Cross-Border E-Commerce Intelligent Information Recommendation System Based on Deep Learning.
In order to improve the effect of cross-border e-commerce intelligent information recommendation, this paper applies deep learning to the intelligent information processing and intelligent recommendation of e-commerce and proposes an improved version of the topic model to solve the problem of feature extraction of the text of the recommendation system. In order to deal with translation problems, this paper proposes an end-to-end sequence-to-sequence learning method. In addition, this study uses the long tail theory to excavate the mass commodities in the niche and recommends these products to users as suggestions. Finally, this paper proposes a niche product recommendation algorithm based on the graph search strategy based on the graph model. The experiment shows that the cross-border e-commerce intelligent information recommendation system based on deep learning proposed in this paper has a good recommendation effect and meets the recommendation needs of cross-border e-commerce.


Socioeconomic and health status of electronics workers employed in organized industry.
To study their socioeconomic and health status, 1,770 workers in the organized electronics industry in India were surveyed. Mean age of the workers employed in this industry was 32.5 +/- 6.01 years. The average per capita income/month was Rupees 333, indicating a higher socioeconomic status, compared with the status of the national population, as well as compared with their counterparts in the unorganized sectors. Respiratory symptoms and impairment rates were significantly higher in workers exposed to soldering fumes. The high prevalence of congested or inflamed throat was also related to chemical exposure specially among solderers and workers exposed to metal oxides. The ocular symptoms and signs were also related to chemical exposure. Musculoskeletal disorders were related to erratic ergonomic postures.


Analysis of the protective potential of antigens released by Leishmania (Viannia) shawi promastigotes.
Leishmania (Viannia) shawi causes cutaneous lesions in humans. Parasite antigens conferring significant protection against American tegumentar leishmaniosis (ATL) might be important for the development of effective vaccine. Therefore, this work evaluates the protective effect of antigenic fractions released by L. shawi. Antigens released by promastigotes to culture medium were concentrated and isolated by SDS-PAGE. The three main fractions LsPass1 (>75 kDa), LsPass2 (75-50 kDa) and LsPass3 (<50 kDa) were electro-eluted according with their molecular mass. Immunized BALB/c mice were challenged with L. shawi promastigotes and the course of infection monitored during 5 weeks. LsPass1-challenged mice showed no protection, however, a strong degree of protection associated to smaller lesions and high expression of IFN-γ and TNF-α by CD4(+) T, CD8(+) T and double negative CD4CD8 cells was achieved in LsPass3-challenged mice. Furthermore, LsPass2-challenged mice showed an intermediated degree of protection associated to high levels of IFN-γ, IL-4 and IL-10 mRNA. In spite of increased expression of IFN-γ and TNF-α, high amounts of IL-4 and IL-10 mRNA were also detected in LsPass3-challenged mice indicating a possible contribution of these cytokines for the persistence of a residual number of parasites that may be important in inducing long-lasting immunity. Therefore, LsPass3 seems to be an interesting alternative that should be considered in the development of an effective vaccine against ATL.


Influence of fluoride recovery alumina on the work environment and the health of aluminum potroom workers.
Dust exposure and health complaints were recorded by means of personal samplers and a questionnaire for potroom workers in a primary aluminum plant situated at the west coast of Norway. The study revealed a higher dust exposure and a higher prevalence of acute health complaints during a period when fluoride recovery alumina from a dry-cleaning process was used compared to another period when pure alumina was used. Weather conditions and work conditions were otherwise similar during the two periods. This finding indicates that the use of recovery alumina increases the pollution of the work atmosphere and thereby causes more health complaints. The study also revealed a higher prevalence of pulmonary symptoms of a chronic recurrent nature than expected, in spite of the thorough selection which takes place before and during employment, and may therefore indicate that potroom workers are under the risk of developing chronic pulmonary disease.


Dynamic Properties of Novel Excipient Suggest Mechanism for Improved Performance in Liquid Stabilization of Protein Biologics.
To improve liquid formulation stability, formulators employ various excipients designed to stabilize protein drugs, including buffers, salts, sugars, and surfactants. One of the roles of surfactants is to protect the protein drug from surface interactions that can destabilize the protein. Protein drug products formulated with surfactants usually contain either a polysorbate or poloxamer. Even in the presence of these surfactants, protein drug stability is often insufficient, particularly because of agitation-induced aggregation. FM1000 is one of a series of surfactants containing an alkyl chain, an amino acid, and a polyetheramine. The characterization of the dynamics of FM1000 at various water/hydrophobic interfaces was compared to Polysorbate 20, Polysorbate 80, and Poloxamer 188. FM1000 stabilizes an interface 1-2 orders of magnitude faster than all three of these surfactants, even in the presence of protein. The faster dynamics leads to improved stabilization of model protein biologic drugs IgG and abatacept against agitation-induced aggregation. These results provide mechanistic understanding of the key causes and drivers of protein aggregation.


A Model for the Regulation of K Influx, and Tissue Potassium Concentrations by Negative Feedback Effects upon Plasmalemma Influx.
By means of a modified Michaelis-Menten equation for K(+) influx, which includes terms for root and external K(+) concentrations (root [K(+)] and [K(+)](0), respectively) it is possible to predict the manner in which short-term (perturbation) fluxes of K(+) into roots of barley plants (Hordeum vulgare cv Fergus) vary with root [K(+)] and [K(+)](0). Influx values derived from this equation were used to predict changes of root and shoot [K(+)] and K(+) absorption rates (as functions of time and [K(+)](0)) from a knowledge of K(+) efflux, relative growth rates of roots and shoots, and the partitioning of absorbed K(+) between these organs. A microcomputer program was employed to model these changes in low-salt plants following transfer to solutions in which [K(+)](0) was maintained at values ranging from 5 to 1000 millimoles per cubic meter. The model was operated on the basis of 10 minute absorption periods which provided data for continuous ;updating' of tissue [K(+)]. The simulations were undertaken for periods corresponding to 30 days. During this time the model accurately predicted the manner in which K(+) influx and root and shoot [K(+)] gradually approach values which are essentially independent of [K(+)](0). The computer program was also used to predict the outcome of changing various external and internal parameters of the proposed regulatory system. The results of these simulations are discussed in the context of current models for negative feedback control of ion fluxes.


[The aging of the French population is inevitable].
Probable population trends in France up to the year 2000 are explored. "Between now and the year 2000, the French population will grow by three or four million. There will be 12 million persons over the age of 60, as compared to 10 million today. The working population will be more numerous, but older. Only the number of young people is difficult to estimate, because of the uncertainty concerning the birth rate." The demographic consequences of alternative fertility trends are discussed. (SUMMARY IN ENG AND SPA)


An Evaluation of the Content of Pediatric Discharge Summaries.
The need for high-quality discharge summaries is critical to ensure safe transitions of care. Deficits may lead to lapses in communication and poor outcomes. In this study, we sought to characterize the completeness, accuracy, and quality of pediatric discharge summaries. A retrospective chart review of 200 discharge summaries of patients discharged from the general pediatrics service from July 2016 to October 2017 was conducted. These summaries were audited for 7 elements: admission date, discharge date, discharge diagnosis, medications, immunizations, pending laboratory tests, and follow-up appointments. Accuracy was verified through chart review. Quality of hospital course and patient instructions was evaluated by using a modified validated discharge summary evaluation tool. Additional data collected included medical complexity of the patient and the number of authors. Analysis of variance, χ2 tests, and Pearson correlations were used to analyze data. Discharge diagnosis, medications, and follow-up appointments had the lowest rates of completion and accuracy. The quality of the hospital course and patient instructions was variable, with no statistical significance seen in quality scores on the basis of the number of authors or medical complexity. There were more inaccuracies in discharge medications for patients with baseline chronic conditions than those without chronic conditions (63% vs 35%; P < .001). Content and quality of discharge summary documentation are inconsistent and have implications for patient outcomes after discharge. This study highlights areas of opportunity to improve pediatric discharge summaries. Future work should be focused on educational and systems-based interventions to improve documentation.


Antibiotic exposure in prenatal and early life and risk of juvenile idiopathic arthritis: a nationwide register-based cohort study.
Early antibiotic exposure influences the gut microbiota which is believed to be involved in the pathogenesis of juvenile idiopathic arthritis (JIA). We aimed to investigate the association between systemic antibiotics in prenatal and early life and risk of JIA. We conducted a register-based cohort study including all children born in Norway from 2004 through 2012. The children were followed until 31 December 2020. Main exposures were dispensed antibiotics to the mother during pregnancy and to the child during 0-24 months of age. The outcome was defined by diagnostic codes indicating JIA. Multivariate logistic regression analyses were performed to estimate the association between antibiotic exposure and JIA. We included 535 294 children and their mothers in the analyses; 1011 cases were identified. We found an association between exposure to systemic antibiotics during 0-24 months and JIA (adjusted OR (aOR) 1.40, 95% CI 1.24 to 1.59), with a stronger association for >1 course (aOR 1.50, 95% CI 1.29 to 1.74) vs 1 course (aOR 1.31, 95% CI 1.13 to 1.53). Subanalyses showed significant associations in all age periods except 0-6 months, and stronger association with sulfonamides/trimethoprim and broad-spectrum antibiotics. There was no association between prenatal antibiotic exposure and JIA. The novel observation of no association with prenatal antibiotic exposure and JIA suggests that the association between antibiotics in early life and JIA is unlikely to be confounded by shared family factors. This may indicate that exposure to antibiotics in early life is an independent risk factor for JIA.


High-dose chemotherapy for male germ cell tumor.
Today, 20-30% of male patients with advanced germ cell tumor (GCT) do not have durable, complete remission in spite of cis-platinum (CDDP)-based chemotherapy. High-dose chemotherapy (HDCT) has been tried in CDDP refractory GCT patients. Initially HDCT was performed with autologous bone marrow transplantation in heavily treated patients. However, the clinical outcome was not good and the treatment-related death rate was not ignorable. Therefore, earlier introduction of HDCT with peripheral blood stem cell transplantation was preferable as it renders HDCT more effective and less toxic, and multicycle HDCT is feasible. The durable free rate of recent HDCT for refractory GCT patients is 32-65%. HDCT is also performed as first line chemotherapy for poor prognosis GCT patients. Induction chemotherapy followed by multicycles of HDCT was tried. The durable free rate of recent HDCT as first line chemotherapy is 43-73%. Although previous reports suggest the superiority of HDCT, one recent randomized controlled trial (RCT) failed to show an improvement with one cycle of HDCT followed by three cycles of standard-dose chemotherapy (SDCT) compared with four cycles of SDCT. Ongoing RCT comparing multicycles of HDCT with SDCT for poor prognostic GCT patients will clarify the role of HDCT. Recently, new regimens of HDCT containing paclitaxel have been devised. In this review, the history, current status and future of HDCT for advanced or refractory GCT will be discussed.


Visualizing Grain Statistics in MOCVD WSe2 through Four-Dimensional Scanning Transmission Electron Microscopy.
Using four-dimensional scanning transmission electron microscopy, we demonstrate a method to visualize grains and grain boundaries in WSe2 grown by metal organic chemical vapor deposition (MOCVD) directly onto silicon dioxide. Despite the chemical purity and uniform thickness and texture of the MOCVD-grown WSe2, we observe a high density of small grains that corresponds with the overall selenium deficiency we measure through ion beam analysis. Moreover, reconstruction of grain information permits the creation of orientation maps that demonstrate the nucleation mechanism for new layers-triangular domains with the same orientation as the layer underneath induces a tensile strain increasing the lattice parameter at these sites.


Recurrent laryngeal nerve and voice preservation: routine identification and appropriate assessment - two important steps in thyroid surgery.
The aims of this study were to assess and compare vocal cord functions before and after thyroid surgery after intra-operative identification of recurrent laryngeal nerve. Recurrent laryngeal nerve (RLN) is seen intra-operatively in all cases undergoing thyroid surgeries. Vocal cord functions including any voice change were evaluated by indirect laryngoscopy (I/L) and direct laryngoscopy (D/L) before and after surgery. Prospective study on 100 patients over 18 months with a total of 146 nerves at risk (NAR). Majority were women (n = 86) with mean age of 37.48 years (range, 13-60 years). RLN was seen in all patients and 19 patients complained of some change in quality of their voice after surgery. Evaluation by I/L and D/L at 6 weeks showed recurrent laryngeal nerve palsy (RLNP) in nine (47.36%) and five (26%) of these 19 patients respectively. Analysed according to total NAR, the incidence of voice change and temporary RLN palsy (I/L and D/L) at 6 weeks was still less at 13.01%, 6.16% and 3.42%, respectively. Voice change improved in all cases at 3 months with no RLNP palsy by I/L or D/L. All these 19 patients had undergone difficult or extensive surgery for malignancy, large gland, extratyhroidal spread or fibrosis. Despite identification and preservation of RLN, patients can develop postoperative voice change and RLNP although all voice change cannot be attributed to damaged RLN. Proper assessment of vocal cord functions by I/L and D/L laryngoscopy is required to rule out injuries to these nerves. Risk of damage is higher in patients undergoing more difficult surgery.


LIPH expression in skin and hair follicles of normal coat and Rex rabbits.
Natural mutations in the LIPH gene were shown to be responsible for hair growth defects in humans and for the rex short hair phenotype in rabbits. In this species, we identified a single nucleotide deletion in LIPH (1362delA) introducing a stop codon in the C-terminal region of the protein. We investigated the expression of LIPH between normal coat and rex rabbits during critical fetal stages of hair follicle genesis, in adults and during hair follicle cycles. Transcripts were three times less expressed in both fetal and adult stages of the rex rabbits than in normal rabbits. In addition, the hair growth cycle phases affected the regulation of the transcription level in the normal and mutant phenotypes differently. LIPH mRNA and protein levels were higher in the outer root sheath (ORS) than in the inner root sheath (IRS), with a very weak signal in the IRS of rex rabbits. In vitro transfection shows that the mutant protein has a reduced lipase activity compared to the wild type form. Our results contribute to the characterization of the LIPH mode of action and confirm the crucial role of LIPH in hair production.


Distinct dynorphin expression patterns with low- and high-dose estrogen treatment in the arcuate nucleus of female rats.
Kisspeptin (KISS1; encoded by Kiss1) neurons in the arcuate nucleus (ARC) coexpress tachykinin 3 (TAC3; also known as neurokinin B) and dynorphin A (PDYN). Accordingly, they are termed KNDy neurons and considered to be crucial in generating pulsatile release of gonadotropin-releasing hormone. Accumulating evidence suggests that Kiss1 and Tac3 are negatively regulated by estrogen. However, it has not been fully determined whether and how estrogen modulates Pdyn and PDYN. Here, we examined the expression of Pdyn mRNA and PDYN by in situ hybridization and immunohistochemistry, respectively, in the ARC of female rats after ovariectomy (OVX) and OVX plus low- or high-dose beta-estradiol (E2) replacement. We also investigated the effect of E2 on expression of Kiss1, KISS1, Tac3, and TAC3. Furthermore, colocalization of PDYN and estrogen receptor alpha (ESR1) was determined. Subsequently, we found that low-dose E2 treatment had no effect on Pdyn mRNA-expressing cells, but increased PDYN-immunoreactive (ir) cell numbers. In contrast, high-dose E2 treatment resulted in prominent reductions in both Pdyn mRNA-expressing and PDYN-ir cell numbers. Changes induced by low or high doses of E2 were similarly observed in the expression of Kiss1, KISS1, Tac3, and TAC3. The majority of PDYN-ir neurons coexpressed ESR1 in all groups. Our results indicate that E2 regulates the expression of PDYN, as well as KISS1 and TAC3, with regulation by E2 differing according to its levels.


Comparison of lithium dilution and thermodilution cardiac output measurements in anaesthetised neonatal foals.
Knowledge of cardiac output is expected to help guide the treatment of hypotension associated with critical illness and/or anaesthesia in neonatal foals. However, a practical and safe method of measuring cardiac output has not been described for the foal. Lithum dilution, a new method of cardiac output determination not requiring cardiac catheterisation, has recently been reported in mature horses. We compared this method to thermodilution in isoflurane-anaesthetised foals age 30-42 h and found good agreement between the 2 methods in a range of cardiac outputs 5.4-20.4 l/min. The lithium dilution technique is a practical and reliable method of measuring cardiac output in anaesthetised neonatal foals, and warrants investigation in critically ill conscious foals.


Sliding dynamics of multi-rings on a semiflexible polymer in poly[n]catenanes.
The sliding dynamics of one- or multi-ring structures along a semiflexible cyclic polymer in radial poly[n]catenanes is investigated using molecular dynamics simulations. The fixed and fluctuating (non-fixed) semiflexible central cyclic polymers are considered, respectively. With increasing bending energy of the central cyclic polymer, for the fixed case, the diffusion coefficient increases monotonically due to the reduction of the tortuous sliding path, while for the fluctuating case, the diffusion coefficient decreases. This indicates that the contribution of the polymer fluctuation is suppressed by a further increase in the stiffness of the central cyclic chain. Compared with the one ring case, the mean-square displacement of the multiple rings exhibits a unique sub-diffusive behavior at intermediate time scales due to the repulsion between two neighboring rings. In addition, for the multi-ring system, the whole set of rings exhibit relatively slower diffusion, but faster local dynamics of threading rings and rotational diffusion of the central cyclic polymer arise. These results may help us to understand the diffusion motion of rings in radial poly[n]catenanes from a fundamental point of view and control the sliding dynamics in molecular designs.


Porcine adiponectin receptor 1 transgene resists high-fat/sucrose diet-induced weight gain, hepatosteatosis and insulin resistance in mice.
Adiponectin and its receptors have been demonstrated to play important roles in regulating glucose and lipid metabolism in mice. Obesity, type II diabetes and cardiovascular disease are highly correlated with down-regulated adiponectin signaling. In this study, we generated mice overexpressing the porcine Adipor1 transgene (pAdipor1) to study its beneficial effects in metabolic syndromes as expressed in diet-induced obesity, hepatosteatosis and insulin resistance. Wild-type (WT) and pAdipor1 transgenic mice were fed ad libitum with a standard chow diet (Chow) or a high-fat/sucrose diet (HFSD) for 24 weeks, beginning at 6 to 7 weeks of age. There were 12 mice per genetic/diet/sex group. When challenged with HFSD to induce obesity, the pAdipor1 transgenic mice resisted development of weight gain, hepatosteatosis and insulin resistance. These mice had lowered plasma adiponectin, triglyceride and glycerol concentrations compared to WT mice. Moreover, we found that (indicated by mRNA levels) fatty acid oxidation was enhanced in skeletal muscle and adipose tissue, and liver lipogenesis was inhibited. The pAdipor1 transgene also restored HFSD-reduced phosphoenolpyruvate carboxykinase 1 (Pck1) and glucose transporter 4 mRNA in the adipose tissues, implying that the increased Pck1 may promote glyceroneogenesis to reduce glucose intolerance and thus activate the flux of glyceride-glycerol to resist diet-induced weight gain in the adipose tissues. Taken together, we demonstrated that pAdipor1 can prevent diet-induced weight gain and insulin resistance. Our findings may provide potential therapeutic strategies for treating metabolic syndromes and obesity, such as treatment with an ADIPOR1 agonist or activation of Adipor1 downstream targets.


Hydrogel behavior of a sugar-based gelator by introduction of an unsaturated moiety as a hydrophobic group.
The new sugar-based gelators 1 and 2 were synthesized, and their gelation abilities were evaluated in organic solvents and in water. Compound 1 gelates both water and organic solvents whereas 2 gelates only organic solvents. Superstructural difference between hydrogel 1 and organogel 2 was investigated by CD, TEM, AFM, 1H NMR and XRD. Hydrogel 1 displays a well-developed helical ribbon structure with 20-150 nm diameter and a length of several hundred microm whereas organogel 2 shows a twisted fiber structure of diameter 20 nm. CD measurements of hydrogel 1 and organogel 2 indicate that hydrogel 1 maintains a well-ordered chiral structure whereas organogel 2 maintains a relatively disordered chiral structure. The 1H NMR and XRD results suggest that the hydrophobic interaction in hydrogel 1 are relatively weak, with a relatively small region interdigitated between lipophilic alkyl groups. In addition, upon irradiation at 254 nm wavelength, hydrogel 1 reveals a red coloration at 540 nm. These results indicate that the self-assembled hydrogel 1 was polymerized by UV-irradiation. The intensity of the CD spectrum of the polymerized hydrogel markedly decreased. This result indicates that upon polymerization the highly ordered chiral structure of hydrogel 1 changes to a disordered molecular packing structure.


Purification and Developmental Analysis of the Major Anionic Peroxidase from the Seed Coat of Glycine max.
We show that the majority of peroxidase activity in soybean (Glycine max var Williams 82) seeds is localized to the seed coat. A single isozyme is responsible for this activity and has been purified to electrophoretic homogeneity by successive chromatography on DEAE Sepharose Fast Flow, concanavalin A-Sepharose, and Sephadex G-75. The peroxidase exhibits a pl of 4.1, an apparent molecular mass of 37 kilodaltons, and has properties characteristic of a glycoprotein. The enzyme begins to accumulate approximately 21 days after anthesis and continues to do so throughout the maturation of the seed coat where it can represent at least 5% of the soluble protein in dry seed coats. Due to its localization in the seed, we propose that this isozyme may play a role in the hardening of the seed coat.


Gene silencing in adipose tissue macrophages regulates whole-body metabolism in obese mice.
Adipose tissue (AT) inflammation and infiltration by macrophages is associated with insulin resistance and type 2 diabetes in obese humans, offering a potential target for therapeutics. However, whether AT macrophages (ATMs) directly contribute to systemic glucose intolerance has not been determined. The reason is the lack of methods to ablate inflammatory genes expressed in macrophages specifically localized within AT depots, leaving macrophages in other tissues unaffected. Here we report that i.p. administration of siRNA encapsulated by glucan shells in obese mice selectively silences genes in epididymal ATMs, whereas macrophages within lung, spleen, kidney, heart, skeletal muscle, subcutaneous (SubQ) adipose, and liver are not targeted. Such administration of GeRPs to silence the inflammatory cytokines TNF-α or osteopontin in epididymal ATMs of obese mice caused significant improvement in glucose tolerance. These data are consistent with the hypothesis that cytokines produced by ATMs can exacerbate whole-body glucose intolerance.


Choice of lasers for minimally invasive spinal surgery.
Recently, there has been increased interest in less invasive spinal surgery techniques. This has led to the development of procedures such as automated percutaneous lumbar discectomy and arthroscopic microdiscectomy. Lasers are now used in many areas of medicine and may have applications in minimally invasive spinal surgery. A number of different laser systems have been evaluated for their effectiveness in removing disc tissue in the laboratory, but technical problems have limited their clinical use. Only the Nd:YAG (1,064 nm and 1,320 nm) and KTP (532 nm) systems have been used clinically. Unsuccessful clinical results were obtained with the 1,064 nm Nd:YAG, whereas the other two systems appeared to produce results similar to the present mechanical systems but required less time for disc removal. This paper discusses considerations for choosing a laser system for spinal applications and reviews the work performed in this area.


Handedness Dependent Electromagnetically Induced Transparency in Hybrid Chiral Metamaterials.
We provide the first experimental demonstration of the handedness dependent electromagnetically induced transparency (EIT) in chiral metamaterials during the interaction with circularly polarized waves. The observed chiral-sensitive EIT phenomena arise from the coherent excitation of a non-radiative mode in the component split ring resonators (SRRs) produced by the corresponding Born-Kuhn type (radiative) resonators that are responsible for the pronounced chirality. The coherent coupling, which is dominated by the bonding and antibonding resonances of the Born-Kuhn type resonators, leads to an extremely steep dispersion for a circularly polarized wave of predefined handedness. Accordingly, retrieved effective medium parameters from simulated results further reveal a difference of 80 in the group indices for left- and right-handed circularly polarized waves at frequencies within the EIT window, which can potentially result in handedness-sensitive pulse delays. These chiral metamaterials which enable a handedness dependent EIT effect may provide more degrees of freedom for designing circular polarization based communication devices.


Correlation of Valsalva leak point pressure with subjective degree of stress urinary incontinence in women.
We correlated symptoms of stress urinary incontinence in women with intrinsic urethral function, as measured by Valsalva leak point pressure. In addition, we assessed the effects of urethral hypermobility, baseline resting abdominal pressure, patient age and menopausal status on Valsalva leak point pressure. We evaluated 64 consecutive women (mean age 50 years, range 20 to 79) with complaints of stress urinary incontinence. Initially the patient history was obtained and the subjective degree of stress urinary incontinence was graded as 1, 2 or 3 according to the SEAPI-QMN classification. Multichannel video urodynamics were then performed. At a volume of 150 to 200 ml. (or half bladder capacity when functional capacity was less than 150 ml.) filling was stopped. Resting, coughing and progressive Valsalva maneuvers were performed to determine Valsalva leak point pressure and the presence of urethral hypermobility. Valsalva leak point pressure was defined as the minimum total vesical pressure required to cause urinary incontinence in the absence of a detrusor contraction. Urodynamics were completed and detrusor instability or stress induced instability was noted. Of the 64 women 52 (81.3%) had stress urinary incontinence. The exact test for trend demonstrated a statistically significant difference in the number of patients with a Valsalva leak point pressure of 90 cm. water or less (p = 0.0002) and 60 cm. water or less (p = 0.0002) among the 3 symptom groups. There was no correlation between Valsalva leak point pressure and resting vesical (which equals abdominal) pressure, patient age or menopausal status, or urge incontinence or detrusor instability among the 3 groups. The subjective degree of stress urinary incontinence can predict intrinsic urethral function as measured by Valsalva leak point pressure. Higher grades of stress urinary incontinence have a higher likelihood of a low Valsalva leak point pressure. Many women with grade 2 or 3 stress urinary incontinence have a Valsalva leak point pressure of 90 cm. water or less despite urethral hypermobility and they may have a component of intrinsic urethral deficiency.


BLogo: a tool for visualization of bias in biological sequences.
Blogo is a web-based tool that detects and displays statistically significant position-specific sequence bias with reduced background noise. The over-represented and under-represented symbols in a particular position are shown above and below the zero line. When the sequences are in open reading frames, the background frequency of nucleotides could be calculated separately for the three positions of a codon, thus greatly reducing the background noise. The chi(2)-test or Fisher's exact test is used to evaluate the statistical significance of every symbol in every position and only those that are significant are highlighted in the resulting logo. The perl source code of the program is freely available and can be run locally. http://acephpx.cropdb.org/blogo/, http://www.bioinformatics.org/blogo/.


Biological Function of Acetic Acid-Improvement in Obesity and Glucose Tolerance by Acetic Acid in Type 2 Diabetic Rats.
Fatty acids derived from adipose tissue are oxidized by β-oxidation to form ketone bodies as final products under the starving condition. Previously, we found that free acetic acid was formed concomitantly with the production of ketone bodies in isolated rat liver perfusion, and mitochondrial acetyl CoA hydrolase was appeared to be involved with the acetic acid production. It was revealed that acetic acid was formed as a final product of enhanced β-oxidation of fatty acids and utilized as a fuel in extrahepatic tissues under the starving condition. Under the fed condition, β-oxidation is suppressed and acetic acid production is decreased. When acetic acid was taken daily by obesity-linked type 2 diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats under the fed condition, it protected OLETF rats against obesity. Furthermore, acetic acid contributed to protect from the accumulation of lipid in the liver as well as abdominal fat in OLETF rats. Transcripts of lipogenic genes in the liver were decreased, while transcripts of myoglobin and Glut4 genes in abdominal muscles were increased in the acetic acid-administered OLETF rats. It is indicated that exogenously administered acetic acid would have effects on lipid metabolism in both the liver and the skeletal muscles, and have function that works against obesity and obesity-linked type 2 diabetes.


[The history and principle of spinal manipulation in the treatment of lumbar intervertebral disc herniation].
It is generally agreed that spinal manipulation has been applied into the treatment of lumbar intervertebral disc herniation (LDH) for thousands of years according to historical reviews of the paper. The balance restore of spinal column had been always the main aim of spinal manipulation during the time. The situation has been changed after LDH was discovered pathomechanically about 70 years ago and the protruded nucleus pulposus has attracted the attention of whole world ever since and surgery become the major choice for LDH patients. Nevertheless, some latest reports of clinical observation in past decades explored more and more solid evidences to prove that most of the patients need no surgery at all and would be cured by conservative therapy without any changes of protruded nucleus pulposus at involved segment. The modern management of LDH suggests that we should not only pay attention to the protruded disk but also to the biomechanical balance of spinal column again as we had for thousands of years,which is concluded from the reviews of previous reports and history of LDH recognition in the paper. The only thing we should care more about is how to make full use of our modern knowledge to adjust our view of observation and management in clinical practice of spinal manipulation and to make a further understanding of the pathomechanics of LDH.


Ablation of triadin causes loss of cardiac Ca2+ release units, impaired excitation-contraction coupling, and cardiac arrhythmias.
Heart muscle excitation-contraction (E-C) coupling is governed by Ca(2+) release units (CRUs) whereby Ca(2+) influx via L-type Ca(2+) channels (Cav1.2) triggers Ca(2+) release from juxtaposed Ca(2+) release channels (RyR2) located in junctional sarcoplasmic reticulum (jSR). Although studies suggest that the jSR protein triadin anchors cardiac calsequestrin (Casq2) to RyR2, its contribution to E-C coupling remains unclear. Here, we identify the role of triadin using mice with ablation of the Trdn gene (Trdn(-/-)). The structure and protein composition of the cardiac CRU is significantly altered in Trdn(-/-) hearts. jSR proteins (RyR2, Casq2, junctin, and junctophilin 1 and 2) are significantly reduced in Trdn(-/-) hearts, whereas Cav1.2 and SERCA2a remain unchanged. Electron microscopy shows fragmentation and an overall 50% reduction in the contacts between jSR and T-tubules. Immunolabeling experiments show reduced colocalization of Cav1.2 with RyR2 and substantial Casq2 labeling outside of the jSR in Trdn(-/-) myocytes. CRU function is impaired in Trdn(-/-) myocytes, with reduced SR Ca(2+) release and impaired negative feedback of SR Ca(2+) release on Cav1.2 Ca(2+) currents (I(Ca)). Uninhibited Ca(2+) influx via I(Ca) likely contributes to Ca(2+) overload and results in spontaneous SR Ca(2+) releases upon beta-adrenergic receptor stimulation with isoproterenol in Trdn(-/-) myocytes, and ventricular arrhythmias in Trdn(-/-) mice. We conclude that triadin is critically important for maintaining the structural and functional integrity of the cardiac CRU; triadin loss and the resulting alterations in CRU structure and protein composition impairs E-C coupling and renders hearts susceptible to ventricular arrhythmias.


Asymmetric Intermolecular Iodinative Difunctionalization of Allylic Sulfonamides Enabled by Organosulfide Catalysis: Modular Entry to Iodinated Chiral Molecules.
Electrophilic halogenation of alkenes is a powerful transformation offering a convenient route for the construction of valuable functionalized molecules. However, as a highly important reaction in this field, catalytic asymmetric intermolecular iodinative difunctionalization remains a formidable challenge. Herein, we report that an efficient Lewis basic chiral sulfide-catalyzed approach enables this reaction. By this approach, challenging substrates such as γ,γ-disubstituted allylic sulfonamides and 1,1-disubstituted alkenes with an allylic sulfonamide unit undergo electrophilic iodinative difunctionalization to give a variety of iodine-functionalized chiral molecules in good yields with excellent enantio- and diastereoselectivities. A series of free phenols as nucleophiles are successfully incorporated into the substrates. Aside from phenols, primary and secondary alcohols, fluoride, and azide also serve as efficient nucleophiles. The obtained iodinated products are a good platform molecule, which can be easily transformed into various chiral compounds such as α-aryl ketones, chiral secondary amines, and aziridines via rearrangement or substitution. Mechanistic studies revealed that the chiral sulfide catalyst displays a superior effect on control of the reactivity of electrophilic iodine and the enantioselective construction of the chiral iodiranium ion intermediate and catalyst aggregates might be formed as a resting state in the reactions.


Reversible photo control of proton chemistry.
Spatial, temporal, and remote control of proton chemistry can be achieved by using photoacids, which are molecules that transform from weak to strong acids under light. Most of proton chemistry is driven by a high concentration of protons ([H+]), which is difficult to obtain using excited-state photoacids. Metastable-stable state photoacids (mPAHs) can reversibly generate a high [H+] under visible light with a moderate intensity. It has been widely applied in different fields, e.g. fueling dissipative assemblies, driving molecular machines, controlling organic reactions, powering nanoreactors, curing diseases, manipulating DNA and proteins, developing smart materials, capturing carbon dioxide in air etc. This article compares mPAH with excited-state photoacid as well as common acids e.g. HCl to explain its advantages. Recent studies on the thermal dynamics, kinetics, and photoreaction of mPAHs are reported. The advantages and disadvantages of the three types of mPAHs, i.e. merocyanine, indazole, and TCF mPAHs, are compared with regard to photo-induced [H+], switching rate, and other properties. The mechanisms of controlling or driving functional systems, which involve acid-base reactions, acid catalyzed reactions, ionic bonding, coordination bonding, hydrogen bonding, ion exchange, cation-π interaction, solubility, swellability, permeability, and pH change in biosystems, are described. Applications of mPAHs in the chemical, material, energy, biotechnology and biomedical fields published in the past 5 years are reviewed. Prospects in the development and application of mPAHs are discussed.


Predicting dengue outbreaks at neighbourhood level using human mobility in urban areas.
Dengue is a vector-borne disease transmitted by the Aedes genus mosquito. It causes financial burdens on public health systems and considerable morbidity and mortality. Tropical regions in the Americas and Asia are the areas most affected by the virus. Fortaleza is a city with approximately 2.6 million inhabitants in northeastern Brazil that, during the recent decades, has been suffering from endemic dengue transmission, interspersed with larger epidemics. The objective of this paper is to study the impact of human mobility in urban areas on the spread of the dengue virus, and to test whether human mobility data can be used to improve predictions of dengue virus transmission at the neighbourhood level. We present two distinct forecasting systems for dengue transmission in Fortaleza: the first using artificial neural network methods and the second developed using a mechanistic model of disease transmission. We then present enhanced versions of the two forecasting systems that incorporate bus transportation data cataloguing movement among 119 neighbourhoods in Fortaleza. Each forecasting system was used to perform retrospective forecasts for historical dengue outbreaks from 2007 to 2015. Results show that both artificial neural networks and mechanistic models can accurately forecast dengue cases, and that the inclusion of human mobility data substantially improves the performance of both forecasting systems. While the mechanistic models perform better in capturing seasons with large-scale outbreaks, the neural networks more accurately forecast outbreak peak timing, peak intensity and annual dengue time series. These results have two practical implications: they support the creation of public policies from the use of the models created here to combat the disease and help to understand the impact of urban mobility on the epidemic in large cities.


Retention of halogenated solutes on stationary phases containing heavy atoms.
To examine the effects of weak intermolecular interactions on solid-phase extraction (SPE) and chromatographic separation, we synthesized some novel stationary phases with a heavy atom effect layer by immobilizing halogenated aromatic rings and hydroxyl groups onto the surface of a hydrophilic base polymer. Using SPE cartridges packed with the functionalized materials, we found that the heavy atom stationary phases could selectively retain halophenols in organic solvents, such as 1-propanol which blocks the hydrogen bonding, or acetonitrile which blocks the π-π interaction. The extraction efficiency of the materials toward the halophenols depended on the dipole moments of phenoxy groups present as functional groups. On the other hand, the extraction efficiency of solutes toward the functional group depended on their molar refractions, i.e., induced dipole moments. The retention of the solutes to the stationary phase ultimately depended on not only strong intermolecular interactions, but also the effects of weak interactions such as the dispersion force.


Fractional extreme value adaptive training method: fractional steepest descent approach.
The application of fractional calculus to signal processing and adaptive learning is an emerging area of research. A novel fractional adaptive learning approach that utilizes fractional calculus is presented in this paper. In particular, a fractional steepest descent approach is proposed. A fractional quadratic energy norm is studied, and the stability and convergence of our proposed method are analyzed in detail. The fractional steepest descent approach is implemented numerically and its stability is analyzed experimentally.


High School Sport Specialization Patterns of Current Division I Athletes.
Sport specialization is a strategy to acquire superior sport performance in 1 sport but is associated with increased injury risk. Currently, the degree of high school specialization among Division I athletes is unknown. College athletes will display increased rates of specialization as they progress through their high school careers. Descriptive epidemiological study. Level 4. Three hundred forty-three athletes (115 female) representing 9 sports from a Midwest Division I University completed a previously utilized sport specialization questionnaire regarding sport participation patterns for each grade of high school. McNemar and chi-square tests were used to investigate associations of grade, sport, and sex with prevalence of sport specialization category (low, moderate, high) (a priori P ≤ 0.05). Specialization increased throughout high school, with 16.9% (n = 58) and 41.1% (n = 141) of athletes highly specialized in 9th and 12th grades, respectively. Football athletes were less likely to be highly specialized than nonfootball athletes for each year of high school ( P < 0.001). There was no difference in degree of specialization between sexes at any grade level ( P > 0.23). The majority of Division I athletes were not classified as highly specialized throughout high school, but the prevalence of high specialization increased as athletes progressed through high school. Nonfootball athletes were more likely to be highly specialized than football athletes at each grade level. Most athletes who are recruited to participate in collegiate athletics will eventually specialize in their sport, but it does not appear that early specialization is necessary to become a Division I athlete. Athletes should be counseled regarding safe participation in sport during high school to minimize injury and maximize performance.


Hyperbaric Oxygen Therapy with Iloprost Improves Digit Salvage in Severe Frostbite Compared to Iloprost Alone.
Background and Objectives: Frostbite is a freezing injury that can lead to amputation. Current treatments include tissue rewarming followed by thrombolytic or vasodilators. Hyperbaric oxygen (HBO) therapy might decrease the rate of amputation by increasing cellular oxygen availability to the damaged tissues. The SOS-Frostbite study was implemented in a cross-border program among the hyperbaric centers of Geneva, Lyon, and the Mont-Blanc hospitals. The objective was to assess the efficacy of HBO + iloprost among patients with severe frostbite. Materials and Methods: We conducted a multicenter prospective single-arm study from 2013 to 2019. All patients received early HBO in addition to standard care with iloprost. Outcomes were compared to a historical cohort in which all patients received iloprost alone between 2000 and 2012. Inclusion criteria were stage 3 or 4 frostbite and initiation of medical care <72 h from frostbite injury. Outcomes were the number of preserved segments and the rate of amputated segments. Results: Thirty patients from the historical cohort were eligible and satisfied the inclusion criteria, and 28 patients were prospectively included. The number of preserved segments per patient was significantly higher in the prospective cohort (mean 13 ± SD, 10) compared to the historical group (6 ± 5, p = 0.006); the odds ratio was significantly higher by 45-fold (95%CI: 6-335, p < 0.001) in the prospective cohort compared to the historical cohort after adjustment for age and delay between signs of freezing and treatment start. Conclusions: This study demonstrates that the combination of HBO and iloprost was associated with higher benefit in patients with severe frostbite. The number of preserved segments was two-fold higher in the prospective cohort compared to the historical group (mean of 13 preserved segments vs. 6), and the reduction of amputation was greater in patients treated by HBO + iloprost compared with the iloprost only.


Serum gamma-glutamyltransferase and risk of type 2 diabetes mellitus in men and women from the general population.
To examine gender-specific associations between gamma-glutamyltransferase (GGT) and incident type 2 diabetes mellitus in a representative population-based sample in Germany. Prospective population-based study. The study was based on 1851 men and 1836 women (aged 25-64 years) who participated in the first Monitoring Trends and Determinants on Cardiovascular Diseases (MONICA) Augsburg Survey 1984/1985, and who were free of diabetes at baseline. Incident cases of type 2 diabetes were assessed using follow-up questionnaires in 1987/1988, 1997/1998 and 2002/2003 and were validated with medical records. Gender-specific hazard ratios (HRs) were estimated from Cox proportional hazard models. A total of 172 cases of incident type 2 diabetes amongst men and 109 amongst women were registered during a mean follow-up period of 14.7 years. In both sexes the risk of type 2 diabetes increased with increasing levels of serum GGT. After multivariable adjustment HRs for incident type 2 diabetes across GGT categories (<25th, <50th, <75th, <87.5th and > or =87.5th percentiles) were 1.0, 1.81, 2.37, 3.41 and 4.24 (P-value for trend <0.0001) in men and 1.0, 1.42, 1.48, 1.95 and 2.41 (P-value for trend 0.0179) in women. Obesity appeared to be more strongly associated with type 2 diabetes in women with GGT equal or greater than the median compared to women with GGT below the median. However, in men the association between obesity and type 2 diabetes was almost identical in the two groups. The GGT is an important predictor for incident type 2 diabetes in men and women from the general population.


EPR line shifts and line shape changes due to spin exchange of nitroxide free radicals in liquids: 6. Separating line broadening due to spin exchange and dipolar interactions.
EPR spectra of perdeuterated 2,2,6,6-tetramethyl-4-oxopiperidine-1-oxyl (PDT) are studied as functions of molar concentration, c, and temperature, T, in water and 70 wt % glycerol in water. The increase of the intrinsic line width averaged over the three hyperfine lines, B(tot), varies linearly with c with zero intercept in both solvents at all temperatures; therefore dB(tot)/dc is independent of c. The spin exchange induced dispersion, from which the spin exchange frequency, omega(e), may be computed, increases linearly with B(tot), passing through the origin in water and in 70% glycerol at high temperatures; however, at low temperatures, where dipolar interactions broaden the spectra, linearity does not prevail until B(tot) > 1 G due to a contribution of dipolar interactions to the dispersion. The broadening constant due to spin exchange, dB(e)/dc, is found from the slope of the linear region, permitting a computation of the dipolar constant, dB(dip)/dc = dB(tot)/dc - dB(e)/dc. Thus, the separation of concentration broadening into spin exchange and dipolar contributions is effected without having to appeal to some supposed temperature dependence of the two interactions. The fractional broadening by spin exchange, Omega(T), is near unity at high temperatures in both solvents, decreasing to zero in 70% glycerol at 273 K. Omega(T) is a continuous function of the inverse rotational correlation time of PDT but is discontinuous as a function of T/eta where eta is the shear viscosity. Omega(T) = 0.5, where spin exchange and dipolar interactions contribute equally to the line width occurs at T/eta = 20 +/- 1 K/cP in 70% glycerol. Hydrodynamic predictions of dB(e)/dc via the Stokes-Einstein (SE) equation are remarkably accurate in 70% glycerol comparable with the results in a series of alkanes. In water, dB(e)/dc is linear with T/eta with zero intercept as required by the SE; however, with slope a factor of 0.73 smaller. dB(dip)/dc is reasonably predicted by the SE only at very small values of eta/T very quickly following an approximately logarithmic dependence rather that the linear prediction. Values of dB(dip)/dc approach a plateau above eta/T = 0.20 cP/K that is about one-half the solid state limit. Line shifts due to spin exchange are not yet useful to deduce values of Omega(T) due to a lack of knowledge of the time between re-encounters; however, they may be used to verify the values determined from line broadening and spin exchange induced dispersion. Some effects at low temperatures in 70% glycerol suggest that the effects of dipolar interaction are inadequately described by the widely accepted theory.


Oxathiin carboxanilide, a potent inhibitor of human immunodeficiency virus reproduction.
Oxathiin carboxanilide (OC), NSC 615985, a compound originally synthesized as a potential fungicide, was demonstrated to be highly active in preventing human immunodeficiency virus (HIV)-induced cell killing and in inhibiting HIV reproduction. Virus-infected CD4+ lymphocytes were completely protected by 0.5 microM OC, whereas no toxicity was observed at concentrations below 50 microM OC. Production of infectious virus, viral p24 antigen, and virion reverse transcriptase were reduced by OC at concentrations that prevented viral cell killing. A variety of CD4+ T-cell lines were protected by OC from HIV cytopathicity, and OC inhibited two distinct strains of HIV-1. However, HIV-2 infections were unaffected by OC. OC had no direct effect on virions of HIV or on the enzymatic activities of HIV reverse transcriptase or HIV protease. Time-limited treatments of cells with OC before, during, or after exposure of cells to virus failed to protect cells from the eventual cytopathic effects of HIV, and OC failed to inhibit the production of virus from cells in which infection was established or from chronically infected cells. We conclude that the highly active OC has a reversible effect on some early stage of HIV-1 reproduction and cytopathicity. Pilot in vivo experiments showed that circulating concentrations of OC exceeding 1 microM could be achieved and sustained in hamsters for at least a week with no remarkable toxicological sequelae. OC represents a new class of anti-HIV agents that are promising candidates for drug development.


Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review.
The objective of this review is to determine the effectiveness of Harpagophytum procumbens preparations in the treatment of various forms of musculoskeletal pain. Several databases and other sources were searched to identify randomized controlled trials, quasi-randomized controlled trials, and controlled clinical trials testing Harpagophytum preparations in adults suffering from pain due to osteoarthritis or low back pain. Given the clinical heterogeneity and insufficient data for statistical pooling, trials were described in a narrative way, taking into consideration methodological quality scores. Twelve trials were included with six investigating osteoarthritis (two were identical trials), four low back pain, and three mixed-pain conditions. There is limited evidence for an ethanolic Harpagophytum extract containing less than <30 mg harpagoside per day in the treatment of knee and hip osteoarthritis. There is moderate evidence of effectiveness for (1) the use of a Harpagophytum powder at 60 mg harpagoside in the treatment of osteoarthritis of the spine, hip and knee; (2) the use of an aqueous Harpagophytum extract at a daily dose of 100 mg harpagoside in the treatment of acute exacerbations of chronic non-specific low back pain; and (3) the use of an aqueous extract of Harpagophytum procumbens at 60 mg harpagoside being non-inferior to 12.5 mg rofecoxib per day for chronic non-specific low-back pain (NSLBP) in the short term. Strong evidence exists for the use of an aqueous Harpagophytum extract at a daily dose equivalent of 50 mg harpagoside in the treatment of acute exacerbations of chronic NSLBP.


Microsomal ethanol oxidizing system activity by human hepatic cytochrome P450s.
To assess the contribution of cytochrome P450 (P450) to the microsomal ethanol oxidation system (MEOS) in humans, we examined ethanol oxidization activity in human hepatic microsomes and multiple forms of human hepatic P450s expressed in B-lymphoblastoid cells. Acetaldehyde produced by the MEOS was converted into a fluorescent derivate with cyclohexane-1,3-dione and analyzed by high-performance liquid chromatography using a fluorescence detector. The ethanol oxidation activity of seven forms of human P450s was investigated. P450s 2E1 and 1A2 formed acetaldehyde at high rates. In immunoinhibition studies, anti-P450 2E1 antibody inhibited the ethanol oxidation activity of human hepatic microsomes by 54%, and anti-P450 1A2 antibody inhibited ethanol oxidation activity by 21%. 7,8-Benzoflavone, an inhibitor of P450 1A forms, also inhibited this activity by 38%. The correlation of ethanol oxidation activity with the levels of immunoreactive P450 2E1 in individual human microsomes was highly significant (r = 0.91, P < .001), and the correlation of ethanol oxidation activity with the levels of P450 1A2 was also highly significant (r = 0.87, P < .001). The Km values of P450s 2E1 and 1A2 for ethanol oxidation were 16.5 and 23.6 mM, respectively. These results indicated that P450 2E1 was a major contributor to the MEOS in humans; however, P450 1A2 was considered to play an important role in the MEOS.


Controllable Fabrication of Percolative Metal Nanoparticle Arrays Applied for Quantum Conductance-Based Strain Sensors.
We use gas phase deposition of well-defined nanoparticles (NPs) to fabricate closely-spaced Pd NP arrays on flexible membranes prepatterned with interdigital electrodes (IDEs). The evolution of the morphology and electron conductance of the NP arrays during deposition is analyzed. The growth of two-dimensional percolation clusters of interconnected NPs, which correlate with the percolation pathway for electron conduction in the NP deposits, is demonstrated. The percolative nature of the NP arrays permits us to finely control the percolation geometries and conductance of the NP film by controlling the NP deposition time so as to realize a precise and reproducible fabrication of sensing materials. Electron transport measurements reveal that the electrical conductance of the NP films is dominated by electron tunneling or hopping across the NP percolating networks. Based on the percolative and quantum tunneling nature, the closely-spaced Pd NP films on PET membranes are used as flexible strain sensors. The sensor demonstrates an excellent response ability to distinguish tiny deformations down to 5×10-4 strain and a high sensitivity with a large gauge factor of 200 up to 4% applied strain.


Endobronchial valve therapy for severe emphysema: an overview of valve-related complications and its management.
Bronchoscopic lung volume reduction treatment with one-way valves is an effective guideline treatment option for patients with severe emphysema. However, important challenges and adverse reactions may occur after treatment. This review summarizes the complications after endobronchial and intrabronchial valve treatment that have been described by the currently published randomized controlled trials and other relevant papers regarding the complications and its management. In case there was no relevant literature regarding these subjects, recommendations are based on expert opinion. Complications include pneumothorax, post-obstruction pneumonia and hemoptysis. Also, the treatment may not be effective due to the presence of collateral ventilation or misplaced valves. Furthermore, an initial beneficial effect may vanish due to granulation tissue formation, valve dysfunction or valve migration. Careful follow-up after treatment with valves is important. Evaluation with a CT-scan and/or bronchoscopy is needed if there is no improvement after treatment, loss of benefit, or occurrence of important adverse events during follow-up. Treating severe emphysema patients with one-way valves requires continuous dedication and expertise, especially to achieve an optimal outcome and elegantly deal with the various complications after treatment.


Z helix-coil transition of d(C-Br8G-C-G-C-Br8G) studied by CD, 1H-NMR and IR spectroscopies.
The conformation of d(C-Br8G-C-G-C-Br8G) in aqueous solution was studied by CD and 1H-NMR spectroscopy and in condensed phase by IR spectroscopy. Whether in 0.1 M or 3 M NaCl solution or in film the only double helical structure adopted by brominated d(C-G)3 oligomer is the Z form. The IR spectrum of the film presents all the characteristic absorptions of the Z conformation and in particular is indicative of a syn conformation for the central guanosine as well as for the brominated one. Imino proton resonances of d(C-Br8G-C-G-C-Br8G) demonstrating the duplex formation were observed up to 60 degrees C. It is interesting to note that the significant highfield shifts of the dC H5" exocyclic sugar protons characteristic of the non exchangeable proton spectra of d(C-G)3 containing 5-methyl dC residues in the Z form were also detected in the proton spectrum of brominated oligomer. Whereas formation of the Z helix of methylated d(C-G)3 oligomers dependent on the salt concentration was found to occur via the preliminary formation of a B helix even in 4 M NaCl solution, the Z helix of d(C-Br8G-C-G-C-Br8G) is obtained directly from the coil form. However, IR data suggest that in the Z form of d(C-Br8G-C-G-C-Br8G), the overlapping of the base planes should be slightly different in comparison with the stacking observed in d(C-G)3 crystals. The kinetic data (activation energy and lifetime) of the Z helix-coil transition of brominated d(C-G)3 are compared to those of the B helix-coil transition observed for methylated d(C-G)3 in 0.1 M NaCl solution while the thermodynamic data of these two reactions (enthalpy and midpoint temperature) are slightly different.


Evidence that the growth hormone receptor mediates differentiation and development of the mammary gland.
We have shown that nonlactogenic rat (r) GH is far more potent than rPRL in inducing rat mammary development. To determine the relative roles of GH and PRL in mammary development and their mechanisms of action, we have compared the abilities of a group of native and mutant GHs, PRLs, and placental lactogens (PLs) to induce mammary development, bind to GH receptors, and activate lactogenic receptors. Mammary development was assessed histologically by counting terminal end buds and alveolar structures in glands from sexually immature, hypophysectomized, castrated, estradiol-treated rats. Hormones were implanted, in Elvax pellets, into the lumbar mammary gland. Significant increases in terminal end buds (P < 0.03) over internal control values were obtained with rGH, recombinant human GH (rhGH), rbGH, and one of two mutant rhGHs. These four hormones were also found to bind to GH receptors with high affinity. In contrast, little development occurred with hPRL, rPRL, rhPL, ovine PRL, mutant forms of rhPRL and rhPL, and a mutant of rhGH altered to reduce binding to GH and PRL receptors. All of these substances are more than 50-fold reduced in binding to the GH receptor, yet can bind and activate lactogenic receptors. Thus, only those natural or mutant pituitary or placental hormones with high binding affinity to GH receptors induce mammary development, suggesting that GH receptors play a central role in this process.


Fingerprint sensor using a polymer dispersed liquid crystal holographic lens.
We used a polymer dispersed liquid crystal material holographic lens in a fingerprint sensor, which reduced the total size of the sensor and improved image quality. The beam carrying fingerprint information was diffracted by the holographic lens and converged onto the complementary metal-oxide semiconductor image sensor directly, which omitted the traditional lens or fiber taper. The phenomenon that the image quality is poor when the finger is too dry or wet was explained based on the evanescent wave theory. The total size of the device was 50 mm x 25 mm x 30 mm. The fingerprint image had a contrast of 250:1 and a resolution of 800 dots/in.


Adjuvant chemotherapy guidance for pT1-3N0-1 breast cancer patients with HR+, HER2- subtype: a cohort study based on the SEER database.
Although the results of gene testing can guide early breast cancer patients with hormone receptor (HR)+, human epidermal growth factor receptor 2 (HER2)- to decide whether they need chemotherapy (CHT), there are still many patients worldwide whose problems cannot be resolved by genetic testing. A total of 144,735 patients with HR+, HER2-, pT1-3N0-1 breast cancer from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015 were included. They were divided into CHT and no CHT groups, and after propensity score matching (PSM), overall survival (OS) and breast cancer-specific survival (BCSS) were tested using the Kaplan-Meier plot. The Cox proportional hazards regression model was used to identify independent prognostic factors. A nomogram was constructed to score each patient. Patients were divided into high- or low-risk groups according to their nomogram score using X-tile. Patients receiving CHT had better OS before and after matching (P<0.05), but BCSS was not significantly different between patients with and without CHT after matching. Independent prognostic factors were included to construct the nomogram, which could calculate the risk score for each patient, and then all patients were divided into two groups using X-tile: a risk score ≤238 was classified as the low-risk group and >238 was classified as the high-risk group. Patients in the high-risk group (score >238) could achieve better OS and from CHT; however, the low-risk group (score ≤238) could not. In this study, a well-validated nomogram and a risk stratification model was built. Patients in the high-risk group should receive CHT, while patients in low-risk group may be exempt from CHT.


Copper-Catalyzed Azide-Alkyne Cycloaddition of Hydrazoic Acid Formed In Situ from Sodium Azide Affords 4-Monosubstituted-1,2,3-Triazoles.
We report a copper-catalyzed cycloaddition of hydrogen azide (hydrazoic acid, HN3) with terminal alkynes to form 4-substituted-1H-1,2,3-triazoles in a sustainable manner. Hydrazoic acid was formed in situ from sodium azide under acidic conditions to react with terminal alkynes in a copper-catalyzed reaction. Using polydentate N-donor chelating ligands and mild organic acids, the reactions were realized to proceed at room temperature under aerobic conditions in a methanol-water mixture and with 5 mol % catalyst loadings to afford 4-substituted-1,2,3-triazoles in high yields. This method is amenable on a wide range of alkyne substrates, including unprotected peptides, showing diverse functional group tolerance. It is applicable for late-stage functionalization synthetic strategies, as demonstrated in the synthesis of the triazole analogue of losartan. The preparation of orthogonally protected azahistidine from Fmoc-l-propargylglycine was realized on a gram scale. The hazardous nature of hydrazoic acid has been diminished as it forms in situ in <6% concentrations at which it is safe to handle. Reactions of distilled solutions of hydrazoic acid indicated its role as a reactive species in the copper-catalyzed reaction.


Variable conformation and dynamics of calmodulin complexed with peptides derived from the autoinhibitory domains of target proteins.
Calcium-saturated calmodulin (CaM) can bind and activate many target proteins through the direct association with the respective autoinhibitory domains. The CaM binding sequences within the autoinhibitory domains of these proteins have little sequence homology, and the mechanisms associated with CaM's ability to recognize and productively bind with these variable sequences is unclear. Common structural features of CaM bound to five peptides that are homologous to the autoinhibitory domains of smooth muscle myosin light chain kinase, CaM-dependent protein kinase II alpha, the plasma membrane Ca-ATPase, a MARCKS homolog, and glycogen phosphorylase kinase were assessed using frequency-domain fluorescence spectroscopy. In addition, the structural features of CaM complexed with the peptide melittin was also considered. We observe similar decreases in the average fluorescence lifetime and similar increases in the solvent accessibility of N-(1-pyrenyl)maleimide (PM) bound at Cys27 in calcium binding loop I in the amino terminal domain of CaM upon association with all six target peptides. Likewise, using fluorescence resonance energy transfer to measure the spatial separation between the opposing globular domains in CaM, we observe a similar spatial separation between the opposing globular domains of CaM bound to all six peptides. This indicates that CaM undergoes comparable structural changes upon association with all six target peptides. However, there are significant differences in the observed lifetime, solvent accessibility, correlation time associated with the segmented rotational motion of PM-CaM, and in the spatial separation between the opposing globular domains in CaM upon association with the individual target peptides, which indicates that CaM adopts a different tertiary structure that is dependent on the structural features of the bound target peptide. The correlation times associated with the overall hydrodynamic properties of CaM complexed with all six peptides are nearly identical (phi 2 approximately 10.6 +/- 0.4 ns) and are consistent with the known dimensions of CaM complexed to a peptide homologous to the CaM binding sequence of CaM-dependent protein kinase II alpha. Therefore, while these results are consistent with a common binding mechanism between CaM and all six target peptides, they indicate that the binding domains of CaM adopt different tertiary structures that allow them to bind with the variable sequences found in the autoinhibitory domains of target proteins with high affinity.


Reconstruction of irradiated postpneumonectomy empyema cavity with chain-link coupled microsurgical omental and TRAM flaps.
We present the first case of complete hemithoracic reconstruction of an irradiated postpneumonectomy recurrent empyema cavity that was unresponsive to multiple conventional treatments. The procedure described used a chain-link of two coupled free flaps consisting of an omental and TRAM flap. A single abdominal donor site and single operative position are other advantages of this technique that provides sufficient volume to obviate the need for thoracoplasty even in the largest wounds.


Intradural-extramedullary spinal cavernous angioma--case report.
An extremely rare case of intradural-extramedullary spinal cavernous angioma in a 65-year-old male is reported. The clinical presentation was recurrent episodes of subarachnoid hemorrhage (SAH). Magnetic resonance images disclosed the tumor at the 1st thoracic vertebra, without gadolinium enhancement. The tumor was tightly adhered to the cord surface and successfully removed microsurgically. The previous two reports of this unusual tumor also showed repeated SAH and the tumor attachment to the spinal cord or nerve roots. Intradural-extramedullary cavernous angioma possibly originates in the surface of the spinal cord or nerve root and then extends extraphytically.


Protective Effects of alpha-Tocopherol and N-Acetyl-Cysteine on Diazinon-Induced Oxidative Stress and Acetylcholinesterase Inhibition in Rats.
ABSTRACT Diazinon, an organophosphate (OP) insecticide, is widely used in agriculture and domestically. Reactive oxygen species (ROS) caused by OPs are involved in the toxicity of various pesticides. The aim of the present study was to analyze the role of diazinon in inducing oxidative stress in adult male Wistar rats and to evaluate the possible protective effects of alpha-tocopherol (TPH) and the glutathione prodrug N-acetyl-cysteine (NAC) after 4 weeks of exposure to a sublethal dose of diazinon. TPH (10 mg/kg/day), NAC (160 mg/kg/day), diazinon (25 mg/kg/day), a combination of NAC (160 mg/kg/day) and diazinon (25 mg/kg/day), and a combination of TPH (10 mg/kg/day) and diazinon (25 mg/kg/day) were given to rats orally via gavage for 4 weeks. The thiobarbituric acid reactive substances (TBARS) marker of lipid peroxides levels, total thiol molecules, and total antioxidant capacity of plasma were all analyzed as biomarkers of oxidative stress. In addition, the acetylcholinesterase (AChE) activity was measured as a biomarker of toxicity. The results from this study well indicate diazinon-induced oxidative stress demonstrated by enhanced TBARS, decreased total thiol molecules, and total antioxidant capacity. In addition, AChE activity was inhibited as a marker of OP toxicity. Data show the protective roles of TPH and NAC in reducing the diazinon-induced oxidative stress. Interestingly, both TPH and NAC recovered diazinon-induced AChE inhibition. It is concluded that supplementation with TPH and NAC can reduce toxicity of OP in human exposure.


[Stage migration after biopsy of internal mammary sentinel lymph node in breast cancer patient].
The development of sentinel lymph nodes biopsy rouses a newer interest to internal mammary lymph nodes region. We report a case of internal mammary sentinel lymph nodes biopsy of a woman with breast cancer leaded to stage migration. A 71 years old woman with upper medial quadrant left breast cancer is reported. The tumor is 2.5 cm in size. Marking of SLN with radionuclide (Tc99m) and with 2 dyes (Patent blue V and Indocyanin green) are done. Only internal mammary lymph node is established with lymphoscintigrapgy. Intraopperative only an internal mammary sentinel lymph node is discovered with gamma probe and no sentinel lymph nodes neither in the axilla nor in parasternal chain. A mastectomy with dissection ofaxillary limph nodes and excision of radiopositive internal mammary lymph node are performed. Only the iternal mammary lymph node is metastatic from all nodes (13 axillar and 1 parasternal). This fact determines the N status as N3, which is different from the N status in case of no internal mammary lymph node biopsy was performed (N0). Further treatment is based on N3 status which is different from the treatment of patients with N0 axillary status. The case is interested with the rare clinical situation of lymph metastases presence only in internal mammary lymph nodes, detect with sentinel lymph nodes biopsy. This leads to optimization of treatment.


Nitrate translocation by detopped corn seedlings.
Five-day-old seedlings of corn (Zealpha mays L.) grown without nitrate were decapitated and exposed to 0.5 mm KNO(3) or 0.5 mm KCl in aerated solutions at 30 C. Uptake of nitrate, chloride, and potassium was determined by replacing solutions hourly and measuring their depletion. Translocation of these ions and of organic nitrogen was determined by hourly analysis of the vascular exudate. Nitrate reduction was estimated by the difference between nitrate uptake and nitrate recovered in the tissue and exudate. Nitrate uptake exhibited its usual pattern of apparent induction resulting in the development of an accelerated uptake phase. Chloride uptake remained fairly constant throughout the experimental period. Translocation of nitrate increased progressively for at least 7 hours whereas chloride translocation reached a maximum about the 3d hour and then declined to a lower rate than nitrate translocation. Nitrate uptake and translocation were restricted by anaerobiosis, by 20 and 40 C relative to 30 C, and by 0.05 mm 6-methylpurine, an RNA-synthesis inhibitor. Accumulation, reduction and translocation of nitrate had different sensitivities to all these factors. The effect of 0.05 mm 6-methylpurine was more detrimental to nitrate translocation and nitrate reduction than to nitrate uptake.Ambient nitrate, relative to chloride, enhanced the exudation volume and the translocation of organic nitrogen within 4 hours from initiation of the experiments. Translocation of nitrate and organic nitrogen decreased shortly after removal of external nitrate. The higher rates of organic nitrogen translocation which occurred during nitrate uptake indicates either (a) rapid translocation of amino acids synthesized from the entering nitrate, or (b) an accelerated rate of protein turnover and a resulting enhancement in translocation of endogenous amino acids.


Antigen-bearing immature dendritic cells induce peptide-specific CD8(+) regulatory T cells in vivo in humans.
Regulatory T cells (T(R)s) can suppress the function of other effector T cells in the setting of autoimmunity, transplantation, and resistance to tumors. The mechanism for the induction of T(R)s has not been defined. We previously reported that an injection of immature dendritic cells (DCs) pulsed with influenza matrix peptide (MP) led 7 days later to antigen-specific silencing of effector T-cell function in the blood of 2 healthy human subjects. Here, we found that interferon-gamma-producing effectors return by 6 months. Importantly, in mixing experiments, CD8(+) T cells from the sample obtained 7 days after injection could suppress MP-specific effectors obtained before injection and those in recovery samples. This suppression or regulation was specific for the immunizing peptide (MP) and cell-dose dependent, and it required contact between the 2 samples. These data show the capacity of immature DCs to induce antigen-specific regulatory CD8(+) T cells in humans.


Tako-tsubo cardiomyopathy.
A 48-year-old woman presented to her local hospital with chest pain. Her electrocardiogram showed incomplete right bundle branch block, diffuse ST segment elevation and QTc prolongation. Shortly after admission, she became hypotensive and was referred for a coronary angiogram. Her coronary arteries were normal, but left ventriculography showed morphological changes typical of apical ballooning, as found in tako-tsubo cardiomyopathy. An echocardiogram confirmed complete akinesis of the left ventricular apex, with hyperkinesis of basal segments and an ejection fraction of 35% to 40%. Dynamic left ventricular outflow tract obstruction was also noted. After temporary support with intra-aortic balloon counterpulsation, fluids and noradrenaline, she recovered promptly. The present paper reviews the characteristic features of tako-tsubo cardiomyopathy.


Long-term pulmonary complications of chemical weapons exposure in former poison gas factory workers.
Sulfur mustard (SM) and lewisite are vesicant chemical warfare agents that can cause skin blistering and chronic lung complications. During 1929-1945, a Japanese factory produced poisonous gases, which included SM, lewisite and other chemical weapons. The aim of this study was to investigate the chest computed tomography (CT) findings among long-term survivors who worked at this factory. During 2009-2012, we evaluated chest CT findings from 346 long-term survivors who worked at the poison gas factory. Skin lesions were used as an indicator of significant exposure to vesicant agents. Among the 346 individuals, 53 (15%) individuals experienced skin lesions while working at the factory, and chest CT revealed abnormal findings in 179 individuals (52%). Emphysema was the most common CT finding and was observed in 75 individuals (22%), while honeycombing was observed in 8 individuals (2%). Emphysema and honeycombing were more prevalent among individuals with skin lesions, compared to individuals without skin lesions. Multivariate analyses revealed significant associations between the presence of emphysema and skin lesions (p = 0.008). Among individuals who never smoked, individuals with skin lesions (n = 26) exhibited a significantly higher rate of emphysema, compared to individuals without skin lesions (n = 200) (35% versus 7%, respectively; p < 0.001). Among the long-term survivors who worked at the poison gas factory, a history of skin lesions was associated with the presence of emphysema, even among never smokers, which suggests that emphysema might be a long-term complication of exposure to chemical warfare agents.


Neural representations of absolute and relative magnitudes in symbolic and nonsymbolic formats.
Humans differ from other animal species in their unique ability to use symbols to represent numerical information. This ability is thought to emerge from the "neural recycling" of mechanisms supporting nonsymbolic magnitudes in the intraparietal sulcus (IPS), a hypothesis that has been applied to both absolute magnitudes (e.g., whole numbers) and relative magnitudes (e.g., fractions). Yet, evidence for the neuronal recycling hypothesis is inconsistent for absolute magnitudes and scarce for relative magnitudes. Here, we investigated to what extent the neural representations of absolute and relative magnitudes in symbolic and nonsymbolic formats overlap in the IPS. In a functional magnetic resonance imaging (fMRI) adaptation design, 48 adult participants were sequentially presented with lines, whole numbers, line ratios, and fractions that varied (vs. not varied) in magnitudes. Univariate analyses showed that the extent to which IPS mechanisms associated with whole numbers relied on mechanisms associated with lines depended upon participants' arithmetic fluency. Multivariate analyses revealed that the right IPS encoded differences in format (nonsymbolic vs. symbolic) across both absolute and relative magnitudes. Therefore, IPS activity associated with magnitude processing may depend on the presentation format (nonsymbolic vs. symbolic) more than it depends on the type of magnitude (absolute vs. relative), at least for most adult participants.


Novel demonstration of RNAi in citrus reveals importance of citrus callose synthase in defence against Xanthomonas citri subsp. citri.
Citrus is an economically important fruit crop that is severely afflicted by citrus canker, a disease caused by the bacterial phytopathogen, Xanthomonas citri subsp. citri (Xcc). GenBank houses a large collection of Expressed Sequence Tags (ESTs) enriched with transcripts generated during the defence response against this pathogen; however, there are currently no strategies in citrus to assess the function of candidate genes. This has greatly limited research as defence signalling genes are often involved in multiple pathways. In this study, we demonstrate the efficacy of RNA interference (RNAi) as a functional genomics tool to assess the function of candidate genes involved in the defence response of Citrus limon against the citrus canker pathogen. Double-stranded RNA expression vectors, encoding hairpin RNAs for citrus host genes, were delivered to lemon leaves by transient infiltration with transformed Agrobacterium. As proof of principle, we have established silencing of citrus phytoene desaturase (PDS) and callose synthase (CalS1) genes. Phenotypic and molecular analyses showed that silencing vectors were functional not only in lemon plants but also in other species of the Rutaceae family. Using silencing of CalS1, we have demonstrated that plant cell wall-associated defence is the principal initial barrier against Xanthomonas infection in citrus plants. Additionally, we present here results that suggest that H₂O₂ accumulation, which is suppressed by xanthan from Xcc during pathogenesis, contributes to inhibition of xanthan-deficient Xcc mutant growth either in wild-type or CalS1-silenced plants. With this work, we have demonstrated that high-throughput reverse genetic analysis is feasible in citrus.


Evaluation of attitudes and perceptions of key clinical stakeholders regarding out-of-hospital diagnosis and treatment of ST elevation myocardial infarction patients using a region-wide survey.
In ST elevation myocardial infarction (STEMI), prehospital management (PHM) may improve clinical outcomes through a reduction in reperfusion delay. The purpose of this study was to evaluate perceptions among healthcare stakeholder groups relating to the barriers and facilitators of implementing a PHM programme. A 25-question cross-sectional survey, using a four-point Likert scale assessing barriers and facilitators of PHM, was distributed to paramedics, cardiologists, emergency physicians and emergency nurses within the Edmonton region, where prehospital STEMI treatment is established. The proportion of responses on each question was compared and differences between groups were determined using chi(2) and Fisher's exact tests. 57% (355/619) of subjects responded: 69% paramedics, 50% cardiologists, 54% emergency physicians and 45% emergency nurses. A majority believed PHM reduced treatment delays in both rural (96-100%) and urban (86-96%) areas, while decreasing patient mortality (paramedics 97%, cardiologists 74%, emergency physicians 85%, emergency nurses 88%). Regarding the capability of paramedics to deliver PHM, paramedics 25%, cardiologists 33%, emergency physicians 67%, and emergency nurses 47% stated that urban paramedics are better equipped and trained than rural paramedics. Although 81% of paramedics supported the possibility of PHM delivery without physician overview, 0% of cardiologists, 98% of emergency physicians and 95% emergency nurses agreed. A majority (71-88%) favoured mandatory signed informed consent. While stakeholders agreed on the benefits of PHM, perceptual differences existed on paramedics' ability to deliver PHM without physician overview. Addressing real and perceived barriers through communication and educational programmes may enhance PHM within this healthcare region and facilitate the implementation of PHM programmes.


Quorum sensing-controlled biofilm development in Serratia liquefaciens MG1.
Serratia liquefaciens MG1 contains an N-acylhomoserine lactone-mediated quorum-sensing system that is known to regulate swarming motility colonization. In this study, we describe for S. liquefaciens MG1 the development of a novel biofilm consisting of cell aggregates and differentiated cell types, such as cell chains and long filamentous cells. Furthermore, quorum sensing is shown to be crucial for normal biofilm development and for elaborate differentiation. A mutant of S. liquefaciens MG1 that was incapable of synthesizing extracellular signal formed a thin and nonmature biofilm lacking cell aggregates and differentiated cell chains. Signal-based complementation of this mutant resulted in a biofilm with the wild-type architecture. Two quorum-sensing-regulated genes (bsmA and bsmB) involved in biofilm development were identified, and we propose that these genes are engaged in fine-tuning the formation of cell aggregates at a specific point in biofilm development.


Nanoholes as nanochannels: flow-through plasmonic sensing.
We combine nanofluidics and nanoplasmonics for surface-plasmon resonance (SPR) sensing using flow-through nanohole arrays. The role of surface plasmons on resonant transmission motivates the application of nanohole arrays as surface-based biosensors. Research to date, however, has focused on dead-ended holes, and therefore failed to harness the benefits of nanoconfined transport combined with SPR sensing. The flow-through format enables rapid transport of reactants to the active surface inside the nanoholes, with potential for significantly improved time of analysis and biomarker yield through nanohole sieving. We apply the flow-through method to monitor the formation of a monolayer and the immobilization of an ovarian cancer biomarker specific antibody on the sensing surface in real-time. The flow-through method resulted in a 6-fold improvement in response time as compared to the established flow-over method.


Influence of acetaldehyde on some serotonergic mechanisms in rat blood platelets.
Acetaldehyde (ACT), both, ex vivo and in vitro did not change the ADP-induced rat platelet aggregation and the potentiating action of serotonin. The whole blood serotonin content was decreased only when ACT was used in doses of 20 and 30 mg/kg, i.v. and the platelet serotonin content remained unchanged. Ex vivo, ACT had no influence on the labeled serotonin uptake, whereas in experiments in vitro it inhibited the amine uptake and augmented the serotonin release from blood platelets in a dose dependent manner. The results indicate that all the changes in the platelet serotonergic mechanisms appear only after high concentrations of ACT. They may be of significant importance in the circulatory system or hemostasis only during disulfiram or calcium carbamide therapy.


Extenuating circumstances. Student selection of case presentations for a required rural family medicine clerkship.
The Fourth Year Rural Family Medicine Clerkship has been a required four-week clinical rotation at the Sanford School of Medicine of the University of South Dakota (SSOM) for more than 30 years. Among the clerkship requirements has been a graded, formal case presentation. The purpose of this study was to examine the case presentations selected by the medical students for this required component of the clerkship and to determine if this correlated with their overall clinical experiences. Clinical diagnoses of patients selected by all students for their formal case presentations were recorded and compared with the overall clinical experiences as documented using the Student Patient Experience Log database. The frequency of multiple diagnosis cases was also determined. Although the large majority of clinical experiences occur in ambulatory settings during this clerkship, findings suggest students have a preference for presenting on patients who were hospitalized. This does not, however, indicate that students wish to necessarily present more complicated cases. In fact, the percentage of patients selected who had multiple diagnoses was much lower compared with their overall clinical experiences. The variety of clinical cases selected for presentation is different than the variety of overall clinical experiences. This suggests that some selection criteria are being used by students.


Role of microRNAs and DNA Methyltransferases in Transmitting Induced Genomic Instability between Cell Generations.
There is limited understanding of how radiation or chemicals induce genomic instability, and how the instability is epigenetically transmitted to the progeny of exposed cells or organisms. Here, we measured the expression of microRNAs (miRNAs) and DNA methyltransferases (DNMTs) in murine embryonal fibroblasts exposed to ionizing radiation or 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), which were previously shown to induce genomic instability in this cell line. Cadmium was used as a reference agent that does not induce genomic instability in our experimental model. Measurements at 8 and 15 days after exposure did not identify any such persistent changes that could be considered as signals transmitting genomic instability to the progeny of exposed cells. However, measurements at 2 days after exposure revealed findings that may reflect initial stages of genomic instability. Changes that were common to TCDD and two doses of radiation (but not to cadmium) included five candidate signature miRNAs and general up-regulation of miRNA expression. Expression of DNMT3a, DNMT3b, and DNMT2 was suppressed by cadmium but not by TCDD or radiation, consistently with the hypothesis that sufficient expression of DNMTs is necessary in the initial phase of induced genomic instability.


Long-Term Clinical Efficacy and Perioperative Safety of Endoscopic Submucosal Dissection versus Endoscopic Mucosal Resection for Early Gastric Cancer: An Updated Meta-Analysis.
To systematically evaluate the safety and efficacy of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) for early gastric cancer (EGC). We searched the databases of PubMed, Web of Science, EMBASE, and the Cochrane Library from January 2000 to April 2017 and included studies that compared the outcomes of ESD with EMR for EGC. These eligible studies that met the inclusion criteria were screened out and were assessed by two independent investigators. In total, 18 retrospective cohort studies were eligible for analysis. Our results indicated that ESD is more beneficial than EMR in increasing the complete resection rate and en bloc resection rate and decreasing the local recurrence rate. However, ESD prolonged operative time and increased incidence of gastric perforation than EMR. No differences were found in postoperative bleeding rate between the two approaches. Compared with EMR, ESD offers higher complete resection rate, higher en bloc resection rate, and lower local recurrence rate but has prolonged operative time and increased incidence of gastric perfusion. There is no statistical difference in the rate of postoperative bleeding between the two groups. However, the above conclusion needs further verification by well-designed, randomized trials with larger samples and long follow-up periods.


Enzyme-free method for cultured skin grafting.
Cultured skin autografting has promise to improve the prognosis of severe burn injury. Established methods for cultured epithelial cell autografting need enzymatic proteolytic reaction that have potential risks of losing cell surface structures and causing allergic reactions in the recipients. Therefore, we have developed an enzyme-free method of cultured skin autografting. Donor skin was obtained in 0.2-0.3 mm thickness during an operation of debriding burned eschar. The skin was cut into pieces and spread on removable soft culture surface membrane in culture plates. Modified MCDB 153 medium with 10 microg/L epidermal growth factor and 150 mg/L bovine pituitary extract was used. The tissues were incubated at 37 degrees C in a water-saturated atmosphere of 5% CO2 in air. After 3 weeks, the cultured tissue on the membrane was removed mechanically from the bottom of the plates and implanted on granulated recipient sites in upside down manner. The cultured auto-skin grafting was successfully performed in two patients with severe burn. The recipient sites were partially epithelized in 2 weeks and maintained thereafter. Our method is performed easily using partial thickness donor skin without enzymatic processes.


Chlamydial infection and sexual behavior in young pregnant teenagers.
Chlamydia trachomatis infection is one of the most common sexually transmitted diseases (STD) among adolescents and is one of the most common causes of perinatal infection. We have screened 267 young nulliparous adolescent girls (12-17 years old) for cervical C. trachomatis infection during their pregnancy using tissue culture methods. The population was a cohort of pregnant teenagers who had limited sexual exposure (mean duration of sexual activity, 14.3 months, mean number of lifetime partners, 2.0 +/- 1.5). The initial screening was done at enrollment to a prenatal care clinic, and the third trimester examination at 32 to 36 weeks of gestation. According to clinical indications, additional interim STD examinations were carried out. The cervical C. trachomatis infection rate was 18.7% (50/267) at intake and 7.9% (14/178) in the third trimester. Three of the 40 interim STD examinations also were positive for cervical C. trachomatis infection. Prenatally, 64 of 267 (24.0%) girls were positive for C. trachomatis at one or more times. The repeat culture positive rate for C. trachomatis was 7.8% (17/218), and 14 of those that were negative on the initial screening were positive on the subsequent screening. One or more types of treatable STDs (chlamydial, gonorrhea, syphilis, or trichomonal) were identified in 38.6% (103/267) of the study population during pregnancy. These findings suggest that high-risk sexual behavior may continue in teen pregnancy, and repeated prenatal chlamydial and other STD screening and counseling are indicated in this population.


Sonographic prenatal diagnosis of marginal placental cord insertion: clinical importance.
To assess the impact of a sonographic diagnosis of marginal placental cord insertion on birth weight and duration of pregnancy. A retrospective chart review was performed for 100 singleton pregnancies with prospectively identified marginal placental cord insertion. Birth weights below the 10th percentile occurred in 6.25% of pregnancies without preeclampsia. Spontaneous preterm delivery occurred in 7.3% of pregnancies without preeclampsia. Rates of birth weight below the 10th percentile and preterm delivery were not significantly different from those in the general population. Preeclampsia developed in 4 patients; all had elective preterm deliveries, and all gave birth to neonates with birth weights below the 10th percentile. A prenatal diagnosis of marginal placental cord insertion is not associated with increased risk of growth impairment or preterm delivery.


Periodic colonic motor activity identified by 24-h pancolonic ambulatory manometry in humans.
The pattern of colonic motor activity in healthy humans has not been fully elucidated to date. The aim of this study was to evaluate colorectal motor activity employing 24-h ambulant pancolonic manometry. Ten healthy volunteers (6F, 4M), aged 19-31 years were studied. Motor activity was measured using two custom-made silicone coated catheters, each with five solid-state pressure transducers. No bowel preparation or sedation was used. The study period was 24 h. A total of 232 h of recording was obtained. Sixty-three high amplitude propagated contractions were observed, median six per 24-h period. Low-amplitude colonic contractile activity showed regional and diurnal variations. Frequency of contraction was highest in the right colon [median 5.26 cpm (cycles per minute)], and transverse colon and splenic flexure (median 5.15 cpm). The interval between colonic motor complexes was shortest in the transverse colon and splenic flexure. This study introduces a new technique for the evaluation of colorectal motor activity. Subjects were studied in an ambulant setting in their own environment ensuring that this method of study is as physiological as possible. This study demonstrates that colonic motor activity has two main components: high amplitude propagated contractions and low amplitude colonic contractile activity.


Phytochrome-controlled Hydrogen Ion Excretion by Avena Coleoptiles.
A red light-induced, far red reversible stimulation of proton efflux from apical segments of etiolated Avena sativa L. cv. Victory coleoptiles was observed. The acidification responses to red light and also to auxin were not the consequence of respired CO(2). The response to red light was strongly inhibited by cycloheximide and carbonyl cyanide, m-chlorophenyl hydrazone, but mannitol had a stimulatory effect. Red light and auxin applied together yielded a greater than additive response, in comparison to the effects of the two stimuli applied separately.