Posttraumatic stress symptom severity and cognitive-based smoking processes among trauma-exposed treatment-seeking smokers: The role of perceived stress.
Trauma exposure and smoking co-occur at an alarmingly high rate. However, there is little understanding of the mechanisms underlying this clinically significant relation. The present study examined perceived stress as an explanatory mechanism linking posttraumatic stress symptom severity and smoking-specific avoidance/inflexibility, perceived barriers to smoking cessation, and negative affect reduction/negative reinforcement expectancies from smoking among trauma-exposed smokers. Participants were trauma-exposed, treatment-seeking daily cigarette smokers (n=179; 48.0% female; Mage=41.17; SD=12.55). Results indicated that posttraumatic stress symptom severity had an indirect significant effect on each of the dependent variables via perceived stress. The present results provide empirical support that perceived stress may be an underlying mechanism that indirectly explains posttraumatic symptoms relation to smoking-specific avoidance/inflexibility, perceived barriers to smoking cessation, and negative affect reduction/negative reinforcement expectancies among trauma-exposed smokers. These findings suggest that there may be clinical utility in targeting perceived stress among trauma-exposed smokers via stress management psychoeducation and skills training.


Structure-Activity Relationships of Novel Tau Ligands: Passive Fibril Binders and Active Aggregation Inhibitors.
Intrinsically disordered proteins (IDPs) are core components of many biological processes and are central players in several pathologies. Despite being important drug targets, attempts to design small-molecule ligands that would help understand and attenuate their behavior are frustrated by the structural diversity exhibited by these flexible proteins. To accommodate the dynamic nature of IDPs, we developed a procedure that efficiently identifies active small-molecule ligands for disordered proteins. By exploring the chemical space around these ligands, we refined their effect on aggregation and identified molecular features critical for activity and affinity. Notably, the discovery of this new family of disordered protein ligands was achieved more quickly and with less expense than conventional high-throughput screening (HTS) or docking alone would have allowed. The resulting ligands include tau aggregation inhibitors as well as at least one compound that binds fibrils potently but does not appear to perturb the extent of kinetics of aggregation.


Xanthones: A Class of Heterocyclic Compounds with Anticancer Potential.
Xanthones (9H xanthen-9-one) are an important class of heterocyclic compounds containing oxygen and a moiety of gamma-pirone, dense with a two-benzene ring structure, distributed widely in nature. Naturally occurring xanthones are found in micro-organisms and higher plants as secondary metabolites in fungi and lichens. Compounds of the family Caryophyllaceae, Guttiferae and Gentianaceae, are the most common natural source of xanthones. The structure of the xanthones nucleus, coupled with its biogenetic source, imposes that the carbons are numbered according to the biosynthetic pact. The characteristics oxygenation pattern of xanthones earlier is mixed shikimateacetate biogenesis. The major class of xanthones includes simple oxygenated, non-oxygenated, xanthonolignoids, bisxanthones, prenylated and related xanthones, miscellaneous xanthones. Their great pharmacological importance and interesting scaffolds were highly encouraged by scientists to investigate either the synthesis design or natural products for cancer treatment. Because currently used antitumor drugs possess high toxicity and low selectivity, efficacious treatment may be compromised. This review is limited to the antitumor activity of xanthones and the chemistry of xanthone core, which may help provide fundamental knowledge to the medicinal chemist for new and advanced research in drug development.


Revision of failed knee replacements using fixed-axis hinges.
Forty failed hinged arthroplasties of the knee were revised by the insertion of another hinged implant. In 14 cases the prosthesis used at the revision operation was similar to the primary implant; in 26, a hinge with an elongated femoral stem was used, usually replacing part of the femoral shaft. In seven of these knees an elongated tibial stem was also required, though the tibial shaft was replaced in only two of them. There were many complications. Fracture of the femur at the tip of the femoral stem was the most frequent. Sixteen first revisions failed and were revised a second time; 12 required replacement of the distal femoral shaft and three required replacement of the proximal tibia. The incidence of complications in knees requiring a second revision was even higher. Four required a third revision after an average interval of three years. Failure of a hinged prosthesis results in bone loss mainly in the femur. Revision of a failed hinged prosthesis with another of the same design is unlikely to be successful and may cause fracture of the femur.


The Reelin (RELN) gene is associated with executive function in healthy individuals.
Executive functions such as set-shifting and maintenance are cognitive processes that rely on complex neurodevelopmental processes. Although neurodevelopmental processes are mainly studied in animal models and in neuropsychiatric disorders, the underlying genetic basis for these processes under physiological conditions is poorly understood. We aimed to investigate the association between genetic variants of the Reelin (RELN) gene and cognitive set-shifting in healthy young individuals. The relationship between 12 selected single nucleotide polymorphisms (SNPs) of the RELN gene and cognitive set-shifting as measured by perseverative errors using the modified card sorting test (MCST) was analysed in a sample of N=98 young healthy individuals (mean age in years: 22.7 ± 0.19). Results show that in individual MANCOVA analyses two of five significant SNPs (rs2711870: F(2,39)=7.14; p=0.0019; rs2249372: F(2,39)=6.97; p=0.002) withstood Bonferroni correction for multiple testing (corrected p-value: p=0.004). While haplotype analyses of the RELN gene showed significant associations between three haplotypes and perseverative error processing in various models of inheritance (adjusted for age, gender, BDI, MWTB IQ), the GCT haplotype showed the most robust finding with a recessive model of inheritance (p=2.32 × 10(-5)) involving the functional SNP rs362691 (Leu-Val amino acid change). Although our study strongly suggests the involvement of the RELN gene in cognitive set-shifting and maintenance, our study requires further exploration as well as replication of the findings in larger samples of healthy individuals and in clinical samples with neuropsychiatric disorders.


Measuring risk perception among low-income minority primary care patients.
Studying patients' risk perceptions by ascertaining the probabilities of developing a disease is suboptimal, as patients might have difficulty using numerical expressions to depict the probabilities/chances of developing a disease. We surveyed patients at 2 community health centers and assessed risk perception by patients' self-reported chance of developing a disease (expressed in percentages), patients' relative chance of developing a disease compared to others' chance of developing a disease, and patients' ranked chances of developing different diseases. Many patients had difficulties understanding percentages and most patients overestimated their absolute risk. However, most patients indicated that they had a lower chance of developing diseases when compared to others. Patients with known risk factors (smoking) indicated a higher relative risk of developing an associated disease (lung cancer). Patients' ranked chances of developing different diseases were consistent with the actual frequency of developing a disease. Although patients had difficulty expressing risk in percentages, they estimated their risks well through comparisons with others and by ranking of disease frequencies.


[Ethnonursing, combining culture, health and care].
The life history of the patient, his or her intentions and normative system must be taken into account before any decisions are made with regard to health care. Ethnonursing thereby constitutes a qualitative research methodology exploring, from both an ethnographic and nursing perspective, the meaning, expression, regularities, function and structuring of health and care notions within a cultural group.


Cardiorespiratory adjustments during hypercarbia in rainbow trout Oncorhynchus mykiss are initiated by external CO(2) receptors on the first gill arch.
Experiments were performed to test the hypothesis that the marked ventilatory and cardiovascular responses to hypercarbia in rainbow trout Oncorhynchus mykiss arise from specific stimulation of chemoreceptors localised to the first gill arch. This was accomplished by measuring cardiorespiratory variables during acute hypercarbia (20 min at P(CO(2))=8 mmHg; 1 mmHg=0.133 kPa) in fish subjected to selective bilateral extirpation of the first gill arch. The cardiovascular responses to hypercarbia in the intact fish included a significant bradycardia (from 75.0+/-1.6 to 69.0+/-2.0 beats min(-1); means +/- S.E.M.; N=16), an increase in dorsal aortic blood pressure (from 30.8+/-1.5 to 41.9+/-2.5 mmHg; N=16) and a rise in systemic vascular resistance (from 1.1+/-0.1 to 1.4+/-0.1 mmHg ml(-1) kg(-1) min(-1); N=16). Removal of the first gill arch or pre-treatment with the muscarinic receptor antagonist atropine prevented the hypercarbic bradycardia without affecting the pressure or resistance responses. Correlation analysis, however, revealed shallow but significant inverse relationships between water P(CO(2)) and cardiac frequency in both atropinised (r(2)=0.75) and gill-extirpated (r(2)=0.90) fish, suggesting a direct mild effect of CO(2) on cardiac function. The ventilatory response to hypercarbia in the intact fish consisted of an increase in ventilation amplitude (from 0.62+/-0.06 to 1.0+/-0.13 cm; N=16) with no change in breathing frequency. Removal of the first gill arch lowered resting breathing frequency and prevented the statistically significant elevation of breathing amplitude. Gill extirpation, however, did not totally abolish the positive correlation between water P(CO(2)) and ventilation amplitude (r(2)=0.84), suggesting the presence of additional (although less important) chemoreceptive sites that are not confined to the first gill arch. Plasma catecholamine levels were elevated during hypercarbia, and this response was unaffected by prior gill extirpation. To assess whether the CO(2) chemoreceptors of the first gill arch were sensing water and/or blood P(CO(2)), bolus injections of CO(2)-enriched water or saline were made into the buccal cavity or caudal vein, respectively. Injections of CO(2)-enriched water to preferentially stimulate external receptors evoked catecholamine release and cardiorespiratory responses that closely resembled the responses to hypercarbia. As in hypercarbia, extirpation of the first gill arch prevented the bradycardia and the increase in ventilation amplitude associated with externally injected CO(2)-enriched water. Except for a slight decrease in cardiac frequency (from 73.0+/-2.8 to 70.3+/-3.5 beats min(-1); N=11), injection of CO(2)-enriched saline to preferentially stimulate internal chemoreceptors did not affect any measured variable. Taken together, these data indicate that, in rainbow trout, the bradycardia and hyperventilation associated with hypercarbia are triggered largely by external CO(2) chemoreceptors confined to the first gill arch.


Therapy of type 2 diabetes mellitus based on the actions of glucagon-like peptide-1.
GLP-1 is a peptide hormone from the intestinal mucosa. It is secreted in response to meal ingestion and normally functions in the so-called ileal brake, that is, inhibition of upper gastrointestinal motility and secretion when nutrients are present in the distal small intestine. It also induces satiety and promotes tissue deposition of ingested glucose by stimulating insulin secretion. Thus, it is an essential incretin hormone. In addition, the hormone has been demonstrated to promote insulin biosynthesis and insulin gene expression and to have trophic effects on the beta cells. The trophic effects include proliferation of existing beta cells, maturation of new cells from duct progenitor cells and inhibition of apoptosis. Furthermore, glucagon secretion is inhibited. Because of these effects, the hormone effectively improves metabolism in patients with type 2 diabetes mellitus. Thus, continuous subcutaneous administration of the peptide for six weeks in patients with rather advanced disease greatly improved glucose profiles and lowered body weight, haemoglobin A(1C), and free fatty acids (FFA). In addition, insulin sensitivity doubled and insulin responses to glucose were greatly improved. There were no side effects. Continuous administration is necessary because of rapid degradation by the enzyme dipeptidyl peptidase-IV. Alternative approaches include the use of analogues that are resistant to the actions of the enzyme, as well as inhibitors of the enzyme. Both approaches have shown remarkable efficacy in both experimental and clinical studies. The GLP-1-based therapy of type 2 diabetes, therefore, represents a new and attractive alternative.


Cloning of genes encoding extracellular metalloproteases from Erwinia chrysanthemi EC16.
A 14-kilobase BamHI-EcoRI DNA fragment cloned from Erwinia chrysanthemi EC16 contained a gene encoding a metalloprotease inhibitor as well as three tandem prt genes encoding metalloproteases. The prt genes were separated from the inhibitor gene by a ca. 4-kilobase region that was necessary for extracellular secretion of the proteases. When individually subcloned downstream from vector promoters, the three prt genes each led to substantial extracellular secretion of the proteases by Escherichia coli cells, provided that the 4-kilobase required region was supplied in cis or trans. One of the protease structural genes, prtC, was sequenced and had high homology to a metalloprotease gene previously described from Serratia species as well as to the prtB gene of E. chrysanthemi B374. Marker exchange mutants of E. chrysanthemi EC16 defective in production of one or all of the extracellular proteases were not impaired in virulence on plant tissue.


Scattering functions near the Sun by large aerosols.
In the course of a lengthy series of observations since 1975, a large, continuous decrease of the brightness of the solar aureole has been found west of Boston, at Hanscom Air Force Base and at Lexington, Mass. This points to the virtual disappearance from the lower atmosphere of giant particles larger than ~ 10 microm. in size while total suspended particulates in Boston and other U.S. cities have barely decreased. Results of calculations to better understand the relation between forward scattering and aerosol mass distribution [coarse fraction (CF)] are presented. In addition, a method to modify steep scattering functions calculated for a plane-wave source (Sun treated as a star) to those of the actual (and limb-darkened) Sun is presented. The calculated wavelength dependence of extinction, which is lower than that observed, is found to be little affected by the CF, but seems, like forward scattering, to be sensitive to mass distribution of sizes of < 0.4 and ~ 0.6 microm because of the anomal scattering behavior of spheres.


Vascular growth and remodeling in compensatory lung growth following right lobectomy.
Studies in animal models have shown that, following lobectomy (LBX), there is compensatory growth in the remaining lung. The vascular growth response following right LBX (R-LBX) is poorly understood. To test the hypothesis that arterial growth and remodeling occur in response to LBX, in proportion to the amount of right lung tissue removed, two (24% of lung mass; R-LBX2 group) or three right lobes (52% of lung mass; R-LBX3 group) were removed via thoracotomy from adult rats. Sham control animals underwent thoracotomy only. Arteriograms were generated 3 wk after surgery. The areas of the left lung arteriogram, arterial branching, length of arterial branches, arterial density, and arterial-to-alveolar ratios were measured. To determine whether R-LBX causes vascular remodeling and pulmonary hypertension, muscularization of arterioles and right ventricular hypertrophy were assessed. Lung weight and volume indexes were greater in R-LBX3. Arterial area of the left lung increased 26% in R-LBX2 and 47% in R-LBX3. The length of large arteries increased in R-LBX3 and to a lesser extent in R-LBX2. The ratio of distal pulmonary arteries to alveoli was similar after R-LBX2 compared with sham but was 30% lower in R-LBX3. Muscularization of arterioles increased after R-LBX3, but not in R-LBX2. Right ventricular hypertrophy increased 50-70% in R-LBX3, but not in R-LBX2. Whereas removal of three right lung lobes induced arterial growth in the left lungs of adult rats, which was proportionate to the number of lobes removed, the ratio of distal pulmonary arteries to alveoli was not normal, and vascular remodeling and pulmonary hypertension developed.


Significant and meaningful effects in sports biomechanics research.
Errors in statistical analysis of multiple dependent variables and in documenting the size of effects are common in the scientific and biomechanical literature. In this paper, I review these errors and several solutions that can improve the validity of sports biomechanics research reports. Studies examining multiple dependent variables should either control for the inflation of Type I errors (e.g. Holm's procedure) during multiple comparisons or use multivariate analysis of variance to focus on the structure and interaction of the dependent variables. When statistically significant differences are observed, research reports should provide confidence limits or effect sizes to document the size of the effects. Authors of sports biomechanics research reports are encouraged to analyse and present their data accounting for the experiment-wise Type I error rate, as well as reporting data documenting the size or practical significance of effects reaching their standard of statistical significance.


[Strategies used by mothers to feed preschool-aged children in a marginal urban area of Lima, Peru].
This study explored the strategies for feeding preschool-aged children used by mothers in a marginal urban area of Lima. This qualitative, grounded theory method-based study included 30 mothers who participated in 1 of 4 focus group sessions and/or 1 of 11 in-depth interviews. Previously recorded in-depth interviews and focus groups were transcribed to identify the final issues. The mothers' ages ranged from 22 to 42 years, and 60% had not completed a basic education. The children's ages ranged from 36 to 66 months. The following positive strategies were identified: a) feeding when hungry and b) management of feeding opportunities. The following negative strategies were also identified: a) forcing a child to eat and b) use of punishment or reward to encourage complete food consumption. In conclusion, the mothers in our study cohort employed both positive and negative strategies to encourage food consumption in their children.


Laminin alpha 5 is required for lobar septation and visceral pleural basement membrane formation in the developing mouse lung.
Laminin alpha/beta/gamma heterotrimers are the major noncollagenous components of all basement membranes. To date, five alpha, three beta, and three gamma chains have been identified. Laminin alpha 5 is expressed early in lung development and colocalizes with laminin alpha1. While laminin alpha1 expression in the lung is restricted to the embryonic period, laminin alpha 5 expression persists throughout embryogenesis and adulthood. Targeted mutation of the mouse laminin alpha 5 gene Lama5 causes embryonic lethality at E14-E17 associated with exencephaly, syndactyly, placentopathy, and kidney defects, all attributable to abnormal basement membranes. In this investigation, lung development in Lama5(-/-) mice up to E16.5 was examined. We observed normal lung branching morphogenesis and vasculogenesis, but incomplete lobar septation and absence of the visceral pleura basement membrane. Preservation of branching morphogenesis was associated with ectopic deposition of laminin alpha 4 in the airway basement membrane. Perturbation of pleural basement membrane formation and right lung septation correlated with absence of laminin alpha 5, which was found to be the only laminin alpha chain present in the normal visceral pleura basement membrane. Our finding of normal lung branching morphogenesis with abnormal lobar septation demonstrates that these processes are not obligatorily linked.


Robust, but transient expression of adeno-associated virus-transduced genes during human T lymphopoiesis.
Recombinant adeno-associated viruses (rAAV) have been proposed to be gene transfer vehicles for hematopoietic stem cells with advantages over other virus-based systems due to their high titers and relative lack of dependence on cell cycle for target cell integration. We evaluated rAAV vector containing a LacZ reporter gene under the control of a cytomegalovirus (CMV) promoter in the context of primary human CD34+CD2- progenitor cells induced to undergo T-cell differentiation using an in vitro T-lymphopoiesis system. Target cells from either adult bone marrow or umbilical cord blood were efficiently transduced, and 71% to 79% CD2+ cells expressed a LacZ marker gene mRNA and produced LacZ-encoded protein after exposure to rAAV-CMV-LacZ. The impact of transgene expression on the differentiation of T cells was assessed by sequential quantitation of immunophenotypic subsets of virus-exposed cells and no alteration was noted compared with control. The durability of transgene expression was assessed and found to decay by day 35 with kinetics dependent on the multiplicity of infection. In addition, vector DNA was absent from CD4 or CD8 subselected CD3+ cells by DNA-polymerase chain reaction. These data suggest that rAAV vectors may result in robust transgene expression in primitive cells undergoing T-cell lineage commitment without toxicity or alteration in the pattern of T-cell differentiation. However, expression is transient and integration of the transgene unlikely. Recombinant AAV vectors are potentially valuable gene transfer tools for the genetic manipulation of events during T-cell ontogony but their potential in gene therapy strategies for diseases such as acquired immunodeficiency syndrome is limited.


Quantitative determination of cis-3,4-dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cyclohexyl)-benzamide and three of its metabolites in plasma by high-performance liquid chromatography.
A sensitive HPLC method was developed for simultaneous quantitation of cis-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)-cyclohexyl]-benzamide and three of its metabolites in dog plasma. The method involved selective solid-phase extraction of the compounds of interest from dog plasma and HPLC separation of the analytes on a cyano column. Absorbance of the column effluent was monitored at 230 nm by a UV detector. The analytical procedure has a linear range of 10 ng/mL to 20 micrograms/mL, with a low limit of quantitation of 10 ng/mL for each analyte. The accuracy and intra- and interassay precision for each compound were < or = 11% in the concentration range evaluated. Applicability of this method to the quantitation of 1 and its metabolites was assessed in a preclinical pharmacokinetic study.


Effectiveness of Cinacalcet in Patients with Chronic Kidney Disease and Secondary Hyperparathyroidism Not Receiving Dialysis.
Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) patients. Cinacalcet could be a therapeutic option although its use is controversial in patients not receiving dialysis. Thus, the aim of this study is to assess the effectiveness and safety of cinacalcet in patients with CKD and SHPT without renal replacement treatment (RRT) and without renal transplantation (RT). A retrospective observational study was conducted. Patients were included if they had collected cinacalcet, under off-label use, during 2010 and 2011. Patients selected were followed from the beginning of cinacalcet therapy for one year of treatment. A total of 37 patients were included with CKD stage 3 (38%), 4 (51%) and 5 (11%). Baseline mean PTH value was 400.86 ± 168.60 mg/dl. At 12 months, a 67% of patients achieved at least a 30% reduction in their PTH value (p<0.001; CI 49.7-83.6), and the overall mean reduction of PTH values was 38% (p< 0.001; IC -49.1, -27.5). A 28% of the patients achieved KDOQI PTH goals (p = 0.003, CI 12%-50%). At 12 months, mean serum calcium values decreased by 6% and mean serum phosphorus values increased by 13%. A 19% of patients experienced hypocalcemia episodes while an increase of 24% in hyperphosphatemia episodes was observed. A 25% of patients finished cinacalcet before a year of treatment. Main withdrawal reasons were: gastrointestinal and other discomfort (8%), hypocalcaemia (8%), non-compliance (3%), interactions (3%) and excess of efficacy (3%). Cinacalcet was effective in patients with CKD and SHPT not receiving dialysis. Electrolytic imbalances could be managed with administration of vitamin D and analogues or phosphate binders.


Immune Checkpoint Inhibitors for Unresectable Hepatocellular Carcinoma.
Despite the advances in screening protocols and treatment options, hepatocellular carcinoma (HCC) is still considered to be the most lethal malignancy in patients with liver cirrhosis. Moreover, the survival outcomes after failure of first-line therapy for unresectable HCC is still poor with limited therapeutic options. One of these options is immune checkpoint inhibitors. The aim of this study is to comprehensively review the efficacy and safety of immune checkpoint inhibitors for patients with HCC.


Mechanochemical Immobilisation of Metathesis Catalysts in a Metal-Organic Framework.
A simple, one-step mechanochemical procedure for immobilisation of homogeneous metathesis catalysts in metal-organic frameworks was developed. Grinding MIL-101-NH2 (Al) with a Hoveyda-Grubbs second-generation catalyst resulted in a heterogeneous catalyst that is active for metathesis and one of the most stable immobilised metathesis catalysts. During the mechanochemical immobilisation the MIL-101-NH2 (Al) structure was partially converted to MIL-53-NH2 (Al). The Hoveyda-Grubbs catalyst entrapped in MIL-101-NH2 (Al) is responsible for the observed catalytic activity. The developed synthetic procedure was also successful for the immobilisation of a Zhan catalyst.


Targeting pericytes diminishes neovascularization in orthotopic uveal melanoma in nerve/glial antigen 2 proteoglycan knockout mouse.
In this investigation, we explored whether knockout of nerve/glial antigen 2 (NG2), a pericyte component, inhibited neovascularization and growth of uveal melanoma xenografts. For this, we used multichannel laser scanning confocal microscopy and quantitative image analysis. Orthotopic human uveal melanoma (OCM-1A) xenografts were induced in NG2 knockout and wild-type mice, which were immunosuppressed with cyclosporin A. Inhibition of pericytes through NG2 proteoglycan decreased neovascularization and tumor end volume, rendering pericytes and NG2 proteoglycan potential cellular and molecular therapeutic targets in uveal melanoma.


Micro-CT in ophthalmology: ex vivo preparation and contrasting methods for detailed 3D-visualization of eye anatomy with special emphasis on critical point drying.
Micro-computed tomography (micro-CT) provides detailed 3-dimensional (3D) visualization of anatomical structures and encourages morphological reinvestigation of organs with delicate features. The low radiodensity of soft tissues necessitates preceding sample preparation to conduct X-ray imaging with decent contrast between different tissues. In this study, we demonstrate the preparation with three radiopaque agents in combination with elimination of liquids by critical point drying (CPD) introduced for ocular samples. Enucleated porcine eyes were prepared with ethanolic iodine (EI), aqueous iodine-potassium iodide, or ethanolic phosphotungstic acid (EPTA). Micro-CT scans of the samples were conducted in a moist environment with an isotropic resolution of 9.2-12.5 µm voxel size. Subsequently, samples were chemically dehydrated and critical point (CP) dried to conduct a second scan in a dry environment with a resolution up to 4.7-5.4 µm in voxel size. The visualization effects were qualitatively and semi-quantitatively evaluated with regard to the generated contrast between different ocular tissues. All three contrast agents accumulated well in most of the investigated ocular tissues and lead to an increased X-ray attenuation which allowed for differentiated visualization of ocular structures. Problematic agent penetration into the lens was obvious for iodine-potassium iodide and EPTA. Artificial damages of the lens and thickness reduction for the cornea and sclera due to CPD were noticed. The effects of the different contrasting treatments are described and compared with regard to the effects of CPD. Exclusively CP dried samples that were not treated with contrast agents could also be visualized excellently with a good distinction of different ocular structures from each other. All ocular structures can be visualized by micro-CT. To contrast moist samples, the best results were achieved with iodine potassium iodide (IPI). CPD improved the scan quality in all cases. Even without pretreatment with contrasting agents, the CP dried samples showed a contrast similar to the IPI treated samples.


Mechanisms of supported bilayer detection using field-effect devices.
The adsorption of positively charged supported lipid bilayers (SLBs) on field-effect devices was studied using various salt solutions to make it possible to understand the signal generation mechanisms of the devices. The flat-band voltage change that occurred with SLB formation was dependent on the type of monovalent cations contained in the solution. Zeta potential data showed that the intrinsic charge of the bilayers was almost constant in the presence of any of the examined alkali ions. The results suggest that the lipid charge does not solely determine the flat-band voltage. The binding affinity of alkali ions to silicon nitride showed a similar trend to the dependence of the flat-band voltage change on alkali ions. The results indicate that the specific interaction of small inorganic ions with the device surface has a significant influence on the magnitude of the signal response that occurs with SLB formation. It appears that salt ions specifically bound to the device surface and the charge of the bilayers both contribute to the signal generation mechanisms.


Physical fitness factors to predict female Olympic wrestling performance and sex differences.
To determine differences in anthropometric, body composition, physiological and neuromuscular markers between elite and amateur female wrestlers, 35 female wrestlers were assigned into 4 groups according to their body mass (light and middle weight) and their competitive level (elite and amateur): light weight (between 49 and 58 kg) in elite (n = 6) and amateur (n = 12) levels, and middle weight (between 58 and 67 kg) in elite (n = 7) and amateur (n = 10) levels. A binary logistic regression analysis was performed to identify which variables better predict female wrestling success. Elite female wrestlers were older (8-10%), had more training experience (27-29%), fat-free mass (3%), maximum strength in absolute and allometrically scaled values (13-33%), maximal muscle power (16-34%), mean and peak power during an arm crank Wingate testing in absolute and allometrically scaled values (17-23%), jumping height (2-9%) and grip (5-13%), and back isometric strength (10-13%) compared with amateur wrestlers (p < 0.05). When the results of the present research and those of a recent study performed in our laboratory with elite male wrestlers were compared, elite women presented lower (p < 0.05) maximum isometric and dynamic strength, muscle power output, and anaerobic metabolism values even when these data were normalized using allometric methods.


Unusual coexistence of first and second branchial fistulas: clinical case and review of the literature.
Branchial fistulas are uncommon in the clinical setting. The coexistence of first and second branchial fistulas has not been previously reported. We herein describe a 12-year-old girl who presented with a 2-year history of repeated swelling and purulence behind the right earlobe and neck. According to the patient's physical and auxiliary examination findings, she was diagnosed with coexisting first and second branchial fistulas, both of which were completely removed by surgery. No clinical signs of fistula recurrence were present at the patient's 20-month postoperative follow-up. Ipsilateral coexisting first and second branchial fistulas are very rare; thus, a false-positive diagnosis can easily occur if the doctor does not carefully perform specialized physical examinations. Surgery is an effective method for treating this condition. Adequate preoperative imaging preparation is imperative to ensure the most effective course of treatment. The purpose of this article is to improve clinicians' awareness of this disease, thereby effectively reducing the rates of missed diagnosis and recurrence.


Peptide-Controlled Assembly of Macroscopic Calcium Oxalate Nanosheets.
The fabrication of two-dimensional (2D) biomineral nanosheets is of high interest owing to their promise for applications in electronics, filtration, catalysis, and chemical sensing. Using a facile approach inspired by biomineralization in nature, we fabricate laterally macroscopic calcium oxalate nanosheets using β-folded peptides. The template peptides are composed of repetitive glutamic acid and leucine amino acids, self-organized at the air-water interface. Surface-specific sum frequency generation spectroscopy and molecular dynamics simulations reveal that the formation of oxalate nanosheets relies on the peptide-Ca2+ ion interaction at the interface, which not only restructures the peptides but also templates Ca2+ ions into a calcium oxalate dihydrate lattice. Combined, this enables the formation of a critical structural intermediate in the assembly pathway toward the oxalate sheet formation. These insights into peptide-ion interfacial interaction are important for designing novel inorganic 2D materials.


Genetic relatedness of antibiotic-resistant pneumococci isolated during case clusters.
Multilocus sequence typing of Streptococcus pneumoniae associated with two case clusters of disease is reported here for the first time. Isolates from the first cluster were serotype 19F, resistant to penicillin and erythromycin, and were characterized as ST 320. Isolates from the second cluster were serogroup 4, resistant to ciprofloxacin, and were characterized as ST 206. Therefore, the isolates from these clusters were antibiotic-resistant, of serotypes infrequently isolated, and of uncommon sequence types.


Outcomes of recalcitrant idiopathic epistaxis in children: Septoplasty as a surgical treatment.
Our objective was to measure short- and long-term outcomes of children presenting with recalcitrant idiopathic epistaxis. The study was an 11-year (2000-2011) retrospective chart review of children evaluated and treated for epistaxis. A retrospective review of patients with diagnostic International Classification of Diseases, Ninth Revision code 784.7 (epistaxis) and 21.5/21.88 (septoplasty) was completed reviewing age at presentation, type of surgery, and number of bleeding events prior to and after surgery. In our cohort, almost 100% of children with idiopathic recurrent epistaxis responded to topical treatments. About 0.2% were refractory (20/9239), and 90% of those (18/20) resolved with either a traditional septoplasty (14/20) or modified septoplasty (6/20) without cartilage excision, with a mean follow-up of 35 months. One of the patients who did not show resolution was found to have Von Willebrand disease, which likely contributed to this outcome. Septoplasty surgery, with or without cartilage removal, appears beneficial for refractory idiopathic epistaxis in children. 4 Laryngoscope, 126:2833-2837, 2016.


Standardized reporting of co-morbidity outcome after bariatric surgery: low compliance with the ASMBS outcome reporting standards despite ease of use.
Despite the publication of the American Society for Metabolic and Bariatric Surgery (ASMBS) Outcome Reporting Standards in 2015, there is still a great variety in definitions used for reporting remission of co-morbidities after bariatric surgery. This hampers meaningful comparison of results. To assess compliance with the ASMBS standards in current literature, and to evaluate use of the standards by applying them in a report on the outcomes of 5 co-morbidities after bariatric surgery. Two clinics of the Dutch Obesity Clinic, location Den Haag and Velp, and three affiliated hospitals: Haaglanden Medical Center in Den Haag, Groene Hart Hospital in Gouda, and Vitalys Clinic in Velp. A systematic search in PubMed was conducted to identify studies using the ASMBS standards. Besides, the standards were applied to a cohort of patients who underwent a primary bariatric procedure between November 2016 and June 2017. Outcomes of co-morbidities were determined at 6 and 12 months after surgery. Ten previous studies applying ASMBS definitions were identified by the search, including 6 studies using portions of the definitions, and 4 using complete definitions for 3 co-morbidities or in a small population. In this study, the standards were applied to 1064 patients, of whom 796 patients (75%) underwent Roux-en-Y gastric bypass and 268 patients (25%) underwent sleeve gastrectomy. At 12 months, complete remission of diabetes (glycosylated hemoglobin <6%, off medication) was reached in 63%, partial remission (glycosylated hemoglobin 6%-6.4%, off medication) in 7%, and improvement in 28% of patients (n = 232/248, 94%). Complete remission of hypertension (normotensive, off medication) was noted in 8%, partial remission (prehypertensive, off medication) in 23% and improvement in 63% (n = 397/412, 96%). Remission rate for dyslipidemia (normal nonhigh-density lipoprotein, off medication) was 57% and improvement rate was 19% (n = 129/133, 97%). Resolution of gastroesophageal reflux disease (no symptoms, off medication) was observed in 54% (n = 265/265). Obstructive sleep apnea syndrome improved in 90% (n = 157/169, 93%). Compliance with the ASMBS standards is low, despite ease of use. Standardized definitions provided by the ASMBS guideline could be used in future research to enable comparison of outcomes of different studies and surgical procedures.


Integration of faces and voices, but not faces and names, in person recognition.
Recent studies on cross-modal recognition suggest that face and voice information are linked for the purpose of person identification. We tested whether congruent associations between familiarized faces and voices facilitated subsequent person recognition relative to incongruent associations. Furthermore, we investigated whether congruent face and name associations would similarly benefit person identification relative to incongruent face and name associations. Participants were familiarized with a set of talking video-images of actors, their names, and their voices. They were then tested on their recognition of either the face, voice, or name of each actor from bimodal stimuli which were either congruent or novel (incongruent) associations between the familiarized face and voice or face and name. We found that response times to familiarity decisions based on congruent face and voice stimuli were facilitated relative to incongruent associations. In contrast, we failed to find a benefit for congruent face and name pairs. Our findings suggest that faces and voices, but not faces and names, are integrated in memory for the purpose of person recognition. These findings have important implications for current models of face perception and support growing evidence for multisensory effects in face perception areas of the brain for the purpose of person recognition.


A complex pattern of recurrent chromosomal losses and gains in T-cell prolymphocytic leukemia.
T-cell prolymphocytic leukemia (T-PLL) is a rare malignant proliferation of lymphoid cells with a postthymic phenotype. Previous cytogenetic and molecular studies reported complex karyotypes with recurrent chromosomal abnormalities, including translocations involving either TCL1 at 14q32.1 or MTCP1 at Xq28, inactivation of the ATM gene by deletion and/or mutation, and isochromosomes 8. For extensive study of chromosomal imbalances in T-PLL, we analyzed 22 tumoral DNAs using comparative genomic hybridization (CGH). Abnormal CGH profiles were detected in all cases, demonstrating highly recurrent gains and losses and largely extending the abnormalities previously established. Only a few nonrecurrent abnormalities were observed, in contrast to the genetic instability anticipated from ATM inactivation. Nine recurrent regions of loss were identified at 8p (frequency 86%), 11q (68%), 22q11 (45%), 13q (41%), 6q (36%), 9p (27%), 12p (23%), 11p11-p14 (23%), and 17p (23%), as well as four regions of gain at 8q (82%), 14q32 (50%), 22q21-qter (41%), and 6p (23%). Several recurrent chromosomal abnormalities were simultaneously present in each case (mean, 5.7; up to 10), none being mutually exclusive of another. Fluorescence in situ hybridization analysis confirmed and extended 22q11 and 13q losses, giving final frequencies of 55% and 45%, respectively. Analysis of one case over a 7-year period confirmed the overall genetic stability of T-PLL and showed that tumor progression was associated with the onset of a few chromosomal abnormalities. This study establishes a complex pattern of highly recurrent chromosomal abnormalities in T-PLL, including some, such as chromosome 13 deletion, commonly found in other lymphoid malignancies.


Loss of heterozygosity at 1p, 7q, 17p, and 22q in meningiomas.
Allelic losses or loss of heterozygosity (LOH) at many chromosomal loci have been found in the cells of meningiomas. The objective of this study was to evaluate LOH at several loci of different chromosomes (1p32, 17p13, 7q21, 7q31, and 22q13) in different grades of meningiomas. Forty surgical specimens were obtained and classified as benign, atypical, and anaplastic meningiomas. After DNA extraction, ten polymorphic microsatellite markers were used to detect LOH. Medical and surgical records, as well as pathologic findings, were reviewed retrospectively. LOH at 1p32 was detected in 24%, 60%, and 60% in benign, atypical, and anaplastic meningiomas, respectively. Whereas LOH at 7q21 was found in only one atypical meningioma. LOH at 7q31 was found in one benign meningioma and one atypical meningioma. LOH at 17p13 was detected in 4%, 40%, and 80% in benign, atypical, and anaplastic meningiomas, respectively. LOH at 22q13 was seen in 48%, 60%, and 60% in benign, atypical, and anaplastic meningiomas, respectively. LOH results at 1p32 and 17p13 showed statistically significant differences between benign and non-benign meningiomas. LOH at 1p32 and 17p13 showed a strong correlation with tumor progression. On the other hand, LOH at 7q21 and 7q31 may not contribute to the development of the meningiomas.


Virtual interferogram-generation algorithm for robust complex amplitude measurement using two interferograms.
We propose a virtual interferogram-generation algorithm using two interferograms. This algorithm can measure a complex amplitude of a signal beam with high accuracy even when its intensity is greater than the intensity of a reference beam. Unlike the conventional algorithm that uses two interferograms, our algorithm can compute measurements when the phase shift of interferograms in not equal to π/2. Our method generates two phase-shifted holograms in a computer by capturing the intensities of two signal beams, two reference beams, and two interferograms. The complex amplitude of a signal beam is calculated by four interference patterns, two holograms, and two interferograms. The proposed algorithm can drastically suppress the calculation error caused by the smaller value between the intensity of the reference beam and can choose the most suitable phase shift.


The tension free vaginal tape operation for women with mixed incontinence: Do preoperative variables predict the outcome?
The aims of our study were (1) to investigate subjective and objective outcomes after tension free vaginal tape (TVT) operations in mixed incontinent women, (2) to detect if preoperative subjective and objective variables predict the outcome, and (3) to evaluate whether the surgical outcome is different for women who preoperatively find stress incontinence, urge incontinence, or urge and stress incontinence equally the predominant bother. A prospective cohort study was performed on 450 mixed incontinent women. A short-form disease-specific validated questionnaire, 24-hr pad test, standardized stress test, residual urine, and maximum urinary flow were used before and after a TVT operation. "Cure" was defined as a condition where the women were very satisfied with the TVT operation and had negative stress- and 24 hr pad tests. Preoperatively 69% had stress incontinence, 7% urge incontinence, and 24% urge and stress incontinence equally as the predominant bother. Cure rates were 80%, 52%, and 60%, respectively, in these groups. Postoperatively 43% of the women had no urge incontinence, while 49% were less, and only 8% were more bothered by urge incontinence. A higher preoperative urge incontinence index was correlated with significantly higher postoperative bother for all indices and leakage during 24-hr pad test. Mixed incontinent women with predominant stress incontinence had a better cure rate than those with predominant urge incontinence and those who were equally bothered by urge and stress incontinence. This point needs to be addressed when informing mixed incontinent women before a TVT operation.


Chemical Composition, Antibacterial Properties and Mechanism of Action of Essential Oil from Clove Buds against Staphylococcus aureus.
The essential oil of clove has a wide range of pharmacological and biological activities and is widely used in the medicine, fragrance and flavoring industries. In this work, 22 components of the essential oil obtained from clove buds were identified. Eugenol was the major component (76.23%). The essential oil exhibited strong antibacterial activity against Staphylococcus aureus ATCC 25923 with a minimum inhibitory concentration (MIC) of 0.625 mg/mL, and the antibacterial effects depended on its concentration and action time. Kill-time assays also confirmed the essential oil had a significant effect on the growth rate of surviving S. aureus. We hypothesized that the essential oil may interact with the cell wall and membrane first. On the one hand it destroys cell wall and membranes, next causing the losses of vital intracellular materials, which finally result in the bacterial death. Besides, essential oil penetrates to the cytoplasmic membrane or enters inside the cell after destruction of cell structure, and then inhibits the normal synthesis of DNA and proteins that are required for bacterial growth. These results suggested that the effects of the clove essential oil on the growth inhibition of S. aureus may be at the molecular level rather than only physical damage.


Effects of Tooth Coating Material and Finishing Agent on Bleached Enamel Surfaces by KTP Laser.
The purpose of this study was to evaluate the effect of tooth coating material and finishing agent on bleached enamel surfaces after using KTP laser with 27% hydrogen peroxide. There have been few reports on the effects of tooth coating materials and finishing agents after bleaching. After 40 crowns of human extracted maxillary incisors were bleached by KTP laser, bleached enamels were finished with fluoride only or both of fluoride and nano-hydroxyapatite as a finishing agent. After application(s) of fluoride and/or finishing agent, the enamel surfaces were divided into 2 groups, which were covered with the coating material or without coating material. After application of coating materials, all specimens were kept for 2 weeks at 37°C of 100% humidity. After removing the coating material, color changing was measured and enamel surfaces were examined by scanning electron microscopy (SEM). SEM observation of enamel surfaces treated the fluoride gel, finishing agent and coating material showed the most flattered surface compared to other groups. By measuring the color changing, few color changing was observed on the enamel surfaces treated the fluoride gel, finishing agents and coating material. These results suggested that applications of fluoride gel, finishing agent and coating material made the enamel-surfaces flattered and kept effects of bleaching, could prevent the re-coloration. After applications of fluoride gel and finishing agent, covering the bleached-enamel surfaces with the coating material enhanced the keeping whiteness. It would give the patients satisfaction of whiteness.


microRNA-145 Inhibition Upregulates SIRT1 and Attenuates Autophagy in a Mouse Model of Lung Ischemia/Reperfusion Injury via NF-κB-dependent Beclin 1.
MicroRNA-145 (miR-145) has been shown to play a critical role in ischemia/reperfusion (I/R) injury; however, the expression and function of miR-145 in lung I/R injury have not been reported yet. This study aimed to elucidate the potential effects of miR-145 in lung I/R injury. Lung I/R mice models and hypoxia/reoxygenation (H/R) pulmonary microvascular endothelial cell models were established. The expression of miR-145 and sirtuin 1 (SIRT1) was measured with reverse transcription-quantitative polymerase chain reaction and Western blot analysis in mouse lung tissue and cells. Artificial modulation of miR-145 and SIRT1 (downregulation) was done in I/R mice and H/R cells. Additionally, Pao2/FiO2 ratio, wet weight-to-dry weight ratio, and cell apoptosis in mouse lung tissues were determined by blood gas analyzer, electronic balance, and deoxyuridine triphosphate-biotin nick end-labeling assay, respectively. Autophagy marker Beclin 1 and LC3 expression, NF-κB acetylation levels, and autophagy bodies were detected in cell H/R and mouse I/R models by Western blot analysis. pulmonary microvascular endothelial cell apoptosis was detected with flow cytometry. miR-145 was abundantly expressed in the lung tissue of mice and PMVECs following I/R injury. In addition, miR-145 directly targeted SIRT1, which led to significantly decreased Pao2/FiO2 ratio and increased wet weight-to-dry weight ratio, elevated acetylation levels and transcriptional activity of NF-κB, upregulated expressions of tumor necrosis factor-α, interleukins-6, and Beclin 1, autophagy bodies, cell apoptosis, as well as LC3-II/LC3I ratio. In summary, miR-145 enhances autophagy and aggravates lung I/R injury by promoting NF-κB transcriptional activity via SIRT1 expression.


Hepatic actinomycosis: an overview of salient features and outcome of therapy.
A 34-y-old African-American male developed Actinomyces liver abscess 8 months after appendectomy. Review of the English language literature revealed 56 additional cases of hepatic actinomycosis. Affected patients were typically immunocompetent, had a wide age range (4-86 y) and were predominantly male (70.2%). Infection was frequently (80.7%) cryptogenic, presenting with fever (83.3%), abdominal pain (74.5%) and weight loss (50.9%) over a 3.7 +/- 5.1 month period. The most common radiographic finding was a single hypodense mass/abscess (68.4%). Extension to surrounding tissues was evident in 19 cases (33.3%). Diagnosis was usually accomplished microscopically and culture was often (33.3%) negative. Infection was often (35.2%) mixed, usually with anaerobic bacteria. A surgical or percutaneous approach was diagnostic in 29/35 (82.9%) and 24/33 (72.7%) cases, respectively. The overall mortality rate was 8.8%; it was 10.7% with medical therapy alone and 4.0% using a combined medical/intervention approach (p = 0.6). In conclusion, hepatic actinomycosis is a rare subacute infection that may mimic neoplasm. It is usually cryptogenic, is more common among immunocompetent individuals and male subjects and is highly responsive to medical therapy.


Abnormalities of coagulation, platelet function, and fibrinolysis associated with syndromes of insulin resistance.
Insulin resistance that accompanies obesity, hypertension, polycystic ovary syndrome, and the early phases of type 2 diabetes is characterized by a prothrombotic state. The prothrombotic state is a reflection of the direct effects of hyperinsulinemia and associated metabolic abnormalities (postprandial hyperglycemia, increased free fatty acids, and hypertriglyceridemia) on platelets, coagulation, and fibrinolysis. Therapies that improve insulin sensitivity and thereby decrease insulin resistance, hyperinsulinemia, and metabolic abnormalities decrease the prothrombotic state.


[Detection of Angiostrongylus cantonensis circulating antigen by monoclonal antibodies].
To prepare monoclonal antibodies (McAbs) against soluble antigens of adult worms of Angiostrongylus cantonensis (A. cantonensis) on the purpose to detect CAg of A. cantonensis. Female BALB/c mice were immunized with soluble antigens of adult worms of A. cantonensis and the spleen cells were fused with myeloma SP2/0 cells. The hybridoma cell strains were screened by enzyme-linked immunosorbent assay (ELISA) and Western blotting. Two McAbs (3F1 and 4H2) were applied to detect the CAg in the sera of rats and mice infected with A. cantonensis and angiostrongyliasis patients respectively by double antibody sandwich ELISA. Three McAbs against A. cantonensis adult were obtained. Two McAbs (3F1, 4H2) were identified as IgG1 and one McAb (2A2) was identified as IgM. The titers of culture fluid and ascites was 1:25,600, 1:25,600, 1:12,800 and 1:80,000, 1:80,000, 1:40,000 respectively. Western blotting results showed three McAb could be used to identify 15,000 protein of adult worms of A. cantonensis. The detection rates of the CAg in the sera of infected rats and mice were 84.2% (48/57) and 87.2% (41/47) respectively. The detection rate of the CAg in the sera of angiostrongyliasis patients was 86.4% (19/22), and no cross reactions with sera from patients with schistosomiasis, cysticercosis cellulose, paragonimiasis and trichinellosis were observed. The CAg in the sera from mice examined at different periods after infection revealed positive 2 week after inoculation and the titer of CAg peaked 4 week after inoculation. A new method of sandwich ELISA with high sensitivity and specificity to detect the serum A. cantonensis CAg has been obtained, it could be applicable to the diagnosis, observation of curative effect and epidemiology of angiostrongyliasis.


Incidence of endometrial hyperplasia.
The objective of the study was to estimate the age-specific incidence of endometrial hyperplasia: simple, complex, and atypical, in order of increasing likelihood of progression to carcinoma. Women aged 18-90 years with endometrial pathology specimens (1985-2003) at a large integrated health plan were identified using automated data. Incidence rates were obtained by dividing the number of cases by the estimated number of female health plan enrollees who retained a uterus. Endometrial hyperplasia peak incidence was: simple, 142 per 100,000 woman-years, complex, 213 per 100,000 woman-years, both in the early 50s; and atypical, 56 per 100,000 woman-years in the early 60s. Age-adjusted incidence decreased over the study period, especially for atypical hyperplasia. Endometrial hyperplasia incidence without and with atypia peaks in the early postmenopausal years and in the early 60s, respectively. Given that some cases of endometrial hyperplasia likely go undiagnosed, the figures provided should be viewed as minimum estimates of the true incidence.


[Memantine and Complex Regional Pain Syndrome (CRPS): effects of treatment and cortical reorganisation].
In recent studies a central nervous system involvement in the pathogenesis of Complex Regional Pain Syndrome (CRPS) was suggested, stimulating the introduction of central acting drugs. Animal studies have demonstrated an increased expression of the N-methyl-D-aspartate (NMDA) receptors in experimental neuropathic pain. The aim of this study was to investigate the relationship between NMDA receptor blockers and CRPS. Three patients suffering from CRPS of one upper extremity where treated with oral NMDA antagonist Memantine for eight weeks. Patients expressed their pain levels with a visual analog scale ranging from zero to ten at rest and after fist clenching. Furthermore, the range of movement of the fingers and the wrist were documented. To assess force, a pinchmeter and a dynamometer were used. Cortical reorganisation was studied with functional Magnetic Resonance Imaging (fMRI) and Magnetoencephalography (MEG). Six months after treatment with Memantine no rest pain was present in any of the patients. Furthermore, an increase in finger movement was observed after six-month follow-up with no deficits and free movement ranges. Additionally, wrist movement was improved and an increase of force was measured after six months with the dynamometer and the pinchmeter. Moreover the functional impairment, cortical reorganisation was observed in all patients before treatment. These changes returned to a normal pattern after eight weeks of treatment with Memantine. These first results demonstrate central nervous system involvement in the development and maintenance of CRPS. The results (functional, pain, fMRI, MEG) after treatment with Memantine indicate the importance of the NMDA receptor system in neuropathic pain syndromes and provide a promising approach for the treatment of CRPS.


Virtual touch quantification (VTq) elastography for non-invasive assessment of liver disease and its complications: what the clinician needs to know.
Liver stiffness measurement (LSM) is the most widely used non-invasive alternative to biopsy for assessing liver fibrosis in the UK. Virtual touch quantification (VTq, also known as acoustic radiation force impulse) is the principal available alternative to transient elastography (Fibroscan) and is delivered via software enhancements to standard ultrasound (US) machines. It has recently been endorsed by National Institute for Health and Care Excellence in terms of both accuracy and cost-effectiveness for use in viral hepatitis. However, while an increasing proportion of radiologists use VTq, familiarity among gastroenterologists and trainees with LSM techniques is variable and implementation is patchy. This review considers the background, evidence for and practical use of VTq elastography in clinical practice in the UK. Potential future developments in this rapidly evolving field are also highlighted.


[Presence of respiratory pathogens in the oral biofilm of patients with nosocomial pneumonia].
Hospitalized patients receiving treatment at intensive care units (ICU) usually show poor oral hygiene, and may have the mouth and oropharingeal region colonized by pathogens involved in nosocomial pneumonia. The presence of these pathogens may increase the risk for respiratory diseases. The aim of this study was to investigate the presence of respiratory pathogens in the oral cavity of hospitalized patients at ICU. Were included in the study 30 patients from Hospital Raul Sertã, Nova Friburgo, with the diagnostic of nosocomial pneumonia, and tracheal aspirate samples were cultured to identify the causing microorganisms. In addition, microbiological samples from supragingival dental plaque, tongue and respiratory tube were cultured for the presence of a panel of respiratory pathogens. The most frequently found bacteria in the tracheal aspirate were S. Pneumoniae 23.3% (7), P. aeruginosa 20% (6), S. aureus 13.3% (4), K. pneumoniae 13.3% (4), C. albicans 6.6% (2), a-hemolytic streptococcus 6.6% (2), Staphylococcus sp. 6.6% (2), A. calcoaceticus 3.3% (1), E. coli 3.3% (1) and E. cloacae 3.3% (1). 70% (21) of these microorganisms were found in the dental biofilm, 63.33% (19) in tongue samples; 73.33% (22) in the respiratory tube; and 43.33% (13) in all sampling sites simultaneously. No differences in proportions could be observed between the sampling sites (p > 0.05) CONCLUSIONS: The results of this study show that respiratory pathogens associated with nosocomial pneumonia are present in the oral biofilm of hospitalized patients in ICU, which may serve as a reservoir for these microorganisms.


Effect of sunlight exposure on circulating 1,25-dihydroxyvitamin D in hemodialyzed patients and of exogenous parathyroid hormone in anephric patients.
Sunshine exposure increased the serum concentration of 25-hydroxyvitamin D (25-OHD) in 9 hemodialyzed patients. Mean 1,25-dihydroxyvitamin D (1,25-(OH)2D) was unchanged, but in two patients with low initial 25-OHD values this increase was accompanied by a rise in circulating 1,25-(OH)2D, although not to normal levels. One hemodialyzed patient developed liver insufficiency with a resultant reduction of serum 25-OHD concentration accompanied by a decrease in serum 1,25-(OH)2D concentration. The results indicate that the circulating levels of 1,25-(OH)2D in patients with end-stage renal failure are to some extent regulated by the serum 25-OHD concentrations. Injection of parathyroid hormone (PTH) induced minor increases in serum concentrations of 1,25-(OH)2D in patients with end-stage renal failure and even in anephric patients, suggesting the existence of an extrarenal PTH-sensitive 1-alpha-hydroxylase. However, the enzyme was stimulated by supraphysiological concentrations of PTH, and therefore not necessarily of importance in the normal regulation of calcium metabolism.


Presurgical localization of parathyroid adenomas with magnetic resonance imaging at 3.0 T: an adjunct method to supplement traditional imaging.
To investigate the use of a chemical shift-based water-fat separation magnetic resonance imaging (MRI) method, and time-resolved contrast-enhanced MRI at 3 T for improved presurgical localization of parathyroid adenomas. Twenty-five patients with primary hyperparathyroidism were prospectively enrolled. Patients underwent MRI, which was reviewed by two experienced neuroradiologists who were blinded to Tc-99m sestamibi imaging and operative results. Overall, MRI detected 16 adenomas in 25 patients (sensitivity 64%, positive predictive value 67%), while sestamibi detected 18 of 25 adenomas (sensitivity 72%, positive predictive value 90%). Importantly, MRI was able to detect adenomas in four (57%) of the seven patients whose disease was missed by sestamibi analysis. MRI demonstrated excellent image quality and fat suppression by using a chemical shift-based water-fat separation technique. The time-resolved MRI was considered to be less helpful, although in some cases it was indispensable. MRI is an excellent adjunct for preoperative parathyroid localization. The advent of improved fat suppression techniques in the neck, including chemical shift-based water-fat separation, is critical to its utility. Although time-resolved MRI was not always helpful, it was crucial in certain cases. It may prove to be more useful with the development of faster scanning techniques.


Imidazolin-2-iminato complexes of rare earth metals with very short metal-nitrogen bonds: experimental and theoretical studies.
The reactions of 1,3-bis(2,6-diisopropylphenyl)imidazolin-2-imine (Im(Dipp)NH, 1-H) with trimethylsilylmethyl lithium (LiCH(2)SiMe(3)) and anhydrous rare earth metal trichlorides MCl(3) afforded the imidazolin-2-iminato complexes [(1)MCl(2)(THF)(3)] (2a, M = Sc; 2b, M = Y; 2c, M = Lu) and [(1)GdCl(2)(THF)(2)] x [LiCl(THF)(2)] (2d). Treatment of complexes 2 with dipotassium cyclooctatetradienide, K(2)(C(8)H(8)) resulted in the formation of two- or three-legged piano-stool complexes of the type [(eta(8)-C(8)H(8))M(1)(THF)(n)] (3a, M = Sc, n = 1; 3b, M = Y, n = 2; 3c, M = Lu, n = 2; 3d, M = Gd, n = 2). X-ray diffraction analyses of all eight complexes 2 and 3 revealed the presence of very short metal-nitrogen bonds, which are among the shortest ever observed for these elements. [(eta(8)-C(8)H(8))Sc(1)(THF)] (3a) reacted with 2,6-dimethylphenyl isothiocyanate (Xy-NCS) to form the [2 + 2]-cycloaddition product 4, which contains a thioureato-N,N' moiety. The related COT-titanium complex [(eta(8)-C(8)H(8))TiCl(1)] (6) could be obtained from [(1)TiCl(3)] (5) by reaction with K(2)(C(8)H(8)) and was structurally characterized. As a theoretical analysis of the nature of the metal-nitrogen bond, density functional theory (DFT) calculations have been carried out for complexes 3a and 6 and also for the model complexes [(eta(8)-C(8)H(8))Sc(NIm(Me))] (7), [(eta(8)-C(8)H(8))Ti(NIm(Me))](+) (8), and [(eta(8)-C(8)H(8))Ti(NXy)] (9), revealing a marked similarity of the bonding in imidazolin-2-iminato and conventional imido metal complexes.


[Decrease in arterial PO2 with captopril administration in secondary pulmonary hypertension and right heart failure].
The ventilation-perfusion match under therapy with captopril was registered in 14 patients with secondary pulmonary hypertension and right heart failure caused by chronic obstructive lung disease. In none of the cases, changes of cranialisation of the perfusion or increasing ventilation-perfusion mismatch was found, but a significant fall in O2 was seen in all patients. This O2-depression is due to decreasing stroke volume of the right to left shunt.


Zinc Dyshomeostasis in Cardiomyocytes after Acute Hypoxia/Reoxygenation.
Zinc dyshomeostasis may play a role in the pathogenesis of myocardial ischemia/reperfusion injury. The objective of this study was to investigate the expression profile of zinc regulated transporter like- and iron-regulated transporter-like proteins (ZIPs) and zinc transporter proteins (ZnTs) in cardiomyocytes and their modulation in response to hypoxia and reoxygenation. Adult rat ventricular myocytes (ARVMs) were subjected to 6 h of hypoxia, followed by 18 h of reoxygenation. Intracellular and extracellular zinc concentrations were determined using Fluozin-3 and Newport Green fluorescence, respectively. Expression of ZnTs 1, 2, 5, and 9 along with ZIPs 1, 2, 3, 6, 7, 9, 10, 11, 13, and 14 was detectable in the cardiomyocytes by real-time reverse transcriptase polymerase chain reaction. Hypoxia elicited accumulation of intracellular free zinc, but subsequent reoxygenation resulted in striking loss of intracellular free zinc and decreased the cardiomyocyte viability. Concomitantly, extracellular zinc levels dropped rapidly during hypoxia, but increased after reoxygenation. Immunoblotting analysis revealed that hypoxia increased the expression of ZnT1, but reoxygenation significantly increased the expression of ZnTs 2 and 5. Neither hypoxia nor reoxygenation altered the levels of ZnT9. Increased intracellular zinc at the end of hypoxia is related to enhanced expression of ZIPs, whereas decreased intracellular zinc during reoxygenation appears to be due to lowered expression of all ZIPs, in addition to elevated levels of ZnTs 2 and 5. These results thus suggest that there is impaired accumulation of intracellular zinc during reoxygenation, due to overexpression of specific ZnTs and downregulation of ZIP expression.


Review of surgical experience in 61 patients with mixed total anomalous pulmonary venous connection.
Prior studies have reported a high mortality and incidence of post-repair pulmonary venous obstruction (PVO) in mixed total anomalous pulmonary venous connection (TAPVC). This study sought to review the surgical outcomes in this entity. A review of 61 patients undergoing surgical repair of mixed TAPVC was conducted. Patients with a single ventricle were excluded. Patients were subdivided into 3 groups according to Chowdhury's classification. Predictors for death and postoperative PVO were explored by Cox regression model. This study trended towards an older cohort with a median age of 88 days (interquartile range, 56.5-177). Twelve patients belonged to '2 + 2' type, 40 belonged to '3 + 1' type and the remaining 9 belonged to bizarre type. There were no early death and 7 late deaths. Follow-up was available in 96.7% of the patients after discharge with a median duration of 53 months (range, 1-177). Nineteen patients developed post-repair PVO among whom 2 required reintervention. Patients with preoperative PVO had a 4-fold higher risk (95% confidence interval, 1.36-12.38) of postoperative PVO than those without and were more likely to die (P = 0.009). No statistical difference was observed among the 3 subgroups in terms of mortality (P = 0.058) and postoperative PVO (P = 0.186). Preoperative PVO was significantly associated with postoperative PVO. There was no statistical difference in terms of death and postoperative PVO among the 3 subtypes of mixed TAPVC. Mid-term results favoured a complete rechanneling of pulmonary veins in '3 + 1' type.


Effects of mortality awareness on attitudes toward dying and death and meaning in life-a randomized controlled trial.
A randomized controlled trial was carried out to investigate effects of heightened mortality awareness on meaning in life and attitudes toward dying and death. An intervention group (n = 51) completed questionnaires and participated in interventions to increase mortality awareness; a control group (n = 47) only completed the questionnaires. Longitudinal analyses revealed a decrease in the intervention group's fear of dying and an increase in their acceptance of dying, but no effects on attitudes toward death. Changes in meaningfulness were contingent on participants' religiousness. Unexpected cross-sectional results and the study's implications for theory and further empirical work are discussed.


Extending Efforts to Move Cigarette and e-Cigarette Beliefs: Message Exposure and Belief Structures.
This study examines message exposure and belief structures in the context of tobacco prevention and education efforts. Though it is imperative that researchers identify and test messaging strategies that move beliefs in the desired direction, these efforts must take care to consider the existing belief structures of the target audience. A pretest-posttest design was employed in order to extend an existing tobacco-free initiative. The study examined how participants structured their beliefs about tobacco and the initiative at the first time point (T1: N = 404) and tested the impact of persuasive messages at a second time point (T2: N = 192). The findings indicated that while one message produced change in a targeted norms-oriented belief, a constellation of messages hold promise for modifying a broader belief structure. The results are discussed in terms of their implications for message design and tobacco-free initiatives.


Multimodal therapy for the treatment of severe ischemic stroke combining endovascular embolectomy and stenting of long intracranial artery occlusion.
Embolic occlusion of cerebral arteries is a major cause for stroke. Intravenous thrombolysis showed positive results in this condition, however even when strict criteria are used, the risk of hemorrhagic transformation is possible. Microsurgical embolectomy has been described earlier. Purpose. We performed multimodal therapy of cerebral artery occlusion. Case Report. We present a case of a 49-year-old female patient who-according to the National Institute of Health Stroke Scale (NIHSS)-was rated as 19 due to acute occlusion of the horizontal segment of the left middle cerebral artery (MCA). After failed i.v. thrombolysis, only a part of the clot could be evacuated by the endovascular approach-without restoration of blood flow. Normal patency of the left MCA was re-established after stenting. Within 72 hours, the patient had an NIHSS score of 14, with a small haematoma in the left hemisphere. Conclusion. In our case multimodal therapy combining i.v. thrombolysis, mechanical disruption of thrombus, MCA stenting and platelet function antagonists, resulted in successful recanalization of the acutely occluded left MCA.


Separation of elastin components by thin layer chromatography and electrophoresis.
Several methods are described which employ thin layer chromatography and electrophoresis for investigations into the structure and synthesis of crosslinked elastin. These procedures are more sensitive and involve less elaborate equipment than separation on paper. The methods described include an electrophoretic procedure for detecting the cross-linking amino acids in elastin hydrolysates, a method for completely separating desmosine, isodesmosine and merodesmosine in these hydrolysates, and a method for producing two-dimensional peptide maps of elastase digests of elastin.


Experiences with Medicaid Renewal and Reauthorization Policies in the Context of Child Health and Vaccine Coverage.
Difficulties complying with Medicaid recertification requirements may be responsible for a portion of Medicaid disenrollments and may impact access to preventive care. This study aimed to explore the barriers parents experienced renewing their child's Medicaid, how those barriers impact access to healthcare, and how changes in Medicaid policy can improve child health outcomes. To understand the barriers associated with Medicaid renewal, authors conducted in-depth interviews (N = 24) with racially and demographically diverse parents living in Baltimore. They found that administrative burden, lack of awareness regarding reauthorization, challenges with navigation assistance, and lack of access to the renewal system were crucial barriers to renewing Medicaid. Many participants identified negative impacts on child health outcomes resulting from lapses in coverage, including lack of healthcare access and missed immunizations. Drawing on these findings, the authors provide recommendations for streamlining and clarifying the Medicaid renewal process in Maryland, and the role of social work policy and practice in reducing barriers to renewal.


Protrusio acetabuli in Marfan's syndrome.
Marfan's syndrome is an autosomal dominant disorder of connective tissue, commonly involving the cardiovascular, ocular, and skeletal systems. Revised criteria for the clinical diagnosis of Marfan's syndrome regard skeletal involvement as a major criterion if at least four of eight typical skeletal manifestations are present, one of which is protrusio acetabuli. Using Kulman's method to determine the presence of protrusio, we analysed the pelvic X-rays of 15 patients with Marfan's syndrome and 15 controls. Protrusio was present in 47% (7/15) of Marfan patients, compared with 7% (1/15) of controls (P = 0.035). Using the revised criteria, the presence of protrusio would have affected the final diagnosis of Marfan's syndrome in only one patient out of 15. Therefore, we recommend that a pelvic X-ray is reserved for those cases in which the presence of protrusio will alter the final diagnosis. With regard to the radiological assessment of protrusio, in our opinion this can be performed simply and reliably using the position of the acetabular line alone.


WHO indicators for evaluation of maternal health care services, applicability in least developed countries: a case study from Eritrea.
The World Health Organization has recommended a number of process indicators to monitor the effect of health care programmes on maternal mortality. This study was therefore conducted to know if the recommended process indicators are useful also in the least developed countries. In 1994, all 17 health facilities offering maternal health care in a rural province in Eritrea were visited. An assessment was made of the obstetric services provided, obstetric complications, and accessibility of health facilities. The study revealed that necessary data were available for most indicators. The indicators were helpful to follow the coverage of obstetric care and to identify problems within the health care system. However, in countries where the coverage of assisted deliveries is low with few obstetric complications seen within the health care system, the indicators cannot be used as a tool to monitor the effect of maternal health care programmes on maternal mortality.


Sulfonic Acid- and Lithium Sulfonate-Grafted Poly(Vinylidene Fluoride) Electrospun Mats As Ionic Liquid Host for Electrochromic Device and Lithium-Ion Battery.
Electrospun polymer nanofibrous mats loaded with ionic liquids (ILs) are promising nonvolatile electrolytes with high ionic conductivity. The large cations of ILs are, however, difficult to diffuse into solid electrodes, making them unappealing for application in some electrochemical devices. To address this issue, a new strategy is used to introduce proton conduction into an IL-based electrolyte. Poly(vinylidene fluoride-co-hexafluoropropylene) (P(VDF-HFP)) copolymer is functionalized with sulfonic acid through covalent attachment of taurine. The sulfonic acid-grafted P(VDF-HFP) electrospun mats consist of interconnected nanofibers, leading to remarkable improvement in dimensional stability of the mats. IL-based polymer electrolytes are prepared by immersing the modified mats in 1-butyl-3-methylimidazolium tetrafluoroborate (BMIM(+)BF4(-)). It is found that the SO3(-) groups can have Lewis acid-base interactions with the cations (BMIM(+)) of IL to promote the dissociation of ILs, and provide additional proton conduction, resulting in significantly improved ionic conductivity. Using this novel electrolyte, polyaniline-based electrochromic devices show higher transmittance contrast and faster switching behavior. Furthermore, the sulfonic acid-grafted P(VDF-HFP) electrospun mats can also be lithiated, giving additional lithium ion conduction for the IL-based electrolyte, with which Li/LiCoO2 batteries display enhanced C-rate performance.


Role of Hot Water System Design on Factors Influential to Pathogen Regrowth: Temperature, Chlorine Residual, Hydrogen Evolution, and Sediment.
Residential water heating is linked to growth of pathogens in premise plumbing, which is the primary source of waterborne disease in the United States. Temperature and disinfectant residual are critical factors controlling increased concentration of pathogens, but understanding of how each factor varies in different water heater configurations is lacking. A direct comparative study of electric water heater systems was conducted to evaluate temporal variations in temperature and water quality parameters including dissolved oxygen levels, hydrogen evolution, total and soluble metal concentrations, and disinfectant decay. Recirculation tanks had much greater volumes of water at temperature ranges with potential for increased pathogen growth when set at 49°C compared with standard tank systems without recirculation. In contrast, when set at the higher end of acceptable ranges (i.e., 60°C), this relationship was reversed and recirculation systems had less volume of water at risk for pathogen growth compared with conventional systems. Recirculation tanks also tended to have much lower levels of disinfectant residual (standard systems had 40-600% higher residual), 4-6 times as much hydrogen, and 3-20 times more sediment compared with standard tanks without recirculation. On demand tankless systems had very small volumes of water at risk and relatively high levels of disinfectant residual. Recirculation systems may have distinct advantages in controlling pathogens via thermal disinfection if set at 60°C, but these systems have lower levels of disinfectant residual and greater volumes at risk if set at lower temperatures.


Retrograde Ender nailing for humerus shaft fractures.
Humerus fractures are common; their management remains controversial. Infection, neurovascular injury, joint problems and non-union are recognised complications of surgical treatment. These complications can be decreased by opting for a surgical treatment that is less invasive and safe. We present a series of 59 patients treated with retrograde Ender nailing; 56 healed in an average of 9.1 weeks, 2 had delayed union (> 15 weeks) and one went on to non-union, which healed after secondary plate fixation. Nail back out occurred in 8 cases, of which only 3 required nails repositioning. The mean Constant score at final follow-up (mean 19 months) was 91; it was significantly lower in patients over 50 years of age and in those with segmental fractures. In this series, Ender retrograde nailing gave overall satisfactory results and appeared as a safe and efficient technique.


Catalyst-Free 1,2-Dibromination of Alkenes Using 1,3-Dibromo-5,5-dimethylhydantoin (DBDMH) as a Bromine Source.
A direct 1,2-dibromination method of alkenes is realized using 1,3-dibromo-5,5-dimethylhydantoin (DBDMH) as a bromine source. This reaction proceeds under mild reaction conditions without the use of a catalyst and an external oxidant. Various sorts of alkene substrates are transformed into the corresponding 1,2-dibrominated products in good to excellent yields with broad substrate scope and exclusive diastereoselectivity. This method offers a green and practical approach to synthesize vicinal dibromide compounds.


Air pollution related prothrombotic changes in persons with diabetes.
Population studies suggest that persons with diabetes are more sensitive to the effects of particulate matter (PM) air pollution. However, the biological mechanisms of a possible prothrombotic effect underlying this enhanced susceptibility remain largely unknown. We hypothesized that exposure to PM causes prothrombotic changes in persons with diabetes, possibly via systemic inflammation. Our study included 137 nonsmoking adults with diabetes who were outpatients at the University Hospital Leuven. Recent exposure (2 hr before examination) to ambient PM was measured at the entrance of the hospital. Individual chronic exposure to PM was assessed by measuring the area occupied by carbon in airway macrophages obtained by sputum induction. Platelet function was measured ex vivo with the PFA-100 platelet function analyzer, which simulates a damaged blood vessel; we analyzed the function of platelets in primary hemostasis under high shear conditions. Total and differential blood leukocytes were counted. Independent of antiplatelet medication, an interquartile range (IQR) increase of 39.2 microg/m3 in PM10 (PM with aerodynamic diameter <or= 10 microm) concentration measured 2 hr before the clinical examination (recent exposure) was associated with a decrease of 21.1 sec [95% confidence interval (CI), 35.3 to 6.8] in the PFA-100 closure time (i.e., increased platelet activation) and an increase in blood leukocytes of 512 per microliter of blood (95% CI, 45.2979). Each area increase of 0.25 microm2 (IQR) in carbon load of airway macrophages (chronic exposure) was associated with an increase of 687 leukocytes per microliter of blood (95% CI, 2241,150). A relevant increase in recent PM exposure was associated with a change in platelet function toward a greater prothrombotic tendency. The magnitude of the change was about two-thirds (in the opposite direction) of the average effect of antiplatelet medication. Diabetic patients showed evidence of proinflammatory response to both recent and chronic exposure to PM air pollution.


Exploitation of biological wastes for the production of value-added hydrolases by Streptomyces sp. MSWC1 isolated from municipal solid waste compost.
Actinomycetes with the ability to degrade natural polysaccharides were isolated during a screening programme from soil, farmyard manure and municipal solid waste compost. One of the most potent isolates was identified as Streptomyces sp. MSWC1 using morphological and biochemical properties along with 16S rDNA partial sequence analysis. The highest enzyme production by Streptomyces was observed for the xylanase and chitinase activity on different carbon sources with an optimum of 12,100 IU ml(-1) and 110 IU ml(-1) at 3 days' culture on 1% of xylan and chitin, respectively. To meet the demand of industry, low-cost medium is required for the production of hydrolases by Streptomyces sp. Strain MSWC1 grown on manure, compost, and a natural carbon source was used to evaluate the re-utilisation of biological wastes for the production of value-added products. Despite the presence of a high amount of toxic heavy metals in the compost, Streptomyces produced interesting enzymes that have been biochemically characterized.


Healthcare Professional Students' Perspectives on Substance Use Disorders and Stigma: A Qualitative Study.
Access to and quality of care for Substance Use Disorders (SUDs) remain a major public health issue. Stigma associated with SUDs contributes to the gap between the number of patients who need treatment and the much smaller fraction that receive it. Healthcare professional students are future care providers; an opportunity exists to characterize their collective perspectives on patients with SUDs and how that informs the care they provide. Healthcare professional students participated in online, semi-structured focus group (FGs) between March and April 2021. The FGs were conducted until thematic saturation was achieved. All verbatim transcripts were analyzed applying Thematic Analysis using Dedoose® qualitative software. Inductive codes were grouped into categories based on similarities that facilitated the emergence of themes. Thematic Analysis revealed one theme (1) Decreasing stigma among healthcare professionals by viewing substance use disorder as a disease; and two sub-themes: Subtheme 1a: Relating with the patients, "It could be me…"; Subtheme 1b: Interactions with patients, "We just don't know exactly how to counsel these patients…" These themes describe how future healthcare professionals might perceive and approach patients with SUDs and highlight the importance of SUD training in the curriculum. Medical and pharmacy students are uniquely positioned to apply critical thinking from their didactic training to their real-world clinical experiences, and their collective perspectives inform gaps in training and opportunities to develop best practices for SUD care. An opportunity exists to leverage these findings in order to train future healthcare professionals to ensure access to and quality of SUD care.


Components of Pre-professional/Adolescent Dance Screens: What Should We Include?
Increasingly, best practice in dance healthcare includes preseason screening. But do preseason screenings give us useful information? Can they provide assessment of injury risk? Can we use a common screen for all athletes or need ones specific to dancers? What is the purpose of screening and what tests are appropriate for adolescent dancers? In this editorial, I make recommendations based on over 20 years of experience screening pre-professional and professional dancers.


Characterization of vasoactive intestinal peptide receptors on human megakaryocytes and platelets.
Vasoactive intestinal peptide receptor I (VIPRI) expression was examined in megakaryocytes using reverse transcriptase-polymerase chain reaction (RT-PCR). VIPRI protein was characterized in platelet membranes using covalent crosslinking techniques. Human megakaryocytes were isolated from suspension cultures of cord blood and adult bone marrow mononuclear cells using a murine monoclonal antibody to human platelet glycoprotein IIB/IIIA (CD41) and immunomagnetic beads. RT-PCR primers were constructed for the VIP, VIPRI, and VIPRII genes as well as for megakaryocyte specific genes, c-mpl and platelet factor 4 (PF-4). VIP, VIPRI, c-mpl, and PF-4 were coexpressed in megakaryocyte mRNA. Southern blot analysis confirmed the expression of VIPRI. 125I-VIP was covalently cross-linked to human platelet membranes using the homobifunctional reagent disuccinimidyl suberate, followed by polyacrylamide gel electrophoresis and autoradiography. A 125I-VIP-protein complex of Mr = 50,000 was identified. Labeling of the Mr = 50,000 component was completely abolished by unlabeled VIP, but not by peptide histidine methionine or growth hormone releasing factor, indicating specific binding of VIP to the platelet membranes. Taken together, these results suggest that VIP may have direct effects on megakaryocytopoiesis and support our earlier observations of VIP modulation of platelet aggregation.


Needs-based health care rights.
Man's inherent dignity endows him with rights, and his objective interests give content to these rights. Rights are a subset of needs which are a subset of interests. Health care interests are defined in terms of deviation from species functioning; needs are those objectively important interests which impact opportunities. Society prioritizes needs according to the abilities it values, transforming the most important into rights, inviolable claims to society's resources. Rights inform man of the balance between his self-interest claims versus his obligations to fellow citizens. Health care rights thus facilitate just health care spending which protects vital interests without bankrupting society.


A site-specific recombinase-based method to produce antibiotic selectable marker free transgenic cattle.
Antibiotic selectable marker genes have been widely used to generate transgenic animals. Once transgenic animals have been obtained, the selectable marker is no longer necessary but raises public concerns regarding biological safety. The aim of this study was to prepare competent antibiotic selectable marker free transgenic cells for somatic cell nuclear transfer (SCNT). PhiC31 intergrase was used to insert a transgene cassette into a "safe harbor" in the bovine genome. Then, Cre recombinase was employed to excise the selectable marker under the monitoring of a fluorescent double reporter. By visually tracking the phenotypic switch from red to green fluorescence, antibiotic selectable marker free cells were easily detected and sorted by fluorescence-activated cell sorting. For safety, we used phiC31 mRNA and cell-permeant Cre protein in this study. When used as donor nuclei for SCNT, these safe harbor integrated marker-free transgenic cells supported a similar developmental competence of SCNT embryos compared with that of non-transgenic cells. After embryo transfer, antibiotic selectable marker free transgenic cattle were generated and anti-bacterial recombinant human β-defensin-3 in milk was detected during their lactation period. Thus, this approach offers a rapid and safe alternative to produce antibiotic selectable marker free transgenic farm animals, thereby making it a valuable tool to promote the healthy development and welfare of transgenic farm animals.


Leiomyoma of the orbit.
A rare case of leiomyoma located anteroinferiorly in the orbit of a 39-year-old male patient is reported. The histopathogenesis and management is discussed.


An fNIRS Study of Brain Lateralization During Observation and Execution of a Fine Motor Task.
Brain activity in the action observation network (AON) is lateralized during action execution, with greater activation in the contralateral hemisphere to the side of the body used to perform the task. However, it is unknown whether the AON is also lateralized when watching another person perform an action. In this study, we use fNIRS to measure brain activity over the left and right cortex while participants completed actions with their left and right hands and watched an actor complete action with their left and right hands. We show that while activation is lateralized when the participants themselves are moving, brain lateralization is not affected by the side of the body when the participant is observing another person's action. In addition, we demonstrate that individual differences in hand preference and dexterity between the right and left hands are related to brain lateralization patterns.


An Adenomatoid Odontogenic Cyst (AOC) with an Assorted Histoarchitecture: A Unique Entity.
AOC - a relatively uncommon lesion of odontogenic origin, that is non-invasive, slow growing and composed of odontogenic epithelium, shows varied clinical and histoarchitectural patterns. It has been regarded as a benign odontogenic tumour for more than a century, sharing its clinical and radiographic features with that of dentigerous cysts. Few cases which have shown the association of this lesion with dentigerous cysts have also been reported. Some authors have reported a distinct hybrid variety of this lesion which was derived from dentigerous cysts. An attempt has been made in this article, in describing this lesion as a "hamartomatous odontogenic cyst" rather than a tumour. Although this lesion has been known to the oral pathologists for a long time, its histogenesis still remains obscure. The present case highlights a new school of thought regarding the origin of this lesion.


Heterologously expressed serotonin 1A receptors couple to muscarinic K+ channels in heart.
In cardiac atrial cells, muscarinic acetylcholine receptors activate a K+ current directly via a guanine nucleotide-binding protein (G protein). Serotonin type 1A receptors may activate a similar pathway in hippocampal neurons. To develop a system in which receptor/G protein/K+ channel coupling can be experimentally manipulated, we have used a highly efficient recombinant vaccinia virus vector system to express human serotonin 1A receptors in primary cultures of rat atrial myocytes. The expressed 1A receptors activated the inwardly rectifying K+ conductance that is normally activated by the endogenous muscarinic acetylcholine receptors. Maximal responses to either agonist occluded further activation by the other agonist. The average activation time constants for serotonin were about 5 times slower than for acetylcholine. The data support suggestions that the intracellular signaling pathway from seven-helix receptors to G proteins and directly to ion channels is widespread in excitable cells. After a fraction of the G proteins are activated irreversibly by guanosine 5'-[gamma-thio]triphosphate, subsequent transduction proceeds more efficiently. One possible interpretation is that multiple G-protein molecules are required to activate each channel. Vaccinia virus expression vectors are thus useful for expressing seven-helix receptors in primary cultures of postmitotic cells and have provided a heterologous expression system for the signaling pathway from seven-helix receptors to G proteins and directly to ion channels.


Polycyclic aromatic hydrocarbons in aquatic animals: a systematic review on analytical advances and challenges.
Polycyclic aromatic hydrocarbons (PAHs), the main component of petroleum, are a concern due to their environmental persistence, long-range transport, and potential toxic effects on animal, human health, and the environment. PAHs are considered persistent compounds and can be bioaccumulated in sediments and aquatic biota. Determining PAHs in animals and environmental samples consists of three steps: extraction, clean-up or purification, and analytical determination. The matrix complexity and the diversity of environmental contaminants, such as PAHs resulted in the development of numerous analytical techniques and protocols for the extraction of these components and analysis in several samples. This systematic review article seeks to relate the extraction and preparation methods of complex samples from aquatic animals and the two main detection techniques of PAHs. For the elaboration of the research, 67 articles published between 2011 and 2021 were sought, which specifically contemplated the isolation of aquatic extracts and detection and quantification techniques of PAHs.


An individualized approach in the education of asthmatic children.
Asthma is the most prevalent chronic disorder of childhood. In a large number of cases, it can be well managed. In addition to accurate diagnosis, appropriate therapy and control of environmental factors, a good educational program is required, which has not yet received due attention. Prompted by the fact that a large number of asthmatic children and their parents lack sufficient knowledge about asthma, six years ago we launched an individual educational program for all asthmatic children over seven years of age and their parents. We monitored a group of 58 asthmatics, the first to have completed our individual educational program, during the year before and the year after they had received individual education. The prerequisites for inclusion in the study were that the child was over seven years of age, diagnosed with chronic asthma according to the GINA guidelines and had been monitored for one year prior to receiving individual education. We compared the number of asthma exacerbations, hospitalizations due to asthma, days with asthmatic symptoms, the mean value of the forced expiratory volume in 1 second (FEV 1), and the mean dose of inhaled corticosteroids (ICS) taken during the year before and the year after receiving individual education. Study results showed the number of asthma exacerbations (p < 0.0001), hospitalizations due to asthma (p = 0.0236) and days with asthmatic symptoms (p < 0.0001) to have significantly reduced, along with a significant increase in FEV 1 (p < 0.0001) and lower mean ICS dose (p < 0.0001) upon completion of individual educational program. It is concluded that the addition of individual education in the treatment of asthmatic children enables better control of the disease (lower number of hospitalizations and asthma exacerbations, increased FEV 1) with a lower mean ICS dose. The knowledge about asthma acquired by the children and their parents, self-management, compliance with the written asthma management plan, control of environmental factors, along with good cooperation of the patients and parents in the management of asthma certainly contributed to this favorable observation.