Clinical effects and outcomes with new P2Y12 inhibitors in ACS.
Thienopyridines have become the cornerstone of treatment for percutaneous coronary intervention although no survival benefit has ever been shown with clopidogrel despite increasing loading doses. Newly developed P2Y12 inhibitors are more potent, more predictable, and have a faster onset of action than clopidogrel, characteristics that make them particularly attractive for high-risk percutaneous coronary intervention (PCI). Four new P2Y12 inhibitors have been tested each of them having particular individual properties. Prasugrel is an oral pro-drug leading to irreversible blockade of the P2Y12 receptor and is approved worldwide for ACS PCI. Ticagrelor is a direct-acting and reversible inhibitor of the P2Y12 receptor with potentially more pleiotropic effects. Cangrelor is an intravenous direct and reversible inhibitor of the P2Y12 receptor providing the highest level of inhibition, and elinogrel is an intravenous and oral P2Y12 antagonist with a direct and reversible action. Both prasugrel and ticagrelor, opposed to clopidogrel, have shown that stronger P2Y12 inhibition led respectively to significant 19 and 16% relative risk reduction of a similar primary end point combining cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke. Both drugs showed a significant 0.6% absolute excess of TIMI major bleeding not related to CABG surgery. Because in clinical trials, patients perceived to be at higher risk of bleeding usually are excluded, the risk of major and even fatal bleeding might even be higher in a 'real-world' setting, i.e. in the elderly patient with comorbidities. On the other hand, these newly developed P2Y12 inhibitors decrease mortality after PCI compared with clopidogrel. The risk/benefit ratio is particularly favorable in PCI for patients with STEMI.


Determination of thin hydrodynamic lubricating film thickness using dichromatic interferometry.
This paper introduces the application of dichromatic interferometry for the study of hydrodynamic lubrication. In conventional methods, two beams with different colors are projected consecutively on a static object. By contrast, the current method deals with hydrodynamic lubricated contacts under running conditions and two lasers with different colors are projected simultaneously to form interference images. Dichromatic interferometry incorporates the advantages of monochromatic and chromatic interferometry, which are widely used in lubrication research. This new approach was evaluated statically and dynamically by measuring the inclination of static wedge films and the thickness of the hydrodynamic lubricating film under running conditions, respectively. Results show that dichromatic interferometry can facilitate real-time determination of lubricating film thickness and is well suited for the study of transient or dynamic lubricating problems.


Surgical decision-making for rectal prolapse: one size does not fit all.
Surgery remains the only known treatment option for rectal prolapse. Although over 100 abdominal and perineal procedures are available, there is no consensus as to which intervention is best suited for an individual. This retrospective cohort study describes the patient- and disease-related factors involved in making surgical recommendations around rectal prolapse in a single surgeon experience. 91 consecutive patients ≥18 years old diagnosed with external and/or high-grade internal rectal prolapse were assessed and were prospectively entered into an IRB approved registry. Information on patient symptoms, comorbidities, exam findings, surgeon judgment, and patient preference was collected. Treatment recommendations (abdominal, perineal, or no operation) were analyzed and compared. Surgical intervention was recommended to 93% of patients. Of those, 66% were recommended robotic abdominal procedures: 75%, robotic ventral mesh rectopexies; 16%, resection rectopexies; and 9%, suture rectopexies. On univariate analysis, patients with older age, higher ASA scores, presence of cardiopulmonary morbidity, pain as a primary rectal prolapse symptom, rectal prolapse always descended, and surgeon concern for frailty and general anesthesia were associated with recommendations for perineal operations (p < 0.05 for all). However, on multivariate analysis, only age and concern over prolonged anesthesia remained correlated with a recommendation for perineal surgery. Of patients >80 years of age, 15% were recommended an abdominal approach. With multiple options available for the treatment of rectal prolapse, treatment recommendations remain surgeon-dependent and may be influenced by many factors. In our practice, robotic ventral mesh rectopexy was the most commonly recommended operation and was offered to carefully selected patients of advanced age. Although robotic surgery and ventral mesh rectopexy may not be accessible to all patients and surgeons, this represents a single surgeon's practice bias. This study reinforces the importance of perineal procedures for higher-risk individuals.


Improved venous drainage of the radial artery forearm free flap: use of the profundus cubitalis vein.
The radial artery forearm free flap (RAFFF) is a versatile and popular flap used in various reconstructive procedures. This flap contains two venous drainage systems: a superficial (cephalic) route, and a deep (venae comitantes) route. Most surgeons use either the deep venous system alone or in combination with a superficial vessel, hence requiring two venous anastomoses. The authors describe a novel technique of providing venous drainage for the RAFFF, incorporating both deep and superficial systems, and using one venous anastomosis. From 10 consecutive operative and five cadaveric dissections, it was noted that paired venae comitantes, corresponding to the radial artery, coalesce into a single vein at the level of the brachial artery bifurcation. The profundus cubitalis vein (vena anastomotica) connects this coalesced (deep) vein to the cephalic (superficial) vein at the level of the cubital fossa. Both the deep and superficial venous systems are drained via one large anastomosis, situated proximal to the profundus cubitalis interconnection. Advantages of this technique include: 1) improved venous drainage of the RAFFF; 2) rendering the venous anastomosis technically easier, due to its larger size; and 3) more available versatility in designing the venous portion of the vascular pedicle.


An improved method for detection of B-lymphoid clonality by polymerase chain reaction.
Several groups have recently described methods for the detection of clonal immunoglobulin heavy chain (IgH) gene rearrangements in B-cell malignancies by polymerase chain reaction (PCR) gene amplification using variable region-(VH) and joining (JH) region-specific primers. The simplest methods utilize a single VH primer specific for sequences present in most VH regions corresponding to the third framework region (FR3). An alternative approach is to use a panel of VH family-specific primers specific for the first framework regions (FR1). In the course of nucleotide sequence analysis of IgH gene rearrangements amplified using a VH FR1 primer panel, these authors previously observed 3' VH region deletion and/or base mis-matches sufficient to prevent efficient priming from the VH FR3 primer target sequence in a significant minority of cases of B-lineage malignancy. An improved PCR method has therefore been developed by using a panel of seven VH FR1 family-specific primers incorporated in a single reaction. By using this method clonal IgH gene rearrangement is detected in 15 of 16 cases of B-lineage malignancy. Significantly, this series included four cases of B-lymphoma in which previous attempts to detect PCR clonal IgH gene rearrangements using a VH FR3 primer were unsuccessful. In two of these cases, nucleotide sequence analysis of the amplified DNA showed that failure to prime with the VH FR3 primer was likely to be attributable to insufficient homology with the target sequence. The use of the approach described in this paper should significantly improve the reliability of detection of B-lymphoid clonality by PCR.


A characterization of glycinergic receptors present in cultured rat medullary neurons.
1. Whole-cell current responses to bath application of glycine, beta-alanine, and taurine were studied in medullary neurons cultured from embryonic rats. 2. Two current components were seen in the responses to bath application of agonist, one component that desensitized and another that did not. 3. The two current components have different dose-response characteristics, with the nondesensitizing component being activated more effectively at lower concentrations than the desensitizing component and also reaching its peak at lower concentrations. The agonist concentrations producing half-maximal responses are 26 +/- 4 (SE, n = 6) and 69 +/- 17 (n = 7) microM for the nondesensitizing and desensitizing components, respectively, for glycine; 54 +/- 7 (n = 9) and 127 +/- 37 (n = 7) microM for beta-alanine; and 153 +/- 24 (n = 9) 443 +/- 99 (n = 3) microM for taurine. Thus, for each component, the order of potency is glycine greater than beta-alanine greater than taurine. 4. When total responses to glycine, beta-alanine, and taurine are compared in the same cells, taurine and beta-alanine are less potent agonists than glycine, with relative potencies of 1:0.4:0.1 for glycine-beta-alanine-taurine. 5. The desensitizing component is more sensitive to strychnine than the nondesensitizing one. The strychnine concentrations that block 50% of the response to a control dose of agonist are 15 and 500 nM for the desensitizing and nondesensitizing components, respectively, for glycine; 60 nM and 1 microM for beta-alanine; and 18 and 500 nM for taurine. 6. The complete occlusion between the responses to glycine and beta-alanine or glycine and taurine suggests that these agonists activate the same receptors. 7. The two current components may be manifestations of one receptor population with complicated kinetics or two independent receptor populations.


Noninvasive detection of Chlamydia trachomatis urethritis in men by a rapid enzyme immunoassay test.
The purpose of this investigation was to evaluate the ability of a rapid enzyme immunoassay test to noninvasively detect Chlamydia trachomatis urethritis in men from a urine specimen. Urethral samples and urine from 207 patients were evaluated. Urethral and urine sediment Gram stains, leukocyte esterase dipstick tests, and enzyme immunoassay analyses of centrifuged and uncentrifuged urine were compared with urethral C trachomatis culture. The prevalence of infection in this population was 10.3%. Sensitivity and specificity of the enzyme immunoassay on the centrifuged urine specimen were 70% and 96%, respectively. The positive and negative predictive values were 67% and 97%, respectively. The uncentrifuged urine enzyme immunoassay sensitivity was 35.7% and specificity was 98.9%. Leukocyte esterase test sensitivity compared with that of the Neisseria gonorrhoeae and/or C trachomatis cultures was 83.3%, and specificity was 52%. The rapid enzyme immunoassay clinically complemented the screening urine sediment Gram stain and the leukocyte esterase test. The judicious use of a noninvasive C trachomatis rapid enzyme immunoassay test to identify organism-specific urethritis may improve patient management of sexually transmitted disease.


Ancient schwannoma of the true vocal cord.
Ancient schwannomas are benign nerve origin neoplasms that may cause difficulties in the differential diagnosis with other benign or malignant tumors. They usually occur in the head and neck region (epiglottis, arytenoepiglottic fold, false vocal cord). Involvement of the true vocal cords is extremely rare (less than 10 cases have ever been reported in the English literature--mainly in women). The present case describes a 27-year-old man who presented with a 2-year history of hoarseness. Indirect laryngoscopy showed a small polypoid mass in the middle of the left vocal cord. During microlaryngoscopy under general anesthesia, the polypoidal mass was removed and sent for histology. Immunohistochemistry and detailed histological examination revealed an ancient schwannoma. The present case in a male patient aims to increase awareness of the possibility that these tumors may also exist in the true vocal cords mimicking other more frequent lesions.


Rescue of HSV-1 neurovirulence is associated with induction of brain interleukin-1 expression, prostaglandin synthesis and neuroendocrine responses.
Several HSV-1 neurovirulence genes have been mapped but the mechanisms by which they affect host-virus interactions are not known. We have previously mapped HSV-1 neurovirulence to the UL53 gene region of the viral DNA by transfer of this gene from the neurovirulent R-19 strain to the non-neurovirulent R-15 strain in the generation of the p-71 recombinant, in which neurovirulence was rescued. In the present study we inoculated these strains into the paraventricular nucleus (PVN) of the hypothalamus of rats. We examined: (1) Clinical course of encephalitis. (2) Hypothalamic-pituitary-adrenocortical (HPA) axis function. (3) Brain cytokine gene mRNA expression and prostaglandin E2 (PGE2) production. (4) The relation of these parameters to viral replication and to cellular inflammation. In R-15 infected rats no signs of disease were observed. There was a temporary inflammatory reaction and IL-1 beta transcription in the PVN area. The function of the HPA axis was similar to control rats. Only slight increase in brain PGE2 production was found. In R-19 and p-71 infected rats, overt clinical signs of encephalitis and cellular inflammation in the PVN area were observed within 3 days post-infection (p.i). All rats died between 4-7 days p.i. These strains induced IL-1 beta transcription in the hypothalamus as well as in extra-hypothalamic brain regions in which no cellular inflammation was found. Basal serum ACTH and' CS were markedly elevated and hypothalamic CRF-41 content was significantly reduced as compared to R-15 infected rats. Both strains markedly increased brain PGE2 production. HSV-1 brain titers at 3 days p.i. were 100-fold lower than the inoculum titer although clinical signs of encephalitis were prominent. The results suggest that rescue of HSV-1 neurovirulence by the UL53 gene region of the viral genome is associated with enhancement of viral-induced brain IL-1 beta gene expression, increased brain PGE2 synthesis and hypersecretion of HPA axis hormones. Viral-induced brain derived cytokines and prostaglandins may contribute to the clinical syndrome of acute herpetic encephalitis in particular at early stages of the disease when virus load in the brain is low and cellular infiltrates are not widespread.


The Psoas Muscle Index Is Associated with Prognosis in Elderly Patients Undergoing Cardiovascular Surgery.
Sarcopenia is associated with poor outcomes in elderly patients. However, current surgical risk assessment tools for cardiovascular surgery do not include the impact of sarcopenia. This study aimed to assess whether the psoas muscle index, a numerical score used to assess sarcopenia, is associated with outcomes in elderly patients undergoing cardiovascular surgery. This nested case-control study evaluated patients aged ≥ 75 years who underwent elective cardiovascular surgery and were admitted to the intensive care unit at Jichi Medical University, Saitama Medical Center between January 1, 2016 and March 31, 2017. The case group (poor outcomes) included patients who either died or were transferred to a rehabilitation facility postoperatively. The control group (good outcomes) included patients who were discharged postoperatively. Clinical factors likely to affect patient outcomes were assessed, and the characteristics of the two outcome groups were compared using logistic regression analysis. In total, 183 patients were evaluated; among them, 137 and 46 patients were categorized to the good and poor outcome groups, respectively. The psoas muscle index was significantly associated with outcome (odds ratio: 0.25; 95% confidence interval: 0.14 - 0.43; P < 0.001). A psoas muscle index cut-off of 3.24 had a specificity, sensitivity, positive predictive value, and negative predictive value of 0.86, 0.63, 0.58, and 0.87, respectively, for predicting worse outcome at discharge. The psoas muscle index was strongly associated with discharge to home in patients aged ≥ 75 years who underwent elective cardiovascular surgery. This finding suggests that the psoas muscle index might be useful in identifying the eligibility of older patients for cardiovascular surgery.


Preparation of superhydrophilic microrough titanium implant surfaces by alkali treatment.
A new strategy to render intrinsically hydrophobic microrough titanium implant surfaces superhydrophilic is reported, which is based on a rapid treatment with diluted aqueous sodium hydroxide solutions. The physicochemical characterization and protein interaction of the resulting superhydrophilic implant surfaces are presented. The superhydrophilicity of alkali treated microrough titanium substrates was mainly attributed to deprotonation and ion exchange processes in combination with a strong enhancement of wettability due to the roughness of the used substrates. Albeit these minor and mostly reversible chemical changes qualitative and quantitative differences between the protein adsorption on untreated and alkali treated microrough titanium substrates were detected. These differences in protein adsorption might account for the enhanced osseointegrative potential of superhydrophilic alkali treated microrough implant surfaces. The presented alkali treatment protocol represents a new clinically applicable route to superhydrophilic microrough titanium substrates by rendering the implant surface superhydrophilic "in situ of implantation".


167.75-nm vacuum-ultraviolet ps laser by eighth-harmonic generation of a 1342-nm Nd:YVO4 amplifier in KBBF.
We demonstrate a ps 167.75-nm vacuum-ultraviolet (VUV) laser by cascaded second-harmonic generation (SHG). The VUV laser is produced by eighth-harmonic generation (EHG) of a mode-locked ps 1342-nm Nd:YVO4 amplifier through three stages cascaded SHG with two LiB3O5 crystals and one KBe2BO3F2 crystal, successively. The 167.75-nm laser provides up to 65-μW output power, and the corresponding photon flux and photon flux density are 5.5×10(13) s(-1) and 1.6×10(18) s(-1)·cm(-2), respectively.


Metabolic impairment elicits brain cell type-selective changes in oxidative stress and cell death in culture.
Abnormalities in oxidative metabolism and inflammation accompany many neurodegenerative diseases. Thiamine deficiency (TD) is an animal model in which chronic oxidative stress and inflammation lead to selective neuronal death, whereas other cell types show an inflammatory response. Therefore, the current studies determined the response of different brain cell types to TD and/or inflammation in vitro and tested whether their responses reflect inherent properties of the cells. The cells that have been implicated in TD-induced neurotoxicity, including neurons, microglia, astrocytes, and brain endothelial cells, as well as neuroblastoma and BV-2 microglial cell lines, were cultured in either thiamine-depleted media or in normal culture media with amprolium, a thiamine transport inhibitor. The activity levels of a key mitochondrial enzyme, alpha-ketoglutarate dehydrogenase complex (KGDHC), were uniquely distributed among different cell types: The highest activity was in the endothelial cells, and the lowest was in primary microglia and neurons. The unique distribution of the activity did not account for the selective response to TD. TD slightly inhibited general cellular dehydrogenases in all cell types, whereas it significantly reduced the activity of KGDHC exclusively in primary neurons and neuroblastoma cells. Among the cell types tested, only in neurons did TD induce apoptosis and cause the accumulation of 4-hydroxy-2-nonenal, a lipid peroxidation product. On the other hand, chronic lipopolysaccharide-induced inflammation significantly inhibited cellular dehydrogenase and KGDHC activities in microglia and astrocytes but not in neurons or endothelial cells. The results demonstrate that the selective cell changes during TD in vivo reflect inherent properties of the different brain cell types.


Ion-pairing molecular recognition in water: aggregation at low concentrations that is entropy-driven.
Investigations into the thermodynamic parameters that characterize the binding of citrate to tris-guanidinium host 1 in water are reported. The parameters K(a), DeltaH degrees, DeltaS degrees, and DeltaG degrees for the binding event were quantified using isothermal titration calorimetry (ITC) techniques. The 1:1 binding stoichiometry was verified by a Job plot derived from NMR data, and the microcalorimetry data was collected for solutions of 1 and citrate ranging from 1 to 100 mM using phosphate buffer concentrations of 5 and 103 mM. At low buffer concentrations (low ionic strength) complexes with greater than 1:1 stoichiometries were observed by ITC, and K(1) was determined to range from 2.0 x 10(3) to 3.0 x 10(3) M(-1). At higher buffer concentrations (high ionic strength) the higher-order complexes were not detected, and K(1) was determined to be 409 M(-1). The 1:1 association of host 1 and citrate is characterized by a large favorable entropy component and negative enthalpy. However, the complexes with higher-order stoichiometry arise from desolvation processes that result from the association of polyions in aqueous media and is entirely entropy driven. This leads to an unusual observation: the dilution of one component of the host/guest complex leads to the formation of the higher-order complexes. The reason for this observation is discussed.


UCP1 Knockin Induces Lipid Dynamics and Transcriptional Programs in the Skeletal Muscles of Pigs.
Uncoupling protein 1 (UCP1), the hallmark protein responsible for nonshivering thermogenesis in adipose tissue (especially brown adipose tissue) has regained researchers' attention in the context of metabolic disorders following the realization that UCP1 can be activated in adult humans and reconstituted in pigs. Both skeletal muscle and adipose tissue are highly dynamic tissues that interact at the metabolic and hormonal level in response to internal and external stress, and they coordinate in maintaining whole-body metabolic homeostasis. Here, we utilized lipidomics and transcriptomics to identify the altered lipid profiles and regulatory pathways in skeletal muscles from adipocyte-specific UCP1 knock-in (KI) pigs. UCP1 KI changed the contents of glycerophospholipids and acyl carnitines of skeletal muscles. Several metabolic regulatory pathways were more enriched in the UCP1 KI skeletal muscle. Comparison of the transcriptomes of adipose and skeletal muscle suggested that nervous system or chemokine signaling might account for the crosstalk between these two tissues in UCP1 KI pigs. Comparison of the lipid biomarkers from UCP1 KI pigs and other mammals suggested associations between UCP1 KI-induced metabolic alternations and metabolic and muscle dysfunction. Our study reveals the lipid dynamics and transcriptional programs in the skeletal muscle of UCP1 KI pigs and suggests that a network regulates metabolic homeostasis between skeletal muscle and adipose tissue.


Subtenon triamcinolone injection for postoperative cystoid macular edema associated with tafluprost.
We report the successful treatment of a case of cystoid macular edema (CME) associated with topical tafluprost, which was accompanied by serous retinal detachment (SRD). A 78-year-old woman underwent intraocular lens suture surgery, including anterior vitreous cutting, for crystalline lens dislocation in the right eye. Tafluprost was initiated 12 weeks after surgery. Intraocular pressure (IOP) was controlled at 10-14 mmHg. Visual acuity remained at 20/40-30/40. However, the patient complained of blurred vision (20/200) 9 months after surgery. CME accompanied by SRD was identified by optical coherence tomography (OCT) and treated with subtenon triamcinolone injection. Visual acuity rapidly increased to 20/50, and the volume of SRD decreased in a few days. Discontinuation of tafluprost and initiation of diclofenac eye drops improved visual acuity to 20/40 and resulted in improved OCT findings within a few weeks. Three months after injection, tafluprost was resumed along with diclofenac. No recurrence of CME occurred over the following 3 months, and IOP was controlled at 10-15 mmHg. SRD is considered to be a symptom of treatment-resistant CME, which may lead to poor visual acuity after recovery. In such cases, subtenon triamcinolone injection should be strongly considered at an early stage.


Mental health treatment patterns among adults with recent suicide attempts in the United States.
We examined mental health treatment patterns among adults with suicide attempts in the past 12 months in the United States. We examined data from 2000 persons, aged 18 years or older, who participated in the 2008 to 2012 National Survey on Drug Use and Health and who reported attempting suicide in the past 12 months. We applied descriptive analyses and multivariable logistic regression models. In adults who attempted suicide in the past year, 56.3% received mental health treatment, but half of those who received treatment perceived unmet treatment needs, and of the 43.0% who did not receive mental health treatment, one fourth perceived unmet treatment needs. From 2008 to 2012, the mental health treatment rate among suicide attempters remained unchanged. Factors associated with receipt of mental health treatment varied by perceived unmet treatment need and receipt of medical attention that resulted from a suicide attempt. Suicide prevention strategies that focus on suicide attempters are needed to increase their access to mental health treatments that meet their needs. To be effective, these strategies need to account for language and cultural differences and barriers to financial and treatment delivery.


Malignant Struma Ovarii: an autopsy report of a clinically unsuspected tumor.
Struma Ovarii represents less than 3% of ovarian teratomas. The malignant counterpart is very rare. A 67-year-old female with ascites and progressive weight loss died of respiratory failure secondary to severe chronic obstructive pulmonary disease. Autopsy revealed ascites, hepatic cirrhosis, emphysema, and bronchiectasis. As an incidental finding was seen a huge tumor (10 x 9.5 x 6 cm) in the left ovary. Multiple nodules were detected in the lungs. The thyroid was normal. Microscopy revealed a follicular variant of papillary carcinoma arising in ectopic thyroid tissue in the ovary with metastasis to lungs and pleura. The thyroid gland tissue was normal. To our knowledge, this is the first autopsy report of a clinically unsuspected malignant Struma Ovarii.


Age Advantages in Emotional Experience Persist Even Under Threat From the COVID-19 Pandemic.
The COVID-19 pandemic is creating unprecedented, sustained, and unavoidable stress for the entire population, and older people are facing particularly heightened risk of contracting the virus and suffering severe complications, including death. The present study was conducted when the pandemic was spreading exponentially in the United States. To address important theoretical questions about age differences in emotional experience in times of crisis, we surveyed a representative sample of 945 Americans between the ages of 18 and 76 years and assessed the frequency and intensity of a range of positive and negative emotions. We also assessed perceived risk of contagion and complications from the virus, as well as personality, health, and demographic characteristics. Age was associated with relatively greater emotional well-being both when analyses did and did not control for perceived risk and other covariates. The present findings extend previous research about age and emotion by demonstrating that older adults' relatively better emotional well-being persists even in the face of prolonged stress.


The restorative and surgical technique for the full maxillary subperiosteal implant.
The edentulous atrophic maxilla represents one of the most challenging implant restorative opportunities. When prescribed within the appropriate diagnostic range and performed by a highly skilled and experienced practitioner, the full maxillary subperiosteal implant is a predictable solution for the patient with an edentulous atrophic maxilla.


Mind matters. Coping and cancer progression.
The idea that having an 'attitude' about cancer makes a difference in its course is a popular but controversial one. Most oncologists and surgeons believe that tumor type and stage, general health, and medical treatment are all that account for the variance in outcome. Many patients and their families believe that having the right attitude makes a difference in the course of disease. This leads us to two empirical questions: (1) Does coping make a difference in disease progression when medical prognostic variables are taken into account? and (2) What constitutes the 'right attitude'?


Cortical blindness: a rare complication of cyclosporine therapy.
We report a bone marrow transplant patient who developed a reversible episode of cortical blindness, a rare complication of cyclosporine therapy. We review previously reported cases and the mechanisms involved in this complication.


Habitat fragmentation and recent bottlenecks influence genetic diversity and differentiation of the Central European halophyte Suaeda maritima (Chenopodiaceae).
Central European salt habitats are mainly restricted to the maritime coast but scattered occurrences can also be found inland. In inland habitats, human activities have caused losses and reductions in the size of natural salt sites but have also created new anthropogenic habitats around potash mining dumps colonized by halophytic species in the last 30 yr. We aimed to investigate the effects of bottlenecks, isolation, and ongoing habitat fragmentation on the genetic variation of a species commonly growing in these special habitats. We used 10 microsatellite markers to compare genetic diversity and differentiation of 31 populations of Suaeda maritima (Chenopodiaceae) from Central European coasts and inland habitats. Two approaches were applied to analyze the tetraploid data based on allele frequencies directly derived from microsatellite data and from transformed binary data. In comparison to the coastal populations from the North Sea and the English Channel, significantly reduced genetic variation and increased between-population differentiation was revealed for populations from the German inland and the Baltic Sea coast. Genetic structure analyses clearly separated coastal and inland populations. Our results indicate that gene flow is restricted among populations from inland salt sites and the Baltic Sea coast, presumably due to their isolation, small sizes, genetic bottlenecks and/or founder events. Patterns of allele distribution indicate some occasional genetic exchange among habitat types in the past. Anthropogenic salt sites may facilitate gene flow among inland salt habitats preventing endangered inland halophyte populations from genetic erosion.


An in-depth exploration of the post-test informational needs of BRCA1 and BRCA2 pathogenic variant carriers in Asia.
Identification of one's status as a BRCA1/2 pathogenic variant carrier often marks the start of navigating challenging decisions related to cancer risk management and result disclosure. Carriers report unmet informational needs, but studies have yet to explore the specific aspects of and how best to fulfill these needs. This study aims to explore the informational needs of BRCA1/2 pathogenic variant carriers in Asia to inform for the design of educational materials to support risk management decision-making. Semi-structured in-depth interviews were conducted with two male and 22 female English-speaking BRCA1/2 pathogenic variant carriers, aged 29-66 years, identified through the Cancer Genetics Service at the National Cancer Centre Singapore. A grounded theory approach with thematic analysis was undertaken to extract dominant themes. Four themes were identified: (i) proactive online information seeking behaviors (ii) personalized informational needs; (iii) challenges in sharing the results; and (iv) lack of genetic awareness. Participants highlight challenges with sharing their result arising from significant post-result informational needs, which have manifested into proactive online information-seeking behaviors. They desire for an online source of information, where content is personalized, reliable and local. Participants foresee the potential of an online resource to raise genetic awareness. This suggests the use of a culturally tailored online-based genetics resource, to promote result disclosure, empower risk-management decisions and raise genetic literacy rates. Supplementary information accompanies this paper at 10.1186/s13053-020-00154-x.


Association of High Serum Chemerin with Bone Mineral Density Loss and Osteoporotic Fracture in Elderly Chinese Women.
Chemerin has been suggested to be a risk factor for osteoporosis; however, its relationship with osteoporotic fracture is poorly understood. Herein, we intend to explore the association between serum chemerin and osteoporotic fracture. A total of 111 elderly women patients diagnosed with osteoporotic fracture were selected as the observation group, and 40 healthy subjects were enrolled as controls. Dual-energy X-ray absorptiometry, enzyme-linked immunosorbent assay, electrochemiluminescence immunoassay, and biochemical analysis were separately performed to determine body bone mineral density (BMD), chemerin levels, bone turnover markers, and other parameters. Pearson's correlation analysis was conducted to examine a relationship between chemerin and laboratory parameters. Moreover, the levels of chemokine-like receptor 1 (CMKLR), C-C motif chemokine receptor-like 2 (CCRL2), collagen type I alpha (COLA1), and runt-related transcription factor-2 (RUNX2) were confirmed by quantitative polymerase chain reaction, and the effect of chemerin on osteogenic differentiation of hFOB1.19 cells was indicated by tartrate-resistant acid phosphatase and alkaline phosphatase double staining. A higher level of chemerin was generally detected in patients with osteoporotic fracture compared with those without (P<0.05). Compared with controls, lower BMD levels and higher β-CTx and P1NP levels were detected in patients with osteoporotic fracture (all P<0.05). Interestingly, chemerin level was negatively correlated to BMD, but positively related to P1NP and β-CTx. Risk of osteoporotic fracture was 2.75-fold higher in subjects with each standard deviation increment of chemerin. Compared with controls, there were no significant differences in CMKLR1 and CCRL2 mRNA after incubation with osteogenic differentiation medium (all P>0.05), whereas there was a remarkable decrease of COLA1 and RUNX2 after incubation with chemerin for nine days (all P<0.05). Furthermore, prolonged incubation with chemerin enhanced osteoclast differentiation and maturation, consequently contributing to an increased risk of fracture. Chemerin is a strong and independent risk factor for osteoporosis-related fracture among elderly Chinese women.


Investigating cycle shifts in women's clothing style and grooming.
In contrast to some non-human primate species, human females do not show overt cues to fertility. Previous research argued that women still show systematic changes in their appearance across their ovulatory cycle to enhance their mating success when fertile. We report five studies investigating whether women's clothing style and grooming behaviour change across the ovulatory cycle. All studies were large (with N = 157 in Study 1, N = 109 in Study 2, N = 257 in Studies 3-5), longitudinal studies with four testing sessions per participant. They involved salivary hormone samples and luteinizing hormone tests to validate conception risk estimates. Across all studies, our results suggest no compelling evidence for cycle shifts in clothing style and grooming. Rather, two studies suggest effects in the opposite direction as hypothesized, as women wore more skin-revealing clothes when non-fertile. One study suggests small effects of wearing necklaces more and eyeglasses less often when fertile. However, these effects were not robust across all studies. Our results are in line with other recent null replications and suggest that, if existent, cues to fertility might be even more subtle than previously assumed. We discuss the need for testing competing theories that explain the evolution of concealed ovulation.


Colon cancer screening in African American women.
African American women are more likely to die of colorectal cancer than are women of any other racial or ethic group. Early diagnosis depends on routine examination and screening. However, studies have shown that African American women are not utilizing available screening tools. African American women age fifty or older were questioned about their risk factors and frequency of CRC screening. The conceptual framework used was the Health Belief Model. Women who perceived fewer barriers, more benefits, higher perceived susceptibility, and increased confidence in the accuracy of screening, were likely to undergo screening. Implications for nursing practice are discussed especially focused on the role of advanced practice nurses as primary care providers. Utilization of a faith-based approach to reaching this population was also suggested.


Histological Justification for the Need of Radiofrequency Ablation of Pulmonary Arteries in Patients with High-Grade Secondary Pulmonary Hypertension.
The aim of the study was to perform a histological assessment of the effectiveness of radiofrequency exposure for circular denervation of the pulmonary artery in patients with secondary high pulmonary hypertension. The study was carried out on the autopsy material derived from non-operated patients. Three groups were formed. The experimental group included the material (207 histological samples) from the patients with chronic high pulmonary hypertension arising on the background of mitral heart disease. The samples of this group were exposed to circular radiofrequency ablation. In the comparison group, we used autopsy material (24 samples) obtained from the patients with high pulmonary hypertension. The control group included material (35 samples) from the patients without pulmonary hypertension who died from causes not associated with cardiovascular diseases. The samples of the comparison and control groups were not exposed to radiofrequency.Visual evaluation of the damage to the vascular wall was performed after hematoxylin and eosin staining, according to Van Gieson. Damage to the nerve plexuses was evaluated after their impregnation by silver salts. To assess the degree of damage to the vascular wall on the stained sections, a scoring method of semi-quantitative analysis of the observed pathological processes (fibrinoid necrosis, metachromasia, karyorrhexis, karyolysis, fibrinoid and mucoid swelling, lipid presence) was used. Silver salt impregnation allowed visualizing damage to the reticular fibers, trunks and endings of peripheral nerve fibers. The mean optical density of the ablation group was statistically significantly lower than in the comparison and control groups (p<0.001). The mean specific area of tissue dissociation was higher in the "marginal zones" of the ablated sections, under pronounced mechanical compression in these areas. The difference in the mean areas of the argentophilic samples of the ablation and comparison and control groups was expressed in a lower percentage of argentophilic fibrous structures (p<0.05). At the same time, the highest concentration of argentophilic structures was observed in the comparison group, which points to a bigger content of nerve fiber structures in the patients with high pulmonary hypertension. The results of the histological study demonstrated the feasibility of radiofrequency ablation of the pulmonary arteries in patients with high-grade secondary pulmonary hypertension. Radiofrequency denervation leads to the destruction of the sympathetic ganglia in the adventitial layer of the pulmonary arteries, which are responsible for the spasm of the precapillary bed of the pulmonary circulation, which promotes vasodilation, an increase in the vascular bed, and, as a result, a reduction in pulmonary hypertension.


Size-Dependent Photodynamic Anticancer Activity of Biocompatible Multifunctional Magnetic Submicron Particles in Prostate Cancer Cells.
In this study, newly designed biocompatible multifunctional magnetic submicron particles (CoFe₂O₄-HPs-FAs) of well-defined sizes (60, 133, 245, and 335 nm) were fabricated for application as a photosensitizer delivery agent for photodynamic therapy in cancer cells. To provide selective targeting of cancer cells and destruction of cancer cell functionality, basic cobalt ferrite (CoFe₂O₄) particles were covalently bonded with a photosensitizer (PS), which comprises hematoporphyrin (HP), and folic acid (FA) molecules. The magnetic properties of the CoFe₂O₄ particles were finely adjusted by controlling the size of the primary CoFe₂O₄ nanograins, and secondary superstructured composite particles were formed by aggregation of the nanograins. The prepared CoFe₂O₄-HP-FA exhibited high water solubility, good MR-imaging capacity, and biocompatibility without any in vitro cytotoxicity. In particular, our CoFe₂O₄-HP-FA exhibited remarkable photodynamic anticancer efficiency via induction of apoptotic death in PC-3 prostate cancer cells in a particle size- and concentration-dependent manner. This size-dependent effect was determined by the specific surface area of the particles because the number of HP molecules increased with decreasing size and increasing surface area. These results indicate that our CoFe₂O₄-HP-FA may be applicable for photodynamic therapy (PDT) as a PS delivery material and a therapeutic agent for MR-imaging based PDT owing to their high saturation value for magnetization and superparamagnetism.


Osteoblastic gene expression during adipogenesis in hematopoietic supporting murine bone marrow stromal cells.
A growing body of data suggests that the bone marrow stroma contains a population of pluripotent cells capable of differentiating into adipocytes, osteoblasts, and lymphohematopoietic supporting cells. In this work, the murine stromal cell lines BMS2 and +/+ 2.4 have been examined as preadipocytes and adipocytes for evidence of osteoblastic gene expression. Adipocyte differentiation has been quantitated using fluorescence activated cell sorting. Within 7-10 days of adipocyte induction by treatment with glucocorticoids, indomethacin, and methylisobutylxanthine, between 40% to 50% of the cells contain lipid vacuoles and exhibit a characteristic adipocyte morphology. Based on immunocytochemistry, both the adipocytes and preadipocytes express a number of osteoblastic markers; these include alkaline phosphatase, osteopontin, collagen (I, III), bone sialoprotein II, and fibronectin. Based on biochemical assays, the level of alkaline phosphatase expression is not significantly different between preadipocyte and adipocyte cells. However, unlike rat cell lines, dexamethasone exposure causes a dose-dependent decrease in enzyme activity. The steady-state mRNA levels of the osteoblast associated genes varies during the process of adiopogenesis. The relative level of collagen I and collagen III mRNA is lower in adipocyte-induced cells when compared to the uninduced controls. Osteocalcin mRNA is detected in preadipocytes but absent in adipocytes. These data indicate that osteoblastic gene expression is detected in cells capable of undergoing adipocyte differentiation, consistent with the hypothesis that these cell lineages are interrelated.


Effects of lithium on dopamine behavioural supersensitivity induced by rapid eye movement sleep deprivation.
The effects of lithium on the potentiation of d-amphetamine-induced hyperlocomotion were evaluated in rapid eye movement (REM) sleep deprived rats. Under control conditions, pretreatment with lithium during 7 days did not modify the hyperlocomotion produced by d-amphetamine. REM sleep deprivation induced a pronounced potentiation of the locomotor response to d-amphetamine. In a stress control group this potentiation also occurred, but to a lesser degree than in the REM sleep deprived group. Lithium pretreatment prevented the increased response to d-amphetamine in both REM sleep deprived and stress control animals. The effects of lithium in REM sleep deprived rats are in accordance with reports that lithium is able to prevent the development of dopamine receptor supersensitivity. However, it cannot be excluded that in both REM sleep deprived and stress control groups the increased response to d-amphetamine is related to noradrenergic changes and/or noradrenergic-dopaminergic interactions. REM sleep deprivation seems to be an interesting model to study the underlying mechanisms of manic-depressive illness.


Correlates of benzodiazepine dependence in patients with depression followed up in a psychiatric outpatient unit in Tunisia.
Benzodiazepines may be prescribed to manage anxiety and insomnia in patients with depression. However, as noticed during our daily practice, a considerable proportion of patients treated for depression and receiving benzodiazepines developed a dependence to these medicines. Our aims were to estimate the proportion of patients with depression who develop a benzodiazepine dependence and to identify its correlates. We conducted a comparative study in Razi Hospital's outpatient psychiatry unit (Tunisia). We included patients aged 18 to 65 years who were diagnosed with depression during the first three quarters of 2014. Included patients were prescribed benzodiazepines. Follow-up period was of 2 years. A multivariate analysis was performed to identify dependence-associated factors. We included 54 patients, and 52% developed a benzodiazepine dependence during the follow-up period. Two associated factors were identified: a daily mean benzodiazepine dose of more than 9.5 milligrams of diazepam equivalents prior to taper off (p = .001) and a benzodiazepine taper-off initiated after the fifth week of benzodiazepine intake onset (p = .007). The proportion of patients who developed a benzodiazepine dependence was high. Low doses and time-limited benzodiazepine prescription should be taken into consideration when managing patients with depression in order to prevent dependence.


Aneurysms of the superior mesenteric artery and its branches.
Aneurysms of the superior mesenteric artery (SMA) and its branches are rare and account for only 6% to 15% of all visceral artery aneurysms. In the present report, we have described our 30-year experience with the management of aneurysms of the SMA and its branches at a high-volume referral center. A retrospective review of all patients with a diagnosis of an aneurysm of the SMA or one of its branches from 1988 to 2018 was performed. Pseudoaneurysms and mycotic aneurysms were excluded. The clinical presentation, etiology, aneurysm shape and size, treatment modalities, and outcomes were analyzed. The growth rate of the aneurysms was estimated using linear regression. A total of 131 patients with 144 aneurysms were reviewed. The patients were primarily men (64%), with a median age of 60 years. Of the 144 aneurysms, 57 were fusiform, 30 were saccular, and 57 were dissection-associated aneurysms. Of the 131 patients, 41 had had an isolated SMA branch aneurysm. Degenerative aneurysms were the most common etiology (66%). A total of 35 patients (27%) were symptomatic at presentation. Of the 144 aneurysms, 111 had multiple computed tomography angiograms available, with a median follow-up of 43.6 months (interquartile range, 10.6-87.2 months). Only 18 aneurysms (16%) had had an estimated growth rate of ≥1.0 mm/y. The initial aneurysm size was significantly associated with the growth rate for the fusiform aneurysms (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.0-1.3]; P = .02) but not for the saccular (OR, 0.91; 95% CI, 0.76-1.1; P = 1.1) or dissection-associated (OR, 1.2; 95% CI, 0.91-1.5; P = .20) aneurysms. Acute abdominal pain (OR, 5.9; 95% CI, 1.6-22; P = .01) and chronic abdominal pain (OR, 3.7; 95% CI, 1.1-13; P = .04) were associated with aneurysm growth. Only two patients had a ruptured aneurysm, both of whom presented with rupture with no prior imaging studies. These two patients had a diagnosis of fibromuscular dysplasia and systemic lupus erythematosus, respectively. Of the 131 patients, 46 (34%) had undergone operative repair, including 36 open revascularizations and 8 endovascular procedures. The average aneurysm size for these 46 patients was 24.0 ± 8.6 mm. One patient died perioperatively, and nine patients experienced perioperative complications (25%). Of the 144 aneurysms, 91 were <20 mm, with an average size of 13.4 ± 3.1 mm. These 91 aneurysms had been followed up for a median of 120.8 months (interquartile range, 30.5-232.2 months), with no ruptures within this cohort during the follow-up period. The present study represents one of the largest series on aneurysms of the SMA and its branches. Our results showed that aneurysms of the SMA are relatively stable. Patients with symptomatic and fusiform aneurysms had a greater risk of growth. Aneurysms <20 mm with a degenerative etiology can be safely monitored without treatment.


Association of alexithymia and depression symptom severity in adults aged 50 years and older.
Alexithymia is a characteristic style of thinking and feeling involving deficits in the recognition of emotions. It is associated with depression onset and severity in younger adults, but researchers have not yet examined the association between alexithymia and depression severity in clinically depressed older adults. Cross-sectional. One hundred thirty-four patients aged 50 years or older with a confirmed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I mood disorder and currently receiving mental health treatment. Alexithymia was measured using the Toronto Alexithymia Scale-20, a 20-item measure with subscales assessing difficulty identifying feelings, difficulty describing feelings (DDF), and externally oriented thinking. Depression symptom severity was measured using the Beck Depression Inventory, Second Edition (BDI-II). Total alexithymia scores were independently related to depressive symptom severity after controlling for demographics, cognitive functioning, and illness burden. DIF and DDF subscale scores were also independently associated with BDI-II scores. The association between alexithymia and depression symptom severity could be attributed to difficulties in recognizing and describing negative emotions and resulting delays in seeking mental health treatment. Future research should focus on modifiable risk factors related to difficulties identifying and describing feelings.


Hunting strategies used in the semi-arid region of northeastern Brazil.
Hunting for wild animals is stimulated by the many different human uses of faunal resources, and these animals constitute important subsistence items in local communities in the Caatinga region. In order to gain access to these resources, hunters have developed a series of techniques and strategies that are described in the present work. The principal hunting techniques encountered were: waiting, especially directed towards hunting diurnal birds; calling ("arremedo"), a technique in which the hunters imitate the animal's call to attract it to close range; hunting with dogs, a technique mostly used for capturing mammals; tracking, a technique used by only a few hunters who can recognize and follow animal tracks; and "facheado", in which the hunters go out at night with lanterns to catch birds in their nests. Additionally, many animal species are captured using mechanical traps. The types of traps used by the interviewees were: dead-fall traps ("quixó"), iron-jaw snap traps ("arataca"), wooden cages with bait ("arapuca"), iron-cage traps ("gaiola'), "visgo", multi-compartment bird cages ("alçapão"), buried ground traps with pivoted tops ("fojo"), and nooses and cages for carnivorous. The choice of which technique to use depends on the habits of the species being hunted, indicating that the hunters possess a wide knowledge of the biology of these animals. From a conservation perspective, active hunting techniques (waiting, imitation, hunting with dogs, and "facheado") have the greatest impact on the local fauna. The use of firearm and dogs brought greater efficiency to hunting activities. Additional studies concerning these hunting activities will be useful to contribute to proposals for management plans regulating hunting in the region - with the objective of attaining sustainable use of faunal resources of great importance to the local human communities.


Functional analysis of an intron 3' splice site in Caenorhabditis elegans.
Caenorhabditis elegans introns typically lack both branch point and polypyrimidine tract consensus sequences utilized in other organisms for intron recognition. However, most introns have an unusually long, highly conserved consensus, UUUCAG/R, at the 3' splice site. This site can be recognized even when the -1G is changed to A. To determine how the 3' splice site is defined, we tested mutations in the sequence UUUCAA/A at the 3' splice site of the first intron of a test gene in vivo. Replacement of individual U's with A's or C's compromised splicing. When the sequence UUUCAA/AAG was tested, splicing occurred following both the -1A and the +3G, indicating that both UUUC and the AG contain 3' splice site information. When the sequence UUUCAA/AAA was tested, all splicing occurred following the -1A, suggesting that the UUUC contains sufficient information in the absence of an AG to specify the location of the splice site. In support of this idea, when point mutations were introduced into the UUUC, unspliced RNAs accumulated. Surprisingly, RNAs containing the mutant intron often contained the second, nonmutated intron as well, suggesting that interference with splicing of one intron can interfere with splicing of a second intron in the same pre-mRNA. The majority of these unspliced RNAs were degraded by the system responsible for degradation of transcripts containing nonsense mutations (smg), even though the intron contained no nonsense codon.


A new device for noncontact wide-angle viewing of the fundus during vitrectomy.
Noncontact wide-angle viewing of the fundus during vitrectomy has heretofore relied on an image inverter and a 90-diopter lens fixed with a tube under the microscope. A new device in which the 90-diopter lens is not connected to the microscope but, rather, is connected to an independent support system is described. This device offers many advantages: (1) focusing on the various parts of the eye during vitreous surgery need not be done manually but is achieved by the up or down movement of the microscope, (2) translation of the microscope is easier during tilting of the eye, (3) a lateral slit-lamp can be easily added for illumination of the fundus, and (4) there is no risk that the 90-diopter lens will touch the cornea.


Presynaptic regulation of cardiac sympathetic function in hypoxic guinea pigs.
In the normal heart, presynaptic cholinergic muscarinic and alpha 2-adrenergic mechanisms modify the fractional rate constant for norepinephrine (NE) synthesis (kNE), an index of sympathetic neural function. To evaluate presynaptic regulation of kNE, conscious guinea pigs subjected to normoxia and then hypoxia (n = 7-8 in each group) were pretreated with 1) vehicle; 2) a cholinergic muscarinic antagonist, methyl atropine; 3) an alpha 2-antagonist, yohimbine; or 4) a combination of the two. An increase of kNE was determined from incorporation of radiolabeled tyrosine into NE in a control period (arterial PO2 130 +/- 1.7 Torr, PCO2 36 +/- 0.5 Torr) and during a hypoxic state (PO2 49.6 +/- 1.0 Torr, PCO2 36 +/- 0.5 Torr). Hypoxia activated kNE in the atrioventricular node and right ventricular moderator band in vehicle-treated animals (P less than 0.05). Sympathetic activation was more general, however, because alpha 2-presynaptic influence acted to limit kNE in all tissues tested (P less than 0.05) except muscle, spleen, and posterior left ventricle. Cholinergic muscarinic presynaptic restraint on kNE was detected during hypoxia only in the left atrial appendage and lung (P less than 0.05). These data indicate that hypoxia increases kNE in the heart, but restraint by cholinergic muscarinic and alpha 2-adrenergic presynaptic mechanisms limits increases in neurotransmitter synthesis and noradrenergic activation regionally.


Predicting willingness to engage in unsafe sex and intention to perform sexual protective behaviors among adolescents.
This article examines the sociocognitive processes contributing to intention to use contraception and willingness to engage in unsafe sex, using extended versions of the theory of planned behavior (TPB) and the Prototype/Willingness model (Gibbons & Gerrard, 1995, 1997). Data were obtained from a questionnaire delivered to all the pupils in ninth grade (N = 196) at three schools in Oslo. Hierarchical multiple regression analysis was used to predict intention and willingness. The results showed that subjective norm was the most important predictor of intentions for girls, whereas moral norm was most important for boys' intentions and willingness. Prototypes were the most important predictor for girls' willingness. Implications of the findings are discussed.


The internist as clinical ethics consultant: An antidote to "the barbarism of specialisation" in hospital practice.
The development of hospital clinical ethics in Spain depends almost exclusively on the healthcare ethics committees, which have been criticized for a lack of proximity to the patient's bedside in day-to-day ethical conflicts and for their scarce practical operation, reflected in the low number of consultations they receive. In this study, we reflect on the need to change the current healthcare model in clinical ethics so as to reactivate it and call attention to the essential role of internists as the engine for this change. To this end, we propose a model in which the healthcare ethics committees incorporate ethics consultants, who are better positioned to discuss cases at the patient's bedside. We then analyse the characteristics that these consultants should have.


Rhythmic auditory stimuli modulate movement recovery in response to perturbation during locomotion.
The capacity to recover after a perturbation is a well-known intrinsic property of physiological systems, including the locomotor system, and can be termed 'resilience'. Despite an abundance of metrics proposed to measure the complex dynamics of bipedal locomotion, analytical tools for quantifying resilience are lacking. Here, we introduce a novel method to directly quantify resilience to perturbations during locomotion. We examined the extent to which synchronizing stepping with two different temporal structured auditory stimuli (periodic and 1/f structure) during walking modulates resilience to a large unexpected perturbation. Recovery time after perturbation was calculated from the horizontal velocity of the body's center of mass. Our results indicate that synchronizing stepping with a 1/f stimulus elicited greater resilience to mechanical perturbations during walking compared with the periodic stimulus (3.3 s faster). Our proposed method may help to gain a comprehensive understanding of movement recovery behavior of humans and other animals in their ecological contexts.


Career satisfaction amongst dental students and dentists in Saudi Arabia: A cross-sectional survey.
Dental students' satisfaction with their own career can significantly improve the quality of care provided to patients. The aim of the current study was to assess the level of career satisfaction amongst Saudi dental students and dentists. A cross-sectional survey was conducted from October 2019 to January 2020 all over Saudi Arabia. A sample of 750 Saudi dental students and dentists were invited to complete an online questionnaire. The questionnaire was composed of two sections of closed-ended questions. The first section included personal, professional background factors and level of career satisfaction assessed. The second section included different reasons for choosing dentistry as a career. Multivariable linear regression was used at significance <0.05. Only 674 responded to the questionnaire. About half of the included respondents were males. Most of the participants were undergraduate students attended Saudi dental schools. 72.3% chose dentistry for helping other people. Graduated dentists had significantly lower satisfaction score than dental students (p = .007). Dentists, who chose dentistry because it is a secured job with good income (p < .001), had significantly lower satisfaction score than those who did not, whilst those who chose it for the social status had significantly higher satisfaction score than those who did not (p = .04). Dental students and dentists were motivated to choose dentistry as it is an opportunity to help others and achieve good salary with appropriate social position in community. Dental students were more satisfied than dentists due to lack of financial responsibilities and absence of educational expenses.


Secondary Metabolites and Their Bioactivities Produced by Paecilomyces.
Paecilomyces, a common saprobic filamentous fungus, not only plays an important role in biological control, but also has applications in medicine, food, and environmental protection. In this paper, 223 secondary metabolites and their bioactivities from 13 known species and various unidentified strains of Paecilomyces are reviewed. Their structures can be described as polyketide, terpenoid, peptide, alkaloid, quinone, pyrone, sterol, and fatty acid. They have been demonstrated varying biological activities, including antimicrobial, antitumor, insecticidal, antiplasmodial, antimalarial, nematicidal, herbicidal, and enzyme-inhibiting. This review provides a comprehensive overview of secondary metabolites and their biological activities from strains of Paecilomyces.


Level of Agreement Between Forearm and Upper Arm Blood Pressure Measurements in Patients With Large Arm Circumference.
The purpose of the study was to determine if forearm blood pressures (BPs) measured in three different locations agree with the recommended upper arm location for noninvasive BP measurement. A method-comparison design was used. In a convenience sample of postanesthesia care unit patients with large upper arm circumference, BP's were obtained in three different forearm locations (lower forearm, middle forearm, and upper forearm) and compared to upper arm BP using an automated BP measuring device. The level of agreement (bias ± precision) between each forearm location and the upper arm BP was calculated using standard formulas. Acceptable levels of agreement based on expert opinion were set a priori at bias and precision values of less than ±5 mm Hg (bias) and ±8 mm Hg (precision). Forty-eight postanesthesia patients participated in the study. Bias and precision values were found to exceed the acceptable level of agreement for all but one of the systolic and diastolic BP comparisons in the three forearm BP locations. Fifty-six percent of all patients studied had one or more BP difference of at least 10 mm Hg in each of the three forearm locations, with 10% having one or more differences of at least 20 mm Hg. The differences in forearm BP measurements observed in this study indicate that the clinical practice of using a forearm BP with a regular-sized BP cuff in place of a larger sized BP cuff placed on the upper arm in postanesthesia care unit patients with large arm circumferences is inappropriate. The BPs obtained at the forearm location are not equivalent to the BPs obtained at the upper arm location.


Cytoarchitectonic study of the cerebral cortex in the horse brain--classification of the cortex area.
A cytoarchitectural classification of the horse cerebral cortex was done to determine whether functional locations exist or not such as found in the human cerebral cortex. Two adult horse brains were examined by Nissl and myelin stained methods. Six cell layers of the cerebral cortex were identified and classified into five types areas based on the cytoarchitectural organization: agranular, frontal, parietal, polar and granulous types. The agranular type was seen around the gyrus sylvius. In layer V of the agranular type, there were the many large cells that seemed like Betz cells. This type was recognized as motor area. The frontal type was seen in the lower and parietal parts of the cortex. The parietal type was seen in the rostral and occipital lobes. The polar type was seen in the frontal and dorsal-occipital sides. The granulous type was seen in the anterior-lower and posterior-lateral part of the cortex. The occupational ratios of the five types, that is, agranular, frontal, parietal, polar and granulous, to the whole cerebral cortex, were calculated by three-dimensional analysis using computer system as 19.6, 27.0, 28.9, 13.6 and 10.9%, respectively. As a result of myelin stain, horizontal fibers were seen in layer IV of parietal and polar types which looked liked the line of Gennari, therefore this area was recognized as the primary visual area.


[Physical therapy and rehabilitation].
The characteristic of increasing frailty in the elderly is amyotrphia, the so-called sarcopenia. At this physiological ageing is as important as lifestyle and environmental influences. With specific physical activities, older people have the ability to gain positive effects in strength, balance and quality of life. This fits as well in prevention as in rehabilitation after sickness.


[Relationship between the level of serum TNF-alpha of patients with chronic hepatitis C and treatment with interferon-alpha and the influencing factors].
To assess the relationship between the level of serum TNF-alpha of chronic hepatitis C with severity of disease and curative effect of anti-virus therapy with interferon alpha. Thirty healthy controls and 102 patients with chronic hepatitis C were recruited into this study. The level of serum TNF-alpha was determined by ELISA in both groups. Then the 102 patients with chronic hepatitis C were evaluated after being classified into mild (44 cases), moderate (34 cases), and severe types (24 cases) based on the results of liver function tests. Liver functions, viral load and genotype of HCV RNA were measured. Before anti-virus treatment, the level of fasting serum TNF-alpha in the patients with chronic hepatitis C (1) was higher than that of the normal controls; (2) in the cases with mild type was lower than that in the moderate and severe groups; (3) serum TNF-alpha was not associated with the HCV load; (4) serum TNF-alpha was not significantly different between HCV subtypes 1b and 2a; (5) serum TNF-alpha was not significantly different between the patients responsive and non-responsive to the anti-virus treatment; (6) serum TNF-alpha was positively correlated with the level of serum direct bilirubin, negatively correlated with cholinesterase (CHE). The level of fasting serum TNF-alpha in the patients with chronic hepatitis was higher than that in the normal controls, and was positively correlated with the severity of the disease but not correlated with the therapeutic effect of interferon-alpha.


[Immunologic profile of patients with carcinoma of the colorectum in the aged].
The authors, after explaining why they were persuaded to effect a study about the immunological outline of patients in geriatric age, suffering from colorectal carcinoma in different stages, state the methods they adopted for the in vivo and in vitro study of the cellular and humoral immunity. In order to better characterize these subjects, the authors also dosed tumoral markers, specific enough for the large intestine carcinoma, such as CEA and AFP. After reporting the results of their research, the authors, as a conclusion, assert there is certainly a straight correlation between immunity faults, bound to ageing, and neoplastic disease; therefore, the study of the immunological outline in aged patients is very useful, not only for prognostic purposes, but also to monitoring the immunitary state, mot inclined to meet depression in such patients as a consequence of the different therapies performed.


Chemical species of lipids in bile.
Bile salts, phospholipids and sterols are the major lipid species in bile. The common bile salts possess a steroid nucleus of four fused hydrocarbon rings with polar hydroxyl functions and an aliphatic side chain conjugated in amide linkage with glycine or taurine. Since the ionized carboxylate or sulfonate group on the side chain renders bile salts water soluble, they are formally classified as soluble amphiphiles. The common bile salts differ in the number and orientation of the hydroxyl groups on the steroid nucleus. Bile salts synthesized from cholesterol in the liver are called primary bile salts, which in humans are cholate, with three hydroxyl groups, and chenodeoxycholate, with two hydroxyl groups. Secondary bile salts are created by the action of intestinal bacteria on primary bile salts; deoxycholate, with two hydroxyl groups, and lithocholate, with a single hydroxyl group, are formed from cholate and chenodeoxycholate, respectively. "Tertiary" bile salts are the result of modification of secondary bile salts by intestinal flora or hepatocytes; in humans these are the sulfate ester of lithocholate and ursodeoxycholate, the 7 beta-epimer of chenodeoxycholate. Lecithin (diacylphosphatidylcholine), the major phospholipid in bile, is an insoluble, swelling amphiphile with a hydrophilic, zwitterionic phosphocholine head group and hydrophobic tails comprised of two long fatty acyl chains. Biliary lecithin is derived from the least hydrophobic hepatic lecithins and typically contains a saturated C-16 acyl chain in the sn-1 position and an unsaturated C-18 or C-20 acyl chain in the sn-2 position. Cholesterol, present solely as the nonesterified free alcohol, accounts for more than 90% to 95% of the sterols in bile.(ABSTRACT TRUNCATED AT 250 WORDS)


Characterization of KLBCK1, encoding a MAP kinase kinase kinase of Kluyveromyces lactis.
The cellular integrity and response to hypoosmotic conditions in the yeast Saccharomyces cerevisiae are ensured by a MAP kinase signal transduction pathway mediated by the yeast homolog of mammalian protein kinase C. Bck1p functions as the MAP kinase kinase kinase of this pathway. Here we report on the cloning and analysis of the BCK1 homolog from the milk yeast Kluyveromyces lactis (KlBCK1). The deduced protein sequences display three highly conserved domains with the serine/threonine kinase domain containing 89 % identical amino acid residues. Interestingly, a region identified in KlBck1p as a putative SAM domain, mediating protein-protein interactions, is also conserved in ScBck1p. Yet, two-hybrid analyses indicate that this region may not be involved in dimerization of KlBck1p in contrast to its S. cerevisiae counterpart. Expression of KlBCK1 fully complements the defects in a Scbck1 null mutant and is capable of activating the pathway as indicated by a reporter system based on the transcription factor Rlm1p. However, deletion from the haploid K. lactis genome does not result in a loss of cellular integrity under a variety of conditions tested. Thus, despite the functional conservation in this component of the MAP kinase pathway in both yeast, cellular integrity in K. lactis may depend at least in part on different signalling mechanisms when compared with S. cerevisiae.


The prevalence, reasons and attitudes for the practice of informal medicine.
Informal medicine, entailing undocumented medical advice, has been described in diverse medical disciplines and geographical regions. We assessed the current prevalence and characteristics of informal medical consulting, the reasons physicians provide it, and their attitudes toward it. We conducted a survey among family physicians in Israel, a country with a national health insurance system. A questionnaire was emailed to all primary care physicians in the two largest HMOs in southern Israel. Fifteen questions addressed the prevalence, practice and attitudes to informal medical consulting. Ten questions assessed demographics and professional experience. Of 143 respondents (mean age 41 years), 55% were women. Ninety-five percent of the respondents reported requesting informal medical consulting from other physicians. Fifty-four percent reported often providing informal consulting to family and friends; and an additional 27% reported doing so under exceptional circumstances. The main reasons given for informal consulting requests were availability and accessibility (81% of respondents), and not financial savings. Only 17.5% stated being in favor of informal consulting for family and friends. Only 11% expressed feeling satisfaction after providing such consultation; 49% expressed discomfort. Sixty-six percent thought a position paper on informal consulting to family and friends is needed. Our survey of primary care physicians shows very frequent informal medical consulting, despite high dissatisfaction with such, and an interest in receiving guidelines on this practice.


Short-term plasticity of unitary inhibitory-to-inhibitory synapses depends on the presynaptic interneuron subtype.
Excitatory-to-inhibitory cortical synapses exhibit either short-term facilitation or depression, depending on the subtype identity of the postsynaptic interneuron, while the short-term plasticity (STP) of inhibitory-to-excitatory synapses depends on the presynaptic interneuron. However, the rules governing STP of inhibitory-to-inhibitory synapses have not yet been determined. We recorded 109 unitary connections made by the two major inhibitory interneuron subtypes in layer 4 of mouse somatosensory cortex, fast-spiking (FS) and somatostatin-containing (SOM) interneurons, on each other and on excitatory, regular-spiking (RS) neurons. In all pairs, we measured dynamic changes in the postsynaptic response to a 20 Hz train of presynaptic action potentials. In half of our dataset, we also measured kinetic properties of the unitary IPSC: latency, rise time, and decay time constant. We found a pronounced dependency of STP on the presynaptic, but not the postsynaptic, identity: FS interneurons made strongly depressing connections on FS, SOM, and RS targets, while in synapses made by SOM interneurons on FS and RS targets, weak early depression was followed by weak late facilitation. IPSC latency and rise time were also strongly dependent on the presynaptic interneuron subtype, being 1.5-2× slower in output synapses of SOM compared with FS interneurons. In contrast, the IPSC decay time constant depended only on the postsynaptic class, with 1.5× slower decay on excitatory compared with inhibitory targets. The properties of the inhibitory outputs of FS and SOM interneurons reciprocate the properties of their excitatory inputs and imply a dynamic spatiotemporal division of labor between these two major inhibitory subsystems.


Aerosol assisted fabrication of two dimensional ZnO island arrays and honeycomb patterns with identical lattice structures.
Two dimensional island arrays and honeycomb patterns consisting of ZnO nanocrystal clusters were fabricated on predefined TiO(2) seed patterns prepared by vacuum free, aerosol assisted wet-chemical synthesis. The TiO(2) seed patterns were prepared by applying an aerosol of a water soluble titanium complex on hexagonally close-packed polystyrene bead arrays for different lengths of time. Scanning electron microscopy revealed that a dot array grows into a honeycomb shape as increasing amounts of the precursor were deposited. ZnO nucleation on substrates with a dot array and honeycomb patterns resulted in the formation of two discrete patterns with contrasting fill fractions of the materials.


Fast Roughness Minimizing Image Restoration Under Mixed Poisson-Gaussian Noise.
Image acquisition in many biomedical imaging modalities is corrupted by Poisson noise followed by additive Gaussian noise. While total variation and related regularization methods for solving biomedical inverse problems are known to yield high quality reconstructions in most situations, such methods mostly use log-likelihood of either Gaussian or Poisson noise models, and rarely use mixed Poisson-Gaussian (PG) noise model. There is a recent work which deals with exact PG likelihood and total variation regularization. This method adapts the primal-dual approach involving gradients steps on the PG log-likelihood, with step size limited by the inverse of its Lipschitz constant. This leads to limitations in the convergence speed. Although the alternating direction method of multipliers (ADMM) algorithm does not have such step size restrictions, ADMM has never been applied for this problem, for the possible reason that PG log-likelihood is quite complex. In this paper, we develop an ADMM based optimization for roughness minimizing image restoration under PG log-likelihood. We achieve this by first developing a novel iterative method for computing the proximal solution of PG log-likelihood, deriving the termination conditions for this iterative method, and then integrating into a provably convergent ADMM scheme. We experimentally demonstrate that the proposed method outperform primal-dual method in most of the cases.


Stability of blood biochemistry levels in animal model research: effects of storage condition and time.
The purpose of this study was to compare whole blood and plasma in terms of the subsequent accuracy of blood lactate, glucose, lactate dehydrogenase (LDH), creatine phosphokinase (CPK), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) measurement. Blood samples were drawn from 8 male Wistar-Kyoto rats. The rats were homologous, weighed 300- 380 g, were housed in the same environment, and were provided with food and water under the same conditions. Blood draws occurred in all rats at same time. The blood specimens were divided into two samples, one to be stored as whole blood (WBS) and one to be stored as plasma (PS). All the blood sample analyses were performed by trained and experienced personnel to ensure that differences in results were due to variation in form in which specimens were stored rather than to technique. The lactate concentration in the WBS group gradually increased over time, intraclass correlation coefficient (ICC) = 0.541, 95% confidence interval (CI; -0.197, 0.893), and was higher than that of the PS group, ICC = 0.897, 95% CI (0.733, 0.976). By contrast, glucose level gradually declined for the WBS group, ICC= -0.367, 95% CI (-2.563, 0.682). Whole blood storage increased measurement variation for lactate, glucose, LDH, and CPK. Plasma storage prolonged the stability of the biochemical components. This study demonstrates the importance of evaluating validity at each stage of developing and testing animal models.


[Cardiovascular effects of autonomic neuropathy in insulin-dependent diabetes mellitus].
The present study was designed to evaluate whether autonomic diabetic neuropathy is a marker of severe cardiovascular disease. We recruited three groups of 12 patients each with the same age, sex and body weight distribution: Group DAN + (diabetics with neuropathy), Group DAN- (diabetics without neuropathy) and Group C (healthy control group). The patients underwent two-dimensional color Doppler echocardiography and maximal electrocardiographic exercise test by cycloergometer (multistage program with 25 W increments 3 min steps). Cardiovascular autonomic function was evaluated by Ewing's tests (heart rate and blood pressure measurement during lying to standing, deep breathing, handgrip isometric stress test and Valsalva manoeuvre). Heart rate and blood pressure proved to be significantly higher in the Group DAN+, than in the other groups, either at baseline or during stress test. Only 33% of DAN+ patients proved to reach 100 W during stress test, compared to 82% of DAN- and 87% of control subjects. No DAN+ patients reached 125 W, compared with 45% of DAN- and 58% of Group C patients. Echocardiographic examination showed normal left ventricular systolic function in all groups, without any significant difference in ventricular dimensions, and impaired left ventricular diastolic function in DAN+ patients, compared to Group C subjects (peak E 66.75 +/- 8.36 vs 73.49 +/- 12.53 cm/s; peak A 72.1 +/- 13.42 vs 59.75 +/- 13.26 cm/s; E/A 0.84 +/- 0.21 vs 1.38 +/- 0.15 and isovolumetric relaxation time 101 +/- 21 vs 70 +/- 17 ms). Our data suggest that diabetic autonomic neuropathy is a marker of reduced exercise tolerance and of diastolic left ventricular dysfunction.


Printing of sub-20 nm wide graphene ribbon arrays using nanoimprinted graphite stamps and electrostatic force assisted bonding.
Nano-graphene ribbons are promising in many electronic applications, as their bandgaps can be opened by reducing the widths, e.g. below 20 nm. However, a high-throughput method to pattern large-area nano-graphene features is still not available. Here we report a fabrication method of sub-20 nm ribbons on graphite stamps by nanoimprint lithography and a transfer-printing of the graphene ribbons to a Si wafer using electrostatic force assisted bonding. These methods provide a path for fast and high-throughput nano-graphene device production.


Clinical characteristics of non-Hodgkin's lymphoma as a second primary tumor: a population-based survey.
Data from 29,845 patients with lymphomas, 981 of whom had lymphoma as a second primary tumor, registered in the Surveillance Epidemiology and End Results (SEER) program in the U.S.A. between 1973 and 1986 were analyzed. The characteristics of the 274 patients with lymphoma as a second tumor who had received chemotherapy and/or radiotherapy for their primary tumor (SEP PT) were compared with 675 patients with second primary lymphomas who had no prior treatment (SEP NT) and with patients with single lymphomas (SIP). Patients with SEP PT disease had a significantly higher percentage of intermediate and high-grade tumors (80%) compared to those with SEP NT or SIP tumors (73% and 72%, respectively). The survival of all patients with SIP tumors did not differ from those with SEP tumors, but the median survival of those with SEP PT disease was shorter than for SEP NT disease. This was most probably due to the high percentage of intermediate and high-grade lymphomas in the SEP PT group. This was statistically significant in the group treated by combined chemotherapy and radiotherapy but not in those treated by a single modality alone. These findings relating to a worse prognosis in patients with SEP PT lymphoma are in line with our previous observations of a poor survival in patients with other multiple primary tumors.


Indoleacetic Acid and Abscisic Acid Antagonism: II. On the Phytochrome-Mediated Attachment of Barley Root Tips on Glass.
The effects of low concentrations (10 nm or less) of indoleacetic acid and abscisic acid on the phytochrome-mediated attachment of barley root (Hordeum vulgare L., var. Compana) tips on glass have been found to be opposite to those reported for mung bean root tips. Unlike their effects on mung bean root tips, indoleacetic acid causes attachment while abscisic acid causes detachment of barley root tips. Both hormones specifically and rapidly counteract the action of the other. No effect on the photoreversibility of attachment was observed when several gibberellins, cytokinins, and ethylene were added to the assay medium over a wide concentration range.


The Akin procedure in hallux valgus.
A retrospective study of 28 Akin procedures was undertaken to assess their results. Patient satisfaction, clinical findings and roentgenographic measurements were evaluated after follow-up periods of 12 to 42 months. The outcome was excellent in nearly 60% of the patients, especially those whose discomfort was related to the laterally deviated great toe and to the prominence of the first metatarsal head.


Cranial nerve schwannoma - A pictorial essay.
Schwannomas are peripheral nerve sheath tumours arising from cranial, spinal or peripheral nerves. Most of the schwannomas are benign with the rare possibility of malignant transformation. Cranial nerve schwannomas can be seen along the course of any cranial nerve in the intracranial region or head and neck location. Although a majority are solitary sporadic lesions, multiple schwannomas can be seen in syndromes like neurofibromatosis type 2 and rarely in type 1. Since intracranial schwannomas are slow-growing, clinical presentation varies between no symptoms to cranial nerve palsy. Most of the times, the symptoms are due to mass effect over the adjacent structures, foraminal widening, compression of other cranial nerves, denervation injury or hydrocephalus. Familiarity with the course of the cranial nerves, imaging appearances and clinical presentation of schwannomas helps in accurate diagnosis and possible differential diagnosis, especially in uncommon clinical and radiological appearances. In this pictorial review, we illustrate relevant anatomy of cranial nerves, imaging features of schwannomas of most of the cranial nerves, clinical presentation and differential diagnosis.


Microglia in neurodegenerative diseases.
A major feature of neurodegeneration is disruption of central nervous system homeostasis, during which microglia play diverse roles. In the central nervous system, microglia serve as the first line of immune defense and function in synapse pruning, injury repair, homeostasis maintenance, and regulation of brain development through scavenging and phagocytosis. Under pathological conditions or various stimulations, microglia proliferate, aggregate, and undergo a variety of changes in cell morphology, immunophenotype, and function. This review presents the features of microglia, especially their diversity and ability to change dynamically, and reinterprets their role as sensors for multiple stimulations and as effectors for brain aging and neurodegeneration. This review also summarizes some therapeutic approaches for neurodegenerative diseases that target microglia.


Ethyl acetate extract from Jiedu Xiaozheng Yin inhibits the proliferation of human hepatocellular carcinoma cells by suppressing polycomb gene product Bmi1 and Wnt/β-catenin signaling.
Jiedu Xiaozheng Yin (JXY) is a Chinese herbal decoction used to treat hepatocellular carcinoma (HCC). Previous studies have demonstrated that JXY can inhibit HCC cell proliferation via induction of G0/G1 phase arrest. In this study, we investigated whether the inhibitory effect of JXY on HCC cells is associated with the inhibition of the Wnt/β‑catenin pathway and the polycomb gene product Bmi1. Ethyl acetate extract from JXY (EE-JXY) was prepared. Methyl thiazolyl tetrazolium (MTT) and colony formation assays were used to measure cell proliferation. Immunofluorescence was used to analyze the expression and location of β-catenin and Bmi1. Immunohistochemistry was used to examine the expression of proliferating cell nuclear antigen (PCNA), c-myc and cyclin D1. β-catenin, Bmi1, c-myc, cyclin D1 and p16INK4A mRNA levels were detected by RT-PCR. The results demonstrated that EE-JXY inhibited the expression of PCNA, c-myc, cyclin D1 and Bmi1, and upregulated the expression of p16INK4A. We also found that EE-JXY could facilitate β-catenin translocation from the cytoplasm and nuclei to the cytomembrane. Finally, suppression of cell proliferation and expression of Bmi1 and Wnt/β-catenin by EE-JXY was confirmed in a mouse xenograft model of HCC. Thus, EE-JXY can inhibit the proliferation of HCC partially via suppression of the Bmi1 and Wnt/β-catenin signaling pathways.


Doxorubicin-induced lipid peroxidation and glutathione peroxidase activity in tumor cell lines selected for resistance to doxorubicin.
Doxorubicin-induced lipid peroxidation was evaluated in four human or murine cell strains in culture and in their doxorubicin-resistant variants, by the quantification of malondialdehyde produced after a 2-h incubation of cells with the drug. Significantly increased malondialdehyde levels were obtained 24 h after doxorubicin treatment in three of the wild-type cell lines with doses as low as 0.05-0.1 micrograms/ml, which is within an order of magnitude of the concentration of the drug which inhibits cell growth by 50%. This production of malondialdehyde was abolished in two doxorubicin-resistant strains, even with high doses of drug (100-300 micrograms/ml), but was maintained in the third resistant line. No malondialdehyde production was observed in the fourth cell line, sensitive or resistant. It is remarkable that an enhancement of selenium-dependent and non-selenium-dependent glutathione peroxidase activities was exhibited during the acquisition of resistance to doxorubicin in the two first lines, but not in the third, whereas a constitutively high non-selenium-dependent glutathione peroxidase activity existed in the doxorubicin-sensitive and doxorubicin-resistant variants of the fourth cell line. Gene expression of selenium-dependent glutathione peroxidase and of glutathione S-transferase pi, which is known partially to bear a non-selenium-dependent glutathione peroxidase activity, were correlated with the corresponding enzyme activities. It appears, therefore, that the already known enhancement of glutathione peroxidase activity and expression in doxorubicin-resistant cell lines has a quantifiable consequence upon doxorubicin-induced lipid peroxidation and may have consequences in the mechanism of resistance to this drug.


Combination of heterogeneous EEG feature extraction methods and stacked sequential learning for sleep stage classification.
This work proposes a methodology for sleep stage classification based on two main approaches: the combination of features extracted from electroencephalogram (EEG) signal by different extraction methods, and the use of stacked sequential learning to incorporate predicted information from nearby sleep stages in the final classifier. The feature extraction methods used in this work include three representative ways of extracting information from EEG signals: Hjorth features, wavelet transformation and symbolic representation. Feature selection was then used to evaluate the relevance of individual features from this set of methods. Stacked sequential learning uses a second-layer classifier to improve the classification by using previous and posterior first-layer predicted stages as additional features providing information to the model. Results show that both approaches enhance the sleep stage classification accuracy rate, thus leading to a closer approximation to the experts' opinion.


Cloning and characterization of two xyloglucanases from Paenibacillus sp. strain KM21.
Two xyloglucan-specific endo-beta-1,4-glucanases (xyloglucanases [XEGs]), XEG5 and XEG74, with molecular masses of 40 kDa and 105 kDa, respectively, were isolated from the gram-positive bacterium Paenibacillus sp. strain KM21, which degrades tamarind seed xyloglucan. The genes encoding these XEGs were cloned and sequenced. Based on their amino acid sequences, the catalytic domains of XEG5 and XEG74 were classified in the glycoside hydrolase families 5 and 74, respectively. XEG5 is the first xyloglucanase belonging to glycoside hydrolase family 5. XEG5 lacks a carbohydrate-binding module, while XEG74 has an X2 module and a family 3 type carbohydrate-binding module at its C terminus. The two XEGs were expressed in Escherichia coli, and recombinant forms of the enzymes were purified and characterized. Both XEGs had endoglucanase active only toward xyloglucan and not toward Avicel, carboxymethylcellulose, barley beta-1,3/1,4-glucan, or xylan. XEG5 is a typical endo-type enzyme that randomly cleaves the xyloglucan main chain, while XEG74 has dual endo- and exo-mode activities or processive endo-mode activity. XEG5 digested the xyloglucan oligosaccharide XXXGXXXG to produce XXXG, whereas XEG74 digestion of XXXGXXXG resulted in XXX, XXXG, and GXXXG, suggesting that this enzyme cleaves the glycosidic bond of unbranched Glc residues. Analyses using various oligosaccharide structures revealed that unique structures of xyloglucan oligosaccharides can be prepared with XEG74.


Immunofluorescence analysis in flow cytometry: better selection of antibody-labeled cells after fluorescence overcompensation in the red channel.
Selection of cells labeled with fluorescein isothiocyanate-conjugated (FITC) antibodies can be difficult if large autofluorescent cells are used and if the cells bind only a few molecules of antibody. We have developed a simple flow cytometric procedure that allows better selection of stained cells. When an argon ion laser emitting at 488 nm is used, the green fluorescence detected is the sum of cell autofluorescence and of the signal generated by the FITC antibody. Thus, when we subtract green signal from the red by fluorescence compensation, the signal of stained cells is on average reduced more than for the unstained counterpart. In this scenario, positive selection of cells with low red signal allows more efficient selection of stained cells. We tested the overcompensation procedure on mixtures of cells unstained and stained with a relevant FITC antibody. Cell mixtures were analyzed using normal vs increased levels of compensation in the red channel. Increased levels of compensation resulted in easier gating and higher recovery of stained cells. The efficiency of the overcompensation procedure was particularly high when using red filters with low cutoff (i.e., 560 or 570 nm), possibly because of the significant emission of fluorescein in the red channel, which caused separation between stained and unstained cells also in the red dimension. This method is useful for sorting cells expressing low levels of surface markers and facilitates selection of rare cells transfected with surface antigen genes. This technique is compatible with the use of propidium iodide for live/dead cell discrimination and with the subtraction of the cellular background of autofluorescence.


[Criteria of the evaluation of tubal function in patients with secretory otitis media].
Tubular function was assessed in patients with secretory otitis media before and after surgery (an original version of anterior tympanostomy). Preoperative tubular function was measured by impedance tympanometry. After tympanostoma was placed the acoustic tube was subjected to direct manometry. Perioperative measurements were made for tube patency for liquid (hydrocortisone). The tests of pressure adjustment implied routine spirit manometry and updated impedancemetry. Technical specifications of modern impedance meters met the criteria of clinical fitness for post-tympanostomy patients. The criteria of assessment and correlating quantitative values of the draining and ventilation capacities of the acoustic tube were determined. This was the basis for an original classification of tubular function grades. It was established that in secretory otitis media drainage dysfunction of the acoustic tube was registered in two thirds of the patients (66%), ventilatory dysfunction occurred in 100% of patients. There was a correlation between these functions. This fact was used for design of a simple screening variant of ear manometry i.e. registration of the threshold of acoustic tube passive opening. Screening manometry is convenient for following up postoperative changes in the tubular function and defining duration of carrying tympanostomy in secretory otitis.


Anatomy of the perirectal fascia at the level of rectosacral fascia revisited.
The relative anatomical understanding of the perirectal fasciae is of paramount importance for the proper performance of total mesorectal excision (TME). This study was to demonstrate the planes of TME and validates the intraoperative findings using cadaveric observations. In this combined retrospective and prospective study, bilateral attachment of the rectosacral fascia (RSF) was observed in 28 cadaveric specimens (male, n = 14; female, n = 14). From January 2018 to December 2019, surgical videos of 67 patients who underwent laparoscopic TME at the Affiliated Union Hospital of Fujian Medical University (Fuzhou, China) were reviewed and interpreted with the cadaveric findings. The RSF (synonym: Waldeyer's fascia) is the end of the pre-hypogastric fascia at the level of S4 and comprises two layers (upper and lower). These two layers provide double fascial protection for the venous sacral plexus. It inserts into the fascia propria of the rectum along a broad horizontal arc that merges anterolaterally in an oblique downward direction until it meets the posterolateral merge of Denonvilliers' fascia at the lateral rectal ligament (LRL). This ligament does not look like a true ligament but is more likely to be a fascial combination that cushions the rectal innervation and middle rectal vessels. Understanding the lateral attachment of RSF and its contribution to LRL provides invaluable surgical guidance to dissect this critical area. Therefore, lateral dissection is proposed from the anterior to the posterior direction to find the correct plane that guarantees an intact mesorectal envelope to protect the important nearby nerve structures.


A Case of May-Thurner Syndrome.
May-Thurner syndrome, which is also known as iliac vein compression syndrome, is caused when an anatomical variant of the left common iliac vein with a lateral or anterior spur is compressed by the right iliac artery, resulting in thrombosis of the vein. It can present as left deep vein thrombosis which can lead to pulmonary embolism or chronic changes of venous insufficiency in the left lower limb. We report a 27-year-old female with pain abdomen, who was diagnosed to have May-Thurner syndrome.