More Zernike modes' open-loop measurement in the sub-aperture of the Shack-Hartmann wavefront sensor.
The centroid-based Shack-Hartmann wavefront sensor (SHWFS) treats the sampled wavefronts in the sub-apertures as planes, and the slopes of the sub-wavefronts are used to reconstruct the whole pupil wavefront. The problem is that the centroid method may fail to sense the high-order modes for strong turbulences, decreasing the precision of the whole pupil wavefront reconstruction. To solve this problem, we propose a sub-wavefront estimation method for SHWFS based on the focal plane sensing technique, by which more Zernike modes than the two slopes can be sensed in each sub-aperture. In this paper, the effects on the sub-wavefront estimation method of the related parameters, such as the spot size, the phase offset with its set amplitude and the pixels number in each sub-aperture, are analyzed and these parameters are optimized to achieve high efficiency. After the optimization, open-loop measurement is realized. For the sub-wavefront sensing, we achieve a large linearity range of 3.0 rad RMS for Zernike modes Z2 and Z3, and 2.0 rad RMS for Zernike modes Z4 to Z6 when the pixel number does not exceed 8 × 8 in each sub-aperture. The whole pupil wavefront reconstruction with the modified SHWFS is realized to analyze the improvements brought by the optimized sub-wavefront estimation method. Sixty-five Zernike modes can be reconstructed with a modified SHWFS containing only 7 × 7 sub-apertures, which could reconstruct only 35 modes by the centroid method, and the mean RMS errors of the residual phases are less than 0.2 rad2, which is lower than the 0.35 rad2 by the centroid method.


Topical Developments in High-Field Dynamic Nuclear Polarization.
We report our recent efforts directed at improving high-field DNP experiments. We investigated a series of thiourea nitroxide radicals and the associated DNP enhancements ranging from ε = 25 to 82 that demonstrate the impact of molecular structure on performance. We directly polarized low-gamma nuclei including 13C, 2H, and 17O using trityl via the cross effect. We discuss a variety of sample preparation techniques for DNP with emphasis on the benefit of methods that do not use a glass-forming cryoprotecting matrix. Lastly, we describe a corrugated waveguide for use in a 700 MHz / 460 GHz DNP system that improves microwave delivery and increases enhancements up to 50%.


Metastasis and MAPK Pathways.
Cancer is a leading cause of death worldwide. In many cases, the treatment of the disease is limited due to the metastasis of cells to distant locations of the body through the blood and lymphatic drainage. Most of the anticancer therapeutic options focus mainly on the inhibition of tumor cell growth or the induction of cell death, and do not consider the molecular basis of metastasis. The aim of this work is to provide a comprehensive review focusing on cancer metastasis and the mitogen-activated protein kinase (MAPK) pathway (ERK/JNK/P38 signaling) as a crucial modulator of this process.


[Depression in children of cancer patients over time and dependence of the parental distress].
This study was part of the German multicentre project "Psychosocial Services for Children of Parents with Cancer" (2009-2012, research grant: German Cancer Aid). 60 parent-child-dyads (children's age: >10 years, at least one parent with cancer) could be included in data analysis. Depressive symptoms of children were assessed with the CES-DC at two times (t1 and t2). Depression scores were compared with a representative comparison group from the general population. Further, the relationship between the distress of cancer patients and the depression of the children was examined. Children with at least one parent with cancer were significantly more depressed than the comparison group (t1 and t2). 25.8% of the boys and 35.7% of the girls reported clinically relevant scores of depression at t1. There were no significant changes in the depression scores on the individual level for boys and girls at t2. There was a positive correlation between children's depression (t1) and the parental anxiety at t1 with r = 0.26 (p <0.05). Depressive symptoms in children of parents with cancer persist over time, and therefore should be identified early.


[Circadian alterations of the cardiovascular system].
Circadian variations have been known for a long time for the influence they have on the physiological systems, including the cardiovascular system. The study of the mechanisms with circadian variation that change the function of the cardiovascular system and its diseases has increased greatly in recent years due to its clinical prominence. Through these studies, physiopathology, epidemiology and factors involved in cardiovascular diseases are more understandable. Thus, the incidence of cardiac events has been clearly associated with the morning hours, as well as the possible mechanisms involved in this variation during the daytime hours. The arterial blood pressure, plasma catecholamine levels and cortisol, platelet aggregation, and fibrinolytic system action are the most implicated mechanisms. From this knowledge, it is possible to design new therapeutic strategies that should consider the time of the day of higher risk for the onset of cardiovascular events.


It's OK having asthma ... young children's beliefs about illness.
Hospitals and illness can be bewildering and frightening for children. To minimise the distress caused to them, health professionals need to communicate effectively. This involves assessing the child's level of development and the amount of knowledge the child needs.


The nature of fluorescence emission in the red fluorescent protein DsRed, revealed by single-molecule detection.
Recent studies on the newly cloned red fluorescence protein DsRed from the Discosoma genus have shown its tremendous advantages: bright red fluorescence and high resistance against photobleaching. However, it has also become clear that the protein forms closely packed tetramers, and there is indication for incomplete protein maturation with unknown proportion of immature green species. We have applied single-molecule methodology to elucidate the nature of the fluorescence emission in the DsRed. Real-time fluorescence trajectories have been acquired with polarization sensitive detection. Our results indicate that energy transfer between identical monomers occurs efficiently with red emission arising equally likely from any of the chromophoric units. Photodissociation of one of the chromophores weakly quenches the emission of adjacent ones. Dual color excitation (at 488 and 568 nm) single-molecule microscopy has been performed to reveal the number and distribution of red vs. green species within each tetramer. We find that 86% of the DsRed contain at least one green species with a red-to-green ratio of 1.2-1.5. On the basis of our findings, oligomer suppression would not only be advantageous for protein fusion but will also increase the fluorescence emission of individual monomers.


Telemedicine: Benefits for Cardiovascular Patients in the COVID-19 Era.
The recent pandemic with SARS-CoV-2 raises questions worldwide regarding telemedicine for housebound patients, including those with cardiovascular conditions. The need for further investigation, monitoring and therapeutic management are advancing practical issues which had not been identified for consideration prior to the pandemic. Using the marketing assessment, we identified the needs of the patients and evaluated the future steps necessary in the short term to meet them. The research found progress made via telemedicine in monitoring and conducting minor decisions (like up-titrating the doses of different medication regimens) in patients with several cardiovascular diseases (heart failure, atrial fibrillation, high blood pressure), as there is a worldwide trend to develop new telemonitoring biosensors and devices based on implantable delivered transcatheter. The worldwide telemedicine trend encourages a switch from small and hesitating steps to a more consistent assessment of the patients, based on high technology and Interventional Cardiology. Cardiovascular telemedicine, although made a sustainable effort in managing patients' health, has many obstacles to overcome before meeting all their needs. Data security, confidentiality and reimbursement are the top priorities in developing remote Cardiology. The regulatory institutions need to play an integrative role in leading the way for defining the framework of future telemedicine activities. The SARS-CoV-2 outbreak with all its tragedy served to reinforce the message that telemedicine services can be life-saving for cardiovascular patients. Once the Covid-19 era will fade away, telemedicine is likely to remain a complementary service of standard care. There is still room to improve the remote identification and investigation of heart disease, provide an accurate diagnosis and therapeutic regimen, and update regulations and guidelines to the new realities of technological progress in the field.


Macrodystrophia lipomatosa: radiographic diagnosis.
Macrodystrophia lipomatosa is a rare form of localized gigantism characterized by progressive overgrowth of all the mesenchymal elements with a disaproportionate increase in the fibroadipose tissues. This congenital abnormality occurs most frequently in the distribution of the median nerve in the upper extremity and in the distribution of the planter nerves in the lower extremity. It is usually recognized at birth or in the neonatal period. As the patient grows, the deformity begins to mechanically interfere with joint function, vascular supply, and innervation. Six cases are described with emphasis on the radiographic findings which differentiate this entity from other forms of local gigantism. These findings include a predominately distal involvement, enlargement of the phalanges and soft tissue elements of the digit, and lucencies within the soft tissues.


Prognostic Nutritional Index Predicts Response and Prognosis in Cancer Patients Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis.
To investigate the association between pretreatment prognostic nutritional index (PNI) and clinical survival outcomes for advanced-stage cancer patients treated with immune checkpoint inhibitors (ICIs). We conducted a comprehensive literature search to identify eligible studies concerning the relationship between pretreatment PNI and survival outcomes in advanced cancer patients treated with ICIs. Published data were extracted and pooled odds ratio (pOR) for objective response rate (ORR), disease control rate (DCR), and pooled hazard ratio (pHR) for overall survival (OS), progressive-free survival (PFS), along with 95% confidence intervals (95% CIs) were calculated. Twelve studies with 1,359 participants were included in our study. A higher level of PNI indicated a greater ORR (pOR = 2.17, 95% CI = 1.52-3.10) and favorable DCR (pOR = 2.48, 95% CI = 1.87-3.29). Low PNI was associated with a shorter OS (pHR = 2.24, 95% CI = 1.57-3.20) and unfavorable PFS (pHR = 1.61, 95% CI = 1.37-1.88). Low PNI might be an effective biomarker of poor tumor response and adverse prognosis of advanced cancer patients with ICIs. Further studies are needed to verify the prognostic value of PNI in clinical practice.


Longitudinal trial of a smartphone pain application for chronic pain patients: Predictors of compliance and satisfaction.
Introduction This study was designed to determine the feasibility, tolerability, safety and efficacy of a smartphone pain application (app) among chronic pain patients over a six-month trial. The app was designed for both Android and iPhone devices and enabled users with chronic pain to assess, monitor, and communicate their status to their providers. Methods We recruited 90 chronic pain patients to use the pain app. All subjects completed baseline measures and were asked to record their progress every day. All participants were supplied an activity monitor. Results Average age of the participants was 46.7 years (range 18-79), 64.4% were female and 31.1% reported multiple pain sites. Satisfaction was rated at three and six months. The app was found to be easily introduced and well tolerated. In general, those who used the app more often were more satisfied with the program ( p < 0.05), although satisfaction ratings of the pain app diminished with time. Greater use of the app and frequent daily assessment entries were found to be related to an overall improvement in mood. However, contrary to our hypotheses, frequent use of the app did not have a positive effect on pain or activity. Those who were more satisfied with the app reported more pain-related disability and were less active than those who were less satisfied with the app. No safety issues were encountered. Discussion Strategies to make the program more engaging and to improve motivation to use the app would be important in the future development and use of a smartphone pain app.


Potential nitrification and denitrification and the corresponding composition of the bacterial communities in a compact constructed wetland treating landfill leachates.
Constructed wetlands can be used to decrease the high ammonium concentrations in landfill leachates. We investigated nitrification/denitrification activity and the corresponding bacterial communities in landfill leachate that was treated in a compact constructed wetland, Tveta Recycling Facility, Sweden. Samples were collected at three depths in a filter bed and the sediment from a connected open pond in July, September and November 2004. Potential ammonia oxidation was measured by short-term incubation method and potential denitrification by the acetylene inhibition technique. The ammonia-oxidising and the denitrifying bacterial communities were investigated using group-specific PCR primers targeting 16S rRNA genes and the functional gene nosZ, respectively. PCR products were analysed by denaturing gradient gel electrophoresis and nucleotide sequencing. The same degree of nitrification activity was observed in the pond sediment and at all levels in the filter bed, whereas the denitrification activity decreased with filter bed depth. Denitrification rates were higher in the open pond, even though the denitrifying bacterial community was more diverse in the filter bed. The ammonia-oxidising community was also more varied in the filter bed. In the filter bed and the open pond, there was no obvious relationship between the nitrification/denitrification activities and the composition of the corresponding bacterial communities.


The LIM domain: regulation by association.
The LIM domain is a zinc finger structure that is present in several types of proteins, including homeodomain transcription factors, kinases and proteins that consist of several LIM domains. Proteins containing LIM domains have been discovered to play important roles in a variety of fundamental biological processes including cytoskeleton organization, cell lineage specification and organ development, but also for pathological functions such as oncogenesis, leading to human disease. The LIM domain has been demonstrated to be a protein-protein interaction motif that is critically involved in these processes. The recent isolation and analysis of more LIM domain-containing proteins from several species have confirmed and broadened our knowledge about LIM protein function. Furthermore, the identification and characterization of factors that interact with LIM domains illuminates mechanisms of combinatorial developmental regulation.


When friend turns foe: central and peripheral neuroinflammation in central nervous system injury.
Injury to the central nervous system (CNS) is common, and though it has been well studied, many aspects of traumatic brain injury (TBI) and stroke are poorly understood. TBI and stroke are two pathologic events that can cause severe, immediate impact to the neurostructure and function of the CNS, which has been recognized recently to be exacerbated by the body's own immune response. Although the brain damage induced by the initial trauma is most likely unsalvageable, the secondary immunologic deterioration of neural tissue gives ample opportunity for therapeutic strategists seeking to mitigate TBI's secondary detrimental effects. The purpose of this paper is to highlight the cell death mechanisms associated with CNS injury with special emphasis on inflammation. The authors discuss sources of inflammation, and introduce the role of the spleen in the systemic response to inflammation after CNS injury.


Prostate sampling by 12-core biopsy: comparison of the biopsy results with tumor location in prostatectomy specimens.
To analyze the diagnostic performance of individual prostate biopsy cores. The 12-core transrectal prostate biopsy scheme has emerged as a standard of care. However, quality of sampling may vary in different areas of the prostate included in this procedure. Two-hundred fifty men underwent radical prostatectomy at our institution. All participants had a systematic 12-core transrectal prostate biopsy containing lateral and medial cores from each side of the apical, medial and basal thirds of the prostate. Biopsy results were matched with histologic maps of the prostatectomy specimens. Sensitivity, negative predictive value (NPV), and overall accuracy were calculated for each biopsy core location and compared between different groups of cores. In addition, patients in the upper quartile of prostate weight were compared with the rest of the cohort. Sensitivity, NPV, and overall accuracy were significantly lower for apical cores. Average NPV and overall accuracy of basal and mid-lateral biopsies were inferior to those of medial biopsies on the same levels. However, sensitivity of these lateral cores was similar to that of the medial cores. Sensitivities of apical and mid cores were significantly lower in patients with larger prostates. Decreased accuracy in lateral mid- and basal cores results from higher frequencies of cancer in corresponding prostate areas, and therefore additional samples should be taken at these locations. In addition, diagnostic accuracy of apical cores may be improved through better targeting of the prostatic apex. This may be particularly important in patients with larger prostates.


Comparison of microleakage on one composite etched with phosphoric acid or a combination of phosphoric and hydrofluoric acids and bonded with several different systems.
There are no data available on whether or to what extent hydrofluoric acid affects the marginal integrity of dentin-bonded composite restorations when it is used instead of phosphoric acid in the total-etch technique. This in vitro study examined the etching effects of phosphoric acid versus a combination of phosphoric and hydrofluoric acid by evaluation of microleakage in a composite restoration bonded with different dentin adhesive systems. Extracted teeth (n = 90) containing 2 class II preparations, mesial occlusal (MO) and distal occlusal (DO) standarized (cervical margins in dentin) were perfused with Ringer solution and etched in 1 of 2 ways: with phosphoric acid only or with phosphoric combined with hydrofluoric acid. Different dentin bonding agents were then applied (Etch & Prime 3.0, Optibond Solo, Prime & Bond NT, Scotchbond 1, Syntac Single Component, or Syntac Sprint; (n = 15 for each etching material)). The preparations were restored with a hybrid composite (Herculite XRV) and submitted to 5000 thermocycles (5 degrees C to 55 degrees C) to simulate the in vivo situation. Microleakage was assessed with 2% methylene blue diffusion for 24 hours. Dye penetration was calculated as a percentage of the total length of the gingival margins of the preparation with light microscopy at original magnification x 32. The results were analyzed with the Kruskal-Wallis multiple comparison z-value assay (alpha = .05). Differences in dye penetration were significant, both as a function of the dentin adhesive and the conditioning mode applied. In the specimen groups conditioned with phosphoric acid, Optibond Solo (54% +/- 44%) and Syntac Sprint (74% +/- 39%) demonstrated the lowest penetration values. Higher values were obtained for Prime & Bond NT (81% +/- 34%), Scotchbond 1 (83% +/- 31%), Etch & Prime 3.0 (85% +/- 33%), and Syntac Single Component (95% +/- 16%), with no significant differences (alpha=.05) between specimen groups. The best results were obtained for Syntac Sprint (24% +/- 26% dye penetration) after conditioning with a mixture of phosphoric and hydrofluoric acid. The least favorable result was obtained for Optibond Solo (65% +/- 31%). It was significantly different from Prime & Bond NT (76% +/- 37%), Scotchbond 1 (85% +/- 29%), and Etch & Prime 3.0 (88% +/- 24%). Syntac Single Component (75% +/- 32%) was significantly different from Syntac Sprint. Syntac Single Component and Syntac Sprint exhibited significantly better results when conditioned with a combination of phosphoric acid and hydrofluoric acid than with phosphoric acid only. Within the limitations of this in vitro study, total-etching water-based (Syntac Single Component) and acetone-based (Syntac Sprint) bonding agents with a combination of phosphoric acid and hydrofluoric acid led to significant reductions (alpha=.05) in dye penetration compared to phosphoric acid conditioning only. Ethanol-based dentin bonding agents (Etch & Prime 3.0, Optibond Solo, and Scotchbond 1) were not significantly influenced by the type of conditioner used.


Washington State Surgeon Perspectives on Quality Measures in the Surgical Care of Stress Urinary Incontinence in Women.
No consensus exists on outcomes that define high quality care in female stress urinary incontinence management. A working group of surgeons from diverse health care settings in Washington State who treat stress urinary incontinence was convened through a state level quality collaborative. Preliminary questions were developed and focus groups conducted to obtain surgeon input and perspectives on stress urinary incontinence surgery quality measures to guide future research. Washington State surgeons who perform sling surgery were recruited via email. Focus groups were convened via teleconference using preliminary questions as discussion points. Participants were surgeons from a variety of locations and practice types. Focus groups were led by a trained moderator, recorded and transcribed verbatim, and qualitatively analyzed using inductive content analysis. Eight urologists and 6 gynecologists from 5 academic, 4 private practice and 5 hospital based settings participated in 3 focus groups. The 4 emergent concepts derived, were a perceived need to individualize rather than standardize the management approach to recurrent and persistent stress urinary incontinence, a need to establish and validate shared decision making tools for synthetic mesh procedures, a need to define risk factors and treatment strategies for unique populations, including those with mixed urinary incontinence, younger patients and those with concomitant prolapse, and an enthusiasm to identify practical and clinically meaningful quality measures. Focus groups with clinical experts on quality of stress urinary incontinence care identified several priority topics for future study. Further work is needed to refine research prioritization on this important area of women's health.


Effects of the CYP2C9*13 allele on the pharmacokinetics of losartan in healthy male subjects.
The aim of the study was to determine the pharmacokinetics of losartan in relation to the CYP2C9*13 allele. A single oral dose of 50 mg losartan was administrated to each of the 16 healthy male volunteers with a different genotype (CYP2C9*1/*1, n = 6; CYP2C9*1/*13, n = 4; and CYP2C9*1/*3, n = 6). Blood samples were collected from pre-dose up to 24 h after the drug administration. Plasma losartan and E3174 (an active metabolite of losartan) were assayed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). All the subjects finished the study without adverse drug effects. In the present study, the frequencies of CYP2C9*13 and *13 alleles were 0.6% and 2.6% in Chinese healthy volunteers, respectively, and both alleles were in Hardy-Weinberg equilibrium. Compared with the subjects in the CYP2C9*1/*1 group, individuals carrying the CYP2C9*1/*13 genotype showed significantly a longer t(1/2) of losartan and E3174 and markedly increased the area under the curve (AUC) of losartan. Meanwhile, the CYP2C9*1/*3 genotype group had significant differences in t(1/2) and Cmax of E3174 compared with the CYP2C9*1/*1 group. The ratio of AUC(E3174)/AUC(losartan) after losartan administration in the CYP2C9*1/*13 and CYP2C9*1/*3 groups was also statistically different from that in the CYP2C9*1/*1 group. The data indicate that the presence of the CYP2C9*13 allele results in poor metabolism of losartan after a single oral dose.


Low-Temperature PECVD Growth of Germanium for Mode-Locking of Er-Doped Fiber Laser.
A low-temperature plasma-enhanced chemical vapor deposition grown germanium (Ge) thin-film is employed as a nonlinear saturable absorber (SA). This Ge SA can passively mode-lock the erbium-doped fiber laser (EDFL) for soliton generation at a central wavelength of 1600 nm. The lift-off and transfer of the Ge film synthesized upon the SiO2/Si substrate are performed by buffered oxide etching and direct imprinting. The Ge film with a thickness of 200 nm exhibits its Raman peak at 297 cm-1, which both the nanocrystalline and polycrystalline Ge phases contribute to. In addition, the Ge thin-film is somewhat oxidized but still provides two primary crystal phases at the (111) and (311) orientations with corresponding diffraction ring radii of 0.317 and 0.173 nm, respectively. The nanocrystalline structure at (111) orientation with a corresponding d-spacing of 0.319 nm is also observed. The linear and nonlinear transmittances of the Ge thin-film are measured to show its self-amplitude modulation coefficient of 0.016. This is better than nano-scale charcoal and carbon-black SA particles for initiating the mode-locking at the first stage. After the Ge-based saturable absorber into the L-band EDFL system without using any polarized components, the narrowest pulsewidth and broadest linewidth of the soliton pulse are determined as 654.4 fs and 4.2 nm, respectively, with a corresponding time-bandwidth product of 0.32 under high pumping conditions.


Pseudorandom testing of ventilatory response to inspired carbon dioxide in man.
A new method of testing the transient ventilatory response to inspired CO2 in humans has been developed in an attempt to improve the resolution and reproducibility of measures of peripheral chemoreceptor-mediated dynamics. The test input consisted of varying the level of inspired CO2 between 0 and 6-8% on a pseudorandom breath-by-breath basis. Cross-correlating this input with responses of end-tidal CO2, tidal volume, durations of inspiration and expiration, and respiratory rate yielded estimates of impulse responses. Computer simulation results and data collected in two subjects showed that reliable estimates of circulatory time lags and rapid dynamics are possible with this method. In one subject, the response dynamics observed were consistent with peripheral chemoreceptor rate sensitivity or adaptation. The rapid changes in inspiratory and expiratory durations also observed are probably mediated by peripheral chemoreceptors and appear to depend on the phase of the breathing cycle at which the CO2 stimulus arrives.


Application of proteomics in ovarian cancer: which sample should be used?
In the last decade several studies have been published using proteomics to unravel molecular pathways and to find biomarkers which can be used for diagnosis and/or prognostication in ovarian cancer. This review gives an overview of proteomic studies performed in ovarian cancer focusing on the nature of samples that have been used. Recent literature regarding the role of proteomic studies in ovarian cancer has been reviewed. Most studies have focused on finding biomarkers for early diagnosis of ovarian cancer using blood samples though proteins identified until now are mainly acute phase reactants. Studies regarding platinum sensitivity have only been performed on cell culture models and need confirmation in tissue samples. Proteomic studies using ovarian cancer tissue are sparse and mostly contain a low number of samples. To date no biomarkers for early diagnosis or prognostication in ovarian cancer have been found using proteomics. We speculate that it would be interesting to investigate the tissue proteome in an attempt to overcome acute phase reactants and to facilitate the discovery of real tumor-specific biomarkers instead of the identification of secondary protein changes.


Pediatric Orbital Fractures: Outcomes in Relation to Time of Surgery.
Orbital trapdoor fractures in children and adolescents can cause persistent problems with vision and appearance. Early surgery is recommended, although, because of the rarity of these fractures, there is a lack of evidence regarding the optimal timing of surgery.The objective of this study was to examine the effect of the time from trauma to surgery on the recovery time and severity of diplopia in children and adolescents with orbital trapdoor fractures. A retrospective cohort study was performed of all orbital fractures in children and adolescents aged 0 to 20 years, treated at a tertiary referral center in 2005-2017. Data relating to demographics, cause of injury, surgery, time of follow-up, and final outcomes were extracted. The cases of trapdoor fracture were specifically examined with regard to the time from trauma to surgery and diplopia at last follow-up, which was the primary outcome. One hundred thirty-five patients, aged 2.4 to 20 years (mean 17.0), were treated for orbital fractures during the period; 37 (27%) had an isolated orbital floor fracture and 12 (9%) had a trapdoor fracture. All patients with trapdoor fractures underwent surgery; the mean time to surgery was 11.9 days in 2007-2011 and 1.1 days in 2012-2017. Although statistical significance cannot be proven in this small and retrospective study, a shorter time from trauma to surgery seems to lead to fewer problems with diplopia and 2 patient cases that highlight this are presented. Delayed surgical intervention in pediatric orbital trapdoor fractures increases the risk of delayed recovery and persistent diplopia. Other factors, such as the degree of muscle incarceration and necrosis and the surgeon's experience and skill, may, however, also influence the outcomes.


Development of the radical-stable Coprinus cinereus peroxidase (CiP) by blocking the radical attack.
Despite the potential use of peroxidases as industrial biocatalysts, their practical application is often impeded due to suicide inactivation by radicals generated in oxidative reactions. Using a peroxidase from Coprinus cinereus (CiP) as a model enzyme, we revealed a dominant factor for peroxidase inactivation during phenol oxidation, and we engineered radical-stable mutants by site-directed mutagenesis of an amino acid residue susceptible to modification by phenoxyl radical. Mass spectrometry analysis of inactivated CiP identified an adduct between F230 and a phenoxyl radical, and subsequently, the F230 residue was mutated to amino acids that resisted radical coupling. Of the F230 mutants, the F230A mutant showed the highest stability against radical inactivation, retaining 80% of its initial activity, while the wild-type protein was almost completely inactivated. The F230A mutant also exhibited a 16-fold higher turnover of the phenol substrate compared with the wild-type enzyme. Furthermore, the F230A mutant was stable during the oxidation of other phenolic compounds, including m-cresol and 3-methoxyphenol. No structural changes were observed by UV-vis and CD spectra of CiP after radical coupling, implying that the F230-phenol radical adduct inactivated CiP by blocking substrate access to the active site. Our novel strategy can be used to improve the stability of other peroxidases inactivated by radicals.


Educational resources: website and book review.
Good quality educational material for anaesthesia providers in the developing world is limited in both quantity and availability. Traditionally, textbooks have been the main source of information but these are frequently expensive, easily damaged and rapidly become outdated. Many first world texts concentrate on the use of expensive drugs for an increasingly complex range of patients and procedures, making them less suitable for practitioners in resource-poor locations. Improved access to broadband internet connections will increasingly be a major portal for the delivery of up to date educational material.


Dietary exposure and trends of exposure to nutrient elements iodine, iron, selenium and sodium from the 2003-4 New Zealand Total Diet Survey.
The mean dietary exposure to the nutrient elements iodine, Fe, Se and Na by eight age-sex groups of the New Zealand population was estimated from foods purchased and prepared as for consumption. A total of 968 samples comprising 121 foods were collected and analysed. Mean daily exposures were calculated from mean concentration levels of the selected nutrients in each food combined with simulated diets for a 25+-year-old male and female, a 19-24-year-old male, a 11-14-year-old boy and girl, a 5-6-year-old child, a 1-3-year-old toddler and a 6-12-month-old infant. Food concentrations and dietary exposures are reported and compared with nutrient reference values (for example, recommended daily intakes, adequate intakes or upper limits). Dietary iodine exposures for all age-sex groups were well below recommended levels and have steadily decreased since 1982, raising concern especially for the physical and mental development of infants and young children. Fe exposures meet the recommended daily intake for the average male and 11-14 year olds but are only about half that recommended for adult females. Se exposure is about 20 % less than optimal for females. Na exposures, excluding discretionary salt, are above the acceptable exposure level for all age-sex groups, and exceed the upper intake limits for 25+-year-old males, 19-24-year-old young males, and 11-14-year-old boys and girls by up to 125 % for an average consumer.


Formation, Analytical Methods, Change Tendency, and Control Strategies of Biogenic Amines in Canned Aquatic Products: A Systematic Review.
Biogenic amines (BAs) are organic compounds with low molecular weight and can be used as indicators of the quality and safety of canned aquatic products during processing and storage. However, excess of these amines can cause foodborne poisoning. Therefore, the determination, analysis, and prevention of BAs are of great importance. This article focuses on the sources, formation, and pretreatment methods, as well as analytical techniques, change tendency, and control techniques of BAs, with the aim of promoting more appropriate analysis of canned aquatic products to provide a reference for the food industries.


Catalytic mechanism in artificial metalloenzyme: QM/MM study of phenylacetylene polymerization by rhodium complex encapsulated in apo-Ferritin.
Artificial metalloenzyme, composed of metal complex(es) and a host protein, is a promising way to mimic enzyme catalytic functions or develop novel enzyme-like catalysis. However, it is highly challenging to unveil the active site and exact reaction mechanism inside artificial metalloenzyme, which is the bottleneck in its rational design. We present a QM/MM study of the complicated reaction mechanism for the recently developed artificial metalloenzyme system, (Rh(nbd)·apo-Fr) (nbd = norbornadiene), which is composed of a rhodium complex [Rh(nbd)Cl](2) and the recombinant horse L-chain apo-Ferritin. We found that binding sites suggested by the X-ray crystal structure, i.e., sites A, B, and C, are only precursors/intermediates, not true active sites for polymerization of phenylacetylene (PA). A new hydrophobic site, which we name D, is suggested to be the most plausible active site for polymerization. Active site D is generated after coordination of first monomer PA by extrusion of the Rh(I)(PA) complex to a hydrophobic pocket near site B. Polymerization occurs in site D via a Rh(I)-insertion mechanism. A specific "hydrophobic region" composed by the hydrophobic active site D, the nonpolar 4-fold channel, and other hydrophobic residues nearby is found to facilitate accumulation, coordination, and insertion of PA for polymerization. Our results also demonstrate that the hydrophobic active site D can retain the native regio- and stereoselectivity of the Rh-catalyzed polymerization of PA without protein. This study highlights the importance of theoretical study in mechanistic elucidation and rational design of artificial metalloenzymes, indicating that even with X-ray crystal structures at hand we may still be far from fully understanding the active site and catalytic mechanism of artificial metalloenzymes.


Construction of a hierarchical architecture in a wormhole-like mesostructure for enhanced mass transport.
A unique hierarchical architecture is successfully constructed in a wormhole-like mesopore structure via a multiple nanocasting route. This novel type of hierarchical porous carbon (HPC) consists of three-dimensional ordered macropores (ca. 150 nm) with interconnecting pore windows, and the walls of these macropores are rich in wormhole-like mesopores (ca. 2.7 nm) and large spherical mesopores (ca. 10 nm), as well as a significant microporosity, presenting a macro-meso-microporous structure with a three-dimensional interconnectivity. Such a hierarchically porous structure may provide fine diffusion pathways for reaction species, which is demonstrated by the experimental result of an enhanced performance in a supercapacitor. For example, with the introduction of a hierarchical porous structure for fast transport and effective access of ions, the as-prepared HPC exhibits a specific capacitance as high as 247 F g(-1), whereas traditional wormhole-like mesoporous carbon has only a specific capacitance of 176 F g(-1).


Engineering the aveC gene to enhance the ratio of doramectin to its CHC-B2 analogue produced in Streptomyces avermitilis.
Avermectin and its analogues are produced by the actinomycete Streptomyces avermitilis and are major commercial products for parasite control in the fields of animal health, agriculture, and human infections. Historically, the avermectin analogue doramectin (CHC-B1), which is sold commercially as Dectomax is co-produced during fermentation with the undesired analogue CHC-B2 at a CHC-B2:CHC-B1 ratio of 1.6:1. Although the identification of the avermectin gene cluster has allowed for characterization of most of the biosynthetic pathway, the mechanism for determining the avermectin B2:B1 ratio remains unclear. The aveC gene, which has an essential role in avermectin biosynthesis, was inactivated by insertional inactivation and mutated by site-specific mutagenesis and error-prone PCR. Several unrelated mutations were identified that resulted in improved ratios of the desirable avermectin analogue CHC-B1, produced relative to the undesired CHC-B2 fermentation component. High-throughput (HTP) screening of cultures grown on solid-phase fermentation plates and analysis using electrospray mass spectrometry was implemented to significantly increase screening capability. An aveC gene with mutations that result in a 4-fold improvement in the ratio of doramectin to CHC-B2 was identified. Subsequent integration of the enhanced aveC gene into the chromosome of the S. avermitilis production strain demonstrates the successful engineering of a specific biosynthetic pathway gene to significantly improve fermentation productivity of a commercially important product.


Aprepitant: a novel antiemetic for chemotherapy-induced nausea and vomiting.
To evaluate the safety and efficacy of aprepitant in the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV). MEDLINE and PubMed database searches were conducted from 1966 to May 2004 using the following search terms: aprepitant, Emend, substance P, neurokinin-1, chemotherapy, nausea, vomiting, L-754,030, and MK-869. Large, randomized Phase II and III clinical trials examining the use of aprepitant for CINV, as well as all published drug interaction studies with aprepitant, were included and reviewed. Data lacking in published trials were supplemented with the manufacturer product information. The pharmacokinetics of aprepitant are favorable for once-daily oral dosing. Based on the results of published clinical trials, aprepitant appears to augment the effects of corticosteroids and 5-HT3 antagonists when given prior to highly emetogenic chemotherapy, including cisplatin. Aprepitant appears to have the most benefit in the prevention of delayed CINV and in preventing emesis rather than nausea. Data in pediatric patients, patients undergoing stem-cell transplantation, and those receiving multiple-day or moderately emetogenic chemotherapy are lacking. Common adverse effects are limited to hiccups, asthenia, and diarrhea. More serious but rare adverse effects include neutropenia. Because aprepitant is a CYP3A4 substrate, a 3A4 inhibitor and inducer, and a 2C9 inducer, close monitoring for drug interactions is warranted. Triple antiemetic therapy with aprepitant, a corticosteroid, and a 5-HT3 antagonist appears to provide improved efficacy in the prevention of emesis in patients receiving highly emetogenic chemotherapy. Due to its novel mechanism of action and demonstrated efficacy in this combination, aprepitant should be considered for formulary addition.


State dependent particle dynamics in liquid alkali metals.
This paper gives a survey of the particle dynamics in the liquid alkali metals observed with inelastic x-ray and neutron scattering experiments. Liquid rubidium and sodium are chosen as model fluids to represent the behaviour of this group of fluids. In the dense metallic monatomic melt the microscopic dynamics is characterized by collective excitations similar to those in the corresponding solids. The collective particle behaviour is appropriately described using a memory function formalism with two relaxation channels for the density correlation. A similar behaviour is found for the single particle motion where again two relaxation mechanisms are needed to accurately reproduce the experimental findings. Special emphasis is given to the density dependence of the particle dynamics. An interesting issue in liquid metals is the metal to non-metal transition, which is observed if the fluid is sufficiently expanded with increasing temperature and pressure. This causes distinct variations in the interparticle interactions, which feed back onto the motional behaviour. The associated variations in structure and dynamics are reflected in the shape of the scattering laws. The experimentally observed features are discussed and compared with simple models and with the results from computer simulations.


Structured patient education is superior to written information in the management of patients with irritable bowel syndrome: a randomized controlled study.
Education and reassurance are proposed to be of great importance in the management of patients with irritable bowel syndrome (IBS), but few trials supporting this are available. Our aim was to compare the effects of a structured patient group education (IBS school) versus receiving written information in the form of an IBS guidebook, on knowledge, symptoms, and quality of life in IBS patients. Patients with IBS according to the Rome II criteria were randomized to participate in the group education or to receive the guidebook. The effects were evaluated by self-administered questionnaires at 3 and 6 months after baseline. One hundred and forty-three patients - 71 in the guidebook group and 72 in the IBS school group - completed the study. Compared with the guidebook group, the patients in the education group showed greater reduction in IBS symptom severity and gastrointestinal (GI)-specific anxiety, as well as greater improvement in perceived knowledge of IBS. Several aspects of health-related quality of life were significantly improved after the group education, but not in the group who received the written information. A structured patient group education is superior to written information to enhance knowledge of IBS, and improve GI symptoms and GI-specific anxiety in IBS patients.


Mannich base-connected syntheses mediated by ortho-quinone methides.
This article provides an overview about specifically modified Mannich reactions where the process involves an ortho-quinone methide (o-QM) intermediate. The reactions are classified on the basis of the o-QM source followed by the reactant, e.g., the dienophile partner in cycloaddition reactions (C=C or C=N dienophiles) or by the formation of multicomponent Mannich adducts. Due to the important pharmacological activities of these reactive o-QM intermediates, special attention is paid to the biological activity of these compounds.


Medical students' perceptions of stress due to academic studies and its interrelationships with other domains of life: a qualitative study.
Medical students have been found to experience considerable stress due to their academic studies. The high demands associated with academic studies may interfere with demands in other domains of life. Conversely, demands in those other domains of life may conflict with academic studies. We aimed to better understand the potential inter-relationships between the demands related to academic studies and in other domains of life. A total of 68 medical students from a medical school in Germany participate in eight focus groups. Sessions were structured by a topic guide and were recorded, transcribed and content-analyzed. Embarking on one's medical studies was perceived to be associated with important personal challenges, such as living alone for the first time and finding a new social role in one's peer group. Permanent stress was perceived to result in emotional exhaustion, which spilled over in other domains of life. Students reported to feel guilty if they did not spend their limited spare time on learning. Consequently, they felt to have little time for leisure time activities and a healthy lifestyle. Feelings of social isolation, especially during exam phases, were reported. Leisure activities were perceived to facilitate recovery from academic stress. Social ties were subjectively able to reduce stress, but also to increase stress due to demands. Side jobs were perceived to increase stress and to be time-consuming and were thus perceived to result in poorer academic performance. Certain personality characteristics seemed to amplify those perceptions. For instance, high levels of conscientiousness were felt to relate to higher expectations regarding one's academic performance and thus increased stress. The demands associated with medical studies, the demands in private life, lacking resources for recovery and certain personal traits as well as interactions between those domains can contribute to stress among medical students and reduce well-being.


[Determination of 20 Trace Elements in the Blood Collection Tubes with ICP-MS].
To investigate the contamination of blood collection tubes, 20 trace elements (Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Mo, Cd, Sn, Sb, Ba, W, Hg, Tl, Pb) in 13 different types of blood collection tube were studied with ICP-MS method. The lixivium of H(2)O and 10% HNO(3) were measured with ICP-MS, and then the contamination coming from the blood collection tube is specified. According to the concentration range of human blood, plasma and serum from recently published literature, this report presents a detailed analysis of capable trace elements for each blood collection tube. The results showed that, tube No.1 is capable to analyze 18 trace elements in the human serum; tube No.6 is capable to analyze 15 trace elements in the human plasma; tube No. 13 is capable to analyze 17 trace elements in the human blood. But we still should be aware that, the elements Sb and W in tube No.1, the elements V, Cr, Ni, and Sb in tube No.6, and the elements Al, Sb and W in tube No.13, are in the same magnitude of the normal trace element concentration range in the human serum, plasma and blood. They might affect the testing results. The serum collected from the same volunteer by tube No.1 and tube No.3 were compared here, the results show that, almost each trace element concentration of human serum from tube No.1 is lower than from tube No.3, especially for elements Al, V, Cr, Mn, As, Sn, and Sb. The results indicate that the blood collection tubes show great impact on determination of trace element.


The impact of Health Information Technology (I-HIT) Scale: the Australian results.
One of role of the nurse in the clinical setting is that of co-ordinating communication across the healthcare team. On a daily basis nurses interact with the person receiving care, their family members, and multiple care providers thus placing the nurse in the central position with access to a vast array of information on the person. Through this nurses have historically functioned as "information repositories". With the advent of Health Information Technology (HIT) tools there is a potential that HIT could impact interdisciplinary communication, practice efficiency and effectiveness, relationships and workflow in acute care settings [1][3]. In 2005, the HIMSS Nursing Informatics Community developed the I-HIT Scale to measure the impact of HIT on the nursing role and interdisciplinary communication in USA hospitals. In 2007, nursing informatics colleagues from Australia, Finland, Ireland, New Zealand, Scotland and the USA formed a research collaborative to validate the I-HIT in six additional countries. This paper will discuss the background, methodology, results and implications from the Australian I-HIT survey of over 1,100 nurses. The results are currently being analyzed and will be presented at the conference.


Unilateral phrenic nerve paralysis from cutting down a Christmas tree.
Stretch injury to the phrenic nerve is an unusual cause of unilateral diaphragmatic paralysis. In this case the injury occurred while the patient was lying on the ground and cutting down a Christmas tree with a hand saw.


Chemical kinetics and promoted Co-immobilization for efficient catalytic carbonylation of ethylene oxide into methyl 3-hydroxypropionate.
The carbonylative transformation of ethylene oxide (EO) into methyl 3-hydroxypropionate (3-HPM) is a key process for the production of 1,3-propanediol (1,3-PDO), which is currently viewed as one of the most promising monomers and intermediates in polyester and pharmaceuticals industry. In this work, a homogeneous reaction system using commercial Co2(CO)8 was first studied for the carbonylation of EO to 3-HPM. The catalytic behavior was related to the electronic environment of N on aromatic rings of ligands, where N with rich electron density induced a stronger coordination with Co center and higher EO transformation. A reaction order of 2.1 with respect to EO and 0.3 with respect to CO was unraveled based on the kinetics study. The 3-HPM yield reached 91.2% at only 40°C by Co2(CO)8 coordinated with 3-hydroxypyridine. However, Co-containing colloid was formed during the reaction, causing the tough separation and impossible recycling of samples. Concerning the sustainable utilization, Co particles immobilized on pre-treated carbon nanotubes (Co/CNT-C) were designed via an in situ reduced colloid method. It is remarkable that unlike conventional Co/CNT, Co/CNT-C was highly selective toward the transformation of EO to 3-HPM with a specific rate of 52.2 mmol·g Co - 1 ·h - 1 , displaying a similar atomic efficiency to that of coordinated Co2(CO)8. After reaction, the supported Co/CNT-C catalyst could be easily separated from the liquid reaction mixture, leading to a convenient cyclic utilization.


Implementation of nursing care plan in the Electronic Patient Record (EPR) findings and experiences.
In this presentation we share findings and experiences from introduction of the nursing care plan in the integrated EPR in our hospital. We explain the chosen implementation strategy, and present findings from a survey distributed to the head nurses and key users, as well as audit of the charted nursing care plans. The main challenges in implementing electronic nursing care plan in our hospital turned out to be organizing and allocating sufficient time for the introduction and necessary training of the users. The head nurses played and play a key role in facilitating for and making sure that introduction to the system and training receives the necessary priority among the staff on the ward. The introduction of the nursing care plan in the integrated EPR concluded the introduction of EPR in the nursing service, and has contributed to a re-newed discussion of ease-of-use in the clinical setting, structure and content of the nursing care plan.


Patients first! Engaging the hearts and minds of nurses with a patient-centered practice model.
Like every healthcare system today, the Cleveland Clinic health system is a combination of medical hospitals, institutes, and services in which the implementation of uniform care methodologies faces significant barriers. The guiding principle of the Cleveland Clinic, 'Patients First,' focuses on the principle of patient- and family-centered care (PFCC) but deliberately lacks details due to the wide scope of care delivered by the organization. The Stanley Shalom Zielony Institute of Nursing Excellence (the Nursing Institute) at the Cleveland Clinic was charged with standardizing nursing practice across a system with 11,000 registered nurses and 800 advanced practice nurses. The challenge involved providing firm direction on delivering PFCC that was appropriate for all clinical disciplines and could be implemented quickly across existing practices and technologies. Successful implementation required full engagement in the concept of PFCC by what the Institute for Healthcare Improvement has termed the 'hearts and minds' of nurses. To achieve these ends, development of a systemwide nursing practice model was initiated. In this article the authors identify the essence of PFCC, consider barriers to PFCC, review their process of developing PFCC, and describe how the Cleveland Clinic health system has implemented a PFCC nursing practice model. In doing so the authors explore how the concept of 'Passion for Nursing' was used to stimulate nurse engagement in PFCC.


Role of antibody in primary and recurrent herpes simplex virus infection.
When herpes simplex virus was inoculated into the flank of a BALB/c mouse by scarification, the local replication of virus was followed by the establishment of an acute ganglionic infection. The subsequent centrifugal spread of this virus along nerves to the skin of the whole dermatome led to the development of a bandlike "zosteriform" rash. This represents a highly reproducible system in which virus travels through the nervous system synchronously in large numbers of animals. The transection of peripheral nerves at various times after infection showed that the virus had completed the round trip 60 h after inoculation into the upper flank and was detectable as infectious virus by 74 h postinfection. After the administration of virus, neutralizing but not nonneutralizing antibodies prevented the development of the zosteriform rash. The target epitopes of the protective antibodies were not confined to a single glycoprotein. Neutralizing antibody was effective even when given up to 60 h postinfection and was protective even when administered after sensory neurotomy at this time. Antibody was therefore able to prevent clinically and virologically detectable infection of the skin, presumably by acting peripherally on virus emerging from nerve endings. A quantitative estimate of the action of one of the neutralizing monoclonal antibody preparations, AP7, showed that high titers (several times higher than those normally found in immune mice) were needed to prevent this type of infection. These results are discussed in relation to antibody prophylaxis.


Applying principles of development to help at-risk preschoolers develop numeracy.
In a yoked control design, multicultural Head Start 4-year-olds played numerous games involving either numeracy or the oddity principle and insertions into series. Children showed better mastery of oddity and insertions after playing games directed at those two concepts. Numeracy scores on the McCarthy Scales of Children's Abilities (D. McCarthy, 1972) were equivalent for children who played numeracy games and children who played oddity and insertion games. These results are consistent with other research indicating that the understanding of oddity relations and that of insertions are key transitional thinking abilities that support numeracy at the preschool-kindergarten interface.


Multiple level spinal injuries: importance of early recognition.
Patients with severe trauma may simultaneously sustain more than one level of spinal injury. Often, the second or third levels of injury are not recognized early enough to prevent clinically significant extension of the neurologic deficit, pain pattern, spinal instability, and/or deformity. A review of 710 spinal injury patients admitted to the Midwest Regional Spinal Cord Injury Care System yielded 4.5% multiple noncontiguous vertebral injuries. Thirty cases were studied in respect to location and type of primary and secondary injury. Of the secondary lesions, 40% occurred above and 60% below the primary lesion. In half of the patients, there was a mean of 52.6 days delay in diagnosis of the secondary lesion. Three major patterns of injury emerged from this analysis. Knowledge of these patterns and careful total spine radiography in patients with severe trauma may be a significant aid in early recognition of multiple level injuries and possible prevention of their complication.


[Marked growth of arteriovenous malformation 19 years after resection: a case report].
We report a case of arteriovenous malformation (AVM) which recurred as a giant AVM 19 years after resection. At the age of 23, the patient underwent craniotomy for a small AVM with surrounding old hematoma in the right parietal lobe. The AVM was judged to have been removed completely on postoperative angiography, while abnormal small vessels were noted retrospectively. He did well until 19 years later when he had seizures. Repeated angiography showed huge recurrent AVM at the operative site. Considering the risk involved in surgery, he was discharged from the hospital with anticonvulsants. Recurrence of AVM after removal is rare, but patients with AVM surgery should be followed up with CT and angiography for a long period of time.


Clinicopathological correlation in 50 cases of erythroderma.
Fifty cases of erythroderma were studied clinically and histopathologically. Clinically 11 were of eczemas, 12 of psoriasis, 14 were drug-induced, 11 of idiopathic group and 1 each of pemphigus foliaceus (PF) and cogenital bullous ichthyosiform erythroderma (CBIE). Histopathologically 10 cases of psoriasis, 1 of PF and 1 of CBIE showed specific histopathology and therefore clinical histopathological correlation was possible only in 12 (24%) cases. Exact differentiation in erythroderma due to eczemas, drugs or idiopathic was not possible histopathologically.


DnaK promotes the selective export of outer membrane protein precursors in SecA-deficient Escherichia coli.
Consistent with many other results indicating that SecA plays an essential role in the translocation of presecretory proteins across the Escherichia coli inner membrane, we previously found that a approximately 95% depletion of SecA completely blocks the export of periplasmic proteins in vivo. Surprisingly, we found that about 25% of the outer membrane protein (OMP) OmpA synthesized after SecA depletion was gradually translocated across the inner membrane. In this study we analyzed the export of several other OMPs after SecA depletion. We found that 25-50% of each OMP as well as an OmpA-alkaline phosphatase fusion protein was exported from SecA-deficient cells. This partial export was completely abolished by the SecA inhibitor sodium azide and therefore still required the participation of SecA. Examination of a variety of OmpA derivatives, however, ruled out the possibility that OMPs are selectively translocated in SecA-deficient cells because SecA binds to their N termini with unusually high affinity. Export after SecA depletion was observed in cells that lack SecB, the primary targeting factor for OMPs, but was abolished by partial inactivation of DnaK. Furthermore, OmpA could be isolated in a stable complex with DnaK. The data strongly suggest that OMPs require only a relatively low level of translocase activity to cross the inner membrane because they can be preserved in a prolonged export-competent state by DnaK.


The tadpoles of five Megophrys Horned frogs (Amphibia: Megophryidae) from the Hoang Lien Range, Vietnam.
Frogs in the genus Megophrys are an Asian radiation of stream-breeding frogs. The tadpoles of many Megophrys species are undescribed; those that are described are often dubiously allocated to species by association with post metamorphic specimens at collection sites and without supportive molecular data. We provide detailed descriptions of the larvae of five species of Megophrys from the Hoang Lien Range in northwest Vietnam: Megophrys fansipanensis, M. gigantica, M. hoanglienensis, M. jingdongensis and M. maosonensis. Tadpoles from different subgenera differ from each other via a combination of patternation in life, oral disc shape and tail morphology but given the small sample size, and limited number of species it is unlikely that these differences can be applied more widely to delineate subgenera. Morphological differences between tadpoles from species within the subgenus Panophrys were insufficient to clearly delineate all species. The ability to identify tadpoles is likely to advance our understanding of the frog fauna in mainland southeast Asia.


Crystal structure of Ba5In4Sb6.
The title compound, penta-barium tetra-indium hexa-anti-mony, was synthesized by an indium-flux reaction and its structure features layers composed of edge-sharing In2Sb6 units. The voids between the In4Sb6 layers are filled by Ba(2+) cations, which are all surrounded by six Sb atoms and form bicapped octa-hedral or triangular prismatic coordination geometries. There are five barium ions in the asymmetric unit: one has no imposed crystallographic symmetry, two lie on mirror planes and two have mm2 point symmetry. The two In atoms and four Sb atoms in the asymmetric unit all lie on general crystallographic positions.


[INVESTIGATION OF SURGICAL CORRECTION OF ANTERIOR APICAL PROLAPSE OF THE PELVIC ORGANS USING A COMBINED TECHNIQUE, MONOLATERAL CYRENE POSTERIOR IN COMBINATION WITH ANTERIOR COLPORRHAPHY].
Objective - to evaluate the results of surgical correction of anterior apical prolapse of the pelvic organs with a combined technique monolateral CYRENE posterior (using monofilament polypropylene tape CYRENE) in combination with anterior colporrhaphy. A prospective cohort study included 240 patients with urogenital prolapse. The subjects were followed up for three months, and the anatomical outcome according to the POP-Q System classification, intra- and postoperative complications, absence or presence of relapse, quality of life and sex life were assessed. A relapse was considered to be grade 3 or more anterior prolapse, grade 2 or more central prolapse. Quality of life and sex life were assessed using the PFDI-20, PFIQ-7 and PSIQ-12 questionnaires. The average age of women was 57.8 years. All 240 patients had grade 3 cystocele, prolapse of the anterior vaginal wall, and prolapse of the uterus. In 23 (9.6%) patients, de novo urinary incontinence developed, 8 patients had stress urinary incontinence before surgery, 6 of them persisted stress urinary incontinence after surgery, 2 of them stress urinary incontinence was arrested without the simultaneous use of a mid-urethral sling. According to questionnaires, the quality of life improved in 225 (96.9%) women according to PFDI-20 and in 210 (90.5%) according to PFIQ-7. There were no changes in the quality of sex life. Anatomically, 235 (96.9%) achieved the desired result (Ba≤ II, C≤ I according to the POPQ System). At the same time, in 36 (15%), 3 months after the operation, cystocele of the 2nd degree was revealed. In all cases, there was minimal blood loss, in 9 cases (3.75%) there was a hematoma of the anterior vaginal wall that did not require additional intervention, at discharge had signs of organization and was completely stopped 6 weeks after surgery; 3 (1.25%) patients had urinary retention after surgery. Dyspareunia was not identified in any patient. The study of the treatment of urogenital prolapse using a combined technique, monolateral CYRENE posterior in combination with anterior colporrhaphy, demonstrates high efficiency and relative safety. The technique showed excellent anatomical results for apical prolapse and good for anterior prolapse. A small number and low significance of postoperative complications were revealed. Longer postoperative follow-up is needed to assess long-term results and long-term prospects in order to form a more complete understanding of this technique.


Baby foods: formulations and interactions (a review).
Infant foods have a special place among food products mainly because of nutritional aspects and preparations methods. A great increase of baby foods incomes is predicted in near future. Formulation, handling, and storage of baby foods are important to keep nutritional quality and physicochemical properties of these foods. During storage some reactions and interactions occur which change physicochemical and nutritional properties of baby foods. Lactose crystallization, Maillard reaction, oxidation, and interactions between micronutrients and other components are the most important aspect of preparation and storage of baby foods. These reactions and interactions influence physical properties such as flowability of powder, solubility, and other functional properties. Controlling of storage conditions such as temperature and moisture content and oxygen quantity in headspace of product is required to keep product quality. In this paper the composition and interactions of baby foods between major components and their effect on nutritional quality of baby foods are explained.


Molybdenum Atom Engineered Vanadium Disulfide for Boosted High-Capacity Li-Ion Storage.
A drawback with lithium-ion batteries (LIBs) lies in the unstable lithium storage which results in poor electrochemical performance. Therefore, it's of importance to improve the electrochemical functionality and Li-ion transport kinetics of electrode materials for high-performance lithium storage. Here, a subtle atom engineering via injecting molybdenum (Mo) atoms into vanadium disulfide (VS2 ) to boost high capacity Li-ion storage is reported. By combining operando, ex situ monitoring and theoretical simulation, it is confirmed that the 5.0%Mo atoms impart flower-like VS2 with expanded interplanar spacing, lowered Li-ion diffusion energy barrier, and increased Li-ion adsorption property, together with enhanced e- conductivity, to boost Li-ion migration. A "speculatively" optimized 5.0% Mo-VS2 cathode that exhibits a specific capacity of 260.8 mA h g-1 at 1.0 A g-1 together with a low decay of 0.009% per cycle over 500 cycles is demonstrated. It is shown that this value is ≈1.5 times compared with that for bare VS2 cathode. This investigation has substantiated the Mo atom doping can effectively guide the Li-ion storage and open new frontiers for exploiting high-performance transition metal dichalcogenides for LIBs.


Enteric Fever Caused by Salmonella enterica Serovars with Reduced Susceptibility of Fluoroquinolones at a Community Based Teaching Hospital of Nepal.
Enteric fever continues to be an important public health problem especially in developing countries of the tropical region including Nepal. In this study, we aimed to investigate the incidence of enteric fever associated with Salmonella enterica and determine its antimicrobial susceptibilities to therapeutic antimicrobials in a community based teaching hospital of Nepal. A total of 2,304 blood samples from suspected enteric fever patients attending Manmohan Memorial Teaching Hospital were processed with standard microbiological methods for the isolation and identification of bacterial pathogens. The Salmonella enterica clinical strains were subjected to antimicrobial susceptibility testing by Kirby-Bauer disk diffusion method, and the results were interpreted according to the criteria suggested by the Clinical and Laboratory Standards Institute (CLSI). A total of 245 (10.6%) cases of enteric fever associated with Salmonella enterica were confirmed by blood culture. Out of them, 162 (66.1%) were caused by Salmonella Typhi and 83 (33.9%) by Salmonella Paratyphi. On Kirby-Bauer disk diffusion antimicrobial susceptibility testing, Salmonella isolates were highly susceptible to cefixime (100%), ceftriaxone (100%), ampicillin (97.9%), cotrimoxazole (94.6%), azithromycin (96.7%), tetracycline (95.5%), and chloramphenicol (97.5%), respectively. Two hundred twenty-six (92.2%) of Salmonella isolates were nalidixic acid resistant with reduced susceptibility to ciprofloxacin (36.7%) and ofloxacin (54.8%), respectively. Although the rate of MDR Salmonella strains was very low (<5%), their reduced susceptibility to fluoroquinolones has restricted their routine empirical use. Third generation cephalosporins are the safest choice for empirical use but ampicillin, cotrimoxazole, azithromycin, and chloramphenicol can be effective alternatives.


Reduction of antigenicity of Cry j I, major allergen of Japanese cedar pollen, by the attachment of polysaccharides.
An attempt was made to mask the allergenic structure of a major allergen protein, Cry j I (CJI), in Japanese cedar pollen using the Maillard-type polysaccharide conjugation. The SDS-PAGE pattern of the CJI-galactomannan conjugate prepared by the Maillard reaction showed broad bands widely distributed from 50 kDa to more than 100 kDa, suggesting the attachment of galactomannan. The competitive enzyme-linked immunosorbent assay showed that the IgE antibody in the sera of cedar pollen-sensitive patients reacted strongly with CJI, while it did not react with the CJI-galactomannan conjugate. This result suggests that the antigenicity of CJI is greatly reduced by the conjugation with galactomannan.


Uterine stem cells: from basic research to advanced cell therapies.
Stem cell research in the endometrium and myometrium from animal models and humans has led to the identification of endometrial/myometrial stem cells and their niches. This basic knowledge is beginning to be translated to clinical use for incurable uterine pathologies. Additionally, the implication of bone marrow-derived stem cells (BMDSCs) in uterine physiology has opened the field for the exploration of an exogenous and autologous source of stem cells. In this review, we outline the progress of endometrial and myometrial stem/progenitor cells in both human and mouse models from their characterization to their clinical application, indicating roles in Asherman syndrome, atrophic endometrium and tissue engineering, among others. A comprehensive search of PubMed and Google Scholar up to December 2017 was conducted to identify peer-reviewed literature related to the contribution of bone marrow, endometrial and myometrial stem cells to potential physiological regeneration as well as their implications in pathologies of the human uterus. The discovery and main characteristics of stem cells in the murine and human endometrium and myometrium are presented together with the relevance of their niches and cross-regulation. The current state of advanced stem cell therapy using BMDSCs in the treatment of Asherman syndrome and atrophic endometrium is analyzed. In the myometrium, the understanding of genetic and epigenetic defects that result in the development of tumor-initiating cells in the myometrial stem niche and thus contribute to the growth of uterine leiomyoma is also presented. Finally, recent advances in tissue engineering based on the creation of novel three-dimensional scaffolds or decellularisation open up new perspectives for the field of uterine transplantation. More than a decade after their discovery, the knowledge of uterine stem cells and their niches is crystalising into novel therapeutic approaches aiming to treat with cells those conditions that cannot be cured with drugs, particularly the currently incurable uterine pathologies. Additional work and improvements are needed, but the basis has been formed for this therapeutic application of uterine cells.


Follicular T-Helper Cells in Marginal Zone Lymphoma: Evidence of an Organoid Immune Response.
Primary cutaneous marginal zone B-cell lymphoma (MZL) follows an indolent clinical course. Histopathologically, there is a polymorphous infiltrate that includes small lymphocyte-like and centrocyte-like B cells and plasma cells usually with a substantial T-cell fraction. Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder, in which the signature cells have a follicular T-helper (TFH) phenotype and are admixed with numerous B cells. Thus, both present histologies of combined B-cell and T-cell infiltrates and represent differential diagnoses. The presence of TFH in MZL has yet to be elucidated. Forty-one biopsies from 40 cases of MZL and 7 cases of lymphoid hyperplasia cutis (LCH) were stained with antibodies to follicular T-helper cells, including Bcl-6, PD-1, ICOS, and CD10, as part of their diagnostic workup, were reviewed, and the stained slides were evaluated semiquantitively. Five reactive lymph nodes were also evaluated as controls. All cases of MZL and LCH contained TFH, albeit usually in low proportions. There were repeated differences in levels of expression between TFH markers, with PD1 and Bcl-6 being the most prevalent. The pattern of involvement in MZL and LCH closely mirrored that observed in the reactive lymph nodes. MZL includes TFH cells, similar to reactive lymph nodes, and a complexity of cell types. This provides evidence of an organoid immune response challenging its simple categorization as a malignancy.


[Carcinomas of the distal bile duct].
Malignancies of the biliary tree are classified into three groups according to location: intrahepatic, central (perihilar), and distal. Of all cholangiocarcinomas, 25% are located distally and can be subdivided into middle and lower bile duct carcinomas. Surgical approaches for achieving tumor-free resection margins (R0) are directly associated with the origin of the tumor. Intrahepatic and central cancers usually must be treated by liver surgery, whereas the majority of distal cholangiocarcinomas require pancreaticoduodenectomy. In case of a small, middle bile duct carcinoma, exclusive extrahepatic bile duct resection without pancreatic resection can be adequate. Five-year survival after radical resection is about 25%. Cancer of the distal bile duct has to be distinguished from ductal adenocarcinoma of the pancreas and carcinoma of the ampulla of Vater. Curative surgery is possible if the tumor is diagnosed early and radical resection is feasible. In this context, the role of an extended lymph node dissection remains unclear. To improve survival, future studies are needed to evaluate the role of novel adjuvant strategies (i.e., gemcitabine, capecitabine).


Knockdown of LINC01614 inhibits lung adenocarcinoma cell progression by up-regulating miR-217 and down-regulating FOXP1.
We tried to identify the function of LINC01614 in lung adenocarcinoma (LUAD) and reveal its underlying mechanisms. qRT-PCR was applied to assess the expression of LINC016014 in LUAD tissues, noncancerous tissues and cells. Through colony formation assay, MTT assay and apoptosis analysis, we examined the variation of cell proliferation and apoptosis ability after silencing LINC01614. Moreover, the targeting interactions among LINC01614, miR-217 and FOXP1 were validated via luciferase reporter assay, and then, we regulated the expression of miR-217 and FOXP1 to ascertain their importance in cell proliferation and apoptosis. LINC01614 and FOXP1 were found to be up-regulated in LUAD tumours and cells, whereas miR-217 was down-regulated. The experiment showed that target-specific selectivity exists between LINC01614-miR-217 and miR-217-FOXP1 3'UTR. Furthermore, we disclosed that inhibition of LINC01614 could activate miR-217, which subsequently restrained FOXP1. It was proved that LINC01614 promoted FOXP1 by inhibiting miR-217, which ultimately stimulated the development of LUAD.


L-DOPA-induced neurotoxic and apoptotic changes on cultured chromaffin cells.
Adrenal chromaffin cell (ACC) transplantation has been considered as one of the therapeutic strategies for Parkinson disease (PD). This strategy involves the administration of L-DOPA, although in reduced doses, to ACC-transplanted patients. Using cytochemical and morphological methods, we examined the effects of clinically applicable concentrations of L-DOPA on cultured chromaffin cells. We found an increase of cell death in both necrotic and apoptotic patterns. These data suggest that therapeutic preventive measures during ACC transplantation processes for PD should be taken.


[Psychologic status comparison in patients treated with transradial or transfermoral approach coronary catheterizations].
We previously showed that factorial score of somatization, which was obtained by the examination of symptom checklist-90 (SCL-90), was higher in patients received transfemoral coronary catheterization than norm. The aim of the present study was to compare the patient's psychologic status between transradial approach and transfemoral approach percutaneous coronary catheterizations. A total of 198 inpatients (105 transfemoral, 93 transradial) underwent scheduled first time coronary catheterizations were enrolled. All patients were studied by symptom SCL-90 on present psychologic status 24 hours before and 24-48 hours after coronary catheterizations. Age, sex, weight, smokers, employment, educational background, marriage status, family relations, family history of cardiovascular disease, income and medical insurance status were similar between the two groups. There was also no difference in diabetes, hypertension history as well as coronary heart disease confirmed by coronary catheterization between the 2 groups. Compared with the status before the procedure, factorial scores of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, global severity index and total positive symptoms were significantly reduced after percutaneous coronary catheterizations (1.50 +/- 0.51 vs. 1.64 +/- 0.53, 1.50 +/- 0.48 vs. 1.67 +/- 0.55, 1.28 +/- 0.41 vs. 1.38 +/- 0.49, 1.42 +/- 0.43 vs. 1.55 +/- 0.53, 1.38 +/- 0.41 vs. 1.58 +/- 0.54, 1.32 +/- 0.35 vs. 1.44 +/- 0.41, 1.38 +/- 0.34 vs. 1.49 +/- 0.42, and 23.08 +/- 17.30 vs. 27.72 +/- 18.79, respectively, P all < 0.05). Scores on somatization, depression and positive symptom severity index were significantly lower in patients received transradial coronary catheterizations than those received transfemoral coronary catheterization approach (1.52 +/- 0.51 vs. 1.62 +/- 0.53, 1.43 +/- 0.54 vs. 1.54 +/- 0.43 and 2.36 +/- 0.66 vs. 2.50 +/- 0.43, respectively, P all < 0.05). Patients' psychologic status improved significantly after percutaneous coronary catheterizations. Improvement on psychologic status is significantly better in patients underwent transradial coronary catheterizations than that underwent transfemoral coronary catheterizations.


Effects of cycloheximide and tunicamycin on opiate receptor activities in neuroblastoma X glioma NG108-15 hybrid cells.
The molecular mechanism of opiate receptor down-regulation and desensitization was investigated by studying the effects of cycloheximide and tunicamycin on opiate receptor activities in neuroblastoma X glioma NG108-15 hybrid cells. Cycloheximide inhibited [35S]methionine and [3H]-glucosamine incorporation by hybrid cells, while tunicamycin inhibited [3H]glucosamine incorporation only. Exposing hybrid cells to these two agents did not alter the viability of the cell. Treatment of NG108-15 cells with cycloheximide or tunicamycin produced a decrease in [3H]diprenorphine binding dependent on both time and concentrations of inhibitors, with no measurable modification in the ability of etorphine to regulate intracellular cyclic AMP production. Cycloheximide attenuated [3H]-diprenorphine binding by decreasing both the number of sites, Bmax, and the affinity of the receptor, Kd. Tunicamycin treatment produced a decrease in Bmax with no apparent alteration in Kd values. Cycloheximide and tunicamycin did not potentiate the rate or magnitude of etorphine-induced down-regulation or desensitization of opiate receptor in NG108-15 cells. Furthermore, there was an apparent antagonism in cycloheximide action on receptor down-regulation. The reappearance of opiate binding sites after agonist removal was affected by these two inhibitors. Cycloheximide and tunicamycin eliminated the increase in [3H]diprenorphine binding in the chronic etorphine-treated cells after agonist removal. These two inhibitors did not alter the resensitization of hybrid cells to etorphine. Thus, the site of opiate agonist action to induce receptor down-regulation and desensitization is not at the site of protein synthesis or protein glycosylation. These data substantiate previously reported observations that receptor down-regulation and receptor desensitization are two different cellular adaptation processes.


[Effect of plasmid pKM101 on the mutability of salmonella strains exposed to polycyclic aromatic hydrocarbons].
The carcinogenic polycyclic aromatic hydrocarbons have been shown to induce frameshift mutations rather than base-pair substitutions in Ames test strains devoid of pKM101 plasmid. This plasmid enhances the frequency of induced frameshift mutations and mediates the induction of base-pair substitutions during the action of these carcinogens. No correlation was observed between the degree of mutagenesis induced in plasmid-containing and in plasmid-free strains by the test agents and their reported carcinogenic activity.


Changes in transfer ribonucleic acids accompanying encystment in Acanthamoeba castellanii.
Transfer ribonucleic acid (tRNA) from exponentially growing cells (trophozoites) and from precysts of Acanthamoeba castellanii were examined by reversed-phase column (RPC-2) chromatography. This system gave excellent resolution of isoaccepting species of tRNA. The tRNAs for 12 amino acids were studied. A comparison of trophozoite and precyst tRNA elution profiles revealed no apparent differences in the number of isoaccepting species of alanyl-, arginyl-, asparaginyl-, glycyl-, leucyl-, lysyl-, methionyl-, phenylalanyl-, tryptophanyl-, or valyl-tRNAs. Seryl-tRNAs from trophozoites were eluted as three components, whereas precyst seryl-tRNAs were eluted as only two components. Precharged trophozoite and precyst isoleucyl-tRNAs were both eluted as single components; however, post-chromatography charging of trophozoite tRNA resulted in three components of activity for tRNA(Ile) and only one component for precyst tRNA(Ile). None of the observed changes could be attributed to differences in synthetases or to the presence of altered tRNA lacking the CCA terminus or partially degraded by nucleases. The possible significance of these observations is discussed.


Non-pharmacological treatment of gout.
Gout is a metabolically-related joint disease, characterized by recurrent episodic arthritis. The recent epidemiological study suggests that the incidence of hyperuricemia and gout in many countries has risen especially in recent decades. A possible explanation may be a decreased physical activity level and changes in eating habits. The patients lifestyle is one of the key factors contributing to the development of hyperuricemia. For patients, an important part of therapy is non-pharmacological treatment through changes in lifestyle factors such as dietary measures, weight control, and adequate hydration and exercise. Lifestyle changes can lead to beneficial health changes in patients. The relationships between serum uric acid levels, hyperuricemia, obesity, and metabolic syndrome are well established. Higher serum uric acid concentration positively correlates with body mass index (BMI) and metabolic syndrome. The reduction of BMI may lead to improved hyperuricemia in patients. Other important changes include stopping alcohol consumption, reducing the intake of sweetened beverages, increasing the intake of dairy products, no eating organ meats, sea fish, sausages. Proper hydration is also an important part of the treatment.


Roles of the Akt/mTOR/p70S6K and ERK1/2 signaling pathways in curcumin-induced autophagy.
Curcumin has a potent anticancer effect and is a promising new therapeutic strategy. We previously demonstrated that curcumin induced non-apoptotic autophagic cell death in malignant glioma cells in vitro and in vivo. This compound inhibited the Akt/mammalian target of rapamycin/p70 ribosomal protein S6 kinase pathway and activated the extracellular signal-regulated kinases 1/2 thereby inducing autophagy. Interestingly, activation of the first pathway inhibited curcumin-induced autophagy and cytotoxicity, whereas inhibition of the latter pathway inhibited curcumin-induced autophagy and induced apoptosis, thus augmenting the cytotoxicity of curcumin. These results imply that these two autophagic pathways have opposite effects on curcumin's cytotoxicity. However, inhibition of nuclear factor kappaB, which is the main target of curcumin for its anticancer effect, was not observed in malignant glioma cells. These results suggest that autophagy but not nuclear factor kappaB plays a central role in curcumin anticancer therapy and warrant further investigation toward application in patients with malignant gliomas. Here, we discuss the therapeutic role of two autophagic pathways influenced by curcumin.


Preparation of microcapsules containing two-phase core materials.
Urea-formaldehyde (UF) microcapsules containing two-phase core materials in which phthalocyanine blue BGS (beta-CuPc) particles were homodispersed in tetrachloroethylene (TCE) were prepared by in situ polymerization. The effects of the various process parameters, including the type of surface modifier, the viscosity of UF prepolymer, the type of water-soluble surfactant, and the concentration of oil-soluble surfactant in the capsule core on the dispersity of beta-CuPc particles in TCE and the properties of the capsule wall and the adsorption of beta-CuPc particles on the internal surface of capsule wall were experimentally investigated. It was shown that using octadecylamine (ODA) to modify beta-CuPc particles resulted in a significant increase of the dispersing extent (DE) and the electrophoresis velocity of the particles in TCE (about 4 and 20 times more than that of unmodified). In addition, the optimal reaction conditions of the synthesis UF prepolymer were obtained by the orthogonal test. On the other hand, as the oil/water interfacial tension of emulsion was big enough, the microcapsule formed. The concentration of Span-80 in TCE was no less than 0.062 mM; the adsorption of beta-CuPc particles on internal surface of wall were restrained. Finally, the microcapsules in which beta-CuPc particles possess reversible response to dc electric field were obtained.


TP53 gene polymorphisms at codons 11, 72, and 248 and association with endometriosis in a Brazilian population.
We evaluated the association between TP53 gene polymorphisms and endometriosis in Brazilian women. Genomic DNA was extracted from swabs of buccal cells collected from hospital patients. TP53 gene polymorphisms were investigated at three codons: TP53 11 Glu/Gln or Lys (GAG->CAG or AAG), TP53 72 Arg/Pro (CCG->CCC), and TP53 248 Arg/Thr (CGG->TCG) using the polymerase chain reaction-restriction fragment length polymorphism method. TP53 11 presented the following genotypic distribution: the control group was 98.28% homozygous wild-type (Glu) and 1.72% homozygous variant (Gln/Lys), and the heterozygous genotype was not identified. The genotypic distribution in the endometriosis group was 96% homozygous wild-type (Glu) and 4% heterozygous (Glu-Gln/Lys); the homozygous variant genotype was not identified (P = 0.02). TP53 72 showed the following genotypic distribution: the control group was 29.75% homozygous wild-type (Arg), 47.11% heterozygous (Arg-Pro), and 23.14% homozygous variant (Pro). The genotypic distribution in the endometriosis group was 16.15% homozygous wild-type (Arg), 51.54% heterozygous (Arg-Pro), and 32.31% homozygous variant (Pro) (odds ratio = 2.26; 95% confidence interval = 1.19-4.03; P = 0.02). Only one patient had the homozygous TP53 248 genotype (Arg-Trp/Gln); all other patients were homozygous wild-type in both the control and endometriosis groups (P = 0.51; NS). We found that TP53 72 polymorphism may be associated with susceptibility to endometriosis; the presence of at least 1 polymorphic allele increased the chance of disease development by 2.26-fold. Hence, this genetic variant is a potential candidate marker for endometriosis.


[Management of pediatric cholelitiasis: our experience].
The aim of this retrospective study was to report our experience about characteristics of clinical presentation, etiologies, diagnosis and medical or surgical treatment of pediatric cholelitiasis. Twenty-four children, ranging from 7 to 17 years of age (14 females and 10 males), with diagnosis of cholelitiasis were studied from 2008 through 2011. Exclusion criteria included: active infection, cholangitis, severe anemia or thrombocytopenia in cases with hemolytic diseases. Diagnosis was performed with abdominal ultrasonography-scanner (US). Furthermore, complete peripheral blood examination was performed to all patients. Follow-up was conducted by clinical and US and/or CT supports between 6 and 24 months. Laparoscopic cholecystectomy was performed in 16 patients, conservative management in 10. No cases of majority morbility or death rate were found. RMN-colangiography was conducted in 2 cases with cholestasis elevated index: no stone were found in common bile duct. During follow-up evaluation, 2 patients began sympotimatic and were undergone to cholecystectomy. "Wait and see" management was performed in all asymptomatic cases. In only 2 cases ursodeoxycholic acid (UDCA) was administrated. Laparoscopic cholecystectomy is a "gold standard" also for a treatment of cholelitiasis in childhood; it is an efficacy and safe treatment also for pediatric gallstones. Medical therapy with UDCA lead not to dissolution of gallstones but it had a positive effect on the symptoms.


Human chorionic gonadotropin and steroid concentrations in human follicular fluid in relation to follicle size and oocyte maturity in stimulated ovarian cycles.
The concentrations in follicular fluid (FF) of beta hCG, progesterone (P), estradiol (E2), androstenedione (A) and testosterone (T) by RIA were determined, in order to study the follicular micro-environment in stimulated cycles. Patients received either clomiphene with hMG plus hCG or hMG plus hCG. With increasing volume of FF (obtained at laparoscopy), P significantly increased (p less than 0.04) and hCG (p less than 0.0004) and T (p less than 0.05) significantly decreased with a borderline decrease in A (p less than 0.07). Progesterone also increased with advancing oocyte maturity. Beta-hCG and P were positively correlated with E2 and negatively correlated with A levels. It is suggested that FF hCG and progesterone levels may be markers of follicular development in stimulated cycles.


The structural and functional analysis of the human HSPA2 gene promoter region.
HSPA2 is a human counterpart of the testis-specific rodent Hst70/Hsp70.2 gene. In contrast to the latter, the expression of the human HSPA2 gene is not limited to the testis, and recent data show that human tumor cells can express this gene at significant levels. The characteristics of HSPA2 expression suggests that it can influence the phenotype and survival of cancer cells similarly as overexpression of major members of the HSP70 gene family. Until now, neither the structure of the transcription unit of the human HSPA2 gene has been established nor a functional analysis of its promoter performed. In this study we established that the human HSPA2 gene, in contrast to its rodent counterparts, is intronless and has a single transcription start site. We also show that the same type of HSPA2 transcripts are synthesized in the testes and in cancer cell lines. In order to perform a functional study of the HSPA2 promoter, we used a transient transfection assay and found that the 392 bp fragment upstream of the ATG codon was a minimal region required for efficient transcription, while a 150 bp deletion from the 5' end of this region dramatically reduced the promoter activity. Delineation of the minimal promoter is a basic step toward identifying the cis and trans elements involved in the regulation of the HSPA2 gene expression in cancer cells.


Early predictors of post-concussion symptoms in patients with mild head injury.
A small proportion of patients with mild head injury (MHI) develop post-concussion symptoms (PCSs). We searched simple measures for the early detection of patients who are probable to develop PCSs. We recorded signs and symptoms, history of previous diseases, medications, and lifestyle factors and measured serum protein S-100B on admission in a series of 172 consecutive MHI patients admitted into the emergency room of a general hospital. A modified Rivermead Post-Concussion Symptoms Questionnaire was used to identify the patients with and without PCSs 1 month after the injury. We identified 37 patients with MHI who developed PCSs (22%). Odds ratios (OR) and 95% confidence intervals (CI) after adjustment for possible confounding variables were calculated by logistic regression. Independent early risk factors for PCSs in the MHI patients were skull fracture (OR 8.0, 95% CI 2.6-24.6), serum protein S-100B >/= 0.50 microg/l (OR 5.5, 95% CI 1.6-18.6), dizziness (OR 3.1, 95% CI 1.2-8.0), and headache (OR 2.6, 95% CI 1.0-6.5). Serum protein S-100B proved to be a specific, but not sensitive predictor of PCSs. The presence of skull fracture, elevated serum protein S-100B, dizziness, and headache may help the emergency room physician to identify patients at risk of PCSs and to refer them for further examination and follow-up.


Effects of confinement on freezing and melting.
We present a review of experimental, theoretical, and molecular simulation studies of confinement effects on freezing and melting. We consider both simple and more complex adsorbates that are confined in various environments (slit or cylindrical pores and also disordered porous materials). The most commonly used molecular simulation, theoretical and experimental methods are first presented. We also provide a brief description of the most widely used porous materials. The current state of knowledge on the effects of confinement on structure and freezing temperature, and the appearance of new surface-driven and confinement-driven phases are then discussed. We also address how confinement affects the glass transition.


Bok, Bcl-2-related Ovarian Killer, Is Cell Cycle-regulated and Sensitizes to Stress-induced Apoptosis.
Bok/Mtd (Bcl-2-related ovarian killer/Matador) is considered a pro-apoptotic member of the Bcl-2 family. Although identified in 1997, little is known about its biological role. We have previously demonstrated that Bok mRNA is up-regulated following E2F1 overexpression. In the current work, we demonstrate that Bok RNA is low in quiescent cells and rises upon serum stimulation. To determine the mechanism underlying this regulation, we cloned and characterized the mouse Bok promoter. We find that the mouse promoter contains a conserved E2F binding site (-43 to -49) and that a Bok promoter-driven luciferase reporter is activated by serum stimulation dependent on this site. Chromatin immunoprecipitation assays demonstrate that endogenous E2F1 and E2F3 associate with the Bok promoter in vivo. Surprisingly, we find that H1299 cells can stably express high levels of exogenous Bok protein. However, these cells are highly sensitive to chemotherapeutic drug treatment. Taken together these results demonstrate that Bok represents a cell cycle-regulated pro-apoptotic member of the Bcl-2 family, which may predispose growing cells to chemotherapeutic treatment.


Physician Compliance to Choosing Wisely® Initiative in Radiographic Imaging of Low Risk Prostate Cancer in an Integrated Health Care System.
We evaluated the adherence of urologists within an integrated health care system to Choosing Wisely®, an initiative aimed at avoiding unnecessary medical tests. In urology, 2 of the guidelines state bone scans and pelvic computerized tomography scans are unnecessary in low risk prostate cancer. We performed a retrospective study on patients diagnosed with low risk prostate cancer between January 1, 2010 and December 31, 2017 at Kaiser Permanente Southern California. All demographics and imaging data were obtained. Patients with symptoms concerning for metastatic disease or with other malignancies were excluded by chart review. Statistical analysis was employed to compare the use of bone scans and computerized tomography scans in this population before and after the Choosing Wisely guidelines were published. Of the 6,996 patients, 121 (1.7%) and 96 (1.4%) underwent a bone scan and computerized tomography scan, respectively. A Cochran-Armitage test showed no change after implementation of the statements. Logistic regression analysis revealed that for every point increase in prostate specific antigen, the odds ratio was 1.09 for ordering both a bone scan and computerized tomography scan. When compared to Whites, the odds ratio of having a bone scan and computerized tomography scan were 0.35 and 0.37 for Blacks, 0.30 and 0.38 for Hispanics, and 0.47 and 0.61 for Asians, respectively. Over the study period, there were low rates of inappropriate imaging for low risk prostate cancer. There was no change in trend after publication of the Choosing Wisely. Higher prostate specific antigen levels and White ethnicity were predictors for ordering inappropriate imaging.