Death Related to a Congenital Vascular Anomaly of Pulmonary Hamartoma Type: Malpractice or Tragic Fatality?
In forensic pathology, apparently straightforward cases can often hide rarities that, if not correctly interpreted, can alter the results of the entire investigation, leading to misinterpretations. This occurs when the investigation is conducted to assess medical malpractice. An unexpected death, with no known apparent cause, is often linked to an underlying disease process of unclear etiological origin whose nature can, unfortunately, be properly investigated only post-mortem. This presentation shows a case study, in which it was possible to reconduct the death of a patient to a natural pathology and not to medical treatment. Here, the authors illustrate a case with a hamartoma developed in chronic inflammatory conditions (bronchiectasis) that was difficult to differentiate from lung cancer due to the inability to perform specific instrumental examinations. The hamartoma, usually benign and identifiable by standard instrumental investigations, in this case, led to the patient's death precisely during the execution of a bronchoscopy. However, in the absence of a certain cause of death, public opinion unanimously attributes a patient's disease to medical error. Indeed, a routine practice such as bronchoscopy should not cause death and consequently, the doctor must have made a mistake. Fortunately, the autopsy not only demonstrated the origin of the bleeding but also unveiled the reason for this, as rare congenital lung disease. Fate, one might say.


Monochromatic light saturation curves for photosynthesis in Chlorella.
We used a small oxygen electrode and a grating monochromator of 10 mmu half-band width to determine light-saturation curves of photosynthesis for films of Chlorella pyrenoidosa no more than 1 cell thick. All curves were referenced to the lightsaturated rate observed in 5 mw/cm(2) of 680 mmu. To a close approximation (+/- 2%) the light-saturated rate was independent of wavelength over the region in which light intensity was sufficient to make the test (450-705 mmu). At wavelengths of high absorption we obtained intensities sufficient to cause photoinhibition. As a measure of photoinhibition we used the breakpoint, the lowest intensity at which rate of photosynthesis decreased with time. In general, the saturated rate was slightly lower and the estimated breakpoint was considerably lower at wavelengths of high absorption. Maximum rate of absorption of quanta at the breakpoint was highest in the far-red (>/= 700 mmu), lower and relatively constant in the near-red (630-680 mmu), and lowest in the blue. At 435 and 450 mmu the breakpoint occurred below saturation. We attribute small deviations in maximum rate of photosynthesis to effects of photoinhibition. Independence of wavelength observed for the light-saturated rate is consistent with models of photosynthesis in which maximum rate is limited by the same dark reaction at all wavelengths.


Changes in human immunodeficiency virus type 1 virus load during mobilization and harvesting of hemopoietic progenitor cells. Adult AIDS Clinical Trials Group 285 Study Team.
Genetic modification of hemopoietic progenitor cells ex vivo, followed by the infusion of the genetically modified cells into the human immunodeficiency virus-1 (HIV-1) infected donor, has been proposed as a treatment for HIV-1 infection. The current study was undertaken to evaluate the effect of hemopoietic stem cell mobilization and harvesting on HIV-1 replication in persons with HIV-1 infection. Eighteen HIV-1-infected persons received recombinant granulocyte colony-stimulating factor (G-CSF; Filgrastim) 10 microg/kg per day, for 7 days. On days 4 and 5, peripheral blood mononuclear cells were harvested by leukapheresis. The CD4+ lymphocyte count at entry was >500/microL for 6 subjects, 200 to 500/microL for 6 subjects, and <200/microL for 6 subjects. For 9 of 18 subjects, plasma HIV-1 RNA levels increased 4- to 100-fold (>0.6 log(10)) above baseline between days 4 and 7 and returned to baseline by day 27. Significant increases of plasma HIV-1 RNA levels occurred in 5 subjects despite 3-drug antiretroviral therapy. Changes in CD4+ and CD34+ cells during mobilization and harvesting were similar in all subjects whether they had or did not have increased plasma HIV-1 RNA levels. Thus, mobilization and harvesting of bone marrow progenitor cells from persons infected with HIV-1 induced a transient increase in viral replication in some patients but was not associated with adverse effects. (Blood. 2000;95: 48-55)


Linking organizational resources and work engagement to employee performance and customer loyalty: the mediation of service climate.
This study examined the mediating role of service climate in the prediction of employee performance and customer loyalty. Contact employees (N=342) from 114 service units (58 hotel front desks and 56 restaurants) provided information about organizational resources, engagement, and service climate. Furthermore, customers (N=1,140) from these units provided information on employee performance and customer loyalty. Structural equation modeling analyses were consistent with a full mediation model in which organizational resources and work engagement predict service climate, which in turn predicts employee performance and then customer loyalty. Further analyses revealed a potential reciprocal effect between service climate and customer loyalty. Implications of the study are discussed, together with limitations and suggestions for future research.


Molecular characterization of a fish-specific toll-like receptor 22 (TLR22) gene from common carp (Cyprinus carpio L.): Evolutionary relationship and induced expression upon immune stimulants.
In the host innate immune system, various pattern recognition receptors (PRRs) recognize conserved pathogens-associated molecular patterns (PAMPs), and represent an efficient first line of defense against invading pathogens. TLR22 is one of the fish-specific Toll-like receptors (TLRs), identified in a variety of fish species. In this study, we report the cloning and identification of a TLR22 cDNA from the gills of common carp (Cyprinus carpio L.). The full-length CcTLR22 cDNA was 3301 bp long, including a 32 bp 5'-untranslated region (UTR), an open reading frame (ORF) of 2838 bp and a 432 bp 3'-UTR.The CcTLR22 protein was found to comprise a signal peptide, 16 LRR domains, a LRRCT domain in the extracellular region and a TIR domain in the cytoplasmic region, which fits with the characteristic TLR domain architecture. The genomic organization of CcTLR22 was identified, which was encoded by an uninterrupted exon. Sequence alignment and phylogenetic analysis showed that all known teleost TLR22 members were clustered into an independent clade of the TLR22 family, and showed high amino acid identities with other fish TLRs. Real-time PCR assay showed that CcTLR22 mRNA was expressed in almost all tissues examined, while the levels obviously varied among different tissues. When challenged with poly(I:C) (a viral model) or A. hydrophila bacteria, the expression level of CcTLR22 was up-regulated in a variety of common carp tissues. These results indicate that CcTLR22 plays a significant role in systemic as well as mucosal defence after viral or bacterial stimulation or infection.


Tracking Preschoolers' Lifestyle Behaviors and Testing Maternal Sociodemographics and BMI in Predicting Child Obesity Risk.
Longitudinal data investigating tracking of children's lifestyle behaviors and predictors of childhood obesity are limited. We examined changes in children's lifestyle behaviors (dietary, physical activity, and screen time) from ages 2-5 y to determine if maternal sociodemographic factors and BMI predict child obesity at 3.5 y and 5 y. Data were obtained from 667 first-time mothers who were recruited into the Healthy Beginnings Trial at 24-34 weeks of gestation in Sydney, Australia. Child lifestyle behaviors were assessed using face-to-face questionnaire interviews with mothers. To measure child and maternal anthropometry, BMI (in kg/m2) was calculated using measured height and weight. Children were categorized as overweight or obese based on the International Obesity Task Force criteria. We used 1-factor repeated-measures ANOVA to track preschoolers' lifestyle behaviors and multiple logistic regression to determine obesity predictors. In children aged 2-5 y, consumption of vegetables (ηp2 = 0.06; P < 0.005) and milk (ηp2 = 0.02; P < 0.001) decreased, whereas physical activity (ηp2 = 0.07; P < 0.001) increased. Discretionary foods (sweet snacks, fast foods, salty snacks, processed meats, confectionary) (ηp2 = 0.03-0.25; P ≤ 0.01) and screen time (ηp2 = 0.39; P < 0.001) increased. Maternal BMI (in kg/m2) (Exp β: 1.06; 95% CI:1.01, 1.12 ; P=0.02), marital status (married/de facto compared with single) (Exp β: 0.06; 95% CI:0.01, 0.26; P < 0.001), and child BMI at 2 y (Exp β: 1.82; 95% CI: 1.46, 2.27; P < 0.001) predicted overweight/obesity at 3.5 y. Child BMI at 3.5 y (Exp β: 3.51; 95% CI: 2.50, 4.93; P < 0.001) predicted obesity at 5 y. Poor dietary and lifestyle behaviours track in early childhood, with maternal single-parent status and high maternal and child BMI at 2 y predicting earlier obesity onset.


Crystal structure of cyanovirin-N, a potent HIV-inactivating protein, shows unexpected domain swapping.
The crystal structure of cyanovirin-N (CV-N), a protein with potent antiviral activity, was solved at 1.5 A resolution by molecular replacement using as the search model the solution structure previously determined by NMR. The crystals belong to the space group P3221 with one monomer of CV-N in each asymmetric unit. The primary structure of CV-N contains 101 residues organized in two domains, A (residues 1 to 50) and B (residues 51 to 101), with a high degree of internal sequence and structural similarity. We found that under the conditions of the crystallographic experiments (low pH and 26 % isopropanol), two symmetrically related monomers form a dimer by domain swapping, such that domain A of one monomer interacts with domain B' of its crystallographic symmetry mate and vice versa. Because the two swapped domains are distant from each other, domain swapping does not result in additional intramolecular interactions. Even though one of the protein sample solutions that was used for crystallization clearly contained 100 % monomeric CV-N molecules, as judged by various methods, we were only able to obtain crystals containing domain-swapped dimers. With the exception of the unexpected phenomenon of domain swapping, the crystal structure of CV-N is very similar to the NMR structure, with a root-mean-square deviation of 0.55 A for the main-chain atoms, the best agreement reported to date for structures solved using both techniques.


[Creation of artificial hybrid operons with partially overlapping genes to achieve an expression of heterologous genes in Escherichia coli cells].
A new method of optimization of foreign gene expression in E. coli, based on the construction of hybrid operons with partially overlapping genes is described. The partial overlapping of the translation termination and initiation sites in the formed operon must provide translational coupling of appropriate gene product synthesis. Such an approach has provided the synthesis of human interferon alpha F in E. coli cells under the control of the lacUV5-promotor up to about (3-4).10(7) units per liter of bacterial culture. The reinitiation of the distal gene translation is shown to take place in the intercistronic region. Substitution of the lacUV5 promotor by the more efficient tac one allowed to increase the synthesis level of interferon alpha F to (1-2).10(8) units per liter. The conclusion is made about the equimolarity of distal and proximal to the promotor genes products syntheses when the intercistronic region of E. coli trpE-trpD genes are used for translational coupling.


Validation of a three-dimensional model of the knee.
Three-dimensional mathematical models of the tibio-femoral joint require input of the geometry of articulating surfaces and ligament insertions, and the mechanical properties of cartilage and ligaments. This paper describes a validation of a knee model through a direct specimen-related comparison between the knee model and the kinematics of four knee joint specimens from which the geometry data were used as input of the model. The knee model is quasi-static and is based on equilibrium of forces and moments. The stiffness properties of the ligaments and articular cartilage were estimated on the basis of data reported in the literature. The so-called reference strains in the ligament bundles for the joint in extension, were determined by using an optimization procedure, minimizing the difference between the kinematics of the model and the kinematics of experimentally obtained flexion motions with an internally or an externally rotated tibia (+/- 3 Nm load). A reasonable to good agreement between the model and the experimental kinematics could be obtained for internal-external rotation laxity and the coupled translations and varus-valgus rotation. The disparity between model and experiment varied from knee to knee, average deviations ranging from close to zero to 8 degrees internal rotation deviation and from 5 mm posterior to 3 mm anterior position deviation. The average anterior-posterior laxities at both 20 degrees and 90 degrees flexion were within the variations reported in the literature, although for each individual joint with some underestimation or overestimation. It was concluded that the optimization procedure compensated for the lack of menisci and capsular structures by higher prestrains, thereby overestimating the ligament forces. Despite the gross simplifications relative to the complex anatomy of the knee, the present knee model can realistically simulate the passive motion characteristics of the human knee joint.


Effect of Different Polishing Systems on the Surface Roughness and Gloss of Novel Nanohybrid Resin Composites.
To evaluate the surface roughness and gloss of three nanohybrid resin composites after polishing with three different polishing systems. A total number of 112 disc specimens (10 × 3 mm) were prepared from nanohybrid-Empress Direct (ID), Grandio (GR), Filtek Z350 (Z350) and a microhybrid resin composite restorative materials-Filtek Z250 (Z250). Following 24-hour storage in 37°C distilled water, each composite group (n = 28) was assigned into four groups (n = 7) according to finishing/polishing (F/P) system: Mylar strip, Optrapol, Politip, and Sof-Lex (SL). The surface roughness (Ra, mm) was measured by a novel three-dimensional method using an image analysis software attached to an environmental scanning electron microscope. A glossometer was used to measure the surface gloss. Statistical analysis used was ANOVA test. Two-way Anova test revealed that the "type of composite" and "F/P techniques" had a significant effect on both surface roughness and gloss of the tested resin composite materials (p < 0.05). Tukey's post hoc test showed that ID, GR, and Z350 revealed lower surface roughness and higher surface gloss than Z250 within the same polishing system (p < 0.05). Sof-Lex polishing discs produced the lowest surface roughness and highest surface gloss values compared with Optrapol and Politip (p < 0.05). The tested F/P systems provided comparable surface roughness and gloss for nanohybrid composites. The Sof-Lex system provided the best surface roughness and gloss for nanohybrid composites.


Klotho induces insulin resistance possibly through interference with GLUT4 translocation and activation of Akt, GSK3β, and PFKfβ3 in 3T3-L1 adipocyte cells.
Klotho is considered as an anti-aging factor inducing insulin resistance and involved in type 2 diabetes. However, mechanisms by which klotho induces insulin resistance remain to be understood. Thus, in this study, we aimed to evaluate possible interference points of klotho with insulin signaling pathways in 3T3-L1 adipocyte cells by focusing on phosphorylation levels of Akt, GSK3β, PFK-fβ3, and GLUT4 translocation. Differentiation of 3T3-L1 cells to the adipocyte-like cells were performed using specific differentiation kit and confirmed by mRNA expression assay of PPARγ using qRT-PCR, and Sudan black staining of lipid droplets. Then cells were co-treated with klotho and insulin. Expression and translocation of GLUT4 mRNA were evaluated using qRT-PCR and Alexa flour 488 conjugated GLUT4 antibody, respectively. P-Akt/Akt, p-GSK3β/GSK3β, and p-PFKfβ3/PFKfβ3 ratios were determined in insulin and klotho/insulin treated cells using western blot. Our result indicated that GLUT4 expression were decreased to 0.72 ± 0.16 fold in insulin treated cells, however it was calculated 1.12 ± 0.25 fold in klotho/insulin treated cells. In addition, klotho prevented GLUT4 membrane translocation by 27.2% in comparison with insulin-treated cells (P < 0.05). Interestingly, in insulin/klotho co-treated cells, phospho-levels of Akt, GSK3β, and PFKfβ3 proteins was decreased to 2.34 ± 0.14, 2.29 ± 0.63, and 1.95 ± 0.37 fold in comparison with the insulin cells, (P < 0.05). In conclusion, our study indicated that klotho induces insulin resistance in adipocytes possibly through prevention of GLUT4 translocation, and interfere with phosphorylation of Akt, GSK3β, and PFKf3β intracellular signaling mediators by insulin.


Effect of water reservoirs types on the prevalence and antibiotic resistance profiles of Pseudomonas aeruginosa isolated from bathroom water in hospitals.
This study was aimed to isolate and characterize Pseudomonas aeruginosa antibiotic resistance profiles that isolated from bathroom water of five hospitals in Bandung, Indonesia, with different types of water reservoirs. Total of 25 water samples from bathrooms of five hospitals were collected and analyzed for the existence of P. aeruginosa colonies on the surface of MacConkey agar media using a streak plate method and identified using phenotypic identification and a series of biochemical tests. All P. aeruginosa isolates were tested against ceftazidime, piperacillin/tazobactam, ciprofloxacin, meropenem, and gentamicin containing in paper disc, using the agar diffusion method. Of all samples, the total number of P. aeruginosa isolates was less than that of non-P. aeruginosa. In hospitals that use permanent bathtubs, a greater total bacterial count was obtained than those using pails. From 110 isolates, 14.54% were multidrug resistance antibiotics. The majority of the resistant isolates were from hospital B with permanent bathtubs. Of 25 isolates from that hospital, P. aeruginosa isolates were resistant to ceftazidime (20%), piperacillin/tazobactam (4%), ciprofloxacin (20%), and gentamicin (20%). The multiple antibiotic resistance index value of P. aeruginosa isolates was 0.4-0.6. Thus, it can be concluded that the bathroom wáter in the hospital with permanent bathtubs were potential reservoirs of antibiotic-resistant P. aeruginosa.


Evaluation of Aerobic Exercise Intensity in Patients with Coronary Artery Disease and Type 2 Diabetes Mellitus.
(1) Background: Physical activity is recommended in patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD) to reduce hyperglycemia and cardiovascular risk. Effective aerobic exercise intensity, however, is not well defined. (2) Methods: 60 consecutive patients performed cardiopulmonary exercise testing (CPX) of 30 min duration targeting a respiratory exchange ratio (RER) between 0.85 and 0.95, being strictly aerobic. Plasma glucose (PG) was measured before and after CPX as well as one and two h after exercise. Maximum exercise intensity was evaluated using a standard bicycle exercise test. (3) Results: 50 patients completed the protocol (62 ± 10 years, BMI (body mass index) 30.5 ± 4.9 kg/m2, HbA1c (glycated haemoglobin) 6.9 ± 0.8%, left ventricular ejection fraction 55 ± 8%). Aerobic exercise capacity averaged at 32 ± 21 Watt (range 4-76 Watt) representing 29.8% of the maximum exercise intensity reached. PG before and after CPX was 9.3 ± 2.2 and 7.6 ± 1.7 mmol/L, respectively (p < 0.0001). PG was further decreased significantly at one and two h after exercise to 7.5 ± 1.6 mmol/L and 6.0 ± 1.0 mmol/L, respectively (p < 0.0001 for both as compared to PG before CPX). (4) Conclusions: Aerobic exercise capacity is very low in patients with CAD and T2DM. Exercise at aerobic intensity allowed for significant reduction of plasma glucose. Individual and effective aerobic exercise prescription is possible by CPX.


A Meta-Analysis of the Outcomes of Ligament Reconstruction Compared to No Reconstruction with or without Tendon Interposition Following Trapeziectomy for Thumb Carpometacarpal Joint Osteoarthritis.
Background: The outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) compared to the trapeziectomy (T) alone or in combination with tendon interposition (TIA) in the treatment of osteoarthritis (OA) of the carpometacarpal joint (CMCJ) of the thumb are still debated. The aim of this study is to conduct a meta-analysis to determine whether the outcomes of LRTI were better compared to T or TIA. Methods: A meta-analysis of randomised trials that included the outcomes of patients with thumb CMCJ OA that underwent LRTI, T or TIA with at least 1 year follow-up. The outcomes included number of patients with pain 1 year after surgery (NPP), Visual Analog Scale for Pain (VAS Pain), key pinch strength, patient reported outcome measurements (PROMs) and number of adverse effect (AEs). The effect was assessed using mean difference for quantitative variables (VAS pain and key pinch), standardised mean difference for PROMs and relative risk for binary variables (NPP and AEs). Results: Seven studies met the inclusion criteria (857 participants: 438 LRTI vs 419 T/TIA). We did not find significant differences between LRTI and T/TIA in NPP, VAS pain, key pinch at 1 year and 5 years or more, PROMs, and AEs at 1 year and at 5 years or more after surgery. Conclusions: The outcomes of LRTI are not superior to T or TIA in the treatment of OA of the thumb CMCJ. Level of Evidence: Level I (Therapeutic).


Validation of the Actical Accelerometer in Multiethnic Preschoolers: The Children's Healthy Living (CHL) Program.
This study aimed to determine the validity and reliability of the Actical accelerometer for measuring physical activity (PA) in preschool children of mixed ethnicity, compared with direct observation via a modified System for Observing Fitness Instruction Time (SOFIT) protocol and proxy parental reports (PA Logs). Fifty children in Hawai'i wore wrist-mounted accelerometers for two 7-day periods with a washout period between each week. Thirty children were concurrently observed using SOFIT. Parents completed PA Logs for three days. Reliability and validity were measured by intra-class correlation coefficient and proportions of agreement concurrently. There was slight agreement (proportion of agreement: 82%; weighted Kappa=.17, P <.001) between the accelerometer and SOFIT as well as between the accelerometer and the PA Logs (proportions of agreement: 40%; weighted Kappa=0.15, P <.001). PA logs underestimated the PA levels of the children, while the Actical was found to be valid and reliable for estimating PA levels of multiethnic, mixed ethnicity preschoolers. These findings suggest that accelerometers can be objective, valid, and accurate physical activity assessment tools compared to conventional PA logs and subjective reports of activity for preschool children of mixed ethnicity.


A New Family of Transcriptional Regulators Activating Biosynthetic Gene Clusters for Secondary Metabolites.
We previously identified the aur1 biosynthetic gene cluster (BGC) in Streptomyceslavendulae subsp. lavendulae CCM 3239 (formerly Streptomycesaureofaciens CCM 3239), which is responsible for the production of the unusual angucycline-like antibiotic auricin. Auricin is produced in a narrow interval of the growth phase after entering the stationary phase, after which it is degraded due to its instability at the high pH values reached after the production phase. The complex regulation of auricin BGC is responsible for this specific production by several regulators, including the key activator Aur1P, which belongs to the family of atypical response regulators. The aur1P gene forms an operon with the downstream aur1O gene, which encodes an unknown protein without any conserved domain. Homologous aur1O genes have been found in several BGCs, which are mainly responsible for the production of angucycline antibiotics. Deletion of the aur1O gene led to a dramatic reduction in auricin production. Transcription from the previously characterized Aur1P-dependent biosynthetic aur1Ap promoter was similarly reduced in the S. lavendulaeaur1O mutant strain. The aur1O-specific coactivation of the aur1Ap promoter was demonstrated in a heterologous system using a luciferase reporter gene. In addition, the interaction between Aur1O and Aur1P has been demonstrated by a bacterial two-hybrid system. These results suggest that Aur1O is a specific coactivator of this key auricin-specific positive regulator Aur1P. Bioinformatics analysis of Aur1O and its homologues in other BGCs revealed that they represent a new family of transcriptional coactivators involved in the regulation of secondary metabolite biosynthesis. However, they are divided into two distinct sequence-specific subclasses, each of which is likely to interact with a different family of positive regulators.


Contralateral eye-to-eye comparison of wavefront-guided and wavefront-optimized photorefractive keratectomy: a randomized clinical trial.
Wavefront-guided (WFG) and wavefront-optimized (WFO) platforms for refractive surgery are designed for improved visual outcomes. It is unclear which treatment profile is superior for patients undergoing photorefractive keratectomy (PRK). To compare the safety, efficacy, predictability, stability, and higher-order aberrations in eyes undergoing WFG and WFO PRK. A prospective, randomized, fellow-eye-controlled clinical trial was conducted at the Byers Eye Institute at Stanford with enrollment between April 2009 and March 2011; 1 year of follow-up was included. Of 90 patients screened, 71 patients (142 eyes) with less than 12.00 diopters (D) of spherical myopia and less than 3.00 D of astigmatism were enrolled consecutively. One eye was randomized to undergo WFG PRK treatment (Visx CustomVue Star S4 IR excimer laser system; Abbott Medical Optics), and the fellow eye received WFO PRK treatment (WaveLight Allegretto Wave Eye-Q 400 Hz excimer laser system; Alcon Surgical). Data on the manifest refraction, uncorrected visual acuity, best-corrected visual acuity, 5% and 25% contrast best-corrected visual acuity, and higher-order aberrations were collected preoperatively and at the 1-, 3-, 6-, and 12-month follow-up visits. Eyes undergoing both treatments had improved best-corrected visual acuity (WFG: mean, 0.05 [95% CI, 0.03-0.07]; WFO: mean, 0.04 [95% CI, 0.02-0.06]) and less sphere (WFG: mean, -4.79 [95% CI, -5.31 to -4.26]; WFO: mean, -4.61 [95% CI, -5.18 to -4.03]), cylinder (WFG: mean, 0.66 [95% CI, 0.49-0.82]; WFO: mean, 0.52 [95% CI, 0.35-0.69]), and spherical equivalents (WFG: mean, -4.45 [95% CI, -4.99 to -3.91]; WFO: mean, -4.34 [95% CI, -4.92 to -3.76]) (P < .001) but higher levels of spherical aberration (WFG: mean, -0.11 [95% CI, -0.15 to -0.06]; WFO: mean, -0.11 [95% CI, -0.14 to -0.07]) (P < .001) and higher-order root-mean-square aberrations (WFO: mean, -0.07 [95% CI, -0.12 to -0.02]; WFO: mean, -0.12 [95% CI, -0.17 to -0.70]) (P = .005 in WFG eyes and P < .001 in WFO eyes) at 12 months compared with preoperative measurements. A total of 93.0% of the eyes in the WFG group and 94.4% in the WFO had an uncorrected visual acuity of 20/20 or better at 12 months, with 56.3% in the WFG group and 43.7% in the WFO group gaining 1 or more lines of best-corrected visual acuity. The stability of the refractive correction was excellent for both groups. A difference in uncorrected visual acuity or contrast acuity between eyes undergoing WFG or WFO treatment at 3 months and beyond could not be identified. This lack of difference suggests that both systems can be used to provide excellent improvement in vision for persons with myopia. clinicaltrials.gov Identifier: NCT01135719.


Oxidation of biphenyl by a multicomponent enzyme system from Pseudomonas sp. strain LB400.
Pseudomonas sp. strain LB400 grows on biphenyl as the sole carbon and energy source. This organism also cooxidizes several chlorinated biphenyl congeners. Biphenyl dioxygenase activity in cell extract required addition of NAD(P)H as an electron donor for the conversion of biphenyl to cis-2,3-dihydroxy-2,3-dihydrobiphenyl. Incorporation of both atoms of molecular oxygen into the substrate was shown with 18O2. The nonlinear relationship between enzyme activity and protein concentration suggested that the enzyme is composed of multiple protein components. Ion-exchange chromatography of the cell extract gave three protein fractions that were required together to restore enzymatic activity. Similarities with other multicomponent aromatic hydrocarbon dioxygenases indicated that biphenyl dioxygenase may consist of a flavoprotein and iron-sulfur proteins that constitute a short electron transport chain involved in catalyzing the incorporation of both atoms of molecular oxygen into the aromatic ring.


Convergent evidence for a role of WIR1 proteins during the interaction of barley with the powdery mildew fungus Blumeria graminis.
Pathogen attack triggers a multifaceted defence response in plants that includes the accumulation of pathogenesis-related proteins and their corresponding transcripts. One of these transcripts encodes for WIR1, a small glycine- and proline-rich protein of unknown function that appears to be specific to grass species. Here we describe members of the HvWIR1 multigene family of barley with respect to phylogenetic relationship, transcript regulation, co-localization with quantitative trait loci for resistance to the barley powdery mildew fungus Blumeria graminis (DC.) E.O. Speer f.sp. hordei, the association of single nucleotide polymorphisms or gene haplotypes with resistance, as well as phenotypic effects of gene silencing by RNAi. HvWIR1 is encoded by a multigene family of moderate complexity that splits up into two major clades, one of those being also represented by previously described cDNA sequences from wheat. All analysed WIR1 transcripts accumulated in response to powdery mildew attack in leaves and all mapped WIR1 genes were associated with quantitative trait loci for resistance to B. graminis. Moreover, single nucleotide polymorphisms or haplotypes of WIR1 members were associated with quantitative resistance of barley to B. graminis, and transient WIR1 gene silencing affected the interaction of epidermal cells with the pathogen. The presented data provide convergent evidence for a role of the HvWIR1a gene and possibly other family members, during the interaction of barley with B. graminis.


Shewanella algae - A Novel Organism Causing Bacteremia: A Rare Case and Literature Review.
Shewanella species are distributed ubiquitously in the soil and water, being common in the marine habitat. Although these bacilli were thought to be rarely pathogenic, there has been an increasing number of reports of them being implicated in a wide variety of clinically significant infections. Three distinct species were initially recognized by MacDonell and Colwell. They were Shewanella putrefaciens, hanedai and benthica. Shewanella algae, which is the most common human clinical isolate, was believed to be a strain of Shewanella putrefaciens by some authors, and was later grouped as a separate and distinct entity. With multi-drug resistance on the rise and the lack of large-scale systemic studies, we describe a case of bacteremia caused by this rare organism. We hope to increase the awareness among care providers on the same.


The diagnostic and prognostic value of tissue Doppler imaging during dobutamine stress echocardiography in end-stage renal disease.
To determine whether a quantitative measurement of peak systolic velocity (PSV) during dobutamine stress echocardiography (DSE) detects severe coronary artery disease (CAD) and predicts mortality in patients with end-stage renal disease. One hundred and forty renal transplant candidates had DSE and coronary angiography. DSE analysis was performed using conventional visual wall motion assessment, longitudinal PSV, and combining the two modalities. Failure of PSV to rise by more than 50% predicted an ischemic response. Significant CAD was defined as luminal stenosis greater than 70%. The number of positive DSE studies according to conventional, PSV, and combined criteria was 41 (30%), 42 (31%), and 46 (34%) respectively. Forty patients (29%) had significant CAD at angiography. The sensitivity, specificity, positive and negative predictive values for conventional DSE analysis were 84, 91, 86, and 90% respectively. The same values for PSV analysis were 86, 92, 86, and 91%, respectively. The same values for the combination of visual and PSV analysis were 88, 94, 87, and 92% respectively. The differences between the three methods were not statistically significant. Sensitivity for single-vessel CAD (P=0.05) and circumflex artery disease (P=0.05) diagnosis was higher with PSV compared with conventional DSE analysis. Failure of PSV to rise by more than 50% during DSE was associated with significantly increased mortality (P=0.001). A quantitative interpretation of DSE, based on the percentage rise of PSV during stress, accurately detects CAD and predicts prognosis in end-stage renal disease.


Enhanced photoluminescence from poly(phenylene vinylene):dendrimer polyelectrolyte assemblies in solution.
Poly(2,5-methoxy-propyloxy sulfonate phenylene vinylene)(MPS-PPV) and DAB-Am-16, a generation 3.0 polypropylenimine hexadecamine dendrimer (DAB), are shown to form a tunable photoresponsive polyelectrolyte assembly in aqueous solution with an enhanced emission signal of up to 18-times that of MPS-PPV alone.


Exposure of the brachiocephalic vessels.
Although the possible combinations of reconstructive procedures used for brachiocephalic arterial lesions are innumerable, all can be performed using four or five basic incisions, singly or in combination, separately or joined by extension. For a number of reasons, not the least of which is that endarterectomy requires more favorable, discrete lesions, bypasses are much more commonly performed than endarterectomy. Direct reconstructions using bypass grafts emanating from the aorta obtain superb patencies but, in the older arteriosclerotic patient with multiple risk factors, cervical bypasses hold the advantage of lower morbidity and mortality. The more common of the cervical or extra-anatomic reconstructions such as carotidsubclavian bypass or transposition themselves have excellent patency.


Mucocutaneous and systemic toxicity of retinoids: monitoring and management.
Oral retinoid therapy is associated with significant mucocutaneous and systemic toxicity similar to that found in hypervitaminosis A. Beside the well-known mucocutaneous adverse effects like cheilitis, xerosis, desquamation, dryness of mucous membranes, more troublesome findings are ocular effects, hair loss or hypergranulation tissue. The most unwanted systemic side effects under both retinoids (isotretinoin and etretinate) are teratogenicity, bone toxicity and serum lipid increments. Careful patient counselling and monitoring will enable the physician to modulate these effects and reduce their impact on patient compliance.


INCIDENCE OF APNEA ATTACK AS ALLERGIC REACTION AFTER ORAL FOOD CHALLENGE IN PATIENT WITH IgE-MEDIATED WHEAT ALLERGY.
Anaphylaxis is a severe allergic reaction that is rapid in onset and might cause death. Although wheezes, dyspnea or loss of consciousness are known to occur with severe allergic reactions with IgE-mediated food allergy, reports of apnea attack associated with IgE-mediated food allergy are rare. In this case, 9-year-old boy with IgE-mediated wheat allergy experienced apnea attack with strong desaturation after an immediate allergic reaction including erythema, abdominal pain, vomiting, and anaphylactic shock. The patient had asphyxia and cyanosis confirmed by medical staff when his oxygen saturation decreased to the 60% level, and he had occasional asphyxia over 10 seconds with no thoracic motion after a desaturation episode. Central apnea attack might be occurred in patient with IgE-mediated food allergy. However, the exact mechanism responsible remains unknown and further research is needed.


Interleukin-1beta and fibroblast growth factor receptor 1 cooperate to induce cyclooxygenase-2 during early mammary tumourigenesis.
Inflammation within the tumour microenvironment correlates with increased invasiveness and poor prognosis in many types of cancer, including breast cancer. We have previously demonstrated that activation of a mouse mammary tumour virus (MMTV)-driven inducible fibroblast growth factor receptor 1 (iFGFR1) transgene in mammary epithelial cells results in an inflammatory response characterised by induction of inflammatory genes in the mammary gland. Specifically, we have observed increased levels of IL-1beta expression in the mammary gland following activation of iFGFR1 and have used the iFGFR1 model to elucidate the function of IL-1beta in promoting iFGFR1-induced mammary lesions. To determine the functional consequences of IL-1beta induction during FGFR1-induced mammary tumourigenesis, the effects of IL-1beta inhibition on the formation of epithelial hyperplasias were examined using the MMTV-iFGFR1 transgenic mouse model. Further studies used a combination of the HC-11 mammary epithelial cell line that stably expresses iFGFR1 and the MMTV-iFGFR1 transgenic mice to further define the mechanisms of IL-1beta function. Inhibition of IL-1beta activity in vivo resulted in reduced iFGFR1-induced epithelial proliferation and formation of hyperplastic structures. Further studies demonstrated that treatment of mammary epithelial cells with IL-1beta-induced expression of cyclooxygenase (Cox)-2 both in vitro and in vivo. Finally, inhibition of Cox-2 prior to activation of iFGFR1 in the transgenic mice also resulted in decreased iFGFR1-induced formation of hyperplastic structures. The results from these studies indicate that targeting the inflammatory cytokine IL-1beta partially inhibits iFGFR1-induced formation of early-stage mammary lesions, in part through induction of Cox-2. These findings demonstrate that activation of a growth factor receptor in mammary epithelial cells results in increased expression of inflammatory mediators, which cooperate to promote the initiation of hyperplastic lesions in the mammary gland.


Theoretical and experimental investigations of BiOCl for electrochemical adsorption of cesium ions.
BiOCl was found to have excellent electrochemical adsorption properties for cesium ions (Cs+) in electrochemically switched ion exchange (ESIX). In this work, BiOCl nanosheets were synthesized by a hydrothermal method and used for electrochemical adsorption of Cs+. The experimental results showed that BiOCl exhibited higher electrochemical adsorption selectivity for Cs+ than Li+ and Na+. Quantum chemical calculations based on density functional theory (DFT) were first performed to compare the adsorption and migration mechanisms of three ions Li+, Na+, and Cs+ in BiOCl crystals. The calculation results revealed that the excellent electrochemical adsorption performance of BiOCl for Cs+ is due to the interaction of embedded Cs with Cl and Bi in BiOCl crystals. This makes it have a higher adsorption energy and a lower ion migration energy barrier due to the balance of interaction forces. In this work experimental and theoretical calculations were used to systematically analyze the adsorption and migration of three ions in BiOCl, which has important guiding significance for the design of highly-efficient electroactive materials for electrochemical adsorption of Cs+.


Characterization of the PAC1 variants expressed in the mouse heart.
Pituitary adenylate cyclase-activating polypeptide (PACAP), a pleiotropic neuropeptide, exerts a variety of physiological functions through three types of G protein-coupled receptors, PAC1, VPAC1, and VAPC2. Characterization of the molecular forms of PAC1 in mouse heart revealed the presence of four types of variant receptors harboring the N or S variant in the first extracellular domain (EC1 domain) with or without the HOP1 insert in the third intracellular cytoplasmic loop (IC3 loop). Then, we assessed the binding affinity and ability to stimulate adenylyl cyclase of the PCA1 variant-expressing cells for PACAP. Adenylyl cyclase activation by PACAP was markedly influenced with the variant in the EC1 domain as well as that in the IC3 loop, in spite of a little difference in their binding properties. These data suggest that the combination of EC1 domain variants and IC3 loop variants might account for the diversity of intracellular signaling, which might contribute to multiple functions of PACAP including a role in the cardiovascular system.


Effects of sildenafil on nocturnal penile tumescence and rigidity in normal men: randomized, placebo-controlled, crossover study.
We studied the effects of sildenafil on sleep-related erections in 44 adult healthy men not affected by erectile dysfunction (mean age +/- SD: 39.3 +/- 10.5 years). No subjects were administered any medication the first night, but all were randomly administered sildenafil 50 mg or placebo the second night and vice versa the third night. Sildenafil and placebo were administered 1 hour before bedtime. The following parameters of sleep-related erections, after taking sildenafil or placebo, were analyzed: total number of valid erections, total duration of rigidity more than or equal to 70% of a tightening force of 2.8 N applied by the recording device, total duration of increase in penile circumference more than or equal to 30 mm, maximum rigidity, mean of maximum rigidity, and maximum increase of tumescence. Apart from the maximum increase of tumescence, all the parameters analyzed were significantly higher after sildenafil than after placebo administration during the first 4 hours of monitoring in all subjects (n = 44) (study 1). All the parameters were significantly higher after sildenafil than after placebo administration during the whole 8 hours of monitoring in 25 of 44 subjects (study 2A) who slept at least 8 hours. Comparing both the first and the second 4 hours in the 25 of 44 subjects who slept at least 8 hours (study 2B), all the parameters were significantly higher after sildenafil than after placebo administration, apart from maximum rigidity and mean of maximum rigidity during the first 4 hours. Our data suggest that sildenafil, administered at bedtime, is efficacious in improving sleep-related erections in normal men, indirectly confirming that the nitric oxide pathway is crucial in the physiology of erections during sleep. The effect of sildenafil is prolonged up to 8-9 hours after its administration.


The change of therapy in esophagus carcinoma between 1975-1996.
196 patients were assigned to an operation because of esophagus carcinoma between 20.05.1975 and 30.09.1996. Whereas until 1984 the surgical treatment was predominantly characterized by the uni-cavity operation, we increasingly practice the bi-cavity operation since them. By this procedure the resection rate could be extended up to 70.1%. As to be expected, most of the carcinomas were positioned in the medium third of the esophagus, the predominant tumor type was the squamos cell carcinoma, 85% of the patients had a stage three tumor. The mortality rate was 19.1% within the period of 6 weeks after the operation.


(-)-Epigallocatechin-3-gallate induces Du145 prostate cancer cell death via downregulation of inhibitor of DNA binding 2, a dominant negative helix-loop-helix protein.
(-)-Epigallocatechin-3-gallate (EGCG) is one of the major polyphenol components in green tea. It effectively induces apoptosis in prostate cancer cells. The anticancer effect of this reagent is appealing because it is a natural component of a popular daily beverage that has proven harmless for thousands of years, making it a good candidate chemopreventive agent. EGCG suppresses cell growth and causes cell death, but the mechanisms are not well characterized, especially in androgen-independent prostate cancer cells. In the present study, using Affymetrix genechip Hu133 2.0, we analyzed the gene expression patterns of the androgen-independent prostate cancer cell line Du145, treated with or without EGCG, and found 40 genes whose expression levels were altered (>twofold, either upregulated or downregulated, P < 0.01) upon treatment with EGCG. These gene products are involved in the functions of transcription, RNA processing, protein folding, phosphorylation, protein degradation, cell motility, and ion transport. Among them, inhibitor of DNA binding 2 (ID2), known as a dominant anti-retinoblastoma (Rb) helix-loop-helix protein, was found to be downregulated fourfold by EGCG treatment. Forced expression of ID2 in Du145 cells reduced apoptosis and increased cell survival in the presence of EGCG, and knockdown ID2 expression in Du145 cells using a morpholino oligonucleotide specific for ID2 mimicked the apoptosis effect generated by EGCG treatment, although it was milder. To our knowledge, this is the first report indicating that ID2 is one of the critical factors in the signaling pathway of Du145 cell death induced by EGCG.


Predictive value of the videofluoroscopic swallowing study for long-term mortality in patients with subacute stroke.
To investigate the usefulness of the videofluoroscopic swallowing study (VFSS) for subacute stroke in predicting long-term all-cause mortality, including not only simple parameters obtained from VFSS results, but also recommended dietary type as an integrated parameter.This was a retrospective study of patients with subacute (<1 month) stroke at a university hospital between February 2014 and September 2019. The independent risk factors were investigated using stepwise Cox regression analysis, which increased the all-cause mortality of patients with stroke among VFSS parameters.A total of 242 patients with subacute stroke were enrolled. The significant mortality-associated factors were age, history of cancer, recommended dietary type (modified dysphagia diet; adjusted hazard ratio [HR], 6.971; P = .014; tube diet, adjusted HR: 10.169; P = .019), and Modified Barthel Index. In the subgroup survival analysis of the modified dysphagia diet group (n = 173), the parameters for fluid penetration (adjusted HR: 1.911; 95% confidence interval, 1.086-3.363; P = .025) and fluid aspiration (adjusted HR: 2.236; 95% confidence interval, 1.274-3.927; P = .005) were significantly associated with mortality.The recommended dietary type determined after VFSS in subacute stroke was a significant risk factor for all-cause mortality as an integrated parameter for dysphagia. Among the VFSS parameters, fluid penetration and aspiration were important risk factors for all-cause mortality in patients with moderate dysphagia after stroke. Therefore, it is important to classify the degree of dysphagia by performing the VFSS test in the subacute period of stroke and to determine the appropriate diet and rehabilitation intervention for mortality-related prognosis.


[Experimental results of using the "open lung concept"].
Several elements of the "open lung concept", like ventilation with small tidal volumes, were incorporated into various ventilatory strategies. Our study demonstrates how the whole concept can be applied in an animal model using a standardized protocol with the following possible results. Eighteen pigs weighing between 30 and 45 kg were anaesthetized, tracheotomized and ventilated. Acute lung injury was induced by surfactant washout. Blood gases were monitored via a continuous arterial sensor system (Trendcare system). After washout, the ventilatory pattern of the American "ARDS Network study" was applied (PEEP = 9 cmH2O, volume controlled mode with a tidal volume of 6 ml/kg body weight and a respiratory rate of 25 breaths per minute). Afterwards, the opening pressure and the pressure at which the lung collapses were titrated. Both levels were used as the basis for adjusting the recruitment pressure and PEEP, which was necessary to keep the lung open. The respiratory rate was chosen in such a way that at a low intrapulmonary pressure difference between inspiration and expiration as well as normocapnia was reached. After induction of an acute lung injury by surfactant washout, the oxygenation index (OI) dropped from 556 +/- 54 to 176 +/- 89 mmHg. In the "ARDS Network" mode, OI increased to 285 +/- 49 mmHg. After alveolar recruitment with a peak pressure of 53 +/- 7 cmH2O and application of a median PEEP of 17 +/- 3 cmH2O, oxygenation returned close to baseline. A pCO2 of 33 +/- 4 mmHg resulted after using a respiratory rate of 39 breaths per minute. The median tidal volume was 8 ml/kg body weight. Despite a short arterial systolic blood pressure drop of 23 +/- 11 mmHg during recruitment, no significant difference was detectable afterwards compared to the baseline. Using low tidal volumes alone, complete reopening was not achieved in an experimentally induced acute lung injury. After recruitment manoeuvres, it was possible to reopen the lung and keep it open by application of a sufficient PEEP.


Erythroleukemia differentiation. Distinctive responses of the erythroid-specific and the nonspecific delta-aminolevulinate synthase mRNA.
We have examined the levels of delta-aminolevulinate synthase (ALAS) mRNAs encoding the erythroid-specific (ALAS-E) and the nonspecific (ALAS-N) ALAS isozymes in murine Friend virus-transformed erythroleukemia (MEL) cells. Both ALAS-E and ALAS-N mRNAs were detected in a clone of dimethyl sulfoxide (Me2SO)-sensitive MEL cells, termed DS-19, without cross-hybridization. Untreated DS-19 cells contained approximately 10-fold more ALAS-E mRNA than ALAS-N mRNA. When DS-19 cells were treated with Me2SO or hemin, ALAS-N mRNA declined rapidly, which was followed by a marked increase in ALAS-E mRNA. Similarly, the immunoquantifiable ALAS-N protein decreased, while the ALAS-E protein increased upon Me2SO treatment. A clone of Me2SO-resistant cells, termed DR-1, which fails to undergo erythroid differentiation, was found to lack ALAS-E mRNA, whereas it showed significant induction responses of mRNAs for other heme pathway enzymes by Me2SO treatment. DR-1 cells contained a similar level of an erythroid-specific transcription factor, GATA-1, as did DS-19 cells, and had neither major deletion nor rearrangement of the ALAS-E gene. These findings indicate that the genes encoding the two ALAS isozymes are under separate controls and suggest that ALAS-E mRNA accumulation is responsible for increased heme synthesis in MEL cells undergoing erythroid differentiation.


Transient vocal cord paralysis after fine-needle aspiration biopsy of thyroid tumor.
Complications of thyroid fine-needle aspiration biopsy (FNAB) are exceedingly rare. Hematoma formation is the most commonly encountered complication. Infection and seeding of carcinoma cells in the needle track has also been reported in a rare case. Here we describe patients diagnosed as having transient vocal cord paralysis after FNAB of benign thyroid tumor. Retrospective review of patients with concurrent diagnosis of vocal cord paralysis after FNAB. Among 10,974 patients who underwent FNAB, 4 patients showed vocal cord paralysis on laryngoscopy. These patients had solid and/or cystic lesion in the thyroid. Routine FNAB of the nodule was performed using a 23-gauge needle. Cytologic findings were benign tumor. Change of voice in the patients occurred 1 or 2 days after FNAB and vocal cord paralysis ipsilateral to FNAB was determined by flexible laryngoscopy. Vocal cord paralysis of all patients resolved spontaneously within 6 months (average, 4 months). Although the incidence of vocal cord paralysis in patients with thyroid tumor after FNAB is reported to be 0.036%, the true incidence is unknown because asymptomatic subjects are not screened. This report should alert the examiner to the possibility of vocal cord palsy after FNAB.


Long-term results of entry closure and aneurysmal wall plication with axillofemoral bypass: a new procedure for repair of DeBakey type 3 dissecting aneurysm.
To prevent aneurysm rupture, avoid pseudoaneurysm formation, and preserve intercostal arteries, a new procedure for repair of DeBakey type 3 dissecting aneurysm was developed. Since January 1977, 28 patients have undergone repair of type 3 dissecting aneurysm. Fifteen patients with type 3b underwent this new procedure (group 1) and 13 patients with type 3a dissecting aneurysm underwent segmental graft replacement (group 2). In group 1 a permanent axillofemoral bypass was placed on the right side. Next the intrathoracic false lumen was opened longitudinally, the entry was closed, and the aneurysmal wall was sutured around the true lumen as tightly as possible. The operative mortality rate was 20% in group 1 and 31% in group 2. One of 15 patients in group 1 died of operation-related causes, whereas three patients in group 2 died. There were six late deaths: three in group 1 and three in group 2. Paraplegia occurred in neither group 1 nor group 2. The mean diameter of the plicated descending aorta was 24.0 +/- 2.7 mm 3 months after surgery. No recurrence was detected in group 1. These results suggested that this new surgical technique for repair of type 3 dissection reduces the incidence of paraplegia and pseudoaneurysm formation.


Clinical relevance of TAp73 and ΔNp73 protein expression in ovarian cancer: a series of 83 cases and review of the literature.
The p73 gene gives rise to the full-length transactivation competent TAp73 and the N-terminally truncated isoform ΔNp73, which inhibits TAp73 and wild-type p53. The clinical relevance of TAp73 and ΔNp73 protein expression has not yet been evaluated in ovarian cancer. TAp73 and ΔNp73 expression was examined using immunohistochemistry and reverse transcription-polymerase chain reaction in 83 and 64 ovarian cancer specimens, respectively. A yeast-based assay and subsequent sequencing were performed to analyze the p53 mutational status. TAp73 and ΔNp73 protein expression was found in 73 of 83 (88%) and 48 of 83 (57.8%) ovarian cancer samples, respectively. The majority of cases showed immunostaining in both the nucleus and cytoplasm of tumor cells. TAp73 and ΔNp73 protein expression correlated with messenger RNA quantification in 25 of 64 (39.1%) and 37 of 64 (57.8%) cancer specimens, respectively. TAp73 and ΔNp73 protein expression was not associated with the p53 mutational status, clinicopathologic parameters, and prognosis of the examined ovarian cancer cases. Although TAp73 and ΔNp73 protein expression did not possess prognostic significance for ovarian cancer in this study, a potential clinical role of p73 isoforms cannot be definitively excluded due to limitations of immunohistochemistry.


Influence of hydration level and body fluids on exercise performance in the heat.
During exercise in the heat, sweat output often exceeds water intake, resulting in hypohydration, which is defined as a body fluid deficit. This fluid deficit is comprised of water loss from both the intracellular and extracellular fluid compartments. Hypohydration during exercise causes a greater heat storage and reduces endurance in comparison with euhydration levels. The greater heat storage is attributed to a decreased sweating rate (evaporative heat loss) as well as a decreased cutaneous blood flow (dry heat loss). These response decrements have been attributed to both plasma hyperosmolality and a plasma hypovolemia. Subject gender, acclimation state, and aerobic fitness do not alter the increased heat storage when hypohydrated. Hyperhydration, or body fluid excess, does not seem to provide a clear advantage during exercise-heat stress, but will delay the development of hypohydration.


Immunophenotyping of the cluster of differentiation 74, migration inhibitory factor, and cluster of differentiation 44 expression on human breast cancer-derived cell lines.
Cluster of differentiation (CD) 74, CD44, and macrophage migration inhibitory factor (MIF) are well known for their immunological functions; however, it has been shown that recently, CD74, CD44, and MIF have a role in tumor and tumor progression. This study was undertaken to investigate the expression of CD74, MIF, and CD44 in breast cancer cells. The expression of CD74, MIF, and CD44 molecules on the breast cancer-derived cell lines CAMA-1, 3,4-methylenedioxyamphetamine (MDA)-MB-231, and MDA-MB-43 was determined by flow cytometry, western immunoblotting, and confocal microscope. To validate the study the studying expression of CD74, MIF, and CD44 on the normal breast cell line 266LDM, whole cell lysate obtained from adult normal breast tissue and normal breast tissue. The results show that all breast cancer cells overexpress CD74 isoforms, MIF, and CD44, in contrast to the normal cell lines and normal breast tissues, which express only CD44 and MIF in low levels. The expression of CD74, MIF, and CD44 was studied in the immortalized normal breast luminal cell line 226LDM, normal breast tissues, and lysate to validate the study. The data show, in this study, the evidence that breast cancer cell lines expressing three different isoforms of CD74. The results of the present study indicate a crucial role of CD74 in breast cancer cells along with MIF and CD44. The results also suggest that CAMA-1, MDA-MB-231, and MDA-MB-435 cells are poorly immunogenic, expressing low levels of HLA-A, B, and C and HLA-DR.


The MED12-MED13 module of Mediator regulates the timing of embryo patterning in Arabidopsis.
The Arabidopsis embryo becomes patterned into central and peripheral domains during the first few days after fertilization. A screen for mutants that affect this process identified two genes, GRAND CENTRAL (GCT)and CENTER CITY (CCT). Mutations in GCT and CCT delay the specification of central and peripheral identity and the globular-to-heart transition, but have little or no effect on the initial growth rate of the embryo. Mutant embryos eventually recover and undergo relatively normal patterning, albeit at an inappropriate size. GCT and CCT were identified as the Arabidopsis orthologs of MED13 and MED12 - evolutionarily conserved proteins that act in association with the Mediator complex to negatively regulate transcription. The predicted function of these proteins combined with the effect of gct and cct on embryo development suggests that MED13 and MED12 regulate pattern formation during Arabidopsis embryogenesis by transiently repressing a transcriptional program that interferes with this process. Their mutant phenotype reveals the existence of a previously unknown temporal regulatory mechanism in plant embryogenesis.


Faunal change, environmental variability and late Pliocene hominin evolution.
Global change during the late Pliocene was manifested in declining temperatures, increased amplitude of climate cycles, and shifts in the periodicity of orbital climate forcing. Linking these changes to the evolution of African continental faunas and to hominin evolution requires well-documented fossil evidence that can be examined through substantial periods of time. The Omo sequence of southern Ethiopia provides such a database, and we use it to analyze change in the abundances of mammal taxa at different levels of temporal and taxonomic resolution between 4 and 2 Ma. This study provides new evidence for shifts through time in the ecological dominance of suids, cercopithecids, and bovids, and for a trend from more forested to more open woodland habitats. Superimposed on these long-term trends are two episodes of faunal change, one involving a marked shift in the abundances of different taxa at about 2.8+/-0.1 Ma, and the second the transition at 2.5 Ma from a 200-ka interval of faunal stability to marked variability over intervals of about 100 ka. The first appearance of Homo, the earliest artefacts, and the extinction of non-robust Australopithecus in the Omo sequence coincide in time with the beginning of this period of high variability. We conclude that climate change caused significant shifts in vegetation in the Omo paleo-ecosystem and is a plausible explanation for the gradual ecological change from forest to open woodland between 3.4 and 2.0 Ma, the faunal shift at 2.8 +/-0.1 Ma, and the change in the tempo of faunal variability of 2.5 Ma. Climate forcing in the late Pliocene is more clearly indicated by population shifts within the Omo mammal community than by marked turnover at the species level.


Antigen-binding characteristics of circulating IgG autoantibodies to cytokeratin 18 protein in patients with nonallergic asthma.
Cytokeratin 18 (CK18) protein was identified as an airway epithelial cell autoantigen associated with nonallergic asthma. Cleavage of CK18 protein by caspase-3 is a marker of early apoptosis in epithelial cells. It has been shown that the expression of active caspase-3 was increased in bronchial epithelial cells of asthmatic patients, when compared with healthy controls. To investigate the antigen-binding characteristics of IgG autoantibodies to CK18 protein in nonallergic asthma, the bindings of IgG autoantibodies to the fragments of CK18 protein cleaved by caspase-3 were analyzed by Western blot using serum samples from three patients with nonallergic asthma. Recombinant human CK18 protein was treated by caspase-3 and cleaved into N-terminal fragment (1-397 amino acids) and C-terminal fragment (398-430 amino acids). The binding capacity of IgG autoantibodies to N-terminal fragment of CK18 was maintained in one patient and reduced in other two patients. IgG autoantibodies from all three patients did not bind to C-terminal fragment of CK 18. In conclusion, IgG autoantibodies to CK18 protein from patients with nonallergic asthma seems to preferentially bind to the whole molecule of CK18 protein and their antigen-binding characteristics were heterogeneous among the patients with nonallergic asthma.


A team approach to the management of intractable leg ulcers.
The management of intractable leg ulcers requires a team approach which includes vascular surgeons and plastic surgeons. We retrospectively reviewed the results of the management of intractable leg ulcers by plastic surgeons. A total of 73 patients with intractable leg ulcers, (79 limbs) were treated at the Department of Plastic Surgery at our institution. Skin perfusion pressure (SPP) around the ulcer on the limb was measured before and after arterial reconstructive procedures. Local ulcer management involved intra-wound continuous negative pressure and irrigation therapy or negative pressure wound therapy. We examined the rates of wound healing and associated prognostic factors. There were 21 limbs without ischemia (non-peripheral arterial disease [Non-PAD] group) and 58 limbs with ischemia (PAD group). The healing rates were 66% in the PAD group and 81% in the Non-PAD group, but the difference between the groups was not significant. A total of 41 limbs in the PAD group underwent revascularization, which involved bypass surgery in 18 limbs and endovascular therapy in 23 limbs. The salvage rate of the revascularized limbs was 83% at 1 year. The primary patency rates at 1 year were 87% for bypass surgery and 58% for endovascular therapy. The healing rate of the revascularized limbs was 66%, and the presence of concomitant hemodialysis, infected ulcers, and limbs without improved SPP were shown to be poor prognostic factors. Limbs treated with bypass surgery had a better healing rate than limbs treated with endovascular therapy, but the difference was not significant. Good ulcer-healing rates were achieved by effective revascularization and aggressive local management. These results suggest that a team approach is useful for the management of intractable leg ulcers. (English translation of Jpn J Vasc Surg 2011; 20: 913-920).


Linking biosensor responses to Cd, Cu and Zn partitioning in soils.
Soils bind heavy metals according to fundamental physico-chemical parameters. Bioassays, using bacterial biosensors, were performed in pore waters extracted from 19 contrasting soils individually amended with Cd, Cu and Zn concentrations related to the EU Sewage Sludge Directive. The biosensors were responsive to pore waters extracted from Zn amended soils but less so to those of Cu and showed no toxicity to pore water Cd at these environmentally relevant amended concentrations. Across the range of soils, the solid-solution heavy metal partitioning coefficient (K(d)) decreased (p<0.01) with increasing amendments of Cu and Zn; Cu exhibited the highest K(d) values. Gompertz functions of Cu and Zn, K(d) values against luminescence explained the relationship between heavy metals and biosensors. Consequently, biosensors provide a link between biologically defined hazard assessments of metals and standard soil-metal physico-chemical parameters for determining critical metal loadings in soils.


Genome-wide characterization of lncRNAs in acute myeloid leukemia.
Long noncoding RNAs (lncRNAs) are a large family of noncoding RNAs that play a critical role in various normal bioprocesses as well as tumorigenesis. However, the expression patterns and biological functions of lncRNAs in acute leukemia have not been well studied. Here, we performed transcriptome-wide lncRNA expression profiling of acute myeloid leukemia (AML) patient samples, along with non-leukemia control hematopoietic samples. We found that lncRNAs were differentially expressed in AML samples relative to control samples. Notably, we identified that lncRNAs upregulated in AML (relative to the control samples) are associated with a lower degree of DNA methylation and a higher ratio of being bound by transcription factors such as SP1, STAT4, ATF-2 and ELK-1 compared with those downregulated in AML. Moreover, an enrichment of H3K4me3 and a depletion of H3K27me3 were observed in upregulated lncRNAs in AML. Expression patterns of three types of lncRNAs (antisense, enhancer and intergenic lncRNAs) have previously been characterized. Of the identified lncRNAs, we found that high expression level lncRNA LOC285758 is associated with the poor prognosis in AML patients. Furthermore, we found that LOC285758 regulates proliferation of AML cell lines by enhancing the expression of HDAC2, a key factor in carcinogenesis. Collectively, our study depicts a landscape of important lncRNAs in AML and provides novel potential therapeutic targets and prognostic markers for AML treatment.


Application of the community periodontal index of treatment needs (CPITN) in a group of 45-54-year-old German factory workers.
The purpose of the present study was to assess the periodontal status of 45-54-year-old patients and to evaluate their treatment needs. Probing depths, bleeding on probing and retentional elements (calculus and overhanging restorations) were determined according to the community periodontal index of treatment needs (CPITN). Additionally, loss of attachment was measured. Results indicated that none of the subjects had a completely healthy periodontium; only 14.7% presented with single sextants which were healthy or needed only improved oral hygiene. Slightly less than half (46.1%) of the subjects were classified as treatment need (TN) category 2 and the remainder (53.9%) as TN3. Of the subjects classed as TN category 3, 14% had the requisite code 4 in one sextant, 18.2% in 2 sextants, 21.7% in half or more of the sextants and 4.2% in all sextants. With a mean of 5.55 sextants per patient, 0.2 sextants per person were scored as code 0 or 1, 1.33 sextants as code 2, 2.79 sextants as code 3 and 1.24 sextants as code 4. The mean loss of attachment was 3.8 mm. Anterior teeth showed less loss of attachment than posterior teeth and buccal and lingual surfaces showed less loss of attachment than mesial and distal surfaces. The data indicate that although this group of 45-54-year-old subjects had high CPITN scores in total TN categories, the codes for complex Treatment Needs (TN3) were recorded only in localized areas.


Keratinocyte apoptosis induced by ultraviolet B radiation and CD95 ligation -- differential protection through epidermal growth factor receptor activation and Bcl-x(L) expression.
Previous work has shown that activation of the epidermal growth factor receptor by endogenous or exogenous signals markedly enhances survival of cultured keratinocytes upon cellular stress such as passaging. This is due, in part, to epidermal-growth-factor-receptor-dependent expression of Bcl-x(L), an antiapoptotic Bcl-2 homolog. In this study we tested whether epidermal-growth-factor-receptor-dependent signal transduction and attendant Bcl-x(L) expression affected survival of human keratinocytes upon exposure to a frequently encountered apoptotic stimulus, radiation with ultraviolet B. We describe that blocking epidermal-growth-factor-receptor-dependent signal transduction sensitized normal keratinocytes to undergo apoptosis upon ultraviolet B radiation with solar light characteristics. Forced expression of Bcl-x(L) partially but significantly inhibited ultraviolet-B-induced apoptosis of immortalized keratinocytes (HaCaT). Bcl-x(L) overexpression afforded no protection to HaCaT cells against apoptosis induced by binding of an agonist antibody to the death receptor CD95, however. CD95 activation has previously been shown to functionally contribute to apoptosis in ultraviolet-irradiated keratinocytes. These results indicate that epidermal growth factor receptor activation and attendant Bcl-x(L) expression provided a physiologically relevant protective pathway of keratinocytes against ultraviolet-induced but not CD95-dependent apoptosis.


Impact of estrogen replacement therapy in a male with congenital aromatase deficiency caused by a novel mutation in the CYP19 gene.
Recent reports of the impact of estrogen receptor alpha and aromatase deficiency have shed new light on the importance of estrogen for bone formation in man. We describe a novel mutation of the CYP19 gene in a 27-yr-old homozygous male of consanguinous parents. A C to A substitution in intron V, at position -3 of the splicing acceptor site before exon VI of the CYP19 gene, is the likely cause of loss of aromatase activity. The mRNA of the patient leads to a frameshift and a premature stop codon 8 nucleotides downstream the end of exon V. Both parents were shown to be heterozygous for the same mutation. Apart from genua valga, kyphoscoliosis, and pectus carniatus, the physical examination was normal including secondary male characteristics with normal testicular size. To substitute for the deficiency, the patient was treated with 50 micro g transdermal estradiol twice weekly for 3 months, followed by 25 micro g twice weekly. After 6 months estrogen levels (<20 at baseline and 45 pg/ml at 6 months; normal range, 10-50) and estrone levels (17 and 34 ng/ml; normal range, 30-85) had normalized. Bone maturation progressed and the initially unfused carpal and phalangeal epiphyses began to close within 3 months and were almost completely closed after 6 months. The bone age, assessed by roentgenographic standards for bone development by Gruelich and Pyle, was 16.5 at baseline and 18-18.5 yr after 6 months of treatment. Bone density of the distal radius (left), assessed by quantitative computed tomography, increased from 52 to 83 mg/cm(3) (normal range, 120-160) and bone mineral density of the lumbar spine, assessed by dual-energy x-ray-absorptiometry, increased from 0.971 to 1.043 g/cm(2) (normal range, >1.150). Osteocalcin as a bone formation parameter increased from 13 to 52 micro g/l (normal range, 24-70) and aminoterminal collagen type I telopeptide as a bone resorption parameter increased from 62.9 to 92.4 nmol/mmol creatinine (normal range, 5-54). Semen analysis revealed oligoazoospermia (17.4 million/ml; normal >20) at baseline. After 3 months of treatment, the sperm count increased (23.1 million/ml) and decreased rapidly (1.1 million/ml) during the following 3 months. The sperm motility was reduced at baseline and decreased further during treatment. Area under the curve of insulin, C-peptide, and blood glucose levels during oral glucose tolerance test decreased after 6 months (insulin: 277 vs. 139 micro U/ml.h; C-peptide 52 vs. 15 ng/m.h; area under the curve glucose: 17316 vs. 12780 mg/d.min). Triglycerides (268 vs. 261 mmol/liter) and total cholesterol levels (176 vs. 198 mmol/liter) did not change significantly, but the low-density lipoprotein/high-density lipoprotein ratio decreased from 5.37 to 3.56 and lipoprotein (a) increased from 19.9 to 60.0 mg/dl (normal range, <30). In this rare incidence of estrogen deficiency, estrogen replacement demonstrated its importance for bone mineralization and maturation and glucose metabolism in a male carrying a novel mutation in the CYP19 gene.


Simple detection of a yeast mitochondrial DNA-binding protein, Abf2p, on SDS-DNA gels.
Abf2p, a mitochondrial DNA-binding protein of yeast Saccharomyces cerevisiae, was selectively detected among mitochondrial nucleoid proteins by SDS-DNA polyacrylamide gel electrophoresis (SDS-DNA PAGE) followed by ethidium bromide staining. This method is simple and specific for the detection of Abf2p, and it may be used to identify an Abf2p-like protein that is present in mitochondrial nucleoids from other yeasts.


Pharmacogenomics DNA Biomarkers in Colorectal Cancer: Current Update.
Colorectal cancer (CRC) remains as one of the most common cause of worldwide cancer morbidity and mortality. Improvements in surgical modalities and adjuvant chemotherapy have increased the cure rates in early stage disease, but a significant portion of the patients will develop recurrence or advanced disease. The efficacy of chemotherapy of recurrence and advanced CRC has improved significantly over the last decade. Previously, the historical drug 5-fluorouracil was used as single chemotherapeutic agent. Now with the addition of other drugs such as capecitabine, irinotecan, oxaliplatin, bevacizumab, cetuximab, panitumumab, vemurafenib, and dabrafenib, the median survival of patients with advanced CRC has significantly improved from less than a year to the current standard of almost 2 years. However, the side effects of systemic therapy such as toxicity may cause fatal complications and have a major consequences on the patients' quality of life. Hence, there is an urgent need for key biomarkers which will enable the selection of optimal drug singly or in combination for an individual patient. The application of personalized therapy based on DNA testing could aid the clinicians in providing the most effective chemotherapy agents and dose modifications for each patient. Yet, some of the current findings are controversial and the evidences are conflicting. This review aims at summarizing the current state of knowledge about germline pharmacogenomics DNA variants that are currently used to guide therapeutic decisions and variants that have the potential to be clinically useful in the future. In addition, current updates on germline variants conferring treatment sensitivity, drug resistance to existing chemotherapy agents and variants affecting prognosis and survival will also be emphasized. Different alteration in the same gene might confer resistance or enhanced sensitivity; and while most of other published reviews generally stated only the gene name and codon location, we will specifically discuss the exact variants to offer more accurate information in this mini review.


Ability of the heparan sulfate proteoglycan syndecan-1 to participate in bacterial translocation across the intestinal epithelial barrier.
Although hundreds of microbial species reside in the human intestinal tract, comparatively few (e.g., Escherichia coli and other enterobacteria, Enterococcus faecalis, etc.) are typically associated with systemic infection in postsurgical, shock, and trauma patients. Syndecan-1 is the predominant cell surface heparan sulfate proteoglycan expressed on epithelia, and there is substantial evidence that heparan sulfate participates in interactions of a variety of frankly pathogenic microbes with mammalian cells. To investigate the role of syndecan-1 in interactions of enteric flora with intestinal epithelium, bacteria that might use the enterocyte as a portal of entry for systemic infection (including E. faecalis, E. coli, and other enterobacteria, and several species of staphylococci and streptococci) were studied for their abilities to interact with syndecan-1. Streptococcus bovis, S. agalactiae, S. pyogenes, Staphylococcus aureus, and S. epidermidis showed increased adherence to ARH-77 cells transfected to express syndecan-1. Heparin, a heparan sulfate analog, inhibited internalization of S. bovis, S. agalactiae, S. pyogenes, and S. aureus by HT-29 enterocytes (prominent syndecan-1 expression), but not Caco-2 enterocytes (relatively low syndecan-1 expression). Data from experiments with Chinese hamster ovary cells with altered glycosaminoglycan expression indicated that heparan sulfate and chondroitin sulfate (glycosaminoglycans on the syndecan-1 ectodomain) participated in bacterial interactions with mammalian cells. Thus, although E. faecalis, E. coli, and other gram-negative enterobacteria did not appear to interact with syndecan-1, this heparan sulfate proteoglycan may mediate enterocyte interactions with some staphylococci and streptococci that are known to cause systemic infections in specific populations of high-risk, immunosuppressed, postsurgical, and trauma patients.


A simple screening procedure for glucose phosphate isomerase, phosphofructokinase, aldolase and glyceraldehyde-3-phosphate dehydrogenase deficiencies.
A simple screening procedure for the detection of glucose-phosphate isomerase (GPI), phosphofructokinase (PFK), aldolase (AL) and glyceraldehyde-3-phosphate dehydrogenase (GAPD) deficiencies in blood, is described. These enzymes catalyze the second, third, fourth, and sixth reactions in the Embden-Meyerhof pathway. The procedure is based on the conversion of glucose-6-phosphate to 1,3-diphosphoglycerate (1,3-DPG) which is catalyzed by the sequential action of the GPI, PFK, AL and GAPD. The presence of the enzyme activities is visually estimated by the reduction of NAD+ (non-fluorescent) to NADH (fluorescent) which occurs when 1,3-DPG is formed. Absence of fluorescence indicates the deficiency of anyone of the four enzymes, which are specified by using separately the PFK, AL and GAPD respective substrates.


[Bilateral retinal arteritis with multiple aneurysmal dilatations].
Bilateral retinal arteritis with multiple aneurysmal dilatations was described for the first time by Kincaid and Schatz in 1983. We have reported a typical case of this disease which occurred in a 49-year-old woman: retinal abnormalities were followed up during two years by repeated fluorescein angiographies. The etiology of the disease and its connexions with periarteritis nodosa are discussed. While the patient was given steroid therapy per os during 16 months, new segmental inflammation of retinal arteries were observed. Inflammation affecting retinal arteries would result in weakening of the arterial wall and aneurysmal outpouchings.


Copper-based conductive composites with tailored thermal expansion.
We have devised a moderate temperature hot-pressing route for preparing metal-matrix composites which possess tunable thermal expansion coefficients in combination with high electrical and thermal conductivities. The composites are based on incorporating ZrW2O8, a material with a negative coefficient of thermal expansion (CTE), within a continuous copper matrix. The ZrW2O8 enables us to tune the CTE in a predictable manner, while the copper phase is responsible for the electrical and thermal conductivity properties. An important consideration in the processing of these materials is to avoid the decomposition of the ZrW2O8 phase. This is accomplished by using relatively mild hot-pressing conditions of 500 °C for 1 h at 40 MPa. To ensure that these conditions enable sintering of the copper, we developed a synthesis route for the preparation of Cu nanoparticles (NPs) based on the reduction of a common copper salt in aqueous solution in the presence of a size control agent. Upon hot pressing these nanoparticles at 500 °C, we are able to achieve 92-93% of the theoretical density of copper. The resulting materials exhibit a CTE which can be tuned between the value of pure copper (16.5 ppm/°C) and less than 1 ppm/°C. Thus, by adjusting the relative amount of the two components, the properties of the composite can be designed so that a material with high electrical conductivity and a CTE that matches the relatively low CTE values of semiconductor or thermoelectric materials can be achieved. This unique combination of electrical and thermal properties enables these Cu-based metal-matrix composites to be used as electrical contacts to a variety of semiconductor and thermoelectric devices which offer stable operation under thermal cycling conditions.


A p.D116G mutation in CREB1 leads to novel multiple malformation syndrome resembling CrebA knockout mouse.
We evaluated an autopsy case with severe neonatal respiratory distress, hypoplasia of thymus, thyroid gland and cerebellum, and agenesis of the corpus callosum displaying striking phenotypic similarity to the CrebA knockout mouse. On the assumption that comparable genetic alterations must be present, we checked the whole genomic DNA sequence of cyclic adenosine monophosphate (cAMP) response element binding protein 1 (CREB1), the human counterpart of mouse CrebA, and found a missense c.347A>G mutation corresponding to p.D116G within the kinase-inducible domain (KID) of CREB1. When transcribed in vitro, while Ser-133 phosphorylation of KID was maintained upon forskolin treatment, mutated CREB1 protein failed to associate with the KIX domain of co-activator CREBBP/EP300, and thereby, interrupted cAMP-dependent protein kinase A signal transduction as the dominant-negative form. This is the first report of a sporadic CREB1-related multiple malformation syndrome that, in light of accumulated knowledge of phenotypic features in gene-targeted animals, clearly emphasizes the importance of cross-species translational research.


Inhibitory dendrite dynamics as a general feature of the adult cortical microcircuit.
The mammalian neocortex is functionally subdivided into architectonically distinct regions that process various types of information based on their source of afferent input. Yet, the modularity of neocortical organization in terms of cell type and intrinsic circuitry allows afferent drive to continuously reassign cortical map space. New aspects of cortical map plasticity include dynamic turnover of dendritic spines on pyramidal neurons and remodeling of interneuron dendritic arbors. While spine remodeling occurs in multiple cortical regions, it is not yet known whether interneuron dendrite remodeling is common across primary sensory and higher-level cortices. It is also unknown whether, like pyramidal dendrites, inhibitory dendrites respect functional domain boundaries. Given the importance of the inhibitory circuitry to adult cortical plasticity and the reorganization of cortical maps, we sought to address these questions by using two-photon microscopy to monitor interneuron dendritic arbors of thy1-GFP-S transgenic mice expressing GFP in neurons sparsely distributed across the superficial layers of the neocortex. We find that interneuron dendritic branch tip remodeling is a general feature of the adult cortical microcircuit, and that remodeling rates are similar across primary sensory regions of different modalities, but may differ in magnitude between primary sensory versus higher cortical areas. We also show that branch tip remodeling occurs in bursts and respects functional domain boundaries.


Fiber-optic particle size monitor based on white-light scattering.
A new fiber-optic particle size monitor for in situ measurement based on white-light scattering is presented. The particle size is determined from the ratio of two scattered light intensities taken at two wavelength bands. By using white-light scattering, the proper wavelength bands in the broad spectral region can be selected in accordance with the particle size that is to be measured. Then the measurable particle size range can be expanded and the particle size can be measured precisely. The performance of this particle size monitor is theoretically discussed, and experimental data from polystyrene latex suspensions are shown to confirm its operation.


Construction and demolition waste framework of circular economy: A mini review.
As the demand for materials continues to increase and building lifespans shorten, the construction industry faces mounting pressure to reduce its material and environmental impacts. Mismanagement of construction and demolition waste (CDW) can have severe environmental consequences. To address this, material recovery and circular economy approaches offer significant potential for reducing construction waste through the sustainable use of resources. Existing circular economy and material recovery models that prioritize recycling and reuse efforts demonstrate a sustained commitment to supporting circular practices in the construction and demolition sector. The goal is to minimize waste production, which poses environmental challenges such as raw material shortages and sustainability concerns. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement for recruiting relevant literature, this mini review aims to identify the obstacles to implementing circular economy practices in the construction industry, while exploring opportunities for material recovery and circularity. The ultimate aim is to facilitate a fair and smooth transition towards sustainable development, while addressing environmental, social and economic barriers. A more sustainable and circular approach to building construction and management can be attained by considering all the aspects of the CDW cycle, resulting in significant benefits for the environment and society as a whole.


How much is a child worth? Providers' and patients' views and responses concerning ethical and policy challenges in paying for ART.
Infertility treatments remain expensive and in many countries are covered by little, if any, insurance, raising critical questions concerning how patients and providers view and make decisions regarding these challenges. In-depth semi-structured interviews of approximately 1 hour were conducted with 37 IVF providers and 10 patients (17 physicians, 10 other providers and 10 patients), and were systematically analyzed. These data suggest current insurance policies and legislation pose critical ethical and logistical challenges for both patients and providers. These individuals face multiple uncertainties about costs and insurance, related to unclear causes of fertility, treatment length, costs and outcomes, and odds that insurers will cover expenses. Insurers frequently decline to agree to reimbursement beforehand, and decide only afterwards, case-by-case, generating stress. Patients and providers thus may not be able to predict how best to allocate limited resources. Providers may advocate for patients, but are usually unsuccessful. Patients may adopt several strategies: e.g., moving/seeking treatment elsewhere, switching or feeling "stuck" in jobs because of insurance, seeking "free" medications, going into debt, or using funds intended for other purposes. Patients do not perceive and respond to resource limitations as fixed phenomena-i.e., patients do not see treatment simply as "affordable" or not. Rather, patients face quandaries of how much to keep spending-how much a child is worth-and are forced to make complex risk/benefit calculations. Couples can disagree, straining relationships. In sum, these data, the first to explore how providers and patients struggle, view, and make decisions regarding limited insurance and resources for infertility, raise several critical ethical and policy issues. These data suggest that individuals have difficulty translating profoundly life-altering, deeply personal quests for meaning and fulfillment into purely economic terms. These findings thus have important implications for future policy, practice, research, and patient and provider education.


Physiological changes and symptoms associated with short-term exposure to electromagnetic fields: a randomized crossover provocation study.
The biological association between electromagnetic fields (EMF) and idiopathic environmental intolerance attributed to EMF (IEI-EMF) has not been established. To assess the physiological changes and symptoms associated with exposure to EMF, we conducted a randomized crossover provocation study. We recruited 58 individuals with IEI-EMF (IEI-EMF group) and 92 individuals without IEI-EMF (control group). In a controlled environment, all participants received EMF signals mimicking those from mobile phone base stations in a randomized sequence under the blinded condition. During the course, participants reported their symptoms and whether they perceived EMF, and we monitored their physiological parameters, including blood pressure (BP), heart rate (HR), and HR variability. The IEI-EMF and control groups reported similar frequencies of symptoms during both the provocation and sham sessions. No participant could accurately identify the provocation. In both groups, physiological parameters were similar between the two sessions. The control group, but not the IEI-EMF group, had elevated HR when they perceived EMF exposure. No symptoms or changes in physiological parameters were found to be associated with short-term exposure to EMF, and no participant could accurately detect the presence of EMF. Moreover, the participants in the control group, but not those in the IEI-EMF group, had elevated HR when they perceived EMF.


Use of parenteral lipid emulsions in French neonatal ICUs.
To determine the types of parenteral lipid emulsions currently used for preterm infants, their mode of delivery, and the main disease conditions that are considered by neonatologists as contraindications. National survey using a questionnaire. 155 neonatal departments in France. 100 (65%) neonatal departments participated in the survey. The most widely used lipid emulsion was the 20% soybean oil/coconut oil-based emulsion (68% of the units), followed by the soybean oil-based emulsion (28.5%) and the soybean oil/olive oil-based emulsion (3.5%). Peripheral venous access was considered to be a possible route for the infusion of lipid emulsions in only 58 (63.7%) of the units. In 80%-90% of the units, sepsis, hemodynamic failure, thrombocytopenia, disseminated intravascular coagulation, and hyperbilirubinemia were considered to be relative or absolute contraindications, whereas only hemodynamic failure, disseminated intravascular coagulation, and to a lesser extent sepsis were most often perceived as absolute contraindications. Neonatologists are somewhat reluctant to use parenteral lipids when only peripheral venous access is available, despite the low osmolarity of the emulsions. This may impair, at least temporarily, the adequate supply of energy and/or essential fatty acids in infants who do not have central venous access. This study also shows a large heterogeneity of responses with regard to the contraindications for parenteral lipids.


An Outbreak Associated with Sapovirus GI.3 in an Elementary School in Gyeonggi-do, Korea.
On October 4, 2018, an outbreak of gastroenteritis associated with sapovirus occurred among elementary school students in Gyeonggi-do, Korea. Epidemiologic studies were conducted in a retrospective cohort approach. Using self-administered questionnaires, we collected information on symptoms and food items consumed. Of the 999 subjects, 17 developed patients that met the case definition. The main symptom was vomiting (100%), and the symptomatic age was 6-12 years. Positive samples were identified by conventional reverse transcription polymerase chain reaction for sequencing. They were classified into genotype GI.3 by phylogenetic analysis. This is the first report of an outbreak associated with sapovirus GI.3 in Korea.


Stress response in Drosophila melanogaster strain inactive with decreased tyramine and octopamine contents.
Juvenile hormone hydrolysis, tyrosine decarboxylase activity, dopamine content and fitness (viability and fertility) were studied under normal and stress conditions in the adults of Drosophila melanogaster inactive strain carrying a mutation that decreases tyrosine decarboxylase activity and results in the lower contents of tyramine and octopamine. A sexual dimorphism of tyrosine decarboxylase activity, dopamine level and survival under heat stress in inactive flies was found. inactive adults showed higher dopamine levels and lower survival levels under heat stress as compared to wild type (Canton S) adults. Juvenile hormone degradation is decreased in young and increased in mature inactive females as compared to wild type. Fertility of the inactive strain did not differ from that of wild type strain under normal conditions, but after heat exposure the dynamics of its restoration was different. inactive females were found to develop the stress reaction, with juvenile hormone degradation, tyrosine decarboxylase activity, dopamine content and fertility levels used as the reaction indicators.


CT arthrography of capsular structures of the shoulder.
The capsular mechanism of the shoulder joint consists of the joint capsule, which is strengthened by the glenohumeral ligaments and the rotator cuff, the glenoid labrum, and a variable number of synovial recesses. Although the fibrous capsule is a lax structure, the normal function of the capsular mechanism makes it an effective barrier against anterior dislocation, particularly in external rotation. There has been a tendency in the past to overestimate the role of the glenoid labrum in stability of the shoulder joint. In patients with instability, the significance of the capsular attachment or its anomalous insertions to the glenoid has not been adequately recognized. Labral tears may develop as secondary lesions due to repeated dislocations and subluxations rather than representing the primary lesion responsible for instability. Operative visualization of capsular defects or detachments is often difficult. Prior knowledge of these lesions can effectively help the choice of an appropriate surgical procedure and reduce operating time. The results of computed tomographic (CT) arthrography of the shoulder joint in 45 patients are reported and the normal and pathologic variations of the joint capsule and particularly the capsular insertions are described. Configuration of the joint recesses and the glenoid labrum are also evaluated. These CT findings were correlated and verified by surgery or arthroscopy in 26 cases.


Technology and managed care: patient benefits of telemedicine in a rural health care network.
Rural health providers have looked to telemedicine as a technology to reduce costs. However, virtual access to physicians and specialists may alter patients' demand for face-to-face physician access. We develop a model of service demand under managed care, and apply the model to a telemedicine application in rural Alaska. Provider-imposed delays and patient costs were highly significant predictors of patient contingent choices in a survey of ENT clinic patients. The results suggest that telemedicine increased estimated patient benefits by about $40 per visit, and reduced patients' loss from rationing of access to physicians by about 20%.


Selective and sensitive fluorescence imaging reveals microenvironment-dependent behavior of NO modulators in the endothelial system.
Nitric oxide (NO) is a second messenger playing crucial roles in the signaling of a variety of cellular functions. Due to its pathophysiological significance, various NO modulators have been developed to explore NO pathways and some have been used as therapies. These modulators are often used directly to observe pharmacological effects in cell lines, but their actual effect on intracellular NO level is seldom analyzed. Herein, facilitated by a selective and sensitive fluorescence probe, we observed that some NO modulators displayed unexpected behaviors with both NO scavenger carboxy-PTIO and endothelial nitric oxide synthase (eNOS) inhibitor N(ω)-nitro-l-arginine methyl ester (l-NAME) failing to decrease intracellular free NO level in EA. hy926 cells while NO donor diethylamine-NONOate (DEA·NONOate) and eNOS activator calcimycin (A23187) failing to increase free NO level in human umbilical vein endothelial cell line (HUV-EC-C), although the reagents were confirmed to work normally in the primary human umbilical vein endothelial cells (primary HUVECs) and RAW 264.7 macrophage cells. Further research suggested that these unusual behaviors might be attributed to the cellular microenvironments including both the NO synthase (NOS) level and the endogenous glutathione (GSH) level. Genetically manipulating eNOS level in both cells restores the expected response, while decreasing GSH level restores the ability of DEA·NONOate to increase NO level in HUV-EC-C. These results reveal that the cellular microenvironment has a profound impact on pharmacological effect. Our study suggests GSH as a reservoir for NO in live cells and highlights the value of chemical probes as valuable tools to reveal microenvironment-dependent pharmacological effects.