Turn-On Fluorescence Aptasensor on Magnetic Nanobeads for Aflatoxin M1 Detection Based on an Exonuclease III-Assisted Signal Amplification Strategy.
In order to satisfy the need for sensitive detection of Aflatoxin M1 (AFM1), we constructed a simple and signal-on fluorescence aptasensor based on an autocatalytic Exonuclease III (Exo III)-assisted signal amplification strategy. In this sensor, the DNA hybridization on magnetic nanobeads could be triggered by the target AFM1, resulting in the release of a single-stranded DNA to induce an Exo III-assisted signal amplification, in which numerous G-quadruplex structures would be produced and then associated with the fluorescent dye to generate significantly amplified fluorescence signals resulting in the increased sensitivity. Under the optimized conditions, this aptasensor was able to detect AFM1 with a practical detection limit of 9.73 ng kg-1 in milk samples. Furthermore, the prepared sensor was successfully used for detection of AFM1 in the commercially available milk samples with the recovery percentages ranging from 80.13% to 108.67%. Also, the sensor performance was evaluated by the commercial immunoassay kit with satisfactory results.


Peripheral Giant Cell Granuloma in a Dog.
Peripheral giant cell granuloma is considered rare in the dog with little known about the clinicopathologic features. There are few reports in the veterinary literature concerning this benign, reactive lesion, formerly known as giant cell epulis. In humans, the four most commonly described reactive epulides are focal fibrous hyperplasia (fibrous epulis), pyogenic granuloma, peripheral ossifying fibroma, and peripheral giant cell granuloma. This case report describes the diagnosis and surgical management of a peripheral giant cell granuloma in a dog.


Cell death induced by ozone and various non-thermal plasmas: therapeutic perspectives and limitations.
Non-thermal plasma has been recognized as a promising tool across a vast variety of biomedical applications, with the potential to create novel therapeutic methods. However, the understanding of the molecular mechanisms behind non-thermal plasma cellular effects remains a significant challenge. In this study, we show how two types of different non-thermal plasmas induce cell death in mammalian cell cultures via the formation of multiple intracellular reactive oxygen/nitrogen species. Our results showed a discrepancy in the superoxide accumulation and lysosomal activity in response to air and helium plasma, suggesting that triggered signalling cascades might be grossly different between different plasmas. In addition, the effects of ozone, a considerable component of non-thermal plasma, have been simultaneously evaluated and have revealed much faster and higher cytotoxic effects. Our findings offer novel insight into plasma-induced cellular responses, and provide a basis for better controlled biomedical applications.


The analyst's hatred of analysis.
Analytic work is loved and hated. Both attitudes deserve scrutiny, but the analyst's hatred of analysis, which transcends countertransference responses to individual patients, represents an impediment to gratifying analytic work whose recognition and conceptualization has been resisted. The author suggests that antipathy among analysts toward analysis and the analytic situation is normative and expectable, yet commonly experienced as shameful. He speculates that it is sometimes disavowed and projected. Training institutes might inadvertently foster this sense of shame rather than promote its working through. The recognition that analytic identity functions as both a loving and a persecutory internal object has implications for psychoanalytic education and practice.


Detecting climate adaptation with mobile network data in Bangladesh: anomalies in communication, mobility and consumption patterns during cyclone Mahasen.
Large-scale data from digital infrastructure, like mobile phone networks, provides rich information on the behavior of millions of people in areas affected by climate stress. Using anonymized data on mobility and calling behavior from 5.1 million Grameenphone users in Barisal Division and Chittagong District, Bangladesh, we investigate the effect of Cyclone Mahasen, which struck Barisal and Chittagong in May 2013. We characterize spatiotemporal patterns and anomalies in calling frequency, mobile recharges, and population movements before, during and after the cyclone. While it was originally anticipated that the analysis might detect mass evacuations and displacement from coastal areas in the weeks following the storm, no evidence was found to suggest any permanent changes in population distributions. We detect anomalous patterns of mobility both around the time of early warning messages and the storm's landfall, showing where and when mobility occurred as well as its characteristics. We find that anomalous patterns of mobility and calling frequency correlate with rainfall intensity (r = .75, p < 0.05) and use calling frequency to construct a spatiotemporal distribution of cyclone impact as the storm moves across the affected region. Likewise, from mobile recharge purchases we show the spatiotemporal patterns in people's preparation for the storm in vulnerable areas. In addition to demonstrating how anomaly detection can be useful for modeling human adaptation to climate extremes, we also identify several promising avenues for future improvement of disaster planning and response activities.


The kinetochore protein Ndc10p is required for spindle stability and cytokinesis in yeast.
The budding yeast kinetochore is comprised of >60 proteins and associates with 120 bp of centromeric (CEN) DNA. Kinetochore proteins are highly dynamic and exhibit programmed cell cycle changes in localization. The CEN-specific histone, Cse4p, is one of a few stable kinetochore components and remains associated with CEN DNA throughout mitosis. In contrast, several other kinetochore proteins have been observed along interpolar microtubules and at the midzone during anaphase. The inner kinetochore protein, Ndc10p, is enriched at the spindle midzone in late anaphase. We show that Ndc10p is transported to the plus-ends of interpolar microtubules at the midzone during anaphase, a process that requires survivin (Bir1p), a member of the aurora kinase (Ipl1p) complex, and Cdc14p phosphatase. In addition, Ndc10p is required for essential non-kinetochore processes during mitosis. Cells lacking functional Ndc10p show defects in spindle stability during anaphase and failure to split the septin ring during cytokinesis. This latter phenotype leads to a cell separation defect in ndc10-1 cells. We propose that Ndc10p plays a direct role in maintaining spindle stability during anaphase and coordinates the completion of cell division after chromosome segregation.


Chromobronchoscopy in the diagnosis of bronchial tumors.
Staining of the bronchi with methylene blue was performed during bronchoscopy in 140 patients with various bronchopulmonary diseases. It was found that malignant bronchial tumors selectively stain dark blue; normal mucous membranes remain unstained. On this basis one can judge rather accurately how far the cancerous growth has spread along the bronchus, and so reach the target area by biopsy in those cases where visual signs of abnormality are indistinct or absent.


Statistical design of noninferiority multiple region clinical trials to assess global and consistent treatment effects.
Noninferiority multiregional clinical trials (MRCTs) have recently received increasing attention in drug development. While a major goal in an MRCT is to estimate the global treatment effect, it is also important to assess the consistency of treatment effects across multiple regions. In this paper, we propose an intuitive definition of consistency of noninferior treatment effects across regions under the random-effects modeling framework. Specifically, we quantify the consistency of treatment effects by the percentage of regions that meet a predefined treatment margin. This new approach enables us to achieve both goals in one modeling framework. We propose to use a signed likelihood ratio test for testing the global treatment effect and the consistency of noninferior treatment effects. In addition, we provide guidelines for the allocation rule to achieve optimal power for testing consistency among multiple regions. Extensive simulation studies are conducted to examine the performance of the proposed methodology. An application to a real data example is provided.


Influence of PET/CT 68Ga somatostatin receptor imaging on proceeding with patients, who were previously diagnosed with 99mTc-EDDA/HYNIC-TOC SPECT.
The aim of this study was the assessment of utility of somatostatin receptor scintigraphy (SRS) by SPECT imaging using 99mTc-EDDA/HYNIC-Tyr3-octreotide (99mTc-EDDA/HYNIC-TOC) in patients with neuroendocrine neoplasm (NEN) or suspected NEN, referred to Nuclear Medicine Dept. of Voivodship Specialty Center in Rzeszow. The selected group of patients was referred also to 68Ga PET/CT. The posed question was the ratio of patients for whom PET/CT with 68Ga would change their management. The distribution of somatostatin receptors was imaged using 99mTc-EDDA/HYNIC-TOC in 61 planar and SPECT studies between 13/05/2010 and 04/02/2013 in Nuclear Medicine Dept. of Voivodship Specialty Center in Rzeszow. The patient age was within a range of 17-80, with the average age of 57.6. The average age of women (65% of patients over-all) was 55.6 and the average age of men (35% of patients overall) was 61.4. In 46 participants (75% of the study group), that underwent SRS, NEN was documented using pathology tests. Selected patients were referred to PET/CT with 68Ga labeled somatostatin analogs, DOTATATE or DOTANOC. This study group consisted of 14 female and 10 male participants with age range of 35-77 and average age of 55.5 years. Patients were classified into 3 groups, as follows: detection - referral due to clinical symptoms and/or biochemical markers (CgA-Chromogranin A, IAA-indoleacetic acid) with the aim of primary diagnosis, staging - referral with the aim of assessment of tumor spread, and follow-up - assessment of the therapy. Out of 61 patients, 24 underwent both 99mTc-EDDA/HYNIC-Tyr3-octreotide SPECT and 68Ga PET/CT. The result of PET/CT was used as a basis for further evaluation. Therefore, the patients were divided into groups; true positive TP (confirmed presence of tissue somatostatin receptors with 68Ga PET/CT) and TN (68Ga PET/CT did not detect any changes and the results were comparable and had the same influence on treatment protocol). In case of SPECT, the results were assigned as follows: TP, TN (in cases where the results were confirmed by 68Ga PET/CT), FP (patient's scintigraphy demonstrated focal change by SPECT but not PET/CT) and FN (99mTc-EDDA/HYNIC-Tyr3-octreotide SPECT failed to demonstrate any abnormalities; however, the treatment protocol was changed after PET/CT). The accuracy of SPECT diagnosis was found to be as high as 91.6%. Only in 8.4% of patients the additional PET/CT with 68Ga-labeled somatostatin analog changed the treatment protocol.


Doubly Constrained Waveform Optimization for Integrated Sensing and Communications.
This paper investigates threshold-constrained joint waveform optimization for an integrated sensing and communication (ISAC) system. Unlike existing studies, we employ mutual information (MI) and sum rate (SR) as sensing and communication metrics, respectively, and optimize the waveform under constraints to both metrics simultaneously. This provides significant flexibility in meeting system performance. We formulate three different optimization problems that constrain the radar performance only, the communication performance only, and the ISAC performance, respectively. New techniques are developed to solve the original problems, which are NP-hard and cannot be directly solved by conventional semi-definite programming (SDP) techniques. Novel gradient descent methods are developed to solve the first two problems. For the third non-convex optimization problem, we transform it into a convex problem and solve it via convex toolboxes. We also disclose the connections between three optimizations using numerical results. Finally, simulation results are provided and validate the proposed optimization solutions.


[Gaseous dispersion in the central airways of the human lung. In vivo study].
In order to estimate the contribution of either laminar or turbulent dispersion in the central airways during spontaneous breathing, the results of the computer simulation of a mathematical model were compared with those of an appropriate in vivo test performed on normal subjects. The model takes into account, along with the summed cross-section of Weibel lung model [31], both axial convection and longitudinal dispersion of helium and sulphur hexafluoride in air. The simulations were carried out by incorporating two dispersion coefficients corresponding to laminar and turbulent flow into the mathematical model. The experiments were performed on five normal subjects by injection of 10 ml bolus of helium and sulphur hexafluoride into the later part of the inspired airstream in such a way that the whole bolus entered the inspiratory flow and was recovered during the following expiration. When the experiment is simulated using the laminar dispersion coefficient, no concordance could be seen between computed and experimental data; however, there is a good concordance when the simulation is performed with the turbulent dispersion coefficient. It is concluded that Taylor laminar dispersion [24] cannot play a significant role in the human airways; however, it seems that convective gas mixing with turbulent dispersion [21] can account for most gas transport during spontaneous ventilation.


Detection and Crystal Structure of Hydrogenated Bipentacene as an Intermediate in Thermally Induced Pentacene Oligomerization.
6,6',13,13'-Tetrahydro-6,6'-bipentacene (HBP), the intermediate molecule connecting pentacene to previously observed peripentacene and extended pentacene oligomers through the formation of a carbon-carbon bond, is synthesized and crystallographically characterized. Heating pentacene to 300 °C under vacuum for 200 h results in pale golden crystals of HBP and amorphous material containing pentacene oligomers, offering experimental evidence that pentacene preferentially dimerizes at the 6,6'-position. Continued heating of HBP results in co-crystals of 6,13-dihydrogenated pentacene and pentacene and further amorphous pentacene oligomers. The amorphous material consists of layered carbonaceous species with a graphenic nature, as determined by Raman spectroscopy and electron microscopy, and suggests HBP as an intermediate to hydrogenated pentacene species and pentacene oligomers, such as peripentacene, of interest in organic electronics.


Assessment of the Generalization Abilities of Machine-Learning Scoring Functions for Structure-Based Virtual Screening.
In structure-based virtual screening (SBVS), it is critical that scoring functions capture protein-ligand atomic interactions. By focusing on the local domains of ligand binding pockets, a standardized pocket Pfam-based clustering (Pfam-cluster) approach was developed to assess the cross-target generalization ability of machine-learning scoring functions (MLSFs). Subsequently, 12 typical MLSFs were evaluated using random cross-validation (Random-CV), protein sequence similarity-based cross-validation (Seq-CV), and pocket Pfam-based cross-validation (Pfam-CV) methods. Surprisingly, all of the tested models showed decreased performances from Random-CV to Seq-CV to Pfam-CV experiments, not showing satisfactory generalization capacity. Our interpretable analysis suggested that the predictions on novel targets by MLSFs were dependent on buried solvent-accessible surface area (SASA)-related features of complex structures, with greater predicted binding affinities on complexes owning larger protein-ligand interfaces. By combining buried SASA-related features with target-specific patterns that were only shared among structurally similar compounds in the same cluster, the random forest (RF)-Score attained a good performance in the Random-CV test. Based on these findings, we strongly advise assessing the generalization ability of MLSFs with the Pfam-cluster approach and being cautious with the features learned by MLSFs.


The protective effect of red palm oil in comparison with massive vitamin A dose in combating vitamin A deficiency in Orissa, India.
Vitamin A deficiency has long been a serious hazard to the world community, especially to children. The main reason for a higher incidence among children is lack of vitamin A in the diet. Carotene rich supplements with sources like Red Palm oil (RPO) could be used as a measure to combat vitamin A deficiency. This study evaluates the protective effect of RPO in comparison with massive vitamin A dose to combat vitamin A deficiency. The study was carried out for a period of three months in 36 school children. Twelve children received a massive dose (50,000 IU) of vitamin A, another twelve children received 4g of RPO containing B-carotene equivalent to 25,000 IU of vitamin A in "Besan laddu" and the remaining twelve received 8g of RPO containing B-carotene equivalent to 50,000 IU of vitamin A in "Besan laddu". Serum vitamin A levels were estimated initially, after 15 days of supplementation and 3 months after termination of supplementation. The levels were maximum 15 days after the supplementation and, though it fell by the end of 3 months, yet it was significantly higher than that of the initial levels in all the three groups. Among both the levels of RPO supplement, 8g RPO was as efficient as was a massive vitamin A dose in providing protection for three months, after cessation of supplementation.


The impact of technology on the future of health/illness education.
The impact of technological advancement and societal pressure for comprehensive, cost effective health care are two current trends which will determine the future of health/illness education. This article predicts a future of health/illness education based on these trends. The issues of depersonalization, cost, privacy, and control involved in the use of computers in health care are identified and discussed.


[Measurement of the AT and the CCD angle of macerated cadaver femora: a comparative study between CT and MRI measurements].
To compare measurements of the real AT (femoral antetorsion) and CCD (caput-collum-diaphysis) angle by computed tomography (CT) and magnetic resonance imaging (MRI) of hip specimen using direct measurements as reference standard, and to show that measurement by MRI can replace CT measurements and may help avoiding X-ray exposition. CT and MRI measurements were obtained on 25 in water-arrested macerated human femora. Postprocessing was done by 4 independent readers on a workstation using a dedicated 3D-software. Direct measurements of the real AT and the CCD angle were used as reference standard. The analysis included Student's t test for paired values, interobserver variability using intra-class correlation coefficients (ICC), maximum and middle divergence of the angles, and Bland-Altman plots. For determining AT and the CCD angle with CT and MRI, good correlation was found between the 4 readers and with measurements using the reference standard. ICCs were 0.97 and 0.90 for measuring AT and CCD angle with CT, and 0.95 and 0.71 for measurements with MRI, respectively. Mean divergence between CT measurements and those of the reference standard was 0.8 degrees for AT and 0.7 degrees for the CCD-angle. Mean divergence between MRI measurements and those of the reference standard was 0.3 degrees for AT and -0.4 degrees for the CCD-angle. Mean divergences between CT and MRI measurements of AT and CCD-angle were 0.5 degrees. Neither systematic errors nor dependences on the qualitative size of the reference data were evident in the divergences of measurements. Measurements of the real AT and CCD angle by CT and MR imaging revealed a good correlation with direct measurements of the femoral specimen and consequently can be recommended for clinical use. MRI measurements can replace CT measurements, avoiding X-ray exposure especially in young patients undergoing preoperative evaluation for hip dysplasia.


Characteristics of recent suicide attempters with and without Borderline Personality Disorder.
The present research compared recent suicide attempters with and without a diagnosis of Borderline Personality Disorder (BPD). One hundred and eighty recent suicide attempters, recruited in the Emergency Department, participated in extensive research interviews. Results showed that suicide attempters with BPD displayed greater severity of overall psychopathology, depression, hopelessness, suicidal ideation, past suicide attempts, and had poorer social problem solving skills than those without a BPD diagnosis. No differences were found between the groups regarding the intent to die or lethality associated with the index suicide attempt. These findings highlight the seriousness of BPD and the risk that individuals diagnosed with this disorder will attempt suicide.


Herpetic shoulder paresis in a Chinese elderly patient.
A patient with left shoulder girdle weakness secondary to herpetic myotomal paresis is reported. Needle electromyography revealed denervational discharge from the left supraspinatus, deltoid, and brachioradialis muscles, compatible with a radiculopathy that was relevant to his myotomes affected by zoster infection. The patient was managed with range-of-movement and strengthening exercises as well as pain relief for post-herpetic neuralgia. Further studies are required to determine whether antiviral treatment can limit the extent of motor deficit and hasten recovery. Zoster paresis should be one of the differential diagnoses of girdle muscle weakness.


Outer membrane protein AlkL boosts biocatalytic oxyfunctionalization of hydrophobic substrates in Escherichia coli.
The outer membrane of microbial cells forms an effective barrier for hydrophobic compounds, potentially causing an uptake limitation for hydrophobic substrates. Low bioconversion activities (1.9 U g(cdw)(-1)) have been observed for the ω-oxyfunctionalization of dodecanoic acid methyl ester by recombinant Escherichia coli containing the alkane monooxygenase AlkBGT of Pseudomonas putida GPo1. Using fatty acid methyl ester oxygenation as the model reaction, this study investigated strategies to improve bacterial uptake of hydrophobic substrates. Admixture of surfactants and cosolvents to improve substrate solubilization did not result in increased oxygenation rates. Addition of EDTA increased the initial dodecanoic acid methyl ester oxygenation activity 2.8-fold. The use of recombinant Pseudomonas fluorescens CHA0 instead of E. coli resulted in a similar activity increase. However, substrate mass transfer into cells was still found to be limiting. Remarkably, the coexpression of the alkL gene of P. putida GPo1 encoding an outer membrane protein with so-far-unknown function increased the dodecanoic acid methyl ester oxygenation activity of recombinant E. coli 28-fold. In a two-liquid-phase bioreactor setup, a 62-fold increase to a maximal activity of 87 U g(cdw)(-1) was achieved, enabling the accumulation of high titers of terminally oxyfunctionalized products. Coexpression of alkL also increased oxygenation activities toward the natural AlkBGT substrates octane and nonane, showing for the first time clear evidence for a prominent role of AlkL in alkane degradation. This study demonstrates that AlkL is an efficient tool to boost productivities of whole-cell biotransformations involving hydrophobic aliphatic substrates and thus has potential for broad applicability.


Fibromyalgia. Part I. Review of the literature.
Fibromyalgia presents with generalized body pain, multiple tender points, and associated ancillary symptoms, including fatigue and nonrestorative sleep. The abnormal sleep pattern is the most common accepted etiology for this condition. The diagnosis may be made on the basis of a classic presentation of symptoms and clinical findings. The treatment of fibromyalgia includes aerobic exercise and the use of tricyclic antidepressants to modulate the sleep disorder with less than excellent results. In spite of the frustrations in treating this condition successfully, many patients are relieved to be provided with a diagnosis and to obtain sympathetic and supportive care from their physicians.


Screening bleeding disorders in adolescents and young women with menorrhagia.
Chronic menorrhagia causes anemia and impairment of life quality. In this study the aim was the screening of bleeding disorders in adolescents and young women with menorrhagia. The study was performed prospectively by pediatric hematologists. A form including demographic characteristics of the patients, bleedings other than menorrhagia, familial bleeding history, characteristics of the menorrhagia, and impairment of life quality due to menorrhagia was filled out by the researcher during a face-to-face interview with the patient. A pictorial blood assessment chart was also used for evaluation of blood loss. All patients underwent pelvic ultrasound sonography testing and women also received pelvic examination by gynecologists. Whole blood count, peripheral blood smear, blood group, serum transaminases, urea, creatinine, ferritin, PFA-100, PT, aPTT, INR, TT, fibrinogen, VWF:Ag, VWF:RCo, FVIII, and platelet aggregation assays were performed. Platelet aggregations were studied by lumiaggregometer. Out of 75 patients enrolled, 60 patients completed the study. The mean age was 20.68±10.34 (range: 10-48) years and 65% (n=39) of the patients were younger than 18 years. In 18 (46%) of the adolescents, menorrhagia subsided spontaneously. In 20% (n=12) of the patients, a bleeding disorder was detected (1 case of type 3 von Willebrand disease, 2 patients with low VWF:Ag, 1 case of probable von Willebrand disease, 3 cases of Bernard-Soulier syndrome, 2 cases of Glanzmann thrombasthenia, 2 cases of immune thrombocytopenic purpura, 1 case of congenital factor VII deficiency). In patients with menorrhagia, at least complete blood count, peripheral smear, aPTT, PT, VWF:Ag, VWF:RCo, FVIII, and fibrinogen assays must be performed. When there is history of nose and gum bleeding, platelet function assay by lumiaggregometer must also be performed. In nearly 50% of adolescents, menorrhagia is dysfunctional and transient. Detailed coagulation assays can be postponed in adolescents if bleeding history other than menorrhagia and/or family history of bleeding and/or parental consanguinity is absent. All subjects with menorrhagia must consult with gynecologists and hematologists. None declared.


Tropisetron sensitizes α7 containing nicotinic receptors to low levels of acetylcholine in vitro and improves memory-related task performance in young and aged animals.
Tropisetron, a 5-HT3 receptor antagonist commonly prescribed for chemotherapy-induced nausea and vomiting also exhibits high affinity, partial agonist activity at α7 nicotinic acetylcholine receptors (α7 nAChRs). α7 nAChRs are considered viable therapeutic targets for neuropsychiatric disorders such as Alzheimer's disease (AD). Here we further explored the nAChR pharmacology of tropisetron to include the homomeric α7 nAChR and recently characterized heteromeric α7β2 nAChR (1:10 ratio) and we evaluated its cognitive effects in young and aged animals. Electrophysiological studies on human nAChRs expressed in Xenopus oocytes confirmed the partial agonist activity of tropisetron at α7 nAChRs (EC50 ∼2.4 μM) with a similar effect at α7β2 nAChRs (EC50 ∼1.5 μM). Moreover, currents evoked by irregular pulses of acetylcholine (40 μM) at α7 and α7β2 nAChRs were enhanced during sustained exposure to low concentrations of tropisetron (10 and 30 nM) indicative of a "priming" or co-agonist effect. Tropisetron (0.1-10 mg/kg) improved novel object recognition performance in young Sprague-Dawley rats and in aged Fischer rats. In aged male and female rhesus monkeys, tropisetron (0.03-1 mg/kg) produced a 17% increase from baseline levels in delayed match to sample long delay accuracy while combination of non-effective doses of donepezil (0.1 mg/kg) and tropisetron (0.03 and 0.1 mg/kg) produced a 24% change in accuracy. Collectively, these animal experiments indicate that tropisetron enhances cognition and has the ability to improve the effective dose range of currently prescribed AD therapy (donepezil). Moreover, these effects may be explained by tropisetron's ability to sensitize α7 containing nAChRs to low levels of acetylcholine.


Achievement of LDL-C Targets Defined by ESC/EAS (2011) Guidelines in Risk-Stratified Korean Patients with Dyslipidemia Receiving Lipid-Modifying Treatments.
This study assessed the proportion of risk-stratified Korean patients with dyslipidemia achieving their low-density lipoprotein cholesterol (LDL-C) targets as defined by the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) (2011) guidelines while receiving lipid-modifying treatments (LMTs). In this multicenter, cross-sectional, observational study, we evaluated data from Korean patients aged ≥19 years who were receiving LMTs for ≥3 months and had an LDL-C value within the previous 12 months on the same LMT. Data were collected for demographics, cardiovascular (CV) risk factors, medical history, and healthcare consumption. Patients were risk-stratified according to the ESC Systematic COronary Risk Evaluation (SCORE) chart and LDL-C target achievement rate was assessed. Guideline-based risk-stratification of the 1,034 patients showed the majority (72.2%) to be in the very high-risk category. Investigators' assessment of risk was underestimated in 71.6% compared to ESC/EAS guidelines. Overall LDL-C target achievement rate was 44.3%; target achievement was the highest (66.0%) in moderate-risk patients and the lowest (39.0%) in very high-risk patients. Overall 97.1% patients were receiving statin therapy, mostly as a single-agent (89.2%). High-intensity statins and the highest permissible dose of high-intensity statins had been prescribed to only 9.1% and 7.3% patients in the very high-risk group, respectively. Physician satisfaction with patients' LDL-C levels was the primary reason for non-intensification of statin therapy. Achievement of target LDL-C level is suboptimal in Korean patients with dyslipidemia, especially in those at very high-risk of CV events. Current practices in LMTs need to be improved based on precise CV risk evaluation posed by dyslipidemia.


Photochemical heterolysis of 3,5-bis(dimethylamino)benzyl alcohols and esters: generation of a benzyl cation with a low-energy triplet state.
An earlier computational study (CASPT2/pVDZ) by Winter et al. predicts the 3,5-bis(dimethylamino)benzyl cation to have nearly degenerate singlet and triplet states. Through product studies it is demonstrated that photolysis of 3,5-bis(dimethylamino)benzyl alcohol and its corresponding acetate and phenylacetate esters in alcoholic solvents produces a solvent incorporated adduct, 3,5-bis(dimethylamino)benzyl ethers, and 3,5-bis(dimethylamino)toluene.


The HOSPITAL score and LACE index as predictors of 30 day readmission in a retrospective study at a university-affiliated community hospital.
Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP) program. Validated risk assessment tools such as the HOSPITAL score and LACE index have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. This study aims to evaluate the utility of HOSPITAL score and LACE index for predicting hospital readmission within 30 days in a moderate-sized university affiliated hospital in the midwestern United States. All adult medical patients who underwent one or more ICD-10 defined procedures discharged from the SIU-SOM Hospitalist service from Memorial Medical Center (MMC) from October 15, 2015 to March 16, 2016, were studied retrospectively to determine if the HOSPITAL score and LACE index were a significant predictors of hospital readmission within 30 days. During the study period, 463 discharges were recorded for the hospitalist service. The analysis includes data for the 432 discharges. Patients who died during the hospital stay, were transferred to another hospital, or left against medical advice were excluded. Of these patients, 35 (8%) were readmitted to the same hospital within 30 days. A receiver operating characteristic evaluation of the HOSPITAL score for this patient population shows a C statistic of 0.75 (95% CI [0.67-0.83]), indicating good discrimination for hospital readmission. The Brier score for the HOSPITAL score in this setting was 0.069, indicating good overall performance. The Hosmer-Lemeshow goodness of fit test shows a χ2 value of 3.71 with a p value of 0.59. A receiver operating characteristic evaluation of the LACE index for this patient population shows a C statistic of 0.58 (95% CI [0.48-0.68]), indicating poor discrimination for hospital readmission. The Brier score for the LACE index in this setting was 0.082, indicating good overall performance. The Hosmer-Lemeshow goodness of fit test shows a χ2 value of 4.97 with a p value of 0.66. This single center retrospective study indicates that the HOSPITAL score has superior discriminatory ability when compared to the LACE index as a predictor of hospital readmission within 30 days at a medium-sized university-affiliated teaching hospital. The internationally validated HOSPITAL score may be superior to the LACE index in moderate-sized community hospitals to identify patients at high risk of hospital readmission within 30 days.


Atypical Presentation of Extramedullary Plasmacytoma.
Plasmacytomas are monoclonal proliferations of plasma cells that typically affect the intramedullary axial skeleton. Imaging findings of an extramedullary plasmacytoma on radiograph and computed tomography can be nonspecific and can resemble other entities such as lymphoma, metastases, chondrosarcomas, or giant cell tumors. A 60-year-old female with a medical history of partial complex seizures, hypertension, diabetes, glaucoma, and hyperlipidemia presented with complaints of superficial abdominal pain associated with erythema and swelling for 3 weeks. Computed tomography of her abdomen at time of presentation revealed a 5.8 × 2.7-cm irregularly marginated soft-tissue density just below the umbilicus with an adjacent defect in the midline rectus abdominis. The final pathologic diagnosis was extramedullary plasmacytoma. Treatment during the next year included local radiation, systemic chemotherapy, and an autologous peripheral blood stem cell transplant. Three years after initial diagnosis, the patient presented to the emergency department, and testing revealed new plasmacytomas. The decision was made to proceed with palliative care. This case is a unique example of a patient with an extramedullary plasmacytoma with no diagnostic signs of multiple myeloma.


Proteolysis in human erythrocytes is triggered only by selected oxidative stressing agents.
Human erythrocytes have been treated with different agents producing oxidative stress. Diamide, tetrathionate, chromate, cystamine and iodate preferentially influenced the cellular redox state by oxidation of free and protein thiol groups leaving the redox state of hemoglobin virtually unaffected. None of these compounds was able to stimulate the proteolysis. By contrast, phenylhydrazine, nitrite, hydrogen peroxide, ter-butylhydroperoxide, cumene hydroperoxide and copper-ascorbate caused a noticeable oxidation of hemoglobin to methemoglobin. These latter agents, except nitrite and copper-ascorbate, triggered proteolysis. Identical results have been obtained in a ghost-free hemolysate. The fraction containing the proteolytic activity was isolated from hemolysate and tested on native or oxidant-treated hemoglobin. The proteolysis was stimulated by all agents able to produce methemoglobin. It is concluded that proteolysis correlated to an unbalance of cellular redox state. The results obtained with isolated and recombined fractions suggests that increased proteolysis does not depend on the removal of the effect of protease(s) inhibitor(s). Since all agents stimulating proteolysis are able to generate free radicals, it seems that protein breakdown is triggered by the direct effect of these intermediates on proteins (mostly hemoglobin) without the involvement of radical species produced in the membranes by action of organic hydroperoxides. In addition, since nitrite and copper-ascorbate, which also oxidize hemoglobin by radical generation, are unable to stimulate proteolysis, it should be concluded that protein degradation induced by oxidative stress is a complex event induced only by specific agents.


Exploring the Level of Physical Fitness on Physical Activity and Physical Literacy Among Chinese University Students: A Cross-Sectional Study.
Physical literacy (PL) has received considerable attention in the field of physical education and physical activity (PA) worldwide. According to recent studies, the level of physical fitness (PF) among Chinese university students is gradually decreasing. This study aims to examine the impact of the PF level (fit/unfit) on PA and PL, as well as the relationships among PF, PA, and PL, in Chinese university students. Participants comprised 798 university students (390 men; mean age, 19.2 ± 1.2 years) in Chongqing, China. Participants completed the tests of vital capacity, cardiorespiratory fitness, muscular strength, and flexibility, according to the National Physical Fitness Measurement Standards Manual (NPFMSM), as well as questionnaires on PA (time spent performing PA at various intensities) and PL. The independent t-tests were conducted to examine sex differences in the evaluated variables, and the Pearson's correlation between each PF test and PL attributes and PA was calculated according to sex. In addition, the independent t-tests were conducted to determine whether the PF level had an effect on PL attributes and PA at various intensities. Significant sex differences were found in the PF domains of vital capacity, muscular strength, and aerobic fitness, with higher scores in men than in women (all p-values < 0.05), but not in the PF domain of flexibility and total PL score. Furthermore, the PF domains of muscular strength and aerobic fitness were significantly and positively correlated with the PL attributes of confidence and physical competence in both men and women, while the PF domains of vital capacity and aerobic fitness were significantly and positively correlated with the PL attribute of motivation in men. In addition, PL was significantly and positively associated with cardiorespiratory fitness, vital capacity, muscular strength, and flexibility among participants in the fit group. These findings support advocating for increased participation in PA in university students and using PL as a tool to improve PF components.


HIV-2 Primary Infection in a French 69-Year-Old Bisexual Man.
More than 1 million individuals, mainly in West Africa, are thought to be infected with HIV-2. Acute HIV-2 infection is rarely observed, only 2 primary infections have been described to date. We report a detailed case of HIV-2 primary infection in a 69-year-old French bisexual Caucasian man, thereby providing valuable insights into HIV-2 early infection.


Loss of l(3)mbt leads to acquisition of the ping-pong cycle in Drosophila ovarian somatic cells.
In Drosophila germ cells, PIWI-interacting RNAs (piRNAs) are amplified through a PIWI slicer-dependent feed-forward loop termed the ping-pong cycle, yielding secondary piRNAs. However, the detailed mechanism remains poorly understood, largely because an ex vivo model system amenable to biochemical analyses has not been available. Here, we show that CRISPR-mediated loss of function of lethal (3) malignant brain tumor [l(3)mbt] leads to ectopic activation of the germ-specific ping-pong cycle in ovarian somatic cells. Perinuclear foci resembling nuage, the ping-pong center, appeared following l(3)mbt mutation. This activation of the ping-pong machinery in cultured cells will greatly facilitate elucidation of the mechanism underlying secondary piRNA biogenesis in Drosophila.


Glutathione S-transferase mu, omega, pi, and theta class variants and smoking in Parkinson's disease.
GSTs are a family of inducible phase II enzymes that may play a neuroprotective role in Parkinson's disease (PD). GSTs may also modify PD risk by metabolizing compounds in cigarettes, as cigarette smoking is generally found to be associated with a decrease in PD risk. Using a population-based case-control study design, we examined polymorphisms of the mu, omega, pi, and theta classes of GST to elucidate the main effects and smoking-GST interactions on PD risk. From three rural California counties, we recruited 289 incident idiopathic PD cases, clinically confirmed by our study neurologist, and 270 population controls, marginally matched by age, gender, and race. We assessed main gene polymorphism associations and evaluated interactions between smoking and GST polymorphisms as departures from a multiplicative scale adjusting for age, gender, and race. We also restricted analyses to Caucasian subjects to address the potential for population stratification (n=235 cases, 220 controls). Among Caucasians, we observed a risk reduction in subjects carrying at least one variant allele for GSTO1 (OR=0.68, 95% CI: 0.47-0.98) and also GSTO2 (OR=0.64, 95% CI: 0.44-0.93); both genes were in strong linkage disequilibrium. No main gene effects were observed for the remaining polymorphisms. We noted a multiplicative interaction between ever having smoked regularly and GSTO1 (OR(interaction)=0.55, 95% CI: 0.33-0.92) and GSTO2 (OR(interaction)=0.54, 95% CI: 0.32-0.90). Results were similar when combining all races. These findings and the paucity of similar studies suggest a need for further inquiry into the association between GSTs, smoking, and PD risk.


Nitric oxide increases cyclic GMP levels, AMP-activated protein kinase (AMPK)alpha1-specific activity and glucose transport in human skeletal muscle.
We investigated the direct effect of a nitric oxide donor (spermine NONOate) on glucose transport in isolated human skeletal muscle and L6 skeletal muscle cells. We hypothesised that pharmacological treatment of human skeletal muscle with N-(2-aminoethyl)-N-(2-hydroxy-2-nitrosohydrazino)-1,2-ethylenediamine (spermine NONOate) would increase intracellular cyclic GMP (cGMP) levels and promote glucose transport. Skeletal muscle strips were prepared from vastus lateralis muscle biopsies obtained from seven healthy men. Muscle strips were incubated in the absence or presence of 5 mmol/l spermine NONOate or 120 nmol/l insulin. The L6 muscle cells were treated with spermine NONOate (20 micromol/l) and incubated in the absence or presence of insulin (120 nmol/l). The direct effect of spermine NONOate and insulin on glucose transport, cGMP levels and signal transduction was determined. In human skeletal muscle, spermine NONOate increased glucose transport 2.4-fold (p < 0.05), concomitant with increased cGMP levels (80-fold, p < 0.001). Phosphorylation of components of the canonical insulin signalling cascade was unaltered by spermine NONOate exposure, implicating an insulin-independent signalling mechanism. Consistent with this, spermine NONOate increased AMP-activated protein kinase (AMPK)-alpha1-associated activity (1.7-fold, p < 0.05). In L6 muscle cells, spermine NONOate increased glucose uptake (p < 0.01) and glycogen synthesis (p < 0.001), an effect that was in addition to that of insulin. Spermine NONOate also elicited a concomitant increase in AMPK and acetyl-CoA carboxylase phosphorylation. In the presence of the guanylate cyclase inhibitor LY-83583 (10 micromol/l), spermine NONOate had no effect on glycogen synthesis and AMPK-alpha1 phosphorylation. Pharmacological treatment of skeletal muscle with spermine NONOate increases glucose transport via insulin-independent signalling pathways involving increased intracellular cGMP levels and AMPK-alpha1-associated activity.


Hypersensitivity reaction with intravenous GnRH after pulsatile subcutaneous GnRH treatment in male hypogonadotrophic hypogonadism.
Chronic pulsatile subcutaneous administration of low doses of gonadotrophin releasing hormone (GnRH) is an effective therapy for men with hypogonadotrophic hypogonadism. Hypersensitivity reactions to GnRH are rare. We wish to report hypersensitivity reactions with intravenous GnRH after low dose subcutaneous pulsatile GnRH treatment in two men with hypogonadotrophic hypogonadism due to suprasellar disease.


Management of Radiation-induced Tissue Injuries: A Review of Current Treatment Strategies.
Although radiation therapy remains an integral component in cancer treatment, the sequela of tissue damage can result in long-term morbidity and mortality for patients. This article aimed to perform a comprehensive review of the current literature for both nonsurgical and surgical management strategies for radiation-induced injuries. A literature search was performed on PubMed to review the current described management and treatment options for radiation-induced injuries. Patient demographics, medical diagnoses, complications, strategies of management care, and outcomes were reviewed. The most commonly described management options and reconstructive techniques of radiation wounds were analyzed and reported. Consideration of current techniques and outcomes in the management of radiation-induced wounds demonstrates that impaired wound healing remains a major problem. This literature review provides a detailed overview of the most frequently used therapies with recommendations for surgeons.


Cell types and hormonal mechanisms associated with mid-cycle corpus luteum function.
This article reviews literature on the highly differentiated nature of the luteal cell types and their regulation in the mid-cycle corpus luteum of ruminants. The blood vessels of the corpus luteum are composed primarily of endothelial cells with few intraluteal arterioles or arteries. Blood flow to the corpus luteum does not seem to be regulated by tropic hormones, metabolic activity, or autonomic nerves, but it is dependent on maintenance of high blood pressure. The density of luteal capillaries and lack of luteal arterioles allows an elevated, relatively unregulated luteal blood flow. Steroidogenesis in the ruminant corpus luteum manifests both dependence on and independence from the actions of LH. Initial luteinization, growth, and development of the corpus luteum is dependent on LH action, but progesterone production by the mid-cycle corpus luteum of ruminants is relatively independent of acute LH stimulation. This apparent enigma may be due to distinct functional properties of the steroidogenic cell types in the corpus luteum. Progesterone production by the large luteal cells is relatively independent of LH action, but the small luteal cells respond to LH stimulation. Much of the progesterone produced by the mid-cycle corpus luteum is produced by the large luteal cells and may not be acutely dependent on LH stimulation. Progesterone production by both cell types is dependent on lipoproteins delivered by the abundant luteal blood supply. Thus, distinct cellular features of the mid-cycle corpus luteum produce considerable steroidogenic capacity.


A nested PCR method for the identification of hepatitis B virus genotype in paraffin blocks of formalin-fixed liver biopsies.
Hepatitis B virus is a hepatotropic virus that causes acute and chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma; it is responsible for more than one million deaths annually worldwide despite hepatitis B vaccination. Until now, there are eight known genotypes (A-H).Clinical course of chronic hepatitis B varies according to the genotype of Hepatitis B virus. Liver biopsy becomes necessary to judge the degree of liver lesions and to make the final diagnosis, especially to make the diagnosis for latent liver damage and early-compensated cirrhosis. Genotype is very important for prognostication, but it has not yet been reported on liver tissues. Sometimes, it can be helpful to do genotyping of Hepatitis B virus of the liver tissue; such conditions include research programs, when serum is not available or when serum is negative for Hepatitis B virus DNA. In this study, we wanted to evaluate the feasibility of a simple method for genotyping of liver tissue samples. We performed genotyping of the liver biopsies and intended to find out a simple and reliable method for genotyping in the paraffin- embedded formalin- fixed liver tissue.Genotype D was the only isolated genotype in all the liver biopsies. The tissue genotype was just the same as that found in serum. The procedure was easy and good for large scale studies.Genotyping in the paraffin-embedded formalin-fixed stored liver tissue can be done with the same accuracy of the serum.


Inheritance of two alkaline phosphatase variants in fowl plasma.
Starch-gel electrophoresis of plasina reveals two mnutually exclusive forms of alkaline phosphatase. Analysis of the plasma of 931 birds from 96 sib families of two inbred lines through two generations shows that the faster-moving isozymne is determined by an autosomal gene Ap(2) which is completely dominant to its allele Ap(4) determining the slower form.


Preeclampsia and Venous Thromboembolism: Pathophysiology and Potential Therapy.
Preeclampsia (PET) is a multisystem inflammatory disorder that represents a leading cause of feto-maternal morbidity and mortality, complicating 2-5% of all pregnancies. PET incurs an increased risk of venous thromboembolism, which is one of the leading causes of death in pregnancy and in the postpartum period. This prothrombotic phenotype is attributable to the maternal phase of PET, which is characterized by a systemic inflammatory response and coagulation activation. Research continues to be undertaken in terms of preventative measures, however, currently revolves around pharmacological low dose aspirin initiated in the first trimester of pregnancy for those with risk factors. Treatment involves antenatal corticosteroids for fetal lung development in preterm birth, parenteral magnesium sulfate for fetal neuroprotection and maternal seizure prophylaxis, and timely birth of the fetus and placenta being the only definitive treatment of PET. Patients with a venous thromboembolism (VTE) risk deemed to be >1-3% are treated with pharmacological thromboprophylaxis in the form of low molecular weight heparin. Completing each woman's VTE risk assessment is crucial, particularly in the setting of PET, as there is also a proven associated competing hemorrhagic risk.


Destructive Upper Airway Disease from Eosinophilic Granulomatosis with Polyangiitis (EGPA): The Very First Case.
Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem vasculitic disorder that predominantly affects medium- and small-sized blood vessels. EGPA belongs to a group of vasculitides known as anti-neutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV). Upper airway involvement is seen in all ANCA-associated vasculitides, but destructive upper airway disease has never been reported in patients with EGPA. We report the first case of erosive chondritis and saddle nose deformity in a 50-year-old patient suffering from EGPA.


A Holistic Approach to Antiaging as an Adjunct to Antiaging Procedures: A Review of the Literature.
Aging is a multifactorial process and depends on both intrinsic and extrinsic factors. Procedural options for diminishing signs of intrinsic aging and cosmetic rejuvenation have expanded dramatically. However, less attention is paid to counseling patients on options for mitigating extrinsic factors related to aging. The objective of this study was to review changes that occur with intrinsic and extrinsic aging, and provide evidence-based holistic counseling recommendations that can be used synergistically with aesthetic procedures to maximize antiaging interventions. A PubMed search was conducted for articles on intrinsic and extrinsic aging as it relates to skin, fat, muscle, and bone. Key clinical trials and studies on the effect of diet, hormones, exercise, sleep, stress, dental hygiene, smoking, pollution, and oxidative stress on the aging process are reviewed, and treatment recommendations are summarized based on available evidence. Conventional cosmetic procedures and cosmeceuticals work together with nutritious diet, exercise, dental hygiene, hormonal balance, stress reduction, smoking and pollution avoidance, and healthy sleep patterns for a better effect on antiaging. A combination approach of multiple nonsurgical modalities along with healthy lifestyle recommendations to minimize intrinsic and extrinsic aging factors allows cosmetic practitioners to target multiple facets of aging concurrently and maximize the aesthetic interventions cosmetic dermatologists/practitioners provide.


[The genetic revolution-impact on therapy and prevention].
After the successful sequencing of the human genome the genetic variation between individuals will be worked out in the near future. The genetic differences are the basis for different predispositions to diseases. The next goal is to correlate the host of genetic variants with phenotypes. This endeavor has already been successful for monogenic diseases; however, it will also be possible in genetically complex diseases. If a trait follows a monogenic mode of inheritance, a phenotype results nearly completely from a single mutation; in genetically complex diseases there exists only a statistical relationship. Predictive genetic diagnostics should only be considered after genetic counseling; it makes sense, if there exists efficient prevention or therapy, respectively. This applies e. g. to various familial cancer predispositions. In the future, medical doctors should be able to apply genetic risk figures and to convey them to their patients.


Current Strategies in the Surgical Management of Ischemic Stroke.
Stroke is a major cause of death and disability in the United States and rapid evaluation and treatment of stroke patients are critical to good outcomes. Effective surgical treatments aim to restore adequate cerebral blood flow, prevent secondary brain injury, or reduce the likelihood of recurrent stroke. Patient evaluation in centers with a comprehensive stroke program and a dedicated neuro- vascular team is recommended. [Full article available at http://rimed.org/rimedicaljournal-2017-06.asp].


Factors predisposing to priapism in haemodialysis patients.
Clinical data and therapy of all male home dialysis patients of two centres were compared in order to establish predisposing factors to priapism. One centre (Frankfurt) had nine priapisms in 96 patients, whereas the other centre (Montpellier) had none in 59 patients. The only difference found were higher haematocrits in Frankfurt than in Montpellier. The highest haematocrits were found in the priapism patients. Further evaluation of the Frankfurt data showed that androgen therapy, high haematocrits and hypovolemia increase the risk of dialysis priapism. It is recommended to withdraw androgen therapy when the haematocrit is consistantly above 25%.


Effects of Banana Plantation Pesticides on the Immune Response of Lepidopteran Larvae and Their Parasitoid Natural Enemies.
Basic research on the insect immune response has progressed dramatically within the last two decades, showing that immunity is one of the most effective defenses against foreign invaders. As such, it is important to understand the causes of variation in this response. Here, we investigate the effects of pesticides used in Costa Rican banana plantations on the immune response of the lepidopteran larva, Caligo memnon (Brassolinae). In addition, we performed a parasitism survey of the banana plantations and surrounding forests to provide a broader assessment of pesticide effects on parasitoid populations. All caterpillars for the immune assay were collected from two banana plantations and brought to La Selva Biology Station for immune challenge. Individuals were fed leaves from the plantations (pesticide) or leaves from La Selva (pesticide-free), then immune challenged with injected sephadex beads. We found that individuals feeding on pesticide leaves had significantly lower bead melanization compared to individuals feeding on pesticide-free leaves. Nonetheless, the parasitism survey showed that caterpillars from the banana plantations had lower parasitism rates compared to caterpillars from the La Selva forest. This study adds to the growing body of evidence documenting negative effects of pesticides on the insect immune response and on adult parasitoids, and underscores the need for more research at the intersection between ecological entomology and immunology.


The effects of maternal depression on fetal heart rate response to vibroacoustic stimulation.
To better understand the effects of untreated maternal depression on the fetus, this study examined fetal heart rate (FHR) and FHR reactivity to vibroacoustic stimulation in pregnant women with untreated depression. The 20 participants were 32- to 36-week pregnant women divided into groups with depression (N = 10) and without depression (N = 10) based on the Beck Depression Inventory (BDI; Beck, 1977; Beck & Steer, 1987). Participants were attached to a fetal heart monitor, and 10 min of baseline FHR were recorded. A vibroacoustic stimulus (VAS) was presented, and an additional 10 min of FHR were recorded. Fetuses of mothers with depression had an elevated baseline FHR and a 3.5-fold delay in return to baseline FHR after VAS presentation. Additionally, mothers with depression had significantly higher anxiety levels and took fewer prenatal vitamins during pregnancy. Delayed habituation of FHR in the fetuses of mothers with depression may be due to alterations in the internal hormonal environment and could have implications for postnatal information processing.


Metaphase and anaphase analysis of V79 cells exposed to erionite, UICC chrysotile and UICC crocidolite.
The cytogenetic effects of erionite treatment of V79 cells were compared with those of UICC crocidolite and UICC chrysotile treatment. A significant reduction in diploid cells with an accompanying increase in aneuploid and polyploid cells was observed with all three treatments. In the erionite-treated cultures, an increase in aneuploidy was observed at all dose levels ranging from 10 to 100 micrograms/ml, whereas in the crocidolite- and chrysotile-treated cultures, significant increases in aneuploidy were observed at all dose levels except the low dose, 10 micrograms/ml. Chromatid aberrations were observed in cultures treated with crocidolite and chrysotile and were especially pronounced at dose 100 micrograms/ml of chrysotile. The clastogenic effect of erionite was weaker but statistically significant at dose 100 micrograms/ml. An extrapolation of these cytogenetic changes over dose in number of fibers suggests that erionite was more reactive than the other two minerals in producing aneuploidy. The number of fibers required to produce a similar degree of cytogenetic effects was several orders of magnitude higher for chrysotile and crocidolite than erionite. These results correlate with the higher tumorigenic potency of erionite. In general, fewer cells treated with erionite entered anaphase than those treated with the other two minerals. As a result, abnormal anaphases representing chromosomal mis-segregation were observed only in the chrysotile- and crocidolite-treated cultures. To our knowledge, this is the first report on cytogenetic effects of erionite.


Forgotten but not gone in rural South Africa: Urinary schistosomiasis and implications for chronic kidney disease screening in endemic countries.
Background: Urinary schistosomiasis caused by infection with Schistosoma haematobium ( S. haematobium) remains endemic in Africa and is associated with haematuria and albuminuria/proteinuria. Kidney Disease Improving Global Outcomes clinical guidelines recommend evaluating proteinuria/albuminuria and glomerular filtration rate for chronic kidney disease (CKD) diagnosis. The guidelines are informed by population data outside of Africa but have been adopted in many African countries with little validation. Our study aimed to characterise the burden of urinary schistosomiasis in rural South Africa (SA) and evaluate its relationship with markers of kidney dysfunction with implications for CKD screening. Methods: In this population-based cohort study, we recruited 2021 adults aged 20 - 79 years in the Mpumalanga Province, SA. Sociodemographic data were recorded, urinalysis performed, and serum creatinine and urine albumin and creatinine measured. Kidney dysfunction was defined as an estimated glomerular filtration rate (eGFR) <60ml/min/1.73m 2 and/or urine albumin-creatinine ratio >3.0mg/mmol. S . haematobium infection was determined by urine microscopy. Multivariable analyses were performed to determine relationships between S. haematobium and markers of kidney dysfunction. Results: Data were available for 1226 of 2021 participants. 717 (58.5%) were female and the median age was 35 years (IQR 27 - 47). Prevalence of kidney dysfunction and S. haematobium was 20.2% and 5.1% respectively. S. haematobium was strongly associated with kidney dysfunction (OR 8.66; 95% CI 4.10 - 18.3) and related to albuminuria alone (OR 8.69; 95% CI 4.11 - 18.8), with no evidence of an association with eGFR <90ml/min/1.73m 2 (OR 0.43; 95% CI 0.05 - 3.59). Discussion: The strong association between urinary schistosomiasis and albuminuria requires careful consideration when screening for CKD. Screening for, and treatment of, schistosomiasis should be a routine part of initial work-up for CKD in S. haematobium endemic areas. Urinary schistosomiasis, a neglected tropical disease, remains a public health concern in the Mpumulanga province of SA.


Analysis of the phasing of four spectrin-like repeats in alpha-actinin.
Selected fragments of the central rod of chicken gizzard alpha-actinin were expressed as fusion proteins in Escherichia coli, with the aim of determining the positions in the sequence of the four successive spectrin-like repeats that make up this domain. The criteria for an independently folding unit were resistance to proteolysis and the high alpha helicity characteristic of the native protein. Sequences containing repeats 1-4, 2-4, 3-4 and 4 all generated stable fragments on digestion with trypsin and/or thermolysin and N-terminal sequencing gave the most probable starting position of each repeat. The sequences of all four inferred repeats and the sequences of the entire rod, were separately expressed and were shown to assume a stable, protease-resistant fold in solution. The repeat boundaries established in this way differed from those originally deduced from sequence alignments; the N-terminal boundaries of the repeats were 14-24 residues nearer the C-terminus than predicted. The ability to express individual repeats should facilitate identification of the binding sites for the cytoplasmic domains of beta 1 integrins and intercellular cell adhesion molecule-1 which have been localised to the rod domain of alpha-actinin.


The Effect of Vietnam-Era Conscription and Genetic Potential for Educational Attainment on Schooling Outcomes.
This study examines whether draft lottery estimates of the causal effects of Vietnam-era military service on schooling vary by an individual's genetic propensity toward educational attainment. To capture the complex genetic architecture that underlies the bio-developmental pathways, behavioral traits and evoked environments associated with educational attainment, we construct polygenic scores (PGS) for respondents in the Health and Retirement Study (HRS) that aggregate thousands of individual loci across the human genome and weight them by effect sizes derived from a recent genome-wide association study (GWAS) of years of education. Our findings suggest veterans with below average PGSs for educational attainment may have completed fewer years of schooling than comparable non-veterans. On the other hand, we do not find any difference in the educational attainment of veterans and non-veterans with above average PGSs. Results indicate that public policies and exogenous environments may induce heterogeneous treatment effects by genetic disposition.


Blood rheology changes during bezafibrate treatment.
To evaluate the effect of bezafibrate on the haemorheological pattern, 30 atherosclerotic non-diabetic patients were enlisted in a double-blind, comparative, parallel group trial with bezafibrate (600 mg daily) or placebo being randomly assigned. The 45-day treatment period was preceded by a three week pharmacological wash-out. Haemorheological parameters such as whole-blood, plasma and serum viscosity, haematocrit, fibrinogen, fibrinogen/albumin ratio and erythrocyte filterability were evaluated before and at the end of treatment. The results showed no change in haemorheological determinants in the placebo-treated group but a significant reduction in whole-blood viscosity, in haematocrit, in fibrinogen and fibrinogen/albumin ratio was observed in the bezafibrate treated patients. No variation was present in the plasma and serum viscosity and in the erythrocyte filterability.


[Long-term results of treatment for articular calcaneus fractures with Westhues method].
In this paper the authors evaluate the long-term results of treatment for articular calcaneus fractures with Westhues method. This evaluation is performed with regard to triple measurement of Böhler's angle value and to subjective criteria. The clinical material from years 1985-2002 consists of 47 patients aged between 24 and 56 years (mean age 32 years) with articular calcaneus fractures--namely, 41 male patients (87.2%) and 6 female patients (12.8%). The follow-up examination was performed in 24 patients (51% of all patients), namely, in 23 male patients (48.8%) and in one female patient (2.2%). Minimum follow-up time was 12 months and maximum was 9 years. Acquired results suggest that Westhues method restores normal Böhler's angle value only in tongue-type calcaneous fractures.


Sma3s: A universal tool for easy functional annotation of proteomes and transcriptomes.
The current cheapening of next-generation sequencing has led to an enormous growth in the number of sequenced genomes and transcriptomes, allowing wet labs to get the sequences from their organisms of study. To make the most of these data, one of the first things that should be done is the functional annotation of the protein-coding genes. But it used to be a slow and tedious step that can involve the characterization of thousands of sequences. Sma3s is an accurate computational tool for annotating proteins in an unattended way. Now, we have developed a completely new version, which includes functionalities that will be of utility for fundamental and applied science. Currently, the results provide functional categories such as biological processes, which become useful for both characterizing particular sequence datasets and comparing results from different projects. But one of the most important implemented innovations is that it has now low computational requirements, and the complete annotation of a simple proteome or transcriptome usually takes around 24 hours in a personal computer. Sma3s has been tested with a large amount of complete proteomes and transcriptomes, and it has demonstrated its potential in health science and other specific projects.


Influence of Beet necrotic yellow vein virus and Freezing Temperatures on Sugar Beet Roots in Storage.
Rhizomania caused by Beet necrotic yellow vein virus (BNYVV) is a yield-limiting sugar beet disease that was observed to influence root resistance to freezing in storage. Thus, studies were conducted to gain a better understanding of the influence of BNYVV and freezing on sugar beet roots to improve pile management decisions. Roots from five commercial sugar beet cultivars (one susceptible and four resistant to BNYVV) were produced in fields under high and trace levels of rhizomania pressure and subjected to storage using five temperature regimes ranging from 0 to -4.4°C for 24 h. After cold treatment, eight-root samples were stored in a commercial indoor storage building (set point 1.1°C) for 50 days in 2014 and 57 days in 2015. Internal root temperature, frozen and discolored tissue, and moisture and sucrose loss were evaluated. The air temperature at 0, -1.1, and -2.2°C matched internal root temperature but internal root remained near -2.2°C when air temperature was dropped to -3.3 and -4.4°C. In a susceptible cultivar produced under high rhizomania pressure, the percentage of frozen tissue increased (P < 0.0001) from an average of 0 to 7% at 0, -1.1, and -2.2°C up to 16 to 63% at -3.3°C and 63 to 90% at -4.4°C, depending on year. Roots from the susceptible cultivar produced under low rhizomania pressure and those from the resistant cultivars from both fields only had elevated (P ≤ 0.05) frozen tissue at -4.4°C in 15 of 18 cultivar-year combinations. Frozen tissue was related to discolored tissue (r2 = 0.91), weight loss (r2 = 0.12 to 0.28), and sucrose reduction (r2 = 0.69 to 0.74). Consequently, BNYVV will not only lead to yield and sucrose loss in susceptible sugar beet cultivars but also to more frozen root tissue as temperatures drop below -2.2°C. Based on these observations, the air used to cool roots in nonfrozen sugar beet piles throughout the winter should not drop below -2.2°C to maximize sucrose retention.


A new methodology for atrial flutter ablation by direct visualization of cavotricuspid conduction with voltage gradient mapping: a comparison to standard techniques.
To demonstrate that critical conduction within the cavotricuspid isthmus (CTI) can be directly visualized by voltage gradient mapping and facilitate efficient ablation compared to standard techniques. Group 1 (1 operator, n = 11) ablated based upon contact voltage measurements and voltage gradient mapping. Ablation targeted low-voltage bridges (LVBs) within the CTI. Repeat maps were obtained following ablation. Group 2 (operators 2, 3, and 4 n = 35) utilized electroanatomic navigation and ablated by the creation of linear lesions from the tricuspid valve to the inferior vena cava. Demonstration of bidirectional block (BDB) was required in both groups. LVB were associated with CTI conduction in all Group A patients. LVB ablation terminated flutter, or created BDB. Following ablation, CTI voltage connections were absent in all patients. Compared with Group B, Group A had less radiofrequency (RF) lesions to atrial flutter (AFL) termination (P = 0.001), less total RF lesions (P = 0.0001), and less total RF time (P = 0.001). Group 1 had no recurrent AFL whereas Group 2 had three recurrences. (follow-up median of 231 ± 181 days). (i) Voltage gradient mapping visualized regions of critical CTI conduction, (ii) ablation of LVB terminated AFL and resulted in BDB, (iii) repeat mapping confirmed the absence of trans-isthmus voltage, and (iv) Compared with standard ablation, voltage gradient mapping decreases total RF lesions, lesions to AFL termination, and total RF time. Use of voltage gradient mapping can facilitate successful AFL ablation.


Monomorphic genotypes within a generalist lineage of Campylobacter jejuni show signs of global dispersion.
The decreased costs of genome sequencing have increased the capability to apply whole-genome sequencing to epidemiological surveillance of zoonotic Campylobacter jejuni. However, knowledge of the genetic diversity of this bacteria is vital for inferring relatedness between epidemiologically linked isolates and a necessary prerequisite for correct application of this methodology. To address this issue in C. jejuni we investigated the spatial and temporal signals in the genomes of a major clonal complex and generalist lineage, ST-45 CC, by analysing the population structure and genealogy as well as applying genome-wide association analysis of 340 isolates from across Europe collected over a wide time range. The occurrence and strength of the geographical signal varied between sublineages and followed the clonal frame when present, while no evidence of a temporal signal was found. Certain sublineages of ST-45 formed discrete and genetically isolated clades containing isolates with extremely similar genomes regardless of time and location of sampling. Based on a separate data set, these monomorphic genotypes represent successful C. jejuni clones, possibly spread around the globe by rapid animal (migrating birds), food or human movement. In addition, we observed an incongruence between the genealogy of the strains and multilocus sequence typing (MLST), challenging the existing clonal complex definition and the use of whole-genome gene-by-gene hierarchical nomenclature schemes for C. jejuni.


[Cardiac arrest caused by coronary arterial vasospasm].
Coronary arterial vasospasm may be associated with acute myocardial infarction, ventricular tachycardia or fibrillation as well as sudden death. Two case reports describing coronary vasospasm leading to ST-segment elevation and cardiac arrest are presented. Coronary arteriography revealed an occlusion that disappeared after injection of nitroglycerine. Both patients were treated with calcium antagonists and a cardioverter defibrillator (ICD) was implanted. One year after the ICD implantation no tachyarrhythmias had been registered.


Morphology control of cerium oxide particles synthesized via a supercritical solvothermal method.
Rod and sphere-like CeO(2) particles were obtained via a supercritical solvothermal method using CeCl(3).7H(2)O and Ce(NO(3))(3).6H(2)O as cerium sources in ethanol and methanol at 400 degrees C for 15 min followed by calcination in air. The rodlike particles were 200-400 nm in diameter and 1-2 mum in length. The spherical particles were 300-500 nm in diameter. The as-prepared rodlike particles using CeCl(3).7H(2)O consisted of mixtures of Ce(OH)(3) and Ce(CH(3)COO)(3) and were converted to rodlike CeO(2) by calcination in air at 500 degrees C. In contrast, the spherical particles prepared using Ce(NO(3))(3).6H(2)O consisted of fluorite-structured CeO(2). The possible formation mechanism was discussed on the basis of the effect of reaction time on the morphology at 400 degrees C. The rod- and spherelike CeO(2) particles exhibited strong UV absorption below 400 nm, and the absorbance edges extend to nearly 500 nm. The rod- and spherelike CeO(2) particles exhibited near-UV emission at 360 nm and blue emission at 465 nm with higher emission intensity compared to the commercial CeO(2) sample.


Two novel ECHS1 variants, affecting splicing and reducing enzyme activity, is associated with mitochondrial encephalopathy in infant: a case report.
Short-chain enoyl-CoA hydratase (ECHS1) is a multifunctional mitochondrial matrix enzyme involved in the second step of mitochondrial fatty acid β-oxidation. Mitochondrial diseases resulting from ECHS1 mutations are often characterised by encephalopathy, deafness, epilepsy, optic atrophy, cardiomyopathy, dystonia, and lactic acidosis. In this study, we report two novel heterogeneous variants, c.414 + 5G > A (in intron 3) and c.310C > G (in CDS), of ECHS1 in an infant with mitochondrial encephalopathy. The two novel variants, c.414 + 5G > A (Chr10:135183403) in intron 3 and c.310C > G (Chr10:135183512) in CDS, were identified by next generation sequencing (NGS). A minigene assay was used to analyse the function of the c.414 + 5G > A variant. ECHS1 enzyme activity was measured by spectrophotometry in the patient-derived myoblasts. The 2-year old patient presented with mitochondrial encephalopathy since birth. Clinical features were encephalopathy, epilepsy, and hindered psychomotor and language development. Serum lactate and blood ammonia levels were elevated, and brain magnetic resonance imaging showed abnormal signals in the bilateral frontal, parietal, and occipital cortices and brainstem and basal ganglia. We found two novel heterogeneous variants in ECHS1 in this patient. Minigene assay revealed the c.414 + 5G > A variant as the cause of intronic cryptic splice site activation and 39 bp deletion in mature mRNA. In silico analysis predicted that c.310C > G might change glutamine (Q) to glutamic acid (E) in the 104th amino acid sequence (p.Q104E). To investigate the impact of these two variants on protein function, we constructed a 3D model of human ECHS1 and showed that the variants might alter the highly conserved region in close proximity to the active site, which might hinder, or even halt, enzymatic activity. The experimental assay showed that ECHS1 enzyme activity in the patient-derived myoblasts decreased compared to that in control. Our findings are the first to report a mitochondrial encephalopathy infant carrying two novel ECHS1 variants, c.414 + 5G > A and c.310C > G, which might be deleterious variants, function as pathogenicity markers for mitochondrial encephalopathy, and facilitate disease diagnosis.


Successful long-term management of a gonadotroph adenoma with bromocriptine.
To report the successful 10-year management of a gonadotroph macroadenoma with bromocriptine and review the management of gonadotroph adenomas with bromocriptine. We present a case and review the pertinent literature. The effectiveness of bromocriptine in the management of gonadotroph adenomas is evaluated. A 62-year-old man was found to have a pituitary tumor after seeking medical assistance because of a 6-month history of headaches and blurred vision. He had decreased visual acuity and bitemporal field defects. Serum follicle-stimulating hormone (FSH) levels were increased, whereas serum luteinizing hormone and total testosterone levels were normal. Treatment with bromocriptine resulted in a decrease in serum FSH levels, complete resolution of his symptoms, and considerable improvement in his visual acuity and visual field defects. Treatment with only bromocriptine for 10 years resulted in maintenance of normal serum FSH levels and no recurrence of symptoms. In the management of a gonadotroph adenoma, we recommend consideration of a therapeutic trial of bromocriptine. In cases that are refractory to this therapy, surgical treatment or external pituitary irradiation could then be used.


Comparison of vasoactive intestinal peptide and isoproterenol relaxant effects in isolated cat airways.
Vasoactive intestinal peptide (VIP), an endogenous peptide found in mammalian tissues including the lung, is a potent relaxant of smooth muscle. In precontracted segments of cat trachea, hilar bronchus, and intrapulmonary bronchus, concentration-relaxation curves to VIP were compared with those produced by isoproterenol. VIP and isoproterenol were nearly equipotent in causing relaxation of extrapulmonary airways. A decreasing sensitivity to VIP was observed in progressively smaller airways, suggesting regional variation in VIP-induced responses. In contrast, tissues showed no regional differences in response to isoproterenol. Propranolol (10(-6) M), which antagonized relaxation responses to isoproterenol, had no effect on VIP concentration-response curves. Indomethacin (10(-5) M) completely prevented responses to exogenous arachidonic acid but did not inhibit VIP-induced relaxation. Avian pancreatic polypeptide, which has been reported to inhibit vasodilator responses to VIP in the cat, was unable to antagonize airway smooth muscle relaxation induced by VIP. These results demonstrate that VIP is a potent relaxant of cat tracheobronchial smooth muscle in vitro and that the relaxant effects of this peptide are not mediated through beta-adrenergic receptors or by prostaglandins. In view of previous reports on the localization of VIP immunoreactivity in nerves around airways in cat lung, results of the present study suggest that VIP may participate in the regulation of airway tone in this species.


DNA orientation using specific avidin-ferritin biotin end labelling.
The orientation of DNA molecules has been determined by labelling one of the molecule end with a Biotin-labelled analog of dTTP (Bio-dUTP) and then by complexing the Bio-dUTP with Avidin-Ferritin. DNAs of phi X174, pBR322 and SV40 were end labelled with Bio-dUTP and imaged by Electron Microscopy (EM). This is a rapid, general method to unambiguously determine the orientation of DNA molecules for precise mapping and quantification of DNA secondary structures or protein-DNA interaction sites using EM.


Use of the levator muscle as a frontalis sling.
To investigate the use of the distal portion of levator aponeurosis as a flap for frontalis suspension in patients with severe congenital ptosis and poor levator function. Eleven procedures were performed on 8 patients with severe congenital ptosis and poor levator muscle function. Three of the 8 patients had Marcus-Gunn jaw-winking phenomenon. Preoperative evaluation included measurements of the degree of ptosis, levator function, superior rectus action, Bell phenomenon, lagophthalmos, and (if present) synkinetic eyelid movement. Surgery involved fashioning a flap from the distal portion of the levator aponeurosis and anchoring it to the frontalis muscle. Postoperatively, patients were followed for at least 6 months to assess the level of the eyelid in the primary position at rest and when the brow is raised, the degree of eyelid margin excursion on brow elevation, persistence of synkinetic eye movement, presence of complications, lagophthalmos, corneal exposure, and symmetry. Synkinetic muscle movements were completely abolished. All cases had good primary eyelid position, no corneal complications, and effective frontalis action on eyelid elevation. The distal levator muscle flap is an effective frontalis suspension material to correct ptosis with poor levator function and to abolish synkinetic eyelid movement without compromising corneal protection.


Dion-Jacobson to Alternating-Cations-Interaction Reconstruction toward Narrow Bandgap 2D Aromatic Hybrid Perovskite.
The 2D aromatic Dion-Jacobson (DJ) hybrid perovskites combining advantages of high stability, enhanced light absorption, and favorable charge transport, are regarded as a kind of very promising materials for high-performance optoelectronic applications. However, due to the rigidity and large size of the aromatic ring, how to further reduce the interlayer distance to achieve better carrier transport and wider light response window still remain extremely challenging. Here, an interesting DJ-to-ACI (alternating-cations-interaction) reconstruction in 2D aromatic perovskite is first realized by inserting MA+ cations into (4-AP)PbI4 (1, 4-AP = 4-amidinopyridinium), successfully constructing an unprecedented ACI perovskite of (4-AP)(MA)2 Pb2 I8 (2, MA = methylamine). Remarkably, such a DJ-to-ACI reconstruction not only effectively reduces the interlayer spacing from 3.89 to 3.15 Å but also alleviates the structural distortion, which jointly causes a significant bandgap narrowing from 2.22 to 1.95 eV (smaller than all current 2D monolayered DJ perovskites), hence achieving a broad photodetection window over 660 nm. This work reports a novel narrow bandgap 2D ACI perovskite derived from the aromatic DJ motif, which sheds light on future regulations on the structure and properties of hybrid perovskites.


Morphology and incidence of testicular tumors in western Austria (1945-1980).
During the years 1945-1980 260 testicular tumors were registered in the two western provinces of Austria ( Tyrol and Vorarlberg ). The histological slices of these tumors were revised and classified according to the revised "British Classification" ( Pugh 1976). 91.9% of investigated testicular tumors were of germinal cell origin: 43.8% of them were seminomas and 38.1% teratomas. Combined tumors first appeared regularly when the surgical material was completely processed. The right side was more common affected than the left, in the ratio 7:5. The age of orchidectomy showed the typical peaks for seminomas, teratomas and combined tumors. 60% of germinal cell tumors were operated in stage pT3 (UICC). The average incidence of all testicular tumors in the years 1945-1980 was 1.9/100,000 males, but in the last decennium (1971-1980) the average incidence was 4.0, with a maximum of 6.9 in 1978. Districts with a high percentage of employed in agriculture and forestry showed lower incidences than industrialized areas.


Validation of the Mind Excessively Wandering Scale and the Relationship of Mind Wandering to Impairment in Adult ADHD.
This study investigates excessive mind wandering (MW) in adult ADHD using a new scale: the Mind Excessively Wandering Scale (MEWS). Data from two studies of adult ADHD was used in assessing the psychometric properties of the MEWS. Case-control differences in MW, the association with ADHD symptoms, and the contribution to functional impairment were investigated. The MEWS functioned well as a brief measure of excessive MW in adult ADHD, showing good internal consistency (α > .9), and high sensitivity (.9) and specificity (.9) for the ADHD diagnosis, comparable with that of existing ADHD symptom rating scales. Elevated levels of MW were found in adults with ADHD, which contributed to impairment independently of core ADHD symptom dimensions. Findings suggest excessive MW is a common co-occurring feature of adult ADHD that has specific implications for the functional impairments experienced. The MEWS has potential utility as a screening tool in clinical practice to assist diagnostic assessment.


[Diagnosis approach of pulmonary embolism].
Pulmonary embolism (PE) is a fairly common condition that can be fatal. The variability of presentation sets clinician up for potentially missing the diagnosis. Routine laboratory findings are nonspecific and are not helpful in diagnosis of PE.Diagnosis is based on clinical prediction rule in combination with laboratory tests such as the D-dimers test leading to the realization ofa confirming examination. To precise the confirming examinations of PE and propose analgorithm based on clinical prediction rules in combination with D-Dimers. A Pub Med search was conducted using the following keywords: pulmonary embolism,computed tomogramphy pulmonary angiography, scintigraphy and D Dimer. The study was based on are view of 18 studies including meta analysis, reviews and original articles referring recent strategy diagnosis of pulmonary embolism. Ventilation/perfusion scan is a type of examination that is used less often because it is not a widespread technology. However,it may be useful in patients who have an allergy to iodinated contrast.Ultrasonography of the legs, also known as leg doppler, in search of deep venous thrombosis (DVT) may help the diagnosis approach particularly when other exams are not available or contraindicated.This may be a valid approach in pregnancy. The gold standard for diagnosing PE is pulmonary angiography. It is used less often due to wider acceptance of multi detector CT scans, which are non-invasive.A normal ventilation/perfusion scan rules out the diagnosis of PE with negative predictive value of 97%. There is no consensus in pregnancy. Finally, the MRI has a low and insufficient sensibility to diagnose PE. D Dimers, multidetector CT, ventilation/ perfusion scintigraphy and ultrasonography of the legs are the most useful examinations to diagnose PE. Many algorithms were established depends on medical experience and examination availability


e-Healthcare in India: critical success factors for sustainable health systems.
As healthcare enterprises seek to move towards an integrated, sustainable healthcare delivery model an IT-enabled or e-Healthcare strategy is being increasingly adopted. In this study we identified the critical success factors influencing the effectiveness of an e-Healthcare strategy in India. The performance assessment criteria used to measure effectiveness were increasing reach and reducing cost of healthcare delivery. A survey of healthcare providers was conducted. Analytic Hierarchy Process (AHP) and Interpretive Structural Modeling (ISM) were the analytical tools used to determine the relative importance of the critical success factors in influencing effectiveness of e-Healthcare and their interplay with each other. To succeed in e-Healthcare initiatives the critical success factors that need to be in place are appropriate government policies, literacy levels, and telecommunications and power infrastructure in the country. The focus should not be on the IT tools and biomedical engineering technologies as is most often the case. Instead the nontechnology factors such as healthcare provider and consumer mindsets should be addressed to increase acceptance of, and enhance the effectiveness of, sustainable e-Healthcare services.


Gold Superparticles Functionalized with Azobenzene Derivatives: SERS Nanotags with Strong Signals.
The surface-enhanced Raman spectroscopy (SERS) nanotag was proposed as a substitute for fluorescent dye for imaging and biosensors several decades ago. However, its weak signal and poor reproducibility has hindered its application. Here, we report a new strategy to form Au superparticles (AuSPs) with high SERS enhancement via one-pot formation and self-assembly of Au nanoparticles (NPs). An azobenzene-carrying Raman reporter was synthesized to exhibit a large Raman cross-section and multiple bands. The self-assembly of the Raman reporter on AuSPs generated SERS nanotags with intense signals. A Raman reporter carrying boronic acid and azobenzene groups displayed six distinctive bands. Its corresponding SERS nanotag demonstrated a high sensing ability toward glycoprotein through aggregation-induced SERS enhancement or as a substitute for labeled antibodies in an immunoassay of the glycoprotein.


[Prevalence and the relevant factors of type 2 diabetes mellitus among adults in Guizhou Province in 2010-2012].
To investigate the prevalence and relevant factors of type 2 diabetes mellitus among urban and rural residents over 18 years old in Guizhou Province in 2010-2012. A total of 3073 residents over 18 years old were sampled by multi-stage and stratified random cluster sampling in Guizhou Province from"2010-2012 Chinese nutrition and health surveillance", including 1576 people in urban areas and 1497 people in rural areas, 1362 males and 1711 females. The participants were investigated for their basic conditions, lifestyle and behavior, and physical indicators, blood pressure, blood glucose, TC, and TG were also measured, and then the prevalence was calculated. Multivariate analysis was performed using an unconditional logistic regression model. Among the 3073 residents aged 18 years and over in Guizhou Province, 151 were diagnosed with type 2 diabetes mellitus, with a prevalence of4. 9%, among which 80 were urban residents and 71 were rural residents, with a prevalence of 5. 1% and 4. 7%, respectively. There was no statistically significant difference between urban and rural areas( χ~2= 0. 183, P = 0. 669). Age was associated with type 2 diabetes mellitus, and the prevalence increased with age( χ_()~2= 55. 478, P =0. 001). The result of multivariate Logistic regression analysis showed that family history, abdominal obesity, hypertension, abnormal TC and abnormal TG all had statistically significant influences on the prevalence of type 2 diabetes mellitus( OR values were2. 377, 1. 721, 1. 666, 1. 619 and 1. 982, respectively, all P <0. 05). The prevalence of type 2 diabetes mellitus in residents aged 18 and over in Guizhou Province was lower than the national average level. The prevention of type 2 diabetes in Guizhou residents should be targeted at middle-aged and elderly people, people with family history, people with abdominal obesity, people with hypertension and dyslipidemia.


Receptors responding to changes in upper airway pressure.
Our purpose was to characterize receptors which respond to changes in upper airway pressures. Such changes cause alterations in hypoglossal and phrenic nerve activities. Decerebrate, vagotomized, paralyzed and ventilated cats were prepared so that pressures could be altered within segments of upper airways. Activities of single fibers in the superior laryngeal and glossopharyngeal nerves were monitored. Most superior laryngeal receptors discharged tonically at zero transmural pressure. Discharges of approximately half decreased (A) and the rest increased (B) with pressure reductions of -7 to -28 cm H2O. Pressure increases of +7 to +28 cm H2O caused increases in Group A activities while Group B responses varied. The remaining receptors were silent, being activated by pressure decreases and/or increases. Activities of other silent receptors, similarly activated, were recorded from glossopharyngeal nerve. Tonically active glossopharyngeal receptors increased discharge after both pressure increases and decreases. Most tonically active and silent receptors, having afferents in either nerve, adapted incompletely to sustained pressures. These may have major functions in hypoglossal responses to changes in upper airway pressures.


Sickle cell disease clinical phenotypes in children from South-Western, Nigeria.
The clinical phenotypes of children with sickle cell disease (SCD) are poorly described in many sub-Saharan countries including Nigeria. The objective was to highlight various clinical phenotypes of SCD in children and investigate the influence of sociodemographic indices on the development of SCD complications. We carried out a cross-sectional study of 240 pediatric patients attending the sickle cell clinic and the emergency room in a teaching hospital in South-Western Nigeria over a 12-month period. The clinical phenotypes and severity of the disease were documented, and the influence of sociodemographic variables was investigated. The five leading clinical phenotypes in our patients were significant pain episodes, that is, vaso-occlusive crisis in 159 (66.3%); anemic crisis in 62 (25.8%); severe bacterial infections, 57 (23.8%); acute chest syndrome (ACS), 27 (11.3%) and stroke, 7 (2.9%). Forty-two (33.1%) had a previous history of dactylitis (hand-foot syndrome). Other clinical phenotypes such as avascular necrosis of the femur, 4 (1.7%); nephropathy, 2 (0.8%); priapism, gallstone and chronic leg ulcer, one (0.4%) each, were not commonly seen. More children with a history of asthma had ACS. Furthermore, high steady-state white blood cell count was associated with severe disease. The clinical phenotypes of SCD in children from South-Western Nigeria are highly variable with the disease manifesting very early and about 10% having significant complications. Sociodemographic characteristics appear to have little influence on the development of SCD complications among our patients, but age and low-socioeconomic class are associated with anemic crisis.


Immunoproteomic identification and characterization of Ni2+-regulated proteins implicates Ni2+ in the induction of monocyte cell death.
Nickel allergy is the most common cause of allergic reactions worldwide, with cutaneous and systemic effects potentially affecting multiple organs. Monocytes are precursors of not only macrophages but also dendritic cells, the most potent activators of nickel hypersensitivity. Monocytes are themselves important antigen-presenting cells, capable of nickel-specific T-cell activation in vivo and in vitro, in addition to being important for immediate innate immune inflammation. To elucidate early Ni2+-dependent inflammatory molecular mechanisms in human monocytes, a Ni2+-specific proteomic approach was applied. Quantitative two-dimensional (2D) differential gel electrophoresis and Delta2D software analyses coupled with matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) revealed that Ni2+ significantly regulated 56 protein species, of which 36 were analyzed by MALDI-MS. Bioinformatics analyses of all identified proteins resulted in Ni2+-associated functional annotation clusters, such as cell death, metal ion binding, and cytoskeletal remodeling. The involvement of Ni2+ in the induction of monocyte cell death, but not T-cell death, was observed at Ni2+ concentrations at or above 250 μM. Examination of caspase activity during Ni2+-mediated cell death revealed monocytic cell death independent of caspase-3 and -7 activity. However, confocal microscopy analysis demonstrated Ni2+-triggered cytoskeletal remodeling and nuclear condensation, characteristic of cellular apoptosis. Thus, Ni2+-specific peripheral blood mononuclear cell stimulation suggests monocytic cell death at Ni2+ concentrations at or above 250 μM, and monocytic effects on immune regulation at lower Ni2+ concentrations.


Death-Associated Protein Kinase 1 Phosphorylation in Neuronal Cell Death and Neurodegenerative Disease.
Regulated neuronal cell death plays an essential role in biological processes in normal physiology, including the development of the nervous system. However, the deregulation of neuronal apoptosis by various factors leads to neurodegenerative diseases such as ischemic stroke and Alzheimer's disease (AD). Death-associated protein kinase 1 (DAPK1) is a calcium/calmodulin (Ca2+/CaM)-dependent serine/threonine (Ser/Thr) protein kinase that activates death signaling and regulates apoptotic neuronal cell death. Although DAPK1 is tightly regulated under physiological conditions, DAPK1 deregulation in the brain contributes to the development of neurological disorders. In this review, we describe the molecular mechanisms of DAPK1 regulation in neurons under various stresses. We also discuss the role of DAPK1 signaling in the phosphorylation-dependent and phosphorylation-independent regulation of its downstream targets in neuronal cell death. Moreover, we focus on the major impact of DAPK1 deregulation on the progression of neurodegenerative diseases and the development of drugs targeting DAPK1 for the treatment of diseases. Therefore, this review summarizes the DAPK1 phosphorylation signaling pathways in various neurodegenerative diseases.