Oxygen K-edge fine structures of water by x-ray Raman scattering spectroscopy under pressure conditions.
Fine structure of the oxygen K edge was investigated for water at ambient pressure, 0.16, 0.21, 0.27, 0.47, and 0.60 GPa using x-ray Raman scattering spectroscopy (XRS). Similarity in near-edge structures at 0.16 and 0.60 GPa suggests little difference in the electronic state of oxygen in the low-pressure and high-pressure forms of water. Yet, we observed significant variation of preedge structure of the XRS spectra with compression. The intensity of the preedge peak at 535.7 eV has a minimal value at around 0.3 GPa, indicating that the number of hydrogen bonding increases first and then decreases as a function of pressure.


[Evaluation of cellular response in engorged females of Boophilus microplus (Canestrini, 1887) inoculated with Metarhizium anisopliae, Beauveria bassiana, Penicillium corylophilum or Fusarium oxysporum].
The effect of Beauveria bassiana, Metarhizium anisopliae, Penicillium corylophilum or Fusarium oxysporum on the dynamic of hemocytes presented in the haemolymph of engorged females of Boophilus microplus was studied. The inoculation was carried out with conidia suspension of different fungi in the concentration of 10(8) conidia/ml. A negative control group was inoculated with 0.1% Tween 80 water solution and a testimony group was comprised of non inoculated ticks. The haemolymph samples were collected in 24, 48 and 72 hours post-challenge. In all the studied periods, prohemocytes, plasmatocytes, granulocytes, spherulocytes and oenocytoids were observed in the specimens inoculated with fungus and also in the controls groups (negative and testimony). Prohemocytes, plasmatocytes and spherulocytes were the most cells in the haemolymph. The absence of hemocytes 72h post-challenging was observed prior to the death of the specimens inoculated with B. bassiana suggesting a failure in the cellular response. Hyphae and conidia growth was observed in the samples treated with entomopathogenic fungi (B. bassiana or M. anisopliae). The groups treated with non entomopathogenic fungi (P. corylophilum or F. oxysporum) did not shown significant differences in relation to the negative control and testimony groups.


Screening for Drought Tolerance in Maize (Zea mays L.) Germplasm Using Germination and Seedling Traits under Simulated Drought Conditions.
Maize is known to be susceptible to drought stress, which negatively affects vegetative growth and biomass production, as well as the formation of reproductive organs and yield parameters. In this study, 27 responsive traits of germination (G) and seedlings growth were evaluated for 40 accessions of the Leibniz Institute of Plant Genetics and Crop Plant Research (IPK) germplasm collection, under no stress and simulated drought stress treatments by 10%, 15%, and 20% of polyethylene glycol (PEG). The three treatments significantly reduced G% and retarded seedlings growth, particularly the 15% and 20% PEG treatments; these two treatments also resulted in a significant increase of abnormal seedlings (AS). The heritability (H2) and correlations of the traits were estimated, and drought tolerance indices (DTIs) were calculated for traits and accessions. The H2 of G% values were reduced, and H2 for AS% increased as the PEG stress increased. Positive correlations were found between most trait pairs, particularly shoot and root traits, with 48 highly significant correlations under no stress and 25 highly significant correlations under the 10% PEG treatments, particularly for shoot and root traits. The medium to high heritability of shoot and root seedling traits provides a sound basis for further genetic analyses. PCA analysis clearly grouped accessions with high DTIs together and the accessions with low DTIs together, indicating that the DTI indicates the stress tolerance level of maize germplasm. However, the resemblance in DTI values does not clearly reflect the origin or taxonomic assignments to subspecies and varieties of the examined accessions.


Does leaning posture on the kitchen counter alleviate workload on the low back and legs during dishwashing?
In this study, we evaluated the effects of leaning posture on the kitchen counter, which was observed during dishwashing in a kitchen, on subjective discomfort and muscle activity in the low back and legs. Twelve female volunteers were asked to wash plates for 30 min in each of three working postures: (a) without support (No support), (b) supported by the kitchen counter (Counter), and (c) supported by a standing aid which was a stand equipment to support the shins and the counter (Aid and counter). In the "Aid and counter" posture, the angle of the bent trunk and the muscle activity in the low back were less than that in the "Counter" posture, which was less than that in the "No support" posture. Also, the muscle activities in the legs were greater in the "Counter" and "No support" postures than in the "Aid and counter" posture. We concluded that the effects of leaning posture on the kitchen counter were not enough to decrease the workload on the low back and legs. To improve the comfort of the dishwashing task, new measures, such as the standing aid, are needed.


Proteomics of nipple aspirate fluid, breast cyst fluid, milk, and colostrum.
Proteomic analysis of breast fluids has wide-ranging clinical applications. Protein expression in nipple aspirate fluid and breast cyst fluid may prove valuable for the detection and monitoring of breast cancer, but has been hampered by the lack of a single marker with sufficient breast cancer sensitivity and specificity to be clinically useful. The assessment of multiple proteins may offer a more powerful cancer detection tool. Breast cancer is particularly difficult to detect in women who are lactating. The identification of cancer predicting proteins in milk may prove very helpful in an early cancer detection in this group of women. A better understanding of the protein composition of milk and colostrum should improve infant care and nutrition, and lead to alternatives for individuals with milk allergies.


Oversensing from electrode 'chatter' in a bipolar pacing lead: a case report.
An 81-year-old man was treated for high degree AV block and syncope with an AV universal (DDD) pacemaker. Bipolar active fixation atrial and ventricular leads were used. Intermittent oversensing from the ventricular lead was detected on Holter monitoring following implantation. This resulted in inappropriate inhibition of ventricular pacing. Ventricular electrogram showed spurious signals between 5 mV and 15 mV in magnitude coincident with ventricular lead inhibition. Treatment consisted of reprogramming the device to the VVT mode. Six weeks after implantation normal pacemaker function in the DDD mode was demonstrated on Holter monitoring and inappropriate pacer inhibition could not be demonstrated. We postulate that electrode 'chatter' between the cathodal ring electrode and the helix of the ventricular lead resulted in artifactual potentials sufficient to inhibit pacing. We hypothesize that fibrosis and fixation of the ventricular lead tip over a period of weeks eliminated these electromechanical artifacts and resulted in the oversensing problem being self-limited. Physicians should be aware of electrode 'chatter' as a cause of pacemaker oversensing.


Microbial pollution in inland recreational freshwaters of Quetta, Pakistan: an initial report.
Parasitic contamination of surface waters, especially recreational waters, is a serious problem for under-developed nations like Pakistan, where numerous outbreaks of parasitic diseases are reported each year. In the current study, parasitic presence in two surface waters (Hanna Lake and Wali-Tangi Dam) of Quetta was monitored quarterly for 1 year. The methodology involved the pre-concentration of the water samples and the subsequent preparation for the microscopic search of parasites. Physico-chemical and bacteriological variables were also studied. Wet staining, modified Trichrome staining, and modified acid-fast staining methods were used to identify various parasitic forms (cysts, oocysts, eggs, trophozoites). Collectively 11 parasitic elements (10 in Lake and 8 in Dam) belonging to 10 species were recorded, many of which are potential human pathogens. The species identified include Trichomonas sp., Isospora sp., Balantidium coli, Cryptosporidium sp., Entamoeba spp., amoebas, Microsporidium sp., Endolimax nana, Ascaris lumbricoides, and Giardia spp. Parasitic contamination remained persistent in both locations throughout the year independent of physico-chemical parameters (temperature, EC, pH, turbidity, and DO) and bacterial concentration of water. Reliance on bacterial presence for monitoring of recreational waters can be a risk for tourists. Entamoeba spp. and A. lumbricoides may be used for surface water monitoring in these waters.


[Holter-detected myocardial ischemia. Impact for prognosis and decision making after acute myocardial infarction].
Aim of the study was to evaluate the prognostic and decision making value of Holter detected myocardial ischemia after acute myocardial infarction in comparison with clinically detected postinfarction angina and exercise test. To this aim the patients consecutively admitted to our coronary care unit with acute myocardial infarction during one year were retrospectively evaluated. One hundred and eighty-nine patients (age 70+/-11 years, 137 male and 51 female) had a 24 hour Holter monitoring. One-year follow up of these patients was obtained. Myocardial ischemia was detected by Holter monitoring in 21 patients (11%), 4 with and 17 without angina. Symptom limited exercise test was obtained before discharge in 116 patients (62%): 45% were positive, 42% non-diagnostic and 13 negative for myocardial ischemia. Post infarction angina was present in 15 patients (9%). Patients with Holter detected myocardial ischemia were older (73+/-10 vs 66+/-11 years, p<0.05) and had higher prevalence of both angina and positive exercise test (p<0.01). One-year follow up was obtained in 186 patients. Holter detected myocardial ischemia positive predictive value for death or reinfarction was 15%, negative predictive value was 90%, similar to the absence of angina (90%) and the absence of positive exercise test (93%). Angina and exercise test identified 62% of patients with Holter detected myocardial ischemia. Residual myocardial ischemia was exclusively observed by Holter monitoring in 4% of the population, particularly in 1 patients with and 7 without exercise test. The additive contribution of Holter detected myocardial ischemia in the prognosis and decision making of post infarction patients is rather scanty.


The structure of human mitochondrial DNA variation.
Restriction analysis of mitochondrial DNA (mtDNA) of 3065 humans from 62 geographic samples identified 149 haplotypes and 81 polymorphic sites. These data were used to test several aspects of the evolutionary past of the human species. A dendrogram depicting the genetic relatedness of all haplotypes shows that the native African populations have the greatest diversity and, consistent with evidence from a variety of sources, suggests an African origin for our species. The data also indicate that two individuals drawn at random from the entire sample will differ at approximately 0.4% of their mtDNA nucleotide sites, which is somewhat higher than previous estimates. Human mtDNA also exhibits more interpopulation heterogeneity (GST = 0.351 +/- 0.025) than does nuclear DNA (GST = 0.12). Moreover, the virtual absence of intermediate levels of linkage disequilibrium between pairs of sites is consistent with the absence of genetic recombination and places constraints on the rate of mutation. Tests of the selective neutrality of mtDNA variation, including the Ewens-Watterson and Tajima tests, indicate a departure in the direction consistent with purifying selection, but this departure is more likely due to the rapid growth of the human population and the geographic heterogeneity of the variation. The lack of a good fit to neutrality poses problems for the estimation of times of coalescence from human mtDNA data.


Collective synchronization in spatially extended systems of coupled oscillators with random frequencies.
We study collective behavior of locally coupled limit-cycle oscillators with random intrinsic frequencies, spatially extended over d -dimensional hypercubic lattices. Phase synchronization as well as frequency entrainment are explored analytically in the linear (strong-coupling) regime and numerically in the nonlinear (weak-coupling) regime. Our analysis shows that the oscillator phases are always desynchronized up to d=4 , which implies the lower critical dimension dP(l) =4 for phase synchronization. On the other hand, the oscillators behave collectively in frequency (phase velocity) even in three dimensions (d=3) , indicating that the lower critical dimension for frequency entrainment is dF(l)=2 . Nonlinear effects due to the periodic nature of limit-cycle oscillators are found to become significant in the weak-coupling regime: So-called runaway oscillators destroy the synchronized (ordered) phase and there emerges a fully random (disordered) phase. Critical behavior near the synchronization transition into the fully random phase is unveiled via numerical investigation. Collective behavior of globally coupled oscillators is also examined and compared with that of locally coupled oscillators.


X chromosome reactivation dynamics reveal stages of reprogramming to pluripotency.
Reprogramming to iPSCs resets the epigenome of somatic cells, including the reversal of X chromosome inactivation. We sought to gain insight into the steps underlying the reprogramming process by examining the means by which reprogramming leads to X chromosome reactivation (XCR). Analyzing single cells in situ, we found that hallmarks of the inactive X (Xi) change sequentially, providing a direct readout of reprogramming progression. Several epigenetic changes on the Xi occur in the inverse order of developmental X inactivation, whereas others are uncoupled from this sequence. Among the latter, DNA methylation has an extraordinary long persistence on the Xi during reprogramming, and, like Xist expression, is erased only after pluripotency genes are activated. Mechanistically, XCR requires both DNA demethylation and Xist silencing, ensuring that only cells undergoing faithful reprogramming initiate XCR. Our study defines the epigenetic state of multiple sequential reprogramming intermediates and establishes a paradigm for studying cell fate transitions during reprogramming.


Modified Frailty Index Is an Effective Risk Assessment Tool in Primary Total Hip Arthroplasty.
Frailty is described as decreased physiological reserve and typically increasing with age. Hospitals are being penalized for reoperations and readmissions, which can affect reimbursement. The purpose of this study was to determine if the modified frailty index (MFI) could be used as a risk assessment tool for preoperative counseling and to make an objective decision on whether to perform total hip arthroplasty (THA) on a frail patient. The American College of Surgeons National Surgical Quality Improvement Program database was queried by Current Procedural Terminology code for primary THA (27130) from 2005 to 2014. MFI was calculated using 11 variables extracted from the medical record. Bivariate analysis was performed for outcomes and complications, and the multiple logistic regression model was used to compare MFI with other predictors of readmission, any complication, and reoperation. A total of 51,582 patients underwent primary THA during the study period. MFI was a significant and stronger predictor than the American Society of Anesthesiologists class and age for readmission (odds ratio [OR], 14.72; 95% confidence interval [CI], 6.95-31.18; P < .001), any complication (OR, 3.63; 95% CI, 1.64-8.05; P = .002), and reoperation (OR, 8.78; 95% CI, 3.67-20.98; P < .001). As MFI increased, adverse discharge, any complication, readmission, reoperation, and mortality significantly increased (P < .001). Rates of systemic complications and length of stay significantly increased with increasing MFI. MFI is a simple and effective risk assessment tool to preoperatively counsel and make an objective decision on whether to perform THA on a frail patient.


Transient hyperglycemia in childhood: identification of a subgroup with imminent diabetes mellitus.
Transient hyperglycemia may represent the earliest manifestation of IDDM. In a series of 30 children referred for transient hyperglycemia, 8/30 (27%) developed IDDM within 10 months of their initial evaluation. Three children with detectable cytoplasmic islet cell antibodies (ICA) and/or positive insulin autoantibodies (CIAA) all developed IDDM, compared to 21% of ICA negative children and 13% who were CIAA negative. Of those with impaired glucose tolerance, 6/11 (55%) developed IDDM, as did 1/14 with normal OGTT. Of the children with a low "K rate" on IVGTT, 75% developed IDDM, compared to 1/13 with a normal "K rate". All four children (100%) whose first phase (1' + 3') insulin secretion never exceeded the first percentile developed IDDM within nine months, while no child with first phase insulin secretion above the first percentile (0/16) developed IDDM during 19 +/- 9 months (mean +/- SD) of follow-up. Thus, in our experience the oral glucose tolerance test is a less accurate predictor of impending IDDM; immunological abnormalities have the highest positive predictive value, while the first phase insulin secretion during an intravenous glucose tolerance test has the highest negative predictive value and the greatest overall accuracy of prediction.


A highly effective nonpolar isostere of deoxyguanosine: synthesis, structure, stacking, and base pairing.
We describe the preparation and structure of the deoxyribonucleoside of 4-fluoro-6-methylbenzimidazole, abbreviated dH (8), which acts as a close shape mimic of the nucleoside deoxyguanosine. The nucleoside is prepared from 2-fluoro-4-methylaniline in seven steps. The X-ray crystal structure reveals a (-sc) glycosidic orientation, an S conformation for the deoxyribose moiety, and quite close shape mimicry of guanine by the substituted benzimidazole. Conformational studies by (1)H NMR and (1)H-(1)H ROESY experiments reveal an S-type conformation and an anti glycosidic orientation in solution (D(2)O), essentially the same as that of deoxyguanosine. Base-stacking studies in a "dangling end" context reveal that the benzimidazole base mimic stacks more strongly than all four natural bases, and more strongly than its counterpart guanine by 1.1 kcal/mol. Base-pairing studies in a 12mer DNA duplex show that, like other nonpolar nucleoside isosteres, H is destabilizing and nonselective when paired opposite natural bases. However, when paired opposite another nonpolar isostere, difluorotoluene (F), a mimic of thymine, the pair exhibits stability approaching that of its natural analogue, a G-T (wobble) base pair. The nucleoside analogue dH will be useful in studies of protein-DNA interactions, and the H-F base pair will serve as a structurally and thermodynamically close mimic of G-T in studies of DNA mismatch repair enzymes.


[Derivatives of 4-phenylcyclohexylethylamine with antidepressive activity].
Several new derivatives of trans-1-(4-phenylcyclohexyl)-ethylamine (M.G. 6669) have been synthesized with various substituents at the alpha-carbon and/or at the amine nitrogen atom. All compounds were evaluated for a potential antidepressant activity taking M.G. 6669 as reference. They turned out to be less active than the reference substance. Pharmacological evaluation of M.G. 6669 itself was broadened during this work. The good antidepressant properties of this compound were confirmed, accompanied however by some toxic phenomena.


Bleomycin-induced chromosome aberrations in the lymphocytes of young and elderly patients.
Phytohaemagglutinin-stimulated lymphocytes from 20 young (16-28 years) and 20 old (70-88 years) healthy subjects were examined for chromosome aberrations before and after exposure to bleomycin in the G2 phase of the cell cycle. No differences were found in unexposed cultures between young and old donors. After treatment with bleomycin, the rate of chromosome aberrations was significantly higher in the elderly persons (p less than 0.05). As the results suggest, different interaction between the mutagen and DNA may be caused by the decreased capacity of the excision repair system in the elderly individuals cells.


Comparison of ventilation techniques for compensation of mask leakage using a ventilator and a regular full-face mask: A bench study.
The use of noninvasive ventilation (NIV) during and after extubation is common. We designed this study to determine the optimal strategy to compensate for mask leaks and achieve effective ventilation during NIV by comparing commonly used operating room ventilator systems and a regular facemask. We tested four operating room ventilator systems (Dägger Zeus, Dägger Apollo, Dägger Fabius Tiro, and General Electric Healthcare Carestation 650) on a lung model with normal compliance and airway resistance and evaluated pressure control ventilation (PCV), volume control ventilation (VCV), and AutoFlow mode (VAF). We set the O2 flow at 10 L/min and the maximal flow at 13, 16, or 26 L/min. We simulated five leak levels, from no leak to over 40 L/min (I to V levels), using customized T-pieces placed between the lung model and the breathing circuit. We recorded the expired tidal volume (Vte) from the lung model and peak inspiratory pressure via two flow/pressure sensors that were placed distally and proximally to the T-pieces. 1. Comparison of four ventilators: with any given ventilation mode, an increase in leak level caused a decrease in Vte. With PCV, only Zeus produced Vte larger than 150 ml at leak level V. 2. Effect of ventilation mode on Vte: across all four ventilators, PCV resulted in a higher Vte than VCV and VAF (P < 0.01). PCV mode with all ventilators at leak level II provided Vte values that were equal to or greater than those obtained with no leak. 3. Effect of O2 flow on Vte Using PCV mode: only Carestation 650 Vte at leak level II during PCV were significantly greater with 16 L/min O2 flow compared with 10 L/min O2 flow (P < 0.01). 4. Actual leak: increasing the O2 flow from 10 L/min to the maximum O2 flow dramatically increased the real leak with all 4 ventilators at any fixed leak level (P < 0.01). 5. Preset PIP vs. actual PIP with PCV: at low preset PIP and leak levels such as leak II and III, the discrepancy between preset PIP and actual PIP was small. The disparity between the preset and actual PIP grew when the target PIP and the leak level were raised. For NIV using a mask, the ventilator is preferred whose Pressure generator is Turbine, the PCV mode is preferred in the ventilation mode and the oxygen flow is set to 10 L/min or maximum oxygen flow.


Liquid crystals of carbon nanotubes and graphene.
Liquid crystal ordering is an opportunity to develop novel materials and applications with spontaneously aligned nanotubes or graphene particles. Nevertheless, achieving high orientational order parameter and large monodomains remains a challenge. In addition, our restricted knowledge of the structure of the currently available materials is a limitation for fundamental studies and future applications. This paper presents recent methodologies that have been developed to achieve large monodomains of nematic liquid crystals. These allow quantification and increase of their order parameters. Nematic ordering provides an efficient way to prepare conductive films that exhibit anisotropic properties. In particular, it is shown how the electrical conductivity anisotropy increases with the order parameter of the nematic liquid crystal. The order parameter can be tuned by controlling the length and entanglement of the nanotubes. In the second part of the paper, recent results on graphene liquid crystals are reported. The possibility to obtain water-based liquid crystals stabilized by surfactant molecules is demonstrated. Structural and thermodynamic characterizations provide indirect but statistical information on the dimensions of the graphene flakes. From a general point of view, this work presents experimental approaches to optimize the use of nanocarbons as liquid crystals and provides new methodologies for the still challenging characterization of such materials.


Modeling of time trends and interactions in vital rates using restricted regression splines.
For the analysis of time trends in incidence and mortality rates, the age-period-cohort (apc) model has became a widely accepted method. The considered data are arranged in a two-way table by age group and calendar period, which are mostly subdivided into 5- or 10-year intervals. The disadvantage of this approach is the loss of information by data aggregation and the problems of estimating interactions in the two-way layout without replications. In this article we show how splines can be useful when yearly data, i.e., 1-year age groups and 1-year periods, are given. The estimated spline curves are still smooth and represent yearly changes in the time trends. Further, it is straightforward to include interaction terms by the tensor product of the spline functions. If the data are given in a nonrectangular table, e.g., 5-year age groups and 1-year periods, the period and cohort variables can be parameterized by splines, while the age variable is parameterized as fixed effect levels, which leads to a semiparametric apc model. An important methodological issue in developing the nonparametric and semiparametric models is stability of the estimated spline curve at the boundaries. Here cubic regression splines will be used, which are constrained to be linear in the tails. Another point of importance is the nonidentifiability problem due to the linear dependency of the three time variables. This will be handled by decomposing the basis of each spline by orthogonal projection into constant, linear, and nonlinear terms, as suggested by Holford (1983, Biometrics 39, 311-324) for the traditional apc model. The advantage of using splines for yearly data compared to the traditional approach for aggregated data is the more accurate curve estimation for the nonlinear trend changes and the simple way of modeling interactions between the time variables. The method will be demonstrated with hypothetical data as well as with cancer mortality data.


Sample management for clinical biochemistry assays: Are serum and plasma interchangeable specimens?
The constrained economic context leads laboratories to centralize their routine analyses on high-throughput platforms, to which blood collection tubes are sent from peripheral sampling sites that are sometimes distantly located. Providing biochemistry results as quickly as possible implies to consolidate the maximum number of tests on a minimum number of blood collection tubes, mainly serum tubes and/or tubes with anticoagulants. However, depending on the parameters and their pre-analytical conditions, the type of matrix - serum or plasma - may have a significant impact on results, which is often unknown or underestimated in clinical practice. Importantly, the matrix-related effects may be a limit to the consolidation of analyses on a single tube, and thus must be known by laboratory professionals. The purpose of the present critical review is to put forward the main differences between using serum and plasma samples on clinical biochemistry analyses, in order to sensitize laboratory managers to the need for standardization. To enrich the debate, we also provide an additional comparison of serum and plasma concentrations for approximately 30 biochemistry parameters. Properties, advantages, and disadvantages of serum and plasma are discussed from a pre-analytical standpoint - before, during, and after centrifugation - with an emphasis on the importance of temperature, delay, and transport conditions. Then, differences in results between these matrices are addressed for many classes of biochemistry markers, particularly proteins, enzymes, electrolytes, lipids, circulating nucleic acids, metabolomics markers, and therapeutic drugs. Finally, important key-points are proposed to help others choose the best sample matrix and guarantee quality of clinical biochemistry assays. Moreover, awareness of the implications of using serum and plasma samples on various parameters assayed in the laboratory is an important requirement to ensure reliable results and improve patient care.


Prevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, Liberia.
Disruption of malaria control strategies during the West African 2014-2016 Ebola epidemic led to an increase in malaria-attributable mortality. However, recent data on malaria infection in vulnerable groups, such as pregnant women, are lacking in this post-Ebola scenario. This cross-sectional study aimed to assess the prevalence of Plasmodium falciparum infection and of molecular markers of drug resistance among pregnant women attending antenatal care in Monrovia, capital of Liberia. From October 2016 to June 2017, all pregnant women attending their first antenatal care visit at the Saint Joseph's Catholic Hospital, Monrovia, were invited to participate in the study. In addition to their routine antenatal care tests, capillary blood spotted onto filter papers were collected from all consenting participants to determine presence of P. falciparum by real-time quantitative PCR. Molecular markers of anti-malarial drug resistance were assessed through Sanger sequencing and quantitative PCR in specimens positive for P. falciparum analysis. Of the 195 women participants, 24 (12.3%) were P. falciparum-positive by qPCR. Infected women tended to be more commonly primigravidae and younger than uninfected ones. Parasite densities were higher in primigravidae. Fever was more frequently detected among the infected women. No statistically significant association between P. falciparum infection and haemoglobin levels or insecticide-treated net use was found. While high prevalence of genetic polymorphisms associated with chloroquine and amodiaquine resistance were detected, no molecular markers of artemisinin resistance were observed. Plasmodium falciparum infections are expected to occur in at least one in every eight women attending first ANC at private clinics in Monrovia and outside the peak of the rainy season. Young primigravidae are at increased risk of P. falciparum infection. Molecular analyses did not provide evidence of resistance to artemisinins among the P. falciparum isolates tested. Further epidemiological studies involving pregnant women are necessary to describe the risk of malaria in this highly susceptible group outside Monrovia, as well as to closely monitor the emergence of resistance to anti-malarials, as recommended by the Liberian National Malaria Control Programme.


Effect of pH on metabolism of glycyrrhizin, glycyrrhetic acid and glycyrrhetic acid monoglucuronide by collected human intestinal flora.
Collected human intestinal flora (whole bacteria) was incubated with glycyrrhizin (GL), glycyrrhetic acid (GA), glycyrrhetic acid monoglucuronide (GAMG) and a combination of the three for 10 min at 37 degrees C under pH 5.6 and 7.0. The effect of these components on GL beta-D-glucuronidase activity, GAMG beta-D-glucuronidase activity and metabolite production in whole bacteria was examined. GL and GA were not metabolized at pH 5.6 and 7.0 by whole bacteria, while the level of GAMG changed at both pH 5.6 and 7.0. However, preincubated whole bacteria converted GA and a combination containing GA to other metabolites removed 3alpha-hydroxyglycyrrhetic acid and 3-oxoglycyrrhetic acid. The level of GL beta-D-glucuronidase activity remaining in whole bacteria after exposure to both GA and GAMG was above its initial level at pH 5.6 and 7.0, and the level of GAMG beta-D-glucuronidase activity remaining after exposure to GL, GA and GAMG was suppressed against control at pH 5.6 and 7.0. It is found that intestinal bacteria had similar action against GL, GA and GAMG at between pH 5.6 and 7.0.


Sarcoidosis or cancer? That is the question.
Sarcoidosis is a granulomatous inflammatory disease of unknown etiology. Sarcoid like granuloma may develop concurrently or following cancer. Detection of granuloma in mediastinal lymph nodes biopsy in patient with pulmonary nodules may be a concern for undiagnosed lung cancer. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a diagnostic modality of choice for the lung lesions. We discussed A 71-year-old man with history of chronic obstructive lung disease (COPD), who presented with a lung nodule and mediastinal lymphadenopathies. The nodule was 9.9 mm when detected and his endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) of lymph nodes in station 7 & 4R showed normal lymph node structure. Two years later, his surveillance chest CT scan indicated an increase in the size of the nodule to 15 mm, and PET/CT showed Fluorodeoxyglucose (FDG) avid nodule & mediastinal Lymph nodes. He complained of Shortness of breath after 2-3 climbs of stairs, without any history of cough or fever. He quit cigarette smoking recently and smoked 50 pack years before. He underwent another set of EBUS and was referred for sarcoidosis treatment due to finding non-necrotizing granuloma in 4L and 11L lymph nodes. The patient also underwent another biopsy of the nodule concerning the possibility of cancer sarcoid syndrome. A poorly differentiated lung adenocarcinoma positive for GATA3, positive for P63 and CK7, TTF-1 was reported. Concurrent lung cancer and granulomatous reaction in mediastinal lymph nodes are being reported more often. Recent studies have shown a better survival of patients with diagnosis of cancer and granulomatous findings of sarcoidosis. Performing lung biopsy from any nodular lesion in a patient with sarcoidosis is essential for the differential diagnosis and early therapeutic measures.


The effect of a long-term excess of pyridoxine on the fatty acid composition of the major phospholipids in the rat.
The effect of a long-term excess of pyridoxine on the fatty acid spectrum of phosphatidylcholine, lysophosphatidylcholine and phosphatidylethanolamine of liver, plasma and kidneys in rats was studied to determine whether this response might be opposite to that observed during a deficiency. As a function of time, the fatty acid composition of the phospholipids generally changed similarly in both the control group and the pyridoxine-treated group. Though differences did occur between the two groups, particularly on day 14 of the treatment, they generally disappeared by day 22. We therefore attributed the major part of the changes occurring in the pyridoxine-treated rats to the age or development of the rats rather than to the pyridoxine treatment itself. In general, the proportion of arachidonic acid increased with time in the phospholipids of both groups while that of linoleic acid decreased. The magnitude of these changes and the proportion of the different fatty acids in the various phospholipids were not uniform from one phospholipid to another or from one tissue to another. Possible mechanism were discussed.


Rapamycin prevents the long-term impairing effects of adolescence Δ-9-tetrahydrocannabinol on memory and plasticity in male rats.
Long-lasting cognitive impairment is one of the most central negative consequences related to the exposure to cannabis during adolescence and particularly of Δ-9-tetrahydrocannabinol (THC). The aim of this study was to compare the protracted effects of adolescent versus late-adolescent chronic exposure to THC on short-term memory and plasticity and to examine whether rapamycin, a blocker of the mammalian target of rapamycin (mTOR) pathway, can restore THC-induced deficits in memory and plasticity. Male rats were injected with ascending doses of THC [2.5, 5, 10 mg/kg; intraperitoneally (i.p.)] during adolescence and late-adolescence (post-natal days 30-41 and 45-56, respectively), followed by daily injections of rapamycin (1 mg/kg, i.p.) during the first 10 days of cessation from THC. Thirty days after the last injection, rats were tested for short-term and working memory, anxiety-like behaviour, and plasticity in the pathways projecting from the ventral subiculum (vSub) of the hippocampus to the prefrontal cortex (PFC) and nucleus accumbens (NAc). THC exposure in adolescence, but not late-adolescence, was found to induce long-term deficits in object recognition short-term memory and synaptic plasticity in the hippocampal-accumbens pathway. Importantly, rapamycin rescued these persistent effects of THC administered during adolescence. Our findings show that some forms of memory and plasticity are sensitive to chronic THC administration during adolescence and that rapamycin administered during THC cessation may restore cognitive function and plasticity, thus potentially protecting against the possible long-term harmful effects of THC.


Estimating soil organic carbon changes in managed temperate moist grasslands with RothC.
Temperate grassland soils store significant amounts of carbon (C). Estimating how much livestock grazing and manuring can influence grassland soil organic carbon (SOC) is key to improve greenhouse gas grassland budgets. The Rothamsted Carbon (RothC) model, although originally developed and parameterized to model the turnover of organic C in arable topsoil, has been widely used, with varied success, to estimate SOC changes in grassland under different climates, soils, and management conditions. In this paper, we hypothesise that RothC-based SOC predictions in managed grasslands under temperate moist climatic conditions can be improved by incorporating small modifications to the model based on existing field data from diverse experimental locations in Europe. For this, we described and evaluated changes at the level of: (1) the soil water function of RothC, (2) entry pools accounting for the degradability of the exogenous organic matter (EOM) applied (e.g., ruminant excreta), (3) the month-on-month change in the quality of C inputs coming from plant residues (i.e above-, below-ground plant residue and rhizodeposits), and (4) the livestock trampling effect (i.e., poaching damage) as a common problem in areas with higher annual precipitation. In order to evaluate the potential utility of these changes, we performed a simple sensitivity analysis and tested the model predictions against averaged data from four grassland experiments in Europe. Our evaluation showed that the default model's performance was 78% and whereas some of the modifications seemed to improve RothC SOC predictions (model performance of 95% and 86% for soil water function and plant residues, respectively), others did not lead to any/or almost any improvement (model performance of 80 and 46% for the change in the C input quality and livestock trampling, respectively). We concluded that, whereas adding more complexity to the RothC model by adding the livestock trampling would actually not improve the model, adding the modified soil water function and plant residue components, and at a lesser extent residues quality, could improve predictability of the RothC in managed grasslands under temperate moist climatic conditions.


Free fatty acid perturbation of transmembrane signaling in cytotoxic T lymphocytes.
Transmembrane signaling in CTL is found to be extremely sensitive to short term exposure to long chain free fatty acids (FFA). Both alloantigen specific target cells and the lectin Con A were used to stimulate cloned murine CTL. This stimulation was monitored by changes in intracellular calcium concentrations ([Ca2+]i) using the fluorescence indicator fura-2. Treatment of the CTL cells with oleic acid (18:1) at concentrations corresponding to less than 10% (mol/mol) bound to the cell, completely inhibits target cell or Con A-mediated rise in [Ca2+]i. The inhibitory effect of oleic acid is observed within seconds of addition and the inhibition is completely reversed by treating cells with fatty acid free BSA. In addition, using the fluorescence indicator 2',7'-bis(carboxyethyl)carboxyfluorescein to monitor intracellular pH, it was found that oleic acid itself acidifies the cytosol by about 0.3 to 0.4 pH units. Acidification is probably necessary, but is not sufficient to inhibit the calcium rise. Stearic acid (18:0), even at concentrations that correspond to a factor of two to three more bound to the cell than for oleic acid, had no effect on either the [Ca2+]i or intracellular pH responses. Oleic acid was found to bind to cells with single site kinetics and with a number of sites and affinity corresponding to membrane lipid binding sites. Esterification of added oleic acid was negligible in the time (seconds to minutes) required to induce inhibition of the [Ca2+]i response. Inasmuch as added FFA primarily binds to membrane lipid, is not appreciably esterified, and the inhibition is reversed by treatment with fatty acid free BSA, it is likely that the oleic acid effects are due to a physical perturbation of membrane lipid. Furthermore, oleic acid does not affect Con A binding or the production of inositol phosphate metabolites, suggesting that the inhibition of the response is distal to surface recognition events or receptor-phospholipase C coupling. Given the relatively low levels of FFA at which these effects occur it is possible, under conditions in which FFA levels are elevated, that FFA perturbation may modulate CTL activity.


Harry F. Harlow and animal research: reflection on the ethical paradox.
With respect to the ethical debate about the treatment of animals in biomedical and behavioral research, Harry F. Harlow represents a paradox. On the one hand, his work on monkey cognition and social development fostered a view of the animals as having rich subjective lives filled with intention and emotion. On the other, he has been criticized for the conduct of research that seemed to ignore the ethical implications of his own discoveries. The basis of this contradiction is discussed and propositions for current research practice are presented.


Deficiency in Mucosa-associated Lymphoid Tissue Lymphoma Translocation 1: A Novel Cause of IPEX-Like Syndrome.
Early-onset inflammatory bowel diseases can result from a wide spectrum of rare mendelian disorders. Early molecular diagnosis is crucial in defining treatment and in improving life expectancy. Herein we aimed at defining the mechanism of an immunodeficiency-polyendrocrinopathy and enteropathy-X-linked (IPEX)-like disease combined with a severe immunodeficiency in 2 siblings born from distantly related parents. Whole exome sequencing was performed on blood-extracted genomic DNA from the 2 affected children and their parents on the genomic platform of Institut IMAGINE. Candidate gene mutation was identified using the in-house software PolyWeb and confirmed by Sanger sequencing. Protein expression was determined by western blot. Flow cytometry was used to assess consequences of the mutation on lymphocyte phenotype and nuclear factor-kappa B (NF-κB) activation at diagnosis and after treatment by hematopoietic stem cell transplantation. We identified a homozygous missense mutation in mucosa-associated lymphoid tissue lymphoma translocation 1 gene (MALT1), which precluded protein expression. In keeping with the known function of MALT1, NF-κB-dependent lymphocyte activation was severely impaired. Moreover, there was a drastic reduction in Forkhead box P3 (FOXP3) regulatory T cells accounting for the IPEX-like phenotype. Following identification of the mutation, both children received hematopoietic stem cell transplantation, which permitted full clinical recovery. Immunological workup at 6 and 12 months after transplantation showed normal NF-κB activation and correction of regulatory T cells frequency. Along with FOXP3, interleukin 2 receptor alpha chain (IL2RA), and cytotoxic T-lymphocyte protein 4 precursor (CTLA-4) mutations, MALT1 deficiency should now be considered as a possible cause of IPEX-like syndrome associated with immunodeficiency that can be cured by hematopoietic stem cell transplantation.


Human granulocyte colony formation in serum-free cultures stimulated with purified recombinant granulocyte colony-stimulating factor.
Granulocyte colony formation by human bone marrow cells in serum-free cultures was studied using purified recombinant granulocyte colony-stimulating factor (rG-CSF). The cloning efficiency of the serum-free cultures was about 80% that of the serum-containing cultures. In addition to purified G-CSF, four ingredients were found to be essential to granulocyte colony formation: bovine serum albumin (BSA), iron-saturated human transferrin, cholesterol, and L-alpha-phosphatidylcholine. Their optimal concentrations were also investigated. Insulin was not indispensable for granulocyte colony formation, but its addition did increase the number of granulocyte colonies. Hydrocortisone was found to be inhibitory to granulocyte colony formation at high concentrations.


Reduction of colitis by prebiotics in HLA-B27 transgenic rats is associated with microflora changes and immunomodulation.
HLA-B27 transgenic rats develop spontaneous colitis under specific pathogen-free conditions (SPF) but germ-free rats remain disease-free, emphasizing a role for intestinal bacteria in the pathogenesis of chronic intestinal inflammation. Prebiotics are dietary substances that affect the host by stimulating growth and/or activity of potentially health promoting bacteria. The aims of this study were to investigate whether prebiotics can prevent colitis in SPF HLA-B27 rats, and secondly, to explore mechanisms of protection. SPF HLA-B27 transgenic rats received orally the prebiotic combination long-chain inulin and oligofructose (Synergy 1), or not, prior to the development of clinically detectable colitis. After seven weeks, cecal and colonic tissues were collected for gross cecal scores (GCS), histologic inflammatory scores (scale 0-4), and mucosal cytokine measurement. Cecal and colonic contents were collected for analysis of the gut microbiota by PCR-denaturing gradient gel electrophoresis (PCR-DGGE) and fluorescent in-situ hybridization (FISH), and analysis of short-chain fatty acid composition. Prebiotic treatment significantly decreased GCS and inflammatory histologic scores in the cecum and colon. Prebiotic treatment also decreased cecal IL-1beta, but increased cecal TGF-beta concentrations. Inulin/oligofructose altered the cecal and colonic PCR-DGGE profiles, and FISH analysis showed significant increases in cecal Lactobacillus and Bifidobacterium populations after prebiotic treatment compared with water-treated rats. In conclusion, the prebiotic combination Synergy 1 reduced colitis in HLA-B27 transgenic rats, which effect was associated with alterations to the gut microbiota, decreased tissue proinflammatory cytokines and increased immunomodulatory molecules. These results show promise for prebiotics as primary or adjuvant maintenance therapy for chronic inflammatory bowel diseases.


Acute diffuse scleroderma.
A case of acute diffuse scleroderma without contemporaneous visceral involvement is described. Antibodies to endothelial cells have been found in the skin.


[Electrostimulation anesthesia in comparison with enflurane-nitrous-oxide anesthesia during gynecologic operations. 1. Clinical experiences].
Concerning twenty-two gynaecological abdomen laparotomies, electrostimulation anaesthesia was opposed to inhalation anaesthesia with nitrous oxide-enflurane. Electrostimulation anaesthesia (ESA) was compared to a nitrous oxide-enflurane technique among two groups of eleven patients each scheduled for gynecological abdominal surgery. The present part of this communication concerns the description of the anesthetic techniques, reactions of the cardiocirculatory system, consumption of muscular relaxants and of analgetics supplementation intraoperatively and during recovery. While heart rate remained fairly normal in both groups, mean arterial pressure in the ESA group increased by 20% of the preanesthetic level as compared to a 10% increase in the enflurane group. It is felt that electrostimulation anaesthesia can be effectively employed even in abdominal surgery. However in cardiac risk patients this technique should not be considered.


Cell Wall Remodeling by a Synthetic Analog Reveals Metabolic Adaptation in Vancomycin Resistant Enterococci.
Drug-resistant bacterial infections threaten to overburden our healthcare system and disrupt modern medicine. A large class of potent antibiotics, including vancomycin, operate by interfering with bacterial cell wall biosynthesis. Vancomycin-resistant enterococci (VRE) evade the blockage of cell wall biosynthesis by altering cell wall precursors, rendering them drug insensitive. Herein, we reveal the phenotypic plasticity and cell wall remodeling of VRE in response to vancomycin in live bacterial cells via a metabolic probe. A synthetic cell wall analog was designed and constructed to monitor cell wall structural alterations. Our results demonstrate that the biosynthetic pathway for vancomycin-resistant precursors can be hijacked by synthetic analogs to track the kinetics of phenotype induction. In addition, we leveraged this probe to interrogate the response of VRE cells to vancomycin analogs and a series of cell wall-targeted antibiotics. Finally, we describe a proof-of-principle strategy to visually inspect drug resistance induction. Based on our findings, we anticipate that our metabolic probe will play an important role in further elucidating the interplay among the enzymes involved in the VRE biosynthetic rewiring.


Time-varying coupling functions: Dynamical inference and cause of synchronization transitions.
Interactions in nature can be described by their coupling strength, direction of coupling, and coupling function. The coupling strength and directionality are relatively well understood and studied, at least for two interacting systems; however, there can be a complexity in the interactions uniquely dependent on the coupling functions. Such a special case is studied here: synchronization transition occurs only due to the time variability of the coupling functions, while the net coupling strength is constant throughout the observation time. To motivate the investigation, an example is used to present an analysis of cross-frequency coupling functions between delta and alpha brain waves extracted from the electroencephalography recording of a healthy human subject in a free-running resting state. The results indicate that time-varying coupling functions are a reality for biological interactions. A model of phase oscillators is used to demonstrate and detect the synchronization transition caused by the varying coupling functions during an invariant coupling strength. The ability to detect this phenomenon is discussed with the method of dynamical Bayesian inference, which was able to infer the time-varying coupling functions. The form of the coupling function acts as an additional dimension for the interactions, and it should be taken into account when detecting biological or other interactions from data.


Complement inhibitors from scabies mites promote streptococcal growth--a novel mechanism in infected epidermis?
Scabies is highly prevalent in socially disadvantaged communities such as indigenous populations and in developing countries. Generalized itching causes discomfort to the patient; however, serious complications can occur as a result of secondary bacterial pyoderma, commonly caused by Streptococcus pyogenes (GAS) or Staphylococcus aureus. In the tropics, skin damage due to scabies mite infestations has been postulated to be an important link in the pathogenesis of disease associated with acute rheumatic fever and heart disease, poststreptococcal glomerulonephritis and systemic sepsis. Treatment of scabies decreases the prevalence of infections by bacteria. This study aims to identify the molecular mechanisms underlying the link between scabies and GAS infections. GAS bacteria were pre-incubated with blood containing active complement, phagocytes and antibodies against the bacteria, and subsequently tested for viability by plate counts. Initial experiments were done with serum from an individual previously exposed to GAS with naturally acquired anti-GAS antibodies. The protocol was optimized for large-scale testing of low-opsonic whole blood from non-exposed human donors by supplementing with a standard dose of heat inactivated human sera previously exposed to GAS. This allowed an extension of the dataset to two additional donors and four proteins tested at a range of concentrations. Shown first is the effect of scabies mite complement inhibitors on human complement using ELISA-based complement activation assays. Six purified recombinant mite proteins tested at a concentration of 50 µg/ml blocked all three complement activation pathways. Further we demonstrate in human whole blood assays that each of four scabies mite complement inhibitors tested increased GAS survival rates by 2-15 fold. We propose that local complement inhibition plays an important role in the development of pyoderma in scabies infested skin. This molecular link between scabies and bacterial infections may provide new avenues to develop alternative treatment options against this neglected disease.


[Surgical treatment of severe lower lid ectropion with a transplant of skin and perichondrium].
A surgical procedure is described for severe ectropions of the lower lid which cannot be treated successfully by conservative measures or minor surgery. This technique, employing a perichondrocutaneous graft, is superior to traditional methods in terms of both the functional and esthetic results. The composite graft is obtained from the anterior surface of the auricular choncha. In about 50% of the patients the postoperative biopsy showed a chondrogenic activity of the transplanted perichondrium substituting the tarsus. In the other cases, though no cartilaginous growth was noted, there was an intense proliferation of collagen fibers stabilizing the lid and the tarsal region. This procedure leads to both functional and natural esthetic rehabilitation and satisfies the criteria which techniques in plastic surgery have to meet today.


Regulating clinical trials in India: The economics of ethics.
The relationship between the ethical standards for the governance of clinical trials and market forces can be complex and problematic. This article uses India as a case study to explore this nexus. From the mid-2000s, India became a popular destination for foreign-sponsored clinical trials. The Indian government had sought to both attract clinical trials and ensure these would be run in line with internationally accepted ethical norms. Reports of controversial medical research, however, triggered debate about the robustness and suitability of India's regulatory system. In response to civil society pressure and interventions by the Supreme Court, the Indian government proposed additional measures aimed at strengthening protections for clinical trial participants. Whilst the reforms can be seen as a victory for human rights activists, they have also been criticised as being overly burdensome for sponsors. Indeed, their announcement prompted an exodus of clinical trials from India. Fearful of losing business to 'rival' countries, the Indian government is revisiting some of its proposals. The Indian example suggests that research ethics frameworks and national policies for economic development are increasingly intertwined. Host countries are in theory free to improve the lot of research participants, but doing so may make them appear less attractive to foreign sponsors, who can simply shift their activities to more industry-friendly jurisdictions. Although these economic pressures are unlikely to lead to a regulatory 'race to the bottom', they may limit host countries' ability to enact socially desirable reforms.


Malignancy and infection risk during adalimumab therapy in hidradenitis suppurativa.
The association of adalimumab therapy with malignancy and infection is established in other inflammatory diseases; however, rates of hidradenitis suppurativa (HS) are based on case reports or retrospective healthcare data and the effect of adalimumab therapy on these rates is unknown. Previously reported rates in the PIONEER OLE Phase 3 study reported on rates only in a subpopulation of 88 participants rather than the entire cohort. To quantify rates of malignancy and serious infection in all patients with HS treated with adalimumab 40 mg weekly. Reanalysis was undertaken of individual patient data from the PIONEER 1, PIONEER 2 and PIONEER open-label extension Phase 3 trial data encompassing 591 unique patients with HS administered adalimumab 40 mg weekly without concurrent antibiotic exposure. Incidence rates of serious infection and malignancy were calculated. Incidence rates of serious infection and malignancy were 2.14 and 0.46 per 100 patient-years, respectively. Rates of infection and malignancy were comparable to those in other inflammatory conditions examined. Incidence of serious infection in patients with HS on adalimumab is comparable to those with psoriasis and inflammatory arthropathies, but the incidence of malignancy is increased. This may reflect disease-specific malignancy risk rather than an effect of adalimumab.


Comparison of Hospital Performance in Acute Ischemic Stroke Based on Mortality and Functional Outcome in South Korea.
Recent evidence suggests a correlation between modified Rankin Scale-based measures, an outcome measure commonly used in acute stroke trials, and mortality-based measures used by health agencies in the evaluation of hospital performance. We aimed to examine whether the 2 types of measures are interchangeable in relation to evaluation of hospital performance in acute ischemic stroke. Five outcome measures, unfavorable functional outcome (3-month modified Rankin Scale score ≥2), death or dependency (3-month modified Rankin Scale score ≥3), 1-month mortality, 3-month mortality, and 1-year mortality, were collected for 8292 individuals who were hospitalized for acute ischemic stroke between January 2014 and May 2015 in 14 hospitals participating in the Clinical Research Collaboration for Stroke in Korea - National Institute of Health registry. Hierarchical regression models were used to calculate per-hospital risk-adjusted outcome rates for each measure. Hospitals were ranked and grouped based on the risk-adjusted outcome rates, and the correlations between the modified Rankin Scale-based and mortality-based ranking and their intermeasure reliability in categorizing hospital performance were analyzed. The comparison between the ranking based on the unfavorable functional outcome and that based on 1-year mortality resulted in a Spearman correlation coefficient of -0.29 and Kendall rank coefficient of -0.23, and the comparison of grouping based on these 2 types of ranks resulted in a weighted kappa of 0.123 for the grouping in the top 33%/middle 33%/bottom 33% and 0.25 for the grouping in the top 20%/middle 60%/bottom 20%, respectively. No significant correlation or similarity in grouping capacities were found between the rankings based on the functional outcome measures and those based on the mortality measures. This study shows that regardless of clinical correlation at an individual patient level, functional outcome-based measures and mortality-based measures are not interchangeable in the evaluation of hospital performance in acute ischemic stroke.


Estimating intracellular lithium in brain in vivo by localized 7Li magnetic resonance spectroscopy.
The therapeutic mechanism of action of lithium (Li) in bipolar disorder is unknown. While Li is presumed to work intracellularly in the brain, the fraction of intracellular Li in the brain in vivo is not known. It has not yet been possible to determine, directly and noninvasively, the intra- to extracellular distribution of Li in human brain in vivo. Lithium-7 ((7)Li) MR is the only technique available for measuring noninvasively the concentration of Li in the brain in vivo. Here the individual components of biexponential (7)Li transverse (T(2)) relaxation in rat brain in vivo are identified with intra- and extracellular Li, and used to estimate its compartmental distribution. Intracellular T(2) was 14.6 +/- 6.9 ms, while extracellular T(2) was 160 +/- 52 ms in nine rats. The fraction of intracellular brain Li ranged from 37% to 75% (mean: 63 +/- 11%). Further, the biexponential T(2) results provided the basis for estimating Li compartmental distribution from monoexponential T(2) decays using a simple linear approximation. The fraction of intracellular Li estimated from monoexponential T(2) decays agreed with the corresponding biexponential estimates in most cases.


How robust is performance on the National Adult Reading Test following traumatic brain injury?
To investigate whether National Adult Reading Test (NART) performance may be impaired by severe traumatic brain injury (TBI). A sample of 26 people who had been given a NART within 12 months of a severe TBI was given a second NART at least 12 months after the first NART. Mean performance on the second NART was significantly better than performance on the first NART. Of the participants, 11 (42%) showed an improvement of more than 5 IQ points in respect of the verbal IQ estimates based on their NART scores, with three participants showing an improvement of 20 points. In applying the NART to determine the presence of an acquired intellectual impairment, use of the first NART scores alone would have resulted in such impairments being missed in at least 25% of a subsample of 16 participants for whom an actual verbal IQ had been obtained at the time of the first NART. An NART given within 12 months of a severe TBI runs the risk of significantly underestimating pre-morbid IQ. If applied in this context, it is recommended that the NART score is used in conjunction with other methods of estimation, such as those based on demographic data.


[Validity and consistency of a new scale (Faces Pain Scale) and of the Spanish version of the CHEOPS scale to evaluate postoperative pain in children].
one of the most used scales for the evaluation of children's pain is the CHEOPS. This is complex, reliable but not commonly used in spanish. We decided to create a new Pain Facial Scale to be considered to be used in spanish. to compare the validity and consistency of two different scales for the evaluation of post-operative pain in children. process, comparative, longitudinal, homodemic, and prolective study. It was elaborated a simple and easy scale, to evaluate the post-operative pain in children. 5 experts evaluated their appearance and content. The original version of CHEOPS was translated to the Spanish by an expert; later this version was corrected and re-translated by a native Anglo-Saxon speaker, the result submitted for evaluation by 5 experts. The validity and consistency of both scales were evaluated by two investigators in a blind way. We used Cronbach's α for the internal consistency of CHEOPS, coefficient of intraclass correlation for the external consistency (inter observer's variability), effect size for sensitivity to the change of category, change of status for internal validity and Spearman's correlation for the convergent analysis. there was great external consistency, and a good and high internal validity, for the Spanish version of the CHEOPS scale, and an excellent internal validity for the Facial Pain Scale, as well as an excellent internal validity for both scales. two scales can be used to evaluate the post-operative pain in children between 4 and 8 years old.


Positive effects of native shrubs on Bromus tectorum demography.
There is increasing recognition that overall interactions among plant species are often the net result of both positive and negative effects. However, the positive influence of other plants has rarely been examined using detailed demographic methods, which are useful for partitioning net effects at the population level into positive and/or negative effects on individual vital rates. This study examines the influence of microhabitats created by the native shrubs Artemisia tridentata and Purshia tridentata on the demography of the invasive annual grass Bromus tectorum in the Great Basin Desert, California, USA. Shrub understory environments differed significantly from intershrub space and were characterized by higher soil fertility and less extreme microclimates. There existed a strong spatial association between B. tectorum and the shrubs across four years, with more than double the density of B. tectorum in shrub microhabitats compared to intershrub space. Periodic matrix models were used to calculate population growth (lamda) and reproductive potential (RP, expected lifetime fecundity of seedlings) of B. tectorum in different microhabitats over two years. Modeled population growth was significantly increased in shrub microhabitats in the first of two years. This was primarily due to increased seedling establishment in Artemisia microhabitats, rather than effects during the growing season. In the following year, B. tectorum individuals in shrub microhabitats had a significantly greater reproductive potential than those in intershrub microhabitats, indicating shrub facilitation during the growing season. Loop analysis revealed an interacting effect of year and microhabitat on B. tectorum life history pathway elasticity values, demonstrating a fundamental influence of spatiotemporal factors on which life history pathways are important and/or possible. Life table response experiment (LTRE) analysis showed that increased survival and growth rates positively contributed to population growth in both years under Purshia, but only in the second year under Artemisia. This research provides evidence that the positive effects of native shrubs on B. tectorum can be strong enough to produce net positive effects at the population level, although positive effects were variable. In this study, a rigorous demographic approach was particularly useful in partitioning overall interactions into positive and negative components.


Unusual complications of incisional hernia.
Incisional hernia represents a breakdown or loss of continuity of a fascial closure. These hernias are of particular concern not only for the high recurrence rates among them but also for the challenges that follow their repair. It is known to occur in 11-23% of laparotomies. This paper presents two unusual complications of incisional hernia managed by the authors. One ruptured incisional hernia with evisceration of gut and a case of incarcerated gravid uterus in a woman in labour. The case records of the two patients with unusual complications of incisional hernia were pooled and presented to highlight the clinical presentation and management options of this condition. The patient with ruptured hernia and eviscerated gut presented immediately and was resuscitated and the hernia repaired with polypropylene mesh. The patient with incarcerated uterus had caesarean section and mesh repair of the hernia. Incisional hernia can present with unusual complications. The management is very challenging. Good knowledge and skills are required to deal with this condition.


Using systematic measurement to target consumer activation strategies.
Current policy directions place high expectations on consumers, pressing them to adopt new roles and behaviors. The price of failing to meet these expectations will be high for the individual, for the care delivery system, and for the society as a whole. Yet there is limited support in place to help consumers meet these expectations. The article reviews the major approaches used to stimulate consumer engagement in health and health care. The concept of activation is explored as a possible organizing construct for informing strategies to increase consumer involvement in health. Illustrative data are presented that show how activation levels are associated with engaging in specific health behaviors. The strategy of measuring activation and calibrating both the type and the amount of support for consumers is discussed as a way to improve current approaches. Tailoring activation to the individual, group, and community level is also explored.


Possible implications of redox-sensitive tumour cell transformation; lessons from cell culture studies.
It is generally accepted that chronic inflammatory disease, either local or generalized, is associated with higher incidence of cancer. Since inflammation is often accompanied by oxidative stress the latter was indicated as the foundation for progressive mutations leading to tumor development (proliferation, invasion, metastasis). Even though, it is very hard to demonstrate by in vitro studies the causal relationship between oxidative stress and cell transformations. From our studies it is clear that cells are more likely to stop divisions and they commit suicide by apoptosis. During last decade, a novel view on the origin of cancer emerged. The so called cancer stem cells (CSC) were found that form the side-population of stem cells (SC) and they are believed to initiate cancer. Are the SC ancestors for CSC? Do SC transform into CSC? These and other questions remain unanswered. We hypothesize that SC might undergo transformation into CSC during prolonged oxidative stress. We claim that several changes in cell biochemistry has to occur to start the molecular modifications leading to neoplasma. These include either hypoxia-promoted apoptosis signal inducing kinase 1 (ASK-1), hypoxia inducing factor 1 alpha (HIF-1alpha) and glycolysis, or normoxia-promoted activating protein-1 (AP-1) or hyperoxia-induced nuclear factor kappa B (NF-kappaB). Next, harsh microenvironment and heterogenous extracellular matrix (ECM) induced by oxidative stress accelerate the selection of clones of cells resistant to apoptogenic signal. HIF-1alpha, protein crucial for transcriptional activation of protooncogene met leads to the overexpression of c-Met receptor that in turn sensitizes cells to hepatocyte growth factor/scatter factor (HGF/SF) mitogen. Finally, both impaired function of mitochondria and hypoxia elevate fibrin protein level and amplify hemostasis as disseminated intracapillary coagulation (DIC). In any case, it is very interesting and remains to be answered whether imbalance in prooxidant-antioxidant homeostasis has causal relationship with transformation of SC to CSC.


INFLUENCE OF BETA-BLOCKERS AND IVABRADINE ON LONG-TERM PROGNOSIS OF PATIENTS WITH STABLE ANGINA.
The purpose of the study was to evaluate the influence of beta-blockers and ivabradine on long-term prognosis of patients with stable angina. 90 patients with stable angina that have been involved in present study along with nitrates, antiplatelet agents and statins received bisoprolol (Group I), carvedilol (Group II) and ivabradine (Group III). We analyzed the following indicators: patient adherence to treatment, cases of myocardial infarction and circulatory decompensation, which resulted in necessity of patient's hospitalization during the year of observation, calculating the probability of achieving a key prognostic endpoint by patient using the concept of the odds ratio and determination of important components in the progression of the disease. We concluded that in compared patients groups developed cardiovascular death and unstable angina with almost equal frequency. As for cases of myocardial infarction and the need for revascularization, their number was smaller in patients who in addition to standard treatment received ivabradine. Prognosis of patients with stable angina after 12 months of treatment primarily depends on their adherence to treatment, age, heart rate, presence of harmful habits, and markers of endothelial dysfunction, including endothelin-1 and homocysteine.


Prediction of acute cardiac rejection using radionuclide techniques.
Radionuclide scanning of the donor left ventricle using technetium-99m-labelled red cells was used to monitor acute rejection after heterotopic heart transplantation and compared with histopathological evidence of rejection obtained at examination of an endomyocardial biopsy specimen. The ejection fraction and end-diastolic, end-systolic and stroke volumes were calculated at each examination; an equation was derived from these data to predict the degree of acute rejection, using histopathological examination of endomyocardial biopsy specimens as criteria of the presence and severity of rejection. A highly significant multiple correlation between radionuclide scanning parameters and endomyocardial biopsy was found. The advantages of non-invasive radionuclide scanning over the invasive procedure of endomyocardial biopsy are discussed.


Identification of pig circovirus type 2 in New Zealand pigs.
Interest in porcine circovirus has been stimulated by the recent emergence of postweaning multisystemic wasting syndrome (PMWS) in pigs and the potential use of pig organs for xenotransplantation in humans. Porcine circovirus type 1 (PCV1) is considered to be widespread in pigs but nonpathogenic. Circovirus type 2 (PCV2) is a similar virus but has been differentiated only recently as a separate type. High tissue concentrations of PCV2 are associated with lesions in PMWS cases, but the etiological role of this agent in the disease remains unclear. The presence of PCV1 in New Zealand pigs has been previously reported based on serological data. PMWS has been recently recorded in New Zealand pigs. The epidemiology of PCV2 in New Zealand pigs has not been examined. The purpose of the study was to look for evidence of circoviruses in New Zealand pig herds. Pig circovirus DNA was sought in various tissues using the polymerase chain reaction. Circovirus type 2 was found in New Zealand pig herds, without any evidence that PMWS has ever occurred in these herds. Newborn piglets were shown to have infection, suggesting vertical transmission of the virus.


Hormonal regulation of leptin mRNA expression and preadipocyte recruitment and differentiation in porcine primary cultures of S-V cells.
The hormonal regulation of leptin mRNA expression and the association between leptin expression and adipocyte differentiation were examined in primary cultures of porcine S-V cells with Northern blot and immunocytochemical analysis. Seeding for 3 days with fetal bovine serum (FBS) with varying levels of dexamethasone (Dex) increased levels of leptin mRNA in a dose-dependent manner in parallel with increases in the proportion of preadipocytes (AD-3 positive cells; AD-3, a preadipocyte marker). Six-day treatment with 10 or 850 nM insulin after FBS+Dex treatment resulted in a similar increase in leptin mRNA expression and morphological differentiation. However, significantly lower levels of leptin mRNA and smaller fat cells were observed in cultures treated with 1 nM insulin or 10 nM insulin-like growth factor-I (IGF-I). Dex-induced increases in leptin mRNA levels and AD-3 cell numbers were blocked completely by the addition of transforming growth factor-beta (TGF-beta) to FBS+Dex-treated cultures. However TGF-beta significantly increased fat cell size and leptin mRNA expression when added to ITS (insulin, 850 nM; transferrin, 5 microg/ml; and selenium, 5 microg/mL) treated cultures during the lipid-filling stage. When added with FBS+DEX for the first 3 days, growth hormone (GH) did not influence the Dex-induced increase in AD-3 cells and leptin mRNA expression, but GH reduced leptin mRNA levels when added with insulin for 6 days after FBS+Dex. These results demonstrated that regulation of leptin mRNA expression by Dex, insulin, IGF-I, TGF-beta, and GH may be associated with changes in preadipocyte number and fat cell size.


The impact of state-specific life tables on relative survival.
Relative survival is based on estimating excess cancer mortality in a study population compared to expected mortality of a comparable population without cancer. In the United States, expected mortality is estimated from national life tables matched by age, sex, race, and calendar year to each individual in the study population. We compared five-year relative survival using state life tables to five-year relative survival using US decennial life tables. We assessed variations by age, race, and cancer site for all cancers combined, lung, colorectal, prostate, and female breast cancers. We used data from 17 National Cancer Institute Surveillance, Epidemiology, and End Results Program registries, including diagnoses from January 1, 2000 to December 31, 2009 with follow-up through December 31, 2010. Five-year relative survival was calculated using US-based life tables (USLT) and state-specific life tables (SLT). Differences in SLT- and USLT-based survival were generally small (SLT < 4 survival percentage points lower than USLT). Differences were higher for states with high SES and low mortality and for prostate cancer. Differences were largest for all cancers combined, colon and rectum, and prostate cancer among males aged 85+ ranging from -10 to -17 survival points for whites and +9 to +17 for blacks. Differences between relative survival based on USLT and SLT were small and state-based estimates were less reliable than US-based estimates for older populations aged 85+. Our findings underscore the need to develop more appropriate life tables that better represent the varying mortality patterns in different populations in order to obtain accurate estimates of relative survival.


Stenotrophomonas maltophilia Infections in Adults: Primary Bacteremia and Pneumonia.
Stenotrophomonas maltophilia is the third most frequent non-fermentative Gram-negative bacilli in nosocomial infections, and usually causes severe infections such as primary bacteremia and pneumonia. The current study aimed to compare the demographic and clinical characteristics, microbiological findings and final outcomes of the patients with primary bacteremia and nosocomial pneumonia caused by S. maltophilia. The current study retrospectively evaluated patients aged 18 years and above with primary bacteremia and nosocomial pneumonia caused by S. maltophilia from January 2006 to December 2013. Medical records of patients, including reports of clinical microbiology and hospital infection control committee, were evaluated. A total of 71 patients with S. maltophilia nosocomial infections, 35 (49.3%) primary bacteremia and 36 (50.7%) pneumonia, were diagnosed. There were no significant differences in gender, age, and co-morbid diseases, except chronic obstructive pulmonary disease; this infection was significantly higher in patients with pneumonia. A slightly higher 14-day mortality was found in patients with pneumonia, but the difference was not statistically significant. Inappropriate antibiotic use and presence of multiple organ dysfunction syndrome were found as independent risk factors for 14-day mortality in multivariate analysis. A slightly higher mortality in patients with pneumonia, caused by S. maltophilia, was strived to explain by advanced age, higher acute physiology and chronic health evaluation (APACHE II) and sepsis related organ failure assessment (SOFA) score, and also higher inappropriate antibiotic use.


Novel water soluble morpholine substituted Zn(II) phthalocyanine: Synthesis, characterization, DNA/BSA binding, DNA photocleavage and topoisomerase I inhibition.
In this study, novel peripherally tetra 3-morpholinophenol substituted zinc(II) phthalocyanine (4) and its water soluble form quaternized zinc(II) phthalocyanine (ZnQ) were synthesized for the first time. These novel compounds were characterized by a combination of different spectroscopic techniques such as FT-IR, 1H NMR, 13C NMR, UV-vis and mass. The DNA binding of ZnQ was investigated using UV-vis absorption titration, competitive ethidium bromide, thermal denaturation and viscosity experiments that the ZnQ bound to CT-DNA via intercalation mode. ZnQ indicated photocleavage activity on supercoiled pBR322 plasmid DNA via formation of singlet oxygen under irradiation at 700nm. Besides, the topoisomerase I inhibitory effect experiments showed that ZnQ inhibited topoisomerase I enzyme in a concentration-dependent manner. The bovine serum albumin (BSA) binding experiments indicated that ZnQ bound to proteins through a static quenching mechanism. All of these results claim that ZnQ has potential agent for photodynamic therapy owing to its nucleic acid interactions and photobiological or photochemical properties.


Brillouin lasing in integrated liquid-core optical fibers.
We report Brillouin lasing in an integrated liquid-core optical fiber filled with neat CS2. This is the first observation of Brillouin lasing in an optical fiber filled with a liquid, to the best of our knowledge. The linewidth of the single frequency liquid-based Brillouin laser was estimated to be <1 kHz by beating two similar but independent lasers against one another.


Fast-Response Bioinspired Near-Infrared Light-Driven Soft Robot Based on Two-Stage Deformation.
Herein, we report a remotely controlled soft robot employing a photoresponsive nanocomposite synthesized from liquid crystal elastomers (LCEs), high elastic form-stable phase change polymer (HEPCP), and multiwalled carbon nanotubes (MWCNTs). Possessing a two-stage deformation upon exposure to near-infrared (NIR) light, the LCE/HEPCP/MWCNT (LHM) nanocomposite allows the soft robot to exhibit an obvious, fast, and reversible shape change with low detection limitations. In addition to the deformation and bending of the LCE molecular chains itself, the HEPCP in the composite material can also be triggered by a reversible solid-liquid transition due to the temperature rise caused by MWCNTs, which further promotes the change of the LCE. In particular, the proposed photodriven LHM soft robot can bend up to 180° in 2 s upon NIR stimulation (320 mW, distance of 5 cm) and generate recoverable, dramatic, and sensitive deformation to execute various tasks including walking, twisting, and bending. With the capacity of imitating biological behaviors through remote control, the disruptive innovation developed here offers a promising path toward miniaturized untethered robotic systems.


Early predictors of adult drinking: a birth cohort study.
Few studies have explored early predictors of problem drinking in youth, and fewer still have simultaneously considered the role of biologic, familial, and intrapersonal factors. The present study explored early life course and later life course predictors of alcohol abuse and dependence in young adulthood. Data were taken from a cohort of 2,551 mothers and their children recruited as part of the longitudinal Mater University Study of Pregnancy and its outcomes (MUSP) carried out in Brisbane, Australia, from 1981 to 1984. Data were collected prenatally and then postnatally at 6 months and at 5, 14, and 21 years. A range of biologic, familial, and intrapersonal factors was considered. A series of logistic regression models with inverse probability weighting was used to explore pathways to problem drinking from adolescence to early adulthood. For males and females, no association was found between either birth factors or childhood factors and a lifetime diagnosis of alcohol disorders at age 21 years. Externalizing symptoms and maternal factors at age 14 years were significantly associated with alcohol problems. For youth aged 14 years, maternal moderate alcohol consumption accounted for the highest percentage of attributable risk among those exposed. Results show that exposure to maternal drinking in adolescence is a strong risk factor for the development of alcohol problems in early adulthood.


Cattle and chemokines: evidence for species-specific evolution of the bovine chemokine system.
The chemokine system comprises a family of small chemoattractant molecules that have roles in both the healthy and diseased organism. Chemokines act by binding specific receptors on the target cell surface and inducing chemotaxis. The human chemokine system is well characterized, with approximately fifty chemokines identified that fall into four families. The chemokines and their receptors are promiscuous in that one chemokine can often bind several receptors, and vice versa. Study of the bovine chemokine system has been restricted to date to a handful of chemokines, and the identification of bovine chemokines is largely based on the closest human homologue. This method of identification is prone to error and may result in the misassumption of function of a particular chemokine. Here, we review current knowledge of bovine chemokines and reassess the bovine chemokine system based on phylogenetic and syntenic approaches. The bovine chemokine system, for the most part, shows high similarity to the chemokine system of other mammals such as humans; however, differences have been identified. Cattle possess fewer chemokines than humans, yet also possess chemokines that have no obvious homologue in the human system. These 'missing' and 'novel' chemokines may represent functional differences between the bovine and human chemokine systems that may affect the way in which these species are able to respond to specific pathogen repertoires.


Gender-Related Difference in D-Dimer Level Predicts In-Hospital Heart Failure after Primary PCI for ST-Segment Elevation Myocardial Infarction.
The prognostic value of plasma D-dimer in patients with coronary artery disease (CAD) remains controversial. The study is aimed at investigating the relationship between plasma D-dimer levels and in-hospital heart failure (HF) in ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (pPCI). STEMI patients who underwent pPCI were enrolled in this study. Venous blood samples were collected from patients on admission before pPCI procedure. The study endpoint was the occurrence of in-hospital HF. The participants were divided into two groups according to plasma D-dimer levels and further compared baseline D-dimer levels between male and female. Logistic regression and receiver operating characteristic (ROC) curves were performed to evaluate the relationship of D-dimer and in-hospital HF. A total of 778 patients were recruited in the study, of which 539 (69.3%) patients had normal D-dimer levels (≤0.5 mg/L) while 239 (30.7%) had increased D-dimer levels (>0.5 mg/L). The female patients have higher D-dimer levels and higher incident rate of in-hospital HF than that in male patients (p < 0.001). The multivariate logistic regression model revealed that D-dimer was an independent predictor for in-hospital HF in overall population (adjusted odds ratio [OR]: 1.197, 95% CI: 1.003-1.429, and p = 0.046) and female patients (adjusted OR: 1.429, 95% CI: 1.083-1.885, and p = 0.012). Increased plasma D-dimer levels were an independent risk factor for incidence of in-hospital HF in STEMI patients who underwent pPCI, especially in female patients, which provides guidance for clinicians in identifying patients at high risk of developing HF and lowering their risk.


Identification of nondeletional α-thalassemia in a prenatal screening program by reverse dot-blot in southern China.
The aim of this study was to demonstrate the performance of nondeletional α-thalassemia (α-thal) prevention using a reverse dot-blot method at a Mainland Chinese hospital. A prenatal control program for nondeletional Hb H disease was performed between January 2009 and December 2013. All couples were screened for α-thal trait, and for couples in which one partner tested positive for α(0)-thal, the other was subjected to screening for Hb Constant Spring (Hb CS, HBA2: c.427T > C) and Hb Quong Sze (Hb QS, HBA2: c.377T > C) mutations by reverse dot-blot assay. Prenatal diagnoses were offered in at-risk pregnancies. During the study period, 51,105 couples were found to be carrying α-thal; among these, 35 (0.07%) couples were found to be at-risk of conceiving an offspring with nondeletional Hb H disease, including 25 couples for Hb H-CS and 10 cases for Hb H-QS. Nine fetuses were diagnosed with nondeletional Hb H disease, and eight of the affected pregnancies were terminated. Detection of nondeletional α-thal is necessary for any prenatal diagnosis (PND) programs in Southeast Asian countries. Reverse dot-blot is a relatively simple method for simultaneous typing of common nondeletional α-thal mutations.


The effect of elbow position at the time of tourniquet inflation on clinical outcomes.
The aim of this study was to prospectively investigate the effects of elbow position on perioperative and postoperative clinical outcomes during tourniquet inflation. The patients were divided into two groups based on their elbow position during tourniquet inflation: patients with elbows extended group E (30 patients), patients with flexed elbows group F (30 patients). Both groups were compared in terms of perioperative bloodless surgical field, tourniquet pain, time to onset of pain, and pain in the tourniquet area on the first postoperative day, plus elbow-forearm range of motion deficit on both the perioperative and postoperative first day. The bloodless surgical field provided by the tourniquet was 0.46 (0-5) in Group E and 0.4 (0-4) in Group F. Perioperative tourniquet pain started in an average of 51 (33-71) minutes in 4 patients in Group E and 49 (31-74) minutes in 5 patients in Group F. Pain was present in 2 patients in both groups in the postoperative tourniquet area. When the preoperatively measured elbow flexion-extension and forearm supination-pronation deficits were compared with the perioperative values, the deficits were 1%, 2%, 1%, 1% in Group E, and 1%, 1%, 2%, 1% in Group F, respectively. When compared with the postoperative values, 1%, 3%, 1%, 1% in Group E and 1%, 2%, 1%, and 1% in Group F were observed, respectively. There was no statistically significant difference between the two groups, but since repositioning the elbow after the tourniquet is inflated will cause an additional shearing effect on the tissues under the cuff, we recommend inflating the tourniquet in that position in which the operation will be performed in upper extremity surgeries.


[Linac-based stereotactic ablative radiotherapy for pancreatic cancer with intrafractional triggered imaging].
Our aim was to present different treatment strategies (non-gated [NG], respiratory-gated [RG] and deep inspiration breath-hold [DIBH] technique) of linac-based stereotaxic ablative radiotherapy (SABR) for pancreatic cancer in terms of use of marker, abdominal compression, image quality, and time efficiency. From October 2016 to October 2020 14 patients were treated with VMAT-based SABR (NG: 6/14, 8/14 RG RT including 3/8 DIBH SABR). Treatment verification consisted of 3D/4D CBCTs. For intrafractional tumor visualization (11/14) different type of fiducials were used. The average treatment time was the shortest with NG RT, followed by DIBH and RG RT. However, the best image quality was achieved with DIBH technique. The Krippendorff's agreement test among three independent RTTs showed that DIBH CBCT (Cone Beam CT) can produce sufficient image quality for OARs and can be used to reliably determine OARs position related to safety zone (PRV). Overall, marker-based DIBH SABR with intrafractional tumor visualization appears to be the best technique on linac at present.


Assessing the economic impact of stress--the modern day hidden epidemic.
This article examines the economic effects of all forms of stress-work-related stress, home stress, and post-traumatic stress disorder (PTSD)-as health hazards. Such an approach inherently broadens the analysis from a few well-defined, quantitative variables, such as those most commonly studied by economists who traditionally examine job stress alone. It also enables us to draw conclusions regarding the socioeconomic factors and the psychology of stress and helps in understanding the larger question of the economic cost of stress in today's global environment. Stress and its related comorbid diseases are responsible for a large proportion of disability worldwide. The World Health Organization (WHO) Global Burden of Disease Survey estimates that mental disease, including stress-related disorders, will be the second leading cause of disabilities by the year 2020. Although the term "stress" is used in a wide variety of contexts, it has consistently been demonstrated that individuals with stress and related disorders experience impaired physical and mental functioning, more work days lost, increased impairment at work, and a high use of health care services. The disability caused by stress is just as great as the disability caused by workplace accidents or other common medical conditions such as hypertension, diabetes, and arthritis. We present evidence that calls for early recognition of workplace stress and for businesses to allocate more resources to stress management in the workplace.


Mouse parabiosis model promotes recovery of lymphocytes in irradiated mice.
Total body irradiation (TBI) -induced hematopoietic system injury is mainly due to the failure of self-renewal and to the differentiation ability of hematopoietic stem cells (HSCs) and hematopoietic progenitor cells (HPCs) after radiation exposure. The mouse parabiosis model is mainly used in the field of aging research to explore whether circulating factors in peripheral blood can improve the functions of aged tissues and organs. In this study, we generated a mouse model to verify whether non-irradiated peripheral circulation can improve the circulatory environment in irradiated mice and ameliorate TBI-induced hematopoietic system injury. Six- to eight-week-old male C57BL/6 mice were adjoined by a surgical operation. Four weeks later, one mouse in the pair was exposed to 8 Gy or 6 Gy X-ray, and B and T cells in the peripheral blood, bone marrow, spleen, mesenteric lymph nodes and thymus were then detected by flow cytometry. Hematopoietic stem/progenitor cells in bone marrow cells and their levels of ROS and apoptosis were also detected in this study. The results showed decreased percentages of B and T lymphocytes in the peripheral blood, bone marrow (BM), spleen and mesenteric lymph nodes (MLNs) in the isotype irradiated mice. The proportions of CD4-positive, CD8-positive, and CD4 and CD8 double-negative cells were also increased, while the proportion of CD4 and CD8 double-positive cells in the irradiated thymus was decreased. Thus, all of the above lymphocyte injuries in the parabiosis model were improved to nearly the levels of the control. We further detected radiation-induced HSC and HPC injury; however, the reduced HSC and HPC numbers, ROS levels and apoptosis percentages were not ameliorated in the parabiotic irradiated mice. Above all, our results showed that non-irradiated peripheral circulation can promote the recovery of TBI-induced lymphocyte injury, further indicating that the recovery of immune cells may play a very important role in the repair of TBI-induced damage.


[Comparison of sonography and arthrography in the examination of cysts around the knee].
Authors used in 1988 simultaneously sonography and arthrography during the treatment of 10 patients admitted with the diagnosis of cyst or tumour around the knee. The experiences with the comparison of the 2 methods are summarized. As this use of the method is first described in this country, before the description of their own material the relevant available foreign literature is also discussed. It is stated that in the differential diagnosis of the cysts around the knee the 2 methods may give good complementary informations. It is stressed that if a choice is possible, the sonography is the method of choice, being exempt from X-rays, noninvasive, not causing pain and cheaper.


Organ donation and transplantation in Poland in 2007.
In 2007 the number of effective cadaveric donors and the number of transplanted organs in Poland significantly decreased. 466 possible deceased organ donors were reported to Polish Transplant Coordinating Center POLTRANSPLANT-Health Ministry Office responsible for organization of procurement, organ allocation and providing registries. Organ recovery took place in 352 (75.5%) cases (9.2 donors/pmp).


Imaging biological macromolecules in thick specimens: The role of inelastic scattering in cryoEM.
We investigate potential improvements in using electron cryomicroscopy to image thick specimens with high-resolution phase contrast imaging. In particular, using model experiments, electron scattering theory, Monte Carlo and multislice simulations, we determine the potential for improving electron cryomicrographs of proteins within a cell using chromatic aberration (Cc) correction. We show that inelastically scattered electrons lose a quantifiable amount of spatial coherence as they transit the specimen, yet can be used to enhance the signal from thick biological specimens (in the 1000 to 5000 Å range) provided they are imaged close to focus with an achromatic lens. This loss of information quantified here, which we call "specimen induced decoherence", is a fundamental limit on imaging biological molecules in situ. We further show that with foreseeable advances in transmission electron microscope technology, it should be possible to directly locate and uniquely identify sub-100 kDa proteins without the need for labels, in a vitrified specimen taken from a cell.