Strategies to Fabricate Polypeptide-Based Structures via Ring-Opening Polymerization of N-Carboxyanhydrides.
In this review, we provide a general and clear overview about the different alternatives reported to fabricate a myriad of polypeptide architectures based on the ring-opening polymerization of N-carbonyanhydrides (ROP NCAs). First of all, the strategies for the preparation of NCA monomers directly from natural occurring or from modified amino acids are analyzed. The synthetic alternatives to prepare non-functionalized and functionalized NCAs are presented. Protection/deprotection protocols, as well as other functionalization chemistries are discussed in this section. Later on, the mechanisms involved in the ROP NCA polymerization, as well as the strategies developed to reduce the eventually occurring side reactions are presented. Finally, a general overview of the synthetic strategies described in the literature to fabricate different polypeptide architectures is provided. This part of the review is organized depending on the complexity of the macromolecular topology prepared. Therefore, linear homopolypeptides, random and block copolypeptides are described first. The next sections include cyclic and branched polymers such as star polypeptides, polymer brushes and highly branched structures including arborescent or dendrigraft structures.


[Deep venous thromboses in obstetrics. Apropos of 19 cases].
Between January 1974 and December 1984, 4 cases of deep venous thrombosis (DVT) during pregnancy and 15 cases in the post-partum period, have been reported. Their frequency reaches 1.5% of the deliveries. The most important encouraging circumstances are a past history of DVT and Caesarean section. The treatment is difficult. In light of the 18 cases reviewed, the surgical treatment gives the best results.


Phosphorylation of serine 21 modulates the proliferation inhibitory more than the differentiation inducing effects of C/EBPα in K562 cells.
The CCAAT/enhancer binding protein α (C/EBPα) is a transcription factor required for differentiation of myeloid progenitors. In acute myeloid leukemia (AML) cells expressing the constitutively active FLT3-ITD receptor tyrosine kinase, MAP kinase-dependent phosphorylation of serine 21 (S21) inhibits the ability of C/EBPα to induce granulocytic differentiation. To assess whether this post-translational modification also modulates the activity of C/EBPα in BCR/ABL-expressing cells, we tested the biological effects of wild-type and mutant C/EBPα mimicking phosphorylated or non-phosphorylatable serine 21 (S21D and S21A, respectively) in K562 cells ectopically expressing tamoxifen-regulated C/EBPα-ER chimeric proteins. We show here that S21D C/EBPα-ER induced terminal granulocytic differentiation of K562 cells almost as well as wild-type C/EBPα-ER, while S21A C/EBPα-ER was less efficient. Furthermore, wild-type C/EBPα suppressed the proliferation and colony formation of K562 cells vigorously, while S21D and S21A C/EBPα mutants had more modest anti-proliferative effects. Both mutants were less effective than wild-type C/EBPα in suppressing endogenous E2F-dependent transactivation and bound less E2F-2 and/or E2F-3 proteins in anti-C/EBPα immunoprecipitates. Together, these findings suggest that mutation of S21 more than its phosphorylation inhibits the anti-proliferative effects of C/EBPα due to reduced interaction with or impaired regulation of the activity of E2F proteins. By contrast, phosphorylation of serine 21 appears to have a modest role in modulating the differentiation-inducing effects of C/EBPα in K562 cells.


In Situ Mo(Si,Al)2-Based Composite through Selective Laser Melting of a MoSi2-30 wt.% AlSi10Mg Mixture.
The laser power bed fusion approach has been successfully employed to manufacture Mo(Si,Al)2-based composites through the selective laser melting of a MoSi2-30 wt.% AlSi10Mg mixture for high-temperature structural applications. Composites were manufactured by leveraging the in situ reaction of the components during printing at 150-300 W laser power, 500-1000 mm·s-1 laser scanning speed, and 100-134 J·mm-3 volumetric energy density. Microcomputed tomography scans indicated a negligible induced porosity throughout the specimens. The fully dense Mo(Si1-x,Alx)2-based composites, with hardness exceeding 545 HV1 and low roughness for both the top (horizontal) and side (vertical) surfaces, demonstrated that laser-based additive manufacturing can be exploited to create unique structures containing hexagonal Mo(Si0.67Al0.33)2.


HER2 expression in breast cancer: correlation with endocrine function and psychological status in operable and metastatic breast cancer.
Node involvement, negative estrogen receptor (ER) and HER2 expression are the main negative prognostic factors for breast cancer. Prolactin (PRL) is involved in the control of breast cancer growth and differentiation. Surgery-induced hyperprolactinemia seems to be a positive prognostic factor for operable breast cancer, whereas high PRL levels may predict a poor prognosis in women with metastatic breast cancer. In this study, we evaluated the relation between HER2 expression and PRL blood concentrations in women with metastatic breast cancer women and those whit operable breast cancer patients prior to before and 7 days after surgery. The study included 50 women with breast cancer, 22 of whom had metastatic disease. HER 2 expression and serum levels of PRL were evaluated by fluorescence in situ hybridization (FISH) method and immunoradiometric assay (IRMA) method, respectively. HER2 expression occurred in 11/28 operable cases and in 8/22 metastatic cases. The percentage of surgery-induced hyperprolactinemia was significantly higher in HER2-negative patients than in those with its expression. Moreover, HER2-positive metastatic cases showed significantly higher mean serum PRL levels than in the negative group. These preliminary results show that metastatic cancer-related hyperprolactinemia and lack of surgery-induced hyperprolactinemia are statistically more frequent in HER2-positive patients, thus suggesting a link between PRL endogenous secretion and HER2 expression in breast cancer.


Upregulation of PAIP1 promotes the gallbladder tumorigenesis through regulating PLK1 level.
Increasing evidence suggests that elevated expression of polyA-binding protein-interacting protein 1 (PAIP1) is associated with cancer development and progression. However, how PAIP1 promotes gallbladder cancer (GBC) is still unclear. Two GBC tissue-derived cell lines, NOZ and GBC-SD cells, were used in this study. Assays of cell proliferation, colony formation, apoptosis, and xenograft tumor model were performed to examine the tumorigenic effects of PAIP1. Immunohistochemical (IHC) staining was used to examine the expression level of PAIP1 in both patient GBC tissues and mouse tumors. Microarray and bioinformatics analysis were used to explore the targets of PAIP1. Quantitative polymerase chain reaction (qPCR) and western blot analysis were used to validate PAIP1-mediated targets. We found that upregulated PAIP1 expression was correlated with GBC. Knockdown of PAIP1 in gallbladder cells alleviated cell proliferation, promoted apoptosis, and inhibited xenograft tumor growth. Gene microarray analysis showed that stable silencing of PAIP1 altered various gene expressions. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis suggested that PAIP1 regulates cell cycle progression. Finally, we found that the PLK1 kinase, a key regulator of cell cycle, was regulated by PAIP1 at the transcriptional and protein levels. PLK1 level was positively correlated with PAIP1 level in both mouse tumors and GBC tissues. PAIP1 interacted with PLK1, and rescue of PAIP1 could recover PLK1 protein level and inhibit apoptosis. Our data suggest that PAIP1 contributes to GBC progression likely through regulating PLK1 level. Since upregulated PAIP1 expression is positively associated with GBC, PAIP1 may act as a clinical prognostic biomarker of GBC.


Functional roles of thrombopoietin-c-mpl system in essential thrombocythemia.
Thrombopoietin (TPO) is implicated as a primary regulator of megakaryopoiesis and thrombopoiesis through binding to the cytokine receptor c-Mpl (the product of the c-mpl-proto-oncogene). In addition to its physiologic role, the TPO-c-mpl system has been suggested to participate in the pathophysiology of essential thrombocythemia (ET) which is a clonal disorder characterized by a sustained elevation of the circulating platelet count and bone-marrow hyperplasia with excessive proliferation of megakaryocytes. Recent studies have demonstrated that serum TPO levels are slightly elevated or within normal range in ET patients, whereas serum TPO levels tend to be inversely correlated with platelet mass. Flow cytometric, Western blot, and Northern blot analyses have revealed that the expression of platelet c-Mpl is strikingly reduced in all of patients with ET, possibly due to the decreased expression of c-mpl mRNA. These results suggest that normal or slightly elevated levels of serum TPO in ET patients may be attributable to the impaired uptake and catabolism of TPO owing to the low c-Mpl expression. Furthermore, immunoblotting with anti-phosphotyrosine antibody showed that no aberrant protein-tyrosine phosphorylation was observed in platelets of ET patients before treatment with TPO, and the levels of TPO-induced protein-tyrosine phosphorylation, including c-Mpl-tyrosyl phosphorylation, roughly paralleled those of c-Mpl expression, suggesting that c-Mpl-mediated signaling pathway was not constitutively activated in platelets of ET patients. Although activating mutation in the TPO gene, which leads to overexpression of TPO mRNA, has been reported in familial thrombocythemia, these results suggest that TPO-c-Mpl system may not be directly linked to pathogenesis of sporadic ET.


The changing trends of HIV/AIDS in an ethnic minority region of China: modeling the epidemic in Liangshan prefecture, Sichuan Province.
This study was to investigate the HIV current situation in Liangshan prefecture, in order to predict prevalence and transmission trends. Region-specific population, behavior, serosurveillence, and policy/program data (from 1995 to 2010) were gathered from various local and national organizations and applied to the Asian Epidemic Model (AEM) and used to derive estimates of future HIV prevalence, epidemic trends, and outcomes of intervention strategies. The AEM projections for 2020 included increased number of people living with HIV (PLHIV; to 136 617), increased HIV prevalence (2.51%), and 8037 deaths from acquired immunodeficiency syndrome (AIDS) in this region. However, the overall HIV incidence rate (per 10 000) was projected to decline from 27 in 2015 to 22 in 2020, largely due to a predicted decrease in HIV infection rate (per 10 000) from 658 in 2013 to 621 in 2020 among intravenous drug users. In contrast, the cases of HIV infection per 10 000 was projected to increase from 420 in 2010 to 503 in 2020 among men who have sex with men, and from 8 in 2010 to 15 in 2020 among the general population. The predominant risk factor for HIV transmission over the next decade in Liangshan was casual sex. Community-based outreach strategies to reduce injected drug use and casual sex, and to promote condom use, were predicted as effective interventions to decrease HIV transmission. Implementation of a comprehensive public health program, with targeting to the region-specific at-risk populations, will help to mitigate HIV/AIDS spread in Liangshan.


Structure-function relationships of iodinated contrast media and risk of nephrotoxicity.
Characteristics of CM have greatly changed over time. First-generation ionic CM have many-fold (5-7) greater osmolalities than plasma. Subsequently non ionic CM generations were looked for to reduce osmolality, and encompass nonionic monomers and nonionic dimers reaching osmolality as low as that of plasma (iso-osmolar CM) but paying however dear, as viscosity is considerably increased. Intrarenal microcirculation has its "Achilles" heel in the outer medulla, where the smallness of capillary lumen and the slackness of the capillary mesh render regular blood flow at high risk, mainly because it is the same area in which the only renal work needing oxygen is made and? Iodinated CM may exert their nephrotoxic effects in three different ways: by interfering with vascular hemodynamics, by interfering with intratubular fluid volume and composition, and by producing direct cytotoxic effects to glomerular and tubular cells due to iodine by-itself. Furthermore, effects of oxygen free radical can damage glomerular cells by increasing the permeability and tubular cells impairing specific function and leading to apoptosis. Although clinical nephrotoxicity has considerably improved over time, there is no evidence for an a priori superiority of a specific CM. In general, low-osmolar (2-3 times blood) and iso-osmolar (the same as blood) CM are recommended, keeping in mind that within last generation CM dimeric iso-somolar compounds reach viscosity values higher than monomeric low-osmolar compounds and hyperviscosity is a neglected mechanisms of nephrotoxicity. We suggest that CM should be classified not only by osmolality, but also by viscosity.


Influence of a replication enhancer on the hierarchy of origin efficiencies within a cluster of DNA replication origins.
DNA replication origins in animal cells sometimes occur in clusters. Often one of the multiple origins within these clusters fires more frequently than the others. The reason for this hierarchy remains unknown. Similar origin clusters occur in the fission yeast, Schizosaccharomyces pombe. One such cluster is located near the ura4 gene on chromosome III and contains three origins: ars3002, ars3003, and ars3004. In their natural chromosomal context (ars3003 is about 2.5 kb upstream of ars3002 and ars3004 is adjacent to ars3002 on the downstream side) their initiation frequencies display a striking hierarchy: ars3002 >> ars3003 >> ars3004. Here, we describe experiments that reveal a 400 bp replication enhancer within ars3004, adjacent to ars3002. The enhancer is essential for ars3004 origin function in a plasmid, but even with the enhancer ars3004 is an inefficient origin. The enhancer is not essential for ars3002 plasmid origin activity, but dramatically stimulates this activity, converting ars3002 from an inefficient plasmid origin to a very efficient one. It also stimulates the plasmid origin activity of ars3001 and ars3003 at all tested positions and orientations on both sides of each autonomously replicating sequence (ARS) element. If ars3002 is redefined to include the enhancer, then the relative activities of the three ARS elements as single origins within separate plasmids or as origins when all three ARS elements are present in a single plasmid is the same as the chromosomal hierarchy. Thus, this replication enhancer defines the relative activities of the three origins in the ura4 origin region. Similar enhancers may affect relative activities in the origin clusters of animal cells.


Potential coexistence of both bacterial and eukaryotic small RNA biogenesis and functional related protein homologs in Archaea.
RNA silencing plays crucial roles in both bacteria and eukaryotes, yet its machinery appears to differ in these two kingdoms. A couple of Argonaute protein homologs have been reported in some archaeal species in recent years. As Argonaute protein is the key component of eukaryotic RNA silencing pathways, such findings suggested the possibility of existence of eukaryotic RNA silencing like pathways in Archaea, which present the life forms between prokaryotes and eukaryotes. To further explore such hypothesis, we systematically screened 71 fully sequenced archaeal genomes, and identified some proteins containing homologous regions to the functional domains of eukaryotic RNA silencing pathway key proteins. The phylogenetic relationships of these proteins were analyzed. The conserved functional amino acids between archaeal and eukaryotic Piwi domains suggested their functional similarity. Our results provide new clues to the evolution of RNA silencing pathways.


Development and use of species-specific oligonucleotide probes for differentiation of Streptococcus uberis and Streptococcus parauberis.
Oligonucleotide probes specific for 16S rRNA and capable of differentiating Streptococcus uberis and S. parauberis from each other and other esculin-hydrolyzing streptococci were developed. Use of a mini-RNA extraction technique for gram-positive cocci associated with bovine mastitis has allowed the probes to be used for identification of esculin-hydrolyzing streptococci from two dairy herds at the Institute for Animal Health, Compton, United Kingdom. One hundred seventy-nine of 206 isolates were identified as S. uberis, 3 were identified as S. parauberis, and 24 were not identified. Isolates not identified by the probes were tested biochemically and found to be mainly Enterococcus faecium, E. faecalis, or S. bovis.


Ethanol production from xylose with the yeast Pichia stipitis and simultaneous product recovery by gas stripping using a gas-lift loop fermentor with attached side-arm (GLSA).
The bioconversion of xylose into ethanol with the yeast Pichia stipitis CBS 5773 is inhibited when 20 g/L of ethanol are present in the fermentation broth. In order to avoid this limitation, the fermentation was carried out with simultaneous recovery of product by CO(2) stripping. The fermentation was also improved by attaching a side-arm to the main body of a classical gas-lift loop fermentor. This side-arm increases the liquid circulation, mass transfer, and gas distribution, reducing the amount of oxygen in the inlet gas necessary to perform the fermentation of xylose under microaerobic conditions (K(L)a approximately 16 h(-1)). The continuous stripping of ethanol from the fermentation broth in this new bioreactor system allowed the consumption of higher xylose concentrations than using Erlenmeyer shaker flasks, improved significantly the process productivity and provided a clean ethanol solution by using an ice-cooled condenser system. Finally, a fed-batch fermentation was carried out with a K(L)a = 15.8 h(-1). Starting with 248.2 g of xylose, 237.6 g of xylose was consumed to produce 88.1 g of ethanol which represents 72.6% of the theoretical yield (47.2 g/L of ethanol was recovered in the condenser, while 9.6 g/L remained in the fermentation broth).


Changes in crevicular cytokines after application of melatonin in patients with periodontal disease.
A clinical trial was designed to evaluate the effects of topical application of melatonin on the crevicular fluid levels of interleukins and prostaglandins and to evaluate changes in clinical parameters. A consecutive sample of 90 patients were recruited from the Health Centre of Pinos Puente in Granada, Spain and divided into 3 groups: 30 patients with diabetes and periodontal disease, who were given melatonin; 30 patients with diabetes and periodontal disease, who were given a placebo, and 30 healthy individuals with no history of systemic disease or clinical signs of periodontal disease, who were also given a placebo. The 30 patients with diabetes and periodontitis were treated with topical application of melatonin (1% orabase cream formula) for 20 days by. The rest of the patients with diabetes and periodontitis and healthy subjects were treated with a placebo of orabase cream. We measured the gingival index by exploring the percentage of standing teeth bleeding on probing. The periodontogram was performed with a Florida Probe. In the diabetic patients who were given topical melatonin, there was a statistically significant decrease in the two clinical parameters. By contrast, in diabetic patients who were given the topical placebo, there was no statistically significant variation. In patients with diabetes and periodontal disease, treatment with topical melatonin was associated with a significant improvement in the gingival index and in pocket depth, and a statistically significant reduction in concentrations of interleukin-1β, interleukin-6 and prostaglandin E2 in gingival crevicular fluid. Key words:Melatonin, periodontal disease, diabetes mellitus, interleukin-1β, interleukin-6, prostaglandin E2.


DNA image cytometry of bladder tumours: comparison of washings and tumour imprints from 61 patients.
Cellular DNA cytometry is commonly used to assess the prognosis of bladder tumours. Measurements are made mainly on voided urine or irrigation fluids by flow or image cytometry. In order to determine whether this material is really representative of the bladder tumour, we compared DNA assessments of bladder washings and tumour imprints from the same patients using image cytometry on Feulgen-stained preparations. DNA aneuploidy was found in 41.0% of the washings, 42.6% of the imprints and 49.2% of the patients if both samples were considered. If DNA histograms are classified into three groups (diploid, diploid+aneuploid, aneuploid), a 70% concordance rate is obtained between washings and imprints. In 15% of the cases, an aneuploid population was found in both samples, but in different proportions. In the latter 15%, an aneuploid population was found in one sample but not in the other; this discrepancy, which is probably due to poor tumour exfoliation or to tumour heterogeneity, is of clinical significance since it indicates the importance of making DNA assessments on both washings and cells directly obtained from the tumour.


[Ratio of adrenergic and cholinergic structures in the prevertebral sympathetic and parasympathetic ganglia].
Histochemical techniques for catecholamines and acetylcholinesterase revealed the ratio of adrenergic and cholinergic neurons in sympathetic (celiac and inferior mesenteric) and parasympathetic (pelvic) plexuses of the abdominal and pelvic cavities. Three types of ganglia were revealed in the pelvic plexus, i.e. cholinergic, adrenergic, and of mixed type. Adrenergic fibers were found in preganglionic nerves both to sympathetic and parasympathetic plexuses. A centripetal transport of catecholamines through axons of adrenergic neurons located in extramural ganglia, was shown.


Systematic Analysis of Molecular Subtypes and Immune Prediction Based on CD8 T Cell Pattern Genes Based on Head and Neck Cancer.
CD8+ T lymphocytes, also known as cytotoxic T lymphocytes, are the most powerful antitumour cells in the human body. Patients with head and neck squamous cell carcinoma (HNSCC) in whom CD8+ T lymphocyte infiltration is high have a better prognosis. However, the clinical significance and prognostic significance of CD8+ T cell-related regulatory genes in HNSCC remain unclear, and further research is required. In total, 446 CD8+ T cell-related genes were obtained using WGCNA. It was discovered that 111 genes included within the TCGA and GSE65858 datasets were intimately linked to the patient's prognosis. These genes were included in the subsequent analysis. According to consensus clustering analysis, HNSCC samples were classified into 3 subtypes (IC1, IC2, and IC3). There were substantial differences between the three subtypes in terms of immunological molecules, immune function, and the response to drug treatment. In addition, the 8-gene signature, which was generated premised on CD8+ T cell-related genes, exhibited stable prognostic prediction in the TCGA and GEO datasets and different HNSCC patient subgroups and independently served as a prognostic indicator for HNSCC. More importantly, the 8-gene signature effectively predicted immunotherapy response. We first constructed a molecular subtype of HNSCC based on CD8+ T cell-related genes. Between the three subtypes, there were significant differences in the prognosis, clinical features, immunological molecules, and drug treatment response. The 8-gene signature that was further constructed effectively predicted prognosis and immunotherapy response.


Epigallocatechin-3-gallate induces cell death in acute myeloid leukaemia cells and supports all-trans retinoic acid-induced neutrophil differentiation via death-associated protein kinase 2.
Acute promyelocytic leukaemia (APL) patients are successfully treated with all-trans retinoic acid (ATRA). However, concurrent chemotherapy is still necessary and less toxic therapeutic approaches are needed. Earlier studies suggested that in haematopoietic neoplasms, the green tea polyphenol epigallocatechin-3-gallate (EGCG) induces cell death without adversely affecting healthy cells. We aimed at deciphering the molecular mechanism of EGCG-induced cell death in acute myeloid leukaemia (AML). A significant increase of death-associated protein kinase 2 (DAPK2) levels was found in AML cells upon EGCG treatment paralleled by increased cell death that was significantly reduced upon silencing of DAPK2. Moreover, combined ATRA and EGCG treatment resulted in cooperative DAPK2 induction and potentiated differentiation. EGCG toxicity of primary AML blasts correlated with 67 kDa laminin receptor (67LR) expression. Pretreatment of AML cells with ATRA, causing downregulation of 67LR, rendered these cells resistant to EGCG-mediated cell death. In summary, it was found that (i) DAPK2 is essential for EGCG-induced cell death in AML cells, (ii) ATRA and EGCG cotreatment significantly boosted neutrophil differentiation, and 67LR expression correlates with susceptibility of AML cells to EGCG. We thus suggest that EGCG, by selectively targeting leukaemic cells, may improve differentiation therapies for APL and chemotherapy for other AML subtypes.


Are You Wearing a Mask? Detecting If a Person Wears a Mask Using a Wristband.
Coronavirus 2019 (COVID-19) has posed a serious threat to the lives and health of the majority of people worldwide. Since the early days of the outbreak, South Korea's government and citizens have made persistent efforts to provide effective prevention against further spread of the disease. In particular, the participation of individual citizens in complying with the necessary code of conduct to prevent spread of the infection, through measures such as social distancing and mask wearing, is as instrumental as the geographical tracking of the trajectory of the infected. In this paper, we propose an activity recognition method based on a wristband equipped with an IR array and inertial measurement unit (IMU) to detect individual compliance with codes of personal hygiene management, such as mask wearing, which are recommended to prevent the spread of infectious diseases. The results of activity recognition were comparatively analyzed by applying conventional machine learning algorithms and convolutional neural networks (CNNs) to the IMU time series and IR array thermal images collected from 25 subjects. When CNN and 24 × 32 thermal images were used, 97.8% accuracy was achieved (best performance), and when 6 × 8 low-resolution thermal images were used, similar performance with 97.1% accuracy was obtained. In the case of using IMU, the performance of activity recognition was lower than that obtained with the IR array, but an accuracy of 93% was achieved even in the case of applying machine learning algorithms, indicating that it is more suitable for wearable devices with low computational capability.


Physical activity, body composition, and blood pressure: a multimethod approach.
The purpose of the current investigation was to evaluate, using multiple measures of physical activity, the relationships among physical activity, body composition, resting heart rate, and blood pressure in an adult population. Subjects were 221 male (135 normal weight, 86 overweight) and 221 female (156 normal weight, 65 overweight) subjects participating in a longitudinal study of cardiovascular risk factors in families. All subjects were administered three physical activity questionnaires. Principal components analyses were conducted to reduce measures into empirically derived subscales; this analysis revealed five stable factors in men and four in women. Results indicated that aerobic/leisure time significantly correlated to body composition and resting heart rate in both men and women. Additionally, aerobic/leisure time activity was related to blood pressure in women, and moderate activity was related positively to blood pressure in men. No other form of activity (e.g., light activity, anaerobic activity) was related to either adiposity or blood pressure. The implications of these results are discussed, and future research directions are highlighted.


Dynamic APACHE II Score to Predict the Outcome of Intensive Care Unit Patients.
This study aims to evaluate the accuracy of the Acute Physiology and Chronic Health Evaluation (APACHE) II score on different days in predicting the mortality of critically ill patients to identify the best time point for the APACHE II score. The demographic and clinical data are retrieved from the Medical Information Mart for Intensive Care (MIMIC)-IV dataset. APACHE II scores on days 1, 2, 3, 5, 7, 14, and 28 of hospitalization are calculated, and their performance is evaluated using the area under the receiver operating characteristic (AUROC) analysis. The cut-off for defining the high risk of mortality is determined using Youden's index. The APACHE II score on day 3 is the best time point to predict hospital mortality of ICU patients. The Hosmer-Lemeshow goodness-of-fit test is then applied to evaluate the calibration of the day 3 APACHE II score. We recruited 6,374 eligible subjects from the MIMIC-IV database. Day 3 is the optimal time point for obtaining the APACHE II score to predict the hospital mortality of patients. The best cut-off for day 3 APACHE II score is 17. When APACHE II score ≥17, the sensitivity for the non-survivors and survivors is 92.8 and 82.2%, respectively, and the positive predictive value (PPV) is 23.1%. When APACHE II socre <17, the specificity for non-survivors and survivors is 90.1 and 80.2%, respectively, and the negative predictive value (NPV) is 87.8%. When day-3 APACHE II is used to predict the hospital mortality, the AUROC is 0.743 (P <0.001). In the ≥17 group, the sensitivity of non-survivors and survivors is 92.2 and 81.3%, respectively, and the PPV is 30.3%. In the <17 group, the specificity of non-survivors and survivors is 100.0 and 80.2%, respectively, and the NPV is 81.6%. The Hosmer-Lemeshow test indicated day-3 APACHE II has a high predicting the hospital mortality (X 2 = 6.198, P = 0.625, consistency = 79.4%). However, the day-1 APACHE II has a poor calibration in predicting the hospital mortality rate (X 2 = 294.898, P <0.001). Day-3 APACHE II score is an optimal biomarker to predict the outcomes of ICU patients; 17 is the best cut-off for defining patients at high risk of mortality.


Believing in paranormal phenomena: relations to asymmetry of body and brain.
The goal of this study was to investigate the possible relationship between established measures of body and brain asymmetries and individual differences in paranormal beliefs. In addition to behavioural measures of cerebral laterality, measures of facial features and finger length were taken to calculate body asymmetry scores and indicators of fluctuating asymmetry (average absolute differences between left and right body features). Both the direction and degree of laterality measures were used. In addition to that, quantitative measures of inconsistency of cerebral lateralization were obtained. Results indicated that a stronger belief in paranormal phenomena was associated with fluctuating asymmetry of finger length, and that this aspect of body asymmetry may be related to greater intraindividual variability in the degree of 'atypical' functional lateralization. This intraindividual variability index, in turn, significantly predicted strength of belief in the paranormal. Belief in the paranormal was also higher in women than men and it was negatively correlated with the education level. In sum, these findings suggest that a part of the variance of strength of belief in paranormal phenomena can be explained by patterns of functional hemispheric asymmetry that may be related to perturbations during fetal development.


Sense of coherence and depression in the framework of immigration: Turkish patients in Germany and in Turkey.
The present study explores sense of coherence (SOC) levels in two clinical samples (outpatients with neurotic disorders) with the same Turkish cultural background in comparison to the German reference values as well as the association between SOC and depression and the protective role of SOC. A total of 96 Turkish patients in Germany (36.67 ± 9.52 years) as well as 60 local Turkish patients (38.57 ± 10.15 years) have been examined for SOC measured with the Sense of Coherence scale (SOC-29) and depression with the Beck Depression Inventory (BDI). Both samples scored significantly lower for SOC compared to the normal Turkish and German population and to German subjects with psychiatric symptoms (p < 0.001) but did not differ significantly from each other. Negative significant correlations were found between SOC and the degree of depressiveness in both groups (immigrants: r = -0.59, p < 0.001; Turks: r = -0.51, p < 0.001). Multiple regression analyses including SOC, age, gender, education, marital and employment status have demonstrated SOC to be the strongest predictor for depressiveness. SOC can be regarded as a protective factor for depression in patients with Turkish migration background in Germany and in local Turkish patients. However, further studies are needed to clarify if the concept SOC can be used adequately in collectivistic cultures as, for example, the Turkish one.


Multinomial N-mixture models for removal sampling.
Multinomial N -mixture models are commonly used to fit data from a removal sampling protocol. If the mixing distribution is negative binomial, the distribution of the counts does not appear to have been identified, and practitioners approximate the requisite likelihood by placing an upper bound on the embedded infinite sum. In this paper, the distribution which underpins the multinomial N -mixture model with a negative binomial mixing distribution is shown to belong to the broad class of multivariate negative binomial distributions. Specifically, the likelihood can be expressed in closed form as the product of conditional and marginal likelihoods and the information matrix shown to be block diagonal. As a consequence, the nature of the maximum likelihood estimates of the unknown parameters and their attendant standard errors can be examined and tests of the hypothesis of the Poisson against the negative binomial mixing distribution formulated. In addition, appropriate multinomial N -mixture models for data sets which include zero site totals can also be constructed. Two illustrative examples are provided.


Genetic Evidence of the Black Death in the Abbey of San Leonardo (Apulia Region, Italy): Tracing the Cause of Death in Two Individuals Buried with Coins.
The Abbey of San Leonardo in Siponto (Apulia, Southern Italy) was an important religious and medical center during the Middle Ages. It was a crossroads for pilgrims heading along the Via Francigena to the Sanctuary of Monte Sant'Angelo and for merchants passing through the harbor of Manfredonia. A recent excavation of Soprintendenza Archeologica della Puglia investigated a portion of the related cemetery, confirming its chronology to be between the end of the 13th and beginning of the 14th century. Two single graves preserved individuals accompanied by numerous coins dating back to the 14th century, hidden in clothes and in a bag tied to the waist. The human remains of the individuals were analyzed in the Laboratorio di Antropologia Fisica of Soprintendenza ABAP della città metropolitana di Bari. Three teeth from each individual were collected and sent to the Istituto Zooprofilattico Sperimentale di Puglia e Basilicata to study infectious diseases such as malaria, plague, tuberculosis, epidemic typhus and Maltese fever (Brucellosis), potentially related to the lack of inspection of the bodies during burial procedures. DNA extracted from six collected teeth and two additional unrelated human teeth (negative controls) were analyzed using PCR to verify the presence of human DNA (β-globulin) and of pathogens such as Plasmodium spp., Yersinia pestis, Mycobacterium spp., Rickettsia spp. and Brucella spp. The nucleotide sequence of the amplicon was determined to confirm the results. Human DNA was successfully amplified from all eight dental extracts and two different genes of Y. pestis were amplified and sequenced in 4 out of the 6 teeth. Molecular analyses ascertained that the individuals buried in San Leonardo were victims of the Black Death (1347-1353) and the data confirmed the lack of inspection of the corpses despite the presence of numerous coins. This study represents molecular evidence, for the first time, of Southern Italy's involvement in the second wave of the plague pandemic.


LRP-1-dependent control of calpain expression and activity: A new mechanism regulating thyroid carcinoma cell adhesion.
The low-density lipoprotein receptor-related protein 1 (LRP1) is a multifunctional endocytic receptor mediating the clearance of various molecules from the extracellular matrix. LRP1 also regulates cell surface expression of matrix receptors by modulating both extracellular and intracellular signals, though current knowledge of the underlying mechanisms remains partial in the frame of cancer cells interaction with matricellular substrates. In this study we identified that LRP1 downregulates calpain activity and calpain 2 transcriptional expression in an invasive thyroid carcinoma cell model. LRP1-dependent alleviation of calpain activity limits cell-matrix attachment strength and contributes to FTC133 cells invasive abilities in a modified Boyden chamber assays. In addition, using enzymatic assays and co-immunoprecipitation experiments, we demonstrated that LRP1 exerts post-translational inhibition of calpain activity through PKA-dependent phosphorylation of calpain-2. This LRP-1 dual mode of control of calpain activity fine-tunes carcinoma cell spreading. We showed that LRP1-mediated calpain inhibition participates in talin-positive focal adhesions dissolution and limits β1-integrin expression at carcinoma cell surface. In conclusion, we identified an additional and innovative intracellular mechanism which demonstrates LRP-1 pro-motile action in thyroid cancer cells. LRP-1 ability to specifically control calpain-2 expression and activity highlights a novel facet of its de-adhesion receptor status.


Infections in open heart surgery.
More than 250,000 open heart surgical procedures are performed annually in the United States. The majority of these procedures are coronary artery bypass grafts (CABG) and valve replacements. In this forum our authors discuss the kinds of infections that occur in patients following open heart surgery, as well as the documented risk factors and microbiology of these infections. We also asked each author to outline the criteria used to diagnose post open heart surgery infections, and to address associated consequences and complications. Finally, we were interested in each author's definition of the infection control practitioner's role in the prevention of this particular subset of nosocomial infections.


DNA typing by triplex affinity capture (TAC) PCR.
Using a triplex affinity capture approach, we extracted PCR-ready DNA from fresh blood, buccal swabs, and bloodstains made on hard objects. We immobilized a biotinylated purine-rich oligonucleotide onto streptavidin-coated magnetic beads, and captured double-stranded DNA via triple-helix formation. We were able to amplify the MCT118, ACTBP2, FGA, D8S320, D11S488, and THO1 loci from the captured DNA. DNA typing by triplex affinity capture PCR is simple, rapid, and well-suited for paternity testing and population studies of microsatellites.


Predictors of atrial fibrillation recurrence after cryoballoon ablation.
Cryoballoon ablation (CA) is a safe and efficient method for pulmonary vein isolation in the treatment of paroxysmal atrial fibrillation (AF). There are conflicting results about the predictors of AF recurrence. The aim of this study is to evaluate the role of hematological indices to predict AF recurrence after CA. A total of 49 patients (mean age 58.3±12.2 years, 51.02% female) with symptomatic paroxysmal AF underwent CA procedure. One hundred and sixty-eight pulmonary veins were used for pulmonary vein isolation with the second-generation cryoballoon. The hematological samples were obtained before and 24 hours after ablation. At a mean follow-up of 10.2±2.4 months, the probability of being arrhythmia-free after a single procedure was 86%. Patients with AF recurrence had higher red cell distribution width levels (16.10%±1.44% vs 14.87%±0.48%, P=0.035). The neutrophil/lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein levels were detected in the patients with or without recurrence. Left atrial diameter (46.28±4.30 mm vs 41.02±4.10 mm, P=0.002), duration of AF (6.71±4.57 years vs 3.59±1.72 years, P=0.003), and age (65.01±15.39 years vs 54.29±11.32 years, P=0.033) were the other independent predictors of clinical recurrence after CA. Multiple regression analysis revealed that left atrial diameter was the only independent predictor for AF recurrence (P=0.012). In this study of patients with paroxysmal AF undergoing cryoablation, increased preablation red cell distribution width levels, and not C-reactive protein or erythrocyte sedimentation rate, was associated with a higher rate of AF recurrence. Our results support the role of a preablation, proinflammatory, and pro-oxidant environment in the development of AF recurrence after ablation therapy but suggest that other factors are also important.


Changes in Human Milk Immunoglobulin Profile During Prolonged Lactation.
Mother's milk immunoglobulins (Igs) delivered to infants during breastfeeding are crucial in shaping and modulating immature infants' immune system and provide efficient protection against pathogens. The aim of the study was to evaluate the immunoglobulin concentrations in milk of 116 lactating mothers over prolonged lactation from the 1st to the 48th month using the ELISA method. The concentration of proteins, SIgA and IgG, but not IgM, showed a positive correlation (r = 0.69, p < 0.005; r = 0.54, p < 0.05; and r = 0.27, p < 0.05, respectively) with lactation from the 1st to the 48th month. The lowest concentrations of SIgA and IgG were observed for the first year (2.12 ± 0.62 g/L and 14.71 ± 6.18 mg/L, respectively) and the highest after the 2nd year of lactation (7.55 ± 7.16 g/L and 18.95 ± 6.76 mg/L, respectively). The IgM concentration remained stable during 2 years (2.81 ± 2.74 mg/L), but after 24 months it was higher (3.82 ± 3.05 mg/L), although not significantly. Moreover, negative correlations of protein (r = -0.24, p < 0.05) and SIgA (r = -0.47, p < 0.05) concentrations with the number of feedings were found. Human milk after the 2nd year of lactation contains significantly higher concentrations of protein, SIgA, and IgG. High concentration of immunoglobulins and protein during prolonged lactation is an additional argument to support breastfeeding even after introducing solid foods and should be one of the overarching goals in the protection of children's health.


Secretory Nanoparticles of Neospora caninum Profilin-Fused with the Transmembrane Domain of GP64 from Silkworm Hemolymph.
Neosporosis, which is caused by Neospora caninum, is a well-known disease in the veterinary field. Infections in pregnant cattle lead to abortion via transplacental (congenitally from mother to fetus) transmission. In this study, a N. caninum profilin (NcPROF), was expressed in silkworm larvae by recombinant Bombyx mori nucleopolyhedrovirus (BmNPV) bacmid and was purified from the hemolymph. Three NcPROF constructs were investigated, native NcPROF fused with an N-terminal PA tag (PA-NcPROF), PA-NcPROF fused with the signal sequence of bombyxin from B. mori (bx-PA-NcPROF), and bx-PA-NcPROF with additional C-terminal transmembrane and cytoplasmic domains of GP64 from BmNPV (bx-PA-NcPROF-GP64TM). All recombinant proteins were observed extra- and intracellularly in cultured Bm5 cells and silkworm larvae. The bx-PA-NcPROF-GP64TM was partly abnormally secreted, even though it has the transmembrane domain, and only it was pelleted by ultracentrifugation, but PA-NcPROF and bx-PA-NcPROF were not. Additionally, bx-PA-NcPROF-GP64TM was successfully purified from silkworm hemolymph by anti-PA agarose beads while PA-NcPROF and bx-PA-NcPROF were not. The purified bx-PA-NcPROF-GP64TM protein bound to its receptor, mouse Toll-like receptor 11 (TLR-11), and formed unique nanoparticles. These results suggest that profilin fused with GP64TM was secreted as a nanoparticle with binding affinity to its receptor and this nanoparticle formation is advantageous for the development of vaccines to N. caninum.


The pathophysiology of primary blast injury and its implications for treatment. Part I: The thorax.
There is insufficient evidence to support a definitive approach to the clinical management of primary pulmonary blast injury. Post-blast cardiovascular and pulmonary changes are reviewed in this paper in order to highlight important aspects in the immediate management of the blast injured casualty. Blast profiles and theoretical mechanisms of injury vary widely but all result in mechanical disruption and cause similar pathological, physiological and biochemical responses. Some patients may present acutely, while others appear unharmed and develop respiratory failure 12-24 hours later. Treatment outcome may depend on the judicious use of resuscitative fluids and respiratory support. The roles of supplementary oxygen and assisted ventilation remain controversial although administration of high inspired oxygen concentrations and respiratory support may be unavoidable. The advantage of pharmacological manipulation of reflex mechanisms is as yet unproven. Hyperbaric therapy may improve survival in pulmonary blast injury.


Regulation of HMG-CoA synthase and HMG-CoA reductase by insulin and epidermal growth factor in HaCaT keratinocytes.
Synthesis of cholesterol, via the isoprenoid/mevalonate pathway, is required for keratinocyte growth and differentiation, and maintenance of the stratum corneum lipid lamellae. 3-hydroxy-3-methylglutaryl coenzyme A synthase catalyzes the first step in isoprenoid/mevalonate synthesis and under some conditions controls the flux into the pathway. We have investigated whether selected growth factors and hormones could increase 3-hydroxy-3-methylglutaryl coenzyme A synthase mRNA in keratinocytes. Northern blotting was used to demonstrate that 10 microg per ml insulin and 0.1 microg per ml epidermal growth factor both increased steady-state levels of 3-hydroxy-3-methylglutaryl coenzyme A synthase mRNA by 2.5 and 6-fold, respectively. Epidermal growth factor and insulin also increased 3-hydroxy-3-methylglutaryl coenzyme A reductase enzyme activity. 3-hydroxy-3-methylglutaryl coenzyme A synthase promoter activity in a luciferase reporter construct was increased 2-fold by insulin and 2.9-fold by epidermal growth factor. When a mutation in the sterol regulatory element was introduced into the 3-hydroxy-3-methylglutaryl coenzyme A synthase promoter, activity was not increased by insulin, but was increased by epidermal growth factor. Mutation of an AP-1 site in the 3-hydroxy-3-methylglutaryl coenzyme A synthase promoter did not affect the increase in activity following treatment with insulin or epidermal growth factor. Therefore, 3-hydroxy-3-methylglutaryl coenzyme A synthase expression in keratinocytes is regulated by insulin and epidermal growth factor by different mechanisms. These results suggest a role for hormones and growth factors in the control of epidermal cholesterol synthesis.


[Factorial analysis of the "proper" angles involved in ethnic prognathism].
This work rest on 10 populations, chiefly arising from "musée de l'Homme" (Paris). 9 angles was considered in squeletal profile, and "reciprocal averaging" analysis was made. It shows the main function of peri-buccal segments situation, relatively to palatal and mandibular planes, as well as participation of facial whole situation relatively to anterior neurocranium. This analysis confirm the peculiar position of leucoderm men with reference to other groups.


CD4+ T cell clones specific for the human p97 melanoma-associated antigen can eradicate pulmonary metastases from a murine tumor expressing the p97 antigen.
p97 is a human tumor-associated Ag present on most melanoma cells that represents a possible target for immunologic attack. To evaluate the capacity of T cells reactive with this protein to promote elimination of melanoma cells expressing p97, a murine model was developed by transfecting a C3H/HeN melanoma with the p97 cDNA, generating p97-specific CD4+ T cells by in vivo immunization of C3H/HeN mice with a vaccinia/p97 recombinant virus followed by in vitro cloning with soluble p97 protein, and determining whether these CD4+ T cells could mediate rejection of pulmonary metastases. Characterization of the T cell clones demonstrated the presence of both I-Ak and I-Ek-restricted clones, although the majority of clones recognized p97 in the context of I-Ek. Analysis of clonal specificity using truncated p97 proteins revealed that at least three epitopes were immunogenic, and further studies with overlapping 15-amino acid peptides from a region of the p97 molecule defined by these truncated proteins identified an immunodominant epitope responsible for the majority of the I-Ek response. The T cell clones were not capable of directly recognizing the p97-expressing melanoma cells but responded to the tumor if syngeneic APC were present to process the tumor-derived p97 Ag. The therapeutic efficacy of these CD4+ T cell clones was evaluated in an adoptive therapy model in which mice bearing metastatic pulmonary lesions were treated by i.v. administration of the p97-specific cells. Despite the inability of the CD4+ clones to directly respond to or lyse the tumor cells, the clones were effective in promoting tumor eradication. In vitro studies demonstrated that this may have reflected secretion of lymphokines that activated macrophages to lyse the tumor. The results suggest that noncytolytic p97-specific CD4+ T cell clones can be effective in therapy of pulmonary melanoma metastases. Moreover, if human T cells reactive with the p97 protein could be generated, the expression of this tumor-associated Ag in melanoma cells might be adequate for such T cells to mediate a therapeutic antitumor response.


Platypnoea-orthodeoxia syndrome in the elderly: A difficult-to-make diagnosis of intracardiac right-to-left shunt.
Introduction Platypnea-orthodeoxia syndrome is a combination of positional dyspnoea and hypoxemia; it is caused by several cardiac, pulmonary and hepatic diseases. Case presentation In this study, we describe a 77-year-old female affected by unexplained dizziness and hypoxia that exacerbated in upright position. After diagnosing platypnea-orthodeoxia syndrome and excluding all possible causes (liver cirrhosis, acute and chronic pulmonary diseases and arteriovenous malformations), the origin of the syndrome was individuated in the presence of a patent foramen ovale with right-to-left shunt. Endovascular patent foramen ovale closure permitted the resolution of symptoms and disappearance of platypnea-orthodeoxia syndrome. Conclusion Although patent foramen ovale may be present since birth without giving clinical signs, it may represent a common enough cause of platypnea-orthodeoxia syndrome and other vascular complications in the elderly.


Online concentration by head-column field-amplified with large-volume sample stacking using flow injection-capillary electrophoresis for the analysis of four active components in cold medicines.
A simple, effective, and sensitive online concentration method for the detection of dextromethorphan hydrobromide (Dex), chlorphenamine hydrogen maleate (Chl), pseudoephedrine hydrochloride (Pse) and paracetamol (Par) based on flow injection-capillary electrophoresis (FI-CE) analysis with head-column field-amplified sample stacking and large-volume sample stacking was developed. The background electrolyte (BGE) was a solution composed of 55 mM borate-15% (v/v) acetonitrile (ACN) (pH 9.3). The sample was injected electrokinetically between plugs of water. Under the optimum conditions, about a 30-fold improvement in the concentration sensitivity relative to normal CE methods was achieved, giving low limits of detection (LOD) of 1.94 x 10(-5), 0.64 x 10(-5), 1.16 x 10(-5) and 2.84 x 10(-5) mg/mL for Dex, Chl, Pse and Par, respectively. The repeatability (defined as RSD) was 1.01, 1.91, 0.89 and 0.92% with the peak-area evaluation and 1.94, 3.98, 2.66 and 3.27% with the peak-height evaluation for Dex, Chl, Pse and Par, respectively. This method has been successfully applied to the analysis of commercial pharmaceutical preparations containing Dex, Chl, Pse and Par.


Measuring Attention and Visual Processing Speed by Model-based Analysis of Temporal-order Judgments.
This protocol describes how to conduct temporal-order experiments to measure visual processing speed and the attentional resource distribution. The proposed method is based on a new and synergistic combination of three components: the temporal-order judgments (TOJ) paradigm, Bundesen's Theory of Visual Attention (TVA), and a hierarchical Bayesian estimation framework. The method provides readily interpretable parameters, which are supported by the theoretical and neurophysiological underpinnings of TVA. Using TOJs, TVA-based estimates can be obtained for a broad range of stimuli, whereas traditional paradigms used with TVA are mainly limited to letters and digits. Finally, the meaningful parameters of the proposed model allow for the establishment of a hierarchical Bayesian model. Such a statistical model allows assessing results in one coherent analysis both on the subject and the group level. To demonstrate the feasibility and versatility of this new approach, three experiments are reported with attention manipulations in synthetic pop-out displays, natural images, and a cued letter-report paradigm.


Low cholesterol, cognitive function and Alzheimer s disease in a community population with cognitive impairment.
The association between cholesterol levels, cognitive impairment and dementia is controversial. To investigate differences in serum total cholesterol levels between mild and moderate cognitive impairment and between dementia syndromes. To investigate the association between cholesterol level and progression of Alzheimer s disease (AD). Non-fasting cholesterol levels were measured in two groups: a) 291 participants in a community study in South Korea, aged 65 or over, and scoring below 25 on the Mini-Mental State Examination (Korean version: MMSE-K); and b) 79 patients with AD attending a local hospital. In the community sample, associations were investigated between cholesterol level and both cognitive function and dementia (DSM-IV). For the hospital sample, associations were investigated between cholesterol level and decline in cognitive function (MMSE-K) and/or functional activities of daily living (ADL, Blessed Dementia Scale) over one year. Lower serum cholesterol level was associated with worse cognitive function in the community sample. Associations with dementia were specific to AD rather than other subtypes. No cross-sectional association was found between cholesterol levels and cognitive function in AD groups from either sample. No prospective associations were found between cholesterol level and decline of cognitive function or functional ADL in hospital attenders with AD. Adjustment for age, gender, education, past occupation, disablement, duration of dementia, and the presence of APOE e4 made little difference to the associations in the hospital sample. Lower serum cholesterol level may be a state marker of AD but does not appear to influence its rate of progression.


Enhancing surface properties of breast implants by using electrospun silk fibroin.
In the present study, a new electrospun silk fibroin coating of silicone breast implants with improved biocompatibility and mechanical properties was obtained. Fibrous scaffolds were produced by electrospinning a solution containing silk fibroin, derived from Bombyx mori cocoons, and polyethylene oxide (PEO) to be used as a coating of breast implants. A randomly oriented structure of fibroin/PEO was electrospun on implants as assessed by SEM analysis, roughness measurements and ATR-FTIR spectroscopy. The scaffold showed 0.25 µm diameter fibres, 0.76 µm size superficial pores, arithmetic roughness of 0.632 ± 0.12 µm and texture aspect ratio of 0.893 ± 0.04. ATR-FTIR spectroscopy demonstrates the presence of PEO and fibroin in the coating. The mechanical characterisation of the implants before and after being coated with fibroin/PEO demonstrated that the fibroin/PEO scaffold contributes to the increase in the elastic modulus from 0.392 ± 0.02 to 0.560 ± 0.03 MPa and to a more elastic behaviour of the breast implants. Using the fibroin/PEO coating, human fibroblasts seeded on this matrix increased viability up to 30% compared to conventional breast implants. Electrospun silk fibroin could represent a clinically compatible, viable form to coat breast implants. Low cytotoxicity by the fibroin coating and its physico-chemical and mechanical properties may find application in improving breast implants biocompatibility. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1655-1661, 2018.


Personalized cell-mediated immunotherapy and vaccination: combating detrimental uprisings of malignancies.
A large number of researchers worldwide have conducted various investigations to advance the cell-based immunotherapies and to examine their clinical benefits as an ultimate prevention and/or treatment modalities against life-threatening malignancies. This dominion needs integration of science and technology to change the face of treatment of diseases towards much more personalized medicines. It is now plausible to reprogram the human cells for the prevention and treatment of diseases through various mechanisms such as modulation of immune system, nonetheless we should understand the complexity of biological functions of the cells in a holistic way to be able to manipulate the central dogma of the life to prevent any inadvertent mistake. We should, if not must, comprehend the interrelations of the cellular components (e.g., transport machineries) in the developmental processes of diseases. Still, we do not have a complete image of life, perhaps as expressive barcodes, and many pieces are missing. While completing this puzzle to picture the whole image and examine new treatment modalities, we should take extra caution upon unknown/little-known biological phenomena because trifling modulation/ alteration in the complex systems of the life may result in tremendous impacts. In short, it seems we need to consider malignancies as complex systems and treat them in a holistic manner by targeting its hallmarks. Taken all, the immune system reinforcement would be one of the main foundations in combating detrimental malignancy uprising.


CARES Act Provider Relief Fund Aid to Otolaryngologists in Small Practices.
The COVID-19 pandemic has placed unprecedented financial strain on otolaryngologists. Otolaryngologists employed by small practices may be particularly vulnerable to the effects of ongoing losses because these organizations often have limited financial reserves. We performed a retrospective cross-sectional analysis of federal direct aid provided to small practices (defined as ≤15 clinicians) employing otolaryngologists, using the Centers for Medicare and Medicaid Services Physician Compare National Downloadable File and the Department of Health and Human Services (HHS) Provider Relief Fund database. As of June 18, 2020, the HHS had allocated nearly $80 million to 966 (88.9%) of 1087 small practices employing 2455 otolaryngologists. The median amount of aid per clinician was $7909 (interquartile range, $4409-$12,710). These findings suggest that the majority of small practices have received direct aid through the HHS Provider Relief Fund, but aid amounts have thus far been modest relative to the fixed costs of practice.


Word-finding difficulties in Parkinson's disease: Complex verbal fluency, executive functions and other influencing factors.
Persons with Parkinson's disease (PD) frequently report word-finding difficulties. Many of the established tests are, however, insufficient in detecting mild cases of such symptoms. Results from earlier research have suggested that controlled oral word association tests (COWATs) with high demands on cognitive processing resources could prove helpful in detecting the more subtle (language-related) problems seen in neurological disorders such as PD. First, to examine whether persons with PD (PwPD) differ in performance on different types of COWATs compared with non-brain-damaged controls. Second, to investigate possible relationships between executive functions and the novel complex oral semantic fluency (COSEF) task performance scores in the PwPD group. Third, to investigate whether age, years of education, severity of motor symptoms and self-perceived severity of word-finding difficulties influenced the COSEF task results. A total of 17 PwPD participated in the study. Their results were compared with a matched control group (n = 17) at both group and individual levels. One phonemic and two types of semantic COWATs were used. Correlations between the COSEF task and executive function results, age, education and severity of motor symptoms were analysed in the PwPD group. The PwPD group had significantly lower scores on the COSEF task compared with the control group, but not on the other COWATs. A variation in the results was seen on an individual level. In the PwPD group, large significant correlations were seen between the COSEF task and verbally based tasks measuring working memory and cognitive flexibility. Both age and education, but neither self-perceived severity of word-finding difficulties nor motor symptoms, were correlated with the COSEF task result in the group of PwPD. The results are in line with the predictions that a relatively more cognitive demanding COWAT such as the COSEF task could prove valuable when assessing word-finding difficulties in PD in research and clinical assessment. What is already known on the subject Varying degrees of word-finding difficulties are a common symptom in PD and may affect everyday communication. Discreet word-finding difficulties can be hard to detect with the established language assessment tools. What this paper adds to existing knowledge This study adds insights into how PwPD perform on different types of COWATs compared with a control group. It also sheds light on the relationships between a novel, more cognitive complex COWAT and executive functions in PD. What are the potential or actual clinical implications of this work? More cognitively complex COWATs can contribute significantly to the assessment of discreet word-finding difficulties, but it is important to include a thorough anamnesis regarding language and communication in PwPD.


Redox titration of antioxidant mixtures with N-bromosuccinimide as titrant: analysis by non-linear least-squares with novel weighting function.
Equations are presented by which potential-volume data from redox titrations can be analyzed. Mixtures of analytes as well as of titrants may be analyzed, yielding for each component its concentration, number of electrons, and reduction potential. A novel weighting function ensures endpoint accuracy in fitting. Standard deviation of each parameter is obtained. The equations can be readily implemented in Microsoft Excel. Agreement with true values and good precision of fit parameters is demonstrated for a number of test cases. Use of these exact equations enables analysis of analyte mixtures without prior separation using single titrant or titrant mixtures. The equations were used to demonstrate that N-bromosuccinimide, a useful oxidant for organic analytes, undergoes hydrolysis.


Intimate Partner Violence and Telemedicine Usage and Satisfaction Early in the COVID-19 Pandemic.
COVID-19 has transformed the landscape of telemedicine utilization, shifting from predominantly in-person services to increased virtual encounters. Although telemedicine offers increased accessibility for medical care, many advocates voice concern about utilization and satisfaction with these services among individuals who experience intimate partner violence (IPV) given the unique practical, mental, and physical health challenges many face. The purpose of the present study was to evaluate differences in telemedicine utilization and satisfaction, as well as global health and perceived loneliness, among data-driven patterns of IPV during the early phases of the pandemic. In this longitudinal survey study, participants first completed an online survey between May 2019 and February 2020 that assessed social, psychological, and physical functioning, as well as emotional and physical IPV. A follow-up survey sent in May 2020 assessed recent telemedicine use and satisfaction, as well as response to the COVID-19 pandemic. Latent class analysis favored 4 classes of IPV that differed based on severity and features of IPV experienced. Although all 4 classes reported high satisfaction with telemedicine, individuals reporting low IPV had the highest satisfaction with telemedicine and the lowest rates of telemedicine utilization. Individuals who experienced IPV, particularly multiple forms of emotional and physical IPV, reported high physical and social concerns and perceived stress. Clinicians using telemedicine should be aware of the multiple challenges faced by individuals experiencing IPV and take additional steps to ensure their needs are met in a safe way. These results have potentially important clinical and policy implications.


Highly efficient ultraviolet photodetection in nanocolumnar RF sputtered ZnO films: a comparison between sputtered, sol-gel and aqueous chemically grown nanostructures.
Highly efficient ultraviolet (UV) photodetection has been realized in nanocolumnar radio frequency (RF) sputtered ZnO thin films as compared to sol-gel nanocrystalline films and aqueous chemically grown nanowire (NW) arrays. The photo-to-dark current ratio in the columnar films reaches a value as high as 10(6) which is at least 2-4 orders of magnitude higher than that of the sol-gel films and NWs. Such a high value is attributed to a dense compact columnar morphology of the sputtered films with higher surface-related trap states. Within 2 s of UV illumination, five orders of change in the photocurrent have occurred in the sputtered film in contrast to three orders of change in the NWs. The photocurrent decay under steady UV illumination in the sputtered films is only 23%, compared to 50% in the NWs. However, the fall in current under the UV 'off' condition in the sputtered film takes a longer time than in the NWs. These changes are correlated to the deep defect levels of the nanocolumnar films.


An unusual mimicker of a sepsis outbreak: ergot intoxication.
Methylergonovine (MEV) is a semi-synthetic ergot alkaloid used in the prevention and control of postpartum hemorrhage. This report describes 12 newborns born on the same day in a local country hospital in Turkey and developed sepsis-like symptoms and encephalopathy within the first 6 h of life due to accidental administration of MEV instead of vitamin K in the delivery room. The major features of MEV poisoning were lethargy (41.7%), seizure (75.0%), feeding intolerance (66.6%), hypoventilation (58.3%), irritability (25%), and peripheral circulatory abnormalities (58.3%). As a conclusion, clinical findings of ergot toxicity in newborns cannot be distinguished from infectious disease or neonatal encephalopathy.


IEX-1: a new ERK substrate involved in both ERK survival activity and ERK activation.
IEX-1 is an early response and NF-kappaB target gene implicated in the regulation of cellular viability. We show here that IEX-1 is a substrate for ERKs and that IEX-1 and ERK regulate each other's activities. IEX-1 was isolated by phosphorylation screening with active ERK2 and found subsequently phosphorylated in vivo upon ERK activation. IEX-1 interacts with phosphorylated ERKs but not with c-jun N-terminal kinase (JNK) or p38. Upon phosphorylation by ERKs, IEX-1 acquires the ability to inhibit cell death induced by various stimuli. In turn, IEX-1 potentiates ERK activation in response to various growth factors. By using various IEX-1 mutants in which the ERK phosphoacceptor and/or ERK docking sites were mutated, we show that the IEX-1 pro-survival effect is dependent on its phosphorylation state but not on its ability to potentiate ERK activation. Conversely, IEX-1-induced modulation of ERK activation requires ERK-IEX-1 association but is independent of IEX-1 phosphorylation. Thus, IEX-1 is a new type of ERK substrate that has a dual role in ERK signaling by acting both as an ERK downstream effector mediating survival and as a regulator of ERK activation.


Mutations causing familial biparental hydatidiform mole implicate c6orf221 as a possible regulator of genomic imprinting in the human oocyte.
Familial biparental hydatidiform mole (FBHM) is the only known pure maternal-effect recessive inherited disorder in humans. Affected women, although developmentally normal themselves, suffer repeated pregnancy loss because of the development of the conceptus into a complete hydatidiform mole in which extraembryonic trophoblastic tissue develops but the embryo itself suffers early demise. This developmental phenotype results from a genome-wide failure to correctly specify or maintain a maternal epigenotype at imprinted loci. Most cases of FBHM result from mutations of NLRP7, but genetic heterogeneity has been demonstrated. Here, we report biallelic mutations of C6orf221 in three families with FBHM. The previously described biological properties of their respective gene families suggest that NLRP7 and C6orf221 may interact as components of an oocyte complex that is directly or indirectly required for determination of epigenetic status on the oocyte genome.


Immersive Virtual Reality as Analgesia during Dressing Changes of Hospitalized Children and Adolescents with Burns: A Systematic Review with Meta-Analysis.
Children and adolescents with severe burns require medical and nursing interventions, associated with pain. As immersive virtual reality (VR) gained prominence as non-pharmacological adjuvant analgesia, we conducted a systematic review and meta-analysis on the efficacy of full immersive VR on pain experienced during dressing changes in hospitalized children and adolescents with severe burns. This exercise included quality and risk of bias assessment. The systematic review resulted in eight studies and 142 patients. Due to missing data, four studies were excluded from the meta-analysis. Fixed effects meta-analysis of the four included studies (n = 104) revealed a large effect size (ES) (Standardized Mean Difference = 0.94; 95% Confidence Interval = 0.62, 1.27; Z = 5.70; p < 0.00001) for adjuvant full immersive VR compared to standard care (SC). In conclusion, adjuvant full immersive VR significantly reduces pain experienced during dressing changes in children and adolescents with burns. We therefore recommend implementing full immersive VR as an adjuvant in this specific setting and population. However, this requires further research into the hygienic use of VR appliances in health institutions. Furthermore, due to the high cost of the hardware, a cost-benefit analysis is required. Finally, research should also verify the long term physical and psychological benefits of VR.


Individuals Post Achilles Tendon Rupture Exhibit Asymmetrical Knee and Ankle Kinetics and Loading Rates During a Drop Countermovement Jump.
Study Design Cross-sectional laboratory study. Background Asymmetrical knee loading during jogging and hopping has been reported in individuals who have ruptured their Achilles tendon. No studies have examined knee loads in individuals post Achilles tendon rupture during high-demand tasks, such as single-limb landings. Objectives We sought to determine whether individuals post Achilles tendon rupture demonstrated asymmetrical knee loads and impact forces during drop countermovement jumps (CMJs). Methods Achilles tendon length and the single-leg heel-rise test for endurance were assessed in 34 individuals (31 male) 6.1 ± 2.0 years post Achilles tendon rupture. Movement patterns were assessed during a drop CMJ. Data were analyzed via repeated-measures analyses of variance, with comparisons between limbs and prior treatment history (surgery versus nonsurgery). Results An 8.6% longer Achilles tendon (P<.001) was found in the involved limb. During the single-leg heel-rise test, the involved limb demonstrated 22.4% less endurance and 14.6% lower heel-rise height (all, P<.001). During the landing phase of the drop CMJ, the involved limb exhibited 39.6% greater loading rate (P<.001), 16.8% greater eccentric knee power (P = .048), but 21.6% lower eccentric ankle power (P<.001). During the take-off phase, the involved limb exhibited 12.1% lower jump height and 19.9% lower concentric ankle power (both, P<.001). Conclusion Elevated eccentric knee joint power and higher loading rates during a drop CMJ in individuals who experienced Achilles tendon rupture several years earlier may be a compensation pattern for reduced plantar flexor function. This movement pattern may place individuals who have had an Achilles tendon rupture at greater risk for knee injuries. J Orthop Sports Phys Ther 2018;48(1):34-43. Epub 26 Oct 2017. doi:10.2519/jospt.2018.7684.


Breathing pattern alterations with aerosolized buffered saline--effects of topical airway anesthesia.
Bronchoconstriction, measured by spirometry and body plethysmography, may occur with inhalation of aerosolized buffered saline (ABS) (0.5% sodium chloride and phosphate buffer) in asymptomatic patients with bronchial asthma. To estimate the prevalence and mechanism of this phenomenon, we employed continuous non-invasive monitoring of the breathing pattern to estimate changes of end-expiratory level, minute ventilation and mean inspiratory flow, which may be more sensitive albeit less specific indicators of bronchoconstriction. We studied normal and asymptomatic asthmatic subjects before and after ABS inhalation. Deep breaths of ABS had no effect on the breathing pattern in normals, but in all of the asthmatics increases of end-expiratory level, minute ventilation, tidal volume and mean inspiratory flow lasted at least 15 minutes. On another day, prior topical airway anesthesia in the asthmatic subjects prevented the changes in breathing pattern after ABS inhalation. Thus analysis of the breathing pattern suggests that bronchoconstriction or irritation of vagal airway receptors after inhalation of aerosolized buffered saline occurs to a high degree in asymptomatic asthmatic subjects because changes in breathing pattern are prevented by prior airway anesthesia which probably inactivates vagal afferent pathways.


High-density hydration layer of lysozymes: molecular dynamics decomposition of solution scattering data.
A characterization of the physical properties of protein hydration water is critical for understanding protein structure and function. Recent small-angle X-ray and neutron scattering data indicate that the density of water on the surface of lysozyme is significantly higher than in bulk water. Here, we provide an interpretation of the scattering results using a molecular dynamics simulation, which allows us to make quantitative predictions about density variations in the first hydration shell. The perturbation relative to bulk water involves statistically significant changes in the average water structure in the first hydration layer. The water density in the first hydration shell is increased by 5% with respect to the bulk. In regions of higher water density, the water dipoles align more parallel to each other and the number of hydrogen bonds per water molecule is higher. Increased water density is found for water molecules interacting with hydrogen and carbon atoms in the backbone or with nonpolar or negatively charged side-chain groups.


Bi-Directional Loop Antenna Array Using Magic Cube Origami.
In this paper, we propose a bi-directional loop antenna array using magic cube origami. The proposed antenna array consists of three one-wavelength loop antenna elements with series feeding. Each loop antenna is realized on a single magic cube, and three cubes are connected in series to form the array. The three cubes can be easily folded and unfolded due to being constructed in the form of a magic cube origami. Antenna volume can be minimized for high mobility by folding the array, which radiates a bi-directional pattern with full volume when unfolded. The proposed antenna was designed at 1.39 GHz. When the single antenna is realized on the single cube, the peak gain is 4.03 dBi. The peak gain increased to 5.2 and 5.53 dBi with two and three antennas, respectively. Half-power beam width (HPBW) with three antenna elements decreased to 40° from 360° compared to the HPBW with the single antenna. The proposed antenna performance was assessed numerically and experimentally.


Direct Aryl C-H Amination with Primary Amines Using Organic Photoredox Catalysis.
The direct catalytic C-H amination of arenes is a powerful synthetic strategy with useful applications in pharmaceuticals, agrochemicals, and materials chemistry. Despite the advances in catalytic C-H functionalization, the use of aliphatic amine coupling partners is limited. Described herein is the construction of C-N bonds, using primary amines, by direct C-H functionalization with an acridinium photoredox catalyst under an aerobic atmosphere. A wide variety of primary amines, including amino acids and more complex amines are competent coupling partners. Various electron-rich aromatics and heteroaromatics are useful scaffolds in this reaction, as are complex, biologically active arenes. We also describe the ability to functionalize arenes that are not oxidized by an acridinium catalyst, such as benzene and toluene, thus supporting a reactive amine cation radical intermediate.


Alcohol consumption and kidney function in IgA glomerulonephritis.
IgA glomerulonephritis (IgAGN) is a kidney disease with variable prognosis. Several known risk factors exist for a more progressive course. Some population studies indicate that moderate alcohol consumption might protect kidney function, but the relationship between alcohol intake and IgAGN has not previously been examined. We examined 158 (95 men) IgAGN patients (37 abstainers, 80 light drinkers, 25 moderate drinkers and 16 heavy drinkers) in a cross-sectional study. The definition of alcohol consumption was based on interviews on the amounts of alcohol intake combined with measurements of serum carbohydrate-deficient transferrin, a specific biomarker of alcohol abuse. Longitudinal data on renal function were available from 117 patients (76 men) in whom an analysis with respect to progression was also performed. Moderate drinkers showed the best kidney function. When adjusted by hypertension and 24-hour protein excretion, moderate alcohol consumption in a cross-sectional multivariate analysis, and both light and moderate alcohol consumption in a longitudinal multivariate analysis were significant factors of better kidney function. When the study population was divided by gender, the best kidney function was among light drinkers in women and among moderate drinkers in men. Moderate alcohol consumption might have a favorable impact on the progression of IgAGN. Light alcohol consumption in women and moderate consumption in men are associated with improved indices of the glomerular filtration estimates in patients with IgAGN.


High-pressure phase transitions in ordered and disordered Bi2Te2Se.
We report studies of pressure-induced phase transitions of ordered and disordered ternary tetradymite-like Bi2Te2Se by synchrotron powder X-ray diffraction (PXRD) in diamond anvil cells (DACs) for pressures up to 59 and 49 GPa, respectively. The first sample (SB) was prepared from a single crystal with ordered Se/Te sites while the second sample (Q) was prepared from a quenched melt resulting in disordered Se/Te. This allows for an investigation of the effect of disorder on the phase transitions and the equation of states (EoS) of the tetradymite-like α phase. Fitting of a third order Birch-Murnaghan EoS to the α phases yielded bulk moduli K0 of 34.5(10) and 38.3(17) GPa and K' of 6.2(3) and 5.0(5) for the SB and Q samples, respectively. An electronic topological transition (ETT) was identified in both samples at pressures of 4.4 and 3.1 GPa, respectively. This was followed by a transition near 11 GPa to a phase that is isostructural with the β phase of Bi2Te3. The Se/Te ordering only affects the transition pressure to a small extent. A cubic phase that resembles the δ phase observed in high-pressure studies of Bi2Te3 appears at 17-20 GPa, but the ternary composition leads to a more complex structure. The presence of a low angle diffraction peak in the δ phase demonstrates that the true structure is not simply body-centred cubic. In this way the samples resemble Bi2Se3 where Bi and Se show a high degree of ordering, but the proposed structure of δ-Bi2Se3 also does not fully describe the data for δ-Bi2Te2Se.


Industrial Co-Agglomeration and Air Pollution Reduction: An Empirical Evidence Based on Provincial Panel Data.
Industrial co-agglomeration plays a significant role in the moving up of the manufacturing industry in the value chain and in transforming China from a manufacturing giant into a world manufacturing power. This study establishes a co-aggregation index to explore spatio-temporal changes of the co-agglomeration between manufacturing and producer services in 30 provinces of China from 2004 to 2019. Furthermore, we use spatial Durbin model to analyze the impact of industrial co-agglomeration on air pollution reduction. We find that (1) the co-agglomeration index varies remarkably at spatio-temporal scale; (2) high co-agglomeration index is mainly distributed in eastern and central China, while low co-agglomeration index is mainly located in the western region; (3) the co-agglomeration index presents a cluster pattern among provinces, with the cluster of high value in eastern China and the cluster of low value in western China; and (4) the co-agglomeration between manufacturing and producer services is proven effetely to reduce air pollution, which is accompanied with spatial spillover effect. We also provided policy implications in line with diverse industries, multi hierarchies, and different regions, promoting the coordination of manufacturing and producer services and improving air quality.


Exposed peptide core of IgA1 hinge region in IgA nephropathy.
The human IgA1 hinge region is a very unique O-linked glycopeptide, and its sialylation and galactosylation recently were reported to be defective in the serum IgA1 derived from patients with IgA nephropathy (IgAN). This study was performed to examine the underglycosylation of the IgA1 hinge region and consequent exposure of the peptide core in IgAN. A polyclonal antibody against a synthetic human IgA1 hinge peptide, PVPSTPPTP SPSTPPTPSPS, (anti-sHP ab) was raised in rabbits and shown specifically to recognize the IgA1 which was treated with neuraminidase, beta-galactosidase and alpha-N-acetylgalactosaminidase. The reactivity of the anti-sHP ab against the purified serum IgA1 was compared among the following three groups: 39 patients with IgAN, 30 patients with other renal diseases (ORD) and 21 healthy controls (HC) using an enzyme-linked immunosorbent assay. The reactivity was significantly higher in the IgAN group (mean +/- SD of OD 490 nm: 0.327 +/- 0.059) than in the ORD group (0.274 +/- 0.043, P=0.0002) and in the HC group (0.265 +/- 0.037, P<0.0001). No significant difference was observed between the latter two groups. The frequency of positive cases (> mean +/- 2SD of HC) was 46.2% (18/39) in the IgAN group, 6.7% (2/30) in the ORD group and 0% (0/21) in the HC group. It was suggested that the peptide core of the IgA1 hinge region is exposed aberrantly by a defective N-acetylgalactosaminylation and plays a possible role in the pathogenesis of IgAN.


A Microtubule-Myelination Connection.
Microtubules are critical for the extension of oligodendrocyte processes and myelin deposition, yet our knowledge of their microtubule biogenesis is limited. In this issue of Cell, Fu et al. (2019) identify an oligodendrocyte-enriched microtubule regulator that promotes microtubule growth from Golgi outposts and controls myelin sheath elongation, linking microtubule cytoarchitecture and myelination in the CNS.


Realization of a CPR using HL7 queries from communication server to information server.
A communication server is often used in Germany to interface legacy systems. It handles the translation, duplication, and transmission of messages to all systems that might need this information. Based on the principles of "for every data there is only one master" and "information on demand" we have built an information server that reduces the messages required and simplifies the handling of messages, the update of data already sent compared to a communication server. It also allows to implement a security policy as required by the German data privacy legislature.


[Pancreatic involvement in inflammatory bowel diseases in children].
Pancreatitis in inflammatory bowel disease (IBD) in children is anecdotal. In adults, symptomatic pancreatitis occurs in 2% and asymptomatic in 8 to 21%. The aim of our study was to review retrospectively the frequency of pancreatitis in 124 pediatric patients (54.8% boys, 45.2% girls; 97 with Crohn disease, 16 with ulcerative colitis and 11 with undetermined colitis). Diagnostic criterion of pancreatitis was an increase of amylasemia > or = +2 SD of the normal with or without evocative clinical symptoms. Symptomatic or asymptomatic pancreatitis was found in 27% (respectively 14.5 and 12.5%). Pancreatitis was significantly more frequent in girls as compared to boys (P = 0.04). Symptomatic pancreatitis was moderate and non complicated, often recurrent. It occurred mainly during active and severe diseases (P = 0.006). The localizations of IBD were not discriminant. Strong relation with drug was found in 25% of pancreatitis mainly due to azathioprine or 5-aminosalicylic acid, and salazopyrin. Duodenal localisation of Crohn disease or hepatobiliary complications were found associated with pancreatitis in 18% and 15% respectively. These data suggest the high incidence of symptomatic and asymptomatic pancreatitis in children with IBD, the importance of its regular monitoring but also its multifactorial causes. Precise diagnosis of pancreatitis in pediatric IBD has to be done in order to avoid inappropriate drug pancreatitis diagnosis.


Prevalence of skin diseases among male adolescent and post-adolescent boarding school students in Turkey.
Skin disease is a common problem in boarding schools and may account for significant morbidity. To document the prevalence and patterns of skin diseases among male adolescent and post-adolescent boarding school residents, a cross-sectional epidemiologic survey was performed. A total of 682 students were examined for evidence of any skin disease, and subjects with skin disease(s) were also asked to fill in a questionnaire. Of the study population, 378 (55.42%) had at least one skin disease. The most prevalent diseases were tinea pedis (32.5%), acne vulgaris (28.6%), onychomycosis (8.06%), androgenetic alopecia (5.6%), common warts (5.3%), unguium incarnatus (4.1%), irritant hand dermatitis (3.6%), foot callosities (3.6%), and pitted keratolysis (2.6%). Of those with skin problem(s), 245 (65%) were not aware of their disease(s) and 45% of the remaining 133 subjects who were aware of their disease(s) had not sought medical help. We concluded that skin diseases, especially foot problems, are very common among male boarding school students. In additional to monitoring the epidemiology of skin diseases, intermittent medical education programs for both health-care workers and residents living in these communities would be useful for enhancing knowledge of available and effective treatments and implementing appropriate preventive measures.


Patterns of stroke recurrence according to subtype of first stroke event: the North East Melbourne Stroke Incidence Study (NEMESIS).
Specific information about the nature of recurrent events that occur after each subtype of index stroke may be useful for refining preventive therapies. We aimed to determine whether stroke recurrence rates, the pattern of subtype recurrence, and prescription of secondary prevention agents differed according to initial stroke subtype. Multiple overlapping sources were used to recruit all first-ever stroke patients from a geographically defined region of Melbourne, Australia over a 3-year period from 1996 to 1999. Potential stroke recurrences (fatal and nonfatal) occurring within 2 years of the initial event were identified following patient interview and follow up of death records. Subjects were classified into the different Oxfordshire groups and the type of first-ever stroke was compared with recurrent stroke events. One thousand, three hundred and sixteen first-ever strokes were registered during the 3-year period (mean age 74.4 years). A total of 103 first recurrent stroke events (fatal and nonfatal) occurred among those with a first-ever ischemic stroke or intracerebral hemorrhage (ICH) during the 2-year follow-up period. The recurrent stroke subtype was different to the index stroke subtype in most (78%) patients. People with partial anterior circulation infarct had the greatest proportion of recurrences (13%), with a third of these being the more severe total anterior circulation infarct subgroup. The relative risk of ICH after an index lacunar infarct (LACI) compared with an index non-LACI was 4.06 (95% CI 1.10-14.97, P=0.038). Prescription of secondary prevention agents was greater at 2 years after stroke than at hospital discharge, and was similar between ischemic stroke subtypes. Approximately 9% of people with first-ever stroke suffered a recurrent event, despite many being prescribed secondary prevention agents. This has implications for the uptake of current preventive strategies and the development of new strategies. The possibility that ICH is greater among index LACI cases needs to be confirmed.


Recent trends in Siberian urban growth.
Future trends in urbanization in the USSR east of the Urals are considered using official Soviet data from 1959 to 1985. "Absolute and relative growth and growth rates are calculated for economic regions, oblast-level administrative entities, and individual cities, as well as for city-size categories. The nature of Siberian growth suggests that in addition to serving as centers of resource exploitation, Siberian cities also function as growth poles for more integrated development. The analysis serves as the preliminary stage for proposed future research on the extent of Siberian urban development and the integration of Siberia into the Soviet economy."


State-dependent laryngomalacia.
We have observed 5 infants who demonstrate normal breathing when awake, but develop stridor while asleep. Flexible laryngoscopy in the awake state reveals either a normal larynx or redundancy of the aryepiglottic folds or arytenoid soft tissue without prolapse into the laryngeal inlet. When these children are sedated, however, the classic signs of laryngomalacia appear. Wet inspiratory stridor with concomitant supraglottic prolapse can be demonstrated by flexible videolaryngoscopy in this state. As these findings vary with level of consciousness, we have dubbed this condition "state-dependent" laryngomalacia. We believe the appearance and disappearance of classic laryngomalacia with changes in level of consciousness adds credence to the neurogenic theory of laryngomalacia.


Concurrent effect of morphine on thalamic nociceptive neurons and medullary on- and off-cells.
On- and off-cells of the rostral ventromedial medulla project to the spinal cord, where off-cells are postulated ot inhibit, and on-cells to facilitate, nociceptive transmission. In the present experiments, unitary recordings were made from ventrobasal (VB) thalamic neurons and, simultaneously, on- or off-cells in lightly anesthetized rats. When the tail was heated (45-55 degrees C) off-cells stopped firing (pause) and on-cells began to fire (burst) 0.5-0.6s before VB neurons responded to the tail stimulus. Administration of morphine sulfate (2 mg/kg i.v.) concurrently prevented the off-cell pause, the on-cell burst an the VB neuronal response. Naloxone (1 mg/kg i.v.) reversed these effects. The results are consistent with the notion that prevention of the off-cell pause and the on-cell burst by morphine is responsible for the lack of nociceptive information flow towards the thalamus.


Comparative study using various methods for identification of Staphylococcus species in clinical specimens.
Coagulase-negative staphylococci (CNS) play a predominant role in nosocomial infections. Rapid, reliable identification of these organisms is essential for accurate diagnosis and prompt effective treatment of these infections. Quite recently, the VITEK 2 g-positive (gram-positive [GP]) identification card (bioMérieux) has been redesigned for greater accuracy in the identification of gram-positive cocci. We compared the BD Phoenix (Becton Dickinson) and VITEK 2 (bioMérieux) automated microbiology systems, using their respective update version cards, and the API ID32 STAPH test. The glyceraldehyde-3-phosphate dehydrogenase (gap) gene-based T-RFLP (terminal restriction fragment length polymorphism) method was used for verifying the results. In total, 86 clinical isolates of CNS and 27 reference strains were analyzed. The results show that for identification of CNS, the automated identification methods using the newest VITEK 2 and BD Phoenix identification cards are comparable. However, API ID32 STAPH revealed more correct results compared to both automated microbiology systems. Despite the increased performance of the phenotypic automated identification systems compared to the former versions, molecular methods, e.g., the gap-based T-RFLP method, still show superior accuracy in identifying Staphylococcus species other than Staphylococcus aureus.


Cytological diagnosis of unifocal Langerhans cell histiocytosis in the temporomandibular joint.
Unifocal Langerhans cell histiocytosis (LCH) presents as a solitary focal bone lesion characterized by clonal proliferation of CD1a (+) and langerin(+) dendritic cells, derived from the bone marrow. In 38-69% of cases BRAF-V600E mutation is revealed. It gains attention to maxillofacial surgeons due to involvement of the orofacial region and early onset of jaws symptoms. If overlooked, massive deconstruction of tissues, occurs. We present a case of LCH of the temporomandibular joint in a 14 aged child where fine needle aspiration favorably contributed in an accurate diagnosis combined with the appropriate clinicoradioliogical findings. This can overrule unwarranted biopsy and monitor the treatment largely where aproach to histopathology services is restricted.


Cervical trachea: dynamics in response to herniation of the normal thymus.
Nineteen infants aged 2 months to 2.5 years, first seen predominantly with stridor, were noted to have intermittent soft-tissue mass effect in the upper airway during routine evaluation with fluoroscopic or radiographic methods. The cervicothoracic trachea was always buckled posteriorly and, in almost all instances, to the right during forced exhalation (crying). Real-time ultrasound examination with the neck extended was used in these patients to define the cause of the tracheal dynamics. The intermittent cephalic movement of the homogeneous echotextured thymus from the anterior mediastinum into the neck was determined to be the probable cause of the mass effect in these infants. Magnetic resonance imaging in three infants confirmed this finding. The intermittent, physiologic suprasternal movement of the thymus in these infants did not by itself cause any luminal compromise of the trachea and did not result in any respiratory difficulty in these infants.


Estimating the predictive value of the Test of Memory Malingering: an illustrative example for clinicians.
Recent years have witnessed an explosion in the amount of research literature dedicated to the identification of symptom exaggeration and/or malingering in neuropsychological assessments. Additionally, there is now a growing literature devoted to estimating the base rates of symptom exaggeration/malingering in a range of populations and settings. However, very little literature has been devoted to estimating the positive predictive value (PPV) or negative predictive value (NPV) of these assessment devices and/or strategies. The current project was conducted to provide an illustrative example of how to use the research literature to calculate both PPV and NPV in everyday clinical practice. When the Word Memory Test (WMT) was used as the "gold standard" to which the Test of Memory Malingering (TOMM) was compared, the TOMM achieved very high PPV (.98) and acceptable NPV (.78). How to incorporate the strategy used into clinical practice is discussed.