITOSIS.
Dividing cells of Spirogyra sp. were examined with both the light and electron microscopes. By preprophase many of the typical transverse wall micro-tubules disappeared while others were seen in the thickened cytoplasmic strands. Microtubules appeared in the polar cytoplasm at prophase and by prometaphase they penetrated the nucleus. They were attached to chromosomes at metaphase and early anaphase, and formed a sheath surrounding the spindle during anaphase; they were seen in the interzonal strands and cytoplasmic strands at telophase. The interphase nucleolus, containing 2 distinct zones and chromatinlike material, fragmented at prophase; at metaphase and anaphase nucleolar material coated the chromosomes, obscuring them by late anaphase. The chromosomes condensed in the nucleoplasm at prophase, moving into the nucleolus at prometaphase. The nuclear envelope was finally disrupted at anaphase during spindle elongation; at telophase membrane profiles coated the reforming nuclei. During anaphase and early telophase the interzonal region contained vacuoles, a few micro-tubules, and sometimes eliminated n ucleolar material; most small organelles, including swollen endoplasmic reticulum and tubular membranes, were concentrated in the polar cytoplasm. Quantitative and qualitative cytological observations strongly suggest movement of intact wall rnicrotubules to the spindle at preprophase and then back again at telophase.


Imaging of anterior cruciate ligament repair and its complications.
This article provides a review of anterior cruciate ligament (ACL) reconstruction procedures and their normal postoperative appearance. Then, we review commonly encountered complications: those associated with decreased range of motion (impingement, arthrofibrosis, intraarticular bodies, ganglion cysts) and those associated with laxity (graft tearing, graft stretching). Finally, we review some miscellaneous complications. Given the number of patients undergoing ACL reconstruction, it is important for radiologists to be familiar with the different reconstruction surgeries and their common complications.


Habituation to galvanic vestibular stimulation.
To examine the response decline that occurs upon repetitive galvanic vestibular stimulation (GVS) and hampers long-term clinical evaluations. This was a prospective experimental study conducted in a tertiary referral centre. In a previous study we developed a standardized procedure for reproducible quantification of galvanic-induced body sway (GBS). The most reproducible responses were found using a continuous 1-cosinusoidal stimulus (0.5 Hz; 2 mA) preceded by a pre-habituating stimulus. This binaural prestimulation reduced the short-term (<5 min) response decline to a non-significant level. The response decline without prestimulation was interpreted as habituation to the galvanic stimulation. In the present study we evaluated possible long-term habituation to GVS, which may hamper longitudinal clinical evaluations. Possible long-term habituation using the short-term habituating prestimulus concept was studied by quantifying GBS in 40 subjects at 5 consecutive time points. Subjects were subdivided into four equal groups who were tested with four different time intervals between the five measurements, ranging from 1 day to 2 weeks. The absolute test results did not vary with the time interval (p=0.217; repeated measurement test). Irrespective of the time interval between the tests, habituation occurred after the first stimulation and remained stable at all consecutive measurements. GVS habituation did not depend on either the degree of daily life activity (moderate practice of sport) or on gender. The current protocol, using a prehabituating binaural stimulus, showed that reproducible assessment of the GVS over a time course of days to weeks was possible starting from the second test.


Review of bubble detector response characteristics and results from space.
A passive neutron-bubble dosemeter (BD), developed by Bubble Technology Industries, has been used for space applications. Both the bubble detector-personal neutron dosemeter and bubble detector spectrometer have been studied at ground-based facilities in order to characterise their response due to neutrons, heavy ion particles and protons. This technology was first used during the Canadian-Russian collaboration aboard the Russian satellite BION-9, and subsequently on other space missions, including later BION satellites, the space transportation system, Russian MIR space station and International Space Station. This paper provides an overview of the experiments that have been performed for both ground-based and space studies in an effort to characterise the response of these detectors to various particle types in low earth orbit and presents results from the various space investigations.


Inhibition of 5-lipoxygenase pathway suppresses the growth of bladder cancer cells.
Many stimuli, including growth factors and cytokines, activate arachidonic acid (AA) metabolic pathways, which are involved in cancer development and progression. We examined the effects of a series of pharmacological inhibitors of AA metabolic enzymes on bladder cancer cells to determine the role of AA pathway in this malignancy. Human bladder cancer cell lines were treated with various AA metabolic enzymes inhibitors for lipoxygense (LOX) and cyclooxygenase (COX) pathways, and the growth suppression effects were examined. The enzyme expression in cancer cells was examined by immunoblot analyses. A 5-LOX-specific inhibitor, AA861, dose-dependently inhibited the growth of bladder cancer cells. The growth inhibitory effects were greatly abolished by 5-LOX product, 5-HETE, but not by other LOX products examined. They were observed in four cancer cells that expressed 5-LOX, but not in one that did not. Of a series of LOX and COX pathway inhibitors, AA861 was the strongest one to suppress the growth of cancer cells. Bladder cancer cells frequently expressed 5-LOX. A 5-LOX-specific inhibitor, AA861, revealed the strongest growth suppression of those cells compared to other LOX and COX pathway inhibitors, and the growth suppression effects were considered to be due to inhibition of the enzymatic activity. Therefore, 5-LOX may play a regulatory role in proliferation and/or survival of bladder cancer, and may be a therapeutic target for the disease.


The value of a single amphotericin B bladder washout in candiduria.
The efficacy of single amphotericin B bladder washout was assessed, and the source of infection was sought, in 47 patients with 62 separate episodes of candiduria. After a single bladder washout, 44 of 62 (71%) candiduria episodes cleared and none of these patients had evidence of invasive disease or kidney infection. Ten (56%) of 18 patients with persistent candiduria had no evidence of invasive disease or kidney infection at autopsy or clinically. The sensitivity of a positive urine culture for Candida spp. after a single amphotericin B bladder washout in predicting kidney infection or invasive candidiasis was 100% (CI = 63-100%); but the specificity was only 81% (CI = 47-100%) and the positive predictive value only 44%.


Evaluation of chemically modified SLA implants (modSLA) biofunctionalized with integrin (RGD)- and heparin (KRSR)-binding peptides.
Enhancing osseointegration through surface immobilization of multiple short peptide sequences that mimic extracellular matrix (ECM) proteins, such as arginine-glycine-aspartic acid (RGD) and lysine-arginine-serine-arginine (KRSR), has not yet been extensively explored. Additionally, the effect of biofunctionalizing chemically modified sandblasted and acid-etched surfaces (modSLA) is unknown. The present study evaluated modSLA implant surfaces modified with RGD and KRSR for potentially enhanced effects on bone apposition and interfacial shear strength during early stages of bone regeneration. Two sets of experimental implants were placed in the maxillae of eight miniature pigs, known for their rapid wound healing kinetics: bone chamber implants creating two circular bone defects for histomorphometric analysis on one side and standard thread configuration implants for removal torque testing on the other side. Three different biofunctionalized modSLA surfaces using poly-L-lysine-graft-poly(ethylene glycol) (PLL-g-PEG) as a carrier minimizing nonspecific protein adsorption [(i) 20 pmol cm⁻² KRSR alone (KRSR); or in combination with RGD in two different concentrations; (ii) 0.05 pmol cm⁻² RGD (KRSR/RGD-1); (iii) 1.26 pmol cm⁻² RGD (KRSR/RGD-2)] were compared with (iv) control modSLA. Animals were sacrificed at 2 weeks. Removal torque values (701.48-780.28 N mm), bone-to-implant contact (BIC) (35.22%-41.49%), and new bone fill (28.58%-30.62%) demonstrated no significant differences among treatments. It may be concluded that biofunctionalizing modSLA surfaces with KRSR and RGD derivatives of PLL-g-PEG polymer does not increase BIC, bone fill, or interfacial shear strength.


Oxygen saturation, periodic breathing and apnea during sleep in infants 1 to 4 month old living at 2,560 meters above sea level.
There are few data in the literature related to polysomnography in infants in altitudes from 2,200 m to 2,800 m. The main objective of this investigation was to describe oxygen saturation (SpO2) levels during sleep in infants aged between 1 and 4 months living at an altitude of 2,560 m. The secondary objectives were the description of periodic breathing (PB) and apnea indexes. Polysomnography was performed in 35 healthy infants 1-4 months in Cuenca (Ecuador) at 2,560 m. The median for SpO2 was 92% and 4.9% for PB. The median for the central apnea index was 23.7/hour and 15.4/hour when related to PB. No correlation was found between PB and SpO2. SpO2 was lower than the values at sea level and PB and central apnea index were higher. When apneas associated with PB were not considered, the central apnea index was similar to that found at sea level.


What if physicians don't believe your quality data?
* If you fail to address improvement opportunities, care at your facility may not be consistent with guideline recommendations. * 'Perhaps the most common pitfall' for quality professionals is to get buy in and enlist a phsyician champion. * Clinician 'story-telling' is good for getting additional buy in for QI projects.


Intracranial aneurysms: endovascular evaluation with three-dimensional-display MR angiography.
To augment information at digital subtraction angiography, 17 patients with 22 intracranial aneurysms underwent three-dimensional-display magnetic resonance (MR) angiography. Reconstructions created to simulate vascular endoscopy provided additional information in 18 aneurysms about the aneurysmal sac, its orifice and neck, and/or its relation to the parent vessel and nearby vasculature. No additional information was provided in two aneurysms, and two aneurysms were not depicted.


L-Asparaginase activity analysis, ansZ gene identification and anticancer activity of a new Bacillus subtilis isolated from sponges of the Red Sea.
This study describes the isolation of various marine bacteriafrom sponges collected from the Red Sea (Saudi Arabia) andL-asparaginase (anti-cancer enzyme) production from bacterialisolates. The 16S rDNA based phylogenetic analysis revealed thatthe isolate WSA3 was a Bacillus subtilis. Its partial-length genesequence was submitted to GenBank under the accession numberMK072695. The new B. subtilis strain harbored the exact size(1128 bp) of the new L-asparaginase (ansZ) gene as confirmedby PCR and in gel visualization, which was submitted to the NCBIdatabase (accession number MN566442). The molecular weightof partially purified L-asparaginase was determined as 45 kDa bySDS-PAGE. In addition, the enzyme L-asparaginase did not showglutaminase activity which is very important from a medical pointof view. Moreover, 100 μg/mL of the partially purified B. subtilis Lasparaginaseshowed promising anti-cancer activities when testedagainst three cancer cell lines (HCT-116, MCF-7, and HepG2).


The Effect of Pharyngeal Packing during Nasal Surgery on the Incidence of Post Operative Nausea, Vomiting, and Sore Throat.
Nausea and vomiting after ear, nose and throat (ENT) surgery is one of the most common and notable problems facing anesthesiologists in this area. This study was conducted to determine the effect of a pharyngeal pack on the severity of nausea, vomiting, and sore throat among patients after ear, pharynx, and throat surgeries. This randomized clinical study was performed in 140 patients (61 men and 79 women; age range, 20-40 years) who had undergone nasal surgery in 2010. Patients were divided into two groups: the first group were treated using a pharyngeal pack (case group) and the second group were managed without a pharyngeal pack (control group). Statistical analysis was performed using the Chi-square test and the Mann-Whitney U test. SPSS software was used for data analysis. The mean severity of nausea and vomiting in the two groups was 2.057, 1.371 and 1.100, respectively, with no significant differences between groups. However, the mean severity of sore throat was 1.714 in the group with the pharyngeal pack and 1.385 in the group without pharyngeal pack (P=0.010). Not only does a pharyngeal pack in ENT surgery not reduce the extent and severity of nausea and vomiting, but it also increases the severity of sore throat in patients when leaving the recovery room and discharging hospital.


Use of chitosan membrane associated with polypropylene mesh to prevent peritoneal adhesion in rats.
The correction of wall abdominal defects often requires the use of implants such as polypropylene meshes. In spite of presenting good tissue acceptance, these biomaterials can migrate to adjacent viscera, promote enterocutaneos fistulas, tissue adherence and visceral erosions. In this work, the barrier effect of chitosan films associated with polypropylene meshes on adhesion formation experimentally induced in Wistar rats was evaluated. The animals were divided into two groups with 10 animals each. Animals in the CPP group were implanted with chitosan films associated with polypropylene meshes, whereas the ones in the PP group received only polypropylene meshes. After 8 days, the animals were submitted to euthanasia using CO(2) and a descriptive study focusing adhesion formation, visceral involvement with sutures and mesh peritonization was performed. Also, subimplanted material was collected for histopathology analysis. The results showed that the CPP group presented weak adhesions to the omentum over the stitch knots in eight animals. In all animals, the meshes were peritonized, not allowing their visualization after removing the chitosan films. In the PP group, six animals presented intestinal adhesions to the meshes and, in one of them, hepatic adhesion to the mesh was observed, besides omentum adhesion on more than 50% of the mesh area. The protective effect of chitosan films when sutured over polypropylene meshes, as well as no exacerbation of inflammation associated to the peritoneal lesions was statistically demonstrated. Therefore, chitosan films can indeed minimize the formation of peritoneal adhesions induced by polypropylene meshes in rats.


Vascular endothelial growth factor promoted endothelial progenitor cell mobilization into the peripheral blood of a patient with POEMS syndrome.
We assessed the percentage of endothelial progenitor cells (EPCs) in the peripheral blood of a patient with POEMS with elevated VEGF plasma levels. High VEGF plasma levels were associated with increased EPC concentration and treatment with an anti-VEGF antibody induced a consensual decrease of both parameters. In vitro cultures of the patient BM cells suggested that the stromal compartment could be responsible for VEGF overproduction.


The predicted beta12-beta13 loop is important for inhibition of PP2Acalpha by the antitumor drug fostriecin.
The potential anticancer agent fostriecin (FOS) is a potent inhibitor of the protein Ser/Thr phosphatases PP2A and PP4 and a weaker inhibitor of PP1. Random mutagenesis and automated screening in yeast identified residues in human PP2Acalpha important for inhibitory FOS binding. A C269S substitution in the predicted beta12-beta13 loop decreased the FOS sensitivity of intact cells and increased the IC(50) of PP2Acalpha by 10-fold in vitro. Changing PP2Acalpha Cys-269 to phenylalanine, the equivalent residue in PP1, and the Y267G and G270D substitutions caused a similar effect. The results provide information relevant to the design of novel protein Ser/Thr phosphatase inhibitory drugs.


Eukaryotic release factor 1 phosphorylation by CK2 protein kinase is dynamic but has little effect on the efficiency of translation termination in Saccharomyces cerevisiae.
Protein synthesis requires a large commitment of cellular resources and is highly regulated. Previous studies have shown that a number of factors that mediate the initiation and elongation steps of translation are regulated by phosphorylation. In this report, we show that a factor involved in the termination step of protein synthesis is also subject to phosphorylation. Our results indicate that eukaryotic release factor 1 (eRF1) is phosphorylated in vivo at serine 421 and serine 432 by the CK2 protein kinase (previously casein kinase II) in the budding yeast Saccharomyces cerevisiae. Phosphorylation of eRF1 has little effect on the efficiency of stop codon recognition or nonsense-mediated mRNA decay. Also, phosphorylation is not required for eRF1 binding to the other translation termination factor, eRF3. In addition, we provide evidence that the putative phosphatase Sal6p does not dephosphorylate eRF1 and that the state of eRF1 phosphorylation does not influence the allosuppressor phenotype associated with a sal6Delta mutation. Finally, we show that phosphorylation of eRF1 is a dynamic process that is dependent upon carbon source availability. Since many other proteins involved in protein synthesis have a CK2 protein kinase motif near their extreme C termini, we propose that this represents a common regulatory mechanism that is shared by factors involved in all three stages of protein synthesis.


[Choledocal cyst: analysis of 29 cases and review or the literature].
The aim of the present study has been to systematize the clinical presentation of the entity named choledochal cyst, in relation with its probable etiopathology and the intraoperative findings as well as its evolution after surgery, based on the revision of the literature and of our experience in 29 cases. 29 cases of cystic dilatation of the biliar duct extra and/or intrahepatic are analyzed. In 4 cases the diagnosis was prenatal and two were excluded of the study after it has been confirmed they suffered biliary atresia type I. In the left 27 cases, 19 variables are analyzed retrospectively, like age, sex, weight, symptoms, ultrasonographic images, etc. Subsequently, intra-operative cholangiographic findings were correlated with the clinic presentation and the evolution of the patients after surgery. Of the 27 cases analyzed 16 (59,25%) were cystic dilatations from which 14 had a neonatal or early clinic presentation (before 2 years), however the fusiform dilatations were presented later on. From the analyzed symptoms, in relation with the age only the pain and the jaundice showed significant differences, being the pain most frequent in later presentation ande the jaundice in the early form. The two cases of type 3 of Todani or choledochocele were of later presentation. An anomaly in the bilionpacreatric junction was detected in 15 patients; the majority had a later presentation, associated to pancreatitis in 4 cases. Primary cyst excision and biliary Roux-en-Y reconstruction was the treatment of election in the majority of cases. In 3 cases we used the appendix to replace the choledocus, but all three cases were reconverted two years later because of permanent elevation of ALT and GGT. In favour of the literature and of our experience nowadays it would be possible to systematize this malformation and make a division in two groups, depending on the cholangiographic findings and clinical presentation: 1. Cystic dilatations with a clinical neonatal presentation or beneath 2 years. 2. Fusiform dilatations with a later clinical predominance and associated frequently to pancreatitis and anomalous pancreatobiliary junction. Choledochocele is an entity that must be considered not only for its etiology but for its clinical presentation and treatment. Primary cyst excision and biliary Roux-en-Y reconstruction is the treatment of election. Regular long-term review of these patients is mandatory in the surveillance of sub-clinic cholangitis and the risk of possible long-term malignance of this entity.


Endocrine abnormality in paraneoplastic syndrome.
Paraneoplastic syndromes denote rare but notable phenomena caused by the tumour mediated release of bioactive substances. Peptide and non-peptide hormone causes are explored with a particular focus on pathogenesis, symptoms, diagnosis and treatment. Early detection and management of paraneoplastic syndromes can improve morbidly and mortality; definitive treatment remains effective surgical or anti-tumour therapies. Pituitary autoimmunity may provide a novel presentation of paraneoplastic syndromes for which further research is warranted.


Regional differences in rat brain dopamine transporter binding: function of time after chronic cocaine.
Chronic administration of cocaine to rats has been shown to produce a persistent decrease in dopamine (DA) and its metabolites in the brain and periphery. To further explore the alterations in the DA system following repeated administration of cocaine, we studied the regional differences in DA transporter binding as a function of time after the last injection of cocaine. Two groups of rats were treated with cocaine (10 mg/kg twice a day) or saline for 7 days. Rats were sacrificed 1, 2, 3, 6, and 12 weeks after the last injection. The corpus striatum and the frontal cortex were dissected and assayed with [3H]GBR 12935 for DA transporter binding. Time-related differences were observed in the frontal cortex but not in the striatum of the saline-treated control rats. Cocaine treatment prevented the time-dependent increase in Bmax over the course of 6 weeks, but not over the course of 12 weeks following withdrawal. Although there was no difference between the cocaine- and saline-treated group in the striatum at any of the time points, cocaine in the frontal cortex produced a 33% reduction in Bmax during weeks 2 and 3 and a 57% reduction in Bmax at week 6 of withdrawal; the reduction persisted for > or = 12 weeks. The KD was not affected by cocaine or time in either brain region. These findings may be functionally related to cocaine craving because the DA transporter has been identified as the neuronal structure and the medial prefrontal cortex as the anatomical site mediating cocaine reinforcement.


Fractionation and characterization of the immunosuppressive substance in crude extracellular products released by Streptococcus intermedius.
The noncytotoxic immunosuppressive substance detected in crude extracellular products of Streptococcus intermedius (CEP-SI) was fractionated by two steps of preparative isoelectric focusing in sucrose gradients using ampholytes of pH range from 3.5 to 6 and 4 to 5, respectively. The in vitro and in vivo suppressor effects of the most highly purified fraction of CEP-Si, designated fraction 3' (F3'EP-Si), corresponded well with those of the original CEP-Si. F3'EP-Si was sensitive to the effects of alpha, gamma, and delta chymotrypsin, trypsin, and heating. It contained approximately 1% of the total amount of protein found in the original CEP-Si, corresponding to a single band on analytical isoelectric focusing, stainable by Coomassie Blue and of isoelectric point of 4.25. The absorption spectrum of F3'EP-Si had a maximum at 260 nm but its biological activity was resistant to deoxyribonuclease and ribonuclease A and it did not contain material stainable by methylene blue. It was also resistant to neuraminidase and did not contain material stainable by periodic acid schiff. We conclude that the substance responsible for the suppressor activity of CEP-Si is a protein of molecular weight approximately 90,000, which adheres to Sephadex of cellulose acetate and forms complexes with other, nonactive constituents of CEP-Si.


Can the Boston Carpal Tunnel Syndrome Questionnaire Be Used as a Screening Tool Among a Potentially High-Risk Population in Singapore?
Introduction Carpal tunnel syndrome (CTS) causes significant morbidity with delayed diagnosis or management. The Boston Carpal Tunnel Questionnaire (BCTQ) is validated for monitoring CTS following diagnosis; however, it has not been trialed in a screening capacity. The study aimed to determine whether it can be utilized when screening a focused population in Singapore. Materials and Methods A single-center survey-based study was undertaken prospectively to identify whether positive symptoms could be identified among nursing and administrative staff. Results A total of 605 staff responded. Positive symptoms were identified in 317 (52.4%) of participants and 23 (3.8%) reported them to be severe. Functional limitations were detected in 157 (26.0%) of participants with 5 (0.8%) reporting these as severe. Positive symptoms (84.9%) and functional limitations (81.5%) were more prevalent among nursing staff. Cronbach's α scores (0.896 for symptoms and 0.84 for functional limitations) suggested good reliability in matching symptoms and functional limitations. Conclusion The BCTQ can potentially be implemented as a screening tool for CTS among those without a prior diagnosis. It has a greater depth of questioning with symptomatic and functional limitations considered, and in situations where a formal diagnosis is subsequently made, the same tool can be subsequently used for progression tracking pre- and post-treatment. Level of Evidence This is a Level II study.


De novo variants in CELF2 that disrupt the nuclear localization signal cause developmental and epileptic encephalopathy.
We report heterozygous CELF2 (NM_006561.3) variants in five unrelated individuals: Individuals 1-4 exhibited developmental and epileptic encephalopathy (DEE) and Individual 5 had intellectual disability and autistic features. CELF2 encodes a nucleocytoplasmic shuttling RNA-binding protein that has multiple roles in RNA processing and is involved in the embryonic development of the central nervous system and heart. Whole-exome sequencing identified the following CELF2 variants: two missense variants [c.1558C>T:p.(Pro520Ser) in unrelated Individuals 1 and 2, and c.1516C>G:p.(Arg506Gly) in Individual 3], one frameshift variant in Individual 4 that removed the last amino acid of CELF2 c.1562dup:p.(Tyr521Ter), possibly resulting in escape from nonsense-mediated mRNA decay (NMD), and one canonical splice site variant, c.272-1G>C in Individual 5, also probably leading to NMD. The identified variants in Individuals 1, 2, 4, and 5 were de novo, while the variant in Individual 3 was inherited from her mosaic mother. Notably, all identified variants, except for c.272-1G>C, were clustered within 20 amino acid residues of the C-terminus, which might be a nuclear localization signal. We demonstrated the extranuclear mislocalization of mutant CELF2 protein in cells transfected with mutant CELF2 complementary DNA plasmids. Our findings indicate that CELF2 variants that disrupt its nuclear localization are associated with DEE.


[Urinary stones in Tunisian infants, based on a series of 64 cases].
To define the epidemiological and clinical characteristics of urinary stones in infants, to study the role of stone chemical analysis in the aetiological assessment of urinary stones and to define the various treatment modalities adapted to this age-group. Between 1984 and 2002, 64 infants (age: 5-24 months) were hospitalised for urinary stones. Urine culture was performed in all patients and metabolic assessment was performed in 24 patients. Physicochemical stone analysis was performed by infrared spectrophotometry in 37 patients. Upper tract and lower tract stones were equally prevalent. Urine culture was positive in 48 cases. The micro-organism most frequently isolated was Proteus mirabilis (19 cases). The metabolic assessment was normal in 15 patients and pathological in 9 patients. Infrared spectrophotometry showed that 17 stones were pure. 60 patients were treated surgically, 2 were treated by endoscopy associated with intracorporeal lithotripsy. One patient was treated medically and another patient passed the stone spontaneously while in hospital. No intraoperative or postoperative complication was observed. No recurrence was observed in this series. The mean follow-up is 16 months (range: 6 months to 94 months). The epidemiological profile of urinary stones in infants in Tunisia is situated between that observed in developed countries and that observed in developing countries. In our study, the incidence of metabolic abnormalities appears to be low despite a high rate of consanguinity in Tunisia. This can be largely explained by the absence of an aetiological survey and/or an inadequate survey when it is performed.


Interaction of Penicillin-Binding Protein 2x and Ser/Thr protein kinase StkP, two key players in Streptococcus pneumoniae R6 morphogenesis.
Bacterial cell growth and division require the co-ordinated action of peptidoglycan biosynthetic enzymes and cell morphogenesis proteins. However, the regulatory mechanisms that allow generating proper bacterial shape and thus preserving cell integrity remain largely uncharacterized, especially in ovococci. Recently, the conserved eukaryotic-like Ser/Thr protein kinase of Streptococcus pneumoniae (StkP) was demonstrated to play a major role in cell shape and division. Here, we investigate the molecular mechanisms underlying the regulatory function(s) of StkP and show that it involves one of the essential actors of septal peptidoglycan synthesis, Penicillin-Binding Protein 2x (PBP2x). We demonstrate that StkP and PBP2x interact directly and are present in the same membrane-associated complex in S. pneumoniae. We further show that they both display a late-division localization pattern at the division site and that the positioning of PBP2x depends on the presence of the extracellular PASTA domains of StkP. We demonstrate that StkP and PBP2x interaction is mediated by their extracellular regions and that the complex formation is inhibited in vitro in the presence of cell wall fragments. These data suggest that the role of StkP in cell division is modulated by an interaction with PBP2x.


Do statins reduce the mortality rate in stroke patients treated with systemic thrombolysis in a 5-year.
The present study investigated the association between pre-treatment with a cholesterol-lowering drug (statin) or new setting hereon and the effect on the mortality rate in patients with acute ischemic stroke who received intravenous systemic thrombolysis. During a 5-year period (starting in October 2008), 542 consecutive stroke patients who received intravenous systemic thrombolysis with recombinant tissue plasminogen activator (rt-PA) at the Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany, were included. Patients were characterized according to statins. The primary endpoint was mortality; it was assessed twice: in hospital and 3 months after discharge. The secondary outcome was the rate of symptomatic intracerebral hemorrhage. Of the 542 stroke patients examined (mean age 72 ± 13 years; 51% women, mean National Institutes of Health Stroke Scale (NIHSS) score 11), 138 patients (25.5%) had been pre-treated with statin, while in 190 patients (35.1%) statin therapy was initiated during their stay in hospital, whereas 193 (35.6%) never received statins. Patients pre-treated with statin were older and more frequently had previous illnesses (arterial hypertension, diabetes mellitus and previous cerebral infarctions), but were comparably similarly affected by the stroke (NIHSS 11 vs. 11; P = 0.76) compared to patients who were not on statin treatment at the time of cerebral infarction. Patients pretreated with statin did not differ in 3-month mortality from those newly treated to a statin (7.6% vs. 8%; P = 0.9). Interestingly, the group of patients pretreated with statin showed a lower rate of in hospital mortality (6.6% vs. 17.0; P = 0.005) and 3-month mortality (10.7% vs. 23.7%; P = 0.005) than the group of patients who had no statin treatment at all. The same effect was seen for patients newly adjusted to a statin during the hospital stay compared to patients who did not receive statins (3-month mortality: 7.1% vs. 23.7%; P < 0.001). With a good functional outcome (mRS ≤ 2), 60% of patients were discharged, the majority (69.6%; P < 0.001) of whom received a statin at discharge. The rate of symptomatic intracerebral hemorrhages in the course of cranial computed tomography was independent of whether the patients were pretreated with a statin or not (8.8% vs. 8.7%, P = 0.96). Pre-treatment with statin as well as new adjustment could reveal positive effect on prognosis of intravenous thrombolyzed stroke patients. Further investigations are required. The study was approved by the Ethic Committee of the University of Lübeck (approval No. 4-147).


Epidemiology and blood flow surveillance of the native arteriovenous fistula: a review of the recent literature.
Vascular access placement is a key management issue for hemodialysis patients. Despite being well regarded as the access of first choice, the native arteriovenous fistula (AVF) remains underutilized in the United States. The first part of this review examines recent epidemiology studies addressing patient factors associated with the use of the synthetic arteriovenous graft as opposed to the native fistula. Female gender and older age are consistently associated with a higher frequency of graft use. Diabetes, peripheral vascular disease, and body mass index were associated with graft use in some but not all of the studies. Recent evidence also suggests an independent survival advantage for patients dialyzing via native fistulae especially for infection-related mortality. The second part reviews evidence surrounding the recommendations for blood flow surveillance of the native fistula. The hemodynamic features of the native fistula are examined and differences from synthetic grafts are highlighted. Clinical studies assessing the use of blood flow surveillance to prevent the sudden thrombosis of native fistulae are reviewed. Blood flow thresholds for further investigation are yet to be determined definitely for AVF and randomized studies should be performed to assesses the impact on AVF thrombosis rates.


Stereocontrol in radical cyclization: change in rate-determining step.
Intramolecular cyclization of an alpha-carbon radical of ester carrying a chiral 2,4-pentanediol tether shows low stereoselectivity when the radical carbon has an alkyl substituent, while the selectivity becomes high to give a single stereoisomer (>99% pure) when the substituent is an aryl group. The difference in the selectivity is attributable to the change in the rate-determining step from the conformational process to the cyclization.


Molecular Scylla and Charybdis: Maneuvering between pH Sensitivity and Excited-State Localization in Ruthenium Bi(benz)imidazole Complexes.
Bi(benz)imidazoles (b(b)im) acting as N,N-chelates in ruthenium complexes represent a unique class of ligands. They do not harbor metal-to-ligand charge-transfer (MLCT) excited states in ruthenium polypyridyl complexes upon visible-light excitation provided that no substitution is introduced at the N atoms. Hence, they can be used to steer light-driven electron-transfer pathways in a desired direction. Nonetheless, the free N atoms are susceptible to protonation and, hence, introduce highly pH-dependent properties into the complexes. Previous results for ruthenium complexes containing R2bbim ligands with alkylic or arylic N,N'-substitution indicated that, although pH insensitivity was accomplished, unexpected losses of spectator ligand features incurred simultaneously. Here, we report the synthesis and photophysical characterization of a series of differently N,N'-alkylated b(b)im ligands along with their corresponding [(tbbpy)2Ru(R2b(b)im)](PF6)2 complexes (tbbpy = 4,4'-tert-butyl-2,2'-bipyridine). The data reveal that elongation of a rigid ethylene bridge by just one methylene group drastically increases the emission quantum yield, emission lifetime, and photostability of the resultant complexes. Quantum-chemical calculations support these findings and allow us to rationalize the observed effects based on the energetic positions of the respective excited states. We suggest that N,N'-propylene-protected 1H,1'H-2,2'-biimidazole (prbim) is a suitable spectator ligand because it stabilizes sufficiently long-lived MLCT excited states exclusively localized at auxiliary bipyridine ligands. This ligand represents, therefore, a vital building block for next-generation photochemical molecular devices in artificial photosynthesis.


Adnexal germ cell carcinoma with bone metastases in pregnant women: case report and review.
Germ cell carcinoma during pregnancy is rare. However, its detection has increased due to the use of ultrasound fetal monitoring in the antenatal care program. In this article, we present the case of a Germ cell carcinoma during pregnancy is rare. However, its detection has increased due to the use of ultrasound fetal monitoring in the antenatal care program. In this article, we present the case of a pregnant 27-year-old diagnosed with an adnexal germ cell carcinoma at six weeks of gestation, whose initial approach was local resection (suboptimal cytoreduction). Four weeks after surgery, the patient presented with grade IV peripheral neuropathy in the lower limbs; magnetic resonance imaging scan indicated an infiltrative lesion at D5. The local medical board decided on chemotherapy starting on the 19th week of gestation. The rest of the pregnancy period was uneventful and the patient had a cesarean section at 34 weeks of gestation and a live newborn with no complications. Unfortunately, four days after caesarean section, the patient died of a septic shock with respiratory focus.


Synthesis of BMS-309403-related compounds, including [¹⁴C]BMS-309403, a radioligand for adipocyte fatty acid binding protein.
Adipocyte fatty acid binding protein (A-FABP; FABP4), which is predominantly expressed in macrophages and adipose tissue, regulates fatty acid storage and lipolysis, and is also an important mediator of inflammation. Here, we report a synthesis of (14)C-labeled 2-[2'-(5-ethyl-3,4-diphenyl-1H-pyrazol-1-yl)biphenyl-3-yloxy]acetic acid (BMS309403), a potent and selective small-molecular FABP4 inhibitor, as a chemical tool for investigating the roles of FABP4 in inflammatory and metabolic disorders. The structure-activity relationship of several BMS derivatives for inhibition of FABP4 is also reported.


Zoo: Selecting Transcriptomic and Methylomic Biomarkers by Ensembling Animal-Inspired Swarm Intelligence Feature Selection Algorithms.
Biological omics data such as transcriptomes and methylomes have the inherent "large p small n" paradigm, i.e., the number of features is much larger than that of the samples. A feature selection (FS) algorithm selects a subset of the transcriptomic or methylomic biomarkers in order to build a better prediction model. The hidden patterns in the FS solution space make it challenging to achieve a feature subset with satisfying prediction performances. Swarm intelligence (SI) algorithms mimic the target searching behaviors of various animals and have demonstrated promising capabilities in selecting features with good machine learning performances. Our study revealed that different SI-based feature selection algorithms contributed complementary searching capabilities in the FS solution space, and their collaboration generated a better feature subset than the individual SI feature selection algorithms. Nine SI-based feature selection algorithms were integrated to vote for the selected features, which were further refined by the dynamic recursive feature elimination framework. In most cases, the proposed Zoo algorithm outperformed the existing feature selection algorithms on transcriptomics and methylomics datasets.


Determinants of treatment non-attendance among those referred to primary mental health care services in Western Sydney, Australia: a retrospective cohort study.
Recommendations of the recent mental health reforms provided an opportunity to implement regional approaches to service provision through Primary Health Networks. This study is designed to identify the determinants of sociodemographic, diagnostic and referral-level factors and first treatment session non-attendance among those referred to primary mental health care (PMHC) services in Western Sydney, Australia. This study used routinely collected retrospective PMHC data between July 2016 and December 2018. The study was based on a geographical catchment that covers four local government areas of Blacktown, Parramatta, Cumberland and Hills Shire in Western Sydney, Australia. All individuals 5 years of age or older referred to PMHC services. First treatment session non-attendance, following a referral to receive psychological treatments. There were 9158 referrals received for 8031 clients, with 1769 (19.32%) referrals resulting in non-attendance to the first treatment session. Those with younger age (ORs ranging from 1.63 to 1.92), substance use (OR=1.55, 95% CI 1.17 to 2.06), poor English proficiency (OR=1.64, 95% CI 1.23 to 2.20), lower socioeconomic status (OR=1.57, 95% CI 1.34 to 1.83), psychotropic medication use (OR=1.20, 95% CI 1.06 to 1.36), and a referral by a social worker (OR=2.04, 95% CI 1.36 to 3.05), allied health (OR=1.49, 95% CI 1.03 to 2.16) or other professional (OR=1.72, 95% CI 1.30 to 2.29) were associated with a higher likelihood of first treatment session non-attendance. Those with a risk of suicide, who mainly speak a language other than English, and a previous use of PMHC services were more likely to attend their first treatment session. Youth-specific treatment approaches, behavioural engagement strategies, facilitation of transport services for those live in deprived regions and improvements in capacity for mental health training among allied health professionals are areas of focus for primary care service and policy responses.


Distribution of beach litter along the coastline of Cádiz, Spain.
A total of 59 categories of litter items were found at 20 beaches (13 mechanically cleaned, 7 non-cleaned) in the Cádiz tourist environment, Spain. Cluster Analysis and Principal Components Analysis were used to highlight similarities and contrasts between sites and/or associations between litter categories. Multivariate analyses separated beaches according to the total numbers of litter items present. Non-cleaned sites showed a variety of litter category abundance with distinct origins and abundant, ubiquitous items (plastic and glass fragments). Of the 7 non-cleaned beaches (49 litter categories) river-mouth sites were distinct due with high numbers of litter items. The sheltered inner part of Cádiz Bay beaches had a wide range of litter type. Many sites were associated with locally deposited recreational litter categories; while industrial/commercial/fishing categories were abundant only at a few sites, indicating items transported onto the shore from the Guadalete river.


Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment.
Obesity is a multifactorial disease resulting in excessive accumulation of fat. Worldwide, obesity is an important public health problem, affecting a large proportion of the world population. The tender cactus Opuntia ficus-indica, commonly known in Mexico as "nopal", is widely distributed in this country, Latin America, South Africa, and the Mediterranean area. Nopal cladodes are commonly marketed in different forms as fresh, frozen, or pre-cooked, and used as fresh green vegetable. The aim of this study was to evaluate the capability of nopal to improve the health condition of participants affected by obesity, in a physical and dietary intervention, through gut microbiota modification. These results were contrasted with the effect of nopal in the gut microbiota of normal weight participants. We describe the association among biochemical, anthropometric markers, and the gut microbiota diversity found in fecal samples of the obese and normal weight groups. The results presented in this work suggest that caloric restriction, addition of nopal to the diet and physical activity, promote changes in the gut microbiota in obese women, improving the host metabolism, as suggested by the correlation between some bacterial species with biochemical and anthropometrical parameters.


Cranial CT in the haemolytic uraemic syndrome.
A patient with the haemolytic uraemic syndrome and severe encephalopathy is described. The initial extensive brain hypodensity on CT scan was followed 10 days later by diffuse enhancement of the cerebral gray-white matter interface. A possible explanation for this phenomenon is suggested.


Evaluation of central vein sizes in patients with autogenous hemodialysis fistulas.
To quantify diameters of central vein segments in patients with autogenous hemodialysis fistulas. A retrospective review of patients within the last year who underwent arterial venous fistula assessment identified 218 patients. Of these, 32 also had computed tomography (CT) of the thorax performed from which venous sizes could be ascertained. Measurements in the axial plane (diameter) of the central veins were obtained from calibrated DICOM images. Additional demographic information including age, sex, and location of the fistula were also acquired to determine whether there was any correlation of these factors with the vein diameters. Variables were compared using the unpaired t test. There were 21 and 11 patients with left-sided and right-sided fistulas, respectively, with a mean age of 61.1 years. There was no statistically significant difference (P<.05) found between the diameter when comparing men to women (P=.93 to .22) or patient ages less than or greater than 70 years old (P=.95 to .11). The only statistically significant difference observed was when the fistula was located in the left arm, with the left axillary vein being larger than the right (11.4 ± 0.6 and 8.4 ± 0.6 respectively P=.003). The remaining vessels showed no statistically significant difference in size with respect to the fistula location (P=.75 to .07). The left axillary vein is significantly larger in patients who have a fistula located in the left arm compared to the right. Central vein sizes measured by CT correlate with sizes measured angiographically in prior retrospective studies.


Using group-specific PCR to detect predation of mayflies (Ephemeroptera) by wolf spiders (Lycosidae) at a mercury-contaminated site.
Bioaccumulation of contaminants can occur across ecosystem boundaries via transport by emergent aquatic insects. In the South River, Virginia, USA, aquatic mercury has contaminated songbirds nesting in adjacent riparian forests. Spiders contribute the majority of mercury to these songbirds' diets. We tested the hypothesis that massive annual mayfly emergences provide a vector for mercury from river sediments to the Lycosid spiders most frequently eaten by contaminated songbirds. We designed mayfly-specific PCR primers that amplified mtDNA from 76% of adult mayflies collected at this site. By combining this approach with an Agilent 2100 electrophoresis system, we created a highly sensitive test for mayfly predation by Lycosids, commonly known as wolf spiders. In laboratory spider feeding trials, mayfly DNA could be detected up to 192h post-ingestion; however, we detected no mayfly predation in a sample of 110 wolf spiders collected at the site during mayfly emergence. We suggest that mayfly predation is not an important mechanism for dietary transfer of mercury to wolf spiders and their avian predators at the South River. Instead, floodplain soil should be considered as a potential proximate source for mercury in the terrestrial food web.


Management of F/P+/- hypereosinophilic syndromes: case report and treatment review.
Eosinophilia in clinical practice can occur due to various pathologic processes. Causes of eosinophilia include idiopathic eosinophilia, reactive eosinophilia, idiopathic hypereosinophilic syndrome (HES), chronic eosinophilic leukemia, and other hematopoietic neoplasms (myeloid, lymphatic, or mast cell). We present a case of a 22-year-old man with HES with remarkable clinical manifestations and treatment challenges.


Development and Prevention of Running-Related Osteoarthritis.
Studies investigating the effect of running on risk for developing osteoarthritis at weight-bearing joints have reported with conflicting results. Generally, moderate-level running is not likely detrimental to joint health. However, many factors may be associated with the increased risk of developing osteoarthritis in runners. Factors often implicated in the development of osteoarthritis comprise those that increase joint vulnerability and those which increase joint loading. It is therefore suggested that running has different effects on different people. Efforts should be made to identify those with joint vulnerability and joint loading, and measures should be taken to have those factors and/or their running programs modified to run safely. Further investigations are needed to examine the effect of running on joint health under different conditions to confirm the association between exposure to risk factors and development of osteoarthritis, as well as to validate the effectiveness of measures for preventing running-related osteoarthritis.


Ameliorative effects of jamun seed and orange peel extracts on microcystin LR induced alterations in calcitonin cells and parathyroid gland of rats.
This study investigated changes in calcitonin cells (C-cells) and parathyroid glands (PTG) induced by microcystin LR (MCLR) exposure to rats and evaluated ameliorative effects of jamun (Syzygium cumini) seed (JSE) and orange (Citrus sinensis) peel (OPE) extracts. Wistar rats were treated as-Group A (control), Group B (MCLR), Group C (MCLR + JSE), Group D (MCLT + OPE), Group E (OPE) and Group F (JSE). Microcystin dose was (10 μg/kg body wt/day whereas OPE and JSE dose was 200 mg/kg body wt/day. Thyroid and PTG were fixed on 15 and 30 days following the treatment. C-cells of treated rats for 15 days with MCLR; MCLR + JSE and MCLR + OPE exhibit degranulation, mitochondrial swelling and prominent RER. In MCLR treated rats few cells completely lack secretory granules. After 30 days MCLR treatment accumulation of secretory granules and degeneration were noticed in C-cells. C-cell nuclear volume (NV) of MCLR, MCLR + JSE and MCLT + OPE treated rats show an increase. In MCLR, MCLR + JSE and MCLR + OPE treated rats PTG exhibit hyperchromatic nuclei, nuclear elongation and increased NV after 15 days. After 30 days MCLR treatment nuclei of PTG become more hyperchromatic, more elongated, show degeneration of nuclei and increase in NV. NV is increased in Group C and Group D. PTG remain unaltered 30 days following treatment with OPE and JSE. Microcystin LR provoke physiological effects on the blood calcium and alterations in C cells and PTG, which cause serious threat to organism. These changes can be protected by JSE and OPE.


Sexuality and sexual health among female youth with borderline personality disorder pathology.
Borderline personality disorder (BPD) is a severe mental disorder that is characterized by unstable relationships, impulsive behaviours and identity disturbance. BPD usually has its onset between puberty and young adulthood and presents disproportionately among females in clinical settings. Taken together, this makes young women with BPD a particularly vulnerable group with regard to healthy psychosexual development. It was hypothesized that female youth with BPD pathology would be more likely to score worse on measures of sexual health and safety, and to show greater uncertainty in sexual identity formation. Fifty 15 to 24 yr-old females with 3 or more Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) BPD criteria were compared with 204 females from a nationally representative sample. Both groups were interviewed using a comprehensive interview for sexual health and relationships. The patient group completed a structured diagnostic interview. Young women with borderline personality pathology engaged in sexual relationships at a younger age, with more sexual partners in the previous year, in more casual relationships. They were more likely to practice unsafe sex for their first sexual experience, to be coerced into unwanted sexual activity, to be unclear about their sexual identity or their sexual attraction, and to report worse overall health status. BPD pathology in youth is associated with poor sexual health and safety, and uncertainty in sexual identity formation. These findings support the need for assessment of the sexuality and sexual health of youth with BPD, along with the need for routine screening in sexual health services for BPD features among high-risk youth.


Length of hospital stay among oral and maxillofacial patients: a retrospective study.
: Many conditions of the oral and maxillofacial region require hospitalization and in-patient care. The average length of stay (LOS) of these patients varies and is usually affected by multiple confounding variables. However, even with an increasing number of hospital admissions, published evidence on the factors that affect the LOS of oral and maxillofacial patients is lacking. Therefore, this study assessed the LOS of in-patients at the oral and maxillofacial surgery department of a government-funded, multi-specialty hospital in Malaysia, based on their reasons for admission and other factors. Our samples were collected retrospectively over a 5-year period and included patients with maxillofacial infections, post-trauma stabilization, facial bone fracture surgery, benign and malignant lesion surgery, dentoalveolar surgery, and other maxillofacial surgeries as reasons for admission. Factors potentially affecting LOS were also recorded, and their significance was determined using multiple logistic regression analyses. A P-value of less than 0.05 was considered to be statistically significant. A total of 1,380 patients were included in this study. Most (84.5%) of our in-patients were of Malay ethnicity, and males outnumbered females in our sample by 502 subjects. The median LOS of our in-patients was 3 days. Sex, ethnicity, age, reason for admission, and American Society of Anesthesiology (ASA) classification were factors that significantly affected LOS. The median LOS reported in this study was 3 days. LOS was significantly affected by sex, ethnicity, age, reason of admission and ASA classification.


Mechanochemical bond scission for the activation of drugs.
Pharmaceutical drug therapy is often hindered by issues caused by poor drug selectivity, including unwanted side effects and drug resistance. Spatial and temporal control over drug activation in response to stimuli is a promising strategy to attenuate and circumvent these problems. Here we use ultrasound to activate drugs from inactive macromolecules or nano-assemblies through the controlled scission of mechanochemically labile covalent bonds and weak non-covalent bonds. We show that a polymer with a disulfide motif at the centre of the main chain releases an alkaloid-based anticancer drug from its β-carbonate linker by a force-induced intramolecular 5-exo-trig cyclization. Second, aminoglycoside antibiotics complexed by a multi-aptamer RNA structure are activated by the mechanochemical opening and scission of the nucleic acid backbone. Lastly, nanoparticle-polymer and nanoparticle-nanoparticle assemblies held together by hydrogen bonds between the peptide antibiotic vancomycin and its complementary peptide target are activated by force-induced scission of hydrogen bonds. This work demonstrates the potential of ultrasound to activate mechanoresponsive prodrug systems.