Effect and Mechanisms of Quercetin for Experimental Focal Cerebral Ischemia: A Systematic Review and Meta-Analysis.
Quercetin, a naturally occurring flavonoid, is mainly extracted from tea, onions, and apples. It has the underlying neuroprotective effect on experimental ischemic stroke. A systematic review and meta-analysis were used to assess quercetin's efficacy and possible mechanisms in treating focal cerebral ischemia. Compared with the control group, twelve studies reported a remarkable function of quercetin in improving the neurological function score (NFS) (P < 0.05), and twelve studies reported a significant effect on reducing infarct volume (P < 0.05). Moreover, two and three studies showed that quercetin could alleviate blood-brain barrier (BBB) permeability and brain water content, respectively. The mechanisms of quercetin against focal cerebral ischemia are diverse, involving antioxidation, antiapoptotic, anti-inflammation, and calcium overload reduction. On the whole, the present study suggested that quercetin can exert a protective effect on experimental ischemic stroke. Although the effect size may be overestimated because of the quality of studies and possible publication bias, these results indicated that quercetin might be a promising neuroprotective agent for human ischemic stroke. This study is registered with PROSPERO, number CRD 42021275656.


Accelerating introduction of new vaccines: barriers to introduction and lessons learned from the recent Haemophilus influenzae type B vaccine experience.
Adoption of new vaccines in developing countries is critical to reducing child mortality and meeting Millennium Development Goal 4. However, such introduction has historically suffered from significant delays that can be attributed to various factors including (i) lack of recognition of the value of a vaccine, (ii) factors related to weak health systems, and (iii) policy considerations. Recently, the Global Alliance for Vaccines and Immunization (GAVI) supported efforts to accelerate the introduction of Haemophilus influenzae type b (Hib) vaccines in developing countries, which resulted in a significant surge in vaccine adoption by these countries. The experience with Hib vaccines, as well as similar efforts by GAVI to support the introduction of new pneumococcal and rotavirus vaccines, provides a strategy for new vaccine adoption that is reviewed in this paper, providing a useful model to help accelerate the uptake of other life-saving vaccines. This strategy addresses barriers for vaccine adoption by focusing on three major areas: (i) communications to increase awareness about the various factors needed for evidence-based decisions that meet a country's health goals; (ii) research activities to answer key questions that support vaccine introduction and long-term programme sustainability; and (iii) coordination with the various stakeholders at global, regional and country levels to ensure successful programme implementation.


FDG-PET imaging in HIV infection and tuberculosis.
The intersection and syndemic interaction between the human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics have global prevalence with devastating morbidity and massive mortality. Using FDG-PET imaging it was shown that in HIV-infected individuals, involvement of the head and neck precedes that of the chest and of the abdomen. The sequence of lymph node involvement observed suggests the existence of a diffusible activation mediator that may be targeted via therapeutic intervention strategies. Furthermore, the degree of FDG uptake proved directly related to viral load and inversely related to CD4 cell count. Available data in acquired immune deficiency syndrome (AIDS)-defining cancers further suggest that FDG-PET/CT imaging may be useful for prognostication of cervical cancer and for identifying appropriate sites for biopsy, staging, and monitoring lymphoproliferative activity owing to HIV-associated Kaposi sarcoma and multicentric Castleman disease. Inversely, in HIV-associated lymphoma, FDG uptake in HIV-involved lymphoid tissue was shown to reduce the specificity of FDG-PET imaging findings, the effect of which in clinical practice warrants further investigation. In the latter setting, knowledge of viremia appears to be essential for FDG-PET image interpretation. Early HIV-associated neurocognitive disorder, formerly known as AIDS dementia complex, proved to be characterized by striatal hypermetabolism and progressive HIV-associated neurocognitive disorder or AIDS dementia complex by a decrease in subcortical and cortical metabolism. In lipodystrophic HIV-infected individuals, lipodystrophy proved associated with increased glucose uptake by adipose tissue, likely resulting from the metabolic stress of adipose tissue in response to highly active antiretroviral therapy. Furthermore, ongoing chronic low-grade infection in arteries of HIV-infected individuals could be depicted by FDG-PET/CT imaging. And there is promising data that FDG-PET/CT in HIV may serve as a new marker for the evaluation of thymic function in HIV-infected patients. In the setting of TB, FDG-PET has proven unable to differentiate malignancy from TB in patients presenting with solitary pulmonary nodules, including those suffering from HIV, and thus cannot be used as a tool to reduce futile biopsy or thoracotomy in these patients. In patients presenting with extrapulmonary TB, FDG-PET imaging was found to be significantly more efficient when compared with CT for the identification of more sites of involvement. Thus supporting that FDG-PET/CT can demonstrate lesion extent, serve as guide for biopsy with aspiration for culture, assist surgery planning and contribute to follow-up. Limited available data suggest that quantitative FDG-PET findings may allow for prediction or rapid assessment, at 4 months following treatment instigation, of response to antituberculostatics in TB-infected HIV patients. These results and more recent findings suggest a role for FDG-PET/CT imaging in the evaluation of therapeutic response in TB patients.


Perceptions of policymakers in Nigeria toward unsafe abortion and maternal mortality.
In Nigeria, abortion is permitted only to save the life of a woman. Unsafe abortion is common and is a major cause of maternal mortality, yet policymakers have done little to address the problem. In-depth interviews were conducted in 2008 with 49 Nigerian politicians and officials to assess their awareness of unsafe abortion and its role in maternal mortality, and to determine their perceptions of the policies and actions needed to address these problems. Participants had poor knowledge of Nigeria's abortion law and the number of abortions and abortion-related deaths, though many knew of women who had died or nearly died from unsafe abortion. Policymakers were guided by moral and religious considerations rather than by evidence-based approaches. About one-third of informants felt that abortion should not be legal under any circumstances, one-fifth supported liberalization on medical grounds and a similar proportion believed that abortion should be legal in cases of rape and incest. Strategies recommended by respondents to reduce maternal mortality included facilitating access to contraceptives, providing sexuality education, improving the health care system, empowering women and providing free pregnancy care. Intense public health education and advocacy targeting policymakers is needed to increase political will for reducing abortion-related maternal deaths in Nigeria. Presenting statistics on unsafe abortion together with compelling personal stories will likely resonate with policymakers and contribute to an informed public debate on abortion law reform.


Job Satisfaction of Fitness Professionals in Portugal: A Comparative Study of Gender, Age, Professional Experience, Professional Title, and Educational Qualifications.
This research characterizes and compares the job satisfaction of fitness professionals in Portugal between genders, ages, professional experience, professional title, and educational qualifications. A total of 401 fitness professionals answered the online questionnaire Job Satisfaction Scale, which has 16 factors rated on a Likert scale with seven levels. The statistical analysis comprises descriptive and statistical tests to compare the results of two (t-test) or more (ANOVA) groups. Overall, the results demonstrated that fitness professionals were moderately satisfied with their work. The lower degrees of job satisfaction were concerning salary, opportunities for promotion, and stability at work. The highest levels of job satisfaction were related to the freedom to choose their work method, their work colleagues, the physical conditions of their workplace, and the opportunity to use their competencies. There were no differences in job satisfaction in terms of gender and a few differences between professional title and between educational levels. Regarding age and professional experience, the results showed significant differences in almost all factors, suggesting that, as fitness professionals get older and more experienced, their job satisfaction is greater. The results of this study suggest that even though fitness professionals are, in general, moderately satisfied with their work, some aspects can be improved by employers to increase their satisfaction levels. Such findings would assist employers in guiding the job satisfaction of their employees with consequent enhancements in the services provided by fitness professionals, which can increase participants' retention in exercise fitness activities.


Redox biology: computational approaches to the investigation of functional cysteine residues.
Cysteine (Cys) residues serve many functions, such as catalysis, stabilization of protein structure through disulfides, metal binding, and regulation of protein function. Cys residues are also subject to numerous post-translational modifications. In recent years, various computational tools aiming at classifying and predicting different functional categories of Cys have been developed, particularly for structural and catalytic Cys. On the other hand, given complexity of the subject, bioinformatics approaches have been less successful for the investigation of regulatory Cys sites. In this review, we introduce different functional categories of Cys residues. For each category, an overview of state-of-the-art bioinformatics methods and tools is provided, along with examples of successful applications and potential limitations associated with each approach. Finally, we discuss Cys-based redox switches, which modify the view of distinct functional categories of Cys in proteins.


Inflammatory myopathy associated with statins: report of three cases.
Statins are well-established lipid-lowering drugs that reduce morbidity and mortality due to cardiovascular disease and cause adverse effects relatively rarely. It is still unclear whether statins are capable of inducing an immune-mediated response directed against skeletal muscle. Here, we present the cases of three patients who developed inflammatory myopathy in the course of statin treatment. Moreover, multiple mitochondrial DNA deletions were found in two of them. The ability of statins to induce an immune-mediated response and their interactions with mitochondrial metabolism pathways are discussed.


Using the conditioned fear stress (CFS) animal model to understand the neurobiological mechanisms and pharmacological treatment of anxiety.
The mechanisms underlying the etiology and pathophysiology of anxiety disorders - the most prevalent class of mental disorders - remain unclear. Over the last 30 years investigators have used the animal model of conditioned fear stress (CFS) to investigate the brain structures and neurotransmitter systems involved in aversive emotional learning and memory. Recent studies have focused on the neuronal circuitry and cellular mechanisms of fearful emotional experiences. This review describes the CFS paradigm, discusses the neural circuit and neurotransmission underlying CFS, and explains the mechanism of action of pharmacological treatments of CFS. The focus of the review is on the molecular mechanisms of fear extinction, a phenomenon directly implicated in the clinical treatment of anxiety. Based on our assessment of previous work we will conclude by considering potential molecular targets for treating symptoms of anxiety and fear.


Pharmacological synergy: the next frontier on therapeutic advancement for migraine.
The burden of migraine significantly impacts the individual sufferer, their families, the workplace, and society. The World Health Organization has identified migraine as an urgent public health priority and has initiated a global initiative to reduce the burden of migraine. Underlying the World Health Organization initiative is the need to discover means of optimizing migraine treatments and make them accessible to the broader portion of the world population. Development of acute migraine medications over the past several decades has largely centered on engineering highly specific receptor molecules that alter migraine pathophysiological mechanisms to abort or reverse the acute attack of migraine. The first product of this line of discovery was sumatriptan and heralded as a landmark therapeutic breakthrough. Sumatriptan is a 5-HT-1B/D receptor agonist considered to activate receptors involved in the pathophysiology specific to migraine. Large-scale regulatory/clinical studies demonstrated statistical superiority for sumatriptan over placebo in reduction or elimination of headache, nausea, photophobia, and phonophobia. Since the introduction of sumatriptan, 6 other triptan products have been released in the United States as acute treatments for migraine, all having the same mechanism of action and similar efficacy. Despite their utility as migraine abortive medications, the triptans do not successfully treat all attacks of migraine or necessarily treat all migraine associated symptoms. In fact, in less than 25% of attacks do subjects obtain and maintain a migraine-free response to treatment for at least beyond 24 hours. A wide range of non-triptan medications also have demonstrated efficacy in acute migraine. These include non-steroidal anti-inflammatory drugs (NSAIDs), opioids, phenothiazines, and valproic acid to name a few. Given the distinctly different mechanisms of actions of these various medications, it is likely that several unique pathophysiological mechanisms are involved in terminating acute episodes of migraine. Clinicians now capitalize on this observation and use migraine medication in combination with another to improve patient outcomes, for example, using an antiemetic with an opioid or a triptan and NSAIDs. More recently, the Food and Drug Adminstration has approved a combination product containing 85mg of sumatriptan plus 500mg of naproxen sodium for acute treatment of migraine. Clinical trials conducted prior to approval demonstrated that the combination of sumatriptan and naproxen was more effective as a migraine abortive than either of its components but that each component and the combination were more effective than placebo. Exactly how sumatriptan and naproxen interact to create therapeutic synergism is unknown though its mere occurrence suggests that models assisting medical understanding and prediction of pharmacological synergism may improve clinical outcome over products acting through a single receptor mechanism. Migraine is a syndrome, meaning it is defined by observed symptoms rather than known pathophysiology. Multiple pathogenic mechanisms are likely involved in generating this diverse array of symptoms understood as the migraine symptom complex. Sumatriptan and naproxen have independent mechanisms of action and target distinct aspects of the vascular and inflammatory processes hypothesized to underlie migraine. Sumatriptan acts on the 5-HT(1B) and 5-HT(1D) receptors, whereas naproxen inhibits the COX-1 and COX-2 enzymes. Sumatriptan has vasoconstricting effects as well as effects on neurogenic inflammation by decreasing the release of substance P and calcitonin gene-related peptide. In contrast, naproxen affects prostaglandins and other inflammatory mediators. Because sumatriptan and naproxen both relieve migraine yet interact with different cellular targets within the migraine pathway, it is reasonable to assume there is a unique synergy between these medications that improves treatment outcomes. Clinical trials supported this contention by demonstrating the combination of sumatriptan/naproxen alleviated migraine pain quickly (primarily based on the sumatriptan mechanism of action), and sustained the response longer (primarily based on the naproxen mechanism of action) than is possible when either drug is given alone. The working hypothesis is that when sumatriptan and naproxen are given at the same time, they affect different mechanisms of the migraine pathway and produce an enhanced therapeutic effect. The purpose of this article is to apply statistical analyses to data from phase II and phase III studies of the combination of sumatriptan and naproxen to determine if this enhanced therapeutic effect is synergistic. This methodology of accessing synergy can be used in the development of future combination migraine treatments to improve treatment outcomes.


Detection of Taenia solium antigens in merthiolate-form preserved stool samples.
Cysticercosis can be controlled by mass treatment of Taenia solium carriers in hyperendemic areas. An automated screening method suitable for mass application is required to determine the prevalence of taeniasis and the efficacy of its treatment, since existing methods of carrier detection are considered insufficient for this purpose. Thus, a biotin/avidin-enhanced enzyme-linked immunosorbent assay (ELISA) was designed, which detected T. solium antigens in supernatants of merthiolate-formalin preserved stool samples. The assay distinguished the nine T. solium carriers tested from 41 negative controls, but cross-reactivity with Taenia saginata was noted.


[Heterogeneity of adrenoceptors in rat basilar and renal arteries].
A comparative study was made on the distribution of alpha- and beta-adrenoceptors between rat basilar (BA) and renal arteries (RA). The results showed that (1) the endothelium-independent relaxation due to beta-agonism was more significant in BA than that in RA; (2) there was no alpha 1-adrenoceptor-mediated vasoconstriction in most of the BA, only a small part of BA showed constriction in response to alpha 1-agonism, but with low affinity and efficacy and a desensitization tendency; (3) no response to alpha 2-agonist BHT 920 (10(-3) mol/L) in BA was shown, either in the presence or absence of endothelium. But in RA there was relaxation in the presence of endothelium and constriction in its absence. The above results suggest that there is a scarce distribution of alpha 1- and alpha 2-adrenoceptors, but an abundant distribution of beta-adrenoceptor in basilar artery compared with that in renal artery. The alpha 1-subtype in BA is different from the alpha 1-subtype in RA, and the alpha 2-receptor which mediates direct smooth muscle constriction and endothelium-dependent relaxation is highly heterogeneous between basilar and renal arteries.


Discrimination between lineage-specific shelters by bat- and human-associated bed bugs does not constitute a stable reproductive barrier.
The common bed bug Cimex lectularius, has been recently shown to constitute two host races, which are likely in the course of incipient speciation. The human-associated lineage splits from the ancestral bat-associated species deep in the history of modern humans, likely even prior to the Neolithic Period and establishment of the first permanent human settlements. Hybridization experiments between these two lineages show that post-mating reproductive barriers are incomplete due to local variation. As mating takes place in off-host refugia marked by aggregation semiochemicals, the present investigation tested the hypothesis that bed bugs use these semiochemicals to differentiate between refugia marked by bat- and human-associated bed bugs; this would constitute a pre-copulation isolation mechanism. The preference for lineage-specific odors was tested using artificial shelters conditioned by a group of either male or female bed bugs. Adult males were assayed individually in four-choice assays that included two clean unconditioned control shelters. In most assays, bed bugs preferred to rest in conditioned shelters, with no apparent fidelity to shelters conditioned by their specific lineage. However, 51 % of the bat-associated males preferred unconditioned shelters over female-conditioned shelters of either lineage. Thus, bed bugs show no preferences for lineage-specific shelters, strongly suggesting that semiochemicals associated with shelters alone do not function in reproductive isolation.


Health and safety concerns in fisheries and aquaculture.
Only 10% of all foodborne illnesses in the United States are attributed to seafood, making seafood a relatively safe food commodity. The implementation of Hazard Analysis and Critical Control Points guidelines should make seafood consumption even safer. Concerns include closed-loop, indoor, water-recirculating production systems; harmful algal blooms in marine environments, which can cause paralytic, neurologic, amnesic, and diarrhetic shellfish poisonings and ciguatera fish poisoning; bacteria (such as Mycobacterium marinum and Streptococcus iniae) and nematode, cestode, trematode, and protozoan parasites found in fish that cause human infections; and the shellfish origin of Norwalk virus infection. Avoidance, control, and treatment of this wide range of maladies contracted by humans from fish are covered in this review article. Prevention of accidents in fisheries and aquaculture is receiving more attention by groups such as the FDA, OSHA, and the Working Group for Quality Assurance in Aquaculture Production, which is part of the federal Joint Subcommittee on Aquaculture in Washington, D.C.


Hypogonadism, Type-2 Diabetes Mellitus, and Bone Health: A Narrative Review.
One of the complications from chronic hyperglycemia and insulin resistance due to type 2 diabetes mellitus (T2DM) on the hypothalamic-pituitary-gonadal axis in men is the high prevalence of hypogonadotropic hypogonadism (HH). Both T2DM and hypogonadism are associated with impaired bone health and increased fracture risk but whether the combination results in even worse bone disease than either one alone is not well-studied. It is possible that having both conditions predisposes men to an even greater risk for fracture than either one alone. Given the common occurrence of HH or hypogonadism in general in T2DM, a significant number of men could be at risk. To date, there is very little information on the bone health men with both hypogonadism and T2DM. Insulin resistance, which is the primary defect in T2DM, is associated with low testosterone (T) levels in men and may play a role in the bidirectional relationship between these two conditions, which together may portend a worse outcome for bone. The present manuscript aims to review the available evidences on the effect of the combination of hypogonadism and T2DM on bone health and metabolic profile, highlights the possible metabolic role of the skeleton, and examines the pathways involved in the interplay between bone, insulin resistance, and gonadal steroids.


Multi-layered control of Galectin-8 mediated autophagy during adenovirus cell entry through a conserved PPxY motif in the viral capsid.
Cells employ active measures to restrict infection by pathogens, even prior to responses from the innate and humoral immune defenses. In this context selective autophagy is activated upon pathogen induced membrane rupture to sequester and deliver membrane fragments and their pathogen contents for lysosomal degradation. Adenoviruses, which breach the endosome upon entry, escape this fate by penetrating into the cytosol prior to autophagosome sequestration of the ruptured endosome. We show that virus induced membrane damage is recognized through Galectin-8 and sequesters the autophagy receptors NDP52 and p62. We further show that a conserved PPxY motif in the viral membrane lytic protein VI is critical for efficient viral evasion of autophagic sequestration after endosomal lysis. Comparing the wildtype with a PPxY-mutant virus we show that depletion of Galectin-8 or suppression of autophagy in ATG5-/- MEFs rescues infectivity of the PPxY-mutant virus while depletion of the autophagy receptors NDP52, p62 has only minor effects. Furthermore we show that wildtype viruses exploit the autophagic machinery for efficient nuclear genome delivery and control autophagosome formation via the cellular ubiquitin ligase Nedd4.2 resulting in reduced antigenic presentation. Our data thus demonstrate that a short PPxY-peptide motif in the adenoviral capsid permits multi-layered viral control of autophagic processes during entry.


In situ histone landscape of nephrogenesis.
In the developing kidney, self-renewing progenitors respond to inductive signaling from the adjacent branching ureteric bud by undergoing mesenchyme-to-epithelium transition. Nascent nephrons subsequently undergo elongation, segmentation, and differentiation into a mature renal epithelium with diverse functions. Epigenetic mechanisms have been implicated in impacting cell fate decisions during nephrogenesis; however, the chromatin landscape of nephron progenitors and daughter differentiating cells are largely unknown. Here, we examined the spatiotemporal expression patterns of histone H3 methylation and histone methyltransferases in E15.5 mouse kidneys. Kidney sections were probed with antibodies against histone modifications, enzymes, and markers of progenitors and differentiation. The results revealed that: (1) nephron progenitor cells exhibit a broad histone methylation signature that comprises both "active" and "repressive" marks (H3K4me3/K9me3/K27me3/R2me2/R17me2); (2) nascent nephrons retain high H3K4me3 but show downregulation of H3K9/K27me3 and; (3) maturing epithelial tubules acquire high levels of H3K79me2/3. Consistent with respective histone marks, the H3K4 methyltransferase, Ash2l, is expressed in progenitors and nascent nephrons, whereas the H3K9/K27 methyltransferases, G9a/Ezh2, are more enriched in progenitors than nascent nephrons. We conclude that combinatorial histone signatures correlate with cell fate decisions during nephrogenesis.


Ascending aortic cannulation via left thoracotomy for distal aortic arch aneurysm operation.
We have cannulated the ascending aorta for cardiopulmonary bypass via left thoracotomy in order to avoid conventional retrograde perfusion from the femoral arteries, which is associated with an increased risk of cerebral embolism. We use silk sutures to retract the anterior margin of the opened pericardium from the chest wall, which provides good exposure and easy control of the ascending aorta. Between July 1997 and November 2000, cannulation proved easy to do and reliable in 24 serial patients.


[A preliminary study on the origin of human lung adenocarcinoma stem cells from lung bonchioalveolar stem cells.].
Lung adenocarcinomas are proposed to originate from the malignant transformation of bronchioalveolar stem cells (BASC). This hypothesis, however, has not been confirmed in humans yet. In the present study, we determined to analyze the BASC properties in human lung adenocarcinoma stem cells. The human lung adenocarcinoma stem cells were obtained by flow cytometry (FCM) and induced with the sphereforming assay. The markers associated with BASC were measured by immunofluorescent staining, and their metastatic capacity was evaluated by injecting into NOD/SCID mice via tail vein. The majority of A549 and SPC-A1 human lung adenocarcinoma cells expressed the type II alveolar cell-specific marker SP-C. However, a minority of cells also expressed the bronchiolar Clara cell-specific marker CCSP and the embryonic stem cell marker OCT4, suggesting that these cells may belong to cancer stem cells with BASC properties. The CD24(+)CD221(+) human lung adenocarcinoma stem cells were purified by FCM and then subjected to the immunofluorescent staining. The results documented that these cells had the phenotype of CCSP(+)SP-C(+)OCT4(+), with the same phenotype as mouse BASC. Furthermore, the floatgrowing spheres (named pulmospheres) were developed after 2-week incubation of cancer cells in the serum-free medium containing EGF, IGF-1, and FGF-10. Again, the resultant pulmosphere cells had the phenotype of BASC. These cells were able to differentiate when incubated for two weeks in serum-containing conditions, exhibiting the loss of CCSP and OCT4 markers. Animal studies indicated that the pulmosphere cells had the highly metastatic capacity. The human lung adenocarcinoma stem cells may originate from the transformation of BASC, as their mouse counterparts. These primitive cancer cells are characterized to express the BASC markers as well as the embryonic stem cell gene OCT4.


Characteristics of minority population distribution and development in Inner Mongolia Autonomous Region.
"This paper attempts to offer a general introduction and analysis of the characteristics of minority population distribution and development [in China's Inner Mongolia Autonomous Region] based on the region's manually collected and 10% pre-selected sample data of the fourth census."


Postoperative physical therapy program for latissimus dorsi and teres major tendons transfer to rotator cuff in children with obstetrical brachial plexus injury.
The transfer of latissimus dorsi and teres major tendons to rotator cuff have been developed to rebalance the muscular dysfunction and improve shoulder range of motion in children with obstetrical brachial plexus palsy (OBPP). No previous study reported the ideal postoperative physical therapy program for these cases. The aim of the present study was to design appropriate postoperative physical therapy (PT) program after latissimus dorsi and teres major tendons transfer to rotator cuff in OBPP to improve upper limb function. Time series design. The patients were recruited from outpatient clinic of Kasr EL Aini Hospital, Cairo, Egypt. Forty seven OBPP infants (4.64±1.21 years with a range of 2.5 to 7 years, 21male and26 female) were allocated to one group. All patients had functional limitation in the involved arm due to muscle paralysis and contracture. Twenty-five patients had C5-C6 nerve root lesions while 22 had C5-C6-C7 nerve root lesions. The children underwent the surgical procedures of the transfer of latissimus dorsi and teres major tendons to rotator cuff. After the surgery the children participated in a designed physical therapy program for 6 months. Active shoulder abduction, flexion and external rotation range of motion (ROM) were assessed by electrogoniometer, and functional assessments were measured using the modified Mallet scale. All measurements were taken preoperative, 6 weeks, 3 months, and 6 months postoperatively after the application of the designed PT program. Repeated measure analysis of variance (ANOVA) followed by Bonferroni post-hoc test were used to show the improvement in all measured variables. Analysis revealed that shoulder abduction, flexion and external rotation ROM and shoulder function measured by modified Mallet scale were significantly improved (P<0.0001) after the designed postoperative PT program. It can be concluded that the combination treatment of surgical procedure and the postoperative physical therapy program seem to be effective in improving shoulder and arm functions in children with OBPP. This study describes a detailed physical therapy program after latissimus dorsi and teres major tendons transfer to rotator cuff in OBPP.


Sperm length variation as a predictor of extrapair paternity in passerine birds.
The rate of extrapair paternity is a commonly used index for the risk of sperm competition in birds, but paternity data exist for only a few percent of the approximately 10400 extant species. As paternity analyses require extensive field sampling and costly lab work, species coverage in this field will probably not improve much in the foreseeable future. Recent findings from passerine birds, which constitute the largest avian order (∼5,900 species), suggest that sperm phenotypes carry a signature of sperm competition. Here we examine how well standardized measures of sperm length variation can predict the rate of extrapair paternity in passerine birds. We collected sperm samples from 55 passerine species in Canada and Europe for which extrapair paternity rates were already available from either the same (n = 24) or a different (n = 31) study population. We measured the total length of individual spermatozoa and found that both the coefficient of between-male variation (CV(bm)) and within-male variation (CV(wm)) in sperm length were strong predictors of the rate of extrapair paternity, explaining as much as 65% and 58%, respectively, of the variation in extrapair paternity among species. However, only the CV(bm) predictor was independent of phylogeny, which implies that it can readily be converted into a currency of extrapair paternity without the need for phylogenetic correction. We propose the CV(bm) index as an alternative measure to extrapair paternity for passerine birds. Given the ease of sperm extraction from male birds in breeding condition, and a modest number of sampled males required for a robust estimate, this new index holds a great potential for mapping the risk of sperm competition across a wide range of passerine birds.


Psychological processes and family variables as prosocial behavior predictors in a sample of Spanish adolescents.
A review of personal and family variables that regulate prosocial behavior is based on a sample of 1,433 Spanish adolescents (ages 9 to 13; 743 boys and 690 girls) who were assessed on the Prosocial Reasoning Objective Measure, the Physical and Verbal Aggression Scale, the Emotional Instability Scale, the State-Trait Anger Inventory, the Child's Report of Parental Behavior Inventory, the Prosocial Behavior Scale, and the Index of Empathy for Children and Adolescents. Discriminant analyses showed that empathy, self-control in anger-provoking situations, and affection in family relationships are the best predictors of prosocial behavior.


Role of ultrasonography in the diagnosis of temporal arteritis.
Temporal artery (TA) biopsy is the current standard for diagnosing temporal arteritis, but has limited sensitivity. Colour duplex ultrasonography is a newer, non-invasive method of diagnosing temporal arteritis. A systematic review was performed of trials comparing TA biopsy with duplex ultrasonography. Duplex results (halo sign, stenosis or vessel occlusion) were compared with either TA biospy findings or the American College of Rheumatology research criteria for diagnosing temporal arteritis. Trials were identified from MEDLINE, Embase and the Cochrane Library trials register. The performance of duplex ultrasonography was assessed with weighted independent sensitivity and specificity values, and summary receiver operating characteristic curve analysis. There were 17 eligible studies containing 998 patients. When the halo sign on duplex imaging was compared with TA biopsy, the sensitivity was 75 (95 per cent confidence interval 67 to 82) per cent and the specificity was 83 (78 to 88) per cent. There was no heterogeneity across the eligible studies. Duplex ultrasonography was relatively accurate for diagnosing temporal arteritis. It should become the first-line investigation, with biopsy reserved for patients with a negative scan.


An unexpected location for a metastasis from esophageal squamous carcinoma.
We report the case of a 69-year-old male with a relevant alcohol consumption and a history of prostate cancer who underwent screening upper gastrointestinal endoscopy and colonoscopy. The upper gastrointestinal endoscopy revealed an ulcerated mass in the middle esophagus occupying half the circumference. Histologic examination was compatible with a squamous cell carcinoma. Staging with endoscopic ultrasound and computed tomography of the neck, chest and abdomen was consistent with a T3N1M0.


'Dos and don'ts' in the management of hyponatremia.
The management of hyponatremia has evolved in recent years, particularly with the introduction of tolvaptan for hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This commentary presents a summary of recent international recommendations in the form of a series of didactic 'dos and don'ts', in order to provide concise, practical guidance for practising clinicians focused on the investigation and management of euvolemic hyponatremia (SIADH). A multidisciplinary group of international experts reviewed existing guidelines and the evidence cited within to summarize the recommendations in a practical method for use in clinical practice. The 'dos and don'ts' are presented under topic headings that include diagnosis and diagnostic tests, specific causes, correction of acute hyponatremia, correction rates for chronic hyponatremia, management of SIADH including fluid restriction, hypertonic saline and pharmacological strategies, and management of overcorrection. Within each topic, the authors summarize the published recommendations on managing hyponatremia and the use of specific agents for the treatment of SIADH. Practising clinicians can use these 'dos and don'ts' to provide clear, up-to-date guidance on how to manage hyponatremia and the use of tolvaptan in SIADH.


Liposomalization of oxaliplatin induces skin accumulation of it, but negligible skin toxicity.
Liposomalization causes alteration of the pharmacokinetics of encapsulated drugs, and allows delivery to tumor tissues through passive targeting via an enhanced permeation and retention (EPR) effect. PEGylated liposomal doxorubicin (Doxil®, Lipo-DXR), a representative liposomal drug, is well-known to reduce cardiotoxicity and increase the anti-tumor activity of DXR, but to induce the hand-foot syndrome (HFS) as a result of skin DXR accumulation, which is one of its severe adverse effects. We have developed a new liposomal preparation of oxaliplatin (l-OHP), an important anti-tumor drug for treatment of colorectal cancer, using PEGylated liposomes (Lipo-l-OHP), and showed that Lipo-l-OHP exhibits increased anti-tumor activity in tumor-bearing mice compared to the original preparation of l-OHP. However, whether Lipo-l-OHP causes HFS-like skin toxicity similar to Lipo-DXR remains to be determined. Administration of Lipo-l-OHP promoted accumulation of platinum in rat hind paws, however, it caused negligible morphological and histological alterations on the plantar surface of the paws. Administration of DiI-labeled empty PEGylated liposomes gave almost the same distribution profile of dyes into the dermis of hind paws with DXR as in the case of Lipo-DXR. Treatment with Lipo-l-OHP, Lipo-DXR, DiI-labeled empty PEGylated liposomes or empty PEGylated liposomes caused migration of CD68+ macrophages into the dermis of hind paws. These findings suggest that the skin toxicity on administration of liposomalized drugs is reflected in the proinflammatory characteristics of encapsulated drugs, and indicate that Lipo-l-OHP with a higher anti-cancer effect and no HFS may be an outstanding l-OHP preparation leading to an improved quality of life of cancer patients.


Ectopic expression of negative ARNT2 factor disrupts fish development.
ARNT factors are a cluster of bHLH-PAS factors that heterodimerize with other specific bHLH-PAS factors to mediate a wide range of biological responses. Previously, we obtained a truncated form of ARNT2-like factor, ARNT2A, from zebrafish, which encompasses the basic-helix-loop-helix and PAS A/B domains, but lacks a transactivation domain at its carboxyl end. Herein, we report another truncated ARNT2-like factor, ARNT2X, in zebrafish, which differs from ARNT2A at its N-terminal region. In cultured ZLE cells, transiently expressed ARNT2X and ARNT2A inhibited 2,3,7,8-TCDD-activated cyp1a1 transcription with different efficiencies. In the developing embryo, arnt2X mRNA was consistently expressed in the retinal and neural tube regions until the hatching stages, but it exhibited a more specific pattern at larval stages, including expression in the brain, eyes, hypothalamus, pharyngeal skeleton, heart, liver, pronephros duct, pectoral fin, and epithelial cells of the swim bladder. In contrast, arnt2A transcription diminished after hatching. Microinjecting a recombinant arnt2X-expression vector into fertilized eggs before cleavage stages caused severe defects in brain, eyes, pectoral fin, heart, and gut development. This suggests that the ARNT-mediated signal transduction pathways play important roles in fish tissue development.


Three-dimensional profilometry using a Dammann grating.
We propose three-dimensional (3D) profilometry based on a Fourier transform in which a two-dimensional (2D) Dammann grating and a cylindrical lens are used to generate structured light. The Dammann grating splits most of the illumination power into a 2D diffractive spot matrix. The cylindrical lens transforms these 2D diffractive spots into one-dimensional fringe lines that are projected on an object. The produced projection fringes have the advantages of high brightness and high contrast and compression ratios. The experiments have verified the proposed 3D profilometry. The 3D profilometry using Dammann grating should be of high interest for practical applications.


Design, synthesis, and polymerase-catalyzed incorporation of click-modified boronic acid-TTP analogues.
DNA molecules are known to be important materials in sensing, aptamer selection, nanocomputing, and construction of unique architectures. The incorporation of modified nucleobases affords unique DNA properties for applications in areas that would otherwise be difficult or not possible. Earlier, we demonstrated that the boronic acid moiety can be introduced into DNA through polymerase-catalyzed reactions. In order to study whether such incorporation by polymerase is a general phenomenon, we designed and synthesized four boronic acid-modified thymidine triphosphate (TTP) analogues. The synthesis of certain analogues was through the use of a single dialkyne tether for both the Sonogashira coupling with thymidine and the later Cu-mediated [3+2] cycloaddition for linking the boronic acid moiety. This approach is much more efficient than the previously described method, and paves the way for the preparation of a large number of boronic acid-modified TTPs with a diverse set of structural features. All analogues showed very good stability under polymerase chain reaction (PCR) conditions and were recognized as a substrate by DNA polymerase, and thus incorporated into DNA.


The Impacts of Sports Schools on Holistic Athlete Development: A Mixed Methods Systematic Review.
To understand the multiple and wide-ranging impacts of intensified youth sport, the need for a holistic approach to athlete development has recently been advocated. Sports schools are an increasingly popular operationalisation of intensified youth sport, aiming to offer an optimal environment for holistic development by combining sport and education. Yet, no study has systematically explored the impacts associated with sports schools. The aims of this mixed method systematic review were to (1) determine the characteristics and features of sports schools; (2) identify the methods used to evaluate sports school impacts, and (3) evaluate the positive and negative holistic athlete development impacts associated with sports school programme involvement. Adhering to PRISMA guidelines, eight electronic databases were searched until the final return in February 2021. Forty-six articles satisfied the inclusion criteria, were analysed thematically, and synthesised using a narrative approach. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Findings indicated (1) sports school student-athletes receive considerable support in terms of academic and athletic services, more intensified training and competition schedules with high-level training partners, but regularly miss school; (2) multiple methods have been used to evaluate student-athlete impacts, making comparison across studies and developing consensus on the impacts of sports schools difficult; and (3) there are a multitude of immediate, short- and long-term positive and negative impacts associated with the academic/vocational, athletic/physical, psychosocial and psychological development of sports school student-athletes. This study is the first to systematically review the research literature to understand the impacts associated with sports schools in terms of holistic athlete development. Practitioners should be aware that they can promote (positive) and negate (negative) health impacts through the design of an appropriate learning environment that simultaneously balances multiple training, academic, psychosocial and psychological factors that can be challenging for youth athletes. We recommend that practitioners aim to design and implement monitoring and evaluation tools that assess the holistic development of student-athletes within their sports schools to ensure they are promoting all-round and healthy youth athlete development.


Eligibility and Prevalence of the American Heart Association Heart Check Certification Program in the US Packaged Food and Beverage Supply: A Cross-Sectional Study.
Objective: Consumers in the US make choices within a food supply dominated by processed packaged foods and beverage products. Front-of-package nutrition labels (FOPL) equip consumers to make healthier choices, but further evaluation and regulation regarding FOPL format, scope, and display have been recommended by the World Health Organization. As a leader in consumer FOPL guidance, the American Heart Association's (AHA) Heart Check programme certifies food companies seeking to add an AHA Heart Check logo as a FOPL for qualifying heart healthy products. A cross-sectional assessment of the AHA Heart Check Standard Certification was conducted within the US packaged food and beverage supply to assess the eligibility and prevalence of the programme as a FOPL. Methods: Data were derived from Label Insight's Open Data initiative, which is the largest publicly-available US branded food composition database. The proportions of products that were certified and eligible to be certified for the Standard Certification were reported by nutrient attributes, grocery aisles and food brands. Results: Among 153,453 products examined, fewer than 1% exhibited the Heart Check certification on their label. Among products that were not Heart Check certified,13.8% were eligible for Standard Certification. The most common reason for ineligibility was the saturated fat content (52%), followed by total fat content (47%) and sodium content (47%). Heart Check certification and eligibility differed substantially across grocery aisle categories. Conclusions: The abundance of unhealthy products in the US packaged food and beverage supply and absence of harmonized FOPL policies suggest the need for FOPL like the Heart Check label to promote adherence to healthy diets. There are opportunities for food manufacturers and the AHA to certify more heart healthy foods and beverages. However, more consistent criteria and transparent labelling could enhance Heart Check certification to facilitate consumers' ability to make more informed and healthful purchases.


Idiopathic Intracranial Hypertension (Pseudotumor Cerebri).
Idiopathic intracranial hypertension has been recognized in the literature for over 100 years. It is a disease of elevated intracranial pressure without evidence of a space-occupying lesion found most often in obese women of childbearing age. The signs and symptoms have been well described; however, the etiology is yet unknown. Medical and surgical treatment is aimed at the preservation of vision and improvement in symptoms. The medical literature is replete with articles addressing the epidemiology, pathophysiology, clinical and imaging features, and treatment. There are limited nursing reports (; ; ). The objective of this manuscript is to provide an overview for the neuroscience nurse of the clinical features, diagnostic work-up, and therapeutic options available for patients with idiopathic intracranial hypertension.


Insights into the green doping of clinoptilolite with Na+ ions (Na+/Clino) as a nanocatalyst in the conversion of palm oil into biodiesel; optimization and mechanism.
The critical demand for eco-friendly, renewable, and safe energy resources is an essential issue encountered in the contemporary world. The catalytic transesterification of plant oils into biodiesel was assessed as promising a technique for providing new forms of clean and safe fuel. Natural clinoptilolite was doped with Na+ ions by green chemical reactions between sodium nitrite and green tea extract, producing a novel modified structure (Na+/Clino). The Na+/Clino product had an enhanced total basicity (6.41 mmol OH/g), ion exchange capacity (387 meq/100 g), and surface area (312.7 m2 g-1), which qualified it to be used as a potential basic catalyst for the transesterification of palm oil. Transesterification tests were statistically assessed using a response surface methodology and a central composite design. Considering the effect of how the significant factors interact with each other, the synthetic Na+/Clino achieved a 96.4% experimental biodiesel yield after 70 min at 100 °C in the presence of 2.75 wt% catalyst loading and a 12.5:1 methanol-to-palm-oil ratio. Based on the optimization function of the statistical model, the performance of Na+/Clino can theoretically be enhanced to increase the yield to 98.2% by expanding the test time to 85 min and the loading value to 3 wt%. The product yielded by the Na+/ClinO process is of adequate technical properties, considering the international levels for standard biodiesel (EN 14214 and ASTM D-6751). Finally, the prepared green Na+ doped clinoptilolite had excellent recyclability as a heterogeneous basic catalyst and displayed higher efficiency than several species of previously studied heterogeneous and homogenous catalysts.


Sleep and respiratory sleep disorders in idiopathic pulmonary fibrosis.
Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease (ILD) characterized by inflammation and progressive scarring of the lung parenchyma. IPF profoundly affects the quality of life (QoL) and fatigue is a frequently disabling symptom. The cause of fatigue is not well understood but patients with IPF often report extremely poor sleep quality and sleep-related breathing disorders (SRBD) that correlate with QoL. IPF patients present alterations in sleep architecture, including decreased sleep efficiency, slow wave sleep and rapid eye movement (REM) sleep, and increased sleep fragmentation. Moreover, sleep related hypoventilation during the vulnerable REM sleep period and obstructive sleep apnea-hypopnea syndrome (OSAHS) are frequent, but remain usually underdiagnosed. These SRBD in IPF are associated with alterations of the sleep structure, reduction of QoL and increased risk of mortality. In the absence of an effective therapy for IPF, optimizing the QoL could become the primary therapeutic goal. In this perspective the diagnosis and treatment of SRBD could significantly improve the QoL of IPF patients.


Phylogenetically balanced evidence for structural and carbon isotope responses in plants along elevational gradients.
We tested three hypotheses related to the functioning of mountain plants, namely their reproductive effort, leaf surface structure and effectiveness of CO(2) assimilation, using archive material from contrasting elevations. Analysis of elevational trends is at risk of suffering from two major biases: a phylogenetic bias (i.e. an elevational change in the abundance of taxonomic groups), and covariation of different environmental drivers (e.g. water, temperature, atmospheric pressure), which do not permit a mechanistic interpretation. We solved both problems in a subcontinental survey of elevational trends in key plant traits in the European Alps and the high Arctic (northern Sweden, Svalbard), using herbarium samples of 147 species belonging to the genera Carex, Saxifraga and Potentilla. We used both species and phylogenetically independent contrasts as data points. The analysis revealed enhanced reproductive efforts at higher elevation in insect-pollinated taxa (not in wind-pollinated taxa), no increase in leaf pubescence at high elevation (as is often assumed), and a strong correlation between (13)C discrimination and elevation. Alpine taxa operate at a smaller mesophyll resistance to CO(2) uptake relative to diffusive resistance (stomata). By comparison with congeneric low altitude polar taxa (low temperature, but high atmospheric pressure), the response could be attributed to the elevational decline in atmospheric pressure rather than temperature (a mean increase in delta(13)C by 1.4 per thousand km(-1)). The signal is consistent within and across genera and within species, suggesting rapid adjustment of leaf physiology to reduced partial pressure of CO(2). These results offer answers to long-debated issues of plant responses to high elevation life conditions.


Young children's difficulty with adjectives modifying nouns.
In two experiments we tested the hypothesis that children have a basic problem in mastering the attributive relation because it involves a two-step logical-semantic integration process of the head-noun and the attributive adjective. Hebrew-speaking children were asked to interpret highly familiar adjective-noun combinations by selecting a photo that depicted the correct referent. In Experiment I there were four choices for each adjective-noun pair: correct object/correct property, correct object/wrong property, wrong object/correct property, wrong object/ wrong property. 170 children (1.6-4.4) participated. Analyses of errors and spontaneous self-corrections indicated that children initially ignored the adjective and based their responses only on the noun. In Experiment 2, in addition to the 4-choice condition, there were two simpler conditions with only two choices: the correct object/correct property, and either the correct object/wrong property, or the wrong object/correct property. 30 children (1.9-4.11) were tested. The children, and in particular the lowest-scoring third of the sample, did significantly better in the 2-pictures conditions. The results suggest that young children do possess a basic adjective vocabulary and can use it in simple discriminations, but have a considerable difficulty in integrating the information furnished by the adjective with information furnished by the noun.


Intraocular gene transfer of ciliary neurotrophic factor rescues photoreceptor degeneration in RCS rats.
Ciliary neurotrophic factor (CNTF) is known as an important factor in the regulation of retinal cell growth. We used both recombinant CNTF and an adenovirus carrying the CNTF gene to regulate retinal photoreceptor expression in a retinal degenerative animal, Royal College of Surgeons (RCS) rats. Cells in the outer nuclear layer of the retinae from recombinant-CNTF-treated, adenoviral-CNTF-treated, saline-operated, and contralateral untreated preparations were examined for those exhibiting CNTF photoreceptor protective effects. Cell apoptosis in the outer nuclear layer of the retinae was also detected. It was found that CNTF had a potent effect on delaying the photoreceptor degeneration process in RCS rats. Furthermore, adenovirus CNTF gene transfer was proven to be better at rescuing photoreceptors than that when using recombinant CNTF, since adenoviral CNTF prolonged the photoreceptor protection effect. The function of the photoreceptors was also examined by taking electroretinograms of different animals. Adenoviral-CNTF-treated eyes showed better retinal function than did the contralateral control eyes. This study indicates that adenoviral CNTF effectively rescues degenerating photoreceptors in RCS rats.


Triplet pregnancy with partial hydatiform mole.
Triplet pregnancy with a coexisting mole is extremely rare. A 26 years old primigravida with multiple gestation and severe pre-eclampsia at 32 weeks gestation was brought to Sri Ramachandra University casualty. In view of abnormal Doppler study with discordant twins emergency lower segment caesarean section was done six days later. Part of the placenta showed molar changes. Histopathology confirmed partial mole. Patient received three cycles of methotrexate in view of rising titres of betahCG. Three months after delivery both babies are alive and well and betahCG for the mother became normal. This pregnancy continued beyond 32 weeks gestational age with both babies being alive. Hence this case is being reported to highlight its rarity.


Interviewing prospective patients for peritoneal dialysis: a five-step approach.
Interviewing the prospective patient for peritoneal dialysis (PD) is a critical step in the development of a relationship between the patient and the PD nurse. Individualizing information for the patient and significant others promotes confidence in making an informed decision. This article presents a five-step approach for interviewing the potential patient for PD.


[The action of lactoperoxidase, lactoferrin and lactoglobulin on Shigella sonnei in an in-vivo experiment].
The synergism of the protective action of lactoperoxidase, lactoferrin and lactoglobulin obtained from cow milk, as well as lactoferrin obtained from human milk, was shown in experiments on white mice, infected intranasally with S. sonnei and used as an experimental model. The combined administration of these preparations in doses, each one having no protective action, contributed to the elimination of the bacteria from the lungs and prevented the death of the animals. This phenomenon was found to be nonspecific and suitable for use in the development of preparations for passive immunization against a wide spectrum of microorganisms.


A1-receptor-mediated effect of adenosine on the release of acetylcholine from the myenteric plexus: role and localization of ecto-ATPase and 5'-nucleotidase.
No attempt has been made so far to classify the subtypes of presynaptic inhibitory adenosine receptors located in the myenteric plexus and to localize ecto-ATPase and 5'-nucleotidase in the intestine. The release of [3H]acetylcholine and smooth muscle responses to acetylcholine were measured and the effect of selective adenosine receptor ligands was studied using field-stimulated isolated longitudinal muscle strips of guinea-pig ileum. Release of ATP and its hydrolysis rate were also measured using the luciferin-luciferase technique. A histochemical method combined with electron microscopy was used for localization of ecto-ATPase and 5'-nucleotidase, enzymes responsible for destruction of extracellular ATP, ADP and AMP. Subtype-selective A1-receptor agonists and antagonists inhibited and enhanced, respectively, the release of acetylcholine associated with neuronal activity. A significant amount of ATP was released in response to electrical stimulation and administration of carbamylcholine. The release of ATP was inhibited by atropine and 4-diphenylacetoxy-N-methylpiperidine methiodide, an M3-receptor antagonist. Hydrolysis of ATP was rapid and resulted in an accumulation of extracellular adenosine involved in presynaptic A1-receptor-mediated inhibition of acetylcholine release. While the inhibitory effect of adenosine and ATP was significantly potentiated by dipyridamol, an adenosine uptake blocker, that of 2-ms ATP was not. The effect of ATP was not competitively antagonized by 8-cyclopentyl-1,3-dipropylxanthine, a selective A1-receptor antagonist. In conclusion, axon terminals of cholinergic interneurons are equipped with inhibitory A1- and P2 gamma-receptors. Therefore, both adenosine and ATP control the release of acetylcholine through these receptors. ATP is mainly released from the smooth muscle in response to stimulation of M3-muscarinic receptors by endogenous acetylcholine (cascade transmission [Vizi E. S. et al. (1992) Neuroscience 50, 455-465]) and is rapidly hydrolysed by ecto-ATPase localized on the surface of the smooth muscle and axon terminals producing ADP and AMP, and by 5'-nucleotidase present only on the surface of smooth muscle cells producing adenosine.


Biliary tract depiction in living potential liver donors: intraindividual comparison of MR cholangiography at 3.0 and 1.5 T.
To intraindividually compare the accuracy of magnetic resonance (MR) cholangiography at 3.0 and 1.5 T for depicting biliary anatomy with intraoperative cholangiography as the reference standard and to compare the image quality for biliary tract visualization at these two field strengths. After obtaining institutional review board approval and informed consent, 52 living potential liver donors underwent MR cholangiography at both 1.5 and 3.0 T. The protocol included projectional single-section rapid acquisition with relaxation enhancement (RARE) and respiratory-triggered three-dimensional (3D) fast spin-echo (SE) T2-weighted sequences. Two readers independently analyzed images, scoring the visualization of all first- and second-order biliary branches on a four-point scale and determining the number of visible third-order branches. MR cholangiography at 3.0 T correctly depicted biliary anatomy in 90.4% of subjects on combined analysis of both sequences by both readers, in 88.5% with projectional RARE images for both readers, and in 84.6% and 88.5% with 3D fast SE images for readers 1 and 2, respectively. MR cholangiography at 1.5 T showed 86.5% and 84.6% accuracy on combined analysis for readers 1 and 2, respectively; 78.8% and 75.0% accuracy on projectional RARE images for readers 1 and 2, respectively; and 84.6% and 86.5% accuracy with 3D fast SE images for readers 1 and 2, respectively. With the projectional RARE sequence, 3.0-T MR cholangiography demonstrated significantly higher mean visualization scores for second-order branches (reader 1: 2.29 vs 1.78, P = .01; reader 2: 2.52 vs 2.10, P < .01) and mean numbers of visible third-order branches (reader 1: 5.53 vs 4.21, P < .01; reader 2: 5.91 vs 3.74, P < .01) than did 1.5-T MR cholangiography. Compared with 1.5-T MR cholangiography, 3.0-T MR cholangiography did not significantly increase accuracy for identification of biliary anatomy. Projectional RARE images at 3.0 T enabled better visualization of second- and third-order branches than did those at 1.5 T.


Structure of an endoglucanase from termite, Nasutitermes takasagoensis.
Contrary to conventional wisdom, it has been shown recently that termites do not necessarily depend on symbiotic bacteria to process cellulose. They secrete their own cellulases, mainly endo-beta-1,4-glucanase and beta-1,4-glucosidase. Here, the first structure of an endogenous endoglucanase from the higher termite Nasutitermes takasagoensis (NtEgl) is reported at 1.40 A resolution. NtEgl has the general folding of an (alpha/alpha)(6) barrel, which is a common folding pattern for glycosyl hydrolase family 9. Three-dimensional structural analysis shows that the conserved Glu412 is the catalytic acid/base residue and the conserved Asp54 or Asp57 is the base. The enzyme has a Ca(2+)-binding site near its substrate-binding cleft. Comparison between the structure of the Ca(2+)-free enzyme produced by reducing the pH of the soaked crystal from 5.6 (the pH of optimum enzyme activity) to 2.5 with that of the Ca(2+)-bound enzyme did not show significant differences in the locations of the C(alpha) atoms. The main differences are in the conformation of the residue side chains ligating the Ca(2+) ion. The overall structure of NtEgl at pH 6.5 is similar to that at pH 5.6. The major change observed was in the conformation of the side chain of the catalytic acid/base Glu412, which rotates from a hydrophobic cavity to a relatively hydrophilic environment. This side-chain displacement may decrease the enzyme activity at higher pH.


Absorption enhancement of oligothiophene dyes through the use of a cyanopyridone acceptor group in solution-processed organic solar cells.
Improvements in the performance of small molecule-based organic solar cells have been reported through the use of a cyanopyridone acceptor group. This acceptor fragment enhances the absorbance of an oligothiophene-based dye and enables the addition of a solubilising alkyl chain that facilitates simple device fabrication from solution.


Selective expression of one c-myc allele in two human myeloma cell lines.
Chromosomal translocations or DNA rearrangements affecting c-myc occur in almost all murine plasmacytoma and human Burkitt's lymphoma tumors and are associated with a high incidence of exon 2 missense mutations and selective expression of the affected allele. Screening nine multiple myeloma cell lines, we identified no exon 2 missense mutations but did identify two lines with single, silent mutations in exon 1 and exon 2, respectively. Each of these informative multiple myeloma cell lines selectively expresses only one c-myc allele despite the apparent absence of chromosomal translocations or DNA rearrangements affecting c-myc.


Evaluation of engraftment syndrome in children following full-matched related donor hematopoietic stem cell transplantations.
The term "ES" has been widely used for describing a clinical condition consisting of skin rash, fever, and weight gain that occur during neutrophil recovery period following HSCT. In this study, the incidence, clinical features, risk factors, and outcomes of ES were evaluated in 169 children following allogeneic HSCT from full-matched related donor according to the Spitzer criteria. Seventeen patients (10.1%) presented with clinical conditions suggesting ES. In both univariate and multivariate analysis underlying malignant disease and early release of monocytes to the PB, and in univariate analysis using only CsA for GVHD prophylaxis were found to be the significant risk factors for the development of ES. Patients with ES experienced significantly higher incidence of acute and chronic GVHD and propensity toward a higher rate of TRM. OS did not differ between the patient groups. Thirteen of 17 patients received steroid therapy, and all but one patient responded to therapy. Monitoring for early detection of ES and early intervention with steroid therapy is the key for recovery. The most crucial approach for this purpose mainly is to find out and use the most useful and feasible diagnostic criteria for routine medical practice.


The case for a qualitative lesion assessment system for coronary angiography.
Since the advent of coronary angiography, the standard for reporting of coronary lesion severity has been to utilize percent diameter stenosis (%DS). Given the imperfections of %DS as well as the widespread availability of intraprocedural intracoronary imaging and physiology assessment, it is time to consider a simpler yet more clinically relevant lesion assessment system. We compiled ten actual cases and presented these cases to 10 operators, providing 100 independent lesion assessments. For each case, operators were asked to describe lesions using %DS and a simplified lesion assessment system. We assessed the relationship between %DS and qualitative lesion assessment as well as the relationship of both measurements to the chosen plan. Greater variability exists with %DS than with qualitative lesion assessment. Despite this, there is good correlation between %DS and the qualitative lesion assessment (ρ = 0.8221). There remains overlap of lesion assessment using the qualitative lesion assessment tool suggesting that even with this simpler tool, there remains interobserver variability (ICC = 0.5164, 95% confidence interval [CI] 0.2924-0.7955). When assessing how both lesion assessment, there appears to be a stronger correlation between the qualitative lesion assessment and the chosen plan versus the %DS and the chosen plan (ρ = 0.9069 vs ρ = 0.8001, P < .01). Given the superior performance of the proposed qualitative system and the ability to estimate lesion severity using both anatomic and clinical factors, we feel that professional societies and clinicians should begin to embrace this simplified means of lesion assessment.


Understanding Down's syndrome: a review.
Each year, one child in every 800 births in the U.S. is born with Down's syndrome. It is the most prevalent chromosomal abnormality found in humans. Of the approximately four million births in the U.S. per year, 5,000 newborns with Down's syndrome can be expected. All health care providers should understand the unique features of this condition. Likewise, dental hygienists should be cognizant of its specific oral manifestations to provide optimum oral care for these clients.


Inherited liver diseases in adults.
Important inherited disorders causing acute and chronic liver disease include hemochromatosis, Wilson's disease, alpha 1-antiprotease (antitrypsin) deficiency, and cystic fibrosis. The detection of an index case has implications for screening family members. A normal life span can be expected with treatment in asymptomatic patients with Wilson's disease and hemochromatosis. We present a clinical approach to disease recognition, investigation, and screening.


Paper-based molecular diagnostic for Chlamydia trachomatis.
Herein we show the development of a minimally instrumented paper-based molecular diagnostic for point of care detection of sexually transmitted infections caused by Chlamydia trachomatis. This new diagnostic platform incorporates cell lysis, isothermal nucleic acid amplification, and lateral flow visual detection using only a pressure source and heat block, eliminating the need for expensive laboratory equipment. This paper-based test can be performed in less than one hour and has a clinically relevant limit of detection that is 100x more sensitive than current rapid immunoassays used for chlamydia diagnosis.


Single ventricle, total transposition, and hypoplastic aorta in a calf.
A purebred Ayrshire calf was born with multiple congenital cardiac defects. The major defects included absence of an interventricular septum (i.e., single ventricle), transposition of the aorta and pulmonary trunk, interatrial septal defect, patent ductus arteriosus, and aortic arch anomalies. Despite the severity of the anomalies, the calf survived to 5 days of age, when it was found dead. This particular combination of cardiac defects has not been previously described in domestic animals.


Evaluating the impact of facilitated communication on the communicative competence of fourteen students with autism.
The purpose of this study was to evaluate facilitated communication (FC) as an augmentative or alternative communication system for 14 students attending the Eden Institute in Princeton, NJ. All participants had an independent diagnosis of autism and standardized testing revealed significant deficits in adaptive behavior across all developmental domains. A pretest-posttest design was utilized to (a) determine if any of the participants were immediately capable of communicating through FC (b) if necessary, instruct the participants in the use FC, and (c) determine if this instruction had any impact on their ability to use FC. At the end of 10 weeks of instruction, no participants were able to produce functional, typed communication. Findings are consistent with other quantitative studies that find no support for the cause-effect relationship proposed by FC proponents.


Structural requirements for potential Na/H exchange inhibitors obtained from quantitative structure-activity relationships of monocyclic and bicyclic aroylguanidines.
The quantitative structure-activity relationship (QSAR) of N-(3-amino-6-chloro-5-ethylisopropylaminopyrazine-4-carbonyl) guanidine (EIPA) 1ac and its derivatives as Na/H exchange inhibitors was analyzed using th steric parameters and an indicator variable. The results indicated that bicyclic aroylguanidines might have Na/H exchange inhibitory activity. Therefore, various bicyclic aroylguanidines were synthesized and tested for Na/H exchange inhibitory activity. The QSAR study of the bicyclic aroylguanidines showed that hydrophobic bicyclic rings seemed to be preferable for potent activity. The hydrophobicity of the aroyl ring moiety was thought to be particularly important. Thus, the QSAR of EIPA and its derivatives was re-analyzed using hydrophobicity and steric parameters. The results indicated that high hydrophobicity of the pseudo-ring moiety and a substituent of appropriate length at the position corresponding to the 5-position of the naphthalene ring enhance the activity. As expected from the results, 5-bromo-2-naphthoylguanidine 3b and 5-methoxy-2-naphthoylguanidine 3c exhibited strong activity. These findings will be helpful to design new, potent Na/H exchange inhibitors.


Towards equitable diagnoses for autism and attention-deficit/hyperactivity disorder across sexes and genders.
Sex/gender-related factors contribute to contextual issues influencing the recognition of autism and attention-deficit/hyperactivity disorder (ADHD), and modulate how neurodevelopmental characteristics are manifested. This review summarizes the empirical literature to provide directions for improving clinical diagnostic practices. Timing of autism and/or ADHD diagnosis, particularly in girls/women, is related to the individual's developmental characteristics and co-occurring diagnoses, and expectancy, alongside gender stereotype biases, of referral sources and clinicians. This is further compounded by sex and gender modulations of behavioural presentations. The emerging 'female autism phenotype' concept may serve as a helpful illustration of nuanced autism phenotypes, but should not be viewed as essential features of autism in a particular sex or gender. These nuanced phenotypes that can present across sexes and genders include heightened attention to socially salient stimuli, friendship and social groups, richness in language expression, and more reciprocal behaviours. The nuanced female-predominant ADHD phenotypes are characterized by subtle expressions in hyperactivity-impulsivity (e.g., hyper-verbal behaviours). Optimizing neurodevelopmental diagnoses across sexes and genders also requires an understanding of sex-related and gender-related variations in developmental trajectories, including compensation/masking efforts, and the influences of co-occurring conditions on clinical presentations. Equitable diagnoses across sexes and genders for autism and ADHD require understanding of the nuanced presentations and the Gestalt clinical-developmental profiles, and addressing contextual biases that influence diagnostic practices.


Language and gesture in late talkers: a 1-year follow-up.
A 1-year follow-up of relationships between language and symbolic gesture in 10 children with delayed onset of early lexical skills (Thal & Bates, 1988a) is reported. Original data are reevaluated in light of new knowledge about which late talkers continued to be significantly delayed 1 year later (truly delayed) and which ones had "caught up" (late bloomers). Results showed that all 4 children who were truly delayed at follow-up had been delayed in language comprehension at the first visit, but the 6 late bloomers had been at the same level as their age-matched controls. In addition, truly delayed late talkers had been significantly poorer on all of the gesture tasks than late talkers who caught up.


Abscisic Acid Stimulated Osmotic Adjustment and Its Involvement in Adaptation of Tobacco Cells to NaCl.
Osmotic adjustment of cultured tobacco (Nicotiana tabacum L. var Wisconsin 38) cells was stimulated by 10 micromolar (+/-) abscisic acid (ABA) during adaptation to water deficit imposed by various solutes including NaCl, KCl, K(2)SO(4), Na(2)SO(4), sucrose, mannitol, or glucose. The maximum difference in cell osmotic potential (Psipi) caused by ABA treatment during adaptation to 171 millimolar NaCl was about 6 to 7 bar. The cell Psipi differences elicited by ABA were not due to growth inhibition since ABA stimulated growth of cells in the presence of 171 millimolar NaCl. ABA caused a cell Psipi difference of about 1 to 2 bar in medium without added NaCl. Intracellular concentrations of Na(+), K(+), Cl(-), free amino acids, or organic acids could not account for the Psipi differences induced by ABA in NaCl treated cells. However, since growth of NaCl treated cells is more rapid in the presence of ABA than in its absence, greater accumulation of Na(+), K(+), and Cl(-) was necessary for ion pool maintenance. Higher intracellular sucrose and reducing sugar concentrations could account for the majority of the greater osmotic adjustment of ABA treated cells. More rapid accumulation of proline associated with ABA treatment was highly correlated with the effects of ABA on cell Psipi. These and other data indicate that the role of ABA in accelerating salt adaptation is not mediated by simply stimulating osmotic adjustment.


Posttranscriptional regulation of gene expression in liver regeneration: role of mRNA stability.
The rentry of hepatocytes and nonparenchymal cells from the normal quiescent G0 phase into the cell cycle during liver regeneration after 70% partial hepatectomy results in the discrete modulation of mRNA transcripts for many different genes. The modulation of steady-state levels of transcripts for genes involved in hepatocyte growth and replication during liver regeneration indicates that gene expression is regulated not only transcriptionally but also posttranscriptionally. In fact, posttranscriptional control appears to be the primary mechanism of regulating gene expression after the first 3 h after partial hepatectomy. Alteration in transcript stability is a key posttranscriptional regulatory mechanism used by the regenerating liver to modulate the steady-state transcript levels of multiple genes. Even genes that are transcriptionally activated during liver regeneration exhibit posttranscriptional control at the level of transcript stability. Moreover, the abundance of mRNA binding proteins, as well as translational activity and rate of poly(A) tail removal, are modulated and appear to influence transcript stability during liver regeneration. However, alteration of transcript stability is not the sole posttranscriptional mechanism regulating steady-state levels. Posttranscriptional control also occurs at the level of alternative splicing, stabilization of heterogeneous nuclear (hn) RNA, and hnRNA processing. Moreover, the role of nucleocytoplasmic transport of mature mRNA during liver regeneration is still undefined. Thus, during liver regeneration gene expression is regulated at multiple levels after the initial synthesis of hnRNA. By understanding the role of posttranscriptional mechanisms in regulating steady-state transcript levels in an in vivo model of normal growth, we will begin to appreciate its role in the genesis of abnormal growth.


Sonographic assessment of infrarenal inferior vena caval dimensions.
The dimensions of the infrarenal inferior vena cava during quiet respiration, single leg lifting, and breath-holding were assessed using sonography in 156 patients. Sonographic assessment of infrarenal inferior vena caval dimensions was feasible in 69% of patients. Measurements during breath-holding were significantly greater than during quiet respiration (P < 0.001) and leg lifting (P < 0.005), although in approximately one quarter of the patients the mean calculated diameter was greatest during quiet respiration. we conclude that sonographic assessment of infrarenal inferior vena caval dimensions is feasible, but it should be performed during quiet respiration and breath-holding to allow for variation with different respiratory maneuvers.


Management of congenital adrenal hyperplasia: results of the ESPE questionnaire.
The management of children and adolescents with congenital adrenal hyperplasia (CAH) remains difficult. To assess the current European practice in diagnosis and management of CAH, an ESPE (European Society for Paediatric Endocrinology) survey was circulated in 2000/2001. The questionnaire was answered by 34% of ESPE members, representing 125 institutions which cared for 6,553 CAH patients. Paediatric endocrinologists, surgeons, gynaecologists, geneticists, and psychologists are involved in the immediate care of the CAH neonate and his family. 44% of centres take part in neonatal screening programmes. In families at risk, prenatal dexamethasone therapy is started at a median gestational age of 6 weeks in a median dose of 20 microg/kg/day. 53% reported maternal adverse events, 8% observed adverse fetal events. Regarding feminizing surgery, 33% reported simultaneous clitoric reduction and vaginoplasty during infancy. However, clitoridectomy is still reported by 13% of centres, and vaginal dilatations have been performed by 27%. Although 71% of female CAH patients with psychosexual problems, only 17% undertake routine psychodiagnostics and counselling. Hydrocortisone is the substance used for the treatment of CAH during growth in 84%; the median dose (mg/m(2)/day) is 17.5 in infants, 15 in children and adolescents, and 13.75 in adults. The glucocorticoid dose is increased two- to sixfold during intercurrent stress. Mineralocorticoid is administered in cases of clinically manifest salt wasting and of elevated plasma renin activity, to decrease high glucocorticoid doses, or according to genotype. All participating ESPE members feel the need for further improvement in prenatal diagnosis and treatment, compliance during puberty, screening programmes, psychological aspects, and corrective surgery.


Mild Hyperthermia Induced by Gold Nanorod-Mediated Plasmonic Photothermal Therapy Enhances Transduction and Replication of Oncolytic Adenoviral Gene Delivery.
Oncolytic adenovirus (Ad) is a promising candidate for cancer gene therapy. However, as a monotherapy, it has shown insufficient therapeutic efficacy in clinical trials. In this work, we demonstrate that gold nanorod (GNR)-mediated mild hyperthermia enhances the cellular uptake and consequent gene expression of oncolytic Ad to head and neck tumor cells. We examined the combination of oncolytic Ad expressing vascular endothelial growth factor promoter-targeted artificial transcriptional repressor zinc-finger protein and GNR-mediated mild hyperthermia to improve antitumor effects. The in vitro mechanisms of increased transduction in the presence and absence of hyperthermia were explored followed by evaluation of efficacy of this combination strategy in an animal model. Exposure to optimized hyperthermia conditions improved endocytosis of oncolytic Ad, transgene expression, viral replication, and subsequent cytolysis of head and neck cancer cells. GNR-mediated plasmonic photothermal therapy resulted in precise control of tumor temperature and induction of mild hyperthermia. A combination of oncolytic Ad and GNRs resulted in potent tumor growth inhibition of head and neck tumors.


Asthma phenotypes and endotypes: an evolving paradigm for classification.
Asthma is a common chronic disease characterized by intermittent chest symptoms, variable airways obstruction, and bronchial hyperresponsiveness. Research performed over the past one to two decades has sought to better understand the heterogeneous clinical nature of asthma. Whereas older attempts at phenotyping asthma emphasized the duality of allergic vs. non-allergic asthma, more recent non-biased analyses have attempted to cluster patients by a multitude of possible features, including age of onset, atopy, severity of airways obstruction, and requirement for medication. Examples of these phenotypes include early-onset mild allergic asthma, later-onset asthma associated with obesity, and severe non-atopic asthma with frequent exacerbations. The elucidation of asthma phenotypes has been further refined by including information regarding pathophysiologic mechanisms present in different groups. These groups, called endotypes, include examples such as aspirin-exacerbated respiratory disease and allergic bronchopulmonary mycosis. A growing understanding of these mechanistically distinct groups, along with the identification of relevant cellular or molecular biomarkers, is already showing promise as a way of predicting clinical response to various asthma therapies. As the number of targeted treatments for asthma continues to grow, physicians will have the opportunity to practice an individualized approach to diagnosis and treatment, which will hopefully improve asthma outcomes and quality of life for these patients.


The accessory stimulus effect is mediated by phasic arousal: A pupillometry study.
People usually respond faster to a visual stimulus when it is immediately preceded by a task-irrelevant, auditory accessory stimulus (AS). This AS effect occurs even in choice reaction time tasks, despite the fact that the AS carries no information about the correct response. Researchers often assume that the AS effect is mediated by a phasic arousal burst evoked by the AS, but direct evidence for that assumption is lacking. We conducted a pupillometry study to directly test the phasic arousal hypothesis. Participants carried out a demanding choice reaction time task with accessory stimuli occurring on 25% of the trials. Pupil diameter, a common index of arousal, was measured throughout the task. Standard analyses of task performance and pupil diameter showed that participants exhibited the typical AS effect, and that accessory stimuli evoked a reliable early pupil dilation on top of the more protracted dilation associated with the imperative stimulus. Moreover, regression analyses at the single-trial level showed that variation in reaction times on AS trials was selectively associated with pupil dilation during the early time window within which the AS had an effect, such that particularly large AS-evoked dilations were associated with especially fast responses. These results provide the first evidence that the AS effect is mediated by AS-evoked phasic arousal.


Chronic rhinosinusitis and allergy.
The role of allergic sensitization in chronic sinusitis in childhood is currently unclear, as contrasting results were reported in the studies thus far available. In fact, some surveys found prevalence of atopy up to 60% in subjects with chronic sinusitis, while other failed to confirm any association between the two conditions. The data we obtained in a cross-sectional study on a large population of children should help in better defining such issue. Among 2200 children referring for evaluation of chronic respiratory symptoms, subjects satisfying at least two of major criteria for the definition of chronic sinusitis were recruited, and underwent to allergen sensitization workup by skin prick test with common inhalant allergens and total IgE measurement. Patients were stratified according to age lower than 3 years (group 1), age between 3 and 6 years (group 2), and age above 6 years (group 3). In all, 351 children (217 boys, 134 girls, mean age 5.23+/-2.11 years, range 1.5-15 years) were available for evaluation and formed three groups (27 in group 1, 261 in group 2 and 63 in group 3). Prevalence of both sensitization to at least one inhalant allergen by skin test and of high total IgE was 29.9%, with significant difference for the former across age groups, with a value of 7.4% in group 1, 31.4% in group 2 and 33.3% in group 3 (p=0.028), but after adjusting for age, sinusitis and aeroallergen sensitization were not significantly correlated. The difference across groups for high total IgE did not reach statistical significance, with respective prevalence of 22.7%, 30.1% and 32.1%. It is possible to conclude that the prevalence of sensitization to aeroallergens in children with chronic sinusitis is comparable with that of the general paediatric population, as assessed in the Italian arm of the ISAAC study and this does not account for routine investigation for allergy in children with chronic sinusitis.


The dent stage of maize kernels is the most conducive for fumonisin biosynthesis under field conditions.
The fungal pathogen Fusarium verticillioides infects maize ears and produces fumonisins, known for their adverse effects on human and animal health. Basic questions remain unanswered regarding the kernel stage(s) associated with fumonisin biosynthesis and the kernel components involved in fumonisin regulation during F. verticillioides-maize interaction under field conditions. In this 2-year field study, the time course of F. verticillioides growth and fumonisin accumulation in developing maize kernels, along with the variations in kernel pH and amylopectin content, were monitored using relevant and accurate analytical tools. In all experiments, the most significant increase in fumonisin accumulation or in fumonisin productivity (i.e., fumonisin production per unit of fungus) was shown to occur within a very short period of time, between 22/32 and 42 days after inoculation and corresponding to the dent stage. This stage was also characterized by acidification in the kernel pH and a maximum level of amylopectin content. Our data clearly support published results based on in vitro experiments suggesting that the physiological stages of the maize kernel play a major role in regulating fumonisin production. Here we have validated this result for in planta and field conditions, and we demonstrate that under such conditions the dent stage is the most conducive for fumonisin accumulation.


Diffusion-Weighted MRI of the Breast in Women with a History of Mantle Radiation: Does Radiation Alter Apparent Diffusion Coefficient?
Fibrosis from chest irradiation could lower the apparent diffusion coefficient (ADC) of breast tissue. ADC values of normal breast tissue in high-risk women who underwent mantle radiation before age 30 years were compared with a screening control group matched for breast fibroglandular tissue (FGT). In this retrospective study, we reviewed 21 women with a history of mantle radiation who underwent breast MRI examinations between 2008 and 2013, and 20 nonirradiated patients (control group) imaged during the same period with matching FGT and similar age. The women were dichotomized into low FGT (10/20, 50%) and high-FGT (10/20, 50%) groups, based on BI-RADS descriptors. All MRI examinations included diffusion-weighted imaging (DWI) (b = 0, 1000); ADC maps were generated and evaluated on PACS workstations by two radiologists in agreement. Region of interest markers were placed on ADC maps in visualized breast tissue in the retroareolar region of each breast. The ADC value was averaged for the right and left breast in each patient included in the study. The Wilcoxon signed-rank test was used to compare the ADC values in the irradiated patients and the matched control patients. The median breast ADC was lower in the irradiated group (1.32 × 10-3mm2/sec) than in the control group (1.62 × 10-3mm2/sec; P = 0.0089). Low FGT in the irradiated group had a lower median ADC (1.25 × 10-3mm2/sec) than it did in the control group (1.53 × 10-3mm2/sec). Irradiated high-FGT breasts had a median ADC (1.52 × 10-3mm2/sec), as compared with nonirradiated control patients with high FGT (1.82 × 10-3mm2/sec). Previously irradiated breasts have lower ADC values than do nonirradiated breasts.


Viscous Boundary-Layer Damping of r-Modes in Neutron Stars.
Recent work has raised the exciting possibility that r-modes (Rossby waves) in rotating neutron star cores might be strong gravitational-wave sources. We estimate the effect of a solid crust on their viscous damping rate and show that the dissipation rate in the viscous boundary layer between the oscillating fluid and the nearly static crust is more than 105 times higher than that from the shear throughout the interior. This increases the minimum frequency for the onset of the gravitational r-mode instability to at least 500 Hz when the core temperature is less than 1010 K. It eliminates the conflict between the r-mode instability and the accretion-driven spin-up scenario for millisecond radio pulsars and makes it unlikely that the r-mode instability is active in accreting neutron stars. For newborn neutron stars, the formation of a solid crust shortly after birth affects their gravitational-wave spin-down and hence their detectability by ground-based interferometric gravitational-wave detectors.


[The target in the healthcare marketing].
In the marketing it is essential to have well clear the characteristics of the consumer/client with the purpose to offer a service contemplated satisfactory: it speaks of marketing oriented, that studies the characteristics of the patient of reference. To have a picture the more exhaustive possible than the consumer type is essential to investigate on what its expectations are, where a similar service is habitually disbursed, when it usually enjoys him of such service, because the patient chooses that service rather than another. Always in the optics of marketing, it's necessary to keep in mind which are the characteristics of a service that can mostly make it desirable:it is must be unpublished, with a low/middle cost(it depends on the characteristics of the consumer), comfortable from take, disbursed in comfortable place and with courtesy, to guarantee the greatest safety degree in terms of reliability and competence, to allow at times to define a status social.


Allocation of gross primary production in forest ecosystems: allometric constraints and environmental responses.
Understanding the allocation of gross primary production (GPP) and its response to climate is essential for improving terrestrial carbon (C) modelling. Here, we synthesize data on component GPP fluxes from a worldwide forest database to determine the allocation patterns of GPP across global gradients in climate and nitrogen deposition (Ndep ). Our results reveal that allocation of GPP is governed in an integrated way by allometric constraints and by three trade-offs among GPP components: wood production (NPPwood ) vs fine-root production (NPPfroot ), NPPwood vs foliage production (NPPfoliage ), and autotrophic respiration (Ra ) vs all biomass production components. Component fluxes were explained more by allometry, while partitioning to components was related more closely to the trade-offs. Elevated temperature and Ndep benefit long-term woody biomass C sequestration by stimulating allometric partitioning to wood. Ndep can also enhance forest C use efficiency by its effects on the Ra vs biomass production trade-off. Greater precipitation affects C allocation by driving the NPPwood vs NPPfoliage trade-off toward the latter component. These results advance our understanding about the global constraints on GPP allocation in forest ecosystems and its climatic responses, and are therefore valuable for simulations and projections of ecosystem C sequestration.


[An epidemiological study of workers exposed to vinyl chloride in the plants of Ferrara, Rosignano and Ravenna].
The aim of the present study is to investigate cause-specific mortality among male workers employed in vinyl chloride manufacture and polymerization in three Italian plants located in Ferrara, Rosignano and Ravenna. The cohorts include all workers hired between start of operation and, respectively 1985, 1978 and 1985, amounting to 418, 206 and 635 subjects followed up for mortality until 1996 (Ferrara and Rosignano) and 1997 (Ravenna). Cause specific SMRs (Standardized mortality ratios) were computed. Expected figures were obtained from mortality rates for the population resident in the region where the plant was located, for each SMR value a 90% confidence interval (CI) was calculated on the assumption of a Poisson distribution. The study detected an increased mortality for primary liver cancer in all three plants; SMR values were 444 in Ferrara (4 Obs. 90% CI 160-1069), 200 in Rosignano (1 Obs. 90% CI 10-869) and 375 in Ravenna (3 Obs. 90% CI 110-1038). In the pooled cohort liver cancer SMR was equal to 364 (8 Obs. 90% CI 108-390). In one plant, Ferrara, observed mortality was above the expected for lung cancer, SMR = 146 (14 Obs. 90% CI 89-229) and for larynx cancer, SMR = 500 (4 Obs. 90% CI 174-1167). One death from pleural cancer was observed in Rosignano (SMR = 1000 90% CI 47-4331). A non significant increase was detected for liver cirrhosis, in Ferrara (SMR 108, 6 Obs. 90% CI 73-332) and Rosignano (SMR 129, 3 Obs. 90% CI 35-332). The study results are confirming the carcinogenic action of vinyl chloride on the liver, they are pointing to its possible role in lung cancer development, as already shown for workers employed in Porto Marghera; an increased risk for larynx cancer is also shown.


Management of acquired bronchobiliary fistula: A systematic literature review of 68 cases published in 30 years.
To outline the appropriate diagnostic methods and therapeutic options for acquired bronchobiliary fistula (BBF). Literature searches were performed in Medline, EMBASE, PHMC and LWW (January 1980-August 2010) using the following keywords: biliobronchial fistula, bronchobiliary fistula, broncho-biliary fistula, biliary-bronchial fistula, tracheobiliary fistula, hepatobronchial fistula, bronchopleural fistula, and biliptysis. Further articles were identified through cross-referencing. Sixty-eight cases were collected and reviewed. BBF secondary to tumors (32.3%, 22/68), including primary tumors (19.1%, 13/68) and hepatic metastases (13.2%, 9/68), shared the largest proportion of all cases. Biliptysis was found in all patients, and other symptoms were respiratory symptoms, such as irritating cough, fever (36/68) and jaundice (20/68). Half of the patients were treated by less-invasive methods such as endoscopic retrograde biliary drainage. Invasive approaches like surgery were used less frequently (41.7%, 28/67). The outcome was good at the end of the follow-up period in 28 cases (range, 2 wk to 72 mo), and the recovery rate was 87.7% (57/65). The clinical diagnosis of BBF can be established by sputum analysis. Careful assessment of this condition is needed before therapeutic procedure. Invasive approaches should be considered only when non-invasive methods failed.