Effectiveness of aroma on work efficiency: lavender aroma during recesses prevents deterioration of work performance.
The present study investigated whether exposure to aromas during recess periods affects work performance. Subjects comprised 36 healthy male students (mean age, 24.2 +/- 2.2 years) who were randomly divided into three groups: (1) control group, not exposed to aroma during recesses; (2) jasmine group, exposed to jasmine aroma during recesses; and (3) lavender group, exposed to lavender aroma during recesses. All participants completed five work sessions performing a task requiring concentration on a computer monitor, with each session lasting 60 min. Recess periods of 30 min were provided between each session. To clarify the time at which work concentration was lowest, work performance for the control group was analyzed. Concentration was lowest in the afternoon period, where afternoon drowsiness is strongest. Comparison of the three groups for this time period indicated significantly higher concentration levels for the lavender group than for the control group. No such effect was noted for the jasmine group. Although lavender is a sedative-type aroma, use during recess periods after accumulation of fatigue seems to prevent deterioration of performance in subsequent work sessions.


NOD2 deficiency exacerbates hypoxia-induced pulmonary hypertension and enhances pulmonary vascular smooth muscle cell proliferation.
Expression of nucleotide-binding oligomerization domain protein 2 (NOD2) is upregulated in pulmonary artery smooth muscle cells (PASMCs) during hypoxia. To investigate the involvement of NOD2 in the pulmonary vascular response to hypoxia, we subjected wild-type and NOD2-deficient mice to chronic normobaric hypoxic conditions. Compared to wild-type mice, NOD2-deficient mice developed severe pulmonary hypertension with exaggerated elevation of right ventricular systolic pressure, profound right ventricular hypertrophy and striking vascular remodeling after exposure to hypoxia. Pulmonary vascular remodeling in NOD2-deficient mice was characterized by increased PASMC proliferation. Furthermore, hypoxia-inducible factor-1α expression and Akt phosphorylation were upregulated in PASMCs from NOD2-deficient mice exposed to hypoxia. Our findings revealed that the absence of NOD2 exacerbated hypoxia-induced PASMC proliferation, pulmonary hypertension and vascular remodeling, but had no effect on PASMC migration or contractility.


Heat capacity of superconducting ternary molybdenum sulfides.
The heat capacities of AgMo(4)S(5), PbMo(6)S(7), and SnMo(5)S(6) are reported. These ternary molybdenum sulfides have been found to be bulk superconductors with very large values of electronic heat capacity coefficients and very low values of Debye temperatures.


Malignant melanoma misdiagnosed as diabetic foot ulcer: A case report.
Acral lentiginous melanoma (AML) does not exhibit the classic signs of malignant melanoma. ALM is frequently misdiagnosed because of its unusual sites and atypical clinical morphologies, which lead to poor prognosis. A female patient aged 78 years was presented to our center with two ulcers on her right foot. Diabetic foot ulcer was considered as the primary diagnosis. The ulcers failed to improve after 2 weeks' therapy. An incisional biopsy of the lesion revealed malignant melanoma. The patient received wide excision, skin grafting as well as biotherapy. The lesion was healed and no other metastasis has been founded until now. Clinicians must maintain a high level of suspicion in distinguishing malignant melanoma from other more benign skin lesions of the foot. The need for early biopsy of ulcer, even when clinical suspicion is low, can not be overemphasized. Only in this way can we reduce misdiagnosis rate and improve survival rate in patients with foot ulcer.


Scalable Synthesis of Human Ultralong Chain Ceramides.
Ceramides with ultralong chains (≥30 carbons), also known as acylceramides, play a critical role in the survival of mammals on dry land. An efficient and scalable synthesis of four major classes of ultralong human skin ceramides is reported. The key approach involves the use of a succinimidyl ester that acts as a protective group, helps overcome the extremely low solubility, and simultaneously activates the fatty acid for its clean and high-yielding attachment to a sphingoid base.


Predictors of bullying perpetration among adolescents attending secondary schools in Sokoto Metropolis, Nigeria, 2019.
bullying affects up to 85% of in-school adolescents in Nigeria. It presents a potentially serious threat to healthy adolescent development. Bullying has not been extensively studied in Nigeria and more so in northern Nigeria. Therefore, we investigated the types and predictors of bullying perpetration among adolescents in secondary schools. we conducted a cross-sectional study between January and March 2019. Using a multistage sampling technique, we recruited 390 adolescents. We estimated the prevalence and types of bullying perpetration, and we examined the predictors of bullying among the participants using chi-square and binary logistic regression at a 5% level of significance. the mean age of adolescents was 15.2 ± 1.9 years. Majority of the participants 234 (60.0%) were in late adolescence (15-19 years), and 205 (52.6%) were males. The most prevalent type of bullying perpetrated was verbal [69.7%; 95% CI = 64.9-74.3%]. Overall, 307 [78.7%; 95% CI = 74.3-82.6%] had perpetrated at least one type of bullying. Male gender (adjusted Odds Ratio (aOR): 2.70; 95%CI = 1.43 - 5.10), attending a boarding school (aOR: 7.93, 95% CI = 2.91 - 21.58) and frequent parental conflicts (aOR: 5.23, 95% CI = 2.15 - 12.71) were independent predictors of bullying perpetration. there is a high prevalence of bullying perpetration among adolescents in Sokoto metropolis, especially among males, those in boarding schools and those who experience frequent parental conflicts. We recommend that school principals should pay close attention to this behaviour and parents should be sensitized on the consequences of their domestic actions on their children.


Discriminative capacity of calcaneal quantitative ultrasound and of osteoporosis and fracture risk factors in postmenopausal women with osteoporotic fractures.
Bone fragility fractures constitute the principal complication of osteoporosis. The identification of individuals at high risk of sustaining osteoporotic fractures is important for implementing preventive measures. The purpose of this study is to analyze the discriminative capacity of a series of osteoporosis and fracture risk factors, and of calcaneal quantitative ultrasound (QUS), in a population of postmenopausal women with a history of osteoporotic fracture. A cross-sectional analysis was made of a cohort of 5195 women aged 65 or older (mean +/- SD: 72.3 +/- 5.4 years) seen in 58 primary care centers in Spain. A total of 1042 women (20.1%) presented with a history of osteoporotic fracture. Most fractures (93%) were non-vertebral. Age-adjusted odds ratios corresponding to each decrease in one standard deviation of the different QUS parameters ranged from 1.47 to 1.55 (P < 0.001) for fractures. The age-adjusted multivariate analysis yielded the following risk factors independently associated with a history of osteoporotic fracture: number of fertile years, a family history of fracture, falls in the previous year, a history of chronic obstructive airway disease, the use of antiarrhythmic drugs, and a low value for any of the QUS parameters. The area under the receiver operating characteristic curve of the best model was 0.656. In summary, a series of easily assessable osteoporotic fracture risk factors has been identified. QUS was shown to discriminate between women with and without a history of fracture, and constitutes a useful tool for assessing fracture risk. Various of the vertebral and hip fracture risk factors frequently cited in North American and British populations showed no discriminative capacity in our series--thus suggesting that such factors may not be fully applicable to our population and/or to the predominant type of fractures included in the present study.


[Trial for estimating the concentration of pesticide residues in the ingredients of processed foods].
If pesticide residues are detected at over the uniform limit (0.01 ppm) in processed foods, the maximum residue limits of pesticides in each ingredient should be considered. For that purpose, analysis of pesticide residues in the ingredients would be required, but in many cases it is difficult to obtain ingredients from the same lot, or the processed foods may have been manufactured overseas. Thus, a means of estimating pesticide concentrations in ingredients before processing would be important. In this study, we estimated the concentration of paclobutrazol, which was detected in LM pickles (LMPs), that would have been present in Takana (LM; mustard leaf) before processing. The LMPs mainly consisted of LM and seasoning liquid (SL), and other ingredients (sesame seeds or red pepper) accounted for less than 0.2% (w/w) of the LMPs. The LM and SL were separated and their paclobutrazol concentrations were determined. The concentration of paclobutrazol in the SL was approximately 1/10 of that detected in LM. Loss of water from LM during processing was taken into account to calculate the content of paclobutrazol in LM before processing, based on the analytical result of processed LM.


Spectral mapping of brain functional connectivity from diffusion imaging.
Understanding the relationship between the dynamics of neural processes and the anatomical substrate of the brain is a central question in neuroscience. On the one hand, modern neuroimaging technologies, such as diffusion tensor imaging, can be used to construct structural graphs representing the architecture of white matter streamlines linking cortical and subcortical structures. On the other hand, temporal patterns of neural activity can be used to construct functional graphs representing temporal correlations between brain regions. Although some studies provide evidence that whole-brain functional connectivity is shaped by the underlying anatomy, the observed relationship between function and structure is weak, and the rules by which anatomy constrains brain dynamics remain elusive. In this article, we introduce a methodology to map the functional connectivity of a subject at rest from his or her structural graph. Using our methodology, we are able to systematically account for the role of structural walks in the formation of functional correlations. Furthermore, in our empirical evaluations, we observe that the eigenmodes of the mapped functional connectivity are associated with activity patterns associated with different cognitive systems.


Chemistry of the silica surface: liquid-solid reactions of silica gel with trimethylaluminum.
The reaction of trimethylaluminum and dry, high-surface-area (500 m2/g) silica gel in a mixed slurry was studied using multinuclear, solid-state NMR spectroscopy. The products of the initial reaction were characterized, and their progress through subsequent washing with diethyl ether and reactions with measured amounts of water was followed. The quantitative distribution of different chemical forms of carbon deposited on the silica surface by the initial reaction was measured. The products of the initial reaction are dominated by methyl species of the types Al(CH3)n (with Si-O-Al linkages), Si-O-CH3, and (Si-O)4-nSi(CH3)n; aluminum is seen to exist predominantly as a five-coordinate species. Subsequent treatment with diethyl ether fails to remove any surface species, but instead the ether becomes strongly associated with the surface and highly resistant to removal. Stepwise additions of water hydrolyze the Al-CH3 and Si-O-CH3 moieties, leading to conversion of five-coordinate aluminum to four- and six-coordinate aluminum, and affect the partial release of the surface-associated diethyl ether; Si-CH3 moieties remain. The effect of aromatic and saturated solvents on the initial reaction was examined and found to cause a small but significant change in the distribution of products. Structures of aluminum-centered species on the silica surface consistent with the spectroscopic data are proposed.


Microscopic abnormality classification of cardiac murmurs using ANFIS and HMM.
Auscultation of heart dispenses identification of the cardiac valves. An electronic stethoscope is used for the acquisition of heart murmurs that is further classified into normal or abnormal murmurs. The process of heart sound segmentation involves discrete wavelet transform to obtain individual components of the heart signal and its separation into systole and diastole intervals. This research presents a novel scheme to develop a semi-automatic cardiac valve disorder diagnosis system. Accordingly, features are extracted using wavelet transform and spectral analysis of input signals. The proposed classification scheme is the fusion of adaptive-neuro fuzzy inference system (ANFIS) and HMM. Both classifiers are trained using the extracted features to correctly identify normal and abnormal heart murmurs. Experimental results thus achieved exhibit that proposed system furnishes promising classification accuracy with excellent specificity and sensitivity. However, the proposed system has fewer classification errors, fewer computations, and lower dimensional feature set to build an intelligent system for detection and classification of heart murmurs.


Urinary tract infection in older adults.
Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults.


Stellate Ganglion Block as Rescue Therapy in Refractory Ventricular Tachycardia.
Pain physicians and anesthesiologists routinely perform stellate ganglion block for the treatment of painful upper extremity sympathetic dystrophy. Close proximity of ganglion to vascular structures warrants some expertise and training in the procedure. Off late, successful use of the technique in intractable ventricular tachyarrhythmias has come in literature. We have few cases wherein we could successfully ablate intractable ventricular tachycardia with stellate block which was refractory to repeated shocks. We are reporting one such case with the intention of making an awareness in the anesthesia community about this treatment option.


Anti-calreticulin antibodies in patients with inflammatory bowel disease.
Although the pathogenesis of inflammatory bowel disease (IBD) is unclear, autoimmune processes seem to play roles in IBD because several types of autoantibodies have been found in it. Calreticulin (CRT) is a soluble Ca2+ binding protein which is present in a wide variety of cells. CRT is localized mainly in the endoplasmic reticulum and is often a target for autoantibodies. The aim of this study was to evaluate the clinical significance of anti-CRT antibodies measured by enzyme-linked immunosorbent assay (ELISA) using the sera of patients with ulcerative colitis (UC) and Crohn's disease (CD). We measured the serum anti-CRT antibodies of 31 Japanese patients with UC and 24 with CD by ELISA. The controls were 105 subjects: 30 healthy persons, 44 patients with primary biliary cirrhosis (PBC), 21 with systemic lupus erythematosus (SLE) and 10 with acute colitis (AC). The mean titer of anti-CRT antibodies was significantly higher in patients with UC than in healthy individuals (p <0.05). The prevalence of anti-CRT antibodies in these patients was significantly higher during the initial phase than during the passing phase (p <0.05). In patients with CD, the mean titer of anti-CRT antibodies was not significantly higher than in healthy individuals. The positivity for anti-CRT antibodies, however, was about 30% in those patients, which was as high as in patients with UC, SLE and PBC. In patients with AC, anti-CRT antibodies were all negative. The positivity of anti-CRT antibodies may have a diagnostic value for IBD, especially in the initial phase of UC.


Moving toward precision PTSD treatment: predicting veterans' intensive PTSD treatment response using continuously updating machine learning models.
Considerable heterogeneity exists in treatment response to first-line posttraumatic stress disorder (PTSD) treatments, such as Cognitive Processing Therapy (CPT). Relatively little is known about the timing of when during a course of care the treatment response becomes apparent. Novel machine learning methods, especially continuously updating prediction models, have the potential to address these gaps in our understanding of response and optimize PTSD treatment. Using data from a 3-week (n = 362) CPT-based intensive PTSD treatment program (ITP), we explored three methods for generating continuously updating prediction models to predict endpoint PTSD severity. These included Mixed Effects Bayesian Additive Regression Trees (MixedBART), Mixed Effects Random Forest (MERF) machine learning models, and Linear Mixed Effects models (LMM). Models used baseline and self-reported PTSD symptom severity data collected every other day during treatment. We then validated our findings by examining model performances in a separate, equally established, 2-week CPT-based ITP (n = 108). Results across approaches were very similar and indicated modest prediction accuracy at baseline (R2 ~ 0.18), with increasing accuracy of predictions of final PTSD severity across program timepoints (e.g. mid-program R2 ~ 0.62). Similar findings were obtained when the models were applied to the 2-week ITP. Neither the MERF nor the MixedBART machine learning approach outperformed LMM prediction, though benefits of each may differ based on the application. Utilizing continuously updating models in PTSD treatments may be beneficial for clinicians in determining whether an individual is responding, and when this determination can be made.


Corneal refractive surgery: past to present.
There have been many historical corneal refractive techniques and procedures developed over the years. From early techniques of radial keratotomy to modern excimer laser techniques, the field of refractive surgery is one of the most rapidly developing in ophthalmology. This review details the historical aspects of the many early techniques up to current techniques used on millions of eyes around the world.


Molecular cloning and sequence analysis of the catalytic subunit of bovine type 2A protein phosphatase.
We have isolated a cDNA clone corresponding to the Mr 38,000 catalytic subunit of bovine type 2A protein phosphatase. The cDNA was isolated from a bovine adrenal gland cDNA library through the use of oligonucleotide probes whose sequences were based on partial amino acid sequence obtained from cyanogen bromide fragments of the purified cardiac enzyme. The entire 1724-base-pair cDNA has been sequenced and found to contain an open reading frame coding for a protein of 325 amino acids having a calculated molecular weight of 37,320. The deduced amino acid sequence contains the experimentally determined sequences of five different cyanogen bromide peptides. Transfection of COS-m6 cells with the cloned cDNA resulted in transient expression of a protein that could be detected by immunoblot analysis with a monoclonal antibody directed against the purified cardiac protein phosphatase. The expressed protein had the same apparent molecular weight as the purified enzyme when analyzed by NaDodSO4/polyacrylamide gel electrophoresis, suggesting that this clone contains the entire coding region of the phosphatase mRNA. The cloned cDNA hybridizes to a mRNA of 2.0 kilobases in bovine heart and adrenal gland. Under conditions of reduced stringency, the cDNA also hybridizes to a mRNA species of 1.2 kilobases in cardiac tissue.


Symptom variation on the trauma symptom checklist for children: a within-scale meta-analytic review.
Trauma exposure in youth is widespread, yet symptom expression varies. The present study employs a within-scale meta-analytic framework to explore determinants of differential responses to trauma exposure. The meta-analysis included 74 studies employing samples of youth exposed to traumatic events and who completed the Trauma Symptom Checklist for Children (TSCC). Mean weighted T scores across all TSCC subscales for U.S. samples ranged between 49 and 52. Youth outside the U.S. reported higher posttraumatic stress, anxiety, and depressive symptoms, whereas those exposed to sexual abuse reported the highest posttraumatic stress, anxiety, depressive, and dissociative symptoms. Higher female representation in samples was associated with higher symptoms on all TSCC subscales except anger. In contrast, ethnic minority representation was associated with lower depressive symptoms. Moderator analyses revealed that sexual abuse, increased percentage of females, and older age were all associated with higher posttraumatic symptoms. The present meta-analytic results help elucidate some of the divergent findings on symptom expression in youth exposed to traumatic events.


Management of neonatal abstinence syndrome in the newborn nursery.
Maternal drug use and neonatal abstinence syndrome (NAS) are being seen across the United States. NAS occurs with withdrawal disturbances in response to the cessation of the pregnancy exposure. The clinical presentation of a newborn with NAS can include gastrointestinal, neurologic, vasomotor and respiratory symptoms. Assessment of newborns with NAS can often present as a challenge to maternal-child nurses. Treatment can include supportive care as well as pharmacologic therapies.


Obesity-induces Organ and Tissue Specific Tight Junction Restructuring and Barrier Deregulation by Claudin Switching.
Obesity increases susceptibility to multiple organ disorders, however, underlying mechanisms remain unclear. The subclinical inflammation assisted by obesity-induced gut permeability may underlie obesity-associated co-morbidities. Despite eminent clinical significance of the obesity led gut barrier abnormalities, its precise molecular regulation remains unclear. It is also unknown whether barrier deregulations, similar to the gut, characterize other vital organs in obese individuals. The claudin family of proteins is integral to the tight junction (TJ), the apical cell-cell adhesion and a key regulator of the epithelial barrier. Using comprehensive physiological and biochemical analysis of intestinal and renal tissues from high-fat diet fed mice, critical for maintaining metabolic homeostasis, this study demonstrates that profound TJ-restructuring by organ and tissue-specific claudin switching characterize obese organs. Protein expression and cellular distribution were examined. In-silico analysis further highlighted potential association of select claudins, modulated by the obesity, with signaling and metabolic pathways of pathological significance. In vitro studies using Leptin or DCA-treatment suggested causal significance of obesity-induced changes in tissue microenvironment in regulating barrier deregulations in tissue-specific manner. Overall, current findings advances our understanding of the molecular undertakings of obesity associated changes that help predispose to specific diseases and also identifies novel windows of preventive and/or therapeutic interventions.


Effect of rifampin on apparent clearance of everolimus.
To assess the influence of the CYP3A4 enzyme inducer rifampin on the pharmacokinetics of the immunosuppressant everolimus to provide guidance for their coadministration. In this open-label, single-sequence, crossover study, 12 healthy subjects received a single oral 4-mg dose of everolimus alone and again after an 8-day pretreatment with rifampin 600 mg/d. Urinary excretion of 6beta-hydroxycortisol was measured at various time points during rifampin treatment as a marker of CYP3A4 induction. Urine excretion of 6beta-hydroxycortisol was significantly elevated during treatment with rifampin compared with prestudy, indicating enzyme induction. When everolimus was coadministered during rifampin treatment, the apparent clearance of everolimus was significantly increased, on average by 172%. This was manifested as a decrease in maximum concentration in all subjects, on average by 58% (range 14-73%). The AUC remained unaffected in 1 subject (although 6beta-hydroxycortisol indicated enzyme induction) and decreased in the other 11 subjects. The average decrease in AUC in the full study population was 63% (range 0-82%). Everolimus half-life was reduced significantly, from an average of 32 hours to 24 hours. In everolimus-treated patients for whom rifampin is indicated, alternative agents with less enzyme induction potential than rifampin could be considered. Alternatively, the dose of everolimus could be individually titrated based on everolimus therapeutic drug monitoring during rifampin therapy.


Molecular and Biological Characterization of Two New Species Causing Peach Shoot Blight in China.
Peach shoot blight (PSB), which kills shoots, newly sprouted leaf buds, and peach fruits, has gradually increased over the last 10 years and resulted in 30 to 50% of total production loss of the peach industry in China. Phomopsis amygdali has been identified as the common causal agent of this disease. In this study, two new species, Phomopsis liquidambaris (strain JW18-2) and Diaporthe eres (strain JH18-2), were also pathogens causing PSB, as determined through molecular phylogenetic analysis based on the sequences of the internal transcribed spacer (ITS) region, translation elongation factor 1-α (EF1-α) and beta-tubulin (TUB), and colony and conidial morphological characteristics. Biological phenotypic analysis showed that the colony growth rate of strain JW18-2 was faster than that of strains JH18-2 and ZN32 (one of the P. amygdali strains that we previously found and identified). All three strains produced α-conidia; however, JW18-2 could not produce β-conidia on alfalfa decoction and Czapek media, and the β-conidia produced by strain JH18-2 were shorter in length and thicker in width than those produced by strain ZN32. Pathogenicity tests showed that JW18-2 presented the strongest pathogenicity for peach fruits and twigs and was followed by strains JH18-2 and ZN32. The results shed light on the etiology of PSB and provide a warning that P. liquidambaris or D. eres might develop into dominant species after a few years while also potentially benefitting the development of effective disease control management strategies.


Killing kinetics of simian immunodeficiency virus-specific CD8+ T cells: implications for HIV vaccine strategies.
Both the magnitude and function of vaccine-induced HIV-specific CD8+ CTLs are likely to be important in the outcome of infection. We hypothesized that rapid cytolysis by CTLs may facilitate control of viral challenge. Release kinetics of the cytolytic effector molecules granzyme B and perforin, as well as the expression of the degranulation marker CD107a and IFN-gamma were simultaneously studied in SIV Gag(164-172) KP9-specific CD8+ T cells from Mane-A*10+ pigtail macaques. Macaques were vaccinated with either prime-boost poxvirus vector vaccines or live-attenuated SIV vaccines. Prime-boost vaccination induced Gag-specific CTLs capable of only slow (after 3 h) production of IFN-gamma and with limited (<5%) degranulation and granzyme B release. Vaccination with live-attenuated SIV resulted in a rapid cytolytic profile of SIV-specific CTLs with rapid (<0.5 h) and robust (>50% of tetramer-positive CD8+ T cells) degranulation and granzyme B release. The cytolytic phenotype following live-attenuated SIV vaccinations were similar to that associated with the partial resolution of viremia following SIV(mac251) challenge of prime-boost-vaccinated macaques, albeit with less IFN-gamma expression. High proportions of KP9-specific T cells expressed the costimulatory molecule CD28 when they exhibited a rapid cytolytic phenotype. The delayed cytolytic phenotype exhibited by standard vector-based vaccine-induced CTLs may limit the ability of T cell-based HIV vaccines to rapidly control acute infection following a pathogenic lentiviral exposure.


Effects of sequential administration of bleomycin in combination with mitomycin C on squamous cell carcinoma of oral regions.
A sequential administration of bleomycin in combination with mitomycin C was evaluated clinically and histologically in ten patients with squamous cell carcinoma of the oral region. The therapy was effective against seven primary lesions and one metastatic lesion with an evident tendency to remission, but was completely ineffective against recurrent carcinomas. Myelosuppression seemed to be a more important toxic effect than the bleomycin-induced pneumonitis. The mechanism of action of the therapy and indications in clinical application are discussed.


Chronic bronchopulmonary aspergillosis in a horse with Cushing's syndrome.
An atypical case of chronic equine bronchopulmonary aspergillosis with an unusual hyphal morphology was diagnosed in a horse with Cushing's syndrome. Because of the hyphal localization in chronic ectatic bronchi and bronchioles, and juxtabronchiolar processes, the observed type of aspergillosis is similar to 'saprophytic bronchopulmonary aspergillosis' or 'semi-invasive pulmonary aspergillosis' in humans. The aetiological diagnosis of aspergillosis was accomplished by the application of a panel of monospecific polyclonal and monoclonal antibodies in immunohistochemical techniques.


Dispersion relations for the convective instability of an acidity front in Hele-Shaw cells.
Autocatalytic chemical fronts of the chlorite-tetrathionate (CT) reaction become buoyantly unstable when they travel downwards in the gravity field because they imply an unfavorable density stratification of heavier products on top of lighter reactants. When such a density fingering instability occurs in extended Hele-Shaw cells, several fingers appear at onset which can be characterized by dispersion relations giving the growth rate of the perturbations as a function of their wave number. We analyze here theoretically such dispersion curves comparing the results for various models obtained by coupling Darcy's law or Brinkman's equation to either a one-variable reaction-diffusion model for the CT reaction or an eikonal equation. Our theoretical results are compared to recent experimental data.


Fasudil improves short-term echocardiographic parameters of diastolic function in patients with type 2 diabetes with preserved left ventricular ejection fraction: a pilot study.
Left ventricular (LV) diastolic dysfunction is observed frequently in patients with type 2 diabetes; however, few studies have focused on the effect of the Rho-associated kinase inhibitor fasudil on cardiac performance in humans. We conducted a prospective pilot study to assess the impact of fasudil on LV diastolic function in patients with diabetes without systolic dysfunction. Two hundred and fifty eligible patients with type 2 diabetes (149 men [61.3 %] and 94 women [38.7 %]) with a mean age of 57.2 years were randomly assigned to fasudil (n = 122, 30 mg intravenously twice a day for 14 days) or placebo (n = 121) groups. Echocardiographic variables were measured at the baseline and 1 month after the intervention. Compared with the placebo group, the fasudil group showed a significant decrease in diastolic blood pressure and in the peak of late diastolic transmitral flow (Am) (P < 0.05 for both). Deceleration time (DT), isovolumic relaxation time (IVRT), the peak of early diastolic annular velocity (e'), the peak of late diastolic annular velocity, and E/e' also exhibited a significant improvement (all, P < 0.05) after fasudil administration. Furthermore, the Em/Am ratio and IVRT, DT, and E/e' values recorded after fasudil treatment in the subgroup with impaired LV relaxation significantly differed from the corresponding values in the subgroup with normal LV relaxation (all, P < 0.05). Fasudil improves short-term echocardiographic parameters of LV diastolic function in patients with type 2 diabetes with preserved left ventricular ejection fraction.


Churg-Strauss syndrome and polyarteritis nodosa.
In the past year, the major contributions to our understanding of Churg-Strauss syndrome and polyarteritis nodosa were the development of classification criteria by which to separate these from other vasculitides. The absence of granulomas in most biopsies from patients with Churg-Strauss syndrome was noted. Other reports suggested that allergic disease may be only one of the hypereosinophilic conditions that predispose to this form of vasculitis. Eosinophilia and vasculitis occurring in a patient after dietary supplementation with L-tryptophan were reported, and the prominent cardiac involvement in Churg-Strauss syndrome was reemphasized. Impressive responses of that disease to cyclophosphamide were documented in one patient. In the American College of Rheumatology Vasculitis Classification Study, polyarteritis nodosa was one of the hardest vasculitides to distinguish. Several reports reiterated the serious risk of major pulmonary hemorrhage from microscopic polyarteritis of the lung, which probably represents a forme fruste of Wegener's granulomatosis. Although no new studies of therapy in polyarteritis were reported, a review of infections in such patients indicated that exposure to more than 15 mg/d of prednisone correlated with infectious complications, and that intra-abdominal infections were particularly problematic.


[Flipping moxibustion of Hui medicine at acupoints in governor vessel combined with acupuncture for vascular dementia].
To observe the difference for vascular dementia among flipping moxibustion of Hui medicine at acupoints in governor vessel combined with acupuncture, simple Hui medicine and simple acupuncture. A total of 120 patients with vascular dementia were randomly assigned into a combination group, a flipping moxibustion group and an acupuncture group, 40 cases in each one, with 2 patients dropping respectively. Flipping moxibustion was used at the acupoints of group A on Monday and at the acupoints of group B on Friday in the flipping moxibustion group. The acupoints of group A were Baihui (GV 20), Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Jizhong (GV 6), Mingmen (GV 4), Yaoyangguan (GV 3), and the acupoints of group B were Fengfu (GV 16), Taodao (GV 13), Shendao (GV 11), Jinsuo (GV 8), Xuanshu (GV 5), Changqiang (GV 1). Acupuncture was used in the acupuncture group at the main acupoints of Baihui (GV 20), Sishencong (EX-HN 1), Neiguan (PC 6), Zusanli (ST 36), Taixi (KI 3) and Xuanzhong (GB 39), matched with the acupoints based on syndrome differentiation, 30 min a time, once a day, continuous 5 times a week. The above two methods were applied in the combination group. All the treaments were for 4 weeks. The indexes were observed before and after treatment, including syndrome differentiationof TCM scale for vascular dementia (SDSVD), simple mental state scale (MMSE), self-care ability of daily life scale (ADL). The clinical effects and safety were evaluated. After treatment, the total effective rate in the combination group was 89.5% (34/38); the rate in the flipping moxibustion group was 65.8% (25/38); the rate in the acupuncture group was 63.2% (24/38). The difference among groups was statistically significant (P<0.05). The effect in the combination group was better than those in the flipping moxibustion group and in the acupuncture group (both P<0.05). There was no statistically significant difference between the flipping moxibustion group and the acupuncture group (P>0.05). The SDSVD scores after treatment were lower and the MMSE and ADL scores after treatment were higher than those before treatment in the three groups (all P<0.01), with better results on the above three scores in the combination group than those in the other two groups (P<0.05, P<0.01), and the differences on the three scores between the flipping moxibustion group and the acupuncture group were not statiatically significant (all P>0.05). The treatment in the three groups was safe, without stastical significance (P>0.05). The effect of flipping moxibustion combined with acupuncture for vascular dementia is better than those of simple flipping moxibustion and simple acupuncture. The combination treatment achieves better effect on TCM syndrome, cognitive function and daily activity ability than the other two simple treatment.


Trapping of anionic organic radicals by (TpMe2)2Ln (Ln = Sm, Eu).
Stoichiometric reaction of [ Sm(Tp(Me2))2 ], 1, with a variety of reducible ketone- and quinone-type substrates gave thermally stable, isolable radical anions/ketyls in moderate to good yields. Thus reaction with benzophenone gave [Sm(Tp(Me2))2(OCPh2)], 2, with fluorenone [Sm(Tp(Me2))2(eta1-OC13H8)], 3, and di-tert-butylparaquinone [Sm(Tp(Me2))2(eta1-OC6H2(tBu)2O)], 4, each of which was structurally characterized. In the case of the less-hindered benzoquinone, an unimetallic semiquinone [Sm(Tp(Me2))2(OC6H4O)], 5, could be isolated, although it was unstable with respect to formation of the dimetallic complex [Sm(Tp(Me2))2]2(mu-OC6H4O), 6. Compound 6 was structurally characterized, as was its anthraquinone analogue [Sm(Tp(Me2))2]2(mu-OC14H8O), 7. When the analogous reaction was carried out between the less-reducing [Eu(Tp(Me2))2] and benzoquinone, only the europium analogue of the semiquinone 5, [Eu(Tp(Me2))2(OC6H4O)], 8, could be isolated. The use of the sterically hindered 3,5-di-tert-butyl-o-benzoquinone allowed isolation of [Sm(Tp(Me2))2(DTBSQ)], 9.


[Epididymis trombosed hemangioma in old patient. Presentation of 1 case with conceptual review and of the literature].
Though theoretically in the paratesticular region one can develop any type of benign tumour of soft tissues, they are the lipomas, leiomyomas and adenomatoid tumours the most usual whereas the hemangiomas are less common. We contribute a new case of epididymis intrascrotal hemangioma (HI), valuing the bibliography that allows us to know the incidence and clinic-pathologic characteristics of these tumours. A 74-year-old patient includes for study with right scrotal tumour, who is practised orchiectomy. Hystopathologic study is realized. Of equal form there is realized a bibliographical examination of this type of tumours across Medline and of not index-linked search with conceptual review and of the literature. The injury corresponds with a HI cavernous trombosed of epididymis with testicular parenchyma respected. Your hystopathologic diagnosis does not present problems, whereas the clinical one and ultrasonographic study, reaches the whole spectrum of tumours, benign and malignant of soft tissues. The number of intrascrotal hemangiomas of epididymis described in the literature is very limited. The scrotal tumours are necessary a preoperatory clinical and sonographic study completely, in spite of the fact that they are diagnosed the majority after your surgical removal. The complex system of the tissues on the zone paratesticular implies that the differential enclosed diagnosis does not allow to differentiate, malignant tumours of benign. The low incident of many of these masses has determined the mistake of standardized protocols for your diagnosis but also for their unified treatment.


Ultrasound, Echocardiography, MRI, and Genetic Analysis of a Fetus with Congenital Diaphragmatic Hernia and Partial 11q Trisomy.
Congenital diaphragmatic hernia (CDH) is a serious birth defect with a significant mortality and morbidity. The current and constant progress in ultrasound techniques has led to the improvement of the prenatal diagnosis of this malformation. CDH is a developmental defect whose etiology is heterogeneous and takes place when the pleuroperitoneal folds and septum transversum fail to converge and fuse. Survival depends on the extent of pulmonary hypoplasia and the disease may be potentially worsened by the presence of added congenital defects. 40% of CDH cases are associated with at least one additional anomaly. The ultrasound diagnosis is established with essential signs: loss of uniform echogenicity of lungs and marked mediastinal shift. We report the case of a fetus with isolated CDH diagnosed at 21 weeks of gestation by ultrasound and confirmed by RMI, whose genetic analysis of amniotic fluid cells identified a de novo partial trisomy of the long arm of chromosome 11. Different genetic causes have been associated with CDH. Moreover, it is expectable that the use of new techniques for prenatal diagnosis will reveal novel CNVs associated with CDH and will help us to estimate the recurrence risk for this defect as well as for other associated anomalies.


[Mandibular resection and reconstruction by an intraoral approach].
Resection and reconstruction of the mandible by intraoral way. The results of resection and reconstruction of the mandible for 12 patients with benign tumors and dysplastic processes by intraoral way are introduced. Indications and the surgery are developed and long-term outcomes are considered. Patients observation for several years proved these suggested methods to be effective.


Measuring hospital staff nurses perception on quality of the professional practice environment.
The purpose of this study was to determine construct validity of the Dutch Essentials of Magnetism II © instrument, designed to assess nursing practice environments, using hypotheses testing. Reduction in hospital length of stay and the number of inpatient beds increases care intensity. Educational levels and numbers of nursing staff in hospitals, however, do not match this increase, resulting in a strain on quality of care and patient safety. A possible answer to existing concerns about quality of care may be the creation of a productive and healthy practice environment, as this has an impact on the quality of care. Therefore, areas requiring improvement of the practice environment have to be defined. A cross-sectional, correlational study design. We determined construct validity with hypotheses testing by relating the Dutch Essentials of Magnetism II to the Dutch Practice Environment Scale of the Nursing Work Index. We formulated 15 hypotheses prior to data-analysis; 10 related to convergent validity and five related to discriminant validity. Data were collected from qualified nurses (N = 259) on nine randomly selected hospital wards from March to April 2012. Response rate was 47% (n = 121). Total scores of both instruments are strongly correlated (r = 0·88). In total, 12 of 15 hypotheses (80%) were confirmed and three were rejected. The D-EOMII has satisfactory construct validity for measuring the nursing practice environment in hospitals and can be used by nurses, managers, health policy makers, hospitals and governments to assess and identify processes and relationships that are in need of improvement.


The "doctor-customer" relationship: Hippocrates in the modern marketplace.
We performed a consecutive survey of 100 people presenting to a hospital injury clinic to ascertain their attitude to terminology currently used to describe them in our own institution and in the international literature. The results of this demonstrated that the subjects significantly preferred the traditional assignation "patient" rather than terms such as client or customer. This finding reflects the need to remember peoples' attitudes and expectations from their consultation with their doctor. Although business models undoubtedly help in the provision of an efficient health care service, remaining at the centre of this encounter is a doctor-patient relationship that involves a more complex interaction than simply a market transaction.


[Trochanteric femoral fractures].
At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. Our department serves as a trauma centre for half of Prague and part of the Central Bohemia Region with a population of 1 150 000. Prague in particular has a high number of elderly citizens. Our experience is based on extensive clinical data obtained from the Register of Proximal Femoral Fractures established in 1997. During 14 years, 4280 patients, 3112 women and 1168 men, were admitted to our department for treatment of proximal femoral fractures. All patients were followed up until healing or development of complications. In the group under study, 82% were patients older than 70 years; 72% of those requiring surgery were in their seventies and eighties. Men were significantly younger than women (p<0.001) and represented 30% of the group. The fractures were 2.3-times more frequent in women than in men. In the category under 60 years, men significantly outnumbered women (p<0.001). The patients with pertrochanteric fractures were, on the average, eight years older than the patients with intertrochanteric fractures, which is a significant difference (p<0.001). The mortality rate within a year of injury was about 30%. Trochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all fractures. The inter-annual increase was 5.9%, with more trochanteric than femoral neck fractures. There was a non-significant decrease in intertrochanteric (AO 31-A3) fractures. On the other hand, the number of pertrochanteric (AO 31-A1+2) fractures increased significantly (p<0.001). A total of 1 394 fractures were treated with a proximal femoral nail; a short nail was used in 1260 and a long nail in 134 of them. A dynamic hip screw (DHS) was employed to treat 947 fractures. Distinguishing between pertrochanteric (21-A1, 31-A2) and intertrochanteric (31-A3) fractures is considered an important approach because of their different behaviour at reduction. Pertrochanteric fractures occurred more frequently (81.5%); the patients' age was higher (80 years on the average) and women outnumbered men at a ratio of 3:1. Intertrochanteric fractures were found in significantly younger patients (average, 72 years), with a women-to-men ratio of 1.3:1. Stable pertrochanteric fractures (31-A1) were preferably indicated for DHS surgery. Unstable pertrochanteric (31-A2) and intertrochanteric (31- A3) fractures were treated with a nail. The patients underwent surgery on the day of injury or the next day. In the case of contraindications to an urgent intervention, surgery was performed after the patient's medical condition had stabilised. The number of complications was largely related to technical errors, such as insufficient reduction or an incorrectly inserted implant. Intertrochanteric fractures were associated with a higher occurrence of complications. No implant can compensate for errors due to surgery. Serious complications can be reduced by the correct assessment of fracture type, the use of an appropriate operative technique and early treatment of potential complications. The necessity of restoring continuity in the medial cortex of the femoral neck (Adams' arch) is the requirement that should be observed. Pseudoarthrosis or varus malalignment in a healed hip should be managed by valgus osteotomy. When the femoral head or the acetabulum is damaged, total hip arthroplasty is indicated. A prerequisite for successful surgical outcome is urgently and correctly performed osteosynthesis allowing for early rehabilitation and mobilisation of the patient.


On the Electrochemical Detection of Alpha-Fetoprotein Using Aptamers: DNA Isothermal Amplification Strategies to Improve the Performance of Weak Aptamers.
Affinity characterization is essential to develop reliable aptamers for tumor biomarker detection. For alpha-fetoprotein (AFP), a biomarker of hepatocellular carcinoma (HCC), two DNA aptamers were described with very different affinity. In this work, we estimate the dissociation constant of both of them by means of a direct assay on magnetic beads modified with AFP and electrochemical detection on carbon screen-printed electrodes (SPCE). Unlike previous works, both aptamers showed similar dissociation constant (Kd) values, in the subµM range. In order to improve the performance of these aptamers, we proposed the isothermal amplification of the aptamers by both terminal deoxynucleotidyl transferase (TdT) and rolling circle amplification (RCA). Both DNA amplifications improved the sensitivity and also the apparent binding constants from 713 nM to 189 nM for the short aptamer and from 526 nM to 32 nM for the long aptamer. This improvement depends on the true affinity of the binding pair, which ultimately limits the analytical usefulness.


Conservation spillover effect of UNESCO World Heritage Sites into surrounding landscapes.
Protected areas (PA) are one of the primary tools for conserving and protecting biodiversity, but their goals have evolved overtime beyond nature conservation to include supporting human communities within and adjacent to the PA. UNESCO World Heritage Sites (WHS) offer a unique perspective on the success of PAs as they fall under three categories, cultural, natural, and mixed heritage sites. The nature of these categories encapsulates the inclusion of human communities in the goals of the WHS. To understand the impact and relationship the WHS has with its surrounding landscape, we assessed changes in three indicators, land use and land cover (LULC), human footprint (HF), and forest landscape integrity index (FLII), across three spatial scales, 1, 10, 100 km from the WHS boundary. We found that there is a conservation spillover effect at least within 1 km of the WHS boundary. In this buffer zone, HF was low and FLII was high. FLII was lower and HF was higher at larger spatial scales. The relationship between the WHS and its surrounding landscape is one reason to support the WHS network, however, management of PAs should be more explicit about this relationship as well as relationships between individual PAs.


John Aitken (d. 1790)--grinder or scholar?
John Aitken attended the University of Edinburgh between 1763 and 1769 but did not graduate MD. He gained the membership (i.e. fellowship) of the Royal College of Surgeons of Edinburgh in 1770, and was for two sessions Senior President of the Royal Medical Society. Between 1771 and 1790 he published numerous books and pamphlets on surgery, medicine, midwifery, anatomy and physiology. As a surgeon at the Royal Infirmary, from 1779, he lectured on most subjects in the medical curriculum. John Struthers was particularly scathing of Aitken's scholarship, and this article attempts to restore Aitken's reputation as a scholar and probably one of the first of the extra-academical lecturers, who taught both anatomy and surgery in Edinburgh from 1779 until his death in 1790.


The NMR-derived conformation of neuropeptide F from Moniezia expansa.
The solution structure of neuropeptide F (NPF), from the flatworm (platyhelminthes) Moniezia expansa, has been determined by (1)H NMR spectroscopy at 800 MHz in 60%/40% CD(3)OH/H(2)O. NPF is the most abundant neuropeptide in platyhelminthes. The secondary structure of NPF contains an alpha helix from residues Lys(14) to Ile(31), while the N terminus, consisting of residues Pro(-2) to Asn(13), and the C-terminus, consisting of residues Gly(32) to Phe(36), are in a random conformation. The structure was calculated by a simulated annealing protocol, and the conformational data are compared to the porcine neuropeptide Y (NPY), a peptide hormone and neurotransmitter. The exact function of NPF is unknown, but structural similarity with porcine NPY indicates that its mode of action is similar. These structural data can serve as a starting point in the design of new antiparasitic drugs.


The folly of boxology.
Although the authors do a valuable service by elucidating the pitfalls of inferring top-down effects, they overreach by claiming that vision is cognitively impenetrable. Their argument, and the entire question of cognitive penetrability, seems rooted in a discrete, stage-like model of the mind that is unsupported by neural data.


Sterile pyuria: a forgotten entity.
Sterile pyuria is a common entity. Yet there are no guidelines to address this issue. We have conducted a systematic review over 20 years and reviewed the results. Guidelines for assessment, diagnosis and management are developed based on these results.


Optimal target blood pressure for major adverse cardiovascular and cerebrovascular events in hypertensive patients: a nationwide population-based study.
Generalizing an 'optimal' blood pressure (BP) level for individuals with hypertension remains controversial due to the implementation of different medical guidelines. This study investigated the association of BP with major adverse cardiovascular and cerebrovascular events (MACCE) and determined the optimal BP for patients with hypertension. A total of 934 179 individuals who received antihypertensive medications were selected from the National Health Insurance Service Examination Database between 2003 and 2011 in Korea. Their BP was measured at the index date, which was the first health examination. The study outcomes were MACCE, including acute myocardial infarction, heart failure, stroke, and all-cause mortality. The participants were monitored until in December, 2017. The hazard ratios were calculated using Cox proportional hazard models. The cumulative incidence of MACCE for each BP group was estimated using the Kaplan-Meier method. A lower risk of MACCE was observed at a SBP of 120-129 mmHg and a DBP of 80-89 mmHg. The endpoint-specific incidence rates and hazard ratios for acute myocardial infarction, heart failure, stroke, and all-cause mortality were the lowest at a SBP of 120-129 mmHg and a DBP of 80-89 mmHg. Even though this observational study did not support inference of a causal relationship, a SBP of 120-129 mmHg and a DBP of 80-89 mmHg may be safely recommended considering the possibility of MACCE in Korean patients with hypertension. In addition, the target BP should be tailored individually according to age, sex, and comorbidities.


Resting State Effective Connectivity Allows Auditory Hallucination Discrimination.
Hallucinations are elusive phenomena that have been associated with psychotic behavior, but that have a high prevalence in healthy population. Some generative mechanisms of Auditory Hallucinations (AH) have been proposed in the literature, but so far empirical evidence is scarce. The most widely accepted generative mechanism hypothesis nowadays consists in the faulty workings of a network of brain areas including the emotional control, the audio and language processing, and the inhibition and self-attribution of the signals in the auditive cortex. In this paper, we consider two methods to analyze resting state fMRI (rs-fMRI) data, in order to measure effective connections between the brain regions involved in the AH generation process. These measures are the Dynamic Causal Modeling (DCM) cross-covariance function (CCF) coefficients, and the partially directed coherence (PDC) coefficients derived from Granger Causality (GC) analysis. Effective connectivity measures are treated as input classifier features to assess their significance by means of cross-validation classification accuracy results in a wrapper feature selection approach. Experimental results using Support Vector Machine (SVM) classifiers on an rs-fMRI dataset of schizophrenia patients with and without a history of AH confirm that the main regions identified in the AH generative mechanism hypothesis have significant effective connection values, under both DCM and PDC evaluation.


Error accumulations in adhesive energies of dihydrogen molecular chains: performances of the XYG3 type of doubly hybrid density functionals.
We have systematically analyzed the error accumulations in the adhesive energies for a series of hydrogen molecular chains calculated by various kinds of density functional theory (DFT) methods. In particular, we have focused on some representative doubly hybrid (DH) functionals of either the B2PLYP type (B2PLYP, B2PLYP-D, and B2GP-PLYP) or the XYG3 type (XYG3, XYGJ-OS, and xDH-PBE0). The hydrogen molecular chain models have recently been proposed by Zheng et al. (J. Chem. Phys. 2012, 137, 214106) to identify the delocalization errors (DEs) in thermodynamic properties. From the perspective of DEs, it is shown here that the XYG3 type of DH functionals yield good performance on the calculated adhesive energies due to the minimizing effects of DEs, highlighting the underlying physics for the successes or failures of the approximate functionals. Examination was also extended to HF-DFT, where DFT energies are evaluated with the Hartree-Fock (HF) densities.


CO2 Adsorption Over Metal-Organic Frameworks: A Mini Review.
Metal-organic frameworks (MOFs) are a class of porous materials that are comprised of metal ion-containing nodes linked by multi-dentate organic ligand bridges principally through coordination bonding. Over the last few decades, MOFs have been studied widely as CO2 adsorbents. CO2 adsorption in MOFs can be enhanced by tuning their physicochemical properties. This short review discusses CO2 adsorption over MOFs with particular focus on the contributory effects of (1) inherent textural properties, (2) coordinatively unsaturated open metal sites, (3) surface functionalization, (4) structural interpenetration (catenation), and (5) ion-exchange.


Programmed-cell-death hallmarks in incompatible pollen and papillar stigma cells of Olea europaea L. under free pollination.
Programmed cell death (PCD) is a process that occurs both in animals and in plants and is an essential element in developmental processes. Pollination is a key factor in fruit production and self-incompatibility is one of the main limiting factors of this process. PCD has recently been put forward as a possible cause of pollen-growth arrest. As far as the olive is concerned, no data have been published concerning the mechanisms involved in hindering the growth of pollen tubes in incompatible pollen. Thus, we have studied olive pistils excised from freely pollinated flowers at different stages before and during the progamic phase using different cytochemical techniques, including trypan blue staining. To discover whether the elimination of incompatible pollen might be associated to PCD, we applied different tests to the excised pistils: (1) TUNEL assay; (2) DNA degradation analysis; (3) detection of caspase-3-like activity. Once we had determined that PCD was involved in pollen selection after free pollination, we conducted experiments after controlled pollination in pistils excised from flowers: (a) developing in the absence of pollen; (b) pollinated with sterile pollen that does not germinate; (c) self-pollinated; (d) pollinated with compatible pollen. Our results demonstrate that the growth of tubes in incompatible pollen is halted in the stylar area in a way that suggests the intervention of PCD. Furthermore, any pollen, even if sterile, seemed to accelerate PCD in papillar cells in the olive.


P glycoprotein: a new mechanism to control drug-induced nephrotoxicity.
The role of P glycoprotein (P-gp) in kidney is now being explored, and under physiological conditions, this protein is thought to be an excretory pump of cationic xenobiotics and metabolites. Functionally, two different types of P-gp have been described, but only the class I has been related to drug transport, and its overexpression confers the multidrug resistance phenotype in tumoral cells. It has been proposed that P-gp is involved in the energy-dependent transport of substrates through the cell membrane (toxic metabolites, toxins, nutrients, ions, peptides, etc.)--like a 'hydrophobic molecule vacuum cleaner'. Several physiological functions have been attributed to P-gp: defense against xenobiotic aggression and transmembrane transport of prenylcysteine methyl esters, removing these cytotoxic metabolites from cells. A variety of substrates ranging from chemotherapeutics to steroid hormones, antibiotics, and calcium channel blockers can be transported by P-gp, suggesting the possible involvement of this protein in other unknown functions. Results from our group and others have suggested that overexpression of P-gp in renal tubular and mesangial cells prevents pharmacological nephrotoxicity by cyclosporin A (CsA). On the other hand CsA, a substrate of the pump, could act as a blocker in tubular cells by competitive inhibition. One relevant aspect in kidney is the possible relationship between P-gp and protein kinase C. Several reports suggest that protein kinase C may play a role in inducing the P-gp overexpression in cells under xenobiotic pressure, through activation of the ras oncoprotein family. This could be mediated directly by angiotensin II as a ras activator. This way, the detoxicant function of P-gp against products of the ras catabolism could mediate their accumulation when the 'vacuum cleaner' function is blocked by CsA or tacrolimus, contributing to the initial development of fibroblastic activation that leads to interstitial fibrosis associated with nephrotoxicity by these immunosuppressor drugs. In conclusion, P-gp expression could be an important component of a complex detoxifying system in kidney against xenobiotics or regulating the traffic of endogenous metabolites responsible for the susceptibility of subjects to the development of nephrotoxicity against different drugs.


Cardiac diastolic function in pediatric patients receiving doxorubicin.
The purpose of the study was to compare systolic and diastolic function in pediatric patients treated with doxorubicin. Left ventricular function was evaluated in 61 children prior to and following chemotherapy. None had clinical evidence of cardiac decompensation prior to treatment. All received relatively low cumulative doses of doxorubicin; the majority received the drug by continuous infusion. Systolic function was estimated using fractional shortening; diastolic function was estimated using A wave velocity, E wave velocity, E to A ratio, and deceleration time. There was a small but significant decline in systolic cardiac function as estimated from changes in fractional shortening that could not be appreciated in any of the measured parameters of diastolic function. A variety of reasons that could be responsible for the absence of significant changes in diastolic function are discussed. For the present, estimations of systolic function are preferred over the studied parameters of diastolic function in the evaluation of cardiac status in pediatric patients receiving doxorubicin containing regimens.


Stereoselective alkyl C-glycosylation of glycosyl esters via anomeric C-O bond homolysis: efficient access to C-glycosyl amino acids and C-glycosyl peptides.
C-Glycosyl peptides possess excellent metabolic stability and therapeutic properties and thus play critical roles in biological studies as well as drug discoveries. However, the limited accessibility of C-glycosyl amino acids has significantly hindered the broader research of their structural features and mode of action. Herein, for the first time we disclose a novel visible-light-driven radical conjugate addition of 1,4-dihydropyridine (DHP)-derived glycosyl esters with dehydroalanine derivatives, generating C-glycosyl amino acids and C-glycosyl peptides in good yields with excellent stereoselectivities. Redox-active glycosyl esters, as readily accessible and bench-stable radical precursors, could be easily converted to glycosyl radicals via anomeric C(sp3)-O bond homolysis under mild conditions. Importantly, the generality and practicality of this transformation were fully demonstrated in >40 examples including 2-dexosugars, oligosaccharides, oligopeptides, and complex drug molecules. Given its mild reaction conditions, robust sugar scope, and high anomeric control and diastereoselectivity, the method presented herein could find widespread utility in the preparation of C(sp3)-linked sugar-based peptidomimetics.


Inner and inter population structure construction of Chinese Jiangsu Han population based on Y23 STR system.
In this study, we analyzed the genetic polymorphisms of 23 Y-STR loci from PowerPlex® Y23 system in 916 unrelated healthy male individuals from Chinese Jiangsu Han, and observed 912 different haplotypes including 908 unique haplotypes and 4 duplicate haplotypes. The haplotype diversity reached 0.99999 and the discrimination capacity and match probability were 0.9956 and 0.0011, respectively. The gene diversity values ranged from 0.3942 at DYS438 to 0.9607 at DYS385a/b. Population differentiation within 10 Jiangsu Han subpopulations were evaluated by RST values and visualized in Neighbor-Joining trees and Multi-Dimensional Scaling plots as well as population relationships between the Jiangsu Han population and other 18 Eastern Asian populations. Such results indicated that the 23 Y-STR loci were highly polymorphic in Jiangsu Han population and played crucial roles in forensic application as well as population genetics. For the first time, we reported the genetic diversity of male lineages in Jiangsu Han population at a high-resolution level of 23 Y-STR set and consequently contributed to familial searching, offender tracking, and anthropology analysis of Jiangsu Han population.


Secreted Protein Acidic and Rich in Cysteine (SPARC) Enhances Cell Proliferation, Migration, and Epithelial Mesenchymal Transition, and SPARC Expression is Associated with Tumor Grade in Head and Neck Cancer.
Secreted protein acidic and rich in cysteine (SPARC) is a secreted protein which is involved in various biological processes. SPARC expression is associated with tumor metastasis and poor prognosis in several types of cancer. However, the SPARC-induced signaling pathway was not fully understood in head and neck cancer. In this study, our results showed that SPARC treatment promoted cell proliferation and migration in head and neck cancer cell lines FaDu and Detroit 562. In addition, SPARC induced expression of epithelial mesenchymal transition (EMT) regulators, including Slug, Snail, and Twist in Detroit 562. The results of phospho-kinase array analysis showed that SPARC treatment increased phosphorylation of some molecules including protein kinase B (PKB/AKT), ribosomal S6 kinase (RSK), and extracellular signal-regulated kinases (ERK). The expression of SPARC-induced EMT regulator Slug was suppressed by AKT inhibitor, but not ERK and RSK inhibitors. The SPARC expression in grade IV tumor samples is higher when compared to that in grade I-III tumor samples. Our results suggest that SPARC treatment enhances the EMT signaling pathway via activation of AKT, and exogenous SPARC and tumor expressing SPARC might be associated with tumor progression in head and neck cancers.


Kinetic studies of sequence-specific binding of GCN4-bZIP peptides to DNA strands immobilized on a 27-MHz quartz-crystal microbalance.
Specific protein-DNA interaction was studied quantitatively by using a highly sensitive 27-MHz quartz-crystal microbalance (QCM). Biotinylated DNA double strands (21 bp, having a CRE site of 5'ATGACGTCAT3') were immobilized on an avidin-bound QCM surface, and sequence-specific binding of bZIP 56-mer peptides (having both the basic region for binding and the leucine zipper region for dimerization) to the DNA strand on the QCM was observed. The binding amount (Deltam) at the nanogram level and kinetic parameters such as association constants (Ka) and binding and dissociation rate constants (k1 and k-1) could be obtained from time courses of QCM frequency decreases. A bZIP peptide as a dimer was observed to bind sequence-specifically to one DNA strand having a CRE site. Ka values of ss-bZIP, in which the leucine-zipper region of bZIP was substituted by a Cys-Cys linkage, were largely decreased, and the sequence selectivity also disappeared. Ka values obtained by the QCM method showed good agreement with those obtained from the conventional gel mobility shift assay or from circular dichroism spectrum changes. When the specific sequence of the CRE site of DNA strands was partly changed, Ka values decreased by about a half due to the increase of the dissociation rate constant (k-1) independent of the binding rate constant (k1).


Leaf senescence.
Leaf senescence constitutes the final stage of leaf development and is critical for plants' fitness as nutrient relocation from leaves to reproducing seeds is achieved through this process. Leaf senescence involves a coordinated action at the cellular, tissue, organ, and organism levels under the control of a highly regulated genetic program. Major breakthroughs in the molecular understanding of leaf senescence were achieved through characterization of various senescence mutants and senescence-associated genes, which revealed the nature of regulatory factors and a highly complex molecular regulatory network underlying leaf senescence. The genetically identified regulatory factors include transcription regulators, receptors and signaling components for hormones and stress responses, and regulators of metabolism. Key issues still need to be elucidated, including cellular-level analysis of senescence-associated cell death, the mechanism of coordination among cellular-, organ-, and organism-level senescence, the integration mechanism of various senescence-affecting signals, and the nature and control of leaf age.


Epithelial-myoepithelial carcinoma: a review of the clinicopathologic spectrum and immunophenotypic characteristics in 61 tumors of the salivary glands and upper aerodigestive tract.
To further define the clinicopathologic spectrum of epithelial-myoepithelial carcinoma (EMCa), we report the gross, histologic, and immunophenotypic characteristics of 61 tumors seen within a 30-year-period. The mean age at presentation was 60.9 years, with a female predominance (1.5:1). The most common sites were parotid (62.1%), sinonasal mucoserous glands (10.3%), palate (8.6%), and submandibular (8.6%). Most EMCas showed a characteristic nodular/multinodular growth pattern and classic biphasic tubular histology. However, new morphologies in EMCa such as ancient change (8.2%), "Verocay"-like change (3.3%), and sebaceous differentiation (13.1%) were noted. Specific histologic variants were dedifferentiated EMCa (3.3%), oncocytic EMCa (8.2%), EMCa ex pleomorphic adenoma (1.6%), double-clear EMCa (3.3%), and EMCa with myoepithelial anaplasia (3.3%). All cytokeratin cocktails selectively highlighted the epithelial component well. Of the myoepithelial markers, p63, smooth muscle actin and vimentin performed best. Bcl-2 and c-kit were frequently positive (66.7% and 69.2%, respectively). p53 was highly expressed only in 1 dedifferentiated EMCa. The recurrence rate was 36.3% (median disease-free survival 11.34 y), but death was rare with 5-year and 10-year disease-specific survivals of 93.5% and 81.8%, respectively. The most important univariate predictors of recurrence were margin status (log rank P=0.006), angiolymphatic invasion (P=0.002), tumor necrosis (P=0.004), and myoepithelial anaplasia (P=0.038). Thus, EMCa is generally a low-grade tumor with a broader morphologic spectrum than previously thought, with several key features predictive of recurrence. Immunohistochemistry can aid diagnosis by highlighting the biphasic nature of the tumor.


Cost-Based Price Calculation of Mexiletine for Nondystrophic Myotonia.
Mexiletine is a long-known drug used for the treatment of arrhythmias and repurposed in the 1980s for patients with nondystrophic myotonia (NDM). Recently, the price of mexiletine in Europe increased significantly after registration as an orphan drug for NDM. This led to international discussions on affordability and willingness to reimburse mexiletine in the absence of background information that would justify such a price. Our objective was to calculate a cost-based price for mexiletine for adult patients with NDM based on detailed information on development costs. We calculated a fair price based on a cost-based pricing model for commercial mexiletine to treat adults with NDM using a recent European drug-pricing model as a framework to include actual costs incurred. Three scenarios were applied: 1 with minimum estimated costs, 1 with maximum estimated costs, and 1 with costs as if mexiletine was innovative. The calculated fair price of mexiletine per patient per year (PPPY) is €452 for the minimum scenario and €1996 for the maximum scenario. By using hypothetical R&D costs used for innovative drugs, the price would be €6685 PPPY. In Europe, the list price of mexiletine ranges from €30 707-60 730 PPPY, based on 600 mg daily. The current list price for mexiletine in Europe is manifold higher than any scenario of the cost-based models. Accounting for the reduced costs for clinical development in a repurposing scenario, the cost-based pricing model provides a fair commercial price range, which can be used as benchmark for pricing negotiations and/or reimbursement decisions.


Prevalence of Certain Urogenital Bacterial Mollicutes in Patients Suffering from Infertility.
Mollicutes urogenital tract infections are considered a possible cause of infertility worldwide. Genital Mollicutes infections are difficult and impractical to diagnose by culturing or serology. Mollicutes included in this study were Mycoplasma hominis, Ureaplasma urealyticum, and Mycoplasma genitalium. This cross-sectional study aimed to determine the prevalence of M. hominis, U. urealyticum, and M. genitalium genital infections among infertile males and females patients. This study included 103 patients who visited Al-Shunar Clinic in Nablus city in Palestine and diagnosed with infertility during January 2018 to October 2018. The semen, urine, and/or vaginal swab specimens collected from patients were examined by PCR for detection of M. hominis, U. urealyticum, and M. genitalium. A total of 57 semen, 37 urine, and 16 vaginal swab specimens were collected. Out of the 110 examined specimens, 35 (31.8%) were PCR positive for at least one Mollicutes, which were 16 (14.6%) M. hominis, 11 (10%) U. urealyticum, and 8 (7.3%) M. genitalium. Significant association were found between infections of M. hominis and U. urealyticum (P=0.044) and between M. hominis and M. genitalium (P=0.005) infections. M. hominis infection was found in significantly (P=0.048) higher percentage in males (20.6%) in comparison with females (5.7%). On the other hand, M. genitalium infection rate in females (8.6%) was slightly higher than males (7.4%). M. hominis was more prevalent in all age groups except for patient's age group 40-50 years old, where M. genitalium was more prevalent. M. hominis was also more prevalent in all occupation types and among all smokers. Urogenital infections caused by M. hominis, M. genitalium, and U. urealyticum could be a possible cause of infertility among patients with different age groups, genders, and occupations. Thus, more attention by infertility centers and physicians is required in adopting molecular methods for diagnosis of infections by these microorganisms.


[Influences of Base Fertilizer Dosage and Root Size on Quality and Yield of Gentiana crassicaulis Root].
In order to optimize the base fertilizer dosage and root size of Gentiana crassicaulis in Ludian,Yulong, Yunnan,the differences in yield and quality of Gentiana crassicaulis caused by different base fertilizer dosage and root size were investigated. The variation in fresh weight, dry weight, drying rate, length, diameter, branches as well as the contents of gentiopicroside, loganin acid, alcohol-soluble extract and total ash were determined. The ideal distance grey relational degree comprehensive evaluation method was applied to make a comprehensive evaluation on the quality and yield of Gentiana crassicaulis. There were big differences in yield and quality of Gentiana crassicaulis among different base fertilizer dosage and root size. 2 000 kg/667 m2 of manure, 20 kg/667 m2 of superphosphate, 100 kg/667 m2 of plant ash and mix size of transplanting roots showed the best comprehensive quality and the highest yield. 2 000 kg/667 m2 of manure, 20 kg/667 m2 of superphosphate,100 kg/667 m2 of plant ash, high quality transplanting roots and stagger certain depth to transplant are highly recommended to produce high quality and high yield of Gentiana crassicaulis in Ludian, Yulong, Yunnan.


Outcome of partial repair of massive rotator cuff tears with and without human tissue allograft bridging repair.
The surgical management of massive rotator cuff tears remains a challenge. It is suggested that, even in a massive tear that appears irreparable, attempting to repair it as much as possible can be helpful in improving functional outcomes. However the results can be short term and variable. The purpose of our study was to determine if human tissue allograft bridged repair of massive irreparable rotator cuff tears to achieve a complete repair produces similar outcomes compared to partial repair alone. We prospectively reviewed outcome scores in 13 patients who underwent partial repair alone for massive irreparable rotator cuff tears and compared them to 13 patients who had partial repairs bridged with allograft. Oxford and Constant scores were compared pre-operatively and at a minimum follow-up of 2 years (range 2 years to 5 years). The mean improvement in the Constant score at final follow-up compared to pre-operative scores was 27.7 points in the partial repair group and 42.8 points in the allograft group (p < 0.01). The Oxford Shoulder Score improved mean of 19.3 points in the partial repair group and 29 points in the allograft group (p < 0.02) at 2 years. Human tissue matrix allograft provides a better outcome for open bridging of irreparable rotator cuff tears than partial repair alone.


Phosphoryl guanidine oligonucleotides as primers for RNA-dependent DNA synthesis using murine leukemia virus reverse transcriptase.
Modern approaches to the detection and analysis of low-copy-number RNAs are often based on the use of RNA-dependent DNA polymerases, for example, in reverse-transcription PCR. The accuracy and eff iciency of cDNA synthesis in the reverse-transcription reaction catalyzed by reverse transcriptase (RNA-dependent DNA polymerase) signif icantly affect the correctness of the results of PCR diagnostic assays and/or RNA sequencing. In this regard, many studies are focused on the optimization of the reverse-transcription reaction, including the search for more perfect primers necessary to obtain a full-length DNA copy of RNA under study. The best-known completely uncharged analogs of oligonucleotides - morpholine oligonucleotides and peptide nucleic acids - cannot be substrates for enzymes that process nucleic acids. The aim of this work was to conduct a pilot study of uncharged phosphoryl guanidine oligodeoxyribonucleotides (PGOs) as primers for mouse leukemia virus reverse transcriptase (MMLV H-). Specif ic features of elongation of partially and completely uncharged PGO primers were investigated. It was demonstrated that PGOs can be elongated eff iciently, e. g., in the presence of a fragment of human ribosomal RNA having complex spatial structure. It was shown that the proportion (%) of abortive elongation products of a PGO primer depends on buffer ionic strength, nucleotide sequence of the primer, and the presence and location of phosphoryl guanidine groups in the primer. The results indicate the suitability of PGOs, including completely electroneutral ones, as primers for reverse-transcription PCR, thereby opening up new prospects for the creation of experimental models for the analysis of highly structured RNA.


Cyclic Nucleotides Differentially Regulate Cx43 Gap Junction Function in Uterine Artery Endothelial Cells From Pregnant Ewes.
Cell-cell communication is dependent on GJ (gap junction) proteins such as Cx43 (connexin 43). We previously demonstrated the importance of Cx43 function in establishing the enhanced pregnancy vasodilatory phenotype during pregnancy in uterine artery endothelial cells from pregnant (P-UAEC) ewes. Cx43 is regulated by elevating cAMP and PKA (protein kinase A)-dependent Cx43 S365 phosphorylation-associated trafficking and GJ open gating, which is opposed by PKC (protein kinase C)-dependent S368 phosphorylation-mediated GJ turnover and closed gating. However, the role of cyclic nucleotide-mediated signaling mechanisms that control Cx43 and GJ function in P-UAECs is unknown. We hypothesize that cAMP will mediate increases in S365 phosphorylation, thereby, enhancing GJ trafficking and open gating, while cGMP will stimulate S368, but not S365, phosphorylation to enhance GJ turnover and closed gating in P-UAECs. Treatment with 8-Bromo (8-Br)-cAMP signal significantly (P<0.05) increased nonphosphorylated S365 signal and total Cx43 phosphorylation, but not S368 phosphorylation, while 8-Br-cGMP significantly (P<0.05) increased Cx43 C-terminus-S365 signal, S368, and total Cx43 phosphorylation. Inhibition of PKA, but not PKG (protein kinase G), abrogated the 8-Br-cAMP-stimulated increase in nonphosphorylated S365 and total Cx43 phosphorylation and inhibited S368 below basal levels, whereas inhibition of PKG blocked (P<0.05) the 8-bromo-cGMP-stimulated rises in nonphosphorylated S365, total Cx43, and S368 phosphorylation levels in P-UAECs. Functional studies showed that 8-Br-cAMP increased dye transfer and sustained calcium bursts, while 8-Br-cGMP decreased both. Thus, in P-UAECs, only 8-Br-cAMP and not 8-Br-cGMP effectively enhances nonphosphorylated S365 and total Cx43 expression that correspondingly reduces S368 phosphorylation, allowing increased GJ communication. This provides new insights into the regulatory mechanisms behind Cx43 function and GJ communication.


Physical properties and mechanism of transfer of R factors in Escherichia coli.
The physical properties of F-like and I-like R factors have been compared with those of the wild-type F factor in Escherichia coli K-12 unmated cells and after transfer to recipient cells by conjugation. The F-like R factor R538-1drd was found to have a molecular weight of 49 x 10(6), whereas the molecular weight of the I-like R factor R64drd11 was 76 x 10(6). The wild-type F factor, F1, had a molecular weight of 62 x 10(6). When conjugation experiments are performed by using donor strains carrying these derepressed F-like or I-like R factors, the transferred deoxyribonucleic acid can be isolated as a covalently closed circle from the recipient cells. This circular deoxyribonucleic acid was characterized by making use of the observation that the complementary strands of these R factors can be separated in a CsCl-poly (U, G) equilibrium gradient. The results of the strand-separation experiments show that only one of the complementary strands of the R factor is transferred from the donor to the recipient. With both the F-like and I-like R factors, this strand is the heavier strand in CsCl-poly (U, G). These results indicate that even though F-like and I-like R factors differ greatly in many properties (phage specificity, size, compatability, etc.), they are transferred by a similar mechanism.


Isolation of an enzymatically active tissue kallikrein from human seminal plasma by immunoaffinity chromatography.
A tissue kallikrein from human seminal plasma was isolated by immunoaffinity chromatography and characterized. Its molecular mass was determined by gel filtration to be approximately 40000 Da. The enzyme preparation liberates kinin from human HMW kininogen (specific activity: 0.594 HMW kininogen-U/mg), lowers the blood pressure of dogs after intravenous injection (specific activity: 1740 biol. kallikrein unit/mg) and is strongly inhibited by aprotinin but not by soybean trypsin inhibitor. N alpha-Acetyl-L-phenylalanyl-L-arginine ethyl ester, D-valyl-L-leucyl-L-agrine ethyl ester and N-benzyloxycarbonyl-L-tyrosine p-nitrophenyl ester are cleaved with identical rates by the enzyme from human seminal plasma and human urinary kallikrein.


Vascularized composite allotransplantation in the United States: A descriptive analysis of the Organ Procurement and Transplantation Network Data.
On July 3, 2014, the Organ Procurement and Transplantation Network/United Network for Organ Sharing was charged with the oversight of vascularized composite allograft (VCA) procurement and transplantation in the United States. As of December 31, 2017, 61 VCA programs at 27 centers were approved in the United States. Fifty candidates have been added to the waiting list at 15 centers. Twenty-eight VCA transplants have been performed at 14 programs (10 upper limb, 10 uterus, 5 craniofacial, 1 scalp, 1 abdominal wall, and 1 penile). Twenty-two VCAs were procured from 21 deceased donors, resulting in 109 non-VCA organs transplanted (15 hearts, 3 intestine, 40 kidney, 20 livers, 24 lungs, and 7 pancreata). Six uterus transplants were performed from living donors. Fourteen candidates were still waiting at 9 centers on December 31, 2017. Two of the 10 uterus recipients had live births and 3 still had viable grafts. Seventeen of 18 nonuterus recipients had functioning grafts. At present, VCA is an emerging field with a small number of patients transplanted. Data on posttransplant survival and functional outcomes continue to be collected to further the understanding of this complex and evolving field. Further systematic data are important for policy refinement and assurance of patient safety.


Effect of the Sacred Hour on Postnatal Depression in Traumatic Childbirth: a Randomized Controlled Trial.
Introduction: the implementation of the baby's nine instinctive stages as a sacred hour after birth is very effective in starting breastfeeding. About half of newly delivered mothers have reported a traumatic childbirth experience often associated with mental health problems. The present study aimed to examine the effect of the sacred hour on the depression in traumatic childbirths. Methods: In this clinical trial, 84 mothers who had experienced a traumatic childbirth were randomly allocated into the intervention (n = 42) and control (n = 42) groups. The intervention group received sacred hour (baby's nine instinctive responses), but the control group received only the routine care. Postnatal depression was evaluated as primary outcome at 2 week, 4-6 week and 3 month intervals after the delivery. The data were analyzed using t test, chi-square test and the repeated measures analysis of variance. Results: The results showed that the marginal total mean (SD: standard deviation) scores of depression in the intervention and control groups were 7.5 (2.6) and 9.6 (2.6); therefore, the mean difference (95% CI) between the groups (-2.1, (-3.2,-0.95)) was significant. Conclusion: The implementation of the sacred hour is recommended as a preventive approach to reduce the postnatal depression in women with a traumatic childbirth experience.


[Isolation rate and antifungal drug susceptibility of yeast like fungi isolated from blood or vascular catheter].
Increased resistance of strains to antifungal drugs has gained increasing attention. We studied the status of fungal isolation from blood and vascular catheters at Juntendo University Hospital from 1994 to 2002. The major fungi isolated were Candida albicans, Candida parapsilosis, Candida glabrata and Candida trophicalis, or 86% yeast-like fungi. Isolation of these fungi from vascular catheters is increasing. The effectiveness of 6 anti-fungal agents against 116 yeast-like fungi was measured by microdilution. In antifungal activity of micafungin (MCFG), MIC90, was < or = 0.03 g/mL for C. albicans, C. glabrata and C. tropicalis. MCFG showed the strongest antifungal activity among the drugs tested for above Candida spp.. Five of 37 strains of C. albicans were resistant to fluconazole (FLCZ) showing MIC > or =64 g/mL. These strains were also resistant to itraconazole (ITCZ) but MICs of MGFG, flurocytosine (5-FC) and amphotericin B (AMPH-B). Two of 38 strains of C. parapsilosis are resistant to flurocytosine (5-FC) showing MIC > or =64 g/mL. There is no resistant strain of fungi (yeast-like organisms) tested against AMPH-B. Six patients from whom resistant fungi were isolated from blood and vascular catheters have severe diseases and/or are have just undergone a major surgical operation. These results indicate that it is vital for deep mycosis to start early treatment with appropriate drugs selected based on rapid detection and identification of organisms and the drug susceptibility of organisms.


Association between selected structural defects and chromosomal abnormalities.
To determine the association between some major structural abnormalities detected prenatally by ultrasound and chromosomal abnormalities. The present study was a retrolective, transversal study. We analyzed case records of patients during the fetal follow-up at the Department of Maternal Fetal Medicine from January 1994 to May 2010 to identify fetal patients with a diagnosis of holoprosencephaly, diaphragmatic hernia, omphalocele, cystic hygroma, hydrops and cardiac defects. We analyzed patients who had a prenatal invasive diagnosis procedure to obtain the odds ratio (OR) for some major isolated anomalies and their different combinations with respect to chromosomal abnormalities. We examined 280 patients with ultrasonographic markers for chromosomal alteration, 197 met inclusion criteria, from which 88 had chromosomal abnormalities. The most frequent diagnosis was trisomy 18 (31.8%), which was followed by trisomy 21 (21.6%), trisomy 13 (21.6%), Turner syndrome (monosomy X) (14.8%) and other chromosomal abnormalities (10.2%). Among the fetuses with nonisolated holoprosencephaly, we obtained an OR of 4.9 95% CI (0.99-24.2) for aneuploidy. Associated omphalocele had an OR of 7.63 95% CI (2.07-46.75), p < 0.01. Interestingly, 62% of aneuploidy cases had associated cardiac defects [OR = 7.7 95% CI (1.4-41.7)]. In addition, associated cystic hygroma had an OR of 2.5 95% CI (0.59-10.91). Heart defects were the most common defects in fetuses with trisomy 18 (57.1%), when they were associated with facial cleft, we had an OR of 11.08 95% CI (2.99-41.11), p < 0.0001. Statistical potency was calculated for each analyzed defect and it was over 80% for all of them but diaphragmatic hernia. The association of 2 or more structural defects increased the probability of a fetus to be a carrier of a chromosomal disorder; however this was not statistically significative except for associated omphalocele. Heart defects showed the greatest association with all chromosomal abnormalities. The most important association was among heart defect, facial cleft and trisomy 13.


Biomarkers of eosinophil involvement in allergic and eosinophilic diseases: review of phenotypic and serum markers including a novel assay to quantify levels of soluble Siglec-8.
There remains considerable controversy in the management of eosinophilic disorders, mainly due to a paucity of information regarding the clinical interpretation of total blood eosinophil counts versus surface activation markers versus eosinophil-derived or eosinophil-influencing mediator levels. Regrettably, few tests have been validated that define a unique clinical or prognostic phenotype that is more useful than simply monitoring total blood eosinophil counts. In this manuscript, phenotypic (cell surface) markers, along with serum and tissue-based markers that have been examined in the context of disease activity, are reviewed. We also report the development of a novel assay for detecting soluble Siglec-8 (sSiglec-8), a protein likely derived largely from eosinophils, as a potential serum biomarker. The assay consists of a competitive ELISA using a recombinant Siglec-8-Fc fusion protein. The goal of this preliminary study was to determine if sSiglec-8 is a useful biomarker that differentiates among patients with various eosinophil-associated diseases. In the final analysis, it is fair to say that further research is sorely needed to fully understand and validate the utility of various biomarkers, including sSiglec-8, before their use in clinical practice can be recommended with confidence.


Cadmium, lead, tin, total mercury, and methylmercury in canned tuna commercialised in São Paulo, Brazil.
The objective of this work was to determine levels of inorganic contaminants in 30 samples of five commercial brands of canned tuna, acquired on the local market in Campinas, São Paulo, Brazil, in the year of 2015. Total mercury and methylmercury (MeHg+) were determined by atomic absorption with thermal decomposition and amalgamation; and cadmium, lead, and tin were determined by inductively coupled plasma optical emission spectrometry. Results indicated that 20% of the tuna samples surpassed limits determined by the Brazilian and European Commission legislation for cadmium; for lead, the maximum value found was 59 µg kg-1 and tin was not detected in any samples. The maximum values found for total Hg and MeHg+ were 261 and 258 µg kg-1, respectively. As from the results obtained, it was estimated that the consumption of four cans per week (540 g) of tuna canned in water could surpass the provisional tolerable monthly intake for MeHg+ by 100%.


Developing a pediatric palliative care program: addressing the lack of baseline expenditure information.
An estimated 500 000 children annually cope with life-limiting conditions expected to lead to premature death, but little is known about their health care expenditures at the end of life. This information is crucial for health planners to propose pediatric palliative care programs. This study aims to estimate predicted health care expenditures for Medicaid-eligible infants and children across several health service categories. Across these categories, infants and children were predicted to spend about US$110 000 and US$62 000 at the end of life, respectively. About 5% of infants and 8% of children incurred hospice expenditures. Results from the multivariate models suggest that black, non-Hispanic children are less likely than white, non-Hispanic children to use hospice care. Baseline expenditure information from this study can be used to develop integrated pediatric palliative care models. Our findings also suggest that many more children could potentially benefit by using hospice care at the end of life.


Spatial genome architecture and the emergence of malignancy.
Human chromosomes are large spatially and hierarchically structured entities, the integrity of which needs to be preserved throughout the lifespan of the cell and in conjunction with cell cycle progression. Preservation of chromosomal structure is important for proper deployment of cell type-specific gene expression programs. Thus, aberrations in the integrity and structure of chromosomes will predictably lead to disease, including cancer. Here, we provide an updated standpoint with respect to chromatin misfolding and the emergence of various cancer types. We discuss recent studies implicating the disruption of topologically associating domains, switching between active and inactive compartments, rewiring of promoter-enhancer interactions in malignancy as well as the effects of single nucleotide polymorphisms in non-coding regions involved in long-range regulatory interactions. In light of these findings, we argue that chromosome conformation studies may now also be useful for patient diagnosis and drug target discovery.


Study of Factors Influencing Moisture Susceptibility of Warm-Mix Asphalt Using the Surface Free Energy Approach.
The application of warm-mixing technology brings considerable economical and environment benefits by decreasing the mixing temperature during warm asphalt mixture (WMA) production. However, the possible water residue also generates concerns for moisture susceptibility. For deep investigation on the influencing factors and mechanisms of the moisture susceptibility of WMA, surface free energy (SFE) tests and laboratory tests are applied in this research. A novel indicator based on SFE, namely, effective adhesion work, is proposed to assess the asphalt-aggregate adhesion with different moisture contents. Then, given the mixing procedure of the dry-mixing method, an advanced three-phase model as a form of asphalt-aggregate-warm mixing additive is introduced, improving the conventional two-phase asphalt-aggregate model for better reflecting the separate addition of warm-mixing additives during mixing. Afterwards, the influence of aggregate type, asphalt type, aggregate moisture content, warm-mixing agent type, and the warm-mixing process on the moisture susceptibility of WMA is analyzed utilizing the models and indicators proposed. Finally, the validity of the SFE indicator is verified by comparing the calculation of effective adhesion work with freeze-thaw splitting test results. The results show that all of the above factors impact the moisture susceptibility of WMA by influencing the interfacial adhesion, with the effect of moisture content being the most significant. Meanwhile, effective adhesion work and the three-phase model brought out in this research are proven to be feasible to characterize the adhesion properties of WMA, offering theoretical support to the research on warm-mixing technology.