[Transdermal fentanyl patch for the treatment of chronic intractable pain].
The purpose of the treatment of chronic non-cancer pain is the improvement of the patient's quality of life, not the complete alleviation of pain. In Japan transdermal fentanyl patch can be used for the treatment of chronic intractable pain including cancer pain and chronic non-cancer pain. In prescribing transdermal fentanyl patch for patients with chronic non-cancer pain, cares should be focused on the selection of the patients and the periodic and continuous observation of analgesic effect and side effects. Patients with mental disorders need the consultation with specialists. In most cases side effects such as nausea, vomiting, constipation and sedation can be well tolerated. However, respiratory suppression or over sedation would also occur and such side effects can sometimes be fatal. Furthermore, long term effects on endocrine and immune systems have not been clarified yet. Proper prescription of opioids during a limited period of time is definitely the primary concern of medical professionals.


Fluid and protein fluxes across small and large pores in the microvasculature. Application of two-pore equations.
Treating the blood-tissue barrier as a two-pore membrane the separate fluid and solute fluxes occurring across 'small pores' and 'large pores' were modelled in continuous capillaries employing two-pore equations for the calculations together with the non-linear flux equation and theories for restricted diffusion and for the reflection coefficient (sigma). The two-pore equations derived proved useful for analyses of transvascular protein flux data obtained at low as well as at high filtration rates. These equations were applied to lymphatic protein flux data from dog paw (Renkin et al. 1977a, b) and to tracer albumin uptake data from rat skeletal muscle (Rippe et al. 1979). For both sets of data the small- and large-pore radii became closely similar, 44 vs. 45 A and 240 vs. 225 A, which also holds for the large-pore fractions of hydraulic conductivity (0.097 vs. 0.056). The main result of this analysis is that the passage of macromolecules normally occurring across the microvascular walls is almost entirely convective, and hence, dependent on the transmural hydrostatic and oncotic pressure gradients and on the hydraulic conductivity. For example, 75-90% of the transvascular passage of albumin was found to be due to convection through large pores at normal lymph flows, the remaining portion being mainly due to diffusion across small pores. Solutes larger than albumin were almost exclusively transported by convection across large pores. Two-pore heterogeneity was found to explain the previously observed variations of the apparent overall large solute diffusion capacity (PSapp) and the overall reflection coefficient (sigma f) with filtration rate and also previous overestimations of PS. Furthermore, the present results were not compatible with protein transport across any 'non-hydraulically conductive capillary pathways' as previously postulated from the lymphatic protein flux data analysed here (Renkin 1985).


Changes in lung and chest wall properties with abdominal insufflation of carbon dioxide are immediately reversible.
Previously we have reported that large increases in lung and chest wall elastances as well as lung resistance occur with abdominal insufflation of carbon dioxide during laparoscopic surgery. To examine whether these effects were reversible with abdominal deflation, we calculated lung and chest wall elastances and resistances from measurement of airway flow and pressure and esophageal pressure in 17 anesthetized/paralyzed patients undergoing laparoscopic surgery. Measurements were made immediately prior to abdominal insufflation and after deflation. Lung and chest wall elastances and resistances were not changed from baseline (P > 0.05), although total respiratory elastance remained slightly increased compared to baseline (P < 0.05). The change in total respiratory elastance did not correlate with abdominal insufflation time, surgical site, smoking history, or physical characteristics of the patients. There were no differences in frequency and tidal volume dependences of the elastances and resistances before and after abdominal insufflation (P > 0.5). We conclude that residual changes in respiratory mechanics caused by carbon dioxide insufflation during laparoscopic surgery are minor, and that the reported compromise of respiratory function indicated by pulmonary function tests after laparoscopy does not appear to be due to changes in passive mechanical properties of the lungs or chest wall.


Temperaments in psychotic and major affective disorders.
Assessment of affective temperaments with the extensively validated, 110-item TEMPS-A autoquestionnaire has been used to characterize patients with mood disorders, and its scores have been associated consistently with suicidal behavior. Much less has been reported about comparisons of characteristics of such assessments in psychotic and other psychiatric disorders. We analyzed results of TEMPS-A assessments in 1081 psychiatrically hospitalized patients in Rome and compared subscale scores (anxious [anx], cyclothymic [cyc], depressive [dep], irritable [irr], hyperthymic [hyp]) and a composite score (anx+cyc+dep+irr - hyp) among diagnoses and subjects with vs. without a suicide attempt. TEMPS-A subscale scores differed significantly among diagnoses and were higher with major affective than psychotic or other disorders. Suicide attempts were 1.5-times more frequent among women than men and with affective versus nonaffective disorders, ranking: bipolar-II > major depression > bipolar-I > other disorders > psychotic disorders. TEMPS-A subscores were significantly higher among suicidal subjects (ranking: anx ≥ cyc ≥ dep > irr) except hyp (lower), but the composite score differed most (1.37-fold higher). Multivariable logistic regression modeling indicated that suicide attempt was significantly and independently associated with: TEMPS-A composite score > female sex > affective disorder > older age. TEMPS-A scores, particularly a composite score (anx+cyc+dep+irr - hyp) may help effectively evaluate suicidal risk in association with nonaffective as well as affective disorders.


Age-Related Gliosis Promotes Central Nervous System Lymphoma through CCL19-Mediated Tumor Cell Retention.
How lymphoma cells (LCs) invade the brain during the development of central nervous system lymphoma (CNSL) is unclear. We found that NF-κB-induced gliosis promotes CNSL in immunocompetent mice. Gliosis elevated cell-adhesion molecules, which increased LCs in the brain but was insufficient to induce CNSL. Astrocyte-derived CCL19 was required for gliosis-induced CNSL. Deleting CCL19 in mice or CCR7 from LCs abrogated CNSL development. Two-photon microscopy revealed LCs transiently entering normal brain parenchyma. Astrocytic CCL19 enhanced parenchymal CNS retention of LCs, thereby promoting CNSL formation. Aged, gliotic wild-type mice were more susceptible to forming CNSL than young wild-type mice, and astrocytic CCL19 was observed in both human gliosis and CNSL. Therefore, CCL19-CCR7 interactions may underlie an increased age-related risk for CNSL.


[Pulmonary sequestration--report of 21 cases].
To evaluate the clinical manifestation and diagnostic characteristics of pulmonary sequestration. By retrospective analysis. 21 cases of pulmonary sequestration, identified by surgicea-pathologically, were reported. Only 4 cases were correctly diagnosed before operation, the other 17 cases were misdiagnosed as cyst, benign tumor or bronchiectasis. 177 cases (including the cases of our own) consist: 146 cases of intralobular type and 31 cases of extra lobular type. In 21 cases of our series, the lesions were found predominantly in the left lower lobe (13), right lower lobe (5), right upper lobe (2), right middle lobe (1). The manifestation of chest X-ray were well defined mass-like density, or cystic shadow with fluid level. Imaging with ultrasound, CT scan and MRI has important value in establishing a definite diagnosis by showing the anomalous artery. However, retrograde aortography plays a decisive role for confirming the diagnosis.


Phenomenon of depression and anxiety related to precautions for prevention among population during the outbreak of COVID-19 in Kurdistan Region of Iraq: based on questionnaire survey.
Since December 2019, the coronavirus disease 2019 (COVID-19) epidemic has swept the world, causing widespread burden and increasingly hospitalizations. Researchers from around the world have tried to study the virus and its effect with more precision in various fields. The purpose of this study is to identify levels of anxiety and depression with regard to precautionary for prevention of COVID-19, and to identify the relationship between demographic variables and both depression and anxiety. This was a descriptive cross-sectional study; data were collected by questionnaire via a mobile phone application in the Kurdistan Region of Iraq from 25 March, 2020 to 5 April, 2020. The sample size was 894 after deleting 20 cases because of duplication. The questionnaire consists of three main parts; part one is related to the sociodemographic characteristics of participants, the second and third parts consist of items related to depression and anxiety about COVID-19 using a 5-point Likert Scale (1 = of course no, 2 = no , 3 = normal for me, 4 = yes, and 5 = of course yes). Data was analyzed using SPSS V.25. The majority of the participants were from Erbil (58.8%), most of them were male (58.4%); nearly 21.2% preferred quarantine and 41.7% chose curfew as a best way to to avoid being infected by COVID-19. Most of the participants had depression because of people's lack of knowledge about how to protect themselves from the virus (88.14%), while the majority of them had anxiety concerning shopping and contact with infected people (97%) and financial problems (97%). Females had higher rates of COVID-19 depression than did males. There was a significant correlation between age and home setting and anxiety, and a significant association between marital status and level of education and depression. There was no significant association between other variables and depression and anxiety. The findings of the study indicated that the majority of participants were depressed and had anxiety about COVID-19. There was a significant association between gender and depression and anxiety, while there was no significant association between occupation and income, and depression and anxiety.


Negative trials in ovarian cancer: is there such a thing as too much optimism?
Recently, two clinical trials of novel agents in metastatic ovarian cancer were published: a phase 3 study of nintedanib and a phase 2 study of volasertib. There seemed to be discordance between the results and conclusions in the publication of both these trials. Despite not very optimistic results, the studies concluded optimistically in favor of the new agents under study. Using these examples, we point out the discrepancies and the risks of concluding optimistically based on statistical significance when the actual benefit is minimal. We also appeal against conducting large phase 3 trials that require significant resources without good phase 2 evidence for doing so.


Pleomorphic adenoma of the trachea.
Primary tracheal tumors are very rare. Pleomorphic adenoma is rarely found in the trachea, despite being the most common histological form of salivary gland neoplasm. We present a case of pleomorphic adenoma of the trachea. Bronchoscopic excision using cold instruments resulted in apparently normal tracheal mucosa.


Does combined dry land strength and aerobic training inhibit performance of young competitive swimmers?
(i) to examine the effects of eight weeks of combined dry land strength and aerobic swimming training for increasing upper and lower body strength, power and swimming performance in young competitive swimmers and, (ii) to assess the effects of a detraining period (strength training cessation) on strength and swimming performance. The participants were divided into two groups: an experimental group (eight boys and four girls) and a control group (six boys and five girls). Apart from normal practice sessions (six training units per week of 1 h and 30 min per day), the experimental group underwent eight weeks (two sessions per week) of strength training. The principal strength exercises were the bench press, the leg extension, and two power exercises such as countermovement jump and medicine ball throwing. Immediately following this strength training program, all the swimmers undertook a 6 week detraining period, maintaining the normal swimming program, without any strength training. Swimming (25 m and 50 m performances, and hydrodynamic drag values), and strength (bench press and leg extension) and power (throwing medicine ball and countermovement jump) performances were tested in three moments: (i) before the experimental period, (ii) after eight weeks of combined strength and swimming training, and (iii) after the six weeks of detraining period. Both experimental and control groups were evaluated. A combined strength and aerobic swimming training allow dry land strength developments in young swimmers. The main data can not clearly state that strength training allowed an enhancement in swimming performance, although a tendency to improve sprint performance due to strength training was noticed. The detraining period showed that, although strength parameters remained stable, swimming performance still improved. Key pointsThis study investigated the effect of dry land strength training on sprint performance in young competitive swimmers.A combined strength and aerobic swimming training allow dry land strength developments in young swimmers.The main data can not clearly state that strength training allowed an enhancement in swimming performance, although a tendency to improve sprint performance due to strength training was noticed.The detraining period showed that, although strength parameters remained stable, swimming performance still improved.


[Oxygen transfer efficiency of four kinds substrates applied in artificial aeration vertical-flow wetland].
In subsurface flow constructed wetlands, artificial aeration plays an important role in enhancing the ability of pollutant removal. Oxygenation capacity of four substrates, limestone, vesuvianite, 500 grade ceramisite and high-strength ceramisite, are tested under three kinds of gas volume [0.19, 0.38, 0.76 m3 x (m2 x h)(-1)] in artificial aeration vertical-flow wetland. When the gas volume is 0.19 m3 x (m2 x h)(-1), the results demonstrate that the oxygen utilization of 500 grade ceramisite and high-strength ceramisite are highest as 14.39% and 14.21%, and the oxygen utilization of limestone and vesuvianite are 11.68% and 13.11% respectively. With the increase of aeration intensity, oxygen transfer efficiency parameter KLa rises accordingly. However, the oxygen utilization of vesuvianite and two other kinds of ceramisite decreases with the increase of aeration intensity. The oxygen utilization of vesuvianite, 500 grad ceramisite and high-strength ceramisite are lower as 7.67%, 10.46% and 10.77% respectively when the aeration intensity is 0.76 m3 x (m2 x h)(-1). On the contrary, the oxygen utilization of limestone get its maximum value of 14.04% as the aeration intensity is 0.38 m3 x (m2 x h)(-1).


Design, Synthesis, and Characterization of Schiff Base Bond-Linked pH-Responsive Doxorubicin Prodrug Based on Functionalized mPEG-PCL for Targeted Cancer Therapy.
The side effects of doxorubicin (DOX) extremely limit its application in the treatment of malignant tumors. Nano-sized polymeric drugs based on the acidic microenvironment of tissular- or intra- tumor have attracted ample attention because of their potential in reducing side effects. In this research, an amphiphilic diblock copolymer based on poly (ethylene glycol) (PEG) and functionalized polycaprolactone (PCL) was synthesized and utilized as the drug carrier. DOX was chemically conjugated with the polymer via acid-cleavable imine bonds to obtain a novel pH-sensitive DOX prodrug (mPEG-PCL-Imi-DOX). mPEG-PCL-Imi-DOX (24.2 wt % DOX content) formed micelles with an average diameter of 125 nm through a simple solvent evaporation method. The in vitro release profile demonstrated that DOX release of the prodrug micelles was pH-responsive and able to be accelerated with the decrease of pH. In vitro cytotoxicity assay tests revealed that the pH-sensitive DOX prodrug micelles exhibited relatively lower toxicity and similar antitumor efficacy towards MCF-7 cells compared with free DOX. Hence, the DOX prodrug micelles with imine bonds can offer a carrier with great potential for chemo-therapeutics.


The allocation of epiblast cells to ectodermal and germ-line lineages is influenced by the position of the cells in the gastrulating mouse embryo.
The developmental potency of cells in the proximal and distal regions of the epiblast of pre- and early-primitive-streak-stage mouse embryos was assessed by their differentiation in the host embryo following orthotopic and heterotopic cell transplantation. Normally, cells in the distal epiblast differentiate predominantly into neuroectoderm and surface ectoderm. However, when they were transplanted to proximal regions of the epiblast, distal epiblast cells behaved like proximal epiblast cells: they colonised the extraembryonic mesoderm and other mesodermal tissues in the posterior region of the host embryo. In addition, about 3.7% of the transplanted distal epiblast cells differentiated into primordial germ cells. This proportion is comparable to the 3.9% of orthotopically transplanted proximal epiblast cells that became primordial germ cells. When proximal epiblast cells were transplanted heterotopically to distal sites, their descendants were generally absent from the extraembryonic mesoderm and the germ cell population of the host embryo. Like cells in the distal epiblast, they mostly colonised the neural plate and surface ectoderm. This plasticity of cell fate suggests that the epiblast cells are not irreversibly allocated to any specific lineages, including the germ line. The adoption of developmental fate that is typical of the cell population at the site of transplantation suggests that the specification of cell lineages is subject to certain site-specific influences in the epiblast. Allocation of cells to the ectodermal and germ cell lineages may be subject to local tissue interactions and the restriction of morphogenetic tissue movement of different epiblast cell populations during gastrulation.


Epithelial-mesenchymal transition-related microRNA-200s regulate molecular targets and pathways in renal cell carcinoma.
Our recent studies of microRNA (miRNA) expression signatures demonstrated that the epithelial-mesenchymal transition (EMT)-related microRNA-200 family (miR-200s: miR-200a/b/c, miR-141 and miR-429) were significantly downregulated in renal cell carcinoma (RCC) and putative tumor-suppressive miRNAs in RCC. In this study, our aim was to investigate the functional significance of the miR-200s in cancer cells and to identify novel miR-200s-regulated molecular targets and pathways in RCC. Expression levels of all the miR-200s members were significantly downregulated in human RCC tissues compared with normal renal tissues. Restoration of mature miR-200s in RCC cell line resulted in significant inhibition of cell proliferation and migration, suggesting that miR-200s function as tumor suppressors in RCC. Furthermore, we utilized gene expression analysis and in silico database analysis to identify miR-200s-regulated molecular targets and pathways in RCC. The miR-200s was categorized into two groups, according to their seed sequences, miR-200b/c/429 and miR-200a/141. Our data demonstrated that the 'Focal adhesion' and 'ErbB signaling' pathways were significantly regulated by miR-200b/c/429 and miR-200a/141, respectively. The identification of novel tumor-suppressive miR-200s-regulated molecular targets and pathways has provided new insights into RCC oncogenesis and metastasis.


Pathotoxin effects in sorghum are also produced by mercuric chloride treatment.
Pathogenic isolates of Periconia circinata produce a host-specific toxin (PC-toxin) and cause a root and crown rot in susceptible genotypes of sorghum. Treatment with PC-toxin leads to selective development of disease symptoms and an increase in synthesis of a group of acidic, low molecular weight proteins only in susceptible genotypes. Treatment of sorghum seedlings or excised root tips with HgCl(2) resulted in responses indistinguishable from those produced by treatment with PC-toxin, but the effects were not genotype specific.


Serum free prostate specific antigen: isoenzymes in benign hyperplasia and cancer of the prostate.
Prostate specific antigen (PSA) in serum of patients with benign prostatic hyperplasia (BPH) or prostate cancer (P-CA) not bound to alpha-1-antichymotrypsin (ACT) was analyzed by chromatofocusing. The procedure allowed the simultaneous separation of complexed and free PSA and the fractionation of the free PSA fraction into several isoenzymes. The detection of the isoenzymes was strongly dependent on the combination of antibodies introduced in the applied commercially available immunoassays (Cobas Core, Delfia). Isoenzymes in sera of patients with benign prostatic hyperplasia were mainly situated in the pI range of 6.6 to 7.3. Isoenzymes in sera of prostate cancer patients or in PSA from LNCAP cells were mainly situated in the pI range 7.0 to 8.3. Neuraminidase treatment of the sera shifted the isoelectric points of all three sources towards more basic pHs. An irregular glycosylation process in the dysplastic cells of the prostate is suggested to be the cause for the shift of the isoelectric points. The difference of isoenzyme distribution along the pH axis is discussed as a diagnostic tool to differentiate between BPH and P-CA.


Divergence and polymorphism analysis of IGF1Ra and IGF1Rb from orange-spotted grouper, Epinephelus coioides (Hamilton).
Orange-spotted grouper (Epinephelus coioides) is one of the most important marine fish and has a high market value. The insulin-like growth factor type 1 receptor (IGF1R) is a component of the insulin-like growth factor signaling system, and demonstrates important roles during growth. Based on information from livestock, we used IGF1R as a candidate gene to survey single nucleotide polymorphisms. In the present study, the sequences of IGF1Ra and IGF1Rb from orange-spotted grouper were obtained from the genome sequences and their clustering in clades a and b, respectively, was confirmed by phylogenetic analysis. Fourteen critical amino acids underlying functional divergence were detected between the two clades, revealing the molecular basis of their functional differences. Nearly one-fourth (22 kbp) of the genomic sequence of IGF1Ra was sequenced in a mass cross population, and nucleotide diversity and linkage disequilibrium levels were investigated. Nucleotide diversity was 0.00328 for π and 0.00344 for θw. The half decay of the squared allele-frequency correlation was 10,835 base pairs. Comparatively, the relatively high level of linkage and the significant deviation from neutrality-based codons in IGR1R showed that this gene was under selection. A site (KR269824.1:g. 63762C>T), located in the sixth intron, was significantly associated with eyeball diameter (P = 1.39 x 10-4, Q-value: 2.33 x 10-2), which accounted for 11.1% of phenotypic variance. These results highlight the important function of IGF1R in orange-spotted grouper and may be beneficial in the breeding of this species.


Involvement of a nucleolar component, perichromonucleolin, in the condensation and decondensation of chromosomes.
A component of the nucleolar material, perichromonucleolin (PCN), was identified by a specific antiserum against nucleoli obtained from a scleroderma patient. The distribution and changes of PCN during the mitotic cycle were followed using this antiserum and indirect immunofluorescence microscopy. Based upon the behavior of PCN during mitosis, it could be differentiated into chromosomal and nonchromosomal portions. During prophase the former gradually associates with the surface of the condensing chromosomes and forms the coat or pellicle around the metaphase and anaphase chromosomes. This pellicle PCN is carried by the anaphase chromosomes to the daughter nuclei. During the time from telophase to interphase, the pellicle PCN dissociates from the decondensing chromosomes and is incorporated into the new nucleoli. The nonchromosomal PCN, after the breakdown of the nuclear membrane, distributes in the cytoplasmic region around the condensed chromosomes and diffuses into the cytoplasm during anaphase. Preliminary biochemical analysis by immunoblotting showed that the PCN consists of two main proteins with molecular masses of 36 kDa and 30 kDa.


Examining the Protective Effect of Ethnic Identity on Drug Attitudes and Use Among a Diverse Youth Population.
Ethnic identity is an important buffer against drug use among minority youth. However, limited work has examined pathways through which ethnic identity mitigates risk. School-aged youth (N = 34,708; 52 % female) of diverse backgrounds (i.e., African American (n = 5333), Asian (n = 392), Hispanic (n = 662), Multiracial (n = 2129), Native American (n = 474), and White (n = 25718) in grades 4-12 provided data on ethnic identity, drug attitudes, and drug use. After controlling for gender and grade, higher ethnic identity was associated with lower past month drug use for African American, Hispanic, and Multiracial youth. Conversely, high ethnic identity was associated with increased risk for White youth. An indirect pathway between ethnic identity, drug attitudes, and drug use was also found for African American, Hispanic, and Asian youth. Among White youth the path model was also significant, but in the opposite direction. These findings confirm the importance of ethnic identity for most minority youth. Further research is needed to better understand the association between ethnic identity and drug use for Multiracial and Hispanic youth, best ways to facilitate healthy ethnic identity development for minority youth, and how to moderate the risk of identity development for White youth.


Distributions of fibronectin, laminin, type I and IV collagens and carbonic anhydrase isozyme III during bovine ruminal epithelial development.
The present study describes the immunohistochemical distributions of extracellular matrices and the carbonic anhydrase isozyme III (CA-3) in the bovine ruminal epithelium during fetal development. Fibronectin (FN), laminin and type I and IV collagens were distributed in the ruminal subepithelial mesenchymal regions with nonspecific regionality during the gestational periods. At stages after about 59 cm crown-rump length (CRL), FN of the epithelial basement membrane disappeared, and CA-3 appeared in the basal epithelial cells of the root of the ruminal papillae, suggesting that the functional differentiation of the ruminal epithelium might start at around 59 cm CRL in bovine fetuses.


The Integration of Emotional, Physiologic, and Communication Responses to Medical Oncology Surveillance Appointments During Breast Cancer Survivorship.
Breast cancer survivors regularly interact with providers during routine surveillance medical oncology visits, discussing uncertainty and anxiety about potential cancer recurrence for many years after treatment. Physiologic alteration can also occur as a stress response, triggered by an upcoming surveillance visit. Survivor-provider communication can theoretically allay emotional distress. The aim of this study was to evaluate associations between emotional (uncertainty, anxiety, concerns about recurrence) and physiologic responses (cytokine levels, lymphocyte counts), and survivor-provider communication (women's plans for their visit, negotiation of decision-making roles). Twenty-seven community-dwelling breast cancer survivors participated. Blood specimens, and self-reported data focusing on the previous month, were collected immediately before and the morning after a regularly scheduled medical oncology visit. Global concerns about cancer recurrence and acute anxiety and uncertainty were associated with changes in immune status before and after the visit. Postvisit natural killer cells increased in 70% of women, and uncertainty/anxiety decreased. Thirty-three percent of women reported a previous minor illness. Most women had a visit plan; 66% successfully negotiated decision-making roles with providers. Triggered by an upcoming medical oncology visit, women experience uncertainty, anxiety, and altered immunity, potentially placing them at risk of disease exacerbations. Not all women respond similarly to a routine surveillance visit; thus, providers must determine who may be at increased risk of emotional distress and physiologic alteration. Survivor-provider communication facilitates immediate resolution of concerns. Explanations of symptom meaning reduce anxiety and uncertainty and by extension may help resolve immune alteration. Between visits, this could be done by nurse-operated telephone-based "help lines."


Different clinical characteristics in Hispanic and non-Hispanic whites with ileal pouch-anal anastomosis: a case-control study.
Inflammatory bowel disease (IBD) is increasingly diagnosed in ethnic and racial minorities. Ileal pouch-anal anastomosis (IPAA) has become the treatment of choice for ulcerative colitis (UC) patients requiring surgery. Few studies have characterized the natural history of IPAA and the pouch outcomes in the Hispanic American population. Ethnicity was designated by self-report and the Hispanics who had IPAA for UC were identified from a prospectively maintained database. Demographics, clinical characteristics, and pouch outcomes were compared between Hispanic and a sample of Non-Hispanic whites (1:4 ratio) randomly selected from the same database. Exclusion criteria were patients with a preoperative diagnosis of Crohn's disease or familial adenomatous polyposis, and patients of other ethnic groups. Thirty-six Hispanics with IPAA were identified. Hispanic patients were younger at UC diagnosis 23.1 ± 13.1 vs. 30.4 ± 12.6 yrs and at colectomy 31.9 ± 13.9 vs. 38.8 ± 13.8 yrs than controls. The interval between diagnosis and colectomy was comparable between the two groups. There were more uninsured in the Hispanic group than controls (13.9% vs. 2.8%). There were no significant differences in gender distribution, family history of IBD, smoking history, extent of UC, fulminant colitis, pouch configuration, stage of pouch, presence of extraintestinal manifestations, or concurrent autoimmune disorders. Pouch-related disorders and pouch failure were also similar. There appeared to be some difference in the preoperative characteristics of patients who underwent colectomy for UC between Hispanics and non-Hispanic whites, but outcomes after the restorative proctocolectomy with IPAA were comparable. Further studies are needed to characterize the natural history of UC and IPAA in the Hispanic population and the associated biosocioeconomic factors.


Improving Imaging Modalities in Early Psoriatic Arthritis: The Role of Ultrasound in Early Diagnosis of Psoriatic Arthritis.
Objective: Despite recent advances, early diagnosis of psoriatic arthritis (PsA) remains a challenge in clinical practice. Ultrasound (US) could be a useful tool for the diagnosis and management of PsA. The objective of this review was to determine the role of US in early diagnosis of PsA. Methods: We have performed a literature review aiming to evaluate studies on US findings in psoriasis and their predictive value of progression to PsA, as well as studies on US features specific for PsA in comparison with other conditions. Results: A total of 40 studies were included. Sixteen studies assessed US findings in psoriasis, of which only 3 prospectively evaluated the role of US in predicting progression to PsA. Patients with PsA had a greater frequency of US abnormalities, in particular enthesitis and Power Doppler(PD) signal compared to patients with psoriasis only. In the longitudinal studies, psoriatic patients with higher enthesopathy scores at baseline were more likely to progress to PsA. Twenty-four studies evaluated US abnormalities in PsA and compared them to other conditions. Most specific US features that distinguish PsA from psoriasis were PD signal and erosions in joints and entheses. Extra-synovial changes, including peri-tendinous dermal soft tissue oedema with associated PD signal and flexor tendon enthesopathy, as well as thickening of the pulleys in the flexor tendons were highly characteristic for PsA, as they were frequently found in PsA patients, but in none of the RA patients. US-detected entheseal abnormalities in particular erosions and PD signal were more frequent in patients with PsA compared to fibromyalgia. Conclusion: Despite the wide use of US in PsA, more research is needed to identify predictive factors of progression to PsA in patients with psoriasis, as well as to determine most specific US features that differentiate PsA from other conditions.


Nuclear medicine evaluation of motion sickness and medications on gastric emptying time.
Diminished gastric motility and lack of bowel sounds have been observed in astronauts aboard the Space Shuttle (4). In this study subjects were given scopolamine 0.6 mg with d-amphetamine 5 mg with and without neostigmine 15 mg. Neostigmine 15 mg alone was also compared with placebo for effect on gastric emptying time. In an additional test, subjects performed head movements in a rotating chair to an end-point of motion sickness short of vomiting. Ten ounces of isotonic saline containing 1 mCl of Tc 99mDPTA was ingested 2 h after the medications and immediately after rotation. The counts from stomach contents were monitored with a Picker small field of view gamma camera every 30 s for 1 h. Gastric motility was inhibited by scopolamine and amphetamine with 14% residual count at the end of 1 h. When neostigmine was added to this combination the results were in the placebo range. Motion sickness produced a profound inhibition of gastric emptying with a 47% residual count. The results indicate that the gastric stasis encountered in space is due mainly to motion sickness with a minimal contribution from the antimotion sickness drugs.


Cost of treating otitis media in Australia.
Otitis media (OM) is an inflammation of the middle ear. It is very common and associated with serious complications, including hearing loss. This study aimed to estimate the treatment costs of OM in Australia and the associated burden of disease (in disability-adjusted life-years). Little Australia-wide epidemiological information is available, so international studies in the main were used to estimate the incidence and prevalence by age and gender. These were triangulated against the available Australian data. Australian health data sets and data collected from the emergency department of a tertiary pediatric hospital were used to estimate the costs of primary care, pharmaceuticals, pathology and imaging, emergency department presentations, specialists, and admitted hospital care. Excluding the costs of the complications and comorbidities associated with OM, treatment costs for the disease in 2008 were between AUS$100 and 400 million. Visits to general practitioners and medicines constituted a high proportion of these costs. Antibiotic prescribing rates remain high despite clear evidence for a limited benefit from antibiotics for most OM cases and concerns regarding bacterial resistance. Treatment costs of OM in Australia are high and can only be estimated within a broad range. Further research on the links between antibiotics for OM and antibiotic resistance, and on the cost-effectiveness of prevention or amelioration of OM would be useful.


Alterations in rat brain thyroid hormone status following pre- and postnatal exposure to polychlorinated biphenyls (Aroclor 1254).
The effect of daily oral maternal exposure to 0, 5, or 25 mg/kg body wt of a polychlorinated biphenyl (PCB) mixture (Aroclor 1254) on Days 10 to 16 of gestation on plasma and brain thyroid hormone concentrations and peripheral thyroid hormone concentrations and peripheral thyroid hormone metabolism were examined in fetal and weanling rats. Plasma thyroid hormone levels and hepatic microsomal thyroid hormone glucuronidation were also examined in pregnant rats and the adult offspring. Plasma and brain levels of PCBs and hydroxylated PCB metabolites were analyzed in fetal, weanling, and adult offspring. Maternal exposure to Aroclor 1254 significantly decreased fetal (Gestation Day 20) and neonatal (Postnatal Day 4) plasma total thyroxine (T4) and free T4 levels in a dose-dependent manner. Effects of maternal Aroclor 1254 exposure on plasma total and free T4 concentrations were less pronounced in offspring at 21 days of age and absent 90 days after birth. Plasma concentrations of thyroid-stimulating hormone were unaltered in fetuses, neonates, weanling rats, and adult offspring following maternal treatment with Aroclor 1254. the concentration of T4 was severely depressed in the forebrain and cerebellum of fetal rats on Day 20 of gestation following maternal Aroclor 1254 exposure. Brain triiodothyronine (T3) concentrations in the Aroclor-exposed fetuses were significantly decreased relative to control values only in the low-dose group. On Day 21 postpartum T4 concentrations were significantly decreased in the forebrains of female weanling rats from the 25 mg Aroclor 1254/kg dose group, and no reductions were observed in forebrain T3 concentrations in male or female neonates. The deiodination of T4 to T3 was significantly increased in fetal forebrain homogenates by both PCB treatments. In female weanling brain homogenates the deiodination of T4 to T3 was significantly decreased in the low-dose group and unaltered in the high-dose group. No alterations in brain thyroid hormone metabolism were observed in forebrain homogenates from adult offspring exposed pre- and postnatally to Aroclor 1254. Hepatic microsomal T4 glucuronidation was significantly decreased in fetal microsomes following perinatal PCB exposure and significantly increased in weanling hepatic microsomes in a dose-dependent manner. An accumulation of mainly one PCB metabolite, 2,3,3',4',5-pentachloro-4-biphenylol was observed in fetal plasma and forebrain on Gestation Day 20 and in neonatal and weanling rat plasma on Postnatal Days 4, 21, and 90. The plasma level of 2,3,3',4',5-pentachloro-4-biphenylol was higher than that of the persistent PCB congener 2,2',4,4',5,5'-hexachlorobiphenyl in the control and PCB-exposed offspring up to Postnatal Day 21, and even after 90 days, the 2,3,3',4',5-pentachloro-4-biphenylol was present in amounts approximately equal to those of CB 153. Although PCB levels were relatively high in the weanling rat forebrain, no hydroxylated PCB metabolites were detected. On Day 90 postpartum, plasma levels of PCBs and 2,3,3',4',5-pentachloro-4-biphenylol were still elevated in the offspring of PCB-treated dams relative to controls. These results suggest that the accumulation of hydroxylated PCB metabolites in fetal plasma can reduce fetal plasma T4 levels and accordingly fetal brain T4 levels. However, in late gestational fetuses, the induction of brain type II thyroxine 5'-deiodinase activity compensates for decreases in brain T4 levels, so that brain T3 levels are maintained.


Feature selection based on fuzzy joint mutual information maximization.
Nowadays, real-world applications handle a huge amount of data, especially with high-dimension features space. These datasets are a significant challenge for classification systems. Unfortunately, most of the features present are irrelevant or redundant, thus making these systems inefficient and inaccurate. For this reason, many feature selection (FS) methods based on information theory have been introduced to improve the classification performance. However, the current methods have some limitations such as dealing with continuous features, estimating the redundancy relations, and considering the outer-class information. To overcome these limitations, this paper presents a new FS method, called Fuzzy Joint Mutual Information Maximization (FJMIM). The effectiveness of our proposed method is verified by conducting an experimental comparison with nine of conventional and state-of-the-art feature selection methods. Based on 13 benchmark datasets, experimental results confirm that our proposed method leads to promising improvement in classification performance and feature selection stability.


Suppression of feeding by cholecystokinin but not bombesin is attenuated in dorsomedial hypothalamic nuclei lesioned rats.
Rats with dorsomedial hypothalamic lesions (DMN-L) or sham operations were injected IP with saline or the satiety peptide cholecystokinin (CCK) at 3.0 and 6.0 micrograms/kg at the onset of the dark phase. Food consumption was then measured 15, 30 and 60 min later. Compared to saline baseline intake, CCK suppressed feeding during the first 30 min following injection in the sham operated group but not in the DMN-L group. Bombesin (BBS), another satiety peptide was also injected (4.0 and 8.0 micrograms/kg) into the two groups. BBS produced significant and comparable suppression of feeding in both DMN-L and sham operated rats. In a third trial a large dose of CCK (12.0 micrograms/kg) was injected into the two groups as described above. The CCK suppressed feeding for 60 min in the control group. CCK also attenuated feeding in the DMN-L group, but for only 30 min. However, even this suppression was reduced compared to the control group. The data suggest that the DMN may play a role in CCK induced satiety.


Paradoxical synergistic effects of tumour necrosis factor and interleukin 1 in murine gut-derived sepsis with Pseudomonas aeruginosa.
The authors evaluated the synergistic effect of tumour necrosis factor (TNF) and interleukin 1 (IL-1) in gut-derived sepsis in mice. After colonization of Pseudomonas aeruginosa strain D4 in the gastrointestinal tract, cyclophosphamide was administered to induce bacterial translocation of the P. aeruginosa and thereby to cause gut-derived sepsis. In this model, treatment either with 8 microg/kg of recombinant human TNF-alpha (rhTNF-alpha) or 2 microg/kg of recombinant human interleukin 1alpha (rhIL-1alpha) solely did not affect the mortality, whereas combined administration of the same doses of rhTNF-alpha and rhIL-1alpha significantly increased the mortality rate in comparison with saline-treated mice. Bacterial counts in liver and blood were significantly higher in rhTNF-alpha and rhIL-1alpha treated mice than in saline-treated mice. Endogenous TNF-alpha and IL-1beta productions were stimulated after combined treatment with rhTNF-alpha and rhIL-1alpha. On the contrary to these adverse effects, combined treatment with 500 microg/kg of rhTNF-alpha and 50 microg/kg of rhIL-1alpha on the day before the administration of cyclophosphamide significantly reduced the mortality from septic infection. We conclude that TNF and IL-1 synergistically affect the mortality of mice after gut-derived sepsis due to P. aeruginosa in mice and the timing of treatment with these cytokines causes both extremes in their effects.


Induction of thyroid cancer cell apoptosis by a novel nuclear factor kappaB inhibitor, dehydroxymethylepoxyquinomicin.
The objective of the study was to determine the effects of a novel selective nuclear factor kappaB (NF-kappaB) inhibitor, dehydroxymethylepoxyquinomicin (DHMEQ), in thyroid carcinoma cells in vitro and in vivo and to additionally elucidate the molecular mechanisms underlying the action of this chemotherapeutic agent. In the in vitro experiments, the induction of apoptosis by DHMEQ in various human thyroid carcinoma cell types was determined by flow cytometry analysis of annexin-V binding and the caspase activation by Western blotting. For the in vivo study, female nu/nu mice were xenografted with s.c. FRO thyroid tumors. DHMEQ solution was injected i.p. at a dose of 8 mg/kg/day for two weeks. Tumor dimensions were monitored twice weekly, and apoptosis in tumor specimens was determined by terminal deoxynucleotidyl transferase-mediated nick end labeling staining. Treatment with DHMEQ substantially inhibited the translocation of p65 and p50 NF-kappaB subunits to the nucleus, the DNA-binding activity of the RelA/p65, NF-kappaB-dependent expression of the inhibitor of apoptosis (IAP)-family proteins, cIAP-1, cIAP-2, and XIAP, and the de novo synthesis of inhibitor of nuclear factor kappaB alpha. At concentration levels ranging from 0.1 to 5 microg/ml, DHMEQ induced a caspase-mediated apoptotic response that could be abrogated by the c-Jun NH(2)-terminal kinase inhibitor SP600125 but not by either mitogen-activated protein/extracellular signal-regulated kinase kinase or p38 inhibitors. In contrast, normal human thyrocytes were resistant to DHMEQ-induced apoptosis. At higher doses of DHMEQ we observed the necrotic-like killing of both normal and malignant thyrocytes, which was resistant to mitogen-activated protein kinase inhibitors. In nude mice DHMEQ substantially inhibited tumor growth without observable side effects, and increased numbers of apoptotic cells were observed in the histologic sections of tumors treated with DHMEQ. Our results show the potential usefulness of the novel NF-kappaB inhibitor, DHMEQ, in future therapeutic strategies for the treatment of thyroid cancers that do not respond to conventional approaches.


Arthrogryposis, ophthalmoplegia, and retinopathy: confirmation of a new type of arthrogryposis.
Arthrogryposis multiplex congenita is a heterogeneous condition and many different types are clinically recognisable. Recently, a new type of autosomal dominant arthrogryposis was described in a father and son. We report on a male patient with similar clinical features, confirming this distinct type of arthrogryposis. The condition is characterised by congenital contractures of the hands and feet with diminished or absent phalangeal creases, ophthalmoplegia, a rigid trunk, deep set eyes, and (in the oldest patient) an abnormal electroretinogram. Differential diagnosis from amyoplasia, the different types of distal arthrogryposis, and symphalangism is discussed.


Interferon modulates glucose-sensitive neurons in the hypothalamus.
Interferon-alpha (IFN) therapy induces feeding suppression that resembles anorexia. The hypothalamic glucose-sensitive neurons engage in feeding behavior. Coronal sections of rat brains, containing both the lateral hypothalamus (LH) and the ventromedial hypothalamus (VMH), as well as single-cell recordings were used to study the interaction between IFN and glucose-sensitive neurons. IFN suppressed the majority (78%) of LH neurons, while reduction in glucose concentration elicited excitation in the majority (85%) of the same neurons. The opposite effects were observed in the VMH, where IFN excited the majority of neurons (61%), and reduction in glucose concentration exerted the opposite effects in 64% of VMH recordings. Concomitant IFN and glucose reduction exhibited only the effects elicited by IFN, regardless of whether the glucose reduction caused excitation (LH) or suppression (VMH). This observation suggests that IFN causes anorexia by modulating the LH and VMH glucose-sensitive neurons.


Survival following mechanical ventilation for acute respiratory failure in adult men.
Survival following mechanical ventilation for acute respiratory failure has important implications for medical decision-making and allocation of expensive resources for critical care. We reviewed a 5-year experience with mechanical ventilation in 383 men with acute respiratory failure and studied the impact of patient age, cause of acute respiratory failure, and duration of mechanical ventilation on survival. Survival rates were 66.6 percent to weaning, 61.1 percent to ICU discharge, 49.6 percent to hospital discharge, and 30.1 percent to 1 year after hospital discharge. When our data were combined with 10 previously reported series, mean survival rates were calculated to be 62 percent to ventilator weaning, 46 percent to ICU discharge, 43 percent to hospital discharge, and 30 percent to 1 year after discharge. Of 255 patients weaned from mechanical ventilation, 44 (17.3 percent) required an additional period of mechanical ventilation during the same hospitalization. Age had a significant influence on survival to hospital discharge and on that to 1 year after hospital discharge, and the cause of acute respiratory failure had a significant influence on survival only to weaning. Survival was best in younger patients and those with COPD or postoperative respiratory failure and worst in patients resuscitated after cardiac or respiratory arrest. Increased duration of mechanical ventilation significantly reduced survival only to hospital discharge. Overall survival was significantly affected by age and cause of acute respiratory failure, but not by duration of mechanical ventilation. We conclude that age, cause of acute respiratory failure, and duration of mechanical ventilation have specific influences on the generally poor outcome of mechanical ventilation for acute respiratory failure.


Hematological toxicity of adjuvant portal liver infusion with fluorouracil, mitomycin and heparin.
Adjuvant perioperative liver infusion chemotherapy with fluorouracil, mitomycin and heparin caused mild but significant myelosuppression in the first two postoperative weeks. This was associated with a slightly increased bleeding tendency. Mortality was not increased. Future trials might combine chemotherapy with hematopoietic growth factors in order to minimize myelosuppression.


Multivariate analysis on unilateral cleft lip and palate treatment outcome by EUROCRAN index: A retrospective study.
This study is to evaluate the dental arch relationship and palatal morphology of unilateral cleft lip and palate patients by using EUROCRAN index, and to assess the factors that affect them using multivariate statistical analysis. A total of one hundred and seven patients from age five to twelve years old with non-syndromic unilateral cleft lip and palate were included in the study. These patients have received cheiloplasty and one stage palatoplasty surgery but yet to receive alveolar bone grafting procedure. Five assessors trained in the use of the EUROCRAN index underwent calibration exercise and ranked the dental arch relationships and palatal morphology of the patients' study models. For intra-rater agreement, the examiners scored the models twice, with two weeks interval in between sessions. Variable factors of the patients were collected and they included gender, site, type and, family history of unilateral cleft lip and palate; absence of lateral incisor on cleft side, cheiloplasty and palatoplasty technique used. Associations between various factors and dental arch relationships were assessed using logistic regression analysis. Dental arch relationship among unilateral cleft lip and palate in local population had relatively worse scoring than other parts of the world. Crude logistics regression analysis did not demonstrate any significant associations among the various socio-demographic factors, cheiloplasty and palatoplasty techniques used with the dental arch relationship outcome. This study has limitations that might have affected the results, example: having multiple operators performing the surgeries and the inability to access the influence of underlying genetic predisposed cranio-facial variability. These may have substantial influence on the treatment outcome. The factors that can affect unilateral cleft lip and palate treatment outcome is multifactorial in nature and remained controversial in general.


[What kind of information do family physicians provide to their patients about possible side effects of contraceptive pills?].
The aim of our survey was to investigate the extent to which family physicians in Lithuanian inform their patients about possible side effects of contraceptive pills. We also aimed to examine the relation between physicians' estimation of the severity and frequency of these side effects and their willingness to inform patients spontaneously. A survey was conducted in Lithuania in 2004 using the methodology and questionnaire developed by the researchers of Department of Medical Philosophy and Clinical Theory, University of Copenhagen. A computerized stratified random sampling was drawn using the list of Territorial Sick Funds. A total of 500 family physicians have been questioned in the survey. Response rate was 64%. Family physicians (83%) informed their patients more frequently when the side effect was regarded as frequent and serious than it was regarded as rare and trivial. Only 2.9% of all the respondents would inform their patients about the all possible side effects. Half of the respondents (51%) would inform about the side effects in order to enable the patients to react appropriately to every side effect. The most common reason (29%) for not informing the patients was an effort to avoid unnecessary patients' anxiety.


A single-system interpretation of dissociations between recognition and categorization in a task involving object-like stimuli.
In previous research (Reed, Squire, Patalano, Smith, & Jonides, 1999), amnesic patients performed at near normal levels in a categorization task involving stimuli with discrete features, but showed impaired recall of the features. These results were taken as evidence of the existence of separate memory systems for categorization and recall/recognition. The present research addresses a single-system account of this dissociation. In Experiment 1, results closely matching the dissociation pattern were obtained when normal participants' classification and recognition performance was tested either immediately or after a week delay. In addition, formal modeling of the data suggested that participants use only a few of the dimensions in the categorization task, whereas they must use many dimensions in the cued-recall task. In Experiment 2, we found that many participants could perform the categorization task without any exposure to the training sequence. These results suggest that different memory demands across the two tasks may be responsible for the observed dissociation--separate memory systems are not necessarily involved.


MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report.
Atypical polypoid adenomyoma (APA) is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands. It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding. In our current case, a 76-year-old woman presented with irregular vaginal bleeding. The final pathological diagnosis of the mass was APA. APA is not easy to diagnose before surgery. On the one hand, there was no obvious particularity in imaging features and clinical features, especially for uncomfortably identifying endometrial cancer. On the other hand, APA has a pedicle, attaching to any part of the uterine cavity, which can cause pseudocoel between the mass with the uterine cavity wall. So, when it comes to getting the pathological tissue in the absence of hysteroscopy, it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass. Therefore, preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA. In the meantime, pathological tissue of APA can be obtained by hysteroscopy in visual conditions.


Conserved beta-tubulin binding domain for the microtubule-associated motors underlying sperm motility and fast axonal transport.
An antiserum against tubulin, NS20, has been previously shown to inhibit anterograde and retrograde axonal transport by 50% in vivo and in vitro. We report here that Protein A purified NS20 antibodies also attenuate sperm motility by 50% in demembranated sea urchin sperm. This inhibition is absorbed out by preincubating the NS20 antibodies with a biochemically purified porcine microtubule preparation, with recombinant Trypanosoma beta- (but not alpha-) tubulin and most specifically, with a 37 amino acid (a.a.) synthetic peptide corresponding to a domain near (but not including) the porcine beta-tubulin C terminus. Furthermore, addition of this beta-tubulin peptide alone is sufficient to attenuate motility by 50% in demembranated sperm, indicating that this critical 37a.a. NS20 antigen is a motor binding domain. Together, the results suggest that at least two phenotypically distinct forms of microtubule-based motility, axonal transport and flagellar beating, are homologous at the fundamental level of the microtubule domains (the beta-tubulin peptide and we suggest a distinct but similarly located alpha-tubulin domain) mediating the attachment of tubulin-associated motors.


Perceived stress, self-compassion and job burnout in nurses: the moderating role of self-compassion.
Job burnout is more prevalent among nurses than other medical team members and may have adverse effects on the mental and physical health of both nurses and their patients. To evaluate the associations between job burnout as a dependent variable with perceived stress and self-compassion as independent variables, and test the buffering role of self-compassion in the link between perceived stress and job burnout in nurses. This is a cross-sectional study with a convenience sampling method. A total of 150 nurses from four hospitals in Tehran, Iran participated in this study and completed three questionnaires, namely the Perceived Stress Scale, the Self-Compassion Scale and the Copenhagen Burnout Inventory. Partial least square-structural equation modelling showed greater levels of perceived stress associated with greater levels of job burnout (β = 0.795, p < 0.001), and greater levels of self-compassion associated with lower levels of job burnout (β = -0.512, p < 0.001) in nurses. The results of the interaction-moderation analysis showed that self-compassion diminished the effect of perceived stress on job burnout in nurses. The results of this study not only showed a significant association between perceived stress and job burnout in nurses, but also increased our understanding about the buffering role of self-compassion in the link between perceived stress and job burnout in nurses.


A minimal set of electrodes for motor imagery BCI to control an assistive device in chronic stroke subjects: a multi-session study.
The brain-computer interface (BCI) system has been developed to assist people with motor disability. To make the system more user-friendly, it is a challenge to reduce the electrode preparation time and have a good reliability. This study aims to find a minimal set of electrodes for an individual stroke subject for motor imagery to control an assistive device using functional electrical stimulation for 20 sessions with accuracy higher than 90%. The characteristics of this minimal electrode set were evaluated with two popular algorithms: Fisher's criterion and support-vector machine recursive feature elimination (SVM-RFE). The number of calibration sessions for channel selection required for robust control of these 20 sessions was also investigated. Five chronic stroke patients were recruited for the study. Our results suggested that the number of calibration sessions for channel selection did not have a significant effect on the classification accuracy. A performance index devised in this study showed that one training day with 12 electrodes using the SVM-RFE method achieved the best balance between the number of electrodes and accuracy in the 20-session data. Generally, 8-36 channels were required to maintain accuracy higher than 90% in 20 BCI training sessions for chronic stroke patients.


Subject-specific lower limb waveforms planning via artificial neural network.
Robotic is gaining its popularity in gait rehabilitation. Gait pattern planning is important, in order to ensure the gait patterns induced by robotic systems on the patient are natural and smooth. It is known that the gait parameters (stride length, cadence) are the key factors, which affect gait pattern. However, a systematic methodology for gait pattern planning is missing. Therefore, a gait pattern generation methodology, GaitGen, was proposed in our previous work. In this paper, we introduce a new model to enhance the proposed methodology for generating the joint angle waveforms of the lower limb during walking, with the gait parameters and the lower limb anthropometric data as input. The walking motion was captured with a motion capture system using passive markers. The waveforms of lower limb joint angles were calculated from the experimental data and the waveforms were then decomposed into Fourier coefficients. Therefore, each joint angle waveform can be represented by a Fourier coefficient vector containing eleven elements to facilitate the waveform analysis. Multi-layer perceptron neural networks (MLPNNs) were designed to predict the Fourier coefficient vectors for specific subject and desired gait parameters. Assessment parameters such as correlation coefficient, mean absolute deviation (MAD) and threshold absolute deviation (TAD) were calculated to examine the quality of MLPNNs' prediction. The constructed waveforms from predicted Fourier coefficient vectors were compared with the actual waveforms calculated from experimental data by using the above-mentioned assessment parameters. The results show that the constructed waveforms closely match the experimental waveforms based on the assessment parameter outcomes.


Pharmacoeconomics and the medicinal chemist.
Pharmacoeconomics is a rational, scientific approach to compare the value (in terms of both cost and patient outcome) of one medication or drug therapy regimen to another. The impact of this new approach on both the practicing medicinal chemist and broader drug discovery efforts is considered.


The effect of coal and diesel particulates on the weathering loss of Portland Limestone in an urban environment.
Due to reductions in domestic usage, legislation and changes in fuel use, coal derived particulates in the UK urban atmosphere have been significantly reduced. However, a large increase in road usage and an expansion in the use of diesel engines, has meant that the majority of particulates, now present in the urban atmosphere, originate from vehicle exhausts. Particulate matter, resulting from coal combustion, has been recorded as being present in black patinas observed on some historic stone buildings and monuments and has been associated with accelerated weathering of stone surfaces as a result of enhanced gypsum formation. In contrast, the effects of particulates resulting from vehicle exhaust on stone are much less understood. To investigate this, a comparative study was undertaken using the technique of microcatchments under ambient atmospheric conditions. This compared the elemental composition and volume of precipitation runoff from Portland Limestone coated with three different particulate treatments. Treatments consisted of coal and diesel particulates, both separately and in combination. Combining these treatments attempts to investigate any synergistic effects that may occur when coal derived particulates are overlain by layers formed by particulates from more contemporary sources. It was found that diesel-coated samples were much darker in appearance and showed a significant reduction (P<0.05) in the overall rate of weathering loss when compared to untreated samples. Microcatchment runoff volume was reduced from diesel-coated Portland Limestone compared to untreated stone. Enhanced surface temperatures may be increasing the rate of moisture loss from the pore network between rainfall events. Since, generally, the pores must be full before runoff can occur, the reduction may be due to the differential volume of empty pore space between diesel-coated and untreated Portland Limestone.


Spinocerebellar ataxia 1 (SCA1) in the Japanese in Hokkaido may derive from a single common ancestry.
Spinocerebellar ataxia 1 (SCA1) is caused by expansion of an unstable CAG triplet repeat located on the short arm of chromosome 6. Precise mapping has shown a positional relationship to closely linked markers in the order of D6S109-D6S274-D6S288-SCA1-AM10GA-D6S89+ ++-EDN1 from centromere to telomere. The haplotype which cosegregated with the disease was determined in 12 Japanese pedigrees with SCA1. Although the alleles of the SCA1 haplotype varied from pedigree to pedigree, depending on the distance from the SCA1 locus, the affected and presymptomatic subjects carried the same alleles at D6S288 and D6S274. All the families with SCA1 had migrated from either Miyagi or Yamagata Prefectures, neighbouring areas in the Tohoku District, the northern part of Honshu which is the main island of Japan. It seems highly likely that SCA1 in the Japanese, at least those residing in Hokkaido, derives from a single common ancestry.


Primary care physician's attitude towards the German e-health card project--determinants and implications.
In Germany e-health cards will be distributed nationwide to over 80 million patients. Given the impending mandatory introduction of the e-health technology, the objective of this study was to examine the determinants of primary care physicians' acceptance of the technological innovation. The study was conducted prior to the introduction of the e-health cards. A questionnaire survey was carried out addressing primary care physicians from different fields. The reduction of medication error rates and the improvement of communication between medical caregivers are central aspects of the perceived usefulness. Primary care physicians rate their involvement in the process of the development of the technology and their own IT expertise concerning the technological innovation as rather low. User involvement and IT expertise can explain 46 % of the variance of perceived usefulness of the e-health card. User involvement plays a crucial role in the adoption of the German e-health card. Primary care physician's perspective should be represented in the process of developing and designing the technology.


Reduced chilling tolerance in elongating cucumber seedling radicles is related to their reduced antioxidant enzyme and DPPH-radical scavenging activity.
Cucumber seedling radicles become more chilling sensitive as they elongate. Chilling seedlings with radicles 20 mm long for 48 h at 2.5 degrees C inhibited subsequent growth by 36%, while it reduced the growth of 70 mm-long radicles by 63%. Although the growth rate of non-chilled cucumber radicles at 25 degrees C is constant from 20 to 80 mm, tissue viability [i.e. reduction of TTC (2,3,5-triphenyltetrazolium chloride) to formazan] and DPPH (alpha,alpha-diphenyl-beta-picrylhydrazyl) radical scavenging activity of apical tissue declines as radicles elongate from 20 to 80 mm in length. TTC reduction, DPPH-radical scavenging activity and protein content of apical tissue were higher in 20 than in 70 mm radicles immediately after chilling and after an additional 48 h of growth at 25 degrees C. Catalase (CAT; EC 22.214.171.124) and ascorbate peroxidase (APX; EC 126.96.36.199) activity was higher in the apical tissue of 20 than in 70 mm radicles before chilling. Immediately after chilling and after an additional 48 h at 25 degrees C, superoxide dismutase (SOD; EC 126.96.36.199), glutathione reductase (GR; EC 126.96.36.199), and guaiacol peroxidase (GPX; EC 18.104.22.168) activity increased more rapidly in 70 mm radicles than in 20 mm radicles (SOD, GR, and GPX activity in 70 mm radicles was 1.5-, 1.9- and 8.6-fold higher, respectively, than in 20 mm radicles). However, APX and CAT activity in 20 mm radicles were always higher than in 70 mm radicles. Growth after chilling enhanced the activity of all antioxidant enzymes compared to that found in non-chilled tissue; however, CAT activity in 70 mm radicles did not recover to levels found in non-chilled tissue. Higher levels of CAT, APX and DPPH-radical scavenging activity are correlated with higher chilling tolerance of 20 mm-long cucumber radicles compared to 70 mm-long radicles.


Activation state of ribulose bisphosphate carboxylase in soybean leaves.
Conditions for extraction and assay of ribulose-1,5-bisphophate carboxylase present in an in vivo active form (initial activity) and an inactive form able to be activated by Mg(2+) and CO(2) (total activity) were examined in leaves of soybean, Glycine max (L.) Merr. cv Will. Total activity was highest after extracts had preincubated in NaHCO(3) (5 millimolar saturating) and Mg(2+) (5 millimolar optimal) for 5 minutes at 25 degrees C or 30 minutes at 0 degrees C before assay. Initial activity was about 70% of total activity. K(act) (Mg(2+)) and K(act) (CO(2)) were approximately 0.3 millimolar and 36 micromolar, respectively. The carry-over of endogenous Mg(2+) in the leaf extract was sufficient to support considerable catalytic activity. While Mg(2+) was essential for both activation and catalysis, Mg(2+) levels greater than 5 millimolar were increasingly inhibitory of catalysis. Similar inhibition by high Mg(2+) was also observed in filtered, centrifuged, or desalted extracts and partially purified enzyme. Activities did not change upon storage of leaves for up to 4 hours in ice water or liquid nitrogen before homogenization, but were about 20% higher in the latter. Activities were also stable for up to 2 hours in leaf extracts stored at 0 degrees C. Initial activity quickly deactivated at 25 degrees C in the absence of high CO(2). Total activity slowly declined irreversibly upon storage of leaf homogenate at 25 degrees C.


An overview of the pharmacology and clinical efficacy of indapamide sustained release.
The relationship between blood pressure (BP) and cardiovascular risk is clearly established; hypertension increases the rate of cardiovascular. High systolic blood pressure (SBP) may be the main parameter involved in cardiovascular morbidity and mortality. The benefit of lowering BP, particularly with diuretics has been proven in many outcome studies. Indapamide, a thiazide-type diuretic, was available for many years at a dosage of 2.5 mg in an immediate release formulation. A new sustained release (SR) formulation has been developed in order to allow the same antihypertensive efficacy with a better acceptability profile. This paper reviews the pharmacology of indapamide 1.5 mg SR from the bench to the bedside. Indapamide has a dual mechanism of action: diuretic effect at the level of the distal tubule in the kidney and a direct vascular effect, both of which contribute to the antihypertensive efficacy of the drug. The SR formulation contains a hydrophilic matrix, which delivers a smoother pharmacokinetic profile. This avoids unnecessary plasma peak concentrations, which may be associated with side effects. Indapamide SR has now been extensively used in hypertensive patients, including those at increased risk, for example elderly or diabetic patients. It has been shown to decrease BP, particularly SBP, with 24-h efficacy, allowing a once-daily dosage. Studies have demonstrated BP lowering to be at least as effective as all major therapeutic classes including the more recent antihypertensive drugs. Beyond BP decrease, indapamide SR has also been shown to protect against hypertensive target-organ damage in the heart and the kidney and to have a favorable metabolic profile. A broad evidence-base has accumulated to support the benefit of indapamide 1.5 mg SR in hypertensive patients, alone or as part of combination therapy, as recommended by the majority of guidelines.


Muscle endoplasmic reticulum stress in exercise.
The endoplasmic reticulum (ER) is an organelle responsible for the post-translational folding and modification of proteins. Under stress conditions, such as physical exercise, there is accumulation of misfolded proteins. The increased load of proteins in the ER results in ER stress, which activates the unfolded protein response (UPR). UPR is comprised of three parallel pathways, responsible for ensuring the quality of secreted proteins. Scientific studies show that resistance or endurance acute physical exercise can induce ER stress and activate the UPR pathways. On the other hand, regular moderate-intensity exercise can attenuate the responses of genes and proteins related to ER stress. However, these positive adaptations do not occur when exercise intensity and volume increase without adequate rest periods, which is observed in overtraining. The current review discusses the frontier-of-knowledge findings on the effects of different acute and chronic physical exercise protocols on skeletal muscle ER stress and its metabolic consequences.


Insecticide-impregnated bed nets for malaria control: varying experiences from Ecuador, Colombia, and Peru concerning acceptability and effectiveness.
Between 1991 and 1994, an intervention program with permethrin- and lambdacyhalothrin-impregnated bed nets was carried out over a period of nine months in each of five endemic, malarious areas of Ecuador, Peru, and Colombia. This program was evaluated through household surveys, blood sampling, in-depth longitudinal studies, and entomologic analysis. Eighty-four communities (including approximately 35,000 individuals) were paired according to malaria incidence, size, and coverage with bed nets and then randomly allocated to intervention and control groups. The results showed that peoples' acceptance of the measure was related to their perception of an immediate protective effect against insects. The effectiveness of the bed nets, measured as a reduction of malaria incidence in intervention communities as against control communities, showed large variations between and within the study areas. The protective efficacy varied between 0% and 70% when looking only at the postintervention differences between intervention and control groups. The average protection was 40.8% when considering a four-month incidence of clinical malaria attacks and 28.3% when considering a two-week malaria incidence. Important factors for the success of the bed net program were insect susceptibility to pyrethroids, high coverage with impregnated bed nets, high malaria incidence, good community participation, high mosquito densities when people go to bed, and a high proportion of Plasmodium falciparum. In one area, where DDT spraying in the control communities was executed, the effectiveness of bed net impregnation was slightly better than that of spraying.


False Lung Metastasis: Concurrent Ewing Sarcoma and Minimally Invasive Adenocarcinoma.
Pediatric lung cancer is a very rare occurrence, particularly as a primary lesion. A concurrent diagnosis is even more unusual and only reported a handful of times in Ewing sarcoma. Our patient is a 13-year-old boy who had concurrent diagnoses of Ewing sarcoma and minimally invasive adenocarcinoma of the lung, formerly bronchoalveolar carcinoma. To our knowledge this has also been found in at least 1 other case. There are some classic genetic mutations associated with Ewing sarcoma. None have been found to be linked with the concurrent diagnosis. A biological linkage is worth considering.


Effect of heparin on the activation of factor XII and the contact system in plasma.
We examined in purified systems and in human plasma whether heparin serves as a contact system activating compound. Purified human factor XII zymogen was not activated by heparin through an autoactivation mechanism, but was activated in the presence of purified prekallikrein. Zn2+ (12 microM) did not support autoactivation by heparin. The activation of factor XII and the contact system by heparin in plasma anticoagulated with citrate or with hirudin (not chelating ions) was examined by the cleavage of 125I-labeled factor XII and high molecular weight kininogen (HK). Heparin at 1.6 and 16 USP U/ml was not able to produce activation, in contrast to dextran sulfate (20 micrograms/ml) which supported activation of both factor XII and HK. This study indicates that heparinized plasma does not support activation of the contact system mediated through activation of factor XII. It is not expected that heparin anticoagulant therapy will contribute to activation of the contact system.


Characterization of Alpinia officinarum Hance polysaccharide and its immune modulatory activity in mice.
This study aimed to characterize the structural features of a novel water-soluble polysaccharide (AOHP) extracted from Alpinia officinarum Hance and to verify its regulating effect on mouse immunity. Cellulose DEAE-52 and Sephadex G-100 columns were used to obtain purified AOHP. Techniques including NMR, methylation, monosaccharide composition, FT-IR, and molecular weight determination were applied to investigate the physicochemical properties and structural characterization of AOHP. Then, the influence of AOHP on mice was studied. After oral administration of AOHP, organ indexes, serum biochemistry indexes, and cytokines in the spleens of the mice were analysed. The results showed that AOHP was composed of T-α-D-Glcp, (1,4)-α-D-Glcp and (1,4,6)-α-D-Glcp with a number-average molecular weight of 26.0 kDa and a weight-average molecular weight of 52.8 kDa. Additionally, the innate immune statuses of the mice were improved by treatment with AOHP, while no obvious damage was identified. To conclude, the immunomodulatory activity and biological safety make AOHP a viable candidate as an ingredient for healthcare drugs.


Widening the spectrum of spinocerebellar ataxia autosomal recessive type 10 (SCAR10).
Biallelic pathogenic variants in the ANO10 gene cause spinocerebellar ataxia recessive type 10. We report two patients, both compound heterozygous for ANO10 variants, including two novel variants. Both patients had onset of cerebellar ataxia in adulthood with slow progression and presented corticospinal tract signs, eye movement abnormalities and cognitive executive impairment. One of them had temporal lobe epilepsy and she also carried a heterozygous variant in CACNB4, a potential risk gene for epilepsy. Both patients had pronounced cerebellar atrophy on cerebral magnetic resonance imaging (MRI) and reduced metabolic activity in cerebellum as well as in the frontal lobes on 2-deoxy-2-(18F)fluoro-D-glucose positron emission tomography ((18F)FDG PET) scans. We provide comprehensive clinical, radiological and genetic data on two patients carrying likely pathogenic ANO10 gene variants. Furthermore, we provide evidence for a cerebellar as well as a frontal involvement on brain (18F)FDG PET scans which has not previously been reported.


A System for Developing and Projecting PM2.5 Spatial Fields to Correspond to Just Meeting National Ambient Air Quality Standards.
PM2.5 concentration fields that correspond to just meeting national ambient air quality standards (NAAQS) are useful for characterizing exposure in regulatory assessments. Computationally efficient methods that incorporate predictions from photochemical grid models (PGM) are needed to realistically project baseline concentration fields for these assessments. Thorough cross validation (CV) of hybrid spatial prediction models is also needed to better assess their predictive capability in sparsely monitored areas. In this study, a system for generating, evaluating, and projecting PM2.5 spatial fields to correspond with just meeting the PM2.5 NAAQS is developed and demonstrated. Results of ten-fold CV based on standard and spatial cluster withholding approaches indicate that performance of three spatial prediction models improves with decreasing distance to the nearest neighboring monitor, improved PGM performance, and increasing distance from sources of PM2.5 heterogeneity (e.g., complex terrain and fire). An air quality projection tool developed here is demonstrated to be effective for quickly projecting PM2.5 spatial fields to just meet NAAQS using realistic spatial response patterns based on air quality modeling. PM2.5 tends to be most responsive to primary PM2.5 emissions in urban areas, whereas response patterns are relatively smooth for NOx and SO2 emission changes. On average, PM2.5 is more responsive to changes in anthropogenic primary PM2.5 emissions than NOx and SO2 emissions in the contiguous U.S.


Collagens and DNA methyltransferases in mare endometrosis.
Inflammation and fibroproliferative diseases may be modulated by epigenetic changes. Therefore, we suggest that epigenetic mechanisms could be involved in equine endometrosis pathogenesis. DNA methylation is one of the methods to evaluate epigenetics, through the transcription of methyltransferases (DNMT1, DNMT3A, DNMT3B). The correlation between DNMTs and collagen (COL) transcripts was assessed for the different Kenney and Doig's (Current Therapy in Theriogenology. Philadelphia: WB Saunders; 1986) endometrium categories. Endometrial biopsies were randomly collected from cyclic mares. Histological classification (category I, n = 13; II A, n = 17; II B, n = 12; and III, n = 7) and evaluation of COL1A2, COL3A1 and DNMTs transcripts by qPCR, were performed. Data were analysed by one-way analysis of variance (ANOVA), Kruskal-Wallis test and Pearson correlation. As mares aged, there was an increase in endometrium fibrosis (p < .01), and in DNMT1 mRNA (p < .001). Considering DNMT3B transcripts for each category, there was an increase with fibrosis (p < .05). No changes were observed for DNMT1 and DNMT3A transcripts. However, DNMT3A mRNA levels were the highest in all categories (p < .01). In category I endometrium, a positive correlation was observed for transcripts of all DNMTs in both COLs (p < .01). In category IIA, this correlation was also maintained for all DNMTs transcripts in COL1A2 (p < .05), but only for DNMT3B in COL3A1 (p < .05). In category IIB, there was a positive correlation between DNMT3B and COL3A1 (p < .05). In category III, a positive correlation was only observed between DNMT3B and COL3A1 (p < .05). Our results suggest that there is a disturbance in COLs and DNMTs correlation during fibrosis.


Mesenchymal stem cells enhance the differentiation of c-kit+ cardiac stem cells.
C-kit+ cardiac stem cells (CSCs) were isolated from neonatal rat and tested for the expression of Nkx2.5 and GATA-4 genes which are important in cardiac development. C-kit+ CSCs were plated into the well below the insert of transwell inserts and bone marrow mesenchymal stem cells (BMMSCs) were plated into the inserts. The expression of cardiac Troponin T (cTnT), p27, CDK2, transforming growth factor-beta receptor II (TGF-beta R II), and Smad2 protein in CSCs were tested by western blot. Expression of p27, TGF-beta R II and Smad2 was found to be upregulated in the co-culture group. In contrast, the expression of CDK2 was downregulated. Our results suggest that BMMSCs could promote the differentiation of c-kit+ CSCs, probably through paracrine activity via the TGF-beta signaling pathway.


Maximum-likelihood estimation: a mathematical model for quantitation in nuclear medicine.
In a stimulation study, we investigated the limitations of quantitation in nuclear medicine using a maximum-likelihood (ML) estimation model. We estimated activity, size, and position of a disk-shaped object on a circular, uniform background of unknown activity. The parameter estimates were unbiased, and their standard error was proportional to the square root of the total image counts. The estimates of object activity and size were strongly (negatively) correlated; the position estimates, however, were not correlated with estimates of any other parameters. This implies that a priori knowledge of object location does not improve precision. The minimal model of quantitation tasks should incorporate unknown object activity and size as well as unknown background activity. The ML estimation procedure was used to investigate the trade-off between resolution and sensitivity in gamma camera collimator design. The results implied that for complex tasks such as the multiparameter estimation task investigated here, optimum performance is achieved at a better resolution than that previously found optimal for detection of a well-specified object in a known background.


Structures of Arg- and Gln-type bacterial cysteine dioxygenase homologs.
In some bacteria, cysteine is converted to cysteine sulfinic acid by cysteine dioxygenases (CDO) that are only ∼15-30% identical in sequence to mammalian CDOs. Among bacterial proteins having this range of sequence similarity to mammalian CDO are some that conserve an active site Arg residue ("Arg-type" enzymes) and some having a Gln substituted for this Arg ("Gln-type" enzymes). Here, we describe a structure from each of these enzyme types by analyzing structures originally solved by structural genomics groups but not published: a Bacillus subtilis "Arg-type" enzyme that has cysteine dioxygenase activity (BsCDO), and a Ralstonia eutropha "Gln-type" CDO homolog of uncharacterized activity (ReCDOhom). The BsCDO active site is well conserved with mammalian CDO, and a cysteine complex captured in the active site confirms that the cysteine binding mode is also similar. The ReCDOhom structure reveals a new active site Arg residue that is hydrogen bonding to an iron-bound diatomic molecule we have interpreted as dioxygen. Notably, the Arg position is not compatible with the mode of Cys binding seen in both rat CDO and BsCDO. As sequence alignments show that this newly discovered active site Arg is well conserved among "Gln-type" CDO enzymes, we conclude that the "Gln-type" CDO homologs are not authentic CDOs but will have substrate specificity more similar to 3-mercaptopropionate dioxygenases.


[Ramadan and customs of life: investigation with 84 adult residents in the district of Tunis].
To know nature and the dimension of the change of the customs of life leads by the Ramadan, we led a comparative descriptive inquiry before and during the month of the fast at 84 adults residents in the district of Tunis. Our results underline an increase of the consumption of meat and eggs with an average frequency of 4.3 and 6.1 times a week respectively. This overconsumption of the animal proteins contrasts with a tendency in the decline of the consumptions of vegetables. The exciting (tea, coffee, tobacco) are less consumed during the Ramadan. Also, we noted a decline of 50% of the average number of smoked cigarettes. There is an intensification of domestic links with an increase of the frequency of exchange of domestic visits. It's crossed of average from 0.7 to 1.2 times a week (p < 0.001). The phenomenon of irritability is frequently lived by near 20% of the investigated. We recommend under shape of an educational program the intensification of positive customs and the correction of negative customs, to benefit of sacred month, to tighten towards a more balanced life all year.


Adoptive transfer of experimental autoimmune uveoretinitis induced by interphotoreceptor retinoid-binding protein.
The immunopathogenic mechanisms of experimental autoimmune uveoretinitis (EAU) induced by interphotoreceptor retinoid-binding protein (IRBP) were studied. Lymph node (LN) cells or spleen cells were collected from donor rats 14 days after the immunization with IRBP. After the 3-day pre-incubation of these cells with either IRBP or Concanavalin A (Con A), the cells were transferred to naive syngeneic rats intraperitoneally. EAU was successfully transferred by LN cells pre-cultured with IRBP, while EAU was poorly transferred by LN cells pre-cultured with Con A. On the other hand, spleen cells pre-cultured with either IRBP or Con A were quite potent to transfer EAU. In addition, the enriched helper/inducer T-cells repeatedly transferred EAU, while the enriched suppressor/cytotoxic T-cells did not. There also existed the simultaneous involvement of pinealitis. The histopathological features of EAU and pinealitis were generally similar to those in actively immunized rats. The immune responses to IRBP in recipients with EAU were mostly cellular (delayed hypersensitivity type skin response and proliferative responses of lymphocytes), while humoral responses (Arthus type skin response and antibody activities) were quite weak in most of the recipients. Thus, it was confirmed that cellular immunity plays a major role in the adoptive transfer of EAU by IRBP as in S-antigen-induced EAU.


Autologous Costal Osteochondral Transplantation for Cystic Osteochondral Lesions of the Talus: Feasible and Effective.
Osteochondral lesions of the talus (OLT) is a common and clinically challenging disease. The optimal management is still under debate. The purpose of this prospective study was to investigate the feasibility and clinical outcomes of autologous costal osteochondral transplantation (ACOT) for the treatment of cystic OLT. From November 2021 to April 2023, five patients underwent autologous costal osteochondral transplantation (ACOT) for cystic OLT. The demographic data was described, including age, gender, lesion size and location. We prospectively evaluated their functional and imaging outcomes of the five patients for 12 months postoperatively, including numeric rating score (NRS) for pain when walking, Tegner score, American Orthopedic Foot & Ankle Society (AOFAS) score and Foot and Ankle Ability Measure (FAAM) score, and imaging results. A paired t-test was used for preoperative and postoperative comparison of the paired-design dataset. The average age was 36.6 ± 11.1 years. The average diameter of chondral lesions was 14.95 ± 2.71 mm, the average diameter of subchondral cysts was 10.66 ± 1.84 mm, and their average depth was 10.40 ± 1.86 mm. At 12 months postoperatively, the clinical function indexes improved significantly, including NRS (from 5.2 ± 2.3 to 0), Tegner score (from 3.2 ± 0.4 to 5.8 ± 0.4), AOFAS score (from 72.8 ± 10.0 to 98.2 ± 4.0), and FAAM score (FAAM/ADL from 61.2 ± 24.7 to 99.3 ± 1.6; FAAM/Sports from 32.5 ± 13.73 to 96.3 ± 8.4). Their magnetic resonance observation of cartilage repair tissue (MOCART) scores reached 78.0 ± 7.6 points. ICRS scores of three patients were nearly normal (10 or 11 points). The biopsy of the surviving grafts showed plenty of hyaline cartilage matrix and scattered chondrocytes histologically. No major severe complications were reported during the 12 months follow-up. ACOT could significantly relieve the symptoms of patients with OLT and improve their clinical function at short-term follow-up. ACOT might be a feasible and useful method for repairing OLT with subchondral cysts.


The North Carolina Eden Coalition: facilitating environmental transformation.
The Eden Alternative, created by Harvard educated physician Dr. William Thomas, is a model for transforming skilled care facilities from institutions based on a medical model of care into human habitats that promote human growth. This change is accomplished through decentralizing the organizational structure of the facility to empower front-line care-delivery staff, and through introduction of plants, animals, gardening, and children into the daily lives of residents. Because the Eden Alternative is a trademarked name, only facilities recognized by the Eden Alternative registry are allowed to use the name. However, any facility may adopt the philosophies embodied by the Eden Alternative, and implement the principles for transforming their facility. In 1996, the North Carolina Division of Facility Services formed the North Carolina Eden Coalition (originally named the North Carolina Eden Alternative Coalition). This was the first organization of its kind in the country. The success of the Coalition has led it to become a model for implementation in other states. Currently, North Carolina leads the country in the number of registered Eden Alternative facilities, and has a large number of other facilities that have instituted some form of environmental enhancement. The Coalition functions as a consumer-driven advisory and educational body rather than a formal regulatory standard body, and endorses implementation of the principles and philosophies embodied in the Eden Alternative. The Coalition has proved to be a successful, cooperative effort among regulators, providers, advocates, and other experts to implement the philosophies of the Eden Alternative without regulatory basis. Because the Coalition was formed under the auspices of the Division of Facility Services and operates with its ongoing cooperation, it is in an excellent position to clarify and influence policies and regulatory issues concerning transformation of long-term care environments in North Carolina. This article explores the history, structure, function, mission, and goals of the North Carolina Eden Coalition. Examples of issues the Coalition has addressed in promoting environmental transformation in North Carolina's skilled care facilities are also included.


Roles of CO2, O2, and acid in arteriovenous [H+] difference during muscle contractions.
To determine the origins of the arteriovenous [H+] difference of muscle during contractions, arterial and muscle venous blood sample pairs were taken before and after 0.5, 5.0, and 30.0 min of 4/s isometric twitches of the gastrocnemius-plantaris muscle group of anesthetized dogs. These samples were analyzed for PO2, PCO2, and pH, the concentrations of O2, CO2, K+, Na+, La-, and Cl- in whole blood, and La-, K+, Na+, and Cl- in plasma. Whole blood was hemolyzed and analyzed for PO2, PCO2, and pH. Net O2 uptake, CO2 output, L, K+, Na+, and Cl- were calculated in addition to net output of non-CO2 acid (HA) and strong ion difference ([SID]) and common ion [SID] ([K+] + [Na+] - [Cl-] - [La-]). From these data we partitioned the origins of the arteriovenous [H+] difference via the common PCO2-pH diagram and via a [H+]-PCO2 diagram and determined whether true plasma arteriovenous [H+] differences reflect plasma and cell arteriovenous [H+] differences. The arteriovenous [H+] differences of plasma and hemolyzed blood were the same, showing that true plasma does reflect plasma and cells. K+ showed a small significant but transient output. Na+ was not significant, whereas Cl- showed a significant transient uptake. Lactate output and HA, calculated for dog blood acid-base, showed transient outputs and were the same. At 5.0 min when the arteriovenous difference was largest, CO2 alone would have increased [H+] 15.9 nmol/l whereas desaturation of Hb would have decreased [H+] 4.2 nmol/l and lactate could have raised [H+] 1.0 nmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)


Detection and Characterization of Hydride Ligands in Iron Complexes by High-Resolution Hard X-ray Spectroscopy and Implications for Catalytic Processes.
Two hydride catalysts [Fe(CO)(dppp)H(NO)] (dppp = 1,3-bis(diphenylphosphino)propane) and [Fe(CO)H(NO)(PPh3)2] in comparison with nonhydride analogues [Fe(dppe)(NO)2] (dppe = 1,3-bis(diphenylphosphino)ethane) and [Fe(NO)2(PPh3)2] are investigated with a combination of valence-to-core X-ray emission spectroscopy (VtC-XES) and high-energy resolution fluorescence detected X-ray absorption near-edge structure (HERFD-XANES). To fully understand the experiments and to obtain precise information about molecular levels being involved in the spectral signals, time-dependent density functional theory (TD-DFT) calculations and ground state density functional theory (DFT) calculations are necessary. An excellent agreement between experiment and theory allows the identification of particular spectral signals of the Fe-H group. Antibonding Fe-H interactions clearly contribute to pre-edge signals in HERFD-XANES spectra, while bonding Fe-H interactions cause characteristic signatures in the VtC-XES spectra. The sensitivity of both methods with respect to the Fe-H distance is demonstrated by a scanning simulation approach. The results open the way to study metal hydride complexes in situ, their formation, and their fate during catalytic reactions, using high-resolution XANES and valence-to-core X-ray emission spectroscopy.


Chronic nitrogen deposition alters the structure and function of detrital food webs in a northern hardwood ecosystem.
During the next century, atmospheric nitrogen (N) deposition is projected to more than double, potentially slowing litter decomposition by altering microbial community composition and function. If the flow of energy though detrital food webs is diminished by the slowing of decay under higher rates of atmospheric N deposition, this agent of global change could also negatively impact the abundance and composition of soil fauna. To test this hypothesis, we studied soil faunal communities in four sugar-maple-dominated forests that comprise a long-term N deposition experiment. To examine whether changes in soil faunal communities could then feed back to influence litter decay, litterbags with 13C-enriched aspen litter were placed in the forest floor in one study site. The microbial community within the litterbags was characterized using PLFA analysis. Overall, long-term experimental N deposition reduced the abundance of microarthropods (ambient vs. experimental N deposition: 7844 vs. 4357 individuals/m2, respectively; P = 0.004). We attribute this overall decline partly to the reduced energy flow entering the detrital food web, which has been documented in previous work in our system. Although there was no difference in microarthropod species richness between N deposition treatments, there was a shift in community composition within the most abundant group (Oribatida), indicating species-specific responses to N deposition. Experimental N deposition reduced the number of microarthropods colonizing litterbags by 41% (P = 0.014). This was associated with a reduction in 13C mobilization from leaf litter into microbial biomass. Overall, this study demonstrates that chronic N deposition has a detrimental effect on the soil detritus food web, and that the negative effect may feed back to influence litter decay and ecosystem functioning.