Expression and Localization of Human Defensins in Palatine Tonsils.
Defensins are small antimicrobial peptides and effector components of innate immune responses. Recent studies have shed light on their beneficial functions for the prevention of infection and potential for development of new drugs. Here, we showed the expression profiles of human defensins in palatine tonsils with 3 different diseases: tonsillar hypertrophy, recurrent tonsillitis and focal infection of the tonsil. RT-PCR analysis and immunofluorescence revealed that the expression of human α-defensin 4 and β-defensin 3 (β3) in palatine tonsils with tonsillar hypertrophy was lower than that in recurrent tonsillitis and focal infection of the tonsil, suggesting that chronic inflammation induces defensin expression. Interestingly, β2 and β3 mRNAs were specifically expressed by palatine tonsil tissues but not in human peripheral blood mononuclear cells and mucosa of the small intestine. Additionally, we observed that exposure to a Toll-like receptor 4 ligand, lipopolysaccharide, which is used as a bacterial infection model, increases the production of β2 in culture supernatants from tonsillar epithelial cells in a dose-dependent manner. Taken together, these results indicate that β2 produced by tonsillar epithelial cells plays an important role in the innate immune response for bacterial infections.


Time-Dependent Protection of CB2 Receptor Agonist in Stroke.
Recent studies have indicated that type 2 cannabinoid receptor (CB2R) agonists reduce neurodegeneration after brain injury through anti-inflammatory activity. The purpose of this study was to examine the time-dependent interaction of CB2R and inflammation in stroke brain. Adult male rats were subjected to right middle cerebral artery occlusion (MCAo). CB2R mRNA expression was significantly elevated >20 fold on day 2, peaked >40-fold on day 5, and normalized on day 10 post-stroke. Inflammatory markers IBA1 and TLR4 were significantly upregulated 15 fold until day 5 after MCAo. Because of the delayed upregulation of CB2R and IBA1, we next treated animals daily with CB2R agonist AM1241 or anti-inflammatory PPAR-γ agonist pioglitazone from 2 to 5 days after MCAo. Delayed treatment with pioglitazone significantly reduced abnormal neurological scores and body asymmetry as well as brain infarction in stroke animals. No behavioral improvement or reduction in brain infarction was found in animals receiving AM1241. Pioglitazone, but not AM1241, significantly reduced IBA1 expression in the stroke cortex, suggesting that delayed treatment with AM1241 failed to alter ischemia-mediated IBA-1 upregulation. In contrast, pretreatment with AM1241 significantly reduced brain infarction and neurological deficits. In conclusion, our data support a time-dependent neuroprotection of CB2 agonist in an animal model of stroke. Delayed post- treatment with PPAR-γ agonist induced behavioral recovery and microglial suppression; early treatment with CB2R agonist suppressed neurodegeneration in stroke animals.


[Inhibition of mitogen-activated protein kinase cascade by baicalein, a flavonoid of natural origin].
Mitogen-activated protein kinase (MAPK) is a family of serine/threonine kinase that appears to be a component common to signalling pathway initiated by a wide range of factors including hormones, differentiation factors and mitogens. Baicalein is a flavonoid derived from the root of Scutellaria baicaleins. From searching the inhibitors of prostaglandin synthesis in C6 rat glioma cells, we found that baicalein had a potent inhibitory activity of prostaglandin synthesis induced by either histamine or A23187, a Ca2+ ionophore. Baicalein inhibited histamine- and A23187-induced phosphorylation of MAPK in the cells, which was known to cause the phosphorylation of cytosolic phospholipase A2. Baicalein also inhibited the phosphorylation of MAPK kinase (MEK) induced by histamine or A23187 in the cells. In vitro kinase assay, baicalein inhibited the activities of raf but not MEK. These results imply that baicalein is a specific inhibitor of MAPK cascade, acting on phosphorylation of MEK by raf.


An Emerging Market: The Impact of User Selection on the Decision-Making Behavior of Mobile Medical Businesses in China.
User selection is an important guarantee for the sustainable development of mobile medical businesses. Under the background of increasingly fierce competition, the decision-making behavior of mobile medical businesses will directly affect the choice of the behavior of users. The study constructs the decision-making behavior model of mobile medical business based on the user choice and adds the role of people in government. It uses the game method to explore the relationship between the government, mobile medical business, and users. Finally, it makes an example analysis. Empirical research is conducted to demonstrate the influence of different parameter changes on the results. The results show that in the absence of government intervention, users' choice of filtering information will create a bad environment for mobile medical businesses, and further will be reduced, and the expected utility of businesses will not be affected causing a reduction in expected utility of companies. Similarly, government regulations can effectively improve the mobile medical environment and enhance the expected utility of mobile medical companies. The government needs to formulate relevant laws and regulations to ensure the orderly operation of the mobile medical market and strengthen government supervision. It is necessary to conduct publicity and education to protect the fundamental interests of users and businesses.


Far-red light-induced changes in intracellular potentials of spinach mesophyll cells: interaction with red light.
In green plants, the large bioelectric changes that photosynthetically active light stimulates make it difficult to observe electrical potential changes related to phytochrome photoconversion. As a first step towards distinguishing between photosynthetic and phytochrome effects, we showed that red light enhances far-red stimulated intracellular potential changes in spinach (Spinacia oleracea) leaf mesophyll cells.For a dark-adapted leaf, the response to far-red light increased during the first 10 to 30 exposures of 2.5 minutes, after which it was constant. The intracellular potential depolarized by an average of 0.3 millivolts during each 2.5-minute far-red light period, and returned to the resting value during each subsequent dark period. Continuous supplementary red light (at 1-5% of the fluence rate of the far-red light that stimulated the depolarizations) increased the response to far-red 2- to 3-fold. Supplementary red light did not amplify the response to alternating 702 nanometers light and dark periods. The Emerson enhancement effect thus does not seem to explain amplification of the response to 730 nanometers light by supplementary red light. This does not prove that photosynthetic pigments are not involved in some other way.


Monitoring and identification of spatiotemporal landscape changes in multiple remote sensing images by using a stratified conditional Latin hypercube sampling approach and geostatistical simulation.
This study develops a stratified conditional Latin hypercube sampling (scLHS) approach for multiple, remotely sensed, normalized difference vegetation index (NDVI) images. The objective is to sample, monitor, and delineate spatiotemporal landscape changes, including spatial heterogeneity and variability, in a given area. The scLHS approach, which is based on the variance quadtree technique (VQT) and the conditional Latin hypercube sampling (cLHS) method, selects samples in order to delineate landscape changes from multiple NDVI images. The images are then mapped for calibration and validation by using sequential Gaussian simulation (SGS) with the scLHS selected samples. Spatial statistical results indicate that in terms of their statistical distribution, spatial distribution, and spatial variation, the statistics and variograms of the scLHS samples resemble those of multiple NDVI images more closely than those of cLHS and VQT samples. Moreover, the accuracy of simulated NDVI images based on SGS with scLHS samples is significantly better than that of simulated NDVI images based on SGS with cLHS samples and VQT samples, respectively. However, the proposed approach efficiently monitors the spatial characteristics of landscape changes, including the statistics, spatial variability, and heterogeneity of NDVI images. In addition, SGS with the scLHS samples effectively reproduces spatial patterns and landscape changes in multiple NDVI images.


Impact of local steroid application in a minimally invasive transforaminal lumbar interbody fusion: results of a prospective, randomized, single-blind trial.
OBJECTIVELocal epidural steroid application may be associated with decreased pain and narcotic use in the immediate postoperative period following lumbar discectomy. However, local steroid delivery following lumbar fusion procedures has not been well characterized. This study aims to characterize the effect of local intraoperative depomedrol application on perioperative and postoperative outcomes following a single-level minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).METHODSA prospective, randomized, single-blinded study was performed. A priori power analysis determined that 86 patients were needed to detect a difference of 1 point in the visual analog scale (VAS) pain score between groups. Ninety-three patients were randomized into depomedrol (DEPO) and no depomedrol (NODEPO) cohorts. Prior to surgical closure, DEPO patients received 1 ml depomedrol (80 mg) applied directly to the surgical site by using a Gelfoam carrier. NODEPO patients received 1 ml saline on the same Gelfoam carrier. Perioperative outcomes including acute postoperative pain and narcotic use were assessed for the duration of inpatient stay. Patient-reported outcomes (PROs) questionnaires including VAS back and leg pain scores, and Oswestry Disability Index (ODI) were administered preoperatively and at 6-week, 12-week, and 6-month follow-up. Outcomes for DEPO and NODEPO cohorts were compared using linear regression controlled for sex.RESULTSOf the 93 patients, 45 (48.4%) were randomized to DEPO and 48 (51.6%) to NODEPO. A greater percentage of DEPO patients were female (53.3% vs 27.1%, p = 0.010). There were no other significant differences in patient baseline characteristics. Similarly, operating time, estimated blood loss, and length of inpatient stay did not differ between cohorts. Patients in the DEPO cohort consumed fewer hourly narcotics on postoperative day 0 (5.3 vs 6.3 oral morphine equivalents/hour, p = 0.034). However, no differences in acute postoperative pain or total narcotics consumption were observed between groups. Preoperative VAS leg scores were statistically different between cohorts (p = 0.027). However, preoperative ODI and VAS back scores did not differ between groups. Additionally, DEPO and NODEPO groups experienced similar improvements in PROs at all postoperative time points.CONCLUSIONSLocal depomedrol use did not lead to decreases in acute postoperative pain or narcotics consumption after MIS TLIF. Additionally, local depomedrol was not associated with postoperative improvements in PROs. The findings of this randomized trial suggest that surgical and clinical outcomes following MIS TLIF may not be impacted by intraoperative application of depomedrol.Clinical trial registration no.: NCT03308084 (clinicaltrials.gov).


Method Modification Study for the Thermo Scientific SureTect™ Listeria Species Assay-Matrix Extension.
The Thermo Scientific™ SureTect™ Listeria species assay is a new real-time PCR assay for the detection of all species of Listeria in food and environmental samples. The assay was originally certified as Performance Tested Methods(SM) (PTM) 071304 in 2013. This report details the method modification study undertaken to extend the performance claims of the assay for matrixes of raw ground turkey, raw ground pork, bagged lettuce, raw pork sausages, pasteurized 2% fat milk, raw cod, pasteurized brie cheese, and ice cream. The method modification study was conducted using the AOAC Research Institute (RI) PTM program to validate the SureTect PCR assay in comparison to the reference method detailed in ISO 11290-1:1996 including amendment 1:2004. All matrixes were tested by Thermo Fisher Scientific (Basingstoke, United Kingdom). In addition, three matrixes (raw cod, bagged lettuce, and pasteurized brie cheese) were analyzed independently as part of the AOAC RI-controlled independent laboratory study by the University of Guelph, Canada. Using probability of detection statistical analysis, there was no significant difference in the performance between the SureTect assay and the International Organization for Standardization reference method for any of the matrixes analyzed in this study.


Medicare program: conditions of participation (CoPs) for community mental health centers. Final rule.
This final rule establishes, for the first time, conditions of participation (CoPs) that community mental health centers (CMHCs) must meet in order to participate in the Medicare program. These CoPs focus on the care provided to the client, establish requirements for staff and provider operations, and encourage clients to participate in their care plan and treatment. The new CoPs enable CMS to survey CMHCs for compliance with health and safety requirements.


R50 as a beam quality specifier for selecting stopping-power ratios and reference depths for electron dosimetry.
For electron beam reference dosimetry in radiotherapy, it is shown that by choosing the reference depth as dref = 0.6R(50)-0.1 cm, where R50 is the half-value depth in centimeters, the Spencer-Attix water-to-air stopping-power ratio at dref is given by (Llp)airw = 1.2534 - 0.1487 (R50)0.2144. This is derived from data for (Llp)airw obtained from realistic Monte Carlo simulations for 24 clinical beams. The rms deviation of this expression from the Monte Carlo calculations is 0.16%, with a maximum deviation of 0.26%. This approach fully takes into account the spectral differences between real electron beams of the same R50 and allows an absorbed-dose calibration at a standards laboratory to be easily and accurately transferred to a reference clinical beam. Using a single parameter to specify (Llp)airw, rather than the two parameters (R50 and depth) needed when the reference depth is chosen as the depth of dose maximum, has the potential to greatly simplify electron beam dosimetry protocols and allows the use of a similar formalism for photon and electron beam dosimetry. For use in converting a depth-ionization curve into a depth-dose curve, a somewhat less accurate but general expression for (Llp)w(air) as a function of R50 and depth is presented.


[Clinical and immunopathological significance of chimerism in bone marrow and organ transplantations]
Chimerism is an exceptional immunogenetic state, characterized by the survival and collaboration of cell populations originated from two different individuals. The prerequisites to induce chimerism are immunosuppression, myeloablation or severe immunodeficiency of the recipients on one side and donor originated immuno-hematopoietic cells in the graft on the other. Special immunogenetic conditions to establish chimerism are combined with bone marrow transplantation, transfusion and various kinds of solid organ grafting. There are various methods to detect the type of chimera state depending on the immunogenetic differences between the donor and recipient. The chimera state seems to be one of the leading factors to influence the course of the post-transplant period, the frequency and severity of graft-versus-host disease (GVHD), and the rate of relapse. However, the most important contribution of the chimeric state is the development of graft versus leukemia (GVL) effect. A new conditioning protocol (DBM/Ara-C/Cy) for allogeneic BMT in CML patients and its consequence on chimera state and GVL effect is demonstrated.


Ultra-low dose one-step CT angiography for coronary, carotid and cerebral arteries using 128-slice dual-source CT: A feasibility study.
Atherosclerotic diseases are systemic and patient outcomes depend on comprehensive imaging evaluation. Computed tomography angiography (CTA) is a powerful tool used to assess atherosclerosis. However, the scanning protocol is designed for cardiovascular and cerebrovascular imaging, which require considerations into the radiation dose, contrast agent and image quality. The purpose of the present study was to evaluate ultra-low dose one-step CTA for coronary, carotid and cerebral arteries with a low concentration contrast agent. A total of 78 patients were enrolled and randomly divided into two groups: Group A (n=38) and B (n=40). High-pitch CTA for coronary, carotid and cerebral arteries with a tube voltage of 70 or 80 kVp and 40 ml contrast agent (270 mgI/ml) was performed by a 128-slice dual-source CT scanner for group A. Standard high-pitch CTA with a tube voltage of 100 kVp and 60 ml contrast agent (370 mgI/ml) was conducted for group B. The image quality, radiation dose and amount of contrast agent in group A were evaluated and compared with group B. The dose length product for groups A and B was 62.95±21.54 vs. 160.15±15.13 mGy cm, respectively (t=-23.157, P<0.001). The mean total iodine content was 10.8±0 mg for group A and 22.2±0 mg for group B. In total, 99.4% of the arterial segments could be assessed for the two groups (χ 2=0.267, P=0.606). The results revealed that ultra-low dose one-step high-pitch CTA can provide assessable image quality, and minimize the radiation dose and contrast agent.


[Development of an automated patient recognition method for chest CT images using a template-matching technique].
If patient information, such as identification number or patient name, has been entered incorrectly in a picture archiving and communication system (PACS) environment, the image may be stored in the wrong place. To prevent such cases of misfiling, we have developed an automated patient recognition system for chest CT images. The image database consisted of 100 cases with present and previous chest CT images. A volume of interest (VOI) measuring 40 × 40 pixels was selected from the left lung region, bronchus region, and right lung region. Next, the overall lung region and these three regions in a current chest CT image were used as a template for determining the residual value with the corresponding four regions in previous chest CT images. To ensure separation between the same and different patients, we applied a combined analysis that employed the ruled-based plus artificial neural network (ANN) method. The overall performance of the method developed was examined in terms of receiver operating characteristic (ROC) curves. The performance of the rule-based plus ANN method using a combination of the four regions was higher than obtained using a rule-based method using these four regions separately. The automated patient recognition system using the rule-based plus ANN method achieved an area under the curve (AUC) value of 0.987. This automated patient recognition method for chest CT images is promising for helping to retrieve misfiled patient images, especially in a PACS environment.


(E)-1-(2'-deoxy-beta-D-ribofuranosyl)-2,4-difluoro-5-(2-iodovinyl)benzene.
This analysis of the title compound, C13H13F2IO3, establishes the orientation of (E)-5-(CH=CH-I) as antiperiplanar (ap) to the C-C bond (5-6 position) of the 2,4-difluorophenyl ring system, with the (E)-5-(CH=CH-I) H atom located in close proximity (2.17 A) to the F4 atom of the 2,4-difluorophenyl moiety.


2,3,7,8-Tetrachlorodibenzo-p-dioxin alters cardiovascular and craniofacial development and function in sac fry of rainbow trout (Oncorhynchus mykiss).
Hallmark signs of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) toxicity in rainbow trout sac fry, are yolk sac edema, hemorrhage, craniofacial malformation, and growth retardation culminating in mortality. Our objective was to determine the role of cardiovascular dysfunction in the development of this toxicity. An embryotoxic TCDD dose (385 pg/g egg) caused a progressive reduction in blood flow in rainbow trout sac fry manifested first and most dramatically in the 1st and 2nd branchial arches and vessels perfusing the lower jaw. Blood flow was reduced later in the infraorbital artery and occipital vein of the head as well as segmental vessels and caudal vein of the trunk. Reduced perfusion occurred last in gill branchial arteries involved with oxygen uptake and the subintestinal vein and vitelline vein involved with nutrient uptake. Although heart rate throughout sac fry development was not affected, heart size at 50 days post-fertilization (dpf) was reduced far more than body weight or length, suggesting that the progressive circulatory failure caused by TCDD is associated with reduced cardiac output. Craniofacial development was arrested near hatch, giving rise to craniofacial malformations in which the jaws and anterior nasal structures were underdeveloped. Unlike the medaka embryo, in which TCDD causes apoptosis in the medial yolk vein, endothelial cell death was not observed in rainbow trout sac fry. These findings suggest a primary role for arrested heart development and reduced perfusion of tissues with blood in the early-life stage toxicity of TCDD in trout.


Thrombocytopenia in 737 adult intensive care unit patients: A real-world study of associated factors, drugs, platelet transfusion, and clinical outcome.
We aimed to identify and represent factors associated with thrombocytopenia in intensive care unit, especially the pathogens and drugs related to severe and extremely thrombocytopenia. Then, we aim to compare the mortality of platelet transfusion and non-transfusion in patients with different degrees of thrombocytopenia. We identified all thrombocytopenic patients in intensive care unit by using platelet-specific values and then extracted electronic health records from our Hospital Information System. Data were statistically analyzed with t test, chi-square test, and logistic regression. We found that infections (32.7%) were the most frequent cause associated with thrombocytopenia, followed by sepsis shock (3.93%) and blood loss (2.99%). Meanwhile, antifungals (p = 0.002) and bacterial infection (p = 0.037) were associated with severe and extremely severe thrombocytopenia. Finally, we found that the mortality of platelet transfusion and non-transfusion in patients was statistically significant for patients with platelet counts between 30 and 49/nL (χ2 = 9.719, p = 0.002). Infection and sepsis emerged as two primary factors associated with thrombocytopenia in intensive care unit. Meanwhile, antifungals and bacterial infection were associated with platelet counts less than 49/nL. Finally, platelet transfusion may be associated with reduced mortality in patients with platelet counts between 30 and 49/nL.


Mouse embryonic explant culture system for analysis of hematopoietic and vascular development.
In vertebrates, the earliest differentiated cell types (hematopoietic and endothelial) arise from mesoderm induced during the process of gastrulation. These cells become organized into the blood islands of the extraembryonic yolk sac and are morphologically apparent by around d 7.5 in the mouse. Additional waves of hematopoietic and vasculogenic/angiogenic activity later result in the development of definitive hematopoietic lineages and in the formation of the allantois and cardiovascular system of the embryo proper. In part because of the limited accessibility of the mammalian embryo to experimental manipulation in vivo, regulation of these events is still not well understood. Both in the yolk sac and within the embryo proper, prospective hematovascular mesoderm differentiates in the vicinity of endodermal tissues. Here we describe an embryonic explant culture system that permits the dissection of mesodermal and endodermal contributions to hematopoietic and endothelial cell formation during gastrulation. This system can be used to assay for soluble or endodermal cell-associated molecules involved in mediating critical interactions between mesoderm and endoderm in the formation of the hematopoietic and endothelial lineages during embryonic development.


Progressive language dysfunction and lobar atrophy.
The patterns of language disorder associated with 'progressive aphasia' due to lobar atrophy were compared with the language dysfunction of patients with dementia of frontal lobe type (DFT). The progressive aphasias were characterised primarily by impairment at the structural levels of language: phonology, grammar and semantics, whereas DFT was associated primarily with spontaneity and loss of generative capability. However, there was overlap in language symptomatology, particularly with progression of disease. The findings lend support to the argument that progressive aphasia and DFT represent different clinical manifestations of a common pathology, and form part of the spectrum of lobar atrophies.


A New Priority Pathway for Biologicals in Australia: Contextualising and Evaluating the Proposed Reforms.
This section examines recent reforms to the regulatory framework for biologicals contained in the Therapeutic Goods Act 1989 (Cth) in the context of the "New Frontier" of reform envisioned in a report completed by the Commonwealth Government in 2021. It compares Australia's proposed reform of the approval processes for biologicals to similar reforms that have been made over the last three decades in the United States and the European Union. It places the Australian reforms in the context of the commercialisation of regenerative medicine and identifies several potential shortcomings of the proposed reforms and reports on the current lack of data on the processes of expedited approvals in Australia more generally.


Tobacco survey among youth in South India.
Smoking of cigarettes and, particularly, of "bidis" (which consist of about 0.2-0.3 gm of tobacco rolled up in the leaf of another plant (temburni) has been widespread for many decades among men in India. There have, however, been no substantial studies on the prevalence of tobacco use among youth in India. Hence a Global Youth Tobacco Survey was conducted in schools in Tamil Nadu as part of on-going Global Youth Tobacco survey in over 150 countries in the world. The two-stage cluster sample method was used to select 100 schools with standards 8, 9 and 10 in Tamil Nadu. The survey used self administered questionnaires, which consisted of 88 multiple choice questions. A total of 4820 students participated (a response rate of 90.1%) in the 99 of 100 schools selected for the survey. About 10% of students aged 13-15 in Tamil Nadu had ever used tobacco. Significantly higher percentages of current tobacco users (one in three students) compared to never tobacco users thought smoking or chewing tobacco makes a boy or girl more attractive. About 3 in 4 current smokers expressed a wish to stop smoking and a similar proportion have already tried to quit the habit. About 80% of students considered using tobacco (smoking or chewing tobacco) to be harmful to their health. Only about half of the students reported that they have been taught in school the health effects of tobacco use during the year preceding the survey. Exposure to environmental tobacco smoke and pro-tobacco advertisements is high. The tobacco prevalence among girls is alarming. The results of the survey show the need to increase awareness about health hazards of tobacco use among students. Tobacco control programs focusing on youth are essential in order to reduce the burden of tobacco related diseases in India. Repeat surveys would help in monitoring the tobacco epidemic in the school and to evaluate the efficacy of state level tobacco control programs.


Tie strength distribution in scientific collaboration networks.
Science is increasingly dominated by teams. Understanding patterns of scientific collaboration and their impacts on the productivity and evolution of disciplines is crucial to understand scientific processes. Electronic bibliography offers a unique opportunity to map and investigate the nature of scientific collaboration. Recent studies have demonstrated a counterintuitive organizational pattern of scientific collaboration networks: densely interconnected local clusters consist of weak ties, whereas strong ties play the role of connecting different clusters. This pattern contrasts itself from many other types of networks where strong ties form communities while weak ties connect different communities. Although there are many models for collaboration networks, no model reproduces this pattern. In this paper, we present an evolution model of collaboration networks, which reproduces many properties of real-world collaboration networks, including the organization of tie strengths, skewed degree and weight distribution, high clustering, and assortative mixing.


The new shank construct of lag screw improves the maximum compression force for internal fixations: preliminary results.
The treatment of osteoporotic intra-articular fractures with AO lag screws remained challenging due to insufficient compression. Several strategies to improve the compressive ability of lag screws have been evaluated. However, the effect of the shank construct on the compressive ability of lag screw has never been explored. The aim of this study was to determine the effect of a shank construction the compressive ability of lag screw for different bone mineral densities (BMDs). Three synthetic cancellous bone blocks were used for this study, including 0.12 g/cc, 0.16 g/cc, and 0.20 g/cc. 24 pilot holes with 3.2 mm diameters were drilled equably in each block. An AO lag screw and a combined lag screw with the newly designed compound shank construct were inserted through the custom-designed measuring device into a pilot hole by hand until failure, and the maximum compressive force (CMAX) was determined. Among three densities specimens CMAX of the combined lag screw was significantly higher than that of the AO lag screw (p < 0.001), and the mean CMAX difference value of the two screws in a specimen increased as the BMD increased. The CMAX of two screws increased as the BMD increased (p < 0.001), and the amplification of the CMAX generated by the combined lag screw was higher than that generated by the AO lag screw when the BMD increased. The newly designed compound shank construct improves the compressive ability of lag screws independent of the BMD.


C-Peptide, Baseline and Postprandial Insulin Resistance after a Carbohydrate-Rich Test Meal - Evidence for an Increased Insulin Clearance in PCOS Patients?
Introduction Known characteristics of patients with PCOS include infertility, menstrual disorders, hirsutism and also often insulin resistance. These symptoms increase with increasing body weight. In the LIPCOS study (Lifestyle Intervention for Patients with Polycystic Ovary Syndrome [PCOS]) long-term changes of the PCOS in dependence on pregnancy and parenthood were systematically assessed. In the framework of the LIPCOS study, PCOS patients were given a standardised carbohydrate-rich test meal in order to examine glucose homeostasis and insulin secretion. The results were compared with those of a eumenorrhoeic control group who all had corresponding BMI values and corresponding ages. Methods and Patients 41 PCOS patients (without diabetes) and 68 controls received a standardised carbohydrate-rich test meal (260 kcal, 62 % carbohydrates, 32 % fat, 6 % proteins) in order to generate a submaximal insulin and glucose stimulation. The values were determined at baseline and postprandial after 60, 120 and 180 minutes. In addition, the corresponding C-peptide levels were recorded. Results In the PCOS patients (n = 41), the insulin secretion test after a standardised test meal showed almost identical baseline and postprandial insulin levels when compared with those of the age- and BMI-matched eumenorrhoeic controls (n = 68). In the PCOS patients, the baseline and postprandial glucose levels were significantly elevated (92.88 ± 10.28 [PCOS] vs. 85.07 ± 9.42 mg/dL [controls]; p < 0.001) so was C-peptide (p < 0.025). Conclusions In the present study we have shown for the first time that, after consumption of a standardised test meal, PCOS patients formally exhibit a higher fasting insulin resistance than controls. In spite of the higher stimulated C-peptide levels, the insulin levels did not increase more strongly with increasing glucose levels than in controls which may be indicative of a higher insulin clearance in PCOS patients.


Prevention of nosocomial infections in intensive care patients.
Changes in patient profile, and in the health care environment, altering socioeconomic conditions and advances in science and information technology challenge the nursing profession, in particular intensive care nursing. All these changes will undoubtedly affect the way we will practice in the (near) future. A comprehensive understanding of these factors is therefore essential if nursing is to meet the challenges presented by tomorrow's critical care environment. Precisely because of the often expensive high-tech evolutions that have occurred at a rapid pace and are to be further expected, a continued focus on the basics of nursing, the core role of care, as well as maintaining confidence in the capacity to deliver safe, high-quality, and evidence-based patient care will increasingly be a challenge to critical care nurses. In particular, basic nursing skills and knowledge remain a key prerequisite in the prevention of nosocomial infections, which is a continuing major complication and threat to intensive care unit patients. However, critical care nurses' knowledge about the evidence-based consensus recommendations for infection prevention and control has been found to be rather poor. It has nevertheless been demonstrated that a meticulous implementation of such preventive bundles may result in significantly better patient and process outcomes. Moreover, many preventive strategies are considered to be easy to implement and inexpensive. As such, a first and critical step should be to increase critical care nurses' adherence to the recommendations of the Centers for Disease Control and Prevention. In this article, an up-to-date assessment of evidence-based recommendations for the prevention of nosocomial infections, with special focus on catheter-related bloodstream infections and strategies relevant for nurses working in critical care environments, will be provided. Additionally, we will detail on a number of approaches advocated to translate the internationally accepted consensus recommendations to the needs and expectations of critical care nurses, and to consequently enhance the likelihood of successful implementation and adherence. These steps will help critical care nurses in their striving towards excellence in their profession. Intensive care nurses can make a significant contribution in preventing nosocomial infections by assuming full responsibility for quality improvement measures such as evidence-based infection prevention and control protocols. However, as general knowledge of the preventive measures has been shown to be rather poor, nurses' education should include supplementary support from evidence-based recommendations.


Dietary Clostridium butyricum and Bacillus subtilis Promote Goose Growth by Improving Intestinal Structure and Function, Antioxidative Capacity and Microbial Composition.
Probiotics are a substitute for antibiotics in the sense of intestinal health maintenance. Clostridium butyricum and Bacillus subtilis, as probiotic bacteria, have been widely used in animal production. The aim of this study was to investigate the effects of the two probiotic bacteria in geese. A total of 288 1-day old, healthy Yangzhou geese were randomly assigned into 4 groups (A, B, C and D) with 6 replicates of 12 birds each. Group A, as control, was fed a basal diet, and the treatment groups (B, C and D) were fed the basal diet supplemented with 250 mg/kg Clostridium butyricum (the viable count was 3.0 × 106 CFU/g), 250 mg/kg Bacillus subtilis (the viable count was 2.0 × 107 CFU/g), or a combination of the two probiotic bacteria for 70 days, respectively. The results indicated that: compared with the control group, dietary probiotics (1) promoted the growth and feed intake of the geese, (2) increased the absolute weight of duodenum, (3) increased the antioxidative capacity (total antioxidative capacity (T-AOC), total superoxide dismutase (T-SOD) and glutathione peroxidase (GSH-PX)) of intestinal mucosa, (4) improved intestinal morphology (the ratio of villus height to crypt depth), (5) but did not induce inflammation and changes of tight junction in the intestine, which was indicated by no induction of pro/inflammatory cytokines (IL-1β, IL-6, IL-10, TNFAIP3) and tight junction related genes (TJP1 and OCLN). Moreover, dietary probiotics increased the relative abundances of Firmicutes phylum and Lactobacillus genus and decreased the relative abundances of Proteobacteria phylum or Ralstonia genus in the intestinal content. In addition, the alpha diversity (observed species, Chao1, and estimate the number of OTUs in the community(ACE)) was reduced and the predicted functions of intestinal microflora, including peptidases, carbon fixation and metabolic function of starch and sugar, were enhanced by dietary probiotics. In conclusion, dietary probiotics promote the growth of geese by their positive effects on intestinal structure and function, the composition and functions of gut microflora, and intestinal antioxidative capacity.


[Pharmacokinetic parameters as criteria for clinical use of hydroxyethyl starch preparations].
Pharmacokinetic Parameters as Criteria for Clinical Use of Hydroxyethyl Starch Preparations In a study with volunteers (n = 2 x 6) pharmacokinetic data of two only marginally differing starch preparations were investigated. We were able to demonstrate that there exist significant differences in raw materials used which determined the pharmacokinetic data in humans. Newly implemented analyzing methods (LALLS) were used. In addition to the degree of substitution, further differences concerning the position of hydroxyethylization at the anhydroglucose molecule could be documented. The C2/C6 positions of hydroxyethylization at the molecule seem to be most essential. To classify and to differentiate starch preparations we propose to include these data in general informations for clinicians because these differences might determine clinical usage and efficacy.


Synthesis and evaluation of substituted 2-phenylcyclobutylamines as analogues of hallucinogenic phenethylamines: lack of LSD-like biological activity.
cis- and trans-2-(2,4,5-trimethoxyphenyl)cyclobutylamine and trans-2-(2,5-dimethoxy-4-methylphenyl)cyclobutylamine were synthesized as conformationally restricted analogues of hallucinogenic phenylisopropylamines. In rats trained to discriminate saline from LSD (0.08 mg/kg, ip) in a two-lever drug discrimination paradigm, no generalization of the LSD stimulus to the cis trimethoxy compound occurred at doses up to 20 mg/kg. For both of the trans compounds, partial generalization of the LSD cue occurred at doses of 5 mg/kg or greater. In contrast, complete generalization occurred with trans-2-(2,5-dimethoxy-4-methylphenyl)cyclopropylamine. The ED50 for this compound and the doses of the trans cyclobutyl homologues at which significant drug-appropriate responding occurred indicate that the latter are on the order of 50-75 times less potent than the cyclopropylamine analogue. The lack of generalization to the cyclobutylamines indicates either that their discriminative stimulus properties differ from LSD or that they lack discriminative effects.


Spectrophotometric determination of doxazosin mesylate in tablets by ion-pair and charge-transfer complexation reactions.
Two accurate, easy spectrophotometric methods for the determination of doxazosin mesylate were described. The first method was based on the formation of ion-pair complexes with the acidic sulfophthalein dyes bromocresol purple (BCP) and bromophenol blue (BPB) in pH 3.3 and 4.5 citrate-phosphate buffer, respectively. The formed complexes were extracted into dichloromethane, and their absorbance was measured at 403 and 410 nm for BCP and BPB, respectively. The second method was based on the charge transfer reaction of the drug as an n-electron donor with either 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) or 7,7,8,8-tetracyanoquinodimethane (TCNQ) as pi-acceptors, to give colored radical anions. The absorbances of products were measured at 457 nm in acetonitrile and 838 nm in methanol for DDQ and TCNQ, respectively. Under the optimum reaction conditions, Beer's law was obeyed with a good correlation coefficient (r = 0.9997-0.9999) in the concentration ranges 3.0-18.0, 3.0-20.0, 15.0-95.0, and 10.0-100.0 microg/mL for the BCP, BPB, DDQ, and TCNQ methods, respectively. Limits of detection of the BCP, BPB, DDQ, and TCNQ methods were 0.314, 0.408, 1.935, and 1.610 microg/mL, respectively. The limits of quantification were 1.045, 1.360, 6.449, and 5.367 microg/mL, respectively. The parameters molar absorptivity, precision, accuracy, recovery, robustness, and stability constant were studied. The proposed methods were successfully applied for determination of the drug in tablets with good accuracy and precision. Statistical comparison of the results with those obtained by a reported method showed good agreement and indicated no significant difference in accuracy and precision.


The combination of N-acetylcysteine and cyclosporin A reduces acetaminophen-induced hepatotoxicity in mice.
Acetaminophen (APAP)-induced hepatotoxicity is the most common cause of acute liver failure in worldwide. N-acetyl cysteine (NAC) is used as the APAP antidote. Cyclosporin A (CsA) is suppressed mitochondrial damage by binding cyclophilin, a mitochondrial pore transport component. The study aimed to evaluate the effects of NAC, CsA, and NAC+CsA treatments on APAP-induced hepatotoxicity in mice. Mice were randomly divided into five groups (n = 6). 400 mg/kg/ip/single dose APAP, 1200 mg/kg/i.p/single dose NAC and 50 mg/kg/i.p/single dose CsA were performed. Light and electron microscopic alterations were investigated in liver samples. Levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and liver glutathione (GSH) were analyzed. 3-nitrotyrosine and cytochrome c immunoreactivities were evaluated in liver tissue. Here, we found that APAP leads to histopathological and ultrastructural changes in mice liver. Also, APAP increased cytochrome c and 3-nitrotyrosine immunopositive staining. Besides, a significant decrease in liver GSH and an increase in serum AST and ALT levels were detected in the APAP group. Interestingly, NAC+CsA treatment improved histological alterations, cytochrome c, and 3-nitrotyrosine immunoreactivities and liver GSH, serum AST/ALT levels caused by APAP. We suggest that the combination of NAC and CsA reduces acetaminophen-induced hepatotoxicity in mice.


Reduced susceptibility of methicillin-resistant Staphylococcus aureus to cetylpyridinium chloride and chlorhexidine.
Sensitivities of 120 strains of Staphylococcus aureus to methicillin, cetylpyridinium chloride (CPC) and chlorhexidine (CH) were measured by the agar dilution technique. The MICs for CPC and CH were < or = 2 micrograms/ml in 93 and 83% of methicillin-sensitive S. aureus, respectively, and > 2 micrograms/ml in 81 and 83% of methicillin-resistant S. aureus (MRSA), respectively. Overall, the MICs for CPC and CH were 5-10 times greater in the methicillin-resistant than in the methicillin-sensitive strains (p < 0.001). The MICs for CPC and CH also predicted the relative susceptibilities of S. aureus strains to the bactericidal action of these agents in growth and time-kill studies. The possibility that antiseptics and disinfectants contribute to the selection and maintenance of multiply resistant MRSA is considered.


Who enrolls in a program for parents of publicly insured children?
Although interest in expanding SCHIP coverage to parents has grown over the past five years, few such expansions have actually been implemented. State governments and health plan administrators remain concerned that these expansions will attract only high-risk enrollees, resulting in costly premiums that require large subsidies. We examine characteristics of enrollees in an SCHIP-like expansion program in Alameda County, California. According to our survey data, the program did not experience unfavorable selection. Rather, it attracted a broad range of eligible adults. Enrollees were comparable to the overall low-income population in Alameda County in terms of age, health status, and various utilization measures.


Lateral Cervical Spine Radiography to Demonstrate Absence of Bony Displacement After Intubation in a Patient with an Acute Type III Odontoid Fracture.
A 72-year-old patient with an acute traumatic Type III odontoid fracture presented to the operating room for an urgent orthopedic procedure with a history of uncontrolled gastroesophageal reflux, a full stomach, and active vomiting. Rather than fiberoptic intubation, a rapid sequence intubation with manual inline stabilization was performed using a videolaryngoscope. A lateral cervical spine radiograph immediately after intubation showed no change in alignment of the fracture of C1-C2. In the presence of cervical spine instability, a postintubation radiograph provides assurance that the cervical spine is appropriately aligned during subsequent surgery.


Chromosome abnormalities in patients with chronic myelocytic leukemia.
Fifty patients with chronic myelocytic leukemia (CML) grouped into four stages on the basis of clinical and hematological results were analyzed with chromosomal banding techniques. Of the 50 patients, 48 hand the "standard" type of Ph1 translocation, t(9 ; 22) (q34 ; q11) and the remaining 2 had Ph1-negative diploid karyotype. The frequency of numerical chromosomal changes and/or structural chromosomal changes other than the Ph1 translocation varied with the stages; the frequency was 1 of 28 cases (3.6%) for patients in stage I (chronic phase), 5 of 11 (45.5%) in stage II (early stage of blastic phase), 11 of 13 (84.6%) in stage III (blastic phase) and 2 of 7 (28.6%) in stage IV (remission phase). Numerical changes in hyperdiploid leukemic cells correlated well with the appearance of extra #8 and extra Ph1 In 5 cases with hypodiploid leukemic cells, one of the #7 pair was absent in 4 cases and Y in 1 case. As structural changes, partial excess of chromosome 1, isochromosome 17q, isochromosome 1q, tdic (20p+ ; 21q-), del (7) (q11), t(2p+ ; 11p-), #12q+ and Xp+ were observed. Chromosomal analysis alone is not the best marker to diagnose the onset of blastic phase; however, it is a useful parameter when considered in combination with clinical and hematological results.


Dynamic contrast-enhanced magnetic resonance imaging of the sarcopenic muscle.
BACKGROUND: Studies about capillarity of the aged muscle provided conflicting results and no data are currently available about the magnetic resonance imaging (MRI) in vivo characteristics of the microvascular bed in aged rats. We have studied age-related modifications of the skeletal muscle by in vivo T2-relaxometry and dynamic contrast-enhanced magnetic resonance imaging (CE-MRI) at high field intensity (4.7 T). The aim of the work was to test the hypothesis that the ageing process involves microvessels in skeletal muscle. METHODS: The study was performed in 4-month-old (n = 6) and 20-month-old (n = 6) rats. RESULTS: At MRI examination, the relaxation time T2 of the gastrocnemius muscle showed no significant difference between these two groups. The kinetic of contrast penetration in the tissue showed that in 4-month-old rats the enhancement values of the signal intensity at different time-points were significantly higher than those found in senescent rats. CONCLUSION: The reported finding suggests that there is a modification of the microcirculatory function in skeletal muscle of aged rats. This work also demonstrates that CE-MRI allows for an in vivo quantification of the multiple biological processes involving the skeletal muscle during aging. Therefore, CE-MRI could represent a further tool for the follow up of tissue modification and therapeutic intervention both in patients with sarcopenia and in experimental models of this pathology.


Defecation delay in patients after lung tumor surgery: a prospective nested case-control study.
Defecation delay (greater than or equal to 3 days post-surgery) is a common symptom in patients after lung tumor surgery. This study investigated the incidence and relevant risk factors of defecation delay in patients after lung tumor surgery. Between October 2019 and March 2020, a prospective nested case-control study was conducted in 80 patients who received lung tumor surgery in the Department of Thoracic Surgery at the Sun Yat-sen University Cancer Center. According to the Rome III criteria for functional constipation and the accepted definitions in the literature, patients with defecation delay time greater than or equal to 3 days post-surgery were classified as the defecation delay group, and the remaining patients were considered the control group. A questionnaire survey was conducted to explore the trait of the stool, defecation time, postoperative activity, diet, and perioperative pain score. Statistical analyses were performed to compare the risk factors affecting defecation time in the two groups. Out of 80 patients, a total of 44 patients (44/80) experienced defecation delay after the operation. Univariate analysis showed that there were significant differences between the two groups in operation methods (P<0.029), postoperative stool trait (P<0.001), difficulty in defecation (P<0.01), and perioperative pain score (P=0.0178), suggesting that change of stool characteristics and pain were possible factors causing defecation delay. Multivariate analysis also revealed significant differences between the two groups in the postoperative pain score on the first day post-surgery (P=0.03). Defecation delay is a common symptom in patients after lung cancer surgery, and is related to operation method, pain score, and changes in stool characteristics. This study identified that minimally invasive surgery, postoperative pain relief treatment, and health education may play an important role in preventing delayed defecation.


Influence of median sternotomy on the psychosomatic outcome in coronary artery single-vessel bypass grafting.
New less invasive surgical techniques for the treatment of coronary artery single-vessel disease have been developed by either avoiding median sternotomy or cardiopulmonary bypass or both, however, until now no prospective randomized trial has been carried out to compare these techniques to the conventional approach with special respect to the psychosomatical effects. In a prospective randomized trial four different surgical techniques were compared. Group 1: conventional technique (median sternotomy, cardiopulmonary bypass) in ten patients (eight male, two female, age 59.6 +/- 11.0 years); Group 2: off-pump coronary artery bypass with median sternotomy in nine patients (six male, three female, age 65.7 +/- 11.1 years); Group 3: lateral minithoracotomy and cardiopulmonary bypass in eight patients (five male, three female, age 62.3 +/- 9.9 years). Group 4: off-pump procedure and lateral minithoracotomy in nine patients (eight male, one female, age 63.8 +/- 11.3 years). All patients due to coronary artery single-vessel disease. The tests used for psychosomatic situation were post-traumatic stress disorders scale, pain behavior rating scale, pain visual analog scale, and 6' walking-distance. For detection of false results due to surgical technical failures 3-month follow-up was undertaken including echocardiography and coronary angiogram. There were no deaths or major complications. Operative time was longer in lateral minithoracotomy procedures, but intensive care unit stay and hospitalization were equal in all groups. Pain visual analog scale and pain behavior rating scale showed a peak on post-operative day 4 in median sternotomy procedures. Post-traumatic stress disorder scale revealed higher values on post-operative day 4 and equalizing with lateral minithoracotomy procedures 1 month post-operatively. Six-minutes walking distance on post-operative day 4 was longer in the group with lateral minithoracotomy. Three-month follow-up revealed patency of all grafts. Even if surgery is successful in all procedures, operative time is longer in lateral minithoracotomy procedures without compromising intensive care unit stay and hospital stay. More pain with multiple post-traumatic stress disorders is related to median sternotomy, and post-operative convalescence is superior for lateral minithoracotomy procedures.


A universal strategy for visually guided landing.
Landing is a challenging aspect of flight because, to land safely, speed must be decreased to a value close to zero at touchdown. The mechanisms by which animals achieve this remain unclear. When landing on horizontal surfaces, honey bees control their speed by holding constant the rate of front-to-back image motion (optic flow) generated by the surface as they reduce altitude. As inclination increases, however, this simple pattern of optic flow becomes increasingly complex. How do honey bees control speed when landing on surfaces that have different orientations? To answer this, we analyze the trajectories of honey bees landing on a vertical surface that produces various patterns of motion. We find that landing honey bees control their speed by holding the rate of expansion of the image constant. We then test and confirm this hypothesis rigorously by analyzing landings when the apparent rate of expansion generated by the surface is manipulated artificially. This strategy ensures that speed is reduced, gradually and automatically, as the surface is approached. We then develop a mathematical model of this strategy and show that it can effectively be used to guide smooth landings on surfaces of any orientation, including horizontal surfaces. This biological strategy for guiding landings does not require knowledge about either the distance to the surface or the speed at which it is approached. The simplicity and generality of this landing strategy suggests that it is likely to be exploited by other flying animals and makes it ideal for implementation in the guidance systems of flying robots.


Host species and strain combination determine growth reduction of spruce and birch seedlings colonized by root-associated dark septate endophytes.
Interactions of Betula pendula and Picea abies with dark septate endophytes of the Phialocephala fortinii-Acephala applanata species complex (PAC) were studied. PAC are ubiquitous fungal root symbionts of many woody plant species but their ecological role is largely unknown. Sterile birch and spruce seedlings in monoculture and mixed culture were exposed to four PAC strains, added either singularly or paired in all possible combinations at 18°C and 23°C. Plant and fungal biomass was determined after 4 months. The most significant factors were strain and host combination. One of the strains significantly reduced biomass gain of spruce but not of birch. Plant biomass was negatively correlated with total endophytic fungal biomass in half of the strain - plant combinations. Endophytic PAC biomass was four times higher in spruce (≈ 40 mg g(-1) drw) than in birch (≈ 10 mg g(-1) drw). Competition between strains was strain-dependent with some strains significantly reducing colonization density of other strains, and, thus, attenuating adverse effects of 'pathogenic' strains on plant growth in some strain - plant combinations. Biomass gain of spruce but not of birch was significantly reduced at higher temperature. In conclusion, host, fungal genotype, colonization density and presence of a competing PAC strain were the main determining factors for plant growth.


Lumbar epidural anesthesia initiated in the knee-chest position.
The knee-chest position may become necessary in labor to mitigate fetal heart rate decelerations. This position may also prove advantageous for initiation of lumbar epidural anesthesia. This case report demonstrates a clinical situation in which lumbar epidural anesthesia was initiated in the knee-chest position. A description of the technique is included.


Propagation of pop ups in kirigami shells.
Kirigami-inspired metamaterials are attracting increasing interest because of their ability to achieve extremely large strains and shape changes via out-of-plane buckling. While in flat kirigami sheets, the ligaments buckle simultaneously as Euler columns, leading to a continuous phase transition; here, we demonstrate that kirigami shells can also support discontinuous phase transitions. Specifically, we show via a combination of experiments, numerical simulations, and theoretical analysis that, in cylindrical kirigami shells, the snapping-induced curvature inversion of the initially bent ligaments results in a pop-up process that first localizes near an imperfection and then, as the deformation is increased, progressively spreads through the structure. Notably, we find that the width of the transition zone as well as the stress at which propagation of the instability is triggered can be controlled by carefully selecting the geometry of the cuts and the curvature of the shell. Our study significantly expands the ability of existing kirigami metamaterials and opens avenues for the design of the next generation of responsive surfaces as demonstrated by the design of a smart skin that significantly enhances the crawling efficiency of a simple linear actuator.


[Expression of uncoupling protein 2 on macrophages and its relation to interleukin-10/interferon ratio in patients with unexplained recurrent spontaneous abortion].
To investigate the relationship between the expression of uncoupling protein 2 (UCP2) and ratio of interleukin-10/interferon-gamma (IL10/IFNgamma) in the macrophages from patients with unexplained recurrent spontaneous abortion (URSA). Twelve women undergoing selective termination of normal early pregnancy (control) and 11 having URSA were included in this study. Magnetic cell sorting (MACS) was used to isolate the macrophages in the decidua, and the expression of UCP2 was detected with flow cytometry. Cytokine (IL10 and IFNgamma) secretion by the macrophages was detected by enzyme-linked immunosorbent spot-forming (ELISPOT) cell assay. Compared to the control group, the women with URSA showed significantly decreased expression of UCP2 on decidual macrophage (136-/+25 vs 201-/+31, P<0.01), and the expression of UCP2 was positively correlated to the ratio of IL10/IFNgamma(r=0.73, P<0.01). UCP2 may play an important role in the regulation of macrophage activity and cytokine secretion to contribute to spontaneous abortion.


Dosimetric factors predicting radiation pneumonitis after CyberKnife stereotactic body radiotherapy for peripheral lung cancer.
The aims of this study were to investigate the frequency of symptomatic radiation pneumonitis (RP) after CyberKnife lung stereotactic body radiotherapy (SBRT) and to evaluate predictive factors of symptomatic RP. 56 patients with peripheral non-small-cell lung cancer were treated using the CyberKnife® VSI™ System (Accuracy Inc., Sunnyvale, CA) between May 2013 and September 2015. Total radiation doses ranged from 48 to 56 Gy, as delivered in four equal fractions. Symptomatic RP was defined as a grade of ≥2. Predictive factors for symptomatic RP were evaluated using univariate and multivariate analyses. With a median follow-up duration of 12.5 months (range, 3-27 months), symptomatic RP was observed in 6 (10.7%) of the 56 patients. In the univariate analysis, percent vital capacity (p < 0.05), maximum tumour diameter (p < 0.05), gross tumour volume (p < 0.05), planning target volume (p < 0.01), mean lung dose (p < 0.01) and a normal lung volume receiving 5-50 Gy of radiation (V5-50) (p < 0.01) were identified as significant predictive factors for symptomatic RP. In the multivariate analysis, only a V25 >3.4% (p = 0.011) was identified as a significant predictive factor of symptomatic RP. The incidence of symptomatic RP after CyberKnife SBRT was almost identical to the incidences reported in the linear accelerator-based SBRT. A significant association was observed between a V25 >3.4% and the risk of developing symptomatic RP. Advances in knowledge: This is the first report that has investigated prognostic factors for symptomatic RP after CyberKnife SBRT for lung cancer. The newly developed scoring system may help to predict symptomatic RP.


Bioanalytical assay validation parameters re-visited: perspectives on stability studies.
Bioanalytical assay validation for plethora of parameters is considered vital for the reliable and accurate generation of raw analytical data used for pharmacokinetic characterization of analytes. Although the validation parameters have been widely accepted, the intent of this communication is to provide some perspectives on the commonly followed approaches for stability studies (i.e. freeze-thaw and long-term freezer stability studies). The proposed discussion is intended to stimulate the thinking process to cut down on the extra work and/or maximize the efficiency in the bioanalytical work. Additionally, the availability of new emerging technological know-hows and latest nuances in the field should provide the necessary impetus to innovate and articulate strategies for smart assay development/validation work for analytes.


18q deletion syndrome - A case report.
We report on a 3 years old boy with severe mental retardation, hypotonia, deafness, cerebral dysmyelination, low levels of immunoglobulin A and dysmorphic features, bearing a distal deletion of 18q: 18q21-qter. Karyotype analysis by GTG banding was performed, revealing a deletion of the distal fragment of chromosome 18q, ranging from band q21 to qter, later confirmed by Fluorescence In Situ Hybridization (FISH). Whole chromosome painting for chromosome 18 ruled out any cryptic rearrangements involving other chromosomes. An attempted therapy with growth hormone did not bring any improvement and was discontinued due to an unexplained febrile episode and overall regress of the patient.


Protective effect of paraoxonase-2 against endoplasmic reticulum stress-induced apoptosis is lost upon disturbance of calcium homoeostasis.
PON2 (paraoxonase-2) is a ubiquitously expressed antioxidative protein which is largely found in the ER (endoplasmic reticulum). Addressing the cytoprotective functions of PON2, we observed that PON2 overexpression provided significant resistance to ER-stress-induced caspase 3 activation when the ER stress was induced by interference with protein modification (by tunicamycin or dithiothreitol), but not when ER stress was induced by disturbance of Ca(2+) homoeostasis (by thapsigargin or A23187). When analysing the underlying molecular events, we found an activation of the PON2 promoter in response to all tested ER-stress-inducing stimuli. However, only tunicamycin and dithiothreitol resulted in increased PON2 mRNA and protein levels. In contrast, when ER stress was caused by thapsigargin or A23187, we observed a Ca(2+)-dependent active degradation of PON2 mRNA, elicited by its 5'-untranslated region. In addition, thapsigargin and A23187 also induced PON2 protein degradation by a Ca(2+)-dependent calpain-mediated mechanism. Thus we provide evidence that independent mechanisms mediate the degradation of PON2 mRNA and protein after disturbance of Ca(2+) homoeostasis. Furthermore, because Ca(2+)-disturbance induces ER stress, but abrogates the otherwise protective function of PON2 against ER-stress-induced apoptosis, we propose that the underlying cause of ER stress determines the efficacy of putative cellular defence mechanisms.


KZn(4)SbO(7) and KZn(4)Sb(3)O(12): syntheses, structures and photophysics of Sb(5+) control materials.
Two novel compounds KZn(4)SbO(7) (1) and KZn(4)Sb(3)O(12) (2) having quasi-white light emission and second-harmonic generation are prepared, and their single-crystal structures are characterized as P6(3)mc and R3 space groups, respectively. The crystal structure transition from high symmetry P6(3)mc of 1 to low symmetry R3 of 2 arises from the large contents of Sb(5+) diluter in wurtzite-type ZnO crystals (ionic ratio of Sb(5+)/Zn(2+) = 1/4 and 3/4 for crystals 1 and 2). The lifetime and quantum efficiency of luminescence are measured, and the density of states and frequency doubling coefficients are calculated for the two compounds. The strong charge transfers from O(2-) to Sb(5+), and blue-shifts of absorption edge and emission bands originate from a large Sb(5+) ion content for compound 2. Further, large charge transfer from O(2-) to Sb(5+) lead to high quantum efficiency and low lifetime, and weak second-harmonic generation intensity for compound 2.


Quantitative autoradiography of the binding sites for [125I] iodoglyburide, a novel high-affinity ligand for ATP-sensitive potassium channels in rat brain.
We have developed a high specific activity ligand for localization of ATP-sensitive potassium channels in the brain. When brain sections were incubated with [125I]iodoglyburide (N-[2-[[[(cyclohexylamino)carbonyl]amino]sulfonyl]ethyl]-5-125I-2- methoxybenzamide), the ligand bound to a single site with a KD of 495 pM and a maximum binding site density of 176 fmol/mg of tissue. Glyburide was the most potent inhibitor of specific [125I]iodoglyburide binding to rat forebrain sections whereas iodoglyburide and glipizide were slightly less potent. The binding was also sensitive to ATP which completely inhibited binding at concentrations of 10 mM. Autoradiographic localization of [125I]iodoglyburide binding indicated a broad distribution of the ATP-sensitive potassium channel in the brain. The highest levels of binding were seen in the globus pallidus and ventral pallidum followed by the septohippocampal nucleus, anterior pituitary, the CA2 and CA3 region of the hippocampus, ventral pallidum, the molecular layer of the cerebellum and substantia nigra zona reticulata. The hilus and dorsal subiculum of the hippocampus, molecular layer of the dentate gyrus, cerebral cortex, lateral olfactory tract nucleus, olfactory tubercle and the zona incerta contained relatively high levels of binding. A lower level of binding (approximately 3- to 4-fold) was found throughout the remainder of the brain. These results indicate that the ATP-sensitive potassium channel has a broad presence in the rat brain and that a few select brain regions are enriched in this subtype of neuronal potassium channels.


Immunological mechanisms in experimental coxsackievirus B3 myocarditis in mice.
To address unresolved questions, experimental models of viral myocarditis may be of great value. In this study, immunological mechanisms of myocardial damage in coxsackievirus B3 myocarditis in mice were investigated. The results showed that susceptibility to viral infection is primarily determined by the genetic background of the host, that the severity of myocarditis depends not upon B cells but upon T cells, and that antigen-specific T cells play a pivotal role in the pathogenesis of acute coxsackievirus B3 myocarditis.


Folded and unfolded conformations of proteins involved in pancreatic cancer: a layman's guide.
Pancreatic cancer (PC) is one of the most difficult illnesses to treat, since the 5-year survival rate is lower than 5% in patients and no substantial advances in its treatment have been achieved in the last 20 years. Since cancer deregulation and progression are associated with changes in at least one biochemical pathway, the knowledge of the structure of the proteins involved in such routes seems to be crucial in order to understand how this cancer progresses and, more importantly, to design more efficient and rationally designed drugs. In this review, we describe the fold and structures of proteins involved in different signaling pathways that intervene during PC development and progression. In particular, we will focus on the most frequently mutated, or alternatively differently expressed, proteins in PC. The current knowledge suggests that most of the proteins carry out their function by interacting with others via specific domains and through key residues at the recognition interfaces; these amino acids are mutated in patients developing PC. Furthermore, phosphorylation seems to be a crucial regulation step along several signaling pathways. Finally, we show not only that well-folded proteins in several signaling pathways are critical in the development of PC, but also that natively unfolded "hub" proteins, able to interact with DNA or proteins, are also important in such cancer progression.


Clinical and acoustic measures of the negative syndrome.
We studied 12 male schizophrenia patients in a 6-week treatment trial comparing two neuroleptics and placebo. Efficacy in regard to negative symptoms was of interest, and Alphs' Negative Symptom Assessment (NSA) was included. The NSA includes behaviorally anchored ratings such as "prolonged time to response" and "restricted speech output." Audio recordings of interviews with the patients were analyzed acoustically. In general, the behavioral anchors did not prevent the ratings from being influenced by global impressions. There was a strong correlation between each item and the total of other items, but a modest correlation with the relevant behavioral measure. Results suggest that, even with specific and behaviorally anchored items, the clinician's assessment is confounded by global impressions. Treatment effects were greater for the acoustic measures than for the clinical measures.


High Manganese Tolerance and Biooxidation Ability of Serratia marcescens Isolated from Manganese Mine Water in Minas Gerais, Brazil.
Manganese is an important metal for the maintenance of several biological functions, but it can be toxic in high concentrations. One of the main forms of human exposure to metals, such as manganese (Mn), is the consumption of solar salt contaminated. Mn-tolerant bacteria could be used to decrease the concentration of this metal from contaminated sites through safer environmental-friendly alternative technology in the future. Therefore, this study was undertaken to isolate and identify Mn resistant bacteria from water samples collected from a Mn mine in the Iron Quadrangle region (Minas Gerais, Brazil). Two bacterial isolates were identified as Serratia marcescens based on morphological, biochemical, 16S rDNA gene sequencing and phylogeny analysis. Maximum resistance of the selected isolates against increasing concentrations of Mn(II), up to 1200 mg L-1 was determined in solid media. A batch assay was developed to analyze and quantify the Mn removal capacities of the isolates. Biological Mn removal capacities of over 55% were detected for both isolates. Whereas that mechanism like biosorption, precipitation and oxidation could be explaining the Mn removal, we seek to give an insight into some of the molecular mechanisms adopted by S. marcescens isolates. For this purpose, the following approaches were adopted: leucoberbelin blue I assay, Mn(II) oxidation by cell-free filtrate and electron microscopy and energy-dispersive X-ray spectroscopy analyses. Overall, these results indicate that S. marcescens promotes Mn removal in an indirect mechanism by the formation of Mn oxides precipitates around the cells, which should be further explored for potential biotechnological applications for water recycling both in hydrometallurgical and mineral processing operations.


Chemoprevention of metaplasia initiation and carcinogenic progression to esophageal adenocarcinoma by resveratrol supplementation.
Resveratrol (3,5,4'-trihydroxy-trans-stilbene), a polyphenol found in the skin of the grape and red wine, has been found to have chemopreventitive effects in some carcinogenic models. The effects of resveratrol on the initiation of Barrett's metaplasia and the carcinogenic progression to esophageal adenocarcinoma have not been evaluated. The aim of this study was to evaluate the effects of resveratrol on the transition from reflux esophagitis to Barrett's metaplasia to dysplasia to esophageal adenocarcinoma in an established rat model. Male Sprague-Dawley rats underwent esophagoduodenal anastomosis as per institutional approved protocol. They were then treated twice weekly with intraperitoneal injection of 7 mg/kg of resveratrol or saline. Additional nonoperated rats served as controls. The rats in each group were assigned to 1, 3, or 5-month subgroups. The distal esophagus was preserved for blinded histopathological examination at the time of harvest. Thirty-one animals in the 5-month resveratrol group showed a decreased severity of esophagitis (P<0.0001), incidence of intestinal metaplasia (P = 0.3567), and incidence of carcinoma (P = 0.4590) as compared with both the saline and nonoperated control groups. In conclusion, morphological characteristics consistent with decreased esophagitis and incidences of metaplasia and esophageal adenocarcinoma were seen on histopathology in the resveratrol group. Resveratrol resulted in a small diminution of the carcinogenic effects and progression to metaplasia, and further human studies are designed to explore the potential anticarcinogenic mechanism.


Immunoadsorption plasmapheresis using a phenylalanine column as an effective treatment for lupus nephritis.
Immunoadsorption plasmapheresis (IAPP) is effective for eliminating pathogenic molecules such as anti-DNA antibody (anti-DNA Ab) and immune complexes from the serum of patients with systemic autoimmune diseases. The purpose of this study was to assess patients with lupus nephritis (LN) treated by IAPP using a phenylalanine column and determine its efficacy with respect to conventional therapies. Six patients (M = 1, F = 5) with histologically proven LN associated with proteinuria and abnormal sedimentation on urinalysis were the subjects for this study. All were treated with oral corticosteroid (prednisolone 1 mg/kg/day) and IAPP (Immusorba PH - 350; 2 L of plasma twice weekly for 2 weeks). Serum anti-DNA Ab and complement, urinary protein, and creatinine clearance were measured over 6 weeks (pretreatment, before and after each of 2 IAPP sessions, and 1 and 4 weeks after the second IAPP session). Clinical efficacy of IAPP was compared with conventional pharmacotherapy regimes by conducting a retrospective review of 23 LN patients treated at our hospital using corticosteroid pulse therapy (CSPT, N = 7, intravenous methylprednisolone 500 mg/day for 3 days), intravenous cyclophosphamide pulse therapy (IVCY, N = 7), or corticosteroid monotherapy (CSMT, N = 9, oral prednisone 1 mg/kg body weight daily, for 4 weeks). Immunosuppressants and anticoagulants were not used. With IAPP, mean urinary protein excretion decreased from 2.2 +/- 1.7 g/day pretreatment to 0.4 +/- 0.6 g/day post-treatment (P < 0.001). Mean serum anti-DNA Ab also decreased from 84.0 +/- 88.1 U/mL pretreatment to 5.8 +/- 5.5 U/mL post-treatment (P < 0.05). In combination with corticosteroid therapy, IAPP would appear to be an effective and safe treatment for LN.


Melatonin reference limits at 3:00 AM and 8:00 AM in healthy adults.
We determined melatonin reference limits in blood serum of 129 healthy volunteers, aged 21 to 70 years, using enzyme-linked immunosorbent assay (IBL ELISA kit, Hamburg, Germany). At 3:00 AM, in almost full dark, the reference limits were found to be 18.3-134 pg/ml in males, 19.0-197 pg/ml in females and 18.5-180 pg/ml in the whole group. At 8:00 AM, they were statistically lower (5.63-61.8, 3.30-93.2 and 3.83-80.4 pg/ml respectively) possibly due to the light.


Rate setting and hospital cost-containment: all-payer versus partial-payer approaches.
This article explores the relative cost-containment potential of hospital rate-setting programs that differ in the extent of payer coverage. While the analysis has implications for the impact that Medicare's prospective payment system (PPS) may have on overall hospital costs, this study is based on a comparison of all-payer and partial-payer state systems in the pre-PPS era. Data on hospital costs are drawn from the 1982 and 1983 American Hospital Association's Annual Surveys of Hospitals. The data confirm that all types of mandatory rate-setting systems are effective systems of cost control. The findings suggest that all-payer approaches may have some short-run advantages in terms of reducing the growth in hospital costs but that, as of 1983, they had not attained a lower level of costs (measured on a per-admission basis) than partial-payer systems.


Uveal melanoma and familial atypical mole and melanoma (FAM-M) syndrome.
We conducted this study to determine whether occurrence of primary uveal melanoma in the setting of familial atypical mole and melanoma (F A M-M) syndrome (an autosomal dominant cutaneous preneoplastic syndrome) follows a pattern of a hereditary cancer predisposition syndrome. A retrospective review of 4600 consecutive patients with primary uveal melanoma revealed eight patients with biopsy-proven F A M-M syndrome. The clinical profile of these patients was studied and their kindreds analyzed. In patients with F A M-M syndrome, the uveal melanoma occurred at a relatively young age (mean 40 years; range 10-52 years). The diagnosis of F A M-M syndrome preceded or followed the diagnosis of uveal melanoma by as much as 10 years. None of the patients had an associated nonmelanocytic malignancy. Three of the eight patients had a positive family history of melanoma (cutaneous melanoma (2) and uveal melanoma (1). The authors conclude that the occurrence of primary uveal melanoma in the setting of F A M-M syndrome does not follow a clear pattern of a hereditary cancer predisposition syndrome.


A new type of power energy for accelerating chemical reactions: the nature of a microwave-driving force for accelerating chemical reactions.
The use of microwave (MW) irradiation to increase the rate of chemical reactions has attracted much attention recently in nearly all fields of chemistry due to substantial enhancements in reaction rates. However, the intrinsic nature of the effects of MW irradiation on chemical reactions remains unclear. Herein, the highly effective conversion of NO and decomposition of H2S via MW catalysis were investigated. The temperature was decreased by several hundred degrees centigrade. Moreover, the apparent activation energy (Ea') decreased substantially under MW irradiation. Importantly, for the first time, a model of the interactions between microwave electromagnetic waves and molecules is proposed to elucidate the intrinsic reason for the reduction in the Ea' under MW irradiation, and a formula for the quantitative estimation of the decrease in the Ea' was determined. MW irradiation energy was partially transformed to reduce the Ea', and MW irradiation is a new type of power energy for speeding up chemical reactions. The effect of MW irradiation on chemical reactions was determined. Our findings challenge both the classical view of MW irradiation as only a heating method and the controversial MW non-thermal effect and open a promising avenue for the development of novel MW catalytic reaction technology.


A Synergistically Enhanced T1 and T₂-Weighted Magnetic Resonance/Near-Infrared Contrast Agent of Gd-Doping Fe₃O₄@Fluorescence PEGylated Nanoparticles for Multimodality Imaging of Hepatocarcinoma.
In recent years, multimodal imaging nanoprobes with high resolution and high sensitivity capabilities have attracted considerable interest because they could offer complementary diagnostic information that would lead to a more precise diagnosis. Herein, the facile fabrication of Gd-doping magnetic nanoparticles conjugated with the PEGylated fluorescence probe Cy5.5 and the tumor-penetrating peptide RGERPPR (R) has been demonstrated for tri-modality targeted T1 and T₂-weighted magnetic resonance (MR) and the near-infrared (NIR) fluorescence imaging of hepatocarcinoma-bearing mice. The obtained R-GdMFs nanoparticles with a rational design are water-dispersible, have long-term stability, and have controllable magnetic delivery and excellent biocompatibility with no impact on the cell and major organ functions, as was confirmed by MTT and LDH assay, ROS measurements and H&E staining. Relaxivity measurements show a better T1 relaxivity (r1) of 16.49 mM-1 s-1 and a T₂ relaxivity (r₂) of 141.98 mM-1 s-1 by mutual enhancement, which realized enhanced T1 and T₂-weighted in vitro and in vivo MR imaging, which accumulated in the tumor region due to the mediation of the tumor-penetrating peptide. Meanwhile, the in vivo NIR fluorescence imaging results also revealed that the R-GdMFs could be significantly targeting the tumor tissue with bright NIR fluorescence imaging, which would lead to a more precise diagnosis. These findings indicated that as-synthesized R-GdMFs nanoparticles could be used as a platform for synergistically enhanced T1 and T₂-weighted MR/NIR fluorescence multimodality imaging in various biomedical systems.


[A case of elderly onset sarcoidosis].
Although sarcoidosis is generally considered a disease of young and middle aged adults, there have been a certain number of cases among elderly. However it is unknown whether sarcoidosis in the elderly is recurrence of prior disease or initial onset at old ages. We present a 77-year-old woman with sarcoidosis the onset of which was considered to be in the last 6 months prior to the initial diagnosis. The patient was admitted to our hospital for further evaluation of bilateral hilar and mediastinal lymphadenopathy (BHL) and uveitis. BHL was not present in a chest radiograph taken 6 months prior to the admission. A clinical diagnosis of sarcoidosis was made by elevated serum angiotensin converting enzyme (ACE) and lysozyme (24.9 IU/L and 18.2 micrograms/ml, respectively), negative tuberculin skin test, concomitant presence of uveitis, and a high proportion of lymphocytes (33.2%) in bronchoalveolar lavage fluid with an elevated CD4/CD8 ratio (24.5). This is a noteworthy case of sarcoidosis in which we could confirm elderly onset of the disease.


Barriers to Condom Use among High Risk Men Who Have Sex with Men in Uganda: A Qualitative Study.
Unprotected sexual intercourse is a major risk factor for HIV transmission. Men who have sex with men (MSM) face challenges in accessing HIV prevention services, including condoms. However, there is limited in-depth assessment and documentation of the barriers to condom use among MSM in sub-Saharan Africa. In this paper, we examine the barriers to condom use among MSM in Uganda. The data for this study were extracted from a larger qualitative study conducted among 85 self-identified adult (>18 years) MSM in 11 districts in Uganda between July and December 2013. Data on sexual behaviours and access and barriers to condom use were collected using semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. This paper presents an analysis of data for 33 MSM who did not use condoms at last sex, with a focus on barriers to condom use. Analysis was conducted using the content analysis approach. Six major barriers to condom use were identified: Difficulties with using condoms, access challenges, lack of knowledge and misinformation about condom use, partner and relationship related issues, financial incentives and socio-economic vulnerability, and alcohol consumption. The findings suggest that several reasons account for lack of condom use among high-risk MSM. The findings are valuable to inform interventions needed to increase condom use among MSM.


Phenotypic diversity in hypertrophic cardiomyopathy.
In recent years, the main focus of human genetic studies on hypertrophic cardiomyopathy (HCM) switched from discovering novel genes and defining disease-causing mutations to studies of mutation distribution in disease populations. Eventually these studies will define genotype-phenotype relationships, which may provide clues to understanding the disease process and help to select the most appropriate treatment strategy. Animal models engineered to recapitulate human disease provide a unique tool to investigate the pathogenic mechanisms and evaluate potential therapies. In this review, we present the spectrum of clinical HCM in the context of the genetic heterogeneity of this common human disease. Recent progress made in understanding molecular pathways that result in cardiac hypertrophy and the factors that modify these processes are discussed.


Delayed brain abscess after embolization of arterio-venous malformation: report of two cases and review of literature.
Infections of central nervous system are rare complications of endovascular procedures. Review of literature revealed only four reported cases of brain abscesses after embolization of intracranial arteriovenous malformations (AVMs). We report two new cases of delayed brain abscess after embolization of AVM. In one of the patients, it was due to an unusual organism, Burkholderia caeci.


Efficient activation of aromatic C-H bonds for addition to C-C multiple bonds
Efficient electrophilic metalation of aromatic C-H bonds leading to new C-C bond formation through regio- and stereoselective addition to alkynes and alkenes has been realized by a catalytic amount (0.02 to 5 mole percent) of palladium(II) or platinum(II) compounds in a mixed solvent containing trifluoroacetic acid at room temperature. Various arenes undergo unexpected selective trans hydroarylation to terminal or internal C&cjs0812;C bonds inter- and intramolecularly with high efficiency (up to a turnover number of 4500 for palladium), especially for electron-rich arenes, giving thermodynamically unfavorable cis-alkenes, and the oxygen- and nitrogen-containing heterocycles. The simplicity, generality, and efficiency of this process should be very attractive to the possible industrial application for the functionalization of arenes.


Update on the Use of Filters for Parenteral Nutrition: An ASPEN Position Paper.
Intravenous in-line filters play a critical role in promoting patient safety during parenteral nutrition (PN) administration. Guidelines for using filters for PN have been issued by a number of professional organizations and manufacturers of PN components. Yet despite this guidance, filter use remains controversial. Recent changes in recommendations for filtering lipid injectable emulsions have added to confusion and created considerable variation in practice. This Position Paper aims to review past guidance regarding the filtration of PN, examine the clinical consequences of infusing particulate matter, discuss the challenges and issues related to filtration, and clarify the American Society for Parenteral and Enteral Nutrition (ASPEN) recommendations for the use of filters for PN administration. This paper was approved by the ASPEN Board of Directors.


Surgical management of ptosis in chronic progressive external ophthalmoplegia.
To determine possible complications and efficacy of ptosis surgery in a series of chronic progressive external ophthalmoplegia (CPEO) patients with healthy tear film. It is a prospective interventional study on 24 eyes from 12 patients with the diagnosis of CPEO and ptosis. Pre-operatively, tear breakup test (TBUT) and Schirmer test were performed to assess lacrimal function unit. Levator resection was performed for 16 eyes with levator function (LF) more than 4 mm, while eight eyes from four patients with poorer LF underwent frontalis silicone sling surgery. Main outcome measures included change in marginal-to-reflex distance (MRD1) and incidence of post-operative exposure keratopathy. The mean age of the patients was 45 ± 15 years. The mean of TBUT and Schirmer test were 12 ± 1.98 s and 15 ± 2.76 mm, respectively. The mean follow-up period was 34 months. Four eyes encountered mild to moderate exposure keratopathy. All cases were managed medically, with no need for surgical revision. The mean pre-operative MRD1, LF, and chin-up angle were -0.54 ± 1.03 mm, 4.21 ± 1.41 mm, and 21.6 ± 6.01 degrees, respectively. The mean post-operative MRD1, LF, and chin-up angle were 2.42 ± 0.60, 4.46 ± 1.53 mm, and 3.3 ± 1.01 degrees, respectively. At 1-year follow-up visit, improvement in MRD1 and chin-up posture was statistically significant (p-value < 0.05). Normal TBUT and Schirmer test results, prophylactic lubricating therapy, and close follow-up can be as important as Bell's phenomenon and palpebral fissure height in predicting post-operative complications.


Retinal Diseases Associated with Oxidative Stress and the Effects of a Free Radical Scavenger (Edaravone).
Oxidative stress plays a pivotal role in developing and accelerating retinal diseases including age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), and retinal vein occlusion (RVO). An excess amount of reactive oxygen species (ROS) can lead to functional and morphological impairments in retinal pigment epithelium (RPE), endothelial cells, and retinal ganglion cells (RGCs). Here we demonstrate that edaravone, a free radical scavenger, decreased apoptotic cell death, oxidative damage to DNA and lipids, and angiogenesis through inhibiting JNK and p38 MAPK pathways in AMD, glaucoma, DR, and RVO animal models. These data suggest that the therapeutic strategy for targeting oxidative stress may be important for the treatment of these ocular diseases, and edaravone may be useful for treating retinal diseases associated with oxidative stress.


Diagnostic peritoneal lavage: integration with clinical information to improve diagnostic performance.
Management of abdominal trauma requires both the detection of injuries sustained and an ability to distinguish patients who require operative repair from those who do not. In this prospective study of 200 patients receiving diagnostic peritoneal lavage (DPL) following blunt trauma, relationships among DPL result, clinical features (information from initial patient assessment), and laparotomy outcome were investigated. The DPL result alone predicted requirement for laparotomy with an accuracy of 93%, a specificity of 96%, a sensitivity of 85%, a positive predictive value (PV-Positive) of 87%, and a negative predictive value (PV-Negative) of 95%. Combining clinical features with the DPL result reduced the number of unnecessary laparotomies (increased PV-Positive and specificity), but increased the number of missed necessary laparotomies (decreased PV-Negative and sensitivity). The best diagnostic performance was found by combining the DPL result with circulatory status, which, in this series of patients, predicted necessary laparotomy with an accuracy of 95%, a specificity of 99%, a sensitivity of 81%, a PV-Positive of 98%, and a PV-Negative of 94%.


Serum creatine kinase levels and renal function measures in exertional muscle damage.
Serum creatine kinase (CK) levels are commonly used to judge the severity of muscle damage and to determine when to hospitalize patients who present with symptoms of exertional rhabdomyolysis in order to prevent renal failure. However, no CK standard exists because of the limited information available regarding exercise-induced CK elevation and renal function. This study determined the magnitude of CK elevation and the effect on renal function produced by exercise in a large subject group. Blood samples were obtained from 203 volunteers who performed 50 maximal eccentric contractions of the elbow flexor muscles. The samples, taken before and 4, 7, and 10 d after exercise, were analyzed for markers of muscle damage (CK, myoglobin (Mb), lactate dehydrogenase, alanine aminotransferase, and aspartate aminotransferase and for measures of renal function (creatinine, blood urea nitrogen, phosphorus, potassium, osmolality, and uric acid). All indicators of muscle damage increased significantly after exercise (P < 0.01). CK levels were 6420, 2100, and 311% above baseline on days 4, 7, and 10 after the exercise, respectively (P < 0.01), and Mb was 1137, 170, and 28% above baseline on days 4, 7, and 10 after exercise, respectively (P < 0.01). Of the 203 participants, 111 had CK values at 4 d postexercise > 2,000 U x L(-1) and 51 had values > 10,000 U x L(-1), levels used to diagnose myopathy (e.g., statin myositis) and rhabdomyolysis, respectively. There were no significant increases in any measure of renal function. Despite marked CK and Mb elevations in some subjects, none experienced visible myoglobinuria or required treatment for impaired renal function. Exertional muscle damage produced by eccentric exercise in healthy individuals can cause profound CK and Mb elevations without renal impairment.


Genomic heterogeneity of background substitutional patterns in Drosophila melanogaster.
Mutation is the underlying force that provides the variation upon which evolutionary forces can act. It is important to understand how mutation rates vary within genomes and how the probabilities of fixation of new mutations vary as well. If substitutional processes across the genome are heterogeneous, then examining patterns of coding sequence evolution without taking these underlying variations into account may be misleading. Here we present the first rigorous test of substitution rate heterogeneity in the Drosophila melanogaster genome using almost 1500 nonfunctional fragments of the transposable element DNAREP1_DM. Not only do our analyses suggest that substitutional patterns in heterochromatic and euchromatic sequences are different, but also they provide support in favor of a recombination-associated substitutional bias toward G and C in this species. The magnitude of this bias is entirely sufficient to explain recombination-associated patterns of codon usage on the autosomes of the D. melanogaster genome. We also document a bias toward lower GC content in the pattern of small insertions and deletions (indels). In addition, the GC content of noncoding DNA in Drosophila is higher than would be predicted on the basis of the pattern of nucleotide substitutions and small indels. However, we argue that the fast turnover of noncoding sequences in Drosophila makes it difficult to assess the importance of the GC biases in nucleotide substitutions and small indels in shaping the base composition of noncoding sequences.


Superconducting multicontact rotary switch.
A compact mechanical multiposition superconducting switch, suitable for a wide variety of cryoelectronic applications, has been developed. The switch is easy to fabricate in laboratory conditions. Its design is based on principles used in normal rotary switches and offers the same ease in stacking together multiple sections.


An upper-bound metric for characterizing spectral and spatial coregistration errors in spectral imaging.
Coregistration errors in multi- and hyperspectral imaging sensors arise when the spatial sensitivity pattern differs between bands or when the spectral response varies across the field of view, potentially leading to large errors in the recorded image data. In imaging spectrometers, spectral and spatial offset errors are customarily specified as "smile" and "keystone" distortions. However these characteristics do not account for errors resulting from variations in point spread function shape or spectral bandwidth. This paper proposes improved metrics for coregistration error both in the spatial and spectral dimensions. The metrics are essentially the integrated difference between point spread functions. It is shown that these metrics correspond to an upper bound on the error in image data. The metrics enable estimation of actual data errors for a given image, and can be used as part of the merit function in optical design optimization, as well as for benchmarking of spectral image sensors.


[Association of lichen sclerosus and monomelic scleroderma].
Coexistence of lichen sclerosus and scleroderma is well demonstrated. However, clinical and histological lesions of lichen sclerosus and scleroderma, in a linear pattern, do not seem to have been reported. We report the case in a six years old boy, of both lichen sclerosus and linear scleroderma lesion that involved his left lower limb. Immunological and inflammatory investigation was normal or negative, as well as, bone and muscles analyze of the leg. Further outcome was benign. This new case confirms the possibility of an association, inside a same limb, of lichen sclerosus and localized scleroderma, and supports the concept of a common etiological process in these two diseases. In an other hand, it could reflect the possibility of two distinct clinical expressions of the same pathogenic process.


The role of exosome in autoimmune connective tissue disease.
Exosomes have generated significant interest in the last few decades owing to their important roles in a diverse range of biological pathways. They are nano-sized lipid bilayer membrane vesicles of endosomal origin, and are produced by a vast number of cell types. They are released into the extracellular environment and are found in most biological fluids. Exosomes can contain proteins, lipids and nucleic acids. The cargo of exosomes allows them to play roles in cell communication, antigen presentation, as biomarkers and in immune regulation. Substantial efforts have been made to understand their biology and potential clinical use in various diseases, including autoimmune connective tissue diseases (ACTD). In this review, we highlight the known functions of exosomes and detail recent advances made in the elucidation of the roles of exosomes in ACTDs with an emphasis on their potential use as a biomarker for disease diagnosis and as a therapeutic target. Key messages Exosome with the function of cell communication, antigen presentation, biomarkers, immune responses and immune regulation have become a hot area and have played an important role in several areas of science and technology especially in medicine. Exosomes play important roles in numerous biological processes as well as in the pathogenesis of ACTDs. Exosome comes into being the non-invasive procedure as potential biomarkers and excellent treatment means in ACTDs.