Gain of chromosome arm 1q in atypical meningioma correlates with shorter progression-free survival.
Atypical (World Health Organization grade II) meningiomas have moderately high recurrence rates; even for completely resected tumours, approximately one-third will recur. Post-operative radiotherapy may aid local control and improve survival, but carries the risk of side effects. More accurate prediction of recurrence risk is therefore needed for patients with atypical meningioma. Previously, we used high-resolution array comparative genomic hybridization to identify genetic variations in 47 primary atypical meningiomas and found that approximately 60% of tumours show gain of 1q at 1q25.1 and 1q25.3 to 1q32.1 and that 1q gain appeared to correlate with shorter progression-free survival. This study aimed to validate and extend these findings in an independent sample. Eighty-six completely resected atypical meningiomas (with 25 recurrences) from two neurosurgical centres in Ireland were identified and clinical follow-up was obtained. Utilizing a dual-colour interphase fluorescence in situ hybridization assay, 1q gain was assessed using Bacterial Artificial Chromosome probes directed against 1q25.1 and 1q32.1. The results confirm the high prevalence of 1q gain at these loci in atypical meningiomas. We further show that gain at 1q32.1 and age each correlate with progression-free survival in patients who have undergone complete surgical resection of atypical meningiomas. These independent findings suggest that assessment of 1q copy number status can add clinically useful information for the management of patients with atypical meningiomas.


Changes in At-Risk American Men's Crime and Substance Use Trajectories Following Fatherhood.
Fatherhood can be a turning point in development and in men's crime and substance use trajectories. At-risk boys (N = 206) were assessed annually from ages 12 to 31 years. Crime, arrest, and tobacco, alcohol, and marijuana use trajectories were examined. Marriage was associated with lower levels of crime and less frequent substance use. Following the birth of a first biological child, men's crime trajectories showed slope decreases, and tobacco and alcohol use trajectories showed level decreases. The older men were when they became fathers, the greater the level decreases were in crime and alcohol use and the less the slope decreases were in tobacco and marijuana use. Patterns are consistent with theories of social control and social timetables.


Process Optimization on Micro-Aeration Supply for High Production Yield of 2,3-Butanediol from Maltodextrin by Metabolically-Engineered Klebsiella oxytoca.
An optimization process with a cheap and abundant substrate is considered one of the factors affecting the price of the production of economical 2,3-Butanediol (2,3-BD). A combination of the conventional method and response surface methodology (RSM) was applied in this study. The optimized levels of pH, aeration rate, agitation speed, and substrate concentration (maltodextrin) were investigated to determine the cost-effectiveness of fermentative 2,3-BD production by metabolically-engineered Klebsiella oxytoca KMS005. Results revealed that pH, aeration rate, agitation speed, and maltodextrin concentration at levels of 6.0, 0.8 vvm, 400 rpm, and 150 g/L respectively were the optimal conditions. RSM also indicated that the agitation speed was the most influential parameter when either agitation and aeration interaction or agitation and substrate concentration interaction played important roles for 2,3-BD production by the strain from maltodextrin. Under interim fed-batch fermentation, 2,3-BD concentration, yield, and productivity were obtained at 88.1±0.2 g/L, 0.412±0.001 g/g, and 1.13±0.01 g/L/h respectively within 78 h.


Extra physical therapy reduces patient length of stay and improves functional outcomes and quality of life in people with acute or subacute conditions: a systematic review.
To investigate whether extra physical therapy intervention reduces length of stay and improves patient outcomes in people with acute or subacute conditions. Electronic databases CINAHL, MEDLINE, AMED, PEDro, PubMed, and EMBASE were searched from the earliest date possible through May 2010. Additional trials were identified by scanning reference lists and citation tracking. Randomized controlled trials evaluating the effect of extra physical therapy on patient outcomes were included for review. Two reviewers independently applied the inclusion and exclusion criteria, and any disagreements were discussed until consensus could be reached. Searching identified 2826 potentially relevant articles, of which 16 randomized controlled trials with 1699 participants met inclusion criteria. Data were extracted using a predefined data extraction form by 1 reviewer and checked for accuracy by another. Methodological quality of trials was assessed independently by 2 reviewers using the PEDro scale. Pooled analyses with random effects model to calculate standardized mean differences (SMDs) and 95% confidence intervals (CIs) were used in meta-analyses. When compared with standard physical therapy, extra physical therapy reduced length of stay (SMD=-.22; 95% CI, -.39 to -.05) (mean difference of 1d [95% CI, 0-1] in acute settings and mean difference of 4d [95% CI, 0-7] in rehabilitation settings) and improved mobility (SMD=.37; 95% CI, .05-.69), activity (SMD=.22; 95% CI, .07-.37), and quality of life (SMD=.48; 95% CI, .29-.68). There were no significant changes in self-care (SMD=.35; 95% CI, -.06-.77). Extra physical therapy decreases length of stay and significantly improves mobility, activity, and quality of life. Future research could address the possible benefits of providing extra services from other allied health disciplines in addition to physical therapy.


Patient safety incident framework will ensure affected staff are not overlooked.
Sam Foster, Chief Nurse, Oxford University Hospitals, considers the term 'second victim', which is used to describe staff who are affected psychologically and emotionally in the aftermath of an incident.


Coupled Electronic and Nuclear Motions during Azobenzene Photoisomerization Monitored by Ultrafast Electron Diffraction.
Ultrafast electron diffraction is a powerful technique that can resolve molecular structures with femtosecond and angstrom resolutions. We demonstrate theoretically how it can be used to monitor conical intersection dynamics in molecules. Specific contributions to the signal are identified which vanish in the absence of vibronic coherence and offer a direct window into conical intersection paths. A special focus is on hybrid scattering from nuclei and electrons, a process that is unique to electron (rather than X-ray) diffraction and monitors the strongly coupled nuclear and electronic motions in the vicinity of conical intersections. An application is made to the cis to trans isomerization of azobenzene, computed with exact quantum dynamics wavepacket propagation in a reactive two-dimensional nuclear space.


The evidence for pharmacological treatment of neuropathic pain.
Randomized, double-blind, placebo-controlled trials on neuropathic pain treatment are accumulating, so an updated review of the available evidence is needed. Studies were identified using MEDLINE and EMBASE searches. Numbers needed to treat (NNT) and numbers needed to harm (NNH) values were used to compare the efficacy and safety of different treatments for a number of neuropathic pain conditions. One hundred and seventy-four studies were included, representing a 66% increase in published randomized, placebo-controlled trials in the last 5 years. Painful poly-neuropathy (most often due to diabetes) was examined in 69 studies, postherpetic neuralgia in 23, while peripheral nerve injury, central pain, HIV neuropathy, and trigeminal neuralgia were less often studied. Tricyclic antidepressants, serotonin noradrenaline reuptake inhibitors, the anticonvulsants gabapentin and pregabalin, and opioids are the drug classes for which there is the best evidence for a clinical relevant effect. Despite a 66% increase in published trials only a limited improvement of neuropathic pain treatment has been obtained. A large proportion of neuropathic pain patients are left with insufficient pain relief. This fact calls for other treatment options to target chronic neuropathic pain. Large-scale drug trials that aim to identify possible subgroups of patients who are likely to respond to specific drugs are needed to test the hypothesis that a mechanism-based classification may help improve treatment of the individual patients.


Insulin-like growth factor-binding protein-1 modulates blood glucose levels.
We have determined the consequences of insulin-like growth factor-binding protein-1 (IGFBP-1) administration alone and in combination with insulin-like growth factor-I (IGF-I). Human recombinant IGF-I, infused as a bolus into male Wistar rats, induced a fall in plasma glucose to 72 +/- 3% of baseline 15 min after injection. Co-infusion of equimolar concentrations of human IGFBP-1 abolished the IGF-I-induced fall (P less than 0.001). Injection of IGFBP-1 alone caused a rise in plasma glucose levels (P less than 0.002). The half life of human IGFBP-1, measured using a primate-specific RIA, was 12.5 +/- 0.7 min and was not influenced by the co-infusion of IGF-I. This study demonstrates that, in the rat, human IGFBP-1 blocks the hypoglycemic response to intravenous IGF-I and increases blood glucose levels when administered alone. Since IGFBP-1 concentrations are dependent on metabolic status, we suggest that fluctuating IGFBP-1 levels might modulate the hypoglycemic activity of unbound IGFs in the circulation.


Central venous disease in hemodialysis patients: prevalence, etiology and treatment.
A common problem in the management of hemodialysis patients is central venous occlusive disease. There has been extensive literature on the treatment of this important and prevalent problem. Treatment options to date include percutaneous balloon angioplasty, bare metal stents and surgical bypass. Unfortunately, all the available treatment options have poor long-term patency, requiring repetitive intervention. More recently, covered stents have been mentioned in the literature for the treatment of central venous stenosis and obstruction. There is very little data to date on this technology, and further randomized controlled trials will be needed to compare the efficacy of percutaneous balloon angioplasty, bare metal stents and covered stents. It appears prevention of this difficult problem is paramount, by limiting venous access or intervention of the central venous system.


Integration of metabolic databases for the reconstruction of genome-scale metabolic networks.
Genome-scale metabolic reconstructions have been recognised as a valuable tool for a variety of applications ranging from metabolic engineering to evolutionary studies. However, the reconstruction of such networks remains an arduous process requiring a high level of human intervention. This process is further complicated by occurrences of missing or conflicting information and the absence of common annotation standards between different data sources. In this article, we report a semi-automated methodology aimed at streamlining the process of metabolic network reconstruction by enabling the integration of different genome-wide databases of metabolic reactions. We present results obtained by applying this methodology to the metabolic network of the plant Arabidopsis thaliana. A systematic comparison of compounds and reactions between two genome-wide databases allowed us to obtain a high-quality core consensus reconstruction, which was validated for stoichiometric consistency. A lower level of consensus led to a larger reconstruction, which has a lower quality standard but provides a baseline for further manual curation. This semi-automated methodology may be applied to other organisms and help to streamline the process of genome-scale network reconstruction in order to accelerate the transfer of such models to applications.


Levels of neonatal care.
The concept of designations for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. Subsequent diversity in the definitions and application of levels of care has complicated facility-based evaluation of clinical outcomes, resource allocation and utilization, and service delivery. We review data supporting the need for uniform nationally applicable definitions and the clinical basis for a proposed classification based on complexity of care. Facilities that provide hospital care for newborn infants should be classified on the basis of functional capabilities, and these facilities should be organized within a regionalized system of perinatal care.


Circulating DHEA-S levels and major cardiovascular outcomes in chronic Chagas cardiomyopathy: A prospective cohort study.
To analyze the association of circulating dehydroepiandrosterone sulfate (DHEA-S) levels with cardiovascular outcomes in patients with chronic Chagas cardiomyopathy (CCM) diagnosis. DHEA-S is among the main endogenous steroid hormones. Some studies have suggested a relevant role of this hormone in infections and the setting of CCM. Nevertheless, no study has evaluated the prognostic role of DHEA-S in CCM patients. Prospective cohort study. Patients with CCM and reduced ejection fraction were included. We explored the association of DHEA-S levels with NT-proBNP levels and echocardiographic variables using linear regression models. Next, by using Cox Proportional Hazard models, we examined whether levels of DHEA-S could predict a composite outcome (CO) including all-cause mortality, cardiac transplantation, and implantation of a left ventricular assist device (LVAD). Seventy-four patients were included (59% males, median age: 64 years). After adjustment for confounding factors, high DHEA-S levels were associated with better LVEF, lower left atrium volume, end-systolic volume of the left ventricle and lower NT-proBNP levels. 43% of patients experienced the CO during a median follow-up of 40 months. Increased levels of DHEA-S were associated with a lower risk of developing the CO (HR 0.43; 95%CI 0.21-0.86). Finally, adding DHEA-S to the multivariate model did not improve the prediction of the CO, but substituting NT-proBNP in the model with DHEA-S showed similar performance. In patients with CCM, higher DHEA-S levels were associated with lower mortality, heart transplantation, and LVAD implantation. Further larger studies are required to confirm our results and assess causality.


Elevated norharman plasma levels in alcoholic patients and controls resulting from tobacco smoking.
Plasma norharman and harman levels were measured by solvent extraction and HPLC with fluorescence detection in alcohol-dependent patients undergoing in-patient abstinence treatment and in control subjects. In both groups, randomly collected samples from smokers contained higher mean norharman levels than those from non-smokers. In three volunteers norharman concentrations rose sharply after smoking of one or two cigarettes and declined to near-basal levels within one hour after one cigarette. When 12 patients kept a smoking-free interval of at least 6 h, they had similarly low plasma norharman concentrations (20 +/- 8 pg/ml) as 18 non-smoking control subjects (17 +/- 8 pg/ml) or as 13 smoking controls who had abstained from smoking (20 +/- 6 pg/ml). Ten of the patients smoked one cigarette and within 5-10 min attained norharman levels of 177 +/- 147 pg/ml plasma. The high prevalence of smokers among chronic alcoholics probably explains the previous finding of elevated norharman plasma levels in these patients.


Analysis of Gene Expression in Experimental Pressure Ulcers in the Rat with Special Reference to Inflammatory Cytokines.
Pressure ulcers have been investigated in a few animal models, but the molecular mechanisms of pressure ulcers are not well understood. We hypothesized that pressure results in up-regulation of inflammatory cytokines and those cytokines contribute to the formation of pressure ulcers. We measured genome-wide changes in transcript levels after compression, and focused especially on inflammatory cytokines. The abdominal wall of rats was compressed at 100 mmHg for 4 hours by two magnets. Specimens were obtained 12 hours, 1, or 3 days after compression, and analyzed by light microscopy, microarray, Real-Time PCR, and ELISA. The skin and subcutaneous tissue in the compressed area were markedly thickened. The microarray showed that numerous genes were up-regulated after the compression. Up-regulated genes were involved in apoptosis, inflammation, oxidative stress, proteolysis, hypoxia, and so on. Real-Time PCR showed the up-regulation of granulocyte-macrophage colony stimulating factor (GM-CSF), interferon γ (IFN-γ), interleukin 1β (IL-1β), interleukin 1 receptor antagonist gene (IL1Ra), interleukin 6 (IL-6), interleukin 10 (IL-10), matrix metalloproteinase 3 (MMP-3), tissue inhibitor of metalloproteinase 1 (TIMP-1), and tumor necrosis factor α (TNF-α) at 12 hours, IFN-γ, IL-6, IL-10, MMP-3, and TIMP-1 at 1 day, and IFN-γ, IL-6, and MMP-3 at 3 days. Some genes from subcutaneous tissue were up-regulated temporarily, and others were kept at high levels of expression. ELISA data showed that the concentrations of IL-1β and IL-6 proteins were most notably increased following compression. Prolonged up-regulation of IL-1β, and IL-6 might enhance local inflammation, and continuous local inflammation may contribute to the pressure ulcer formation. In addition, GM-CSF, IFN-γ, MMP-3, and TIMP-1 were not reported previously in the wound healing process, and those genes may have a role in development of the pressure ulcers. Expression data from Real-Time PCR were generally in good agreement with those of the microarray. Our microarray data were useful for identifying genes involved in pressure ulcer formation. However, the expression levels of the genes didn't necessarily correspond with protein production. As such, the functions of these cytokines need to be further investigated.


[Hygienic, chemical and ecotoxicological aspects of the disinfection of biologically treated waste water by ozone and UV light].
Biologically treated waste water from two different municipal treatment plants with mainly domestic waste water on the one hand and industrial influenced waste water on the other hand was disinfected by UV-irradiation and ozonation. Hygienic, chemical and eco-toxic effects of the disinfection step were examined. It was found that by ozonation as well as by UV-irradiation the required guide and imperative values for fecal and total coliform bacteria were fulfilled. The UV-irradiation induces no changes concerning chemical waste water quality and toxic effects. In contrast to these results ozonation can lead to alterations in chemistry and toxicity depending on the waste water composition.


[Comorbidity of substance use with mental disorders].
This contribution reviews the international literature about dual diagnosis, meaning patients who have simultaneously mental health problems and substance use disorders and discusses epidemiology, clinical characteristics, but primarily etiopathogenesis and different treatment models and interventions. The epidemiological data coming from large-scale studies in the general population in USA, Australia and UK demonstrate the close relationship between mental health problems and substance use disorders. Also, the results from Greek research projects support this close relationship, but their research designs have significant limitations. Multiple and high risks are common in this population, like violent or suicidal behavior, self-harm, physical problems, while they appear less responsive to treatment. Subsequently, different models for etiopathogenesis of dual diagnosis have been suggested: (a) Causal relationship: secondary substance use disorder is subsequent of primary mental illness (self-medication hypothesis, supersenstivity model) or vice versa (alcohol, cannabis, and cocaine use trigger or contribute to development of mental illness). (b) Third factor as the cause of both mental and substance use disorders (genetic factor, neuropathology, traumatic experience, personality characteristics, multiple factors). (c) Comorbidty is due to chance. (d) Each disorder mutually exacerbates the other, regardless the cause. Here, the relationship between alcohol and depression is discussed further as example. The ideas and the research-evidence which support each of these models are presented. Also there is an overview of different treatment models: (a) Consecutive treatment: mental health treatment and substance misuse treatment are provided consecutively. (b) Parallel treatments: the patient attends programs of both mental health and substance use services simultaneously. (c) Integrated treatment: the same clinical team addresses both mental health issues and substance use disorders. The first two models have significant weaknesses due to lack of focus on the interaction of the different disorders or to administrative and managerial barriers. On the other hand, integrated programs appear to overcome these limitations. They use modified interventions provided by the same team in order to address the multiple needs of the patients. Different types of integrated programs are discussed. More pragmatist inter ventions should also be taken into consideration. It is expected that some direction for research and clinical practice to Greece will emerge from this contribution.


In vitro evaluation of human muscle satellite cell migration prior to fusion into myotubes.
We developed a short-time assay to evaluate muscle satellite cell migration, based on the fact that during myogenic differentiation, myoblasts migrate preferentially towards high cellular density areas where myotubes would form. This assay consists of a computer-assisted count of cells within a randomly chosen field, performed every hour for eight hours, and compared with the cell number at the start time of the experiment. Nine primary myoblast cultures were tested in triplicate. The method relies on several requisites. (1) Negligible cell proliferation: cell division was nearly absent in 8 h experiments. (2) Directional cell movement: a major flow of cells, either entering or exiting the fields, was constantly observed. 'Counter-flows', detected by visual counting, involved minor percentages of cells. (3) Constant migration rate: a linear increase in cell count variations over 8 h and a very high degree of intra-assay homogeneity were observed. Individual primary cell culture characteristics (depending on characteristics of the different donors) were the sole factor with a significant impact on migration rate. Automatic cell counting conveniently assessed the inhibitory effect of GRGDTP, an inhibitor of integrin-mediated cell adhesion. The method described here is rapid, does not require heavy equipment, and allows studies under serum-free conditions required to test molecules interfering with cell migration, in the course of the in vitro myogenic process.


Accumulation of heat shock proteins in field-grown cotton.
Cotton (Gossypium hirsutum L.) plants grown under field water deficits exhibited an 80 to 85% reduction in leaf area index, plant height, and dry matter accumulation compared with irrigated controls. Midday photosynthetic rates of dryland plants decreased 2-fold, and canopy temperatures increased to 40 degrees C at 80 days after planting compared with canopy temperatures of 30 degrees C for irrigated plants. Leaves from dryland plants which had exhibited canopy temperatures of 40 degrees C for several weeks accumulated stainable levels of polypeptides with apparent molecular weights of 100, 94, 89, 75, 60, 58, 37, and 21 kilodaltons. These polypeptides did not accumulate in leaves from irrigated plants.Addition of [(35)S]methionine to leaves of growth chamber-grown cotton plants and subsequent incubation at 40 degrees C for 3 hours radiolabeled polypeptides with molecular weights similar to those that accumulate in dryland cotton leaves. These data suggest that the proteins which accumulate in water-stressed cotton leaves at elevated temperatures (40 degrees C) are heat shock proteins and that these proteins can accumulate to substantial levels in field-stressed plants.


Mechanics model for actin-based motility.
We present here a mechanics model for the force generation by actin polymerization. The possible adhesions between the actin filaments and the load surface, as well as the nucleation and capping of filament tips, are included in this model on top of the well-known elastic Brownian ratchet formulation. A closed form solution is provided from which the force-velocity relationship, summarizing the mechanics of polymerization, can be drawn. Model predictions on the velocity of moving beads driven by actin polymerization are consistent with experiment observations. This model also seems capable of explaining the enhanced actin-based motility of Listeria monocytogenes and beads by the presence of Vasodilator-stimulated phosphoprotein, as observed in recent experiments.


The influence of whole-body vs. torso pre-cooling on physiological strain and performance of high-intensity exercise in the heat.
Little research has been reported examining the effects of pre-cooling on high-intensity exercise performance, particularly when combined with strategies to keep the working muscle warm. This study used nine active males to determine the effects of pre-cooling the torso and thighs (LC), pre-cooling the torso (ice-vest in 3 degrees C air) while keeping the thighs warm (LW), or no cooling (CON: 31 degrees C air), on physiological strain and high-intensity (45-s) exercise performance (33 degrees C, 60% rh). Furthermore, we sought to determine whether performance after pre-cooling was influenced by a short exercise warm-up. The 45-s test was performed at different (P<0.05) mean core temperature [(rectal+oesophageal)/2] [CON: 37.3+/-0.3 (S.D.), LW: 37.1+/-0.3, LC: 36.8+/-0.4 degrees C] and mean skin temperature (CON: 34.6+/-0.6, LW: 29.0+/-1.0, LC: 27.2+/-1.2 degrees C) between all conditions. Forearm blood flow prior to exercise was also lower in LC (3.1+/-2.0 ml 100 ml tissue(-1) x min(-1)) than CON (8.2+/-2.5, P=0.01) but not LW (4.3+/-2.6, P=0.46). After an exercise warm-up, muscle temperature (Tm) was not significantly different between conditions (CON: 37.3+/-1.5, LW: 37.3+/-1.2, LC: 36.6+/-0.7 degrees C, P=0.16) but when warm-up was excluded, T(m) was lower in LC (34.5+/-1.9 degrees C, P=0.02) than in CON (37.3+/-1.0) and LW (37.1+/-0.9). Even when a warm-up was performed, torso+thigh pre-cooling decreased both peak (-3.4+/-3.8%, P=0.04) and mean power output (-4.1+/-3.8%, P=0.01) relative to the control, but this effect was markedly larger when warm-up was excluded (peak power -7.7+/-2.5%, P=0.01; mean power -7.6+/-1.2%, P=0.01). Torso-only pre-cooling did not reduce peak or mean power, either with or without warm-up. These data indicate that pre-cooling does not improve 45-s high-intensity exercise performance, and can impair performance if the working muscles are cooled. A short exercise warm-up largely removes any detrimental effects of a cold muscle on performance by increasing Tm.


Record keeping and nurse prescribing: an issue of concern?
As options are explored by the NHS Executive to extend nurse prescribing in terms of expanding the Nurse Prescribers' Formulary and widening the groups of nurses eligible to train to prescribe, issues surrounding record keeping in the community need to be revisited in order to safeguard professional integrity. Prescribing nurses in the community face barriers to accurate and adequate record keeping when access to all patients' records is not permitted and/or time constraints and extra travelling impede the process, potentially threatening the safety of the patient. Until information technology provides the answer to safe and effective use of shared patient records, nurses who prescribe any treatments need to ensure they share full access to all patients' notes.


A randomized controlled trial of emergency LCBDE + LC and ERCP + LC in the treatment of choledocholithiasis with acute cholangitis.
Emergency biliary drainage is the basic treatment for acute cholangitis caused by choledocholithiasis. To compare the effectiveness and safety of emergency laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy (LCBDE + LC) and endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy (ERCP + LC) for the treatment of choledocholithiasis combined with grade I or II acute cholangitis. A total of 80 patients were enrolled in the study, with 40 cases in each group. A prospective randomized controlled study method was adopted, and the eligible patients were randomly divided into two groups in a ratio of 1 : 1 and treated with emergency LCBDE + LC and ERCP + LC, respectively. The relevant clinical data of the two groups were compared. The operation duration was longer and blood loss was greater in the LCBDE + LC group than in the ERCP + LC group, but the therapeutic cost was significantly lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). There was no severe complication in either group. The total number of cases with complications, incidence of postoperative acute pancreatitis and incidence of hemorrhage were higher in the ERCP + LC group than in the LCBDE + LC group, while the incidence of bile leakage was lower in the former than in the latter. The differences were statistically significant (p < 0.05 in all). Both protocols were safe and feasible in the management of grade I or II acute calculous cholangitis. Compared with the protocol of ERCP + LC, the protocol of LCBDE + LC had the advantages of fewer complications and lower therapeutic costs and is worthy of clinical promotion.


A Sensitive Visible Light Photodetector Using Cobalt-Doped Zinc Ferrite Oxide Thin Films.
In this study, a highly sensitive trilayer photodetector using Co-doped ZnFe2O4 thin films annealed at 400 °C was synthesized successfully. Trilayer-photodetector devices with a film stack of 5 at % Co-doped-zinc-ferrite-thin-film/indium-tin-oxide on p+-Si substrates were fabricated by radio-frequency sputtering. The absorbance spectra, photoluminescence spectra, transmission electron microscopy images, and I-V characteristics under various conditions were comprehensively investigated. The outstanding performance of trilayer-photodector devices was measured, including a high photosensitivity of 181 and a fast photoresponse time with a rise time of 10.6 ms and fall time of 9.9 ms under 630 nm illumination. Therefore, the Co-doped ZnFe2O4 thin film is favorable for potential photodetector applications in visible light regions.


Craniomandibular status and function in patients with habitual snoring and obstructive sleep apnoea after nocturnal treatment with a mandibular advancement splint: a 2-year follow-up.
The aim of the investigation was to evaluate the status and function of the temporomandibular joint (TMJ) and masticatory system in patients with habitual snoring and obstructive apnoea after 2 years nocturnal treatment with a mandibular advancement splint. Thirty-two patients participated in the study, ranging from 43.0 to 79.8 years of age (mean 54.4 years, SD 8.78) at the start of treatment. All patients had been referred from the ENT department for treatment with a mandibular advancement splint. The acrylic splint advanced the mandible 50-70 per cent of maximal protrusion, opened 5 mm vertically, and was used 6-8 hours per night and 5-7 nights per week. Overjet, overbite, and molar relationship were measured on dental casts. The patients were asked to answer a questionnaire concerning symptoms of craniomandibular dysfunction (CMD). They were also clinically examined in a standardized manner, including registration of range of mandibular movements, TMJ sounds, pain on movement, and palpatory tenderness of the TMJ and the masticatory muscles. None of the patients showed more than five symptoms of dysfunction either at the start of or after 2 years of treatment. A decrease in the frequency of headache was found for nine of those 18 patients that reported headache (P = 0.004). A minor, but significant decrease in overjet and overbite was found and the molar relationship was also changed. It was concluded that 2 years' treatment with a mandibular advancement splint had no adverse effects on the craniomandibular status and function, but the observed occlusal changes requires further evaluation.


[Noninvasive coronary artery imaging: CT and MR].
The advent of helical multidetector CT has significantly modified several traditional clinical approaches to cardiovascular diagnosis. The current availability of rapid image acquisition has provided the basis for investigating direct imaging in real time of cardiac structures using CT. Application of thin-section submillimetric image acquisitions to three-dimensional (3D) reconstruction algorithms produces 3D data sets from which images of the coronary arteries may be obtained in any anatomic plane. The advantage of the submillimetric isotropic spatial resolution is partly offset by reduced temporal resolution as well as reduced contrast resolution compared to MRI. This lack in contrast sensitivity prevents accurate perfusion imaging and restricts the clinical use to coronary artery imaging. Moreover, the large amount of iodinated contrast medium injected has potential nephrotoxic effects, which can be deleterious if coronary artery angiography must to be performed. On the other hand, MRI has less spatial resolution, and acquisitions must be performed in the plane of each coronary artery because of reduced volume coverage. Both techniques play a role in the non-invasive assessment of coronary artery disease, by providing complementary information already useful in a growing number of clinical situations.


Cerebrospinal fluid biomarkers in Parkinson's disease with freezing of gait: an exploratory analysis.
We explore the association between three Alzheimer's disease-related and ten inflammation-related CSF markers and freezing of gait (FOG) in patients with Parkinson's disease (PD). The study population includes PD patients with FOG (PD-FOG, N = 12), without FOG (PD-NoFOG, N = 19), and healthy controls (HC, N = 12). Age and PD duration are not significantly different between groups. After adjusting for covariates and multiple comparisons, the anti-inflammatory marker, fractalkine, is significantly decreased in the PD groups compared to HC (P = 0.002), and further decreased in PD-FOG compared to PD-NoFOG (P = 0.007). The Alzheimer's disease-related protein, Aβ42, is increased in PD-FOG compared to PD-NoFOG and HC (P = 0.001). Group differences obtained in individual biomarker analyses are confirmed with multivariate discriminant partial least squares regression (P < 0.001). High levels of Aβ42 in PD-FOG patients supports an increase over time from early to advanced state. Low levels of fractalkine might suggest anti-inflammatory effect. These findings warrant replication.


[Urinary infection in patients with neurogenic bladder: patterns of resistance to the most frequent uropathogens].
To analyze the most frequent causes and resistances of the uropathogens in patients affected by neurogenic bladder. A total of 284 patients, in whom a total of 284 urinary cultures were performed, were included. Of these, 106 came from patients with neurological injuries, 28 from a non-neurogenic control group, 75 from patients admitted to the intensive care unit (ICU) of our Hospital and 75 patients who came into the emergency room with the symptoms of an acute urinary tract infection. A quantitative urine culture was performed in a chromogenic media and the resistances of all urine cultures that were positive for one or two micro-organisms were identified and studied. A total of 67% of the patients with neurological injuries had positive urine cultures compared to 25% of control group patients. The urine cultures of patients admitted into the ICU and those of the Emergency Room group were 100% positive, since the first 75 positive urine cultures were selected for the study. E.coli was the most-frequently microorganism isolated in the group of neurological patients, as well as among the patients from the Emergency Room and from the control group. In the ICU, the most-frequently isolated micro-organism was Enterococcus spp. (19.4%), followed by P. aeruginosa (16.5%). The study of resistances in general E. coli has high rates of resistance to ampicillin and co-trimoxazole and, although to a lesser degree to ciprofloxacin. E. coli is the micro-organism most frequently isolated among all of the groups except in the ICU, where it is surpassed by Enterococcus spp. and P. aeruginosa. The resistances among the four population groups studied have different features, overall showing a low rate of resistance to nitrofurantoin and especially to fosfomycin, observed in patients from the Emergency Room or admitted to the ICU and neurological patients.


Haem oxygenase delays programmed cell death in wheat aleurone layers by modulation of hydrogen peroxide metabolism.
Haem oxygenase-1 (HO-1) confers protection against a variety of oxidant-induced cell and tissue injury in animals and plants. In this report, it is confirmed that programmed cell death (PCD) in wheat aleurone layers is stimulated by GA and prevented by ABA. Meanwhile, HO activity and HO-1 protein expression exhibited lower levels in GA-treated layers, whereas the hydrogen peroxide (H(2)O(2)) content was apparently increased. The pharmacology approach illustrated that scavenging or accumulating H(2)O(2) either delayed or accelerated GA-induced PCD. Furthermore, pretreatment with the HO-1 specific inhibitor, zinc protoporphyrin IX (ZnPPIX), before exposure to GA, not only decreased HO activity but also accelerated GA-induced PCD significantly. The application of the HO-1 inducer, haematin, and the enzymatic reaction product of HO, carbon monoxide (CO) aqueous solution, both of which brought about a noticeable induction of HO expression, substantially prevented GA-induced PCD. These effects were reversed when ZnPPIX was added, suggesting that HO in vivo played a role in delaying PCD. Meanwhile, catalase (CAT) and ascorbate peroxidase (APX) activities or transcripts were enhanced by haematin, CO, or bilirubin (BR), the catalytic by-product of HO. This enhancement resulted in a decrease in H(2)O(2) production and a delay in PCD. In addition, the antioxidants butylated hydroxytoluene (BHT), dithiothreitol (DTT), and ascorbic acid (AsA) were able not only to delay PCD but also to mimic the effects of haematin and CO on HO up-regulation. Overall, the above results suggested that up-regulation of HO expression delays PCD through the down-regulation of H(2)O(2) production.


Concanavalin A Induces Cortical Neuron Apoptosis by Causing ROS Accumulation and Tyrosine Kinase Activation.
The lectin, concanavalin A (Con A), is the most extensively investigated member of the lectin family of plant proteins, but its effects on cortical neurons and astrocytes are poorly understood. In cultured cortical neurons and astrocytes, Con A exhibited dose-dependent neurotoxicity, but this was not observed in astrocytes. Similarly, in the cortical areas of rat brains, intracranial administration of Con A caused neuronal but no astrocyte damage. Methyl-α-D-mannopyranoside, a competitor of Con A, blocked Con A-induced cell death, whereas AMPA/KA receptor antagonists showed partial blocking effects. Furthermore, the mRNA levels of TNF-α, IL-1β, and IL-6 were elevated in astrocytes and cortical neurons treated with Con A. Intracellular reactive oxygen species (ROS) levels were increased in Con A-treated cortical neurons, and N-acetyl-cysteine (NAC, an antioxidant) and diphenyleneiodonium (DPI, a NADPH oxidase inhibitor) reduced intracellular ROS accumulation. Likewise, AG556 (a TNF-α inhibitor) and AG82 (a tyrosine kinase inhibitor) both reduced Con A-induced intracellular ROS accumulation. Furthermore, Con A-induced tyrosine phosphorylation was decreased by NAC and by AG556. Taken together, Con A-induced apoptosis in cortical neurons occurred as a sequel to Con A binding to neuronal glycoproteins and intracellular ROS accumulation. Interestingly, Con A-induced cellular damage was observed in cortical neurons but not in astrocytes or microglia.


Plant effects on and response to soil microbes in native and non-native Phragmites australis.
Plant-soil feedbacks (PSFs) mediate plant community dynamics and may plausibly facilitate plant invasions. Microbially mediated PSFs are defined by plant effects on soil microbes and subsequent changes in plant performance (responses), both positive and negative. For microbial interactions to benefit invasive plants disproportionately, native and invasive plants must either (1) have different effects on and responses to soil microbial communities or (2) only respond differently to similar microbial communities. In other words, invasive plants do not need to cultivate different microbial communities than natives if they respond differently to them. However, effects and responses are not often explored separately, making it difficult to determine the underlying causes of performance differences. We performed a reciprocal-transplant PSF experiment with multiple microbial inhibition treatments to determine how native and non-native lineages of Phragmites australis affect and respond to soil bacteria, fungi, and oomycetes. Non-native Phragmites is a large, fast-growing, cosmopolitan invasive plant, whereas the North American native variety is comparatively smaller, slower growing, and typically considered a desirable wetland plant. We identified the effects of each plant lineage on soil microbes using DNA meta-barcoding and linked plant responses to microbial communities. Both Phragmites lineages displayed equally weak, insignificant PSFs. We found evidence of slight differential effects on microbial community composition, but no significant differential plant responses. Soils conditioned by each lineage differed only slightly in bacterial community composition, but not in fungal composition. Additionally, native and non-native Phragmites lineages did not significantly differ in their response to similar soil microbial communities. Neither lineage appreciably differed when plant biomass was compared between those grown in sterile and live soils. Targeted microbial inhibitor treatments revealed both lineages were negatively impacted by soil bacteria, but the negative response was stronger in non-native Phragmites. These observations were opposite of expectations from invasion theory and imply that the success of non-native Phragmites, relative to the native lineage, does not result from its interaction with soil microorganisms. More broadly, quantifying plant effects on, and responses to soil microbes separately provides detailed and nuanced insight into plant-microbial interactions and their role in invasions, which could inform management outcomes for invasive plants.


Comparative evaluation of clinical efficacy of gallium and amalgam alloys in primary molars.
The present study was conducted to compare the clinical efficacy (marginal integrity and bulk fracture) of two alloys--Galloy (gallium based) and Aristaloy (amalgam based) in primary molars. 90 primary molars with initial caries formation were selected. 45 were restored with Galloy and 45 with Aristaloy in Class I and II preparations. They were evaluated at two-month intervals for 6 months. The results showed that Galloy performed at par with Aristaloy with regards to marginal integrity and bulk fracture. Hence Galloy can be considered as an interesting substitute in Pedodontic practice.


Purification and characterization of aspartate aminotransferase isoenzymes from carrot suspension cultures.
Three aspartate aminotransferase isoenzymes were identified from extracts of carrot (Daucus carota L.) cell suspension cultures. These isoenzymes were separated by DEAE chromatography and were analyzed on native gradient polyacrylamide gels. The relative molecular weights of the isoenzymes were 111,000 +/- 5000, 105,000 +/- 5000, and 94,000 +/- 4000 daltons; they were designated forms I, II, and III, respectively. Form I, the predominant form, has been purified to apparent homogeneity (>300-fold) using immunoaffinity chromatography with rabbit anti-pig AAT antibodies. Form I has a subunit size of 43,000 M(r), as determined on sodium dodecyl sulfate polyacrylamide gel electrophoresis. Isoelectric focusing (IEF)-PAGE has resolved three bands at a pl of approximately 5.2. Form I may be composed of subunits of similar molecular weight and different charges, and the three bands with AAT activity on the IEF-PAGE gel are a combination of hetero- and homodimers. Form I has a broad pH optimum of 7.5 to 10.0. K(m) values of 23.6, 2.8, 0.05, and 0.22 millimolar were obtained for glutamate, aspartate, oxaloacetate, and alpha-ketoglutarate, respectively. The mode of action is a ping-pong-bi-bi mechanism.


Prevalence and factors associated with anaemia in children aged 6-24 months living a high malaria transmission setting in Burundi.
In very young children, anaemia has been linked to increased morbidity, mortality and poor cognitive development. Although Burundi has a high burden of anaemia, which may be worsened by the high burden of malaria, little is known about the extent of the problem in very young children who are most at risk of severe disease. We estimated the prevalence, and assessed the factors associated with anaemia in children aged 6-24 months using baseline data collected as part of an on-going study evaluating the effect of Micronutrient supplementation on anaemia and cognition among children in high malaria transmission settings in Burundi. Between February and March 2020, surveys were conducted in 498 households within the catchment area of Mukenke Health Center. One child aged 6-24 months was selected per household to participate in the survey. Following written informed consent, we administered a questionnaire to the child's primary caregiver to capture information on child's demographics, nutritional status, food intake, health (status, and morbidity and treatment-seeking practices), as well as the household markers of wealth. A physical exam was conducted, and a blood sample was collected to: 1) assess for presence of plasmodium infection using a rapid diagnosis test; 2) estimate the haemoglobin levels using a portable haemocue machine. A stool sample was also collected to examine for the presence of helminth infections. The prevalence of anaemia was 74.3% (95% confidence interval [CI] 61.5%-84.0%), with most of the anaemic study participants classified as having moderate anaemia (59.2%). A total of 62 (12.5%) participants had positive malaria rapid diagnosis tests. Factors significantly associated with higher odds of developing anaemia included not receiving deworming medication (adjusted Odd ratio [aOR] = 3.54, 95% CI 1.79-6.99, p<0.001), the child's home location (Mukenke II: aOR = 2.22, 95% CI 1.89-2.62, p<0.001; Mukenke: aOR = 2.76, 95% CI 2.46-3.10, p<0.001 and Budahunga: aOR = 3.12, 95% CI 2. 94-3.31, p<0.001) and the child's age group (Children aged 6-11 months: aOR = 2.27, 95% CI 1.32-3.91, p<0.001). Education level was inversely associated with less odds of anaemia: child's primary care giver with a secondary (aOR = 0.67; 95% CI: 0.47-0.95, p = 0,024) and tertiary education level (aOR = 0.48; 95% CI: 0.38-0.61, p<0.001). Anaemia is highly prevalent among young children in high malaria transmission setting. Anaemia is more prevalent among children who not dewormed and those with malaria. To prevent the long-term adverse outcomes of the anaemia in children, policy makers should focus on improving uptake of the deworming and malaria prevention programs, promote preventive interventions and improve the education of women especially in families with very young children.


Obturator prosthesis for hemimaxillectomy patients.
Rehabilitation of hemimaxillectomy patients can be challenging. The most common problem with prosthetic treatment in such patients is in getting adequate retention, stability, and support. The size and location of the defect usually influences the amount of impairment and difficulty in prosthetic rehabilitation. The obturator prosthesis is commonly used as an effective means for rehabilitating hemimaxillectomy cases. In cases of large maxillary defects, movement of the obturator prosthesis is inevitable and requires a form of indirect retention to limit the rotation of the prosthesis. The goal of prosthodontics is rehabilitation of missing oral and extraoral structures along with restoration of the normal functions of mastication, speech, swallowing, appearance, and so on. Malignancies are common in the oral region, which are treated through surgical intervention. Surgical intervention creates communication between the oral cavity, nasal cavity, and maxillary sinus. In such cases, it is very difficult for the patient to perform various normal functions like mastication, swallowing, speaking, and so on. Prosthodontic rehabilitation with obturator prosthesis restores the missing structures and acts as a barrier between the communication among the various cavities.


Cytogenetic analysis of human bile for mutagenicity and co-mutagenicity.
Cytogenetic analysis was used to test whether or not human bile induced chromosome abnormalities in lymphocytes grown in culture. Bile was obtained from gallbladders resected for various reasons such as cholecystitis, cholelithiasis, polypus and cancers of the biliary tract, stomach and pancreas. After adding human bile to a final concentration of 25 microliters/ml or 12.5 microliters/ml, the culture medium was incubated at 37 degrees C for 72 hr. Air-dried slides were stained with conventional Giemsa and the numerical and structural chromosome abnormalities were scored. Positive and negative controls in terms of chromosome abnormalities were established by using 0.03 micrograms/ml mitomycin C (MMC) and 0.9% normal saline, respectively. Cytogenetic analysis was successfully performed in 6 out of 10 bile samples (60.0%). Bile alone did not induce numerical or structural chromosome abnormalities. Structural abnormalities increased significantly in the 25 microliters/ml bile + 0.03 micrograms/ml MMC group, compared with the 0.03 micrograms/ml MMC group: 36.0% vs. 20.7% in the chromatid-type gaps and breaks, 27.8% vs. 22.7% in the chromosome-type gaps and breaks, and 8.3% vs. 3.2% in the exchange-type abnormalities. It is likely that the interaction between bile and MMC is synergistic rather than additive.


[Research on electrocardiogram classification using deep residual network with pyramid convolution structure].
Recently, deep neural networks (DNNs) have been widely used in the field of electrocardiogram (ECG) signal classification, but the previous models have limited ability to extract features from raw ECG data. In this paper, a deep residual network model based on pyramidal convolutional layers (PC-DRN) was proposed to implement ECG signal classification. The pyramidal convolutional (PC) layer could simultaneously extract multi-scale features from the original ECG data. And then, a deep residual network was designed to train the classification model for arrhythmia detection. The public dataset provided by the physionet computing in cardiology challenge 2017(CinC2017) was used to validate the classification experiment of 4 types of ECG data. In this paper, the harmonic mean F 1 of classification accuracy and recall was selected as the evaluation indexes. The experimental results showed that the average sequence level F 1 ( SeqF 1) of PC-DRN was improved from 0.857 to 0.920, and the average set level F 1 ( SetF 1) was improved from 0.876 to 0.925. Therefore, the PC-DRN model proposed in this paper provided a promising way for the feature extraction and classification of ECG signals, and provided an effective tool for arrhythmia classification.


Oxygen and glucose deprivation induces mitochondrial dysfunction and oxidative stress in neurones but not in astrocytes in primary culture.
In order to investigate the potential neuroprotective role played by glucose metabolism during brain oxygen deprivation, the susceptibility of cultured neurones and astrocytes to 1 h of oxygen deprivation (hypoxia) or oxygen and glucose deprivation (OGD) was examined. OGD, but not hypoxia, promotes dihydrorhodamine 123 and glutathione oxidation in neurones but not in astrocytes reflecting free radical generation in the former cells. A specific loss of mitochondrial complex-I activity, mitochondrial membrane potential collapse, ATP depletion and necrosis occurred in the OGD neurones, but not in the OGD astrocytes. Furthermore, superoxide anion but not nitric oxide formation was responsible for these effects. OGD decreased neuronal but not astrocytic NADPH concentrations; this was not observed in hypoxia and was independent of superoxide or nitric oxide formation. These results suggest that glucose metabolism would supply NADPH, through the pentose-phosphate pathway, aimed at preventing oxidative stress, mitochondrial damage and neurotoxicity during oxygen deprivation to neural cells.


An ultrasensitive photoelectrochemical assay for tumor necrosis factor-alpha based on hollow CdS cubes as a signal generator and NiCo2O4-Au as a signal extinguisher.
Sensitive detection of tumor necrosis factor-alpha (TNF-α) in human serum is beneficial for finding cancer patients early due to overexpressed TNF-α being related to some cancers. Here, a photoelectrochemical (PEC) aptasensor was constructed for ultrasensitive TNF-α assay based on the signal generator of hollow CdS cubes (H-CdS) and the signal extinguishing activity of NiCo2O4-Au. In this work, compared with traditional solid CdS, H-CdS could greatly promote the PEC signal because its hollow structure could accelerate the separation of photogenerated charges, which also possesses abundant active sites and high light absorption capability. Moreover, H-CdS can be prepared facilely with Cd-based Prussian blue analogs as the precursor. Meanwhile, NiCo2O4-Au was fabricated and utilized as a signal extinguisher. In the presence of TNF-α, NiCo2O4-Au could be introduced onto the H-CdS modified electrode, producing competitive consumption of the electron donor effect, the p-n semiconductor quenching effect, and the mimetic enzymatic catalytic precipitation effect, which all can significantly reduce the PEC signal. Based on the signal extinguishing activity of NiCo2O4-Au and the signal generator of H-CdS, TNF-α can be detected sensitively with a lower detection limit (0.63 fg mL-1) and a wide linear range (1 fg mL-1- to 1 ng mL-1), which may have a potential application in the PEC bioanalysis field and the disease diagnostics field.


Effect of islet transplantation on metabolic glucose control in rats with diabetes.
Transplantation of pancreatic islets has been extensively investigated as a strategy for glycemic control in experimental animals and in patients with diabetes. We investigated whether islet transplantation allows us to obtain adequate islet function during glucose stimulation using a continuous glucose monitoring system (CGMS) in the rat. We investigated four groups of eight rats each: healthy rats (controls), rats with diabetes, and rats with diabetes transplanted with microencapsulated islets in the peritoneal cavity or transplanted with free islets under the kidney capsule. Syngeneic islets were isolated from Lewis rats. After diabetes induction and islet implantation, when glycemia was stable, a glucose sensor was implanted, and an intraperitoneal glucose tolerance test (IPGTT) was performed to evaluate islet function. Interstitial glucose levels were analyzed, using a theoretical model, to estimate kinetics of glucose metabolism. Islet transplantation was effective in inducing normoglycemia in both groups, but results of IPGTTs showed that in animals with islets transplanted in microcapsules values of area under the curve and total glucose elimination constant (k(tot)) were significantly different from those in control animals and that these differences were even more important in animals with islets implanted under the kidney capsule. Our present investigation demonstrates that the application of CGMS was effective in evaluation of glucose metabolism by islet transplantation and indicates that efficient diabetes control can be achieved with this technology.


Binding of mouse nidogen-2 to basement membrane components and cells and its expression in embryonic and adult tissues suggest complementary functions of the two nidogens.
Nidogen-1 binds several basement membrane components by well-defined, domain-specific interactions. Organ culture and gene targeting approaches suggest that a high-affinity nidogen-binding site of the laminin gamma1 chain (gamma1III4) is important for kidney development and for nerve guidance. Other proteins may also bind gamma1III4, although human nidogen-2 binds poorly to the mouse laminin gamma1 chain. We therefore characterized recombinant mouse nidogen-2 and its binding to basement membrane proteins and cells. Mouse nidogen-1 and -2 interacted at comparable levels with collagen IV, perlecan, and fibulin-2 and, most notably, also with laminin-1 fragments P1 and gamma1III3-5, which both contain the gamma1III4 module. In embryos, nidogen-2 mRNA was produced by mesenchyme at sites of epithelial-mesenchymal interactions, but the protein was deposited on epithelial basement membranes, as previously shown for nidogen-1. Hence, binding of both nidogens to the epithelial laminin gamma1 chain is dependent on epithelial-mesenchymal interactions. Epidermal growth factor stimulated expression of both nidogens in embryonic submandibular glands. Both nidogens were found in all studied embryonic and adult basement membranes. Nidogen-2 was more adhesive than nidogen-1 for some cell lines and was mainly mediated by alpha3beta1 and alpha6beta1 integrins as shown by antibody inhibition. These findings revealed extensive coregulation of nidogen-1 and -2 expression and much more complementary functions of the two nidogens than previously recognized.


Ketoconazole associated hepatotoxicity: a systematic review and meta- analysis.
To evaluate the incidence of Ketoconazole associated hepatotoxicity and related factor. Literature retrieval was conducted by using multi-databases for meta-analysis on Ketoconazole associated hepatotoxicity. The data were collected with a standardized form. Overall estimation of incidence of hepatotoxicity for specific study type was calculated by using a DerSimonian-Laird random-effects model owing to the substantial differences among the studies. Totally 204 eligible studies were included in the analysis. The incidence of Ketoconazole associated hepatotoxicity was 3.6%-4.2%. The dosage and duration specific subgroup analyses did not show any significant difference among groups, while the age specific subgroup analysis showed the incidence in children and people aged >60 years was 1.4% (95% CI: 0.5%-4.2%) and 3.2% (95% CI: 1.1%-8.7%) respectively. Additionally, the incidence of the hepatotoxicity was higher in people who had oral administration of ketoconazole beyond the provisions of the usage instructions, and the incidence was 5.7% (95% CI: 4.5%-7.2%). Ketoconazole associated hepatotoxicity was common. Off-label use might increase the risk of liver damage. Well-designed large sample studies are needed to identify the risk factors in future.


Response to ConA and PHA of host and donor thymic cells in radiation bone marrow chimeras.
The response of thymic cells to ConA and PHA was followed during 49 days in 9 Gy-irradiated C3H mice reconstituted with (C3H X AKR)F1 BM. Thymic suspension were fractionated firstly according to their capacity to bind PNA, and secondly by their Thy-1 surface antigen: Thy-1.1 antiserum was used either to lyse doner-derived cells or to separate them from host cells by panning. From days 14 to 25, when the donor-derived elements expand rapidly, the PNA- fraction remains stable and equal to 6%, suggesting that PNA+ and PNA- cell populations develop independently of each other. On the contrary, the PNA- fraction which initially represents 6% of the surviving cells rises up to 12% after day 20 and remains at this level in the long-lived host population until the end of the experiment (49 days). The response to ConA returns to normal as early as 15 days after X-rays in the PNA- fraction, whereas the response to PHA is still impaired at the end of the experiment. In both cases host cells express a higher level of responsiveness to mitogens than donor cells.


Evaluation of ozone technology as an alternative for degradation of free gossypol in cottonseed meal: a prospective study.
Free gossypol is a toxic compound which naturally occurs in cottonseed and its derivates, affecting animal and possibly human health. Consequently, alternatives for gossypol destruction must be evaluated. This work evaluated the emerging technology of ozone processing for free gossypol destruction in cottonseed meal. Ozonation was carried out in the actual cottonseed meal and also a model system, designed to describe the involved mode of action. The model system consisted of glass pearls beads covered with free gossypol. Ozonation was performed in two ways: as a static process, i.e., without homogenising the sample after placing them in the reactor, and also homogenising it. Ozone degraded free gossypol in all the systems, but reaching different levels. Free gossypol reduction was higher in the model system than the cottonseed meal, and higher in the homogenised processing than the static one: cottonseed meal in homogenised (56%) and static (25%); model system homogenised (98%) and static (80%). The obtained differences suggest a problem of gas penetration in the solid particles, the effect of unexposed surfaces due to contact areas, and the reaction with other organic molecules further than the target. Ozonation is a promising technique for gossypol degradation in cottonseed meal, but additional strategies are needed to optimise the ozonation process and evaluate toxicological aspects.


Hydration of monovalent and divalent cations near a cathode surface.
Hydration of monovalent (Li+, Na+, K+, and Cs+) and divalent (Mg2+, Ca2+, Sr2+, and Ba2+) cations on a cathode surface was studied by a classical molecular dynamics simulation. The potential of mean force (PMF) for each cation species was calculated as a function of the distance from the cathode surface, and the potential barriers for dehydrating the first and second hydration shells near the cathode surface were estimated. The positions of the minimum of the PMF closest to the cathode surface were found to be in the order Li+ < Na+ < Mg2+ < Ca2+ < Sr2+ < Ba2+ < K+ < Cs+. It was found that Li+, Mg2+, Ca2+, Sr2+, and Ba2+ ions are most likely doubly hydrated when they are adsorbed on the cathode surface without an applied voltage, whereas Na+, K+, and Cs+ ions are most likely singly hydrated at room temperature. On the other hand, when a voltage of 1 V was applied to the electrodes, all the cation species that we studied appeared most likely to be singly hydrated on the cathode surface. The depths of the potential well closest to the cathode surface under an applied voltage of 1 V were found to be in the order Ba2+ < Sr2+ < Ca2+ < Mg2+ for the divalent cations and Li+ < Na+ < K+ < Cs+ for the monovalent cations in the set of models that we used. These orders coincide with the Hofmeister series from the kosmotropic to the chaotropic.


Comparison of two novel one-tube nested real-time qPCR assays to detect human-infecting Cyclospora spp.
Human-infecting Cyclospora spp. cause gastrointestinal distress among healthy individuals contributing to morbidity and putting stress on the economics of countries and companies in the form of produce recalls. Accessible and easy-to-use diagnostic tools available to a wide variety of laboratories would aid in the early detection of possible outbreaks of cyclosporiasis. This, in turn, will assist in the timely traceback investigation to the suspected source of an outbreak by informing the smallest possible recall and protecting consumers from contaminated produce. This manuscript describes two novel detection methods with improved performance for the causative agents of cyclosporiasis when compared to the currently used 18S assay.


Liquid chromatography of polymers under limiting conditions of adsorption: III. Role of experimental variables.
LC of polymers under limiting conditions of adsorption (LC LCA) is a novel method based on different mobility of (pore excluded) macromolecules compared to (pore permeating) solvent molecules. Polymer sample is injected in a solvent preventing its adsorption within the column. Eluent promotes sample adsorption. Under these conditions, macromolecules cannot leave its initial solvent and elute from the column independently of their molar mass. In contrast, a less interactive simultaneously injected polymer leaves its initial solvent zone and is eluted in the size exclusion mode. As a result, chemically different polymer species can be discriminated. The effect of selected experimental conditions was studied on the LC LCA behavior of poly(methyl methacrylate)s eluted from bare silica gel columns. The parameters were packing pore diameter, injected sample volume and concentration, as well as column temperature. The size independent elution was only little affected by the above parameters and LC LCA produced well-focused peaks. The LC LCA mechanism was operative even at a very large sample of both volume and concentration. This makes LC LCA a robust and user-friendly method, likely suitable also for characterization of minor components of polymer mixtures.


Candida dubliniensis in radiation-induced oropharyngeal candidiasis.
Candida dubliniensis is a recently described species that has been shown to cause oropharyngeal candidiasis in patients with HIV. We present a detailed evaluation of a patient undergoing head and neck radiation for oral cancer who developed oropharyngeal candidiasis from a mixed infection of C dubliniensis and Candida albicans. To our knowledge, this is the first described case of C dubliniensis contributing to oropharyngeal candidiasis in this patient population.


Ionotropic glutamate receptor gene GRIK3 SER310ALA functional polymorphism is related to delirium tremens in alcoholics.
Upregulation of glutamatergic neurotransmission resulting from chronic ethanol intoxication may cause a hyperexcitable state during alcohol withdrawal, which may lead to seizures and delirium tremens. The aim of our study was to evaluate the association between a history of alcohol withdrawal-induced seizures and delirium tremens, and a functional polymorphism (Ser310Ala) of the GRIK3 gene coding for the glutamatergic kainate receptor subunit GlurR7 in a sample of well-characterized alcoholics compared to controls. In total, 233 patients meeting DSM-IV alcohol dependence criteria and 309 controls, all of German descent, were investigated. GRIK3 functional polymorphism was determined using PCR (polymerase chain reaction) of lymphocyte DNA. History of alcohol withdrawal-induced delirium tremens and seizures were obtained using the SSAGA (Semi-Structured Assessment for the Genetics of Alcoholism). Data were cross-checked with in-patients' clinical files. While a significant relationship between history of delirium tremens and the Ser310 allele was detected, no significant results were obtained for alcohol withdrawal-related seizures. Although this result is suggestive for a significant role of this polymorphism in the pathogenesis of delirium tremens in alcohol-dependent individuals, further investigation and confirmation are warranted.


Mechanical Behavior of Polyethylene Pipes under Strike-Slip Fault Movements.
The present paper addresses the mechanical behaviors and failure mechanisms of buried polyethylene (PE) pipes crossing active strike slip tectonic faults based on numerical simulation of the nonlinear response of the soil-pipeline system. The developed finite element (FE) model is first verified through comparing the simulation results with those from large-scale tests and good agreement between simulation and experimental measurements is obtained. The FE model is then applied to investigate the effects of fault crossing angle, pipe and soil properties on the mechanical behavior of PE pipe. The results indicate that the PE pipe crossing negative fault angles is primarily subjected to compression and bending, thus exhibits the phenomenon of buckling. With the increase of crossing angle, there is an increase of the axial strain and the maximum Mises stress in the buckled cross section, and a decrease of the distance between the buckling position and the fault plane. While for positive crossing angles, the PE pipe is mainly subjected to tension and relatively small bending. Increasing the crossing angle causes an increase in bending strain and a decrease in the axial strain. In addition, when the fault moving speed is slower, the axial strain and bending strain are larger, whereas the maximum Mises stress in the buckled cross section and the distance between the buckled position and the fault plane are reduced. Furthermore, the most severe deformation of the pipe is observed when it is buried in the sandy soil, followed by cohesive soil and loess soil.


Evidences of the involvement of Bak, a member of the Bcl-2 family of proteins, in active coeliac disease.
Apoptosis of enterocytes is a feature that characterises the development of lesions in coeliac disease (CD). However, the intracellular pathways that lead to apoptosis of enterocytes have not been completely clarified. Bak is a member of the Bcl-2 family of proteins that acts as an endogenous promoter of apoptosis in normal enterocytes. However, its role in coeliac lesions has not been explored. We used small intestinal mucosa from patients with CD to evaluate the differential expression of members of the Bcl-2 family of proteins. Gene expression of Bak was analysed by RT-PCR of biopsies from 14 patients with untreated CD and from 19 controls without CD. In these samples, we also investigated the localisation of the Bak protein by immunohistochemistry and its apoptotic activity. In patients with untreated CD there was a 2.3-fold higher expression of Bak mRNA (p = 0.026), without significant differences in the expression of related genes bax or bcl-2. The higher expression of interferon gamma (IFN-gamma) (p = 0.036) and the higher number of apoptotic cells identified by the TUNEL method (p = 0.032) confirmed the proapoptotic status in the intestinal mucosa of CD patients. We found a significant positive correlation (p < 0.0001) between the expression of IFN-gamma and Bak mRNA in patients with untreated CD. The expression of Bak protein was higher in patients with CD, and the immunoreactivity was almost restricted to the epithelium. We found that Bak mRNA and its protein were overexpressed in the intestinal lesions of CD patients and that IFNgamma confers increased susceptibility for enterocytes to undergo apoptosis via upregulation of Bak.


Mouse gestation length is genetically determined.
Preterm birth is an enormous public health problem, affecting over 12% of live births and costing over $26 billion in the United States alone. The causes are complex, but twin studies support the role of genetics in determining gestation length. Despite widespread use of the mouse in studies of the genetics of preterm birth, there have been few studies that actually address the precise natural gestation length of the mouse, and to what degree the timing of labor and birth is genetically determined. To further develop the mouse as a genetic model of preterm birth, we developed a high-throughput monitoring system and measured the gestation length in 15 inbred strains. Our results show an unexpectedly wide variation in overall gestation length between strains that approaches two full days, while intra-strain variation is quite low. Although litter size shows a strong inverse correlation with gestation length, genetic difference alone accounts for a significant portion of the variation. In addition, ovarian transplant experiments support a primary role of maternal genetics in the determination of gestation length. Preliminary analysis of gestation length in the C57BL/6J-Chr#(A/J)/NaJ chromosome substitution strain (B.A CSS) panel suggests complex genetic control of gestation length. Together, these data support the role of genetics in regulating gestation length and present the mouse as an important tool for the discovery of genes governing preterm birth.


New Vistas in Chemical Product and Process Design.
Design of chemicals-based products is broadly classified into those that are process centered and those that are product centered. In this article, the designs of both classes of products are reviewed from a process systems point of view; developments related to the design of the chemical product, its corresponding process, and its integration are highlighted. Although significant advances have been made in the development of systematic model-based techniques for process design (also for optimization, operation, and control), much work is needed to reach the same level for product design. Timeline diagrams illustrating key contributions in product design, process design, and integrated product-process design are presented. The search for novel, innovative, and sustainable solutions must be matched by consideration of issues related to the multidisciplinary nature of problems, the lack of data needed for model development, solution strategies that incorporate multiscale options, and reliability versus predictive power. The need for an integrated model-experiment-based design approach is discussed together with benefits of employing a systematic computer-aided framework with built-in design templates.


Functional expression of a fusion-dimeric MoFe protein of nitrogenase in Azotobacter vinelandii.
The MoFe protein component of the complex metalloenzyme nitrogenase is an alpha2beta2 tetramer encoded by the nifD and the nifK genes. In nitrogen fixing organisms, the alpha and beta subunits are translated as separate polypeptides and then assembled into tetrameric MoFe protein complex that includes two types of metal centers, the P cluster and the FeMo cofactor. In Azotobacter vinelandii, the NifEN complex, the site for biosynthesis of the FeMo cofactor, is an alpha2beta2 tetramer that is structurally similar to the MoFe protein and encoded as two separate polypeptides by the nifE and the nifN genes. In Anabaena variabilis it was shown that a NifE-N fusion protein encoded by translationally fused nifE and nifN genes can support biological nitrogen fixation. The structural similarity between the MoFe protein and the NifEN complex prompted us to test whether the MoFe protein could also be functional when synthesized as a single protein encoded by nifD-K translational fusion. Here we report that the NifD-K fusion protein encoded by nifD-K translational fusion in A. vinelandii is a large protein (as determined by Western blot analysis) and is capable of supporting biological nitrogen fixation. These results imply that the MoFe protein is flexible in that it can accommodate major structural changes and remain functional.


Estimating mercury emissions from a zinc smelter in relation to China's mercury control policies.
Mercury concentrations of flue gas at inlet/outlet of the flue gas cleaning, electrostatic demister, reclaiming tower, acid plant, and mercury contents in zinc concentrate and by-products were measured in a hydrometallurgical zinc smelter. The removal efficiency of flue gas cleaning, electrostatic demister, mercury reclaiming and acid plant was about 17.4%, 30.3%, 87.9% and 97.4% respectively. Flue gas cleaning and electrostatic demister captured 11.7% and 25.3% of the mercury in the zinc concentrate, respectively. The mercury reclaiming tower captured 58.3% of the mercury in the zinc concentrate. About 4.2% of the mercury in the zinc concentrate was captured by the acid plant. Consequently, only 0.8% of the mercury in the zinc concentrate was emitted to the atmosphere. The atmospheric mercury emission factor was 0.5 g t(-1) of zinc produced for the tested smelter, indicating that this process offers the potential to effectively reduce mercury emissions from zinc smelting.


[Using network planning techniques for work flow analysis in a clinical environment].
In the face of increasing financial pressure on our health care system, one way to reduce costs while maintaining or even improving outcome quality is to improve work flow efficiency. Network Planning Technique (NPT) is a tool for mapping and analyzing work flows. Designing a network plan requires four steps. Step 1 is concerned with the determination of the work flow structure. Step 2 deals with data acquisition. Based on the data retrieved a network plan is created in Step 3. Step 4 includes the calculation of the critical path and slack times under optimistic, realistic and pessimistic conditions. Applied to the ultrasound division in our department a total examination time of 34:14 minutes was calculated with 23:09 minutes total slack time for the technician under realistic conditions. Using NPT creates transparency in work flows and allows us to estimate resource demands. A comparison between two different divisions with a similar work flow structure but different resource allocation demonstrates this method's potential for improving work flows. Limitations of the NPT can be noted when considering cycle overlap in repetitive work flows and modeling non-regular activities.


Organizational structure and human agency within the South African health system: a qualitative case study of health promotion.
Despite international recognition of health promotion (HP) as a cost-effective way to improve population health, it is not highly regarded nor is it sufficiently institutionalized in many health systems. This diminishes its ability to deliver on its public health promises. This paper examined the role of organizational structure and human agency within the South African health system (drawing on Giddens's structuration theory) in determining the extent of, and barriers to, the institutionalization of HP. We conducted a qualitative case study using a combination of in-depth interviews (n = 37), key informant interviews (n = 8) and one-day workshops (n = 5) with Department of Health (DoH) staff (HP and non-HP personnel) from national, provincial and district levels as well as external HP stakeholders. Within the South African health system, there are dedicated HP staffs, with no specified professional competencies or a coherent hierarchy of job titles. Allocated HP resources were frequently shifted to other programmes. This resulted in a disconnect between national and provincial levels, which impeded communication and opportunity to develop a shared vision and coherent programme. We found some examples of successful HP organization and implementation practices, such as the tobacco control legislation. Overall, HP staff had limited agency and were often unable to articulate the vision for HP. Uncertainty about the role of HP has led to powerlessness, and feelings of resentment have generated demotivation and moral distress. HP voices were seldom heard and were repressed by dominant curative-focused structures. If leaders of HP continue to be embedded in such an institution, there is little chance of driving an effective HP agenda. Therefore, there is a need to engage policy-makers to integrate HP into the health system fabric. Establishment of an independent HP foundation could be one mechanism to drive multi-sectoral collaboration, contribute to evidence-based HP research and further develop health in all policies through advocacy.


[Value of additional qualifying tests for home oxygen therapy in patients with chronic obstructive diseases and moderate hypoxemia].
A value of pulmonary artery catheterization, exercise test and blood oxygenation at sleep was assessed. Such tests are considered as the additional possibility for classifying the patients with chronic obstructive disease, with moderate hypoxia, to the treatment with oxygen at home. Hemodynamic tests have shown pulmonary hypertension in 73% of patients. Clinical evaluation of the cor pulmonale seemed satisfactory. A decrease in arterial blood oxygenation during exercise below 88%, being a border value classifying to the treatment with oxygen at home, was found in 82% of patients. Marked decrease in blood oxygenation at sleep has been characteristic feature of all patients. Exercise test and oximetry at night may also valuable for classifying the patients to the treatment with oxygen under home conditions.


High-level noise source for the calibration of Johnson noise power thermometers.
A new high-level noise source was developed specifically for the calibration of Johnson noise power thermometers (JNPT), but it is useful in other applications requiring a stable, wideband, well-defined noise power spectral density. The design concept for the noise source is based on the fact that the open-circuit thermal noise voltage of a feedback resistor, connecting the output to the input of an inverting amplifier, is available at the amplifier output from an equivalent low output impedance caused by the feedback mechanism. The noise power spectral density level at the noise source output is equivalent to the density of the open-circuit thermal noise of a 100-Omega resistor at a temperature of about 64 000 K. The noise source has an output power spectral density that is flat to within 0.1% (0.0043 dB) in the frequency range 1-150 kHz which brackets typical passbands of the signal-processing channels of JNPTs. The noise source was evaluated by comparing its output noise power with the thermal noise power generated by a platinum resistor of known ohmic value at the temperature of the aluminum freezing point (933.52 K). The measured noise power was within 0.06% of the value computed from the fundamental thermal noise equation of Nyquist. The power spectral density varies less than 0.03% for ambient temperature fluctuations in the range 15 degrees -35 degrees C.


Underage drinking among young adolescent girls: the role of family processes.
Guided by family interaction theory, this study examined the influences of psychological, peer, and familial processes on alcohol use among young adolescent girls and assessed the contributions of familial factors. An ethnically diverse sample of 1,187 pairs of girls (M age = 12.83 years), and their mothers completed surveys online. Questionnaires assessed girls' lifetime and recent alcohol use, as well as girls' demographic, psychological, peer, and family characteristics. Hierarchical logistic regression models showed that although girls' drinking was associated with a number of psychological and peer factors, the contributions of family domain variables to girls' drinking were above and beyond that of psychological and peer factors. The interaction analyses further highlighted that having family rules, high family involvement, and greater family communication may offset risks in psychological and peer domains. Study findings underscore the multifaceted etiology of drinking among young adolescent girls and assert the crucial roles of familial processes. Prevention programs should be integrative, target processes at multiple domains, and include work with parents.


3D-STED Super-Resolution Microscopy Reveals Distinct Nanoscale Organization of the Hematopoietic Cell-Specific Lyn Substrate-1 (HS1) in Normal and Leukemic B Cells.
HS1, the hematopoietic homolog of cortactin, acts as a versatile actin-binding protein in leucocytes. After phosphorylation, it is involved in GTPase and integrin activation, and in BCR, TCR, and CXCR4 downstream signaling. In normal and leukemic B cells, HS1 is a central cytoskeletal interactor and its phosphorylation and expression are prognostic factors in chronic lymphocytic leukemia (CLL) patients. We here introduce for the first time a super-resolution imaging study based on single-cell 3D-STED microscopy optimized for revealing and comparing the nanoscale distribution of endogenous HS1 in healthy B and CLL primary cells. Our study reveals that the endogenous HS1 forms heterogeneous nanoclusters, similar to those of YFP-HS1 overexpressed in the leukemic MEC1 cell line. HS1 nanoclusters in healthy and leukemic B cells form bulky assemblies at the basal sides, suggesting the recruitment of HS1 for cell adhesion. This observation agrees with a phasor-FLIM-FRET and STED colocalization analyses of the endogenous MEC1-HS1, indicating an increased interaction with Vimentin at the cell adhesion sites. In CLL cells isolated from patients with poor prognosis, we observed a larger accumulation of HS1 at the basal region and a higher density of HS1 nanoclusters in the central regions of the cells if compared to good-prognosis CLL and healthy B cells, suggesting a different role for the protein in the cell types analyzed. Our 3D-STED approach lays the ground for revealing tiny differences of HS1 distribution, its functionally active forms, and colocalization with protein partners.


Long-Term Outcomes of a Kahook Dual Blade Procedure Combined with Phacoemulsification in Japanese Patients with Open-Angle Glaucoma.
We retrospectively evaluated the long-term surgical outcomes of phacoemulsification combined with a Kahook dual blade (KDB) procedure in Japanese patients with open-angle glaucoma. The primary outcome was surgical success or failure. Surgical failure was indicated by a <20% reduction in preoperative intraocular pressure (IOP) or IOP > 18 mmHg (criterion A), IOP > 14 mmHg (criterion B), or requirement for reoperation. Glaucoma medications after surgery and postoperative complications were recorded. Surgical outcomes were compared between primary open-angle glaucoma (POAG) and exfoliation glaucoma (ExG) groups. The probability of success at 36 months postoperation was 52.5% using criterion A and 36.9% using criterion B. Mean IOP decreased significantly from 19.5 ± 6.9 mmHg preoperatively to 11.9 ± 2.7 mmHg at 36 months, and the mean number of glaucoma medications from 2.4 ± 1.4 to 1.6 ± 1.4 (both p < 0.01). IOP spikes were significantly more common in the ExG group (23.7% vs. 9.1%; p = 0.045), as was the need for additional glaucoma surgery (10.5% vs. 1.8%; p = 0.038). A KDB procedure combined with cataract surgery resulted in significant long-term decreases in IOP and the number of glaucoma medications. The complication rate was higher in eyes with ExG. Therefore, these eyes require more careful management after a KDB procedure.


Multilayered Electride Ca2N Electrode via Compression Molding Fabrication for Sodium Ion Batteries.
Pursuing for novel electrode materials is significant for the progress of sodium ion batteries (SIBs). Here, a multilayered electride prepared by simple thermal decomposition of solid Ca3N2, namely Ca2N, is introduced as a new anode material of SIBs for the first time, and a compression molding electrode fabricated by pressing Ca2N powder into nickel foam is applied to protect Ca2N from trace moisture and oxygen. The as-prepared electrode delivers an initial discharge capacity of 1110.5 mAh g-1 and a reversible discharge capacity of ∼320 mAh g-1. These results suggest that Ca2N has a great potential for sodium ion batteries.


[Comparison of the severity of postoperative pain in patients after thoracic, upper abdominal or lower abdominal surgery].
Different factors influence the severity of postoperative pain. Personality and cultural factors as well as anxiety and fear modify the degree of postoperative pain. The site of surgery is also a major determinant. We evaluated the severity of postoperative pain in patients after three different surgeries, thoracic, upper abdominal and lower abdominal surgeries, from 24 h to 72 h postoperatively. Thirty patients were divided into three groups: thoracic, upper abdominal and lower abdominal groups (n = 10, respectively). All patients received continuous epidural infusion of 0.25% bupivacaine (2 ml.h-1) and buprenorphine (0.2 mg x 24 h-1). Additional analgesics were given when the patient complained of pain. Analgesia was evaluated by 100 mm visual analog scale and demands of analgesics. Pain scores at rest were not different among three groups. Pain after lower abdominal surgery tended to be less severe compared with that after thoracic surgery. Demands of analgesics were not different among three groups at any evaluated point. Pain after thoracic surgery was consistent during 72 postoperative hs, but in the upper and lower abdominal surgery groups pain at 72 hs was significantly weaker than that at 24 hs. We conclude that postoperative pain was not different among the three surgery groups, but pain after upper and lower abdominal surgery decreased more rapidly compared with that after thoracic surgery.


Role of exosomes in the reproductive tract Oviductosomes mediate interactions of oviductal secretion with gametes/early embryo.
The oviductal epithelial membrane releases into the luminal environment extracellular vesicles (EVs) which are pleomorphic in nature and fall into two categories: exosomes and microvesicles. Both of these membrane vesicles are referred to as Oviductosomes (OVS), and to date have been identified in the murine and bovine species. Bovine EVs derived in vivo and from in vitro culture show differences in their protein cargo which includes CD9 and HSC70 biochemical markers and fertility-modulating proteins such as oviduct-specific glycoprotein (OVGP) and Plasma Membrane Ca(2+) ATPase 4 (PMCA4). PMCA4, an essential multifunctional sperm protein, is hormonally-regulated with elevated levels seen in proestrus/estrus. OVS deliver PMCA4 to sperm via a fusogenic mechanism involving the interaction between CD9 and integrins which are present on their surfaces. Studies of OVS are needed to determine the components of their cargoes and their interaction with oocytes and the very early embryo. Based on our present knowledge of their interaction with sperm, they are expected to play pivotal roles in regulating fertility and promise to inform the current IVF practice.


Radiation exposure and pregnancy.
Radiological exposure from nuclear power reactor accidents, transportation of nuclear waste accidents, industrial accidents, or terrorist activity may be a remote possibility, but it could happen. Nurses must be prepared to evaluate and treat pregnant women and infants who have been exposed to radiation, and to have an understanding of the health consequences of a nuclear or radiological incident. Pregnant women and infants are a special group of patients who need consideration when exposed to radiation. Initial care requires thorough assessment and decisions regarding immediate care needs. Ongoing care is based on type and extent of radiation exposure. With accurate, comprehensive information and education, nurses will be better prepared to help mitigate the effects of radiation exposure to pregnant women and infants following a radiological incident. Information about radiation, health effects of prenatal radiation exposure, assessment, patient care, and treatment of pregnant women and infants are presented.


Effects of Consecutive Basketball Games on the Game-Related Statistics that Discriminate Winner and Losing Teams.
The aim of the present study was to identify the game-related statistics that discriminated basketball winning and losing teams in each of the three consecutive games played in a condensed tournament format. The data were obtained from the Spanish Basketball Federation and included game-related statistics from the Under-20 league (2005-2006 and 2006-2007 seasons). A total of 223 games were analyzed with the following game-related statistics: two and three-point field goal (made and missed), free-throws (made and missed), offensive and defensive rebounds, assists, steals, turnovers, blocks (made and received), fouls committed, ball possessions and offensive rating. Results showed that winning teams in this competition had better values in all game-related statistics, with the exception of three point field goals made, free-throws missed and turnovers (p ≥ 0.05). The main effect of game number was only identified in turnovers, with a statistical significant decrease between the second and third game. No interaction was found in the analysed variables. A discriminant analysis allowed identifying the two-point field goals made, the defensive rebounds and the assists as discriminators between winning and losing teams in all three games. Additionally to these, only the three-point field goals made contributed to discriminate teams in game three, suggesting a moderate effect of fatigue. Coaches may benefit from being aware of this variation in game determinant related statistics and, also, from using offensive and defensive strategies in the third game, allowing to explore or hide the three point field-goals performance. Key pointsOverall team performances along the three consecutive games were very similar, not confirming an accumulated fatigue effect.The results from the three-point field goals in the third game suggested that winning teams were able to shoot better from longer distances and this could be the result of exhibiting higher conditioning status and/or the losing teams' exhibiting low conditioning in defense.


Assessing the teaching behaviors of ambulatory care preceptors.
Medical educators are increasingly concerned about the quality of skills instruction at medical schools in the United States, yet few data exist to support quality assessment and faculty development. The purpose of this research was to (1) develop an instrument for measuring teaching behavior of ambulatory care preceptors (the Teaching Encounter Card), and (2) assess current teaching practices at one institution. Based on published guidelines for teaching in the ambulatory setting, the authors identified nine teaching behaviors for inclusion on a Teaching Encounter Card. Students completed the card immediately after a supervised patient (teaching) encounter, indicating (yes/no) if they observed each behavior. Validation of the card was assessed using standardized patients and scripted teaching encounters. A field application of the card assessed behaviors for 17 preceptors and 270 teaching encounters in one ambulatory care clerkship. Validation testing revealed the card was highly accurate. Specificity exceeded 75% for all behaviors and sensitivity exceeded 75% for eight. During the field application, preceptors used each of the behaviors except three in over 70% of encounters. The three exceptions were observing the student interviewing or counseling (68% of encounters), providing feedback (52% of encounters), and observing the student perform any part of the physical examination (24% of encounters). Interpreceptor variability was substantial for several behaviors. The Teaching Encounter Card is valid and represents a new tool for quality assessment and faculty development. Preceptors and course directors will need guidelines or educational standards to help them interpret individual results.


Predictive factors of prostate cancer diagnosis with PSA 4.0-10.0 ng/ml in a multi-ethnic Asian population, Malaysia.
To identify the associated factors determining prostate cancer detection using transrectal ultrasound (TRUS)-guided prostate biopsy, within a multi-ethnic Malaysian population with prostate specific antigen (PSA) between 4.0 and 10.0 ng/ml. Study subjects included men with initial PSA between 4.0 and 10.0 ng/ml that have undergone 12-core TRUS-guided prostate biopsy between 2009 and 2016. The prostate cancer detection rate was calculated, while potential factors associated with detection were investigated via univariable and multivariable analysis. A total of 617 men from a multi-ethnic background encompassing Chinese (63.5%), Malay (23.1%) and Indian (13.3%) were studied. The overall cancer detection rate was 14.3% (88/617), which included cancers detected at biopsy 1 (first biopsy), biopsy 2 (second biopsy with previous negative biopsy) and biopsy ≥ 3 (third or more biopsies with prior negative biopsies). Indian men displayed higher detection rate (23.2%) and increased risk of prostate cancer development (OR 1.85, 95% CI 1.03-3.32, p < 0.05), compared to their Malay (9.8%) and Chinese (14.0%) counterparts. Multivariable analysis revealed that ethnicity and PSA density (PSAD) are independent factors associated with overall prostate cancer detection rate. A unit increase of PSAD reflected an increase in PSA after controlling for prostate volume. Prostate cancer detection in Malaysia is comparatively lower. Our study suggests that ethnicity and PSA density should be considered when recommending first or repeat TRUS-guided prostate biopsy for prostate cancer detection in a multi-ethnic Malaysian population.


Feasibility of Magnetic Resonance Fingerprinting on Aging MRI Hardware.
The purpose of this work is to evaluate the feasibility of performing magnetic resonance fingerprinting (MRF) on older and lower-performance MRI hardware as a means to bring advanced imaging to the aging MRI install base. Phantom and in vivo experiments were performed on a 1.5T Siemens Aera (installed 2015) and 1.5T Siemens Symphony (installed 2002). A 2D spiral MRF sequence for simultaneous T1/T2/M0 mapping was implemented on both scanners with different gradient trajectories to accommodate system specifications. In phantom, for T1/T2 values in a physiologically relevant range (T1: 195-1539 ms; T2: 20-267 ms), scanners had strong correlation (R2 > 0.999) with average absolute percent difference of 8.1% and 10.1%, respectively. Comparison of the two trajectories on the newer scanner showed differences of 2.6% (T1) and 10.9% (T2), suggesting a partial explanation of the observed inter-scanner bias. Inter-scanner agreement was better when the same trajectory was used, with differences of 6.0% (T1) and 4.0% (T2). Intra-scanner coefficient of variation (CV) of T1 and T2 estimates in phantom were <2.0% and in vivo were ≤3.5%. In vivo inter-scanner white matter CV was 4.8% (T1) and 5.1% (T2). White matter measurements on the aging scanner after two months were consistent, with differences of 1.9% (T1) and 3.9% (T2). In conclusion, MRF is feasible on an aging MRI scanner and required only changes to the gradient trajectory.