Concordance of DSM-IV Axis I and II diagnoses by personal and informant's interview.
The validity and reliability of using psychological autopsies to diagnose a psychiatric disorder is a critical issue. Therefore, interrater and test-retest reliability of the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders and the usefulness of these instruments for the psychological autopsy method were investigated. Diagnoses by informant's interview were compared with diagnoses generated by a personal interview of 35 persons. Interrater reliability and test-retest reliability were assessed in 33 and 29 persons, respectively. Chi-square analysis, kappa and intraclass correlation coefficients, and Kendall's tau were used to determine agreement of diagnoses. Kappa coefficients were above 0.84 for substance-related disorders, mood disorders, and anxiety and adjustment disorders, and above 0.65 for Axis II disorders for interrater and test-retest reliability. Agreement by personal and relative's interview generated kappa coefficients above 0.79 for most Axis I and above 0.65 for most personality disorder diagnoses; Kendall's tau for dimensional individual personality disorder scores ranged from 0.22 to 0.72. Despite of a small number of psychiatric disorders in the selected population, the present results provide support for the validity of most diagnoses obtained through the best-estimate method using the Structured Clinical Interview for DSM-IV Axis I and Personality Disorders. This instrument can be recommended as a tool for the psychological autopsy procedure in post-mortem research.


Decoding the language of microbiomes using word-embedding techniques, and applications in inflammatory bowel disease.
Microbiomes are complex ecological systems that play crucial roles in understanding natural phenomena from human disease to climate change. Especially in human gut microbiome studies, where collecting clinical samples can be arduous, the number of taxa considered in any one study often exceeds the number of samples ten to one hundred-fold. This discrepancy decreases the power of studies to identify meaningful differences between samples, increases the likelihood of false positive results, and subsequently limits reproducibility. Despite the vast collections of microbiome data already available, biome-specific patterns of microbial structure are not currently leveraged to inform studies. Here, we derive microbiome-level properties by applying an embedding algorithm to quantify taxon co-occurrence patterns in over 18,000 samples from the American Gut Project (AGP) microbiome crowdsourcing effort. We then compare the predictive power of models trained using properties, normalized taxonomic count data, and another commonly used dimensionality reduction method, Principal Component Analysis in categorizing samples from individuals with inflammatory bowel disease (IBD) and healthy controls. We show that predictive models trained using property data are the most accurate, robust, and generalizable, and that property-based models can be trained on one dataset and deployed on another with positive results. Furthermore, we find that properties correlate significantly with known metabolic pathways. Using these properties, we are able to extract known and new bacterial metabolic pathways associated with inflammatory bowel disease across two completely independent studies. By providing a set of pre-trained embeddings, we allow any V4 16S amplicon study to apply the publicly informed properties to increase the statistical power, reproducibility, and generalizability of analysis.


Hydrophobic ion hydration and the magnitude of the dipole potential.
The magnitude of the dipole potential of lipid membranes is often estimated from the difference in conductance between the hydrophobic ions, tetraphenylborate, and tetraphenylarsonium or tetraphenylphosphonium. The calculation is based on the tetraphenylarsonium-tetraphenylborate hypothesis that the magnitude of the hydration energies of the anions and cations are equal (i.e., charge independent), so that their different rates of transport across the membrane are solely due to differential interactions with the membrane phase. Here we investigate the validity of this assumption by quantum mechanical calculations of the hydration energies. Tetraphenylborate (Delta G(hydr) = -168 kJ mol(-1)) was found to have a significantly stronger interaction with water than either tetraphenylarsonium (Delta G(hydr) = -145 kJ mol(-1)) or tetraphenylphosphonium (Delta G(hydr) = -157 kJ mol(-1)). Taking these differences into account, literature conductance data were recalculated to yield values of the dipole potential 57 to 119 mV more positive in the membrane interior than previous estimates. This may partly account for the discrepancy of at least 100 mV generally observed between dipole potential values calculated from lipid monolayers and those determined on bilayers.


Intrauterine Devices in the Context of Gonococcal Infection, Chlamydial Infection, and Pelvic Inflammatory Disease: Not Mutually Exclusive.
The use of long-acting reversible contraception, namely, intrauterine device (IUDs) and the subdermal implant, has been recommended to address the high rate of the unintended pregnancy in the United States. IUDs are a safe, highly effective contraceptive method, suitable for most women. The underutilization of IUDs arises in part from the lack of translation of best practices in the clinical setting as well as fears and misperceptions about this contraceptive method held by health care providers and women. This article reviews screening and management of Neisseria gonorrhoeae and Chlamydia trachomatis infection and pelvic inflammatory disease (PID) in women who are using or want to use an IUD. An IUD may be inserted without prior screening for N gonorrhoeae or C trachomatis in women who are at low risk for sexually transmitted infections and asymptomatic. An in situ IUD may remain in the uterus during and after treatment for gonococcal infection, chlamydial infection, or PID. The risk of PID with an IUD in situ is less than 1%. Following IUD best practices, including their use in the context of sexually transmitted infections, can increase the availability of this method for suitable candidates and decrease the unintended pregnancy rate.


The NEAT Predictive Model for Survival in Patients with Advanced Cancer.
We previously developed a model to more accurately predict life expectancy for stage IV cancer patients referred to radiation oncology. The goals of this study are to validate this model and to compare competing published models. From May 2012 to March 2015, 280 consecutive patientswith stage IV cancerwere prospectively evaluated by a single radiation oncologist. Patients were separated into training, validation and combined sets. TheNEAT model evaluated number of active tumors ("N"), Eastern Cooperative Oncology Group performance status ("E"), albumin ("A") and primary tumor site ("T"). The Odette Cancer Center model validated performance status, bone only metastases and primary tumor site. The Harvard TEACHH model investigated primary tumor type, performance status, age, prior chemotherapy courses, liver metastases, and hospitalization within 3 months. Cox multivariable analyses and logisticalregressionwere utilized to compare model performance. Number of active tumors, performance status, albumin, primary tumor site, prior hospitalizationwithin the last 3 months, and liver metastases predicted overall survival on uinvariate and multivariable analysis (p < 0.05 for all). The NEAT model separated patients into four prognostic groups with median survivals of 24.9, 14.8, 4.0, and 1.2 months, respectively (p < 0.001). The NEAT model had a C-index of 0.76 with a Nagelkerke's R2 of 0.54 suggesting good discrimination, calibration and total performance compared to competing prognostic models. The NEAT model warrants further investigation as a clinically useful approach to predict survival in patients with stage IV cancer.


Radar evidence for liquid surfaces on Titan.
Arecibo radar observations of Titan at 13-centimeter wavelength indicate that most of the echo power is in a diffusely scattered component but that a small specular component is present for about 75% of the subearth locations observed. These specular echoes have properties consistent with those expected for areas of liquid hydrocarbons. Knowledge of the areal extent and depth of any deposits of liquid hydrocarbons could strongly constrain the history of Titan's atmosphere and surface.


Malignant melanoma of the gallbladder. Report of a case.
A case of malignant melanoma in a 31-year-old man is described to add to the eight cases previously reported in the literature. The tumor in this case shares many common gross and microscopic features with those previously reported. These similarities, in addition to the clinical absence of any primary melanoma in the more common site of occurrence, indicate that the tumor in this case is primary in the gallbladder.


Reconstitution of the early steps of gliotoxin biosynthesis in Aspergillus nidulans reveals the role of the monooxygenase GliC.
The gliotoxin, a member of the epipolythiodioxopiperazine (ETP), has received considerable attention from the scientific community for its wide range of biological activity. Despite the identification of gliotoxin cluster, however, the sequence of steps in the gliotoxin biosynthesis has remained elusive. As an alternative to the gene knock-out and biochemical approaches used so far, here we report using a heterologous expression approach to determine the sequence of the early steps of gliotoxin biosynthesis in Aspergillus nidulans. We identified the GliC, a monooxygenases that involved in the second step of gliotoxin biosynthesis pathway through the catalyzing the hydroxylation at the α-position of L-Phe.


Effects of different intensity of exercise on tissue injury and gene expression in obese rats.
Weight loss is an important aspect of chronic disease prevention and management, with increasing rates of overweight and obesity worldwide. Drugs and surgery are popular approaches to lose weight. Given their potential harm to the body, exercise is an alternative widely accepted approach. However, participation in high intensity exercise entails an inherent risk of sports-related injuries. In this study, a rat model fed with high fat diet was employed to investigate the effects of different intensity of exercise prescription on both weight loss and tissue injury after exercise and to find a proper exercise prescription for losing weight with minimal tissues injuries. We inferred that 3% weight bearing might be the proper exercise prescription for high fat diet-fed rats in our experimental setting.


Combined 60° Wide-Field Choroidal Thickness Maps and High-Definition En Face Vasculature Visualization Using Swept-Source Megahertz OCT at 1050 nm.
To demonstrate ultrahigh-speed swept-source optical coherence tomography (SS-OCT) at 1.68 million A-scans/s for choroidal imaging in normal and diseased eyes over a ∼60° field of view. To investigate and correlate wide-field three-dimensional (3D) choroidal thickness (ChT) and vascular patterns using ChT maps and coregistered high-definition en face images extracted from a single densely sampled Megahertz-OCT (MHz-OCT) dataset. High-definition, ∼60° wide-field 3D datasets consisting of 2088 × 1024 A-scans were acquired using a 1.68 MHz prototype SS-OCT system at 1050 nm based on a Fourier-domain mode-locked laser. Nine subjects (nine eyes) with various chorioretinal diseases or without ocular pathology are presented. Coregistered ChT maps, choroidal summation maps, and depth-resolved en face images referenced to either the retinal pigment epithelium or the choroidal-scleral interface were generated using manual segmentation. Wide-field ChT maps showed a large inter- and intraindividual variance in peripheral and central ChT. In only four of the nine eyes, the location with the largest ChT was coincident with the fovea. The anatomy of the large lumen vessels of the outer choroid seems to play a major role in determining the global ChT pattern. Focal ChT changes with large thickness gradients were observed in some eyes. Different ChT and vascular patterns could be visualized over ∼60° in patients for the first time using OCT. Due to focal ChT changes, a high density of thickness measurements may be favorable. High-definition depth-resolved en face images are complementary to cross sections and thickness maps and enhance the interpretation of different ChT patterns.


Phase I-II trial of low-dose gemcitabine in prolonged infusion and cisplatin for advanced non-small cell lung cancer.
After monotherapy with gemcitabine in low dose in long infusion, promising results in a variety of advanced chemoresistant tumors have been reported. In a previous phase I trial on heavily pre-treated patients, maximum tolerated dose (MTD) of gemcitabine in a 6 h infusion was 250 mg/m. The objective of our phase I-II trial was to test the combination of gemcitabine in a 6-h infusion and cisplatin in the treatment of advanced non-small cell lung cancer (NSCLC). Eligible patients were chemonaive, had locally advanced or metastatic NSCLC, Eastern Oncology Cooperative Oncology Group performance status 0-2 and normal organ function. Treatment consisted of gemcitabine in a 6-h infusion on days 1 and 8, and cisplatin at 75 mg/m on day 2 of a 3-week cycle. During phase I of the trial, the dose of gemcitabine was escalated from 130 to 170, 210 and 250 mg/m. After establishing dose-limiting toxicity (DLT) and MTD of the combination, the trial continued as phase II. Altogether, 61 patients were enrolled, of whom 54 had stage IV disease. In phase I of the trial, groups of six, seven, eight and eight patients were treated at the four dose levels of gemcitabine. In phase II, the remaining 32 patients all received gemcitabine at 250 mg/m. Serious toxicity included a patient with grade 5 ventricular arrhythmia and another with grade 4 cerebrovascular ischemia; four patients had grade 3 anemia. Reversible thrombocytosis with platelets over 500 was recorded in 32 patients; 42 patients had grade 2 alopecia. In general, tolerance to this treatment was good. One patient had complete response and 27 had partial responses, for a 28 of 61 (46%) response rate. Median progression-free survival, median survival and 1-year survival were 6 months, 9.5 months and 40%, respectively. We conclude that this treatment has an acceptable, yet distinct, toxicity profile; routine thromboprophylaxis is recommended. In our population of chemonaive patients, no DLT has been encountered. Due to the remarkable response rate, further research is warranted.


Visual outcomes and patient satisfaction after refractive lens exchange with a single-piece diffractive multifocal intraocular lens.
Purpose. To report visual outcomes and patient satisfaction after unilateral or bilateral refractive lens exchange (RLE) with a single-piece bifocal diffractive multifocal intraocular lens (MIOL). Methods. All patients underwent RLE with the ZMB00 MIOL (Abbott Medical Optics). Patient charts were reviewed to evaluate the distance, intermediate, and near visual acuity (VA), contrast sensitivity, extent of visual symptoms (0-5), satisfaction (1-5), and rate of spectacle independence between unilateral and bilateral RLE group. Results. Forty-seven eyes of 28 patients were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate (67 cm), and near (30 cm) were 0.01 ± 0.12 (standard deviation), 0.27 ± 0.18, and 0.15 ± 0.11, respectively. No eyes lost >1 line of corrected distance VA. Monocular contrast sensitivity remained at normal level. Median scores of halos, night glare, and starbursts for 27 patients were 2.0, 3.0, and 0.0, respectively. Median score of satisfaction was 4.0. There were no differences in visual symptom scores or satisfaction between unilateral and bilateral group (P > 0.05). Eighty percent of 25 patients reported total spectacle freedom, with similar rate between bilateral (82%) and unilateral group (75%) (P = 1.000). Conclusions. RLE with the bifocal diffractive MIOL was safe in presbyopic patients and resulted in a high rate of spectacle independence.


Traffic behavior near an off ramp in the cellular automaton traffic model.
In this paper, we investigate the off-ramp system on the highway using the cellular automaton traffic model. Both the system without an exit lane (case 1) and that with an exit lane (case 2) are considered. The phase diagram and its variation with L(D) (the length of exit lane in case 2 and the length of a special lane-changing section in case 1) is studied. Two phase regions are found in case 1 and a new phase, i.e., the maximum flux phase, is reported in case 2. The density (velocity) distribution near the off ramp and the influence of L(D) on the traffic flow are also discussed in both cases.


Clinical effect of recombinant human erythropoietin on anemia associated with chronic renal failure. A multi-institutional study in Japan.
Clinical effect and safety of recombinant human erythropoietin (r-HuEPO) were evaluated in 66 hemodialysis patients with intractable anemia. Initially, 50U/kg dry weight (DW) of r-HuEPO was administered intravenously at the end of every hemodialysis procedure for 4 weeks, then the dosage was increased to 100 and 200U/kg DW for poor responders. The patients' hematocrits rose from 19.8 +/- 2.3% (pretreatment) to 30.2 +/- 4.9% after 12 weeks. From 206 U of blood transfusion requirement in the 3-month period before the study, only 34 U were needed after treatment. Serum iron and ferritin levels fell significantly during the study, and iron storage was considered to be one of the decisive factors in the response to r-HuEPO. Blood pressure rose in the course of r-HuEPO administration, but uncontrollable hypertension was rarely observed. There was no significant adverse effect of r-HuEPO except for this mild hypertension. These results indicate that r-HuEPO is an excellent therapeutic aid for the anemia associated with chronic renal failure.


Effect of 10-day forced treadmill training on neurotrophic factors in experimental autoimmune encephalomyelitis.
The impact of exercise on disease progression in multiple sclerosis (MS) is unclear. In the present study, we evaluated the clinical effects of forced wheel running on rats induced with experimental autoimmune encephalomyelitis (EAE), a model of MS. Female Lewis rats (n = 40) were randomly assigned to 1 of 4 groups prior to inoculation: EAE exercise (EAE-Ex), EAE sedentary (EAE-Sed), control exercise (Con-Ex), or control sedentary (Con-Sed). Exercise training was composed of forced treadmill running at increasing intensity across 10 consecutive days. No significant differences in clinical disability were observed in the EAE groups at the conclusion of this study. Furthermore, no significant differences in brain mass were observed across groups. Analysis of brain tissue proteins revealed that tumour necrosis factor-α (TNF-α) concentrations were higher in both EAE groups compared with the control groups (p < 0.05); however, no significant differences were seen between the EAE-Ex and EAE-Sed groups. The Con-Ex group had lower whole-brain TNF-α compared with the Con-Sed group (p < 0.05). Nerve growth factor concentrations were greater in the EAE-Ex animals compared with both control groups (p < 0.05 for both). No differences were seen in brain-derived neurotrophic factor. Our results indicate that aerobic exercise can modulate the proteins associated with disability in EAE; however, further research is required to understand the total impact of exercise on EAE disability and disease progression.


Subjective sensitivity to monetary gradients is associated with frontolimbic activation to reward in cocaine abusers.
Drug addiction is characterized by marked disruptions in the ability to process reward. Here we evaluated in cocaine addicted and healthy control participants the subjective sensitivity to reward gradients and its association with neural responses to sustained reward. A self-report questionnaire was used to assess the former. A functional magnetic resonance imaging task that utilized monetary reward as feedback in a blocked design was used to assess the latter. Results revealed that whereas control subjects valued high money more than low money, over half of the cocaine addicted subjects valued all monetary amounts equally. This compromised subjective sensitivity to gradients in reward value was significantly correlated with higher activations to money in the lateral orbitofrontal cortex/inferior frontal gyrus (BA 47) and amygdala, and lower activations in the middle frontal gyrus (BA 6), which together explained 85% of the variability on this rating scale in the cocaine abusers only. These results provide for the first time evidence of restricted subjective sensitivity to gradients of reward in cocaine addiction and of the involvement of frontolimbic brain regions (including the orbitofrontal cortex) in this deficit.


Hand amputations: epidemiology, management and resurfacing options for soft tissue coverage.
Agricultural hand injuries occur mainly among young adults, many affecting the dominant hand, thereby impeding patients' ability to work or cope with social obligations. This study was carried out with the aim of collecting data on the epidemiology and management of agricultural hand injuries in Indian subjects. The study was conducted in the Department of Plastic and Reconstructive Surgery, JN Medical College, AMU, Aligarh, India, from October 2009 to December 2013. Patients with agricultural hand injuries were included. Data collected included socio-demographic details, mode and type of injury, type of reconstruction, complications, length of hospital stay and assessment of post-reconstruction status. These data were tabulated and analysed. The typical patient was young (mean 33.2 years), of lower socio-economic status and with a total disregard for safety regulations. There is clustering of cases during the wheat harvest season (April-June). Wheat thresher injuries were the most common cause of partial hand amputation (51%), especially during this season. This was followed by fodder cutting (kutti/chara) machine injury, especially in females and children (36%). A simple classification for these injuries has been described and Grade II injury was the commonest. Reverse radial forearm flap was the most suitable regional flap for coverage, whereas thoraco-umbilical flap was the most commonly used distant flap. Patients who had the single-stage procedure had a significantly shorter stay. Agricultural hand injuries are not totally avoidable and their incidence can be reduced by proper education, but the low economic and literacy status of the patients is a big hurdle. The forearm offers many flaps for reconstruction of hand, which can be used in defects on dorsal or palmar aspect of hand and results in early discharge from the hospital and early rehabilitation. In patients with associated injury to the forearm, abdominal flaps can be used for cover.


Cost-effectiveness of bupropion, nortriptyline, and psychological intervention in smoking cessation.
Sustained-release bupropion and nortriptyline have been shown to be efficacious in treating cigarette smoking. Psychological intervention is also recognized as efficacious. The cost and cost-effectiveness of the 2 drug therapies have not been estimated. It was hypothesized that nortriptyline would be more cost-effective than bupropion. Hypotheses were not originally proposed concerning the cost-effectiveness of psychological versus drug treatment, but the 2 were compared using exploratory analyses. This was a 3 (bupropion versus nortriptyline versus placebo) by 2 (medical management alone versus medical management plus psychological intervention) randomized trial. Participants were 220 cigarette smokers. Outcome measures were cost and cost-effectiveness computed at week 52. Nortriptyline cost less than bupropion. Nortriptyline was more cost-effective than bupropion; the difference was not statistically significant. Psychological intervention cost less than the 2 drug treatments, and was more cost-effective, but not significantly so. Prospective investigations of the cost and cost-effectiveness of psychological and pharmacological intervention, using adequate sample sizes, are warranted.


Studies on pathogenesis following single and double infection with viral hemorrhagic septicemia virus and infectious hematopoietic necrosis virus in rainbow trout (Oncorhynchus mykiss).
Rainbow trout (Oncorhynchus mykiss) were bath challenged with viral hemorrhagic septicemia (VHS) virus or infectious hematopoietic necrosis (IHN) virus or with both viruses simultaneously. The viral distribution and development of histologic lesions were examined using immunohistochemistry, while virus titer in kidney was determined by viral titration in cell culture. Single infections with VHS virus and IHN virus showed similar distributions of virus in internal organs. The early identification of virus in gill epithelium, 1 and 2 days postinfection (PI) for VHS virus and IHN virus, respectively, indicates that this organ is the point of entry for both viruses. The detection of VHS virus at 1 day PI and 3 days PI for IHN virus is indicative of kidney and spleen being the target organs for these viruses. A simultaneous infection of VHS virus and IHN virus resulted in both viruses establishing an infection. Further double infection did not result in a statistically significant lower titer of both viruses in kidney but a more restricted distribution of IHN virus in internal organs compared with the single infected group. The most striking finding is that, for IHN virus, virus was not detected in the brain in situ in the double-infected group. This study provides support for the conclusion that simultaneous infection with two piscine rhabdoviruses in a susceptible host results in some degree of interaction at the cell level, leading to a reduced systemic distribution of IHN virus.


MyD88 signaling promotes both mucosal homeostatic and fibrotic responses during Salmonella-induced colitis.
Salmonella enterica serovar Typhimurium is a clinically important gram-negative, enteric bacterial pathogen that activates several Toll-like receptors (TLRs). While TLR signaling through the adaptor protein MyD88 has been shown to promote inflammation and host defense against the systemic spread of S. Typhimurium, curiously, its role in the host response against S. Typhimurium within the mammalian gastrointestinal (GI) tract is less clear. We therefore used the recently described Salmonella-induced enterocolitis and fibrosis model: wild-type (WT) and MyD88-deficient (MyD88(-/-)) mice pretreated with streptomycin and then orally infected with the ΔaroA vaccine strain of S. Typhimurium. Tissues were analyzed for bacterial colonization, inflammation, and epithelial damage, while fibrosis was assessed by collagen quantification and Masson's trichrome staining. WT and MyD88(-/-) mice carried similar intestinal pathogen burdens to postinfection day 21. Infection of WT mice led to acute mucosal and submucosal inflammation and edema, as well as significant intestinal epithelial damage and proliferation, leading to widespread goblet cell depletion. Impressive collagen deposition in the WT intestine was also evident in the submucosa at postinfection days 7 and 21, with fibrotic regions rich in fibroblasts and collagen. While infected MyD88(-/-) mice showed levels of submucosal inflammation and edema similar to WT mice, they were impaired in the development of mucosal inflammation, along with infection-induced epithelial damage, proliferation, and goblet cell depletion. MyD88(-/-) mouse tissues also had fewer submucosal fibroblasts and 60% less collagen. We noted that cyclooxygenase (Cox)-2 expression was MyD88-dependent, with numerous Cox-2-positive cells identified in fibrotic regions of WT mice at postinfection day 7, but not in MyD88(-/-) mice. Treatment of WT mice with the Cox-2 inhibitor rofecoxib (20 mg/kg) significantly reduced fibroblast numbers and collagen levels without altering colitis severity. In conclusion, MyD88 and Cox-2 signaling play roles in intestinal fibrosis during Salmonella-induced enterocolitis.


Epidemiological Characteristics of Human Rabies - Shandong Province, China, 2010-2020.
Rabies is a viral zoonotic disease that causes progressive and fatal inflammation in the brain. Rabies has caused more than 5,000 human deaths in Shandong Province since 1955. This study aimed to analyze the epidemiological characteristics of human rabies in Shandong Province from 2010 to 2020 and to provide a scientific basis for policy changes. The data of reported human rabies cases from 2010 to 2020 were obtained from China's National Notifiable Disease Reporting System, and data related to exposure and post-exposure prophylaxis (PEP) of the cases were acquired through case investigation. A total of 414 human rabies cases were reported in Shandong Province from 2010 to 2020. Out of the 414 total cases, 87.20% were primarily farmers; 83.10% were over 40 years old. 70.29% (265/377) belonged to category Ⅲ exposure; and 96.67% (377/390) were exposed to the virus through infected dogs. The vaccine inoculation rate of these cases after exposure was only 8.85%; 1.03% (4/390) had been vaccinated with rabies immunoglobulin, developing the disease 11 to 13 days after category Ⅲ exposure. Dogs were still the primary animal hosts. Most rabies patients died due to no or inadequate post-exposure prophylaxis. Vaccine inoculation rates for dogs should reach the target of 70% as soon as possible. Health departments should improve the accessibility and quality of PEP; and improve the health literacy of the elderly in rural areas.


California Serogroup Virus Infection Associated with Encephalitis and Cognitive Decline, Canada, 2015.
California serogroup (CSG) viruses, such as Jamestown Canyon and snowshoe hare viruses, are mosquitoborne pathogens that cause febrile illness and neurologic disease. Human exposures have been described across Canada, but infections are likely underdiagnosed. We describe a case of neuroinvasive illness in a New Brunswick, Canada, patient infected with a CSG virus.


PPARγ-dependent anti-tumor and immunomodulatory actions of pioglitazone.
Peroxisome proliferator-activated receptor-γ (PPARγ) has been reported to play important roles in carcinogenesis. The current study was carried out to assess the possible anti-tumor effects of pioglitazone (PIO), a PPARγ agonist, in a mouse mammary carcinoma model, i.e. a solid Ehrlich carcinoma (SEC). Effects of PIO on tumor-induced immune dysfunction, and the possibility that PIO may modulate the anti-tumor and immunomodulatory effects of doxorubicin (DOX) were also studied. The effects in tumor-bearing hosts of several doses of PIO (100 mg/kg, per os), with and without the added presence of DOX (2 mg/kg, IP), was investigated in vivo; end-points evaluated included assessment of tumor volume, splenic lymphocyte profiles/functionality, tumor necrosis factor (TNF)-α content, as well as apoptosis and expression of nuclear factor-κB (NF-κB) among the tumor cells. The data indicate that PIO induced significant anti-tumor activity against the SEC. PIO treatments also significantly mitigated both tumor- and doxorubicin-induced declines in immune parameters assessed here. Moreover, PIO led to decreased NF-κB nuclear expression, and, in doing so, appeared to chemo-sensitize these tumor cells to DOX-induced apoptosis. All pioglitazone-studied effects were antagonized by GW9662, a selective PPARγ antagonist.


Fluctuation-enhanced Kerr nonlinearity in an atom-assisted optomechanical system with atom-cavity interactions.
We examine the effect of cavity field fluctuations on Kerr nonlinearity in an atom-assisted optomechanical system. It is found that a new self-Kerr (SK) nonlinearity term, which can greatly surpass that of a classical Λ type atomic system when the hybrid system has numerous atoms, is generated based on cavity field fluctuations by atom-cavity interactions. A strong photon-phonon cross-Kerr (CK) nonlinearity is also produced based on cavity field fluctuations. These nonlinearity features can be modified by atom-cavity and optomechanical interactions. This work may provide a new method to enhance the SK nonlinearity and generate the photon-phonon CK nonlinearity.


The periodic health appraisal of employees.
Periodic health appraisals for employees in business and industry are desirable and effective. Male executives over the age of 40 constitute the group most in need of them. Examinations of the kind done for private patients, including careful history-taking and thorough physical observation, are the most reliable, economical and productive.Undesirable factors to be guarded against in these examinations are unnecessary hospitalization, excessive laboratory and radiologic procedures and absence of rapport between examiner and examinee.Ideally, the results of the examination should be made known to the employee only-not to the employer except with the stated permission of the employee.


On knowing the therapist "as a person".
The point of departure for this paper is the oft-stated complaint by some patients as well as by some therapists that it is very difficult to know the psychoanalytic therapist "as a person." This complaint reflects the view that psychoanalytic psychotherapists are generally impersonal and cold as a function of their therortical orientation. However, numerous opportunities exist in psychoanalytic psychotherapy treatment situations for patients to be aware of a variety of authentic facets of therapists' personalities. Knowledge of, and reactions to, these facets are an important dimension of psychotherapy, in part because the therapist's personality inevitably colors the nature of the treatment. A patient's reaction to the real components of his therapist may be interwoven with his transference reactions. A case example shows how awareness of the patient's conflict about his knowledge of his therapist signified a major turning point in his therapy.


The annual incidence of Langerhans cell histiocytosis among adults living in Greece.
Langerhans cell histiocytosis (LCH) is a rare inflammatory myeloid neoplasia with a variable clinical course and outcome. Although there are some data regarding its incidence in children, such information in adults is lacking. To address the actual annual LCH incidence among adults, we prospectively recorded, during a 12-month period, any new case with a definitive histological diagnosis of LCH, among persons aged 18 and older living in Greece. Fourteen new cases were recorded corresponding to an annual incidence of 1.58 per million population. Female to male ratio was 1.34, and mean age at diagnosis was 43.5 years.


Tuberculosis of the skull mimicking multiple myeloma.
There is a resurgence of tuberculosis globally but lesions affecting the skull are rare. Cases reported are of single, focal lesions as seen on plain x-rays. We report a 34 yearold patient with tuberculosis of the skull where multiple punched out lesions are seen, mimicking that of multiple myeloma.


Outcome of E1224-Benznidazole Combination Treatment for Infection with a Multidrug-Resistant Trypanosoma cruzi Strain in Mice.
Combination therapy has been proposed as an alternative therapeutic approach for the treatment of Chagas disease. In this study, we evaluated the effect of treatment with benznidazole combined with E1224 (ravuconazole prodrug) in an experimental murine model of acute infection. The first set of experiments assessed the range of E1224 doses required to induce parasitological cure using Trypanosoma cruzi strains with different susceptibilities to benznidazole (Y and Colombian). All E1224 doses were effective in suppressing the parasitemia and preventing death; however, parasitological cure was observed only in mice infected with Y strain. Considering these results, we evaluated the effect of combined treatment against Colombian, a multidrug-resistant T. cruzi strain. After exclusion of antagonistic effects using in vitro assays, infected mice were treated with E1224 and benznidazole in monotherapy or in combination at day 4 or 10 postinoculation. All treatments were well tolerated and effective in suppressing parasitemia; however, parasitological and PCR assays indicated no cure among mice treated with monotherapies. Intriguingly, the outcome of combination therapy was dependent on treatment onset. Early treatment using optimal doses of E1224-benznidazole induced a 100% cure rate, but this association could not eliminate a well-established infection. The beneficial effect of combination therapy was evidenced by further reductions of the patent parasitemia period in the group receiving combined therapy compared with monotherapies. Our results demonstrated a positive interaction between E1224 and benznidazole against murine T. cruzi infection using a multidrug-resistant strain and highlighted the importance of a stringent experimental model in the evaluation of new therapies.


Proton Exchange in a Paramagnetic Chemical Exchange Saturation Transfer Agent from Experimental Studies and ab Initio Metadynamics Simulation.
The proton-exchange process between water and a carbamate has been studied experimentally and theoretically in a lanthanide-based paramagnetic chemical exchange saturation transfer agent endowed with potential multimodality detection capabilities (optical imaging, or T1 MRI for the Gd(III) analogue). In addition to an in-depth structural analysis by a combined approach (using X-ray crystallography, NMR, and molecular dynamics), our ab initio simulation in aqueous solution sheds light on the reaction mechanism for this proton exchange, which involves structural Grotthuss diffusion.


Changes in White Matter Microstructure Impact Cognition by Disrupting the Ability of Neural Assemblies to Synchronize.
Cognition is compromised by white matter (WM) injury but the neurophysiological alterations linking them remain unclear. We hypothesized that reduced neural synchronization caused by disruption of neural signal propagation is involved. To test this, we evaluated group differences in: diffusion tensor WM microstructure measures within the optic radiations, primary visual area (V1), and cuneus; neural phase synchrony to a visual attention cue during visual-motor task; and reaction time to a response cue during the same task between 26 pediatric patients (17/9: male/female) treated with cranial radiation treatment for a brain tumor (12.67 ± 2.76 years), and 26 healthy children (16/10: male/female; 12.01 ± 3.9 years). We corroborated our findings using a corticocortical computational model representing perturbed signal conduction from myelin. Patients show delayed reaction time, WM compromise, and reduced phase synchrony during visual attention compared with healthy children. Notably, using partial least-squares-path modeling we found that WM insult within the optic radiations, V1, and cuneus is a strong predictor of the slower reaction times via disruption of neural synchrony in visual cortex. Observed changes in synchronization were reproduced in a computational model of WM injury. These findings provide new evidence linking cognition with WM via the reliance of neural synchronization on propagation of neural signals.SIGNIFICANCE STATEMENT By comparing brain tumor patients to healthy children, we establish that changes in the microstructure of the optic radiations and neural synchrony during visual attention predict reaction time. Furthermore, by testing the directionality of these links through statistical modeling and verifying our findings with computational modeling, we infer a causal relationship, namely that changes in white matter microstructure impact cognition in part by disturbing the ability of neural assemblies to synchronize. Together, our human imaging data and computer simulations show a fundamental connection between WM microstructure and neural synchronization that is critical for cognitive processing.


Patch-Clamp Analysis of the Mitochondrial H+ Leak in Brown and Beige Fat.
Mitochondria convert the chemical energy of metabolic substrates into adenosine triphosphate (ATP) and heat. Although ATP production has become a focal point of research in bioenergetics, mitochondrial thermogenesis is also crucial for energy metabolism. Mitochondria generate heat due to H+ leak across the inner mitochondrial membrane (IMM) which is mediated by mitochondrial uncoupling proteins. The mitochondrial H+ leak was first identified, and studied for many decades, using mitochondrial respiration technique. Unfortunately, this method measures H+ leak indirectly, and its precision is insufficient for the rigorous insight into the mitochondrial function at the molecular level. Direct patch-clamp recording of H+ leak would have a significantly higher amplitude and time resolution, but application of the patch-clamp technique to a small subcellular organelle such as mitochondria has been challenging. We developed a method that facilitates patch-clamp recording from the whole IMM, enabling the direct measurement of small H+ leak currents via uncoupling proteins and thus, providing a rigorous understanding of the molecular mechanisms involved. In this paper we cover the methodology of measuring the H+ leak in mitochondria of specialized thermogenic tissues brown and beige fat.


Arthroscopic synovectomy in haemophilia: indications, technique and results.
Recurrent spontaneous haemarthrosis are commonly seen in patients affected by haemophilia. The knee and the elbow are most commonly affected and both are amenable to arthroscopic treatment. Arthroscopic synovectomy is indicated after failure of appropriate medical management with recurrent bleeding. Many patients also demonstrate motion loss and functional deterioration. The benefits of arthroscopic synovectomy include the ability to perform adequate synovial debridement, but also concomitant lysis of adhesion and capsular release to regain range of motion. Results of arthroscopic synovectomy demonstrate a significant decrease in episodes of haemarthrosis, and significant improvement in pain, range of motion and function. The primary predictor of outcome is degree of pre-existing degenerative changes within the joint. In more severe cases, the results of arthroscopic synovectomy are unpredictable and serious consideration should be given to primary arthroplasty.


Regulating "the artificial family": an Austrian compromise.
Finally Austria, too, has come round to a more or less final draft law on assisted reproduction (at the third attempt). It portrays a compromise of liberal and conservative views, which in some points has led to inconsistencies in its logical conception. The donation of semen, for instance, will be permitted, whereas ova donation will be strictly forbidden; the law will allow AID and at the same time prohibit heterologous IVF. The leading principles throughout this law, viz. human dignity, procreative autonomy, and the best interests of the child, surely vital in this context, are sometimes applied to justify regulations -- e.g. those that deny single women access to assisted reproduction -- violating the principle of equality. In this respect, the draft would definitely not bear a closer examination.


[Cranioplasty using autogenous bone cryopreserved with dimethylsulfoxide (DMSO)].
It is generally agreed that the autogenous bone flap which has been removed at the time of external decompression would be superior to any artificial material if it can be used in cranioplasty. Cranioplasty using autogenous frozen bone graft has been reported and showed good results except for infection and severe bone absorption. We conducted 39 cases of cranioplasty with cryopreserved autogenous bone in the presence of 10% of Dimethylsulfoxide (DMSO), which has been reported as a cryoprotective agent. Although no remarkable histological effects have been recognized in frozen bone with or without DMSO, we have obtained excellent clinical results without bone absorption in 24 of the cases. These results suggest that DMSO is helpful for frozen bone preservation.


Chemical pretreatment of olive oil mill wastewater using a metal-organic framework catalyst.
Olive oil mill wastewaters (OOMW) are not suited for direct biological treatment because of their nonbiodegradable and phytotoxic compound (such as polyphenols) content. Advanced technologies for treatment of OOMW consider mainly the use of solid catalysts in processes that can be operated at room conditions. A system based on combined actions of catalytic oxidations and microbial technologies was studied. The wet hydrogen peroxide catalytic oxidation (WHPCO) process is one of the new emerging oxidation processes particularly attractive for the pretreatment of highly polluted OOMW containing polyphenols that are not suited for classical treatments. In this work, the biodegradability of OOMW was evaluated before and after treating the wastewater samples by the WHPCO process using a metal-organic framework (MOF) as a catalyst. This material, containing Cu and prepared with benzene-1,3,5-tricarboxylic acid (BTC), is a robust metal-organic polymer with a microporous structure that is reminiscent of the topology of zeolite frameworks.


Isoniazid and Rifampicin Produce Hepatic Fibrosis through an Oxidative Stress-Dependent Mechanism.
A combined dose of INH (50 mg) and RMP (100 mg) per kg body weight per day was administered to mice by oral gavage, 6 days a week, for 4 to 24 weeks for the assessment of liver injury, oxidative stress, and development of hepatic fibrosis, including demonstration of changes in key fibrogenesis linked pathways and mediators. Progressive increase in markers of hepatic stellate cell (HSC) activation associated with changes in matrix turnover was observed between 12 and 24 weeks of INH-RMP treatment along with the elevation of liver collagen content and significant periportal fibrosis. These were associated with concurrent apoptosis of the hepatocytes, increase in hepatic cytochrome P450 2E1 (CYP2E1), NADPH oxidase (NOX) activity, and development of hepatic oxidative stress. INH-RMP can activate HSC through generation of NOX-mediated oxidative stress, leading to the development of liver fibrosis.


Impact of Virtual Learning on Mothers With Children in Elementary School: A Psychosocial Viewpoint.
Background Measuring the impact of virtual learning (VL), specifically psychosocially, and its consequences have been poorly studied because VL has never been implemented in this way before worldwide. To our knowledge, no studies in Saudi Arabia have addressed this topic, with very limited available literature internationally. This study aims to evaluate the psychosocial effects of VL on mothers of children in elementary school and its relation to psychosocial factors. Methodology Using an anonymous online questionnaire posted on social media, a quantitative, observational, cross-sectional study was conducted from May through December 2021 in Riyadh, Kingdom of Saudi Arabia. A total of 460 mothers consented to complete the study questionnaire. The questionnaire consisted of a socioeconomic section and collected information on perceived stress via the Perceived Stress Scale (PSS-14). Results The overall PSS-14 score showed a moderate stress level. Our results showed that as age groups tended to rise, stress scores tended to decline. Diabetes was a significant variable contributing to high stress. Verbal abuse toward a child essentially reflects an increase in stress. Mothers with familial conflicts were more prone to high stress. Conclusions The consequences of VL on mothers and the whole family are alarming. Stress, verbal and physical abuse, and unhealthy family dynamics are strongly associated with such a way of learning. The impact of emotional and behavioral changes among this group of individuals needs to be further investigated.


Computer-aided meiotic maturation assay (CAMMA) of zebrafish (danio rerio) oocytes in vitro.
We have developed a new technique called Computer-Aided Meiotic Maturation Assay (CAMMA) for imaging large arrays of zebrafish oocytes and automatically collecting image files at regular intervals during meiotic maturation. This novel method uses a transparency scanner interfaced to a computer with macro programming that automatically scans and archives the image files. Images are stacked and analyzed with ImageJ to quantify changes in optical density characteristic of zebrafish oocyte maturation. Major advantages of CAMMA include (1) ability to image very large arrays of oocytes and follow individual cells over time, (2) simultaneously image many treatment groups, (3) digitized images may be stacked, animated, and analyzed in programs such as ImageJ, NIH-Image, or ScionImage, and (4) CAMMA system is inexpensive, costing less than most microscopes used in traditional assays. We have used CAMMA to determine the dose response and time course of oocyte maturation induced by 17alpha-hydroxyprogesterone (HP). Maximal decrease in optical density occurs around 5 hr after 0.1 micro g/ml HP (28.5 degrees C), approximately 3 hr after germinal vesicle migration (GVM) and dissolution (GVD). In addition to changes in optical density, GVD is accompanied by streaming of ooplasm to the animal pole to form a blastodisc. These dynamic changes are readily visualized by animating image stacks from CAMMA; thus, CAMMA provides a valuable source of time-lapse movies for those studying zebrafish oocyte maturation. The oocyte clearing documented by CAMMA is correlated to changes in size distribution of major yolk proteins upon SDS-PAGE, and, this in turn, is related to increased cyclin B(1) protein.


Roles of Triton X-100 in NADPH-diaphorase histochemistry.
Triton X-100 is widely but not universally used in NADPH-diaphorase histochemical staining. We investigated its effect on the staining and examined nitroblue diformazan (NBF) production under the influence of Triton X-100. Exposure of opossum esophagus, intestine, and colon tissues to Triton X-100 before staining enhanced staining of nerve cells and fibers and suppressed staining of non-neural structures. Long exposures and high concentrations nearly abolished the staining of non-neural structures and decreased the staining of nerves. The use of an incubation medium containing Triton X-100 achieved the best staining of nerve cells and fibers. Addition of Triton X-100 to the incubation medium changed its color from yellow to purple; in the presence of tissues, this color change occurred much more quickly. Spectral analysis showed that Triton X-100 increases the rate of NBF formation in the presence of tissue supernatant. Triton X-100 increases it less in the absence of tissue supernatant. Therefore, Triton X-100 improves the histochemical staining, probably by catalyzing the activity of NADPH-diaphorase, by keeping the extracellular NBF in solution and thus suppressing the staining of non-neural structures, and by increasing the permeability of cell membranes.


Body shape throughout life and correlations with IGFs and GH.
Both insulin-like growth factors (IGF) and body size have been linked to premenopausal breast cancer risk. However, observational studies of IGF have not been consistent, and they suggest that perhaps earlier levels of IGF might be more strongly related to breast cancer than those measured at mid-age. We therefore sought to explore associations between several measures of body size throughout life and IGF levels in premenopausal women. We examined cross-sectional associations of birth weight, body shape (or somatotype) at ages 5 and 10, body mass index (BMI) at age 18 and adulthood, bra cup size at age 20, adult waist circumference and waist-to-hip ratio (WHR), and attained height with plasma levels of IGF-I, IGF binding protein 3 (IGFBP-3), IGFBP-1, and GH. Participants were 592 healthy premenopausal women aged 34-52 from the Nurses' Health Study II. Using multiple linear regression, we computed least-square mean hormone levels across the categories of early life anthropometric factors. We observed consistent and strong inverse associations between body shape at various stages in life and IGF levels. Somatotype at ages 5 and 10 was inversely associated with IGF-I (P for difference, < 0.01) and positively with IGFBP-3 measured later in adulthood. Further, comparing women with a BMI > or = 25 kg/m(2) at age 18 vs < 19 kg/m(2), similar associations were observed for IGF-I (P for trend, 0.005) and IGFBP-3 (P for trend, 0.01), which were even stronger for BMI at blood collection (BMI< 20 versus BMI > or = 30, mean IGF-I 254 ng/ml, 95% CI, 239-271 vs 208 ng/ml, 95% CI, 195-222). Both waist circumference and WHR were strongly and inversely related to IGFBP-1 levels (top versus bottom quartile of waist circumference: 14.5 vs 40.0 ng/ml, P for trend 0.0005; WHR: 18.3 vs 39.4 ng/ml, P for trend 0.002), with similar results for bra cup size at age 20 although they did not reach statistical significance. There was no association between height and IGF or GH levels. Birth weight, on the other hand, was weakly positively associated with both IGF-I and IGFBP-1 levels, and inversely with GH. Our results suggest that childhood and adult body size may affect premenopausal breast cancer risk differently than birth weight, through associations with IGF and GH levels.


Earlier Age at Type 2 Diabetes Diagnosis Is Associated With Increased Genetic Risk of Cardiovascular Disease.
We investigated genetic risk of cardiovascular disease (CVD) by age at type 2 diabetes (T2D) diagnosis. We compared incident CVD events by age at T2D diagnosis using UK Biobank (N = 12,321) and the Seoul National University Hospital (SNUH) cohort (N = 1,165). Genetic risk was quantified using polygenic risk score (PRS). Individuals with earlier T2D diagnosis had higher CVD risk. In UK Biobank, the effect size of coronary artery disease (CAD) PRS on incident CAD was largest in individuals diagnosed with T2D at ages 30-39 years (hazard ratio 2.25; 95% CI 1.56-3.26) and decreased as age at diagnosis increased: ages 40-49 (1.51; 1.30-1.75), 50-59 (1.36; 1.24-1.50), and 60-69 years (1.30; 1.14-1.48) (Pinteraction = 0.0031). A similar trend was observed in the SNUH cohort. This increased genetic risk associated with earlier T2D diagnosis was largely mitigated by a healthy lifestyle. Individuals with an earlier T2D diagnosis have a higher genetic risk of CAD, and this information could be used to tailor lifestyle interventions.


The diagnosis of stress fractures in athletes.
Eighteen patients with shin pain that was clinically considered to be caused by a stress fracture of the tibia or fibula underwent radiological, thermographic, and scintigraphic studies and a test of ultrasound-induced pain. When initially seen, 15 had stress fractures confirmed by scintigraphy. Of these, 12 had abnormal thermograms, eight had positive test results for ultrasound-induced pain, and seven had abnormal radiographs. Thermography used alone seemed to be a safe, rapid means of diagnosis for stress fractures in the tibia or fibula and was not found to be related to symptom duration. In the radiologically normal group of stress fractures, four (50%) had positive test results for ultrasound stress tests and normal thermograms. The combination of these two tests should provide an early method of detecting stress fractures in the tibia and fibula, thereby avoiding scintiscans in some athletes.


Moringa oleifera Ameliorates Histomorphological Changes Associated with Cuprizone Neurotoxicity in the Hippocampal Cornu ammonis (CA) 3 Region.
Cuprizone-induced neurotoxicity has severally been used to study demyelinating diseases like multiple sclerosis(MS), adversely affecting both the white and grey matters of the brain. Lesions have been observed in different regions ofthe brain including, corpus callosum, neocortex and the hippocampal formation. The current study explored the role ofMoringa oleifera leaf extract in restoring the resultant histomorphological changes in cuprizone-induced hippocampaldamage in Wistar rats. Twenty adult female Wistar rats with average weight of 163.74 ± 3.59 g were grouped into A: Control,administered with 1 ml of normal saline, B: received 0.4% cuprizone diet, C: received 1.875 mg/ml/day of Moringa extract,and D: received a combination of cuprizone and Moringa in similar doses. Administration was oral for 5 weeks. The weightsof animals were assessed during treatment, and at the termination of experiment, the rats were euthanized and the brainswere fixed in 4% paraformaldehyde. The tissue was processed for histological and histochemical examinations using theHaematoxylin and Eosin stain and cresyl fast violet stain to assess the general microarchitecture and neuronal cellsrespectively of hippocampal cornu ammonis (CA) 3 region. The body weight of cuprizone-treated rats was reduced and thiswas ameliorated significantly in animals that were co-administered with Moringa. Similarly, there were histologicalalterations in the CA3 region of the hippocampus with the presence of pyknotic pyramidal cells organized in clusters andCA3 cells with degenerative changes, but administration of Moringa led to a better organised and fairly intact histologicalappearance. Pharmaceutical development of Moringa oleifera into appropriate therapeutic formulations could offer somerelief to patients of demyelinating conditions that have clinical features of neurological deficits.


Prevalence of Hepatitis B Surface Antigen in Pregnant Women in Beheshti Hospital of Kashan, Isfahan.
The transmission of hepatitis B virus (HBV) is parenteral, sexual and prenatal. Prevention of vertical transmission of HBV is extremely important, because HBV infection in early life usually results in a chronic carrier state. There has been so much debate about hepatitis B surface antigen (HBsAg) screening in pregnant women. The aim of this study was to determine the prevalence of HBsAg+ among pregnant women referred to Beheshti hospital in Kashan in 2012. This descriptive study was carried out on 768 pregnant women, hospitalized in Beheshti Hospital of Kashan in 2012. After obtaining consent forms, the questionnaires including demographic and HBV infection-associated risk factors were filled through interview and then 5 mL blood was taken from each patient and HBsAg was examined by the enzyme-linked immunosorbent assay (ELISA) method. These data were analyzed by statistical package for the social science (SPSS) software. A total of 12 (1.56%) out of 768 pregnant women were HBsAg+. The mean age of HBsAg+ cases was 24.5 ± 4 years. Most of the HBsAg+ cases (66.6%) were uneducated; 17.7% of the pregnant women were not Iranian, of which 7.4% were HBsAg+. There was no high-risk job, recent dentistry interruption or skin tattoo among the HBsAg+ cases. In this study, 1.56% of pregnant women were HBsAg+, which was higher than the previous studies. This increasing prevalence may be due to the increase of non-Iranians' migrations to Iran. Control of migration and screening and vaccination of these groups should be considered by health policy makers.


Epidermal healing in burns: autologous keratinocyte transplantation as a standard procedure: update and perspective.
Treatment of burned patients is a tricky clinical problem not only because of the extent of the physiologic abnormalities but also because of the limited area of normal skin available. Literature indexed in the National Center (PubMed) has been reviewed using combinations of key words (burns, children, skin graft, tissue engineering, and keratinocyte grafts). Articles investigating the association between burns and graft therapeutic modalities have been considered. Further literature has been obtained by analysis of references listed in reviewed articles. Severe burns are conventionally treated with split-thickness skin autografts. However, there are usually not enough skin donor sites. For years, the question of how covering the wound surface became one of the major challenges in clinical research area and several procedures were proposed. The microskin graft is one of the oldest methods to cover extensive burns. This technique of skin expansion is efficient, but results remain inconsistent. An alternative is to graft cultured human epidermal keratinocytes. However, because of several complications and labor-intensive process of preparing grafts, the initial optimism for cultured epithelial autograft has gradually declined. In an effort to solve these drawbacks, isolated epithelial cells from selecting donor site were introduced in skin transplantation. Cell suspensions transplanted directly to the wound is an attractive process, removing the need for attachment to a membrane before transfer and avoiding one potential source of inefficiency. Choosing an optimal donor site containing cells with high proliferative capacity is essential for graft success in burns.


A new highly efficient three-component domino Heck-Diels-Alder reaction with bicyclopropylidene: rapid access to spiro[2.5]oct-4-ene derivatives.
Bicyclopropylidene (1) was found to surpass even methyl acrylate (17 a) in its rate of undergoing carbopalladation with aryl- or alkenylpalladium species, leading to substituted allylidenecyclopropanes 5, 7 and 10, mostly in high yields (37-78 %). These dienes and cross-conjugated trienes react in a Diels-Alder mode with dienophiles to give spiro[2.5]octenes 18 a-Ph, 18 b-Ph and 18 a-Vin, respectively, in good yields (89, 69 and 65 %). The overall transformation can be achieved as a one-pot three-component reaction with a variety of dienophiles to furnish the domino Heck-Diels-Alder products 18 regioselectively in most cases in good to very high yields (49-100 %). The reaction of 1 with iodobenzene (2-Ph) and 17 a gave 18 a-Ph in virtually quantitative yield-also on a gram scale-using only 1 mol % of catalyst, and even bromobenzene (22) gave 18 a-Ph in 59 % yield. Bicyclopropylidene (1), in the presence of palladium acetate/triphenylphosphane underwent rearrangement to allylidenecyclopropane (5-H), which in turn dimerized (73 %) in the absence of other reaction partners, or could be trapped by diethyl fumarate (17 c) to give the Diels-Alder adduct 18 c-H in 45 % yield. The coupling of oligoiodobenzenes with 1 and subsequent cycloaddition could be extended to a multicomponent reaction. In this way, 1,4-diiodobenzene (37), 1 and an alkyl acrylate gave the products 38 of a twofold Heck-Diels-Alder reaction in up to 87 % yield, 1,3,5-triiodobenzene (39) reacted in up to 72 % yield and ultimately 1,2,4,5-tetraiodobenzene (41) gave the fourfold domino Heck-Diels-Alder product 42 in 47 % isolated yield, in a single operation in which 12 new carbon-carbon bonds were formed.


Robot-assisted radical prostatectomy in low- and high-risk prostate cancer patients.
To evaluate the benefit of robot-assisted radical prostatectomy (RARP) in the low-risk prostate cancer (PCa) patients suitable for active surveillance and in the high-risk PCa patients who would be considered for alternative treatments such as radiotherapy (RT) and androgen deprivation therapy (ADT) instead of radical prostatectomy. Of 548 patients, who underwent RARP, 298 PCa patients (258 low-risk and 40 high-risk) with a mean of 3.6 years follow-up, were included into this study. Oncological outcomes were compared separately in low- and high-risk PCa patients. The pathologic Gleason scores were ≥7 in 73 (28%), and 68 (26%) patients had a pathologic stage of T3, 29 (11%) patients had a positive surgical margin (PSM), and 20 (7%) patients had biochemical recurrence (BCR) in the first year follow-up in the low-risk group. Of 258 low-risk PCa patients, a total of 93 (36%) patients had not either BCR, pathologic Gleason score ≥7, or ≥pT3 disease with PSM. In the high-risk group, the pathologic stage was pT2 in 14 (35%) patients and 29 (72%) patients had no biochemical recurrence in the follow-up of these high-risk PCa patients. Of 40 high-risk PCa patients, in a total of 25 (62.5%) patients ≥pT3b disease, BCR, pT3a disease with PSM were not detected. Approximately two thirds of high-risk PCa patients benefit from RARP without additional RT or ADT. Besides, more than one third of low-risk PCa patients who fit active surveillance criteria would have unfavorable results.


Blood protein repulsion after peptide entrapment in pendant polyethylene oxide layers.
A number of sufficiently small peptides have been shown to integrate into polyethylene oxide (PEO) brush layers in accordance with their amphiphilicity and ordered structure. Those results have suggested that responsive drug delivery systems based on peptide-loaded PEO layers can be controlled by modulation of solution conditions and peptide amphiphilicity. However, the presence of entrapped peptide may compromise the protein repulsive character of the PEO layer, and in this way reduce the viability of a medical device coating based on such an approach. Nisin is a cationic, amphiphilic, and antimicrobial peptide that has been shown to integrate into PEO brush layers. In this work, the preferential location of fibrinogen at PEO-coated, nisin-loaded layers was investigated in nisin-fibrinogen sequential adsorption experiments using detection of fluorescein isothiocyanate labeled fibrinogen, detection of changes in zeta potential, and measurement of adsorption and elution kinetics by optical waveguide lightmode spectroscopy. Results from each technique indicate that the presence of entrapped nisin does not affect fibrinogen interaction with the PEO layer. In addition, entrapment of blood solutes within PEO layers contacted with 25% equine plasma in phosphate-buffered saline was reduced by the prior entrapment of nisin within the layer.


Perceived appraisals by others, self-esteem, and anxiety.
Questionnaire data from 595 male and female college students were used to test four hypotheses regarding interpersonal sources of anxiety--i.e., that high anxiety occurs as a function of (a) low subjective public-esteem (perceived negative appraisals of self by others); (b) low self-esteem; (c) discrepancies where subjective public-esteem is more negative than self-esteem; and (d) absolute discrepancies between subjective public-esteem and self-esteem, regardless of evaluative direction. The results suggested that level of self-esteem and absolute discrepancies between subjective public-esteem and self-esteem are important and relatively independent factors in anxiety.


The evaluation of a clinical thermometer for measuring developer temperature in automatic film processors.
In medical imaging, the temperature of the developer solution in the film processor affects film speed (radiation dose), film contrast, and film base plus fog. The National Council on Radiation Protection and Measurement (NCRP) Report 99 on Quality Assurance, and the American College of Radiology (ACR) Mammography Quality Control Manual for Radiologic Technologists, indicate that the developer temperature should be within +/- 0.5 degree F (+/- 0.3 degree C) of that recommended by the manufacturer for the specific film/developer combination being used. The accuracy and repeatability of the thermometer is most important. This paper describes the requirements of a thermometer for measuring the temperature of the developer solution and suggests an inexpensive but accurate device for doing so.


Transient leukemia in newborns with Down syndrome.
Children with Down syndrome (DS) have a 10- to 20-fold increased risk of developing leukemia, particularly acute megakaryocytic leukemia. Newborns with DS or trisomy 21 mosaicism may exhibit a particularly unique form of leukemia that historically has been associated with a high rate of spontaneous remission. This transient leukemia (TL) has been shown to be a clonal proliferation of blast cells exhibiting megakaryocytic features. Its true incidence remains to be determined. At presentation, many infants are clinically well with only an incidental finding of abnormal blood counts and circulating blasts in the peripheral blood. However, in approximately 20% of cases, the disease is severe and life-threatening, manifesting as hydrops faetalis, multiple effusions, and liver or multi-organ system failure resulting in death. Of those children who enter a spontaneous remission, 13-33% have been found to develop subsequent acute megakaryoblastic leukemia, usually within the first 3 years of life, which if left untreated is fatal. This unique TL of the DS newborn has been the subject of recent clinical cooperative group trials as well as many biological and genetic research efforts. We summarize here the known clinical, biological, and cytogenetic features of TL associated with DS.


Descending projections from the nucleus accumbens shell suppress activity of taste-responsive neurons in the hamster parabrachial nuclei.
The parabrachial nuclei (PbN), the second central relay for the gustatory pathway, transfers taste information to various forebrain gustatory nuclei and to the gustatory cortex. The nucleus accumbens is one of the critical neural substrates of the reward system, and the nucleus accumbens shell region (NAcSh) is associated with feeding behavior. Taste-evoked neuronal responses of PbN neurons are modulated by descending projections from the gustatory nuclei in the forebrain. In the present study, we investigated whether taste-responsive neurons in the PbN project to the NAcSh and whether pontine gustatory neurons are subject to modulatory influence from the NAcSh in urethane-anesthetized hamsters. Extracellular single-unit activity was recorded in the PbN, and taste responses were confirmed by the delivery of 32 mM sucrose, NaCl, quinine hydrochloride, and 3.2 mM citric acid to the anterior tongue. The NAcSh was then stimulated (0.5 ms, ≤100 μA) bilaterally using concentric bipolar stimulating electrodes. A total of 98 taste neurons were recorded from the PbN. Eighteen neurons were antidromically invaded from the NAcSh, mostly the ipsilateral NAcSh (n = 16). Stimulation of the ipsilateral and contralateral NAcSh suppressed the neuronal activity of 88 and 55 neurons, respectively; 52 cells were affected bilaterally. In a subset of pontine neurons tested, electrical stimulation of the NAcSh during taste stimulation also suppressed taste-evoked neuronal firing. These results demonstrated that taste-responsive neurons in the PbN not only project to the NAcSh but also are under substantial descending inhibitory influence from the bilateral NAcSh.


Dynamic Observation of Lung Nodules on Chest CT Before Diagnosis of Early Lung Cancer.
Early recognition and diagnosis of lung cancer can help improve the prognosis of patients. However, early imaging patterns of malignant lung nodules are not fully clear. To understand the early imaging signs of malignant lung cancer nodules, the changes of the lung nodules before diagnosis were dynamically observed and analyzed. This retrospective study observed dynamic changes of lung nodules before pathological confirmation with consecutive regular chest CT examination from January 2003 to December 2018. At least 3 follow-up CT scans were performed in all cases, and the interval between each follow-up was about 1 year. The size, density, and morphological signs of the nodules were evaluated based on the CT axial image, and a reverse line chart or scatter plot with the diagnosis time as coordinate origin was constructed. A total of 55 lung nodules in 53 patients (mean age, 58.40 years ±11.43 [standard deviation]; 20 women) were accessed. The follow-up time was 5.96 ± 2.68 years. The average diameters in maximum slice of the lesion at baseline and last scan were 6.83 ± 2.92 mm and 16.65 ± 7.34 mm, respectively. According to the reverse line chart, the nodule growth curve segments within 4 years from the last scan showed an ascending shape, and those beyond 4 years showed a flat shape. There are 90.9% (50/55) GGN and 9.1% (5/55) SN when the lesion first appears, and 21.8% (12/55) GGN, 38.2% (21/55) PSN, and 40% (22/55) SN in the last scan. There are 12.7% (7/55) and 98.2% (54/55) nodules with poor morphological signs at baseline and last scan, respectively. At the time node close to the diagnosis, the growth curve showed an upward pattern; the proportion of PSN and SN rose as the main density types; and the appearance of poor morphological signs of nodules increased. When a persistent lung nodule starts to show a malignant change, a further diagnostic workup is warranted.


Idiopathic granulomatous mastitis: in search of a therapeutic paradigm.
Idiopathic granulomatous mastitis, also known as idiopathic granulomatous lobular mastitis, is a benign breast lesion that represents both a diagnostic and therapeutic dilemma. We report two cases of granulomatous mastitis recently evaluated and managed at our institution. To better understand this rare disease, we analyzed treatment outcomes in reported cases of granulomatous mastitis. One hundred sixteen cases were subsequently analyzed. Primary management strategies included observation (n = 9), steroids (n = 29), partial mastectomy (n = 75), and mastectomy (n = 3). Success rates with each treatment were observation, 56 per cent; steroids, 42 per cent; partial mastectomy, 79 per cent; and mastectomy, 100 per cent. Based on this analysis, we propose a clinically useful algorithm for both workup and management of these challenging cases.


PACS site visits: when, where, who, and how.
Used correctly, site visits will greatly facilitate the decision making process and will encourage consensus among the PACS selection team. Further, site visits are a great way to see a product in action, to learn from others mistakes and successes, and to make some great contacts for your ongoing PACS journey. Being prepared and organized will ensure a successful site visit. A detailed questionnaire is provided at the end of the article to help facilitate the process.


Design and Evaluation of a Curriculum on Intimate Partner Violence for Medical Students in an Emergency Medicine Clerkship.
Intimate partner violence (IPV) is a widespread public health issue that is relevant to all areas of medicine. Patients who suffer from IPV often contact the health care system via the emergency department, making this a particularly important but too often overlooked issue in this setting. Education on IPV varies in medical schools and emergency medicine (EM) educational programs, and evidence suggests that a barrier to assessing for IPV is a lack of adequate training of clinicians. In this study, we sought to design, implement and evaluate the efficacy of a curriculum on IPV geared towards medical students on an EM clerkship. We assembled a multi-disciplinary team of EM education faculty, a resident content expert on IPV, and social workers to design a two-part curriculum that was administered to medical students on an EM clerkship. The curriculum involved a 20-minute narrated slide presentation viewed asynchronously, followed by a 1-hour case-based discussion session. The curriculum was evaluated using a 13-item self-assessment survey on knowledge, comfort level and skill in managing victims of IPV, administered electronically before and after the curriculum. Survey results were compared pre- and post-curriculum using Wilcoxon signed-rank test. Thirty-four students completed the curriculum and 26 completed both the pre and post self-assessment surveys. A statistically significant improvement in knowledge, comfort level and skills was observed in 11 of the 13 survey elements. Based on the self-assessment survey results, this curriculum was well received and successfully increased participants' comfort, knowledge and skill level regarding assessment of patients for IPV. This is a focused and feasible curriculum that can be easily incorporated into an EM clerkship to provide effective education on a relevant but often overlooked topic.


Centralisation of services for the management of ovarian cancer: arguments against.
In 2000, the Commissioning Guidance for gynaecological cancer services relied on a subset analysis within a retrospective study to support its requirement that surgery for carcinoma of the ovary be centralised. We have reviewed the literature covering this issue, especially that published in the past 6 years. There is no evidence for an advantage for specialist gynaecological oncologists over general gynaecologists for these women; studies that suggest that one exists fail to separate patients presenting to general surgeons, whose patients are at a clear disadvantage, from those seen by gynaecologists. There is evidence for the need for appropriate surgery in women with less extensive disease where the diagnostic difficulties are greatest. We argue for investment in the diagnosis of ovarian cancer and the provision of services for its medical treatment over a prolonged period.


Causes of sudden unexpected deaths in young and middle-aged persons.
The incidence and causes of sudden and/or unexpected deaths in the 15-49-year old population were investigated. The material was collected from 1492 cases in which either a medico-legal or a medical autopsy had been carried out. The necropsy rate was 42% of all deaths. There were 77 sudden deaths in this age-group, involving 64 males (82%) and 13 females (18%). This is 2% of all deaths and 5% of autopsied cases. The incidence per 100,000 persons in 1 year was 19.3 for males and 3.1 for females. Cardiovascular illnesses were the cause of death in 83% of cases. Coronary artery disease was the most common cause, accounting for almost half of these (49.3%). The next most common vascular cause was subarachnoidal haemorrhage (10.4%). The incidence of coronary deaths per 100,000 inhabitants in 1 year was 8.7 for males and 0.7 for females. In all cases the coronary stenosis was due to atheromatosis or more advanced atherosclerosis. Severe stenosis was located in the left descending artery in 58%, and in 52% the disease was only in one vessel. Thrombosis was found in 52%. Alcoholism (5.2%) was the next most common cause after the cardiovascular diseases. Coronary disease was very rare in age-matched victims of violent death. Deaths due to infections were rare, only 3.9%. Other solitary causes of sudden death were carcinomas, epilepsy, diabetes mellitus, intestinal occlusion and atopic dermatitis via sepsis.


Intravenous insulin infusion therapy: indications, methods, and transition to subcutaneous insulin therapy.
To describe indications for intravenous (IV) insulin infusion therapy and glycemic thresholds, discuss methods and protocols, and promote use of and access to IV insulin infusion therapy for all appropriate patients in the hospital setting. Randomized, prospectively designed trials support the use of IV insulin infusion therapy for patients in the surgical intensive-care unit, including postoperative cardiac patients and patients having myocardial infarction. Among patients in the surgical intensive-care unit, reanalysis of the data suggested no threshold at which benefit occurred above the blood glucose level of 110 mg/dL. In another study, retrospective analysis of data among critically ill medical and surgical patients suggested a target blood glucose level of 145 mg/dL or less. In other populations, the threshold or ideal target blood glucose range has not been determined. Three protocols for IV insulin infusion are described that maintain blood glucose levels safely below the upper limit of their respective target ranges without substantial risk of hypoglycemia. The threshold for initiation of IV insulin infusion is 110 mg/dL for critically ill surgical patients, 140 mg/dL for other medical or surgical patients, 180 mg/dL for patients in whom subcutaneous insulin regimens fail, and 100 mg/dL for pregnant women. The blood glucose target range is 80 to 110 mg/dL for selected critically ill surgical patients, 70 to 100 mg/dL for pregnant women, and 90 to 140 mg/dL for all other patients. Hospitals should develop procedures to make IV insulin infusion therapy available to all appropriate patients.


Polypeptide growth factors in the regulation of human tumor cell proliferation.
The capacity of growth factors to activate receptors through autocrine and paracrine pathways continues to be a major focus of cancer biology research. This review of growth factors for solid tumor cells complements our summary of hematopoietic growth factors.


Rat peritoneal neutrophils selectively relax vascular smooth muscle.
A vascular relaxing factor from oyster glycogen-elicited rat peritoneal neutrophils has been shown previously to possess a pharmacologic profile similar to that described for endothelium-derived-relaxing factor. The present experiments were designed to determine the in vitro tissue and species selectivity effects of the neutrophil-derived nitric oxide. Neutrophils (1 x 10(5) to 1 x 10(8) cells/10-ml organ chamber) were added to organ chambers filled with a physiological salt solution (37 degrees C; pH 7.4; 21% O2; 100 U/ml of superoxide dismutase) containing a ring or strip of an isolated tissue contracted with an appropriate contractile agent. Neutrophils caused relaxations in all vascular tissues tested, with the dog coronary artery being the most sensitive (IC50 approximately 1 x 10(5) cells), followed by the dog femoral artery, rabbit aorta and dog saphenous vein, respectively. In the rabbit fundic strip, approximately 1 x 10(7) cells were required to induce 50% relaxation, with 1 x 10(8) cells producing less than 35% relaxation in the dog, guinea pig and rat tracheas. In contrast, nitroprusside- and cromakalim-induced relaxations in all the smooth muscle tissues tested. The response to cromakalim was similar in all tissues with nitroprusside being more active in the vascular tissues. Methylene blue (1 x 10(-5) M) abolished the neutrophil induced relaxations in the rabbit aorta and dog femoral artery but had no effect on the responses to nitroprusside or cromakalim in the rabbit aorta, dog femoral artery or guinea pig trachea. Neutrophils, nitroprusside and cromakalim had limited effects on the spontaneously beating guinea pig right atria.(ABSTRACT TRUNCATED AT 250 WORDS)


[Gastro-hemorrhagic Escherichia coli].
Groups of Escherichia coli enteropathogen are described, with special attention to Escherichia coli enterohaemorragic. Some serotypes of Escherichia coli verocitotoxin-producing are able to produce haemorrhagic enteritis, which can develop a complication with hemolityc uraemic syndrome. This complication is most frequent in children and has a high mortality rate. The transmission takes place via food and its capacity to cause epidemic outbreaks together with the seriousness of the complications caused by enteritys make this microorganism of great importance to Public Health. The epidemiology of this microorganism in Spain is reviewed.


Infectious RNA derived by transcription from cloned cDNA copies of the genomic RNA of an insect virus.
RNA transcripts of cloned cDNA of the genomic RNAs of BBV (black beetle virus) are infectious to cultured cells of Drosophila melanogaster. Individual transcripts had approximately 10% of the infectivity of the corresponding authentic virion RNA. Progeny virus resulting from transcript infection was phenotypically indistinguishable from the progenitor virus used to generate the original cDNA forms as judged by sucrose density gradient sedimentation, specific infectivity, plaque morphology, and serology. Although the transcript RNAs used to produce this virus had 20 nonviral bases headed by a capping group at their 5' termini, these 20 bases were absent in the progeny viral RNAs. The cDNA forms, and therefore the resulting transcript RNAs, should be readily modifiable by the techniques of recombinant DNA technology both for viral studies and for the insertion of foreign genes into the viral genome and thus into the host cytoplasm.


Recent advances in acoustical microscopy.
One cannot be involved in research in universities, government establishments and industry for 35 years without becoming aware of a number of misconceptions about pure science, applied science, engineering and technology in the mind of the public and also in the very places where research is carried out. There is confusion about the aims of research and development. There is uncertainty about the proper roles of universities, research establishments and industry. There is the question whether science is intrinsically good or not. The author illuminates some of these issues by relating milestones in the development of microscopy--optical as well as electron--and gives a snapshot picture of the recent work at Stanford University on the acoustic microscope as a felicitous instance of physics applied to the ever-present desire of mankind: to explore the unknown and to understand nature. Experiments with a mechanically scanning type of acoustic microscope have shown that a resolution limited only by diffraction can be attained and using a sonic frequency of 1-2 GHz, objects of less than 1 mum diameter can in principle be resolved. Various biological tissues have been explored and it appears that the acoustical images contain information substantially different from that obtained optically or electron-optically. Images have also been obtained using the harmonic radiation generated within the object and this mode of operation promises to open up yet another dimension of information. When, in due course, the full power, and the limitations, of the acoustic microscope are appreciated, its use may well lead to advances in science and technology comparable to those brought about by the introduction of the electron microscope.


Dental prophylaxis decreases the risk of esophageal cancer in males; a nationwide population-based study in Taiwan.
Periodontal disease (PD) is one of the most common chronic inflammatory diseases. Esophageal cancer (EC) is also a common cause of death due to cancer among males. Systemic inflammatory processes have been shown to increase the risk of cancer. We conducted a retrospective cohort study to investigate the association between PD and EC. A total of 718,409 subjects were recruited from the Taiwan National Health Insurance Research Database (NHIRD) and followed from January 1, 2000 to December 31, 2010. Of these, 519,831 subjects were diagnosed with PD and were grouped according to the most advanced treatment they received: dental prophylaxis, intensive treatment, or no treatment. The IRs of EC were compared among groups. A total of 682 patients developed EC, resulting in an overall IR of 0.11 case-number per 1000 person-years (‰/y). The dental prophylaxis group had a significantly lower IR of EC (0.06‰/y) than other groups (p<0.001). Multivariable Cox regression analysis further revealed that male subjects [hazard ratio (HR) = 10.04, 95% confidence interval (CI) = 7.58-13.30], as well as a history of esophageal ulcers (HR = 7.10, 95% CI = 5.03-10.01), alcohol abuse (HR = 5.46, 95% CI = 2.26-13.18), or esophageal reflux (HR = 1.86, 95% CI = 1.02-3.52), were factors associated with a higher risk of EC. And the dental prophylaxis group showed a significantly lower risk for EC (HR = 0.53, 95% CI = 0.44-0.65). Further subgroup analysis showed that the dental prophylaxis group among males had a significant lower risk (HR = 0.54, 95% CI = 0.44-0.66) for EC, while that of the females did not has statistically significant difference. For this cohort, subjects received dental prophylaxis reduced the risk of EC compared to all PD and no PD groups among males.


A standardized database management of middle ear surgery in Korea.
The classification and hearing result reporting system of middle ear surgery provide a set of standard that otologic surgeons should comply with when they investigate the efficacy of procedures or report the post-operative results of middle ear surgery. Keeping up with this system will, in turn, facilitate and activate the evidence-based clinical research they would ask for. The aims of the project were to establish the standardized classification nomenclature, to propose a guideline for the post-operative result reporting system, and to develop a database management program for middle ear surgery. Nine otologic surgeons from seven university hospitals in Korea carried out a field survey on the nation-wide status of middle ear surgery and its records, and also collected the information regarding international classification and result reporting system from 2001 through 2004. To make a consensus, it also underwent a process of public audit and, a questionnaire investigation, as well. The classification of surgery consisted of four kinds of procedures of mastoidectomy, tympanoplasty, extraneous procedures, and concurrent procedures. Post-operative hearing result reporting consisted of basic requirement and reporting guidelines of hearing success. The basic requirements stated minimum follow up duration, and computing formulae of pure tone average (PTA) and post-operative air bone gap (ABG). The reporting guidelines included criteria of hearing success (Post-operative ABG <or= 20 dB, hearing gain >or=15 dB, or hearing level <or=30 dB), post-operative ABG grading of excellent, good, no or poor improvement, and comparisons of hearing improvement among the groups. Next, a database management program was developed using the standardized classification and result reporting system. Structure of database is composed of 144 fields including patient information/preoperative findings (45 fields), operative findings (36 fields), operative procedures (29 fields), and post-operative follow up (23 fields).


A new split-flow injector for preparative liquid chromatography columns. Annular injection system.
The packing of large-diameter columns for liquid chromatography is still difficult and numerous publications have reported results from tests which prove the packing is heterogeneous. The slurry is more compact in the wall region and this reduces the flow of the mobile phase, leading to distortion of the sample zone in the column and generation of peak tailing. A new type of injection system for the head of the column has been developed which divides the flow of the solvent from the pump into two parts. One, without sample, is directed to a crown injector, close to the wall. By adjusting the ratio of this flow to that of the bulk flow it is possible to increase the speed of the mobile phase in this part of the stationary phase and reduce distortion of the sample zone. The other part of the solvent carries the sample to the stationary phase through a distributor. The results demonstrate the benefits of this annular injection system, which include increased efficiency and improved column stability.


[Glycogen metabolism of neuronal systems of the spinal cord in experimental ischemia].
The authors carried out histochemical determinations of the glycogen level and the activity of some enzymes controlling carbohydrate metabolism (glycogen transferase and phosphorylase, succinate dehydrogenase) in the lumbar segments of the spinal cord of 40 animals (cats) with circulatory ischemia caused by aorta ligation. The examinations were performed at different periods of time after the ischemia induction under conditions of carbohydrate load. In the course of the pathological process development because of the ischemia (within a period ranging from 6 hours to 26 days) considerable variations of the glycogen-synthetizing capacities of the spinal cord nervous elements were revealed. These variations were of a periodic character. The number of glycogen-containing cells was maximal within a period ranging from the 2nd to the 10th day: this correlated with the highest enzymatic activity in this period. The glycogen content in a cell and the degree of the latter's damage were found to be in an inverse relationship. It is shown that different resistance of the nervous elements to hypoxia is determined to a great measure by their capacity to synthetize and deposit glycogen. Thus, the glycogen metabolism, being a specific compensatory-adaptive mechanism of the nervous tissue, is, thereby, a material basis of its vital activity.


Shape transformation of {hk0}-faceted Pt nanocrystals from a tetrahexahedron into a truncated ditetragonal prism.
Shape transformation of Pt nanocrystals from a {730}-bounded tetrahexahedron into a {310}-bounded truncated ditetragonal prism was achieved using the electrochemical square-wave potential method. The transformation process and mechanism were revealed. This study provides new insight into the nanocrystal growth habit.


Disentangling electronic and vibronic coherences in two-dimensional echo spectra.
The prevalence of long-lasting oscillatory signals in two-dimensional (2D) echo spectroscopy of light-harvesting complexes has led to a search for possible mechanisms. We investigate how two causes of oscillatory signals are intertwined: (i) electronic coherences supporting delocalized wavelike motion and (ii) narrow bands in the vibronic spectral density. To disentangle the vibronic and electronic contributions, we introduce a time-windowed Fourier transform of the signal amplitude. We find that 2D spectra can be dominated by excitations of pathways which are absent in excitonic energy transport. This leads to an underestimation of the lifetime of electronic coherences by 2D spectra.


Secondary analysis of a James Lind Alliance priority setting partnership to facilitate knowledge translation in degenerative cervical myelopathy (DCM): insights from AO Spine RECODE-DCM.
To explore whether a James Lind Alliance Priority Setting Partnership could provide insights on knowledge translation within the field of degenerative cervical myelopathy (DCM). Secondary analysis of a James Lind Alliance Priority Setting Partnership process for DCM. DCM stake holders, including spinal surgeons, people with myelopathy and other healthcare professionals, were surveyed internationally. Research suggestions submitted by stakeholders but considered answered were identified. Sampling characteristics of respondents were compared with the overall cohort to identify subgroups underserved by current knowledge translation. The survey was completed by 423 individuals from 68 different countries. A total of 22% of participants submitted research suggestions that were considered 'answered'. There was a significant difference between responses from different stakeholder groups (p<0.005). Spinal surgeons were the group which was most likely to submit an 'answered' research question. Respondents from South America were also most likely to submit 'answered' questions, when compared with other regions. However, there was no significant difference between responses from different stakeholder regions (p=0.4). Knowledge translation challenges exist within DCM. This practical approach to measuring knowledge translation may offer a more responsive assessment to guide interventions, complementing existing metrics.


Treatment preparation in the context of system coordination serves inmates well.
A large percentage of jail inmates suffer from substance abuse problems; however, providing treatment in jail is difficult. Multnomah County's In Jail Intervention Program (IJIP) demonstrated an effective alternative. Finigan, Barron, and Carey (In press) and Barron and Finigan (1999) demonstrated that inmates with substance use problems, especially women, participating in IJIP experienced fewer rearrests and reincarcerations. To address the question of what led to these outcomes, quantitative data were abstracted from program, jail, and state administrative databases and were supplemented by face-to-face interviews with key informants, including program participants and former participants. In addition to their substance abuse problems, IJIP participants were chronic offenders who were more likely to be diagnosed with mental health problems. Results suggest that treatment preparation together with coordination of jail release and entry to treatment increased numbers enrolling in treatment and helped former inmates engage in treatment more quickly. Quantitative data suggest that the longer inmates stayed in IJIP, the more likely was completion of community treatment.


[Controlled trial of intravenous lyophilized indomethacin in the treatment of persistent ductus arteriosus in premature infants].
As a result of randomized assignment, 24 premature infants with symptomatic patent ductus arteriosus (PDA) were either treated by 0,2 mg I.V. indomethacin just after diagnosis (12) or left untreated for 48 hours (12). Clinical, radiological, and biological data before trial were remarkably similar. In the 12 "treated" infants, the DA closed within 4 to 26 hours of the first dose in 8 cases. In all 12 "non-treated" infants, PDA persisted for at least 48 h, then 10 infants were treated ad libitum by I.V. (5) or oral (5) indomethacin. Three deaths (late) did not appear to be associated with either PDA or treatment. Two surgical closures were required (1 in each group). Four spontaneous closures occurred after more or less delay: 2 in the 2 never treated infants, and 2 after a double failure of I.V. or oral indomethacin. Treatment (even when unsuccessful) was usually followed by some water retention and blood dilution, sometimes of striking magnitude but always transient. To date, I.V. indomethacin can be given earlier than orally and offers slightly better chances for closure of PDA, thereby reducing the needs for surgical closure which should be reserved for badly tolerated failures of pharmacologic closure.


Circulating buttock cells in non-Hodgkin's lymphoma.
Leukemic B cells with a characteristically sharp nuclear cleft seemingly dividing the nucleus into two or more parts have been entitled "buttock cells" and are subject of this study. These cells were found in leukemic non-Hodgkin's lymphomas (NHL) and usually have been related to follicular center cell lymphomas. However, buttock cells also closely resemble cells present in intermediate lymphocytic lymphoma (ILL) and mantle zone cells of reactive lymphoid tissues. Ultrastructurally, it became apparent that the separate nuclear lobes of buttock cells were connected by chromatin bridges. Immunophenotypically, circulating buttock cells had a variable phenotype, which may indicate either a follicle center or mantle zone origin. The use of CD5 and FMC7 monoclonal antibodies might be of discriminative help. These leukemic NHL have to be differentiated from classical chronic lymphocytic leukemia (CLL) with help of cytomorphology and immunophenotyping, since the former usually have a worse prognosis and generally will require a different treatment.