Comparison of the Luminex Respiratory Virus Panel fast assay with in-house real-time PCR for respiratory viral infection diagnosis.
The Luminex xTAG Respiratory Virus Panel (RVP) assay has been shown to offer improved diagnostic sensitivity over traditional viral culture methods and to have a sensitivity comparable to those of individual real-time nucleic acid tests for respiratory viruses. The objective of this retrospective study was to test a new, streamlined version of this assay, the RVP Fast assay, which requires considerably less run time and operator involvement. The study compared the performance of the RVP Fast assay with those of viral culture, a direct fluorescent assay (DFA), and a panel of single and multiplex real-time PCRs in the testing of 286 respiratory specimens submitted to the Edinburgh Specialist Virology Centre for routine diagnosis of viral infection between December 2007 and February 2009. At least one respiratory viral infection was detected in 13.6% of specimens by culture and DFA combined, in 49.7% by real-time PCR, and in 46.2% by the RVP Fast assay. The sensitivity and specificity of the RVP Fast assay compared to the results of real-time PCR as the gold standard were 78.8% and 99.6%, respectively. Real-time PCR-positive specimens missed by the RVP Fast assay generally had low viral loads or were positive for adenovirus. Additionally, a small number of specimens were positive by the RVP Fast assay but were not detected by real-time PCR. For some viral targets, only a small number of positive results were found in our sample set using either method; therefore, the sensitivity of detection of the RVP Fast assay for individual targets could be investigated further with a greater number of virus-positive specimens.


Anti IL-17 in psoriasis.
Introduction: Psoriasis is a chronic, immune-mediated disease with significant associated comorbidities. Its pathogenesis is likely multifactorial, however, the interleukin-23/T helper 17 pathway has been identified as a critical axis in its pathogenesis. Interleukin-17A is the primary effector of this pathway and overexpression of IL-17A results in epidermal hyperplasia and an overly robust inflammatory response, resulting in the skin plaques and systemic inflammation seen in psoriasis. Targeted anti IL-17 therapies have demonstrated efficacy in the treatment of moderate-to-severe plaque psoriasis.Areas covered: A PubMed search was conducted for relevant literature. Secukinumab, ixekizumab, and brodalumab are anti IL-17 inhibitors currently approved for the treatment of moderate-to-severe plaque psoriasis. The efficacy and safety data from key phase III clinical trials are reviewed here.Expert opinion: By targeting a key mediator of the interleukin-23/T helper 17 pathway, IL-17 antagonists are an effective treatment for plaque psoriasis. It has demonstrated efficacy and a favorable safety profile in key phase III clinical trials. In addition to efficacy, IL-17 antagonists have also shown long-term maintenance of treatment response and a quick onset of action. The efficacy of IL-17 inhibitors in the treatment of moderate-to-severe psoriasis underscores the importance of the IL-23/Th17 pathway in the pathogenesis of psoriasis.


Conditions for effective allosteric feedforward and feedback in metabolic pathways.
Whether an allosteric feedback or feedforward modifier actually has an effect on the steady-state properties of a metabolic pathway depends not only on the allosteric modifier effect itself, but also on the control properties of the affected allosteric enzyme in the pathway of which it is part. Different modification mechanisms are analysed: mixed inhibition, allosteric inhibition and activation of the reversible Monod-Wyman-Changeux and reversible Hill models. In conclusion, it is shown that, whereas a modifier effect on substrate and product binding (specific effects) can be an effective negative feedback mechanism, it is much less effective as a positive feedforward mechanism. The prediction is that catalytic effects that change the apparent limiting velocity would be more effective in feedforward activation.


[Intravenously applied immunoglobulin in systemic, autoimmune and vasculitis diseases in children].
Intravenous immunoglobulin (IVIG) have been widely used in clinical practice for more than 35 years. Their specificity and diversity and their relative safety make them potent therapy in antibody deficiencies, certain infections and several autoimmune and inflammatory disorders. IVIG is a biological drug that is used routinely for idiopathic thrombocytopenic purpura, Kawasaki disease, and Guillain-Barré syndrome. Therapeutic approaches for autoimmune diseases are primarily based on suppressive measures that down regulate an over productive immune system. IVIG efficacy has been established in many clinical trials for various autoimmune diseases, vasculitis and neuroimmunological, dermatological and hematological disorders. Despite the evidence of efficacy, there are no generally accepted therapeutic guidelines, the dosage and timing of IVIG therapy, and questions of costs/benefits ratio still remain insufficiently documented and multicentric controlled clinical trials are necessary. Most available evidence for a benefit for IVIG in children comes from uncontrolled open series or case reports.


Why do females of a lekking species mate with multiple males?
In Focus: Rivers, P. R., & DuVal, E. H. (2020). Multiple paternity in a lek mating system: Females mate multiply when they choose inexperienced sires. Journal of Animal Ecology, 89, 1142-1152. In many socially monogamous species with biparental care, some females engage in extra-pair copulations, despite the apparent risk of losing male help in raising their brood. Why females mate with multiple males remains the focus of intense debate, but may be linked to constraints in social mate choice. If so, multiple mating is not expected in a lekking mating system, where females receive no resources from the male other than sperm and are free to choose the 'best' mate to sire their offspring. Rivers and DuVal (2020) report on the occurrence of multiple paternity in lekking lance-tailed manakins and test several hypotheses to explain it. Their study shows that lower-ranked males and males with less experience were more likely to share paternity. However, the process underlying this pattern remains puzzling. The authors suggest female choice related to male characteristics that change with experience as an explanation, but alternative scenarios cannot be excluded.


The Intellectual Disability Mortality Disadvantage: Diminishing With Age?
On average, adults with intellectual disability (ID) have higher mortality risk than their peers in the general population. However, the effect of age on this mortality disadvantage has received minimal attention. Using data from the 1986-2011 National Health Interview Survey-Linked Mortality Files (NHIS-LMF), discrete time hazard models were used to compare mortality risk for adults with and without ID by age and gender. Increased mortality risk was present for all adults with ID, but was most pronounced among younger age females. The mortality differential between those with and without ID diminished with increased age for both females and males. Findings support the argument that heterogeneity of frailty may explain differences in mortality risk between those with and without ID.


The systematic position of Leptorhynchoides (Kostylew, 1924) and Pseudoleptorhynchoides (Salgado-Maldonado, 1976), inferred from nuclear and mitochondrial DNA gene sequences.
The systematic relationships of acanthocephalans, including Leptorhynchoides and Pseudoleptorhynchoides that occur in freshwater and marine fishes in Neartic and Neotropical regions, are enigmatic. Leptorhynchoides (3 species) and Pseudoleptorhynchoides (1 species) are presently classified in the Rhadinorhynchidae. However, recent molecular and morphological phylogenies have challenged the monophyly of this family. Sequences of nuclear ribosomal DNA (large subunit, small subunit regions) and the mitochondrial cytochrome c oxidase subunit I gene of Leptorhynchoides thecatus and Pseudoleptorhynchoides lamothei were used in phylogenetic analyses with available sequences of 26 other acanthocephalans. Maximum parsimony and maximum likelihood analyses were identical in placing both genera in the Illiosentidae. Bootstrap analyses also indicate that placement of these genera with members of Illiosentidae is reliably supported.


In situ time-resolved fluorescence spectroscopy in the frequency domain in capillary electrochromatography.
In situ time-resolved fluorescence spectroscopy for capillary electrochromatography (CEC) is described in the frequency domain. Fluorescence decay of the solute molecules is collected directly in the packed stationary phase of the CEC capillary. The fluorescence lifetime profile of the solute molecules reveals the microenvironments they experience in the C18 chromatographic interface. A quartz flow cell and experimental optimization of the signal-to-noise ratio are described that enable the collection of high-quality decay data and subsequent calculation of fluorescence lifetime profiles of the solute molecules. The distribution of pyrene (PY), 1-pyrenemethanol (PY-MeOH), and 1-pyrenebutanol (PY-BuOH) into the C18 stationary phase and the solute-C18 phase interactions are probed, under separation conditions for CEC. All three molecules display a Gaussian distribution of lifetimes, consistent with an ensemble of heterogeneous microenvironments in the C18 stationary phase. The least polar molecule PY diffuses deeply into and interacts extensively with the C18 phase, experiencing high hydrophobicity and significant heterogeneity of microenvironments. The retention order of PY-MeOH, PY-BuOH, and PY in CEC is determined by their interactions with the stationary phase, revealed by their fluorescence lifetime distributions.


Silkworm apolipophorin protein inhibits hemolysin gene expression of Staphylococcus aureus via binding to cell surface lipoteichoic acids.
We previously reported that a silkworm hemolymph protein, apolipophorin (ApoLp), binds to the cell surface of Staphylococcus aureus and inhibits expression of the saePQRS operon encoding a two-component system, SaeRS, and hemolysin genes. In this study, we investigated the inhibitory mechanism of ApoLp on S. aureus hemolysin gene expression. ApoLp bound to lipoteichoic acids (LTA), an S. aureus cell surface component. The addition of purified LTA to liquid medium abolished the inhibitory effect of ApoLp against S. aureus hemolysin production. In an S. aureus knockdown mutant of ltaS encoding LTA synthetase, the inhibitory effects of ApoLp on saeQ expression and hemolysin production were attenuated. Furthermore, the addition of anti-LTA monoclonal antibody to liquid medium decreased the expression of S. aureus saeQ and hemolysin genes. In S. aureus strains expressing SaeS mutant proteins with a shortened extracellular domain, ApoLp did not decrease saeQ expression. These findings suggest that ApoLp binds to LTA on the S. aureus cell surface and inhibits S. aureus hemolysin gene expression via a two-component regulatory system, SaeRS.


Genetically obese (ob/ob) mice are predisposed to gastric stress ulcers.
Genetically obese (ob/ob) mice and lean littermate controls were food deprived and subsequently physically restrained at normal room temperatures. Obese mice became hypothermic and developed gastric stress ulcers. Lean mice maintained normal body temperatures and did not form gastric ulcers. Oxygen consumption was measured during food deprivation and restraint. Obese and lean mice had parallel metabolic responses, with obese animals using significantly less oxygen at all times. The predisposition to formation of gastric ulcers is a new phenotypic expression of the ob/ob genotype. The pathogenesis of this susceptibility appears to be related to a genetic disturbance in heat production.


The association between parent's health and the educational attainment of their children.
In this paper we compare the educational attainment of adults who had relatively unhealthy parents when they were adolescents to those whose parents were relatively healthy during this time of their lives. We use data from the National Longitudinal Study of Adolescent Health (n = 13,556) to show that U.S. adolescents whose parents described their health as "fair" or "poor" at Wave 1 of the study were more likely to drop out of high school compared to those whose parents reported better levels of health. We do not observe any association between parental health and the likelihood of attending college among those who graduated from high school, however we do show that completing college (among college attendees) is more likely among those whose parents reported better health when they were adolescents. This association persists despite a wide range of statistical controls including socioeconomic status of the household, the physical and mental health status of the respondent, the grade point average of the respondent, the health behaviors of parents, as well as parental time investment. These findings add an important intergenerational component to research on the relationship between socioeconomic status and health.


The relationship of pregnancy to human immunodeficiency virus disease progression.
This study was undertaken to determine the effect of pregnancy on progression of human immunodeficiency virus (HIV) disease. We compared the immunologic, clinical, and virologic courses of 953 women who had no additional pregnancy after their index pregnancy, with the courses of 329 women who had a second pregnancy subsequent to their index pregnancy. Baseline variables included use of antiretroviral therapy, and CD4 and HIV RNA values. A linear spline growth curve model was used to describe trajectories of variables. The Cox proportional hazards model was used to assess selected covariates on the time to development of clinical class C events or death. Women with repeat pregnancies were less likely to be on antiretroviral therapy at baseline and had a higher CD4% count immediately after their first delivery. The average trajectory of CD4 values in the one-pregnancy group was almost identical to the average trajectory in the repeat pregnancy group. RNA levels in the single-pregnancy group started higher but ended lower than in the second-pregnancy group, although slope differences were modest. There were no significant differences in time to class C events, although women in the repeat-pregnancy group tended to survive longer. Repeat pregnancies do not have significant effects on the course of HIV disease.


Bacillus amyloliquefaciens G1: A Potential Antagonistic Bacterium against Eel-Pathogenic Aeromonas hydrophila.
Recent studies have revealed that the use of probiotics is an alternative to control marine aeromonas. However, few probiotics are available against Aeromonas hydrophila infections in eels. In the present study, a potential antagonistic strain G1 against the eel-pathogenic A. hydrophila was isolated from sediment underlying brackish water. Its extracellular products with antibacterial activities were shown to be stable under wide range of pH, temperature, and proteinase K. It was initially identified as Bacillus amyloliquefaciens using API identification kits and confirmed to be B. amyloliquefaciens strain (GenBank accession number DQ422953) by phylogenetic analysis. In addition, it was shown to be safe for mammalians, had a wide anti-A. hydrophila spectrum, and exhibited significant effects on inhibiting the growth of the eel-pathogenic A. hydrophila both in vitro and in vivo. To the best of our knowledge, this is the first report on a promising antagonistic Bacillus amyloliquefaciens strain from brackish water sediment against eel-pathogenic A. hydrophila.


BTA copper complexes.
Cupric oxide is one of the most important additives used (a) to catalyze decomposition reactions in gas generators to obtain cooler reaction gases, (b) as burning enhancer for ammonium perchlorate-based composite propellants, and (c) as coloring agent in pyrotechnics. In this context, the reaction of Cu(2+) ions in aqueous ammonia solution with bis(tetrazolyl)amine (H(2)bta) was investigated. Depending on the reaction conditions three complexes were obtained: Cu(bta)(NH(3))(2) (1), Cu(bta)(NH(3))(2).H(2)O (2), and (NH(4))(2)Cu(bta)(2).2.5H(2)O (3). The crystal structures of 1 and 2 are discussed with respect to the coordination mode of the dianion of N,N-bis(1(2)H-tetrazol-5-yl)-amine (bta), which mediates in the case of 1 and 2 weak superexchange interactions between the adjacent magnetic transition-metal Cu(II) cations. These antiferromagnetic interactions result from 1D copper chains over an hidden azide end-to-end bridge. Interestingly, the structural arrangement of 1 completely changes in the presence of crystal-bound water. Moreover, some physicochemical properties (e.g., heat of formation, friction, and impact sensitivity, DSC) of these complexes with respect to high-energetic materials are discussed.


Tisseel utilized as hemostatic in spine surgery impacts time to drain removal and length of stay.
Although fibrin sealants (FSs) and fibrin glues (FGs) are predominantly utilized to strengthen repairs of cerebrospinal fluid (CSF) fistulas (deliberate/traumatic) during spinal surgery, they are also increasingly utilized to achieve hemostasis. Here, we investigated whether adding Tisseel (Baxter International Inc., Westlake Village, CA, USA), utilized to address increased bleeding during multilevel lumbar laminectomies with non-instrumented fusions, would reduce or equalize the time to drain removal and length of stay (LOS) without contributing to infections or prolonging time to fusion. Prospectively, 39 patients underwent multilevel laminectomies and 1-2 level non-instrumented (in situ) fusions to address stenosis/olisthesis; 22 who demonstrated increased intraoperative bleeding received Tisseel, while 17 without such bleeding did not. The 22 receiving versus 17 not receiving Tisseel, with similar clinical parameters, underwent comparable average multilevel laminectomies (4.36 and 4.25) and 1-2 level fusions (1.4 vs. 1.29 levels). As anticipated, for those receiving Tisseel, the average intraoperative estimated blood loss (EBL), total postoperative blood loss, and total perioperative transfusion requirements [red blood cells (RBC), fresh frozen plasma (FFP), platelets] were higher. However, Tisseel had the added benefit of equalizing the time to postoperative drain removal [e.g. 3.41 days (with) vs. 3.38 days (without)] and LOS [e.g. 5.86 days (with) vs. 5.82 days (without)] without increasing the infection rates (e.g. one superficial infection per group) or average times to fusion (e.g. 5.9 vs. 5.5 months). Adding Tisseel for increased bleeding during multilevel laminectomies/in situ fusions contributed to hemostasis by equalizing the average times to drain removal/LOS compared to patients without increased bleeding and not requiring Tisseel.


Stress and Coping in Youth With Spina Bifida: A Brief Longitudinal Study in a Summer Camp Setting.
It is well established that youth with chronic conditions experience elevated levels of stress; the manner in which they respond to or cope with this stress is likely to impact both health and psychosocial outcomes. The current study examined stress and coping in youth and young adults with spina bifida (SB) using the response to stress questionnaire-SB version (RSQ-SB; Connor-Smith et al., 2000). Data were collected as part of a camp-based psychosocial intervention for children (ages 7-13), adolescents (ages 14-19), and young adults (ages 20-38) with SB. Participants completed the RSQ-SB as well as questionnaires assessing demographics and condition severity. Data were collected prior to camp (T1) and 1 month (T2) after camp ended. Self-report data were collected from adolescents and young adults; parents of children and adolescents reported on their child's stress and coping. Ratios of primary control coping, secondary control coping, disengagement coping, involuntary engagement, and involuntary disengagement coping were calculated. Descriptive statistics and t-tests were utilized to describe coping and stress responses and to determine potential change over time. T-tests were also used to compare youth and parent reported coping styles with those of youth with type 1 diabetes (T1D) and sickle cell disease (SCD). Associations between demographic/disease factors and coping styles were also examined. Parent and youth report indicated that youth with SB tend to use primary control coping. Youth with SB use more primary control coping and less disengagement coping compared to youth with SCD and youth with T1D. Few significant changes in coping were found between T1 and T2. IQ and socioeconomic status were significantly associated with coping styles. Youth with SB use more primary control coping compared to other coping methods and as compared to other pediatric populations. Future studies should examine mechanisms by which primary control coping is advantageous for youth with SB. Future interventions should be more focused on promoting adaptive coping behaviors and be tailored to developmental age and access to resources.


Isolation and characterisation of the linked genes APA2 and QCR7, coding for Ap4A phosphorylase II and the 14 kDa subunit VII of the mitochondrial bc1-complex in the yeast Kluyveromyces lactis.
We report the isolation and characterization of the KlQCR7 gene encoding subunit VII of the mitochondrial bc1 complex of the yeast Kluyveromyces lactis. The coding region is 69.3% identical to its counterpart in Saccharomyces cerevisiae (ScQCR7). Like the KlQCR8 gene (Mulder et al., accompanying paper) expression of the KlQCR7 gene during growth on glucose is high and can be further induced when cells are grown on non-fermentable carbon sources. The chromosomal linkage of the APA2 and QCR7 genes is conserved between S. cerevisiae and K. lactis. The intergenic regions containing the QCR7 promoters of the two yeasts, differ significantly in length and lack overall DNA sequence similarity, but they do share a binding site for the transcription factor complex HAP2/3/4. The KlQCR7 promoter contains, in addition, a CPF1 consensus binding site which is absent from ScQCR7. Deletion of a 35 bp region containing these two sites severely lowers the mRNA expression during growth on both glucose and ethanol/glycerol, but growth rate on both carbon sources is only mildly affected. Interestingly, in respect to the KlQCR7 gene, KlCPF1 seems to act as an important transcriptional activator, thus contrasting the proposed repressor function of ScCPF1 for the ScQCR8 gene of S. cerevisiae.


Elevated calprotectin in patients with atrial fibrillation with and without heart failure.
Calprotectin is an inflammatory marker, which has been found elevated in patients suffering from cardiac conditions, e.g. myocardial infarction, unstable angina and chronic heart failure. Inflammation has further been linked to atrial fibrillation (AF). However, the association between calprotectin and AF is unknown. We aimed to compare calprotectin levels in patients suffering from AF with healthy adults. In addition, AF patients with and without heart failure were compared. Calprotectin was measured in patients undergoing elective direct current cardioversion for AF. Calprotectin was determined before, 4 hours and 3 months after cardioversion. Healthy blood donors were used to verify the reference interval for calprotectin. In total, 104 prospectively enrolled patients were included. The median serum calprotectin level for AF patients was 1.6 μg/mL before cardioversion. Calprotectin levels increased significantly 4 h (1.9 μg/mL) and 3 months (2.2 μg/mL) after cardioversion. Blood donors' median serum calprotectin (1.3 μg/mL) was significantly lower than AF patients. AF patients with heart failure had significantly higher calprotectin at baseline compared with AF patients without a history of heart failure (2.0 μg/mL vs. 1.5 μg/mL). The difference was not significant at 4 h (2.0 μg/mL vs. 1.7 μg/mL) or 3 months (2.5 μg/mL vs. 2.2 μg/mL). In conclusion, the calprotectin levels in patients with AF were significantly higher than healthy blood donors and were further increased after cardioversion. AF patients with heart failure had significantly higher levels of calprotectin than AF patients without heart failure.


Discontinuation rates of anticholinergic medications used for the treatment of lower urinary tract symptoms.
To estimate the discontinuation rates of anticholinergic medications used for the treatment of lower urinary tract symptoms in women. A large administrative database was used for this study. Women aged 18 years and older who were prescribed anticholinergic medications were included. An overall and drug-specific discontinuation rate for nine different anticholinergic medications was estimated. Covariates examined included number of prior drug classes used, number of switches performed, number of prior drug episodes, year of initiation, age, and history of smoking. The Kaplan-Meier method was used to estimate an overall discontinuation rate. A Cox multivariable regression was performed for the drug-specific analysis. There were 49,419 episodes of anticholinergic therapy available for analysis from 29,369 women. The average number of treatment episodes and number of drug classes prescribed per patient were 1.65+/-1.31 and 1.54+/-0.57, respectively. The median time for overall anticholinergic drug discontinuation was 4.76 months. The 6-month unadjusted cumulative incidence of discontinuation was 58.8% (95% confidence interval [CI] 58.4-59.3). The percentage of episodes in which women switched to another medication was 15.8% (95% CI 15.4-16.1). At 6 months, the adjusted cumulative incidence of discontinuation was as follows: oxybutynin 71% (95% CI 68.4-73.5), tolterodine tartrate 61% (59.4,64.3), extended-release oxybutynin 57% (95% CI 55.1-59.4), and extended-release tolterodine tartrate 54% (95% CI 52.3-57.7). Discontinuation rates for anticholinergic medications are high regardless of the class of medication used. II.


In vitro Effect of Harmine Alkaloid and Its N-Methyl Derivatives Against Toxoplasma gondii.
Toxoplasmosis is one of the most prevalent and neglected zoonotic global diseases caused by Toxoplasma gondii. The current pharmacological treatments show clinical limitations, and therefore, the search for new drugs is an urgent need in order to eradicate this infection. Due to their intrinsic biological activities, β-carboline (βC) alkaloids might represent a good alternative that deserves further investigations. In this context, the in vitro anti-T. gondii activity of three βCs, harmine (1), 2-methyl-harminium (2), and 9-methyl-harmine (3), was evaluated herein. Briefly, the three alkaloids exerted direct effects on the parasite invasion and/or replication capability. Replication rates of intracellular treated tachyzoites were also affected in a dose-dependent manner, at noncytotoxic concentrations for host cells. Additionally, cell cycle analysis revealed that both methyl-derivatives 2 and 3 induce parasite arrest in S/M phases. Compound 3 showed the highest irreversible parasite growth inhibition, with a half maximal inhibitory concentration (IC50) value of 1.8 ± 0.2 μM and a selectivity index (SI) of 17.2 at 4 days post infection. Due to high replication rates, tachyzoites are frequently subjected to DNA double-strand breaks (DSBs). This highly toxic lesion triggers a series of DNA damage response reactions, starting with a kinase cascade that phosphorylates a large number of substrates, including the histone H2A.X to lead the early DSB marker γH2A.X. Western blot studies showed that basal expression of γH2A.X was reduced in the presence of 3. Interestingly, the typical increase in γH2A.X levels produced by camptothecin (CPT), a drug that generates DSB, was not observed when CPT was co-administered with 3. These findings suggest that 3 might disrupt Toxoplasma DNA damage response.


Seroreactivity to Campylobacter jejuni and gangliosides in patients with Guillain-Barré syndrome.
Seroreactivities to Campylobacter jejuni or Campylobacter coli and to the gangliosides GM1 and GD1b were studied by quantitative and immunoglobulin class-specific ELISAs in 42 patients with recent onset of acute Guillain-Barré syndrome (GBS), in 39 patients with positive Campylobacter serology but no neurologic disease, and in 52 healthy blood donors. GBS patients showed positive reactivities to C. jejuni in 57%, 26%, and 2% for IgG, IgA, and IgM, respectively, while blood donors had corresponding values of 6%, 2%, and 4%. IgG, IgA, and IgM reactivities to GM1 were 48%, 78%, and 56% for GBS patients and 4%, 2%, and 4% for blood donors, respectively. Reactivities to GD1b were 77%, 51%, and 15% for the GBS group and 2%, 8%, and 8% for the blood donors, respectively. Patients with positive Campylobacter serology but no neurologic disease also had antibodies to GM1 and GD1b in over half of the cases. Increased titers to C. jejuni closely correlated with increased titers to GM1 and GD1b.


[Simplified strategy for anesthesia of pheochromocytoma].
The only curative treatment of phaeochromocytoma consists in surgical removal. This carries a high risk due to the acute release of catecholamines. General anaesthesia cannot by itself prevent haemodynamic disturbances during surgical manipulation of the tumour. Careful preparation, based on intravascular volume repletion as well as alpha-, and, if required, beta-adrenergic blockade, has been shown to reduce morbidity and mortality. However, this protocol is often cumbersome, and does not prevent totally the haemodynamic instability as a decrease in blood pressure at the start of treatment, or after removal of the tumour. Since voltage-dependent calcium channels are involved in both secretion and action of catecholamines, calcium-channel antagonists might be an interesting therapeutic alternative. In fact, short-term treatment by dihydropyridines may attenuate blood pressure variability during the preoperative period. During surgery, a dose-dependent reduction in systemic vascular resistances has been shown with intravenous nicardipine. However, dihydropyridines do not control cardiac adrenergic stimulation, which causes tachycardia or persistently increased blood pressure in spite of low or normal systemic vascular resistances. Such an acute cardiac hyperactivity, which can only be assessed by continuous haemodynamic monitoring, is electively sensitive to a beta-adrenergic blocker rather than a calcium channel antagonist with high cardiac affinity (diltiazem, verapamil). Esmolol is available for intravenous administration. It is an ultra-short acting agent, ensuring a selective dose-related cardiac beta 1-blockade. Combining esmolol with nicardipine gives control over almost all episodes of haemodynamic worsening during phaeochromocytoma resection. Preoperative medical treatment no longer aims to suppress adrenergic stimulation completely, but to prevent acute haemodynamic changes.(ABSTRACT TRUNCATED AT 250 WORDS)


Effect of single essential amino acid excess during pregnancy on dietary nitrogen utilization and fetal growth in rats.
The effect on pregnant rats of individual amino acids added excessively to the diet or intermittently administered in excess directly with a stomach tube was examined. When methionine was excessively added to the diet at a 5% level, amino acid imbalance in plasma was induced and food intake decreased remarkably to approximately one-fifth of that of control rats. However, when administered directly into the stomach, food intake remained almost normal, except for excess of methionine, tryptophan or threonine, and an adverse effect of excess amino acid was not observed. However, in the case of a decrease in food intake, various adverse effects were observed. This was especially so for the group that was administered methionine and whose food intake was far below that of the control group: decrease in maternal body weight, delayed growth of products of conception, and further, significant decrease in brain and liver cells of the fetus were observed. In addition, the changes in nitrogen balance were well correlated with the changes in bodyweight in all groups. In the methionine group, in particular, nitrogen balance was negative throughout the period because of a decrease in food intake, and utilization of dietary nitrogen was inferior. The majority of the various lesions observed with excess administration of individual amino acids were not due to a direct effect of excess amino acid but were mainly caused by the remarkable decrease in food intake.


Change in intestinal flora after treatment in children with focal epilepsy.
To study the difference in intestinal flora between children with focal epilepsy and healthy children and the change in intestinal flora after treatment in children with epilepsy. A total of 10 children with newly diagnosed focal epilepsy were recruited as the case group and were all treated with oxcarbazepine alone. Their clinical data were recorded. Fecal specimens before treatment and after 3 months of treatment were collected. Fourteen aged-matched healthy children were recruited as the control group. Total bacterial DNA was extracted from the fecal specimens for 16S rDNA sequencing and bioinformatics analysis. After 3 months of carbamazepine treatment, the seizure frequency was reduced by >50% in the case group. At the phylum level, the abundance of Actinobacteria in the case group before treatment was significantly higher than that in the control group (P<0.05), and it was reduced after treatment (P<0.05). At the genus level, the abundances of Escherichia/Shigella, Streptococcus, Collinsella, and Megamonas in the case group before treatment were significantly higher than those in the control group (P<0.05), and the abundances of these bacteria decreased significantly after treatment (P<0.05). There is a significant difference in intestinal flora between children with focal epilepsy and healthy children. Oxcarbazepine can significantly improve the symptoms and intestinal flora in children with epilepsy.


Investigation of Seepage Meter Measurements in Steady Flow and Wave Conditions.
Water exchange between surface water and groundwater can modulate or generate ecologically important fluxes of solutes across the sediment-water interface. Seepage meters can directly measure fluid flux, but mechanical resistance and surface water dynamics may lead to inaccurate measurements. Tank experiments were conducted to determine effects of mechanical resistance on measurement efficiency and occurrence of directional asymmetry that could lead to erroneous net flux measurements. Seepage meter efficiency was high (average of 93%) and consistent for inflow and outflow under steady flow conditions. Wave effects on seepage meter measurements were investigated in a wave flume. Seepage meter net flux measurements averaged 0.08 cm/h-greater than the expected net-zero flux, but significantly less than theoretical wave-driven unidirectional discharge or recharge. Calculations of unidirectional flux from pressure measurements (Darcy flux) and theory matched well for a ratio of wave length to water depth less than 5, but not when this ratio was greater. Both were higher than seepage meter measurements of unidirectional flux made with one-way valves. Discharge averaged 23% greater than recharge in both seepage meter measurements and Darcy calculations of unidirectional flux. Removal of the collection bag reduced this net discharge. The presence of a seepage meter reduced the amplitude of pressure signals at the bed and resulted in a nearly uniform pressure distribution beneath the seepage meter. These results show that seepage meters may provide accurate measurements of both discharge and recharge under steady flow conditions and illustrate the potential measurement errors associated with dynamic wave environments.


Large nuclear vacuoles in spermatozoa negatively affect pregnancy rate in IVF cycles.
Recently, motile sperm organelle morphology examination (MSOME) criteria as a new real time tool for evaluation of spermatozoa in intracytoplasmic sperm injection (ICSI) cycles has been considered. The aim was to investigate the predictive value of MSOME in in vitro fertilization (IVF) in comparison to ICSI cycles and evaluation of the association between MSOME parameters and traditional sperm parameters in both groups. This is a cross sectional prospective analysis of MSOME parameters in IVF (n=31) and ICSI cycles (n=35). MSOME parameters were also evaluated as the presence of vacuole (none, small, medium, large or mix); head size (normal, small or large); cytoplasmic droplet; head shape and acrosome normality. In sub-analysis, MSOME parameters were compared between two groups with successful or failed clinical pregnancy in each group. In IVF group, the rate of large nuclear vacuole showed significant increase in failed as compared to successful pregnancies (13.81±9.7vs7.38±4.4, respectively, p=0.045) while MSOME parameters were the same between successful and failed pregnancies in ICSI group. Moreover, a negative correlation was noticed between LNV and sperm shape normalcy. In ICSI group, a negative correlation was established between cytoplasmic droplet and sperm shape normalcy. In addition, there was a positive correlation between sperm shape normalcy and non-vacuolated spermatozoa. The high rate of large nuclear vacuoles in sperm used in IVF cycles with failed pregnancies confirms that MSOME, is a helpful tool for fine sperm morphology assessment, and its application may enhance the assisted reproduction technology success rates.


Estimation of extrinsic parameters for dynamic binocular stereo vision using unknown-sized rectangle images.
An online calibration method of extrinsic parameters for dynamic binocular stereo vision using unknown-sized rectangle images is presented herein. The two cameras can rotate freely in two-axis direction without zooming, and the cameras' intrinsic parameters and initial relative position are known in advance. Hence, only the rotation angles of the cameras, namely, the yaw angle in the horizontal direction and the pitch angle in the vertical direction, must be solved. The approximate values of the rotation angles are obtained by the Ellipse-A attitude and heading reference system in real time, and the rotation angles of each camera are solved iteratively using only a single rectangular centroid according to interimage homography. The pitch and yaw angles are eventually modified based on the property of fundamental matrix by the corresponding rectangular centroids, obtained by the left and right cameras after rotation, respectively. Computer simulations and real experiments are performed to validate the efficiency of the proposed method, and we compare calibration results with that of the scale-invariant feature transform method and Zhang's method. The quantitative results demonstrate that the root mean square (rms) of the absolute error of the attitude angles and the translation vector does not exceed 0.12° and 7.2 mm, respectively. Additionally, the rms of the relative error of the three-dimensional coordinates does not exceed 1.6%.


Plasmonic Control and Stabilization of Asymmetric Light Scattering from Ag Nanocubes on TiO2.
When plasmonic nanoparticles are placed on a highly refractive semiconductor substrate, we can expect three different effects: (i) resonance mode splitting, (ii) asymmetric light scattering based on the split modes, and (iii) site-selective nanoetching due to plasmon-induced charge separation (PICS) at the nanoparticle-semiconductor interface. Here, we develop novel photofunctional materials by taking advantage of those three effects. More specifically, we control the asymmetric scattering of Ag nanocubes on TiO2 by PICS, so as to develop materials for photodrawing of one-way visible translucent images and multicolor scattering images. The one-way visible translucent images, which are translucent scattering images visible only from the back side, are drawn by anaerobic bottom-selective etching of the Ag nanocubes. For drawing the multicolor scattering images, a scattering color of Ag nanocubes is changed from yellow to green by the anaerobic bottom-selective etching and from yellow to red by aerobic nonselective etching. We also theoretically and experimentally examined the contribution of a possible thermal effect to the nanoetching, and revealed that the contribution is negligible; Ag nanocubes on TiO2 are stable even at 473 K for 2 h in the dark, whereas the theoretically expected temperature increase under light is less than 1 K. In addition, we developed methods to stabilize the Ag nanocubes by inactivating PICS. When Ag nanocubes on TiO2 are coated with a thin polymer layer, PICS is decelerated and the stability is improved. Replacing TiO2 with diamond, which does not accept electrons from plasmonic nanoparticles, is also an effective method to stabilize the nanocubes.


Hsa_circ_001659 serves as a novel diagnostic and prognostic biomarker for colorectal cancer.
Colorectal cancer (CRC) is prevalent worldwide and novel diagnostic and prognostic biomarkers are needed to improve precision medicine. Circular RNAs (circRNAs) are currently being considered as emerging tumor biomarkers. Herein, we aimed to explore the possible clinical application of circRNAs in the early diagnosis and prognostic prediction of CRC. First, candidate circRNA was selected by integrating analysis of Gene Expression Omnibus (GEO) database using GEO2R program. ROC curve analysis demonstrated the predictive values and likelihood ratios of circ_001659 were satisfactory for the diagnosis of CRC, including patients in early-stage disease or patients with carcinoembryonic antigen (CEA)-negative status. Moreover, serum circ_001659 may be a novel biomarker in the assessment of successful treatment and remission of cancer tracking. We further investigated the oncogenic role of circ_001659. In vivo and in vitro experiments indicated that circ_001659 could promote CRC cell invasion and migration. Mechanistically, circ_001659 was localized in the nucleus, recruited the RBBP5 to Vimentin promoter and increased H3K4 trimethylation level on the Vimentin promoter region, which epigenetically activated Vimentin transcription. Our findings demonstrate that circ_001659 could be a useful serum biomarker for CRC diagnosis and prognosis. Targeting circ_001659 and its pathway may be meaningful for treating patients with CRC.


Transitional cell carcinoma of the uterine cervix. A report of six cases with clinical, histologic and cytologic findings.
Transitional cell carcinoma of the cervix (TCCC) is a rare neoplasm of recent description. The cytologic characteristics of the tumor have not been published to date. Six cases of TCCC are described, including their clinical, histologic, cytologic and immunohistochemical features. All cases presented at an advanced clinical stage; two recurred, and one metastasized. Five cases showed a papillary exophytic pattern, and one case showed an "inverted" endophytic pattern similar to that of transitional cell carcinoma of the urothelium (TCCU). The cytokeratin profile was similar to that of squamous cell carcinoma of the cervix (SCCC), positive for CK 7 and negative for CK 20. The cervical smears showed a background that was necrotic or hemorrhagic. The cells with transitional features formed cohesive groups in a multilayered fashion and had an oval or spindle shape with tapered ends. The nuclei were hyperchromatic, with coarse and medium-sized granules that frequently displayed a wrinkled membrane, nuclear grooves and rare pseudoinclusions. The nucleoli were small or absent. Others cells with cytologic characteristics of SCCC were seen in all cases. TCCC is a rare neoplasm that probably represents a subgroup of SCCC. The most frequent histologic pattern is papillary-exophytic, but it can be inverted-endophytic. In cervical smears there are cells with characteristics of regular SCCC and others resembling those of TCCU. A larger number of cases is needed to define the evolution and clinical outcome.


The acid stress response of the cyanobacterium Synechocystissp. strain PCC 6308.
The cyanobacterium Synechocystissp. strain PCC 6308 has been shown to exhibit predictable physiological responses to acid stress. Originally isolated from a Wisconsin lake, this cyanobacterium grows optimally under alkaline conditions in the laboratory. After acid stress at a pH of between 4.4 and 7.7, cells return to exponential growth following a lag phase. The organism's response to this tolerable acid stress involves cell concentration-dependent neutralization of the external medium to pH 6 or above within 5 min, maintenance of a transmembrane pH gradient, and maintenance of photosystem II efficiency. Lethal acid stress, at a pH below 4.4, results in the formation of aggregates of denatured proteins observed as granules near the cell periphery, the disruption of the transmembrane pH gradient, cell color change to blue, and damage to photosystem II.


H3K4 Methylation-Dependent Memory of Somatic Cell Identity Inhibits Reprogramming and Development of Nuclear Transfer Embryos.
Vertebrate eggs can induce the nuclear reprogramming of somatic cells to enable production of cloned animals. Nuclear reprogramming is relatively inefficient, and the development of the resultant embryos is frequently compromised, in part due to the inappropriate expression of genes previously active in the donor nucleus. Here, we identify H3K4 methylation as a major epigenetic roadblock that limits transcriptional reprogramming and efficient nuclear transfer (NT). Widespread expression of donor-cell-specific genes was observed in inappropriate cell types in NT embryos, limiting their developmental capacity. The expression of these genes in reprogrammed embryos arises from epigenetic memories of a previously active transcriptional state in donor cells that is characterized by high H3K4 methylation. Reducing H3K4 methylation had little effect on gene expression in donor cells, but it substantially improved transcriptional reprogramming and development of NT embryos. These results show that H3K4 methylation imposes a barrier to efficient nuclear reprogramming and suggest approaches for improving reprogramming strategies.


Investigation of critical polymer properties for polymer release and swelling of HPMC matrix tablets.
Four different HPMC batches were characterized to investigate properties related to critical functionality for their use in hydrophilic matrix tablets. In this study, the HPMC batches were chemically characterized and correlated to the behaviour of pure HPMC tablets. Parameters such as the molecular weight, viscosity, intrinsic viscosity and radius of gyration were kept in a rather limited range, which resulted in a weak correlation to polymer release and degree of swelling. The hydrophilic/hydrophobic character of the HPMC samples was elucidated by the degree of substitution and by the clouding behaviour, where an increased hydrophilicity increased the tablet swelling. This phenomenon was interpreted in a refined model for water transport into HPMC tablets. A five times slower polymer release and a considerably larger degree of swelling were found for one batch of HPMC tablets compared to the others, although the characterized average polymer parameters were in the same range. However, the conformation plot displayed a fraction with compact aggregates. In conclusion, the existence of aggregates in aqueous solution seems to perturb the functionality of HPMC tablets and it seems important to understand and characterize these aggregates to fully predict the polymer release and swelling of HPMC tablets.


[Diseases of the esophagus in the elderly. Deglutition disorders--intermittent thoracic pain--retrosternal burning pain].
As a contribution to the polymorbidity of geriatric patients, gastrointestinal diseases are numerically of only minor importance, occurring four to five times less frequently than diseases of the cardiovascular system. However, a number of gastrointestinal diseases are more commonly found in the elderly than in the younger patient. The symptoms of esophageal diseases include dysphagia, odynophagia, pyrosis, and intermittent chest pain. New developments in the area of drug treatment, and minimally invasive endoscopic procedures usually now permit age adaptet therapeutic management to be offered.


Chemical constituents and antifungal potential of Attalea geraensis Barb. Rodr. (Arecaceae) palm leaves, a species native to the Cerrado of Brazil.
Fungal diseases, especially those that affect the root systems of plants, caused by Rhizoctonia and Macrophomina are limiting factors for achieving high crop yields. Alternatives to controlling fungi with chemical products drive the search for new options for bioactive compounds from plants. Attalea geraensis, a palm tree from the Brazilian Cerrado, is rich in flavonoids with antifungal actions. The objective of this work is to identify the chemical classes present in the ethanolic extract of green leaves of A. geraensis and determine the antifungal potential of the extract against isolates of Macrophomina phaseolina (Tassi) Goid. and Rhizoctonia solani JG Kühn. Phytochemical prospection, flavonoid dereplication, and antifungal activity were carried out of the ethanolic extract of the green leaves of A. geraensis harvested in the Cerrado area of Brazil. Steroids, triterpenes, saponins, and anthraquinones are described here for the first time for the leaves of A. geraensis. The flavonoids quercetin, isorhamnetin, 3,7-dimethylquercetin, quercetin 3-galactoside, 5,7-dihydroxy-2-(4-hydroxy-3-methoxyphenyl)-3-{[3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy}-4H-chromen-4-one, rhamnazin 3-galactoside, keioside, and rhamnazin 3-rutinoside were identified. Of these, only quercetin and isorhamnetin had already been identified in the leaves of A. geraensis. The results show a fungistatic potential for the species. The diversity of flavonoids present in the leaves of A. geraensis may be the result of a synergistic action between fungus and plant or there could be an antagonistic effect between flavonoids and the other identified chemical classes.


Comparison of the efficacy of topical N-acetyl-cysteine and a topical steroid-antibiotic combination therapy in the treatment of meibomian gland dysfunction.
This study aimed to compare the efficacy of topical N-acetyl-cysteine (NAC) with a topical steroid-antibiotic combination, betamethasone-sulfacetamide sodium therapy in patients with meibomian gland dysfunction (MGD). Twenty patients with MGD were prospectively randomized and assigned into 2 groups. The patients were instructed to use either NAC 5% or a topical steroid-antibiotic combination, betamethasone 0.1%-sulfacetamide sodium 10%, topically 4 times a day for a month. All patients were instructed to apply lid hygiene once daily. One month of topical therapy provided statistically significant improvements in fluorescein break-up time and Schirmer scores as compared with the initial study visit in both groups (P≤0.001). Significant improvements for the symptoms of ocular burning, itching, and intermittent filmy or blurred vision were noted in both groups at 1 month as compared with 1 day (P<0.05). Considering these rates, there was no significant difference between the groups (P>0.05). None of the patients developed an allergic reaction to the medications, and intraocular pressure measurements were within the normal limits in both groups. When used in conjunction with eyelid hygiene, topical administration of NAC appears to be as effective as a topical steroid-antibiotic combination, betamethasone-sulfacetamide sodium therapy in patients with MGD.


Effects of drugs which depress the peripheral nervous system on the reticular activating system of the cat.
Some drugs with depressant properties on the peripheral nervous system have been examined for depressant effects on the reticular activating system of the cat. Large doses of nicotine, or of the anti-nicotinic agents dihydro-beta-erythroidine and mecamylamine, failed to depress the reticular activating system; non-quaternary drugs with anti-muscarinic properties, such as atropine and hyoscine, depressed it readily. Hyoscine was the most potent depressant tested and its effects could be antagonized by physostigmine. In contradistinction, depression of the reticular activating system with pentobarbitone was not antagonized by physostigmine. Lignocaine was a weak depressant of the reticular activating system, and the possibility that this might be due to a central anti-muscarinic action is discussed. Adrenergic blocking drugs, such as dihydroergotamine, phenoxybenzamine or choline 2:6-xylyl ether, did not appear to depress the reticular activating system: the significance of this is discussed. It was concluded that the hypothetical cholinergic transmitter, acting somewhere within the reticular activating system, displayed actions analogous to the muscarinic, and not to the nicotinic, actions of acetylcholine.


The Systematic Impact of Personal Characteristics on Entrepreneurial Intentions of Engineering Students.
The impact of personal characteristics on entrepreneurial intention is a classic topic in the field of entrepreneurship research. Previous research mostly used simple linear models, leading to a gap in the study on the interrelationship among personal characteristics and their systematic influence on entrepreneurial intention. This study investigates the interrelationship among the four specific entrepreneurial characteristics (i.e., need for achievement, locus of control, risk-taking propensity, and creativity) and their systematic influence on the entrepreneurial intention of engineering students. The research data is from 210 engineering students via a survey. Logistic regression and path analysis were used for data analysis. The findings suggest that creativity and risk-taking directly influence entrepreneurial intention while the need for achievement and the locus of control influence it indirectly. Implications for entrepreneurship education are finally discussed.


Surgical-orthodontic management of bilateral multiple impactions in non-syndromic patient.
Several surgical and orthodontic treatment options are available to disimpact the impacted teeth. But the closed eruption technique has the best long-term prognosis. The tooth is surgically exposed, an attachment is bonded to it, flap is resutured over it and an orthodontic extrusive force is delivered to bring the tooth into occlusion. This case report presents a case with multiple impacted teeth in which no syndrome or systemic conditions were detected. A 20-year-old female patient reported for orthodontic treatment with chief complaint of multiple unerupted permanent teeth and retained primary teeth. Radiographic examination revealed impacted 14, 15, 24, 25, 33, 34, 43 and 44. Surgical exposure of the impacted teeth was done after extraction of retained primary teeth. Forced eruption of these teeth was done by applying traction with closed eruption technique. After careful treatment planning followed by guided eruption of impacted teeth, patient finished with a significantly improved functional and aesthetic result.


Alveolar process anabolic activity in C3H/HeJ and C57BL/6J inbred mice.
The purpose of this study was to characterize bone activity of the alveolar process in C3H/HeJ (C3H) and C57BL/6J (B6) inbred mice. Based on observations in other animal species, we hypothesized that the bone-formation rate/bone surface (BFR/BS) is greater in the alveolar process compared to the body of the mandible and that the bone anabolic activity is greater in the alveolar process of the mandible than in the maxilla. We also examined the alveolar process of C3H and B6 mice for the presence of secondary osteons. Jaws from 17-week-old C3H and B6 female mice (N = 15/group) were harvested. Histomorphometric parameters were evaluated in sections from the alveolar process, each of which included at least one molar root. In C3H and B6 mice, BFR/BS was not significantly different (P >0.05) between the alveolar process and the body of the mandible. In C3H mice, BFR/BS was significantly greater (P = 0.05) in the mandible compared to the maxilla. BFR/bone volume (BV) was not significantly different (P >0.05) between C3H mandible and maxilla. In the B6 inbred mouse, BFR/BS and BFR/bone volume (BV) were not significantly different (P >0.05) between jaws. After analyzing 165 bone sections, we identified 25 secondary osteons. The surface anabolic activity was not different between the body and the alveolar process of the mandible. The surface activity was greater in the C3H mandible than in the maxilla. Although secondary osteonal bone remodeling existed in the C3H and B6 alveolar bone, this process was not a consistent finding.


Glutamatergic and GABAergic Receptor Modulation Present Unique Electrophysiological Fingerprints in a Concentration-Dependent and Region-Specific Manner.
Brain function depends on complex circuit interactions between excitatory and inhibitory neurons embedded in local and long-range networks. Systemic GABAA-receptor (GABAAR) or NMDA-receptor (NMDAR) modulation alters the excitatory-inhibitory balance (EIB), measurable with electroencephalography (EEG). However, EEG signatures are complex in localization and spectral composition. We developed and applied analytical tools to investigate the effects of two EIB modulators, MK801 (NMDAR antagonist) and diazepam (GABAAR modulator), on periodic and aperiodic EEG features in freely-moving male Sprague Dawley rats. We investigated how, across three brain regions, EEG features are correlated with EIB modulation. We found that the periodic component was composed of seven frequency bands that presented region-dependent and compound-dependent changes. The aperiodic component was also different between compounds and brain regions. Importantly, the parametrization into periodic and aperiodic components unveiled correlations between quantitative EEG and plasma concentrations of pharmacological compounds. MK-801 exposures were positively correlated with the slope of the aperiodic component. Concerning the periodic component, MK-801 exposures correlated negatively with the peak frequency of low-γ oscillations but positively with those of high-γ and high-frequency oscillations (HFOs). As for the power, θ and low-γ oscillations correlated negatively with MK-801, whereas mid-γ correlated positively. Diazepam correlated negatively with the knee of the aperiodic component, positively to β and negatively to low-γ oscillatory power, and positively to the modal frequency of θ, low-γ, mid-γ, and high-γ. In conclusion, correlations between exposures and pharmacodynamic effects can be better-understood thanks to the parametrization of EEG into periodic and aperiodic components. Such parametrization could be key in functional biomarker discovery.


Percutaneous fenestrated endovascular aortic graft treatment of aortocaval fistula with aortic pseudoaneurysms secondary to penetrating trauma.
Aortocaval fistula (ACF) is a lethal complication of aortic aneurysmal disease. Traditional treatment of ACF involves open surgical approaches to fistula ligation and repair of the great vessels, with a high mortality secondary to bleeding and cardiac compromise. We present the case of a 28-year-old man with a chronic ACF with concomitant aortic pseudoaneurysms secondary to penetrating trauma treated with a fenestrated endograft.


Cutaneous melanoma associated with naevi prevalence: A 15-year cross-sectional retrospective study.
Melanoma may develop de novo or naevus associated (NAM). The exact prevalence and features of NAM are not fully elucidated. A 15-year cross-sectional retrospective study was performed of all melanoma cases diagnosed and treated at the skin cancer centre of the University of Naples Federico II from September 2003 to August 2018. Data collected included patient's age, gender, melanoma anatomic site, Breslow thickness, and histolopathology including melanoma-associated lesion characteristics. A total of 1986 melanomas were included in the study. Based on histolopathogical examination, NAM represented 8.4% (n = 167) with de novo melanoma representing the great majority of the melanomas (91.6%). NAM was significantly more common in younger age compared to de novo melamoma (mean age 48 ± 14.9 vs 54.3 ± 15.9 years, P < 0.001), and more frequently involved the trunk (62.3% vs 51.8% P = 0.01). Mean Breslow thickness was significantly higher in de novo melanoma compared to NAM (0.97 ± 1.48 mm vs 0.83 ± 0.95, P < 0.001). However, in situ melanoma was more commonly observed in de novo melanoma (n = 640, 35.2%) rather than NAM (n = 41, 24.5%; P < 0.01) whereas invasive melanoma represented 75.5% (n = 126) of NAM and 64.8% (n = 1179) of de novo melanoma, P < 0.01. NAM represent a small percentage of melanomas (8.4%) compared to de novo melanoma. NAM appeared to be significantly more common in younger age and more frequently involved the trunk, being associated with an overall better prognosis, due to a lower mean Breslow thickness respect to de novo melanoma.


Calculated microdosimetric characteristics of 125I and 103Pd brachytherapy seeds at different depths in water.
Both (125)I and (103)Pd sources have been widely used in the permanent prostate implant. An important consideration for the choice of brachytherapy sources is the relative biological effectiveness (RBE) for the source/seed used in the implantation. As RBE is closely related to the microdosimetric parameter, it is desirable to calculate the dose mean lineal energies for both (125)I and (103)Pd at various radial distances to the seed surface. Monte Carlo simulation was performed for photons emitted from (125)I and (103)Pd. Energy depositions from photons and all their secondary electrons were tracked. Dose distributions of lineal energy, d(y), were calculated for spheres of 1 microm in diameter and at various radial distances to the seed surface. From the dose distribution of lineal energy, the dose mean lineal energy, y(D), was derived. The results showed that the radiation qualities are constant in the distance range from 0.5 to 5 cm. In this distance range, the quality factor, relative to gamma rays from (60)Co, is 2.2 for (125)I and 2.5 for (103)Pd.


Controversies and Advances in Gestational Diabetes-An Update in the Era of Continuous Glucose Monitoring.
Diabetes in pregnancy, both preexisting type 1 or type 2 and gestational diabetes, is a highly prevalent condition, which has a great impact on maternal and fetal health, with short and long-term implications. Gestational Diabetes Mellitus (GDM) is a condition triggered by metabolic adaptation, which occurs during the second half of pregnancy. There is still a lot of controversy about GDM, from classification and diagnosis to treatment. Recently, there have been some advances in the field as well as recommendations from international societies, such as how to distinguish previous diabetes, even if first recognized during pregnancy, and newer diagnostic criteria, based on pregnancy outcomes, instead of maternal risk of future diabetes. These new recommendations will lead to a higher prevalence of GDM, and important issues are yet to be resolved, such as the cost-utility of this increase in diagnoses as well as the determinants for poor outcomes. The aim of this review is to discuss the advances in diagnosis and classification of GDM, as well as their implications in the field, the issue of hyperglycemia in early pregnancy and the role of hemoglobin A1c (HbA1c) during pregnancy. We have looked into the determinants of the poor outcomes predicted by the diagnosis by way of oral glucose tolerance tests, highlighting the relevance of continuous glucose monitoring tools, as well as other possible pathogenetic factors related to poor pregnancy outcomes.


Cultural Competency Education in Academic Dental Institutions in Australia and New Zealand: A Survey Study.
The aim of this study was to assess the status of cultural competency education in Australian and New Zealand dental, dental hygiene, and oral health therapy programs. The study sought to explore the extent to which cultural competence is included in these programs' curricula, building on similar studies conducted in the United States and thus contributing to the international body of knowledge on this topic. A 12-item instrument was designed with questions in four areas (demographics, content of cultural competency education, organization of overall program curriculum, and educational methods used to teach cultural competence) and was sent to all Australian and New Zealand dental, dental hygiene, and oral health therapy educational programs. Of the total 24 programs, 15 responded for a response rate of 62.5%. The results showed that lectures were the most frequent teaching method used in cultural competency education; however, the variation in responses indicated inconsistencies across study participants, as discussions and self-directed learning also featured prominently in the responses. The majority of respondents reported that cultural competence was not taught as a specific course but rather integrated into their programs' existing curricula. The variations in methods may indicate the need for a standardized framework for cultural competency education in these countries. In addition, the notion of cultural competency education in academic dental institutions demands additional evaluation, and further research is required to develop a solid evidence base on which to develop cultural competency education, specifically regarding content, most effective pedagogies, and assessment of student preparedness.


Positional requirements for anionic charge for ileal absorption of bile salt analogues.
Previous structure-activity studies of the ileal bile salt cotransport system have suggested the idea that a coulombic interaction occurs between the negative charge of the bile salt and a cationic site on the carrier. Evidence included observations that modified bile salts with uncharged, cationic, or zwitterionic side chains were poorly transported. They did interact with this system as evidenced by their abilities to inhibit transport. Another prerequisite for coulombic interaction is positional (side-chain) specificity for the anionic grouping. [14C]chenodeoxycholyl-N-ethanolamide-O-sulfate and the 3 alpha-sulfate ester of chenodeoxycholyl-N-ethanolamide were tested for their in vivo absorption from the jejunums and ileums of anesthetized guinea pigs. Active ileal transport was estimated by subtracting jejunal absorption (passive) from ileal absorption (active and passive). Translocation of the anionic SO4(-) radical from the side chain to the 3 alpha position of the steroid decreased active ileal absorption by 95%, demonstrating a positional requirement for the anionic group for optimal transport.


A modified free gracilis flap in the rat.
We present in this paper the use of a combined neurovascularized flap of gracilis muscle and inguinal skin in the rat with the femoral vessels and obturator nerve serving as the pedicles. The epigastric, saphenous, and muscular branch vessels arising from the femoral vessels were preserved, and a portion of adductor magnus muscle was included in the flap to protect the delicate muscle vessels at their origins. The inguinal skin and muscle flap both had independent blood supplies, thus separate assessment of muscle and skin rejection was possible in the single transplanted "packet." The muscle flap with the reconnected motor nerve regained contractile ability upon nerve stimulation within 30 days after the iso-transplantation. The results suggest that the modified gracilis myocutaneous flap provides an ideal model for transplantation research.


Dissimilar mispair-recognition spectra of Arabidopsis DNA-mismatch-repair proteins MSH2*MSH6 (MutSalpha) and MSH2*MSH7 (MutSgamma).
Besides orthologs of other eukaryotic mismatch-repair (MMR) proteins, plants encode MSH7, a paralog of MSH6. The Arabidopsis thaliana recognition heterodimers AtMSH2*MSH6 (AtMutSalpha) and AtMSH2*MSH3 (AtMutSbeta) were previously found to bind the same subsets of mismatches as their counterparts in other eukaryotes--respectively, base-base mismatches and single extra nucleotides, loopouts of extra nucleotides (one or more) only--but AtMSH2*MSH7 (AtMutSgamma) bound well only to a G/T mismatch. To test hypotheses that MSH7 might be specialized for G/T, or for base mismatches in 5-methylcytosine contexts, we compared binding of AtMutSalpha and AtMutSgamma to a series of mismatched DNA oligoduplexes, relative to their (roughly similar) binding to G/T DNA. AtMutSgamma bound G/G, G/A, A/A and especially C/A mispairs as well or better than G/T, in contrast to MutSalpha, for which G/T was clearly the best base mismatch. The presence of 5-methylcytosine adjacent to or in a mispair generally lowered binding by both heterodimers, with no systematic difference between the two. Alignment of protein sequences reveals the absence in MSH7 of the clamp domains that in bacterial MutS proteins--and by inference MSH6 proteins--non-specifically bind the backbone of mismatched DNA, raising new questions as to how clamp domains enhance mismatch recognition. Plants must rigorously suppress mutation during mitotic division of meristematic cells that eventually give rise to gametes and may also use MMR proteins to antagonize homeologous recombination. The MSH6 versus MSH7 divergence may reflect specializations for particular mismatches and/or sequence contexts, so as to increase both DNA-replication and meiotic-recombination fidelity, or dedication of MSH6 to the former and MSH7 to the latter, consistent with genetic evidence from wheat.


Supplemental feeding of deer reduces tick abundance in Mississippi, U.S.A.
Prior research on baiting and feeding of wildlife found changes in habitat and the concentration of wildlife on a local scale (e.g., hundreds of meters). Since changes in habitat and host density affect ticks, feeding wildlife may lead to changes in tick and tick-borne disease ecology. We quantified the effect of feeding deer on ticks and tick-borne diseases at 79 pairs of sites with and without deer feeders during May-August of 2019 and 2020. We captured 0.4 fewer adult (p<0.05) and 1.2 fewer nymphal ticks (p=0.01) at feeder sites. This effect intensified over time with one fewer tick trapped at old feeders (≥5 years) compared to new feeders (<5 years, p<0.05). Greater daily wildlife visitation rates (p<0.001) may have allowed questing ticks to encounter hosts more readily. Most collected ticks were Amblyomma americanum (92.8%), a vector of Ehrlichia and Rickettsia pathogens, though prevalence of these pathogens did not differ (p>0.13) at a local scale. Supplemental deer feeding appears to influence ticks, possibly due to decreased tick habitat and increased wildlife use around feeders. Our findings indicate feeding does not lead to increased prevalence of Ehrlichia or Rickettsia bacteria within A. americanum locally.


Neuropathology of developmental abnormalities.
Varieties of neuropathological disorders are caused by a perturbation of normal developmental processes, resulting from insults by heterogeneous etiologic factors. These factors trigger the sequence of molecular, biochemical, and morphologic alterations of the brain, resulting morphologically and/or functionally abnormal brain. The resulting brain contains basic components of the normal brain but is assembled in an abnormal way. The developmental stage when the insults occur appears to largely dictate the outcome of the pathological processes. Depending on the developmental stage involved, the morphology of the brain may be grossly abnormal or is apparently normal but functionally abnormal. The brain development progresses in an orderly fashion and can be divided into several major developmental stages; the neurulation (neural tube formation), ventral induction (formation of prosencephalon), neuroepithelial cell proliferation and migration, neuroglial differentiation and establishment of neuronal circuits. The perturbation of these developmental stages results in uniquely specific pathological outcome, regardless of the etiologic factors/agents. In this review, I will briefly discuss the normal pattern of brain development and neuropathology of the representative disorders resulting from the deviation of normal developmental processes in the individual developmental stage.


The effect of dose and route of administration of R-cloprostenol on the parturient response of sows.
The aims of the present study were to further examine the efficacy of different doses and routes of R-cloprostenol administration on the parturition response in sows. Fifty crossbred multiparous sows (Landrace x Yorkshire) with an average parity number of 4.7 +/- 2.4 were allocated to induce farrowing by one of the following treatments: Group I (control, n = 10) injection with normal saline 2 ml administered intramuscularly (i.m.); Group II (n = 10) injection with 75 microg of R-cloprostenol administered i.m. (at 7 AM); Group III (n = 10) injection with 75 microg of R-cloprostenol (at 7 AM) together with 10 IU of oxytocin (24 h after injection of R-cloprostenol) administered i.m.; Group IV (n = 10) injection with 37.5 microg of R-cloprostenol (at 7 AM) administered into perivulva region; Group V (n = 10) injection with 37.5 microg of R-cloprostenol (at 7 AM) administered into perivulva region together with 10 IU of oxytocin (24 h after injection of R-cloprostenol) administered i.m. The following parameters: pre-farrowing maternal behaviour, restless behaviour, R-cloprostenol or oxytocin injection to farrowing interval, expulsion intervals, duration of farrowing, total number of piglets born, litter birthweight, umbilical cord morphology and the degree of meconium staining were record. There were no significant differences among groups for the pre-farrowing maternal behaviours. In all the sows, the restless behaviour was not observed. There were no significant effect of oxytocin administration (10 IU, i.m.) on the percentage of umbilical cord morphology and the degree of meconium staining in different groups. There were no significant effect of route and dose of administration on the number of total piglet born, piglet born alive, stillbirth, mummy and litter birthweight. No significant effects of the different groups were found on the R-cloprostenol and oxytocin injection to farrowing interval, expulsion interval and farrowing duration. In conclusion, the present results demonstrated that a half dose (37.5 microg) of R-cloprostenol administered into the perivulva region was effective for inducing farrowing as the full recommended dose (75 microg) administered into the neck region (i.m.) and with no restless behaviour.


Original insight into continuous cardiac output monitoring: "TruCCOMS". Correlation with other methods.
Of all technical devices used for continuous or intermittent monitoring of cardiac output, in our clinical practice during the last year, we tested a new system, the true continuoas cardiac output monitoring system (TruCCOMS), for the continuous real time measurement of cardiac output. The purpose of this study was to compare the accuracy, reliability and promptness of TruCCOMS with other systems and methods of cardiac output (CO) measurement such as pulsion continuous cardiac output (PiCCO) and end diastolic Area (EDA) determination by trans-esophageal-echocar-diography (TEE), keeping as gold standard for CO measurement the thermodilution method by Swan-Ganz. Sixteen male patients, aged 50 to 60 years, with ejection fraction (FE) >50%, EUROSCORE=1, who underwent CABG surgery with circulation extra corporeal (CEC), were analysed with all methods mentioned above. The measurements were obtained at different phases: pre-CEC; post-CEC; and Intensive Care Unit (ICU). In the ICU setting, 5 patients classified as under-filled with a pulmonary capillary wedge pressure (PCWP) =/<8 mmHg were filled until a PCWP gs;13 mmHg in order to evaluate the promptness of the various systems to detect the new condition. The statistical analysis of data obtained in our survey, clearly demonstrates that TruCCOMS is at least equivalent to average thermo-dilution cardiac output (AvTDCO), with the advantage of being continuous, real time and, furthermore, with no need for physician intervention/interference. In our experience the TruCCOMS seems to be an ideal method for continuous cardiac output (CCO) monitoring compared with the other bedside systems challenged.


Cost effectiveness of intrathecal drug therapy in management of chronic nonmalignant pain.
To evaluate the cost effectiveness of intrathecal drug therapy (IDT) compared with conventional medical management (CMM) for patients with refractory chronic noncancer pain. A probabilistic Markov model was developed to evaluate the cost effectiveness of IDT versus CMM from the perspective of a Canadian provincial Ministry of Health using data from our pain clinic. The model followed costs and outcomes in 6-month cycles. Health effects were expressed as quality-adjusted life years (QALYs) gained. Resources use included drugs, physician visits, laboratory tests, scans, and hospitalizations. Unit costs were gathered from public sources and were expressed in 2011 Canadian dollars. Costs and effects were evaluated over a time horizon of 10 years and discounted at 5% per annum after the first year. Cost effectiveness was identified by deterministic and probabilistic sensitivity analyses (50,000 Monte Carlo iterations). Over 10 years, total costs were $61,442 for IDT and $48,408 for CMM. Thus, the incremental effectiveness of IDT was 1.1508 QALYs at an incremental cost of $13,034, resulting in an incremental cost-effectiveness ratio of $11,326/QALY gained. The probability of IDT providing a cost-effective alternative to CMM was 50% and 84% at a willingness-to-pay threshold of $14,200 and $20,000/QALY, respectively. The results were most sensitive to the cost of CMM, the probability of reaching an optimal health state with dual-drug IDT, and the effectiveness of CMM therapy. Sensitivity analyses showed that results were robust to plausible variations in model costs and effectiveness inputs. IDT is cost effective compared with CMM in the management of chronic noncancer pain.


Psychological morbidity and HIV in Kenya.
This paper describes a cross-sectional study with subjects and raters blind to HIV status to assess psychiatric morbidity associated with HIV in a sample of working adults in Western Kenya. Subjects were recruited from an occupational health clinic for statutory annual health checks of workers in the food industry. Psychiatric interviews and neuropsychological tests were conducted. Of 230 subjects, 34% were HIV positive. Women had a higher rate than men, and those who worked as bargirls or were divorced, widowed or separated were particularly at risk. There were no substantial differences in psychiatric morbidity or neuropsychological functioning between the HIV-positive and HIV-negative subjects.


Cladding-like waveguide structure in Nd:YAG crystal fabricated by multiple ion irradiation for enhanced waveguide lasing.
We report on a cladding-like waveguide structure in Nd:YAG crystal fabricated by the multiple carbon ion beam irradiation. After the designed multiple irradiation process, the cladding-like waveguide with triple refractive-index layers were constructed in the region near the surface of the crystal. With such a structure, the waveguiding core was compressed and refractive index profile was modified, resulting in a higher light intensity than that of the single ion-beam-irradiated monolayer waveguide. The waveguide lasing at wavelength of 1064 nm was achieved with enhanced performance in the cladding-like structures with both planar and ridge configurations by the optical pump at 810 nm.


Taguchi's technique: an effective method for improving X-ray medical radiographic screen performance.
Taguchi's technique is a helpful tool to achieve experimental optimization of a large number of decision variables with a small number of off-line experiments. The technique appears to be an ideal tool for improving the performance of X-ray medical radiographic screens under a noise source. Currently there are very many guides available for improving the efficiency of X-ray medical radiographic screens. These guides can be refined using a second-stage parameter optimization. based on Taguchi's technique, selecting the optimum levels of controllable X-ray radiographic screen factors. A real example of the proposed technique is presented giving certain performance criteria. The present research proposes the reinforcement of X-ray radiography by Taguchi's technique as a novel hardware mechanism.


Comprehensive chemical characterization of PM2.5 in the large East Mediterranean-Middle East city of Beirut, Lebanon.
The chemical composition of PM2.5 at two sites in Lebanon, a country in the East Mediterranean - Middle East region, is investigated in the spring and summer seasons. The average PM2.5 concentrations were of (29 ± 16) µg/m3 for Beirut urban site and (32 ± 14) µg/m3 for Beirut suburban site. This study showed that the geographic location of the East Mediterranean region, such as its proximity to the Mediterranean Sea and the dust storm intrusion are a significant contributor to the high PM levels from natural sources, which cannot be mitigated, rendering the PM2.5 WHO annual Air Quality guideline unattainable due to high natural background, which also applies to the entire Middle East region. Turkey and Eastern Europe are the dominant origin of air masses throughout our sampling days, suggesting the long-range transport as an important potential contributor to the high observed concentrations of V, Ni, and sulfate in this region most probably in other East Mediterranean countries than Lebanon too. Main local sources determined through the chemical speciation including organics are road transport, resuspension of dust and diesel private generators. A health risk assessment of airborne metals was performed and the carcinogenic risk for all the metals exceeded by 42 (adults) and 14 (children) times the acceptable risk level (10-6) at both sites. Vanadium was the predominant carcinogenic metal, emphasizing the need to replace energy production with cleaner energy on a regional level and highlighting the severe impact of air pollution on the health of inhabitants in this region's main cities.


Hyperprogressive Disease Caused by PD-1 Inhibitors for the Treatment of Pan-Cancer.
Nowadays, PD-1/PD-L1 inhibitors are widely used to treat various malignant tumors. However, during the immunotherapy in a few patients, a flare-up of tumor growth occurred. This new pattern of progression is called hyperprogressive disease (HPD). Patients and Methods. The retrospective study included 377 patients with various malignant tumors treated with PD-1 inhibitors (nivolumab or pembrolizumab) in the Chinese PLA General Hospital from January 2015 to January 2019. Clinicopathologic variables, tumor growth rate (TGR), and treatment outcomes were analyzed in patients with pan-cancer treated with PD-1 inhibitors. HPD was defined as the difference of TGR before and during immunotherapy exceeding 50%. In 38 of 377 patients (10.08%), HPD occurred after treatment with PD-1 inhibitors. Patients with HPD had lower overall survival (OS) than those without HPD (median OS, 3.6months (95% CI, 3.0-4.2) vs. 7.3 months (95% CI, 5.9-8.7); P < 0.01). Factors related to HPD include more than 2 metastatic sites, ECOG performance status ≥ 2, hepatic metastases, and lactate dehydrogenase level greater than normal upper limit. KRAS status was significantly associated with HPD in patients with colorectal cancer. In the exploratory predictors' analysis, the rapid increase of characteristic tumor markers (such as CEA in colorectal cancer, CA199 in pancreatic cancer and cholangiocarcinoma) within one month was found to be associated with the occurrence of HPD. HPD was developed with different rates in a variety of malignant tumor patients treated with PD-1 inhibitors and related to some clinicopathological features and poor prognosis. Tumor markers, especially CA199, might be served as early predictors of HPD.


Virtual Reality As a Training Tool to Treat Physical Inactivity in Children.
Lack of adequate physical activity in children is an epidemic that can result in obesity and other poor health outcomes across the lifespan. Physical activity interventions focused on motor skill competence continue to be developed, but some interventions, such as neuromuscular training (NMT), may be limited in how early they can be implemented due to dependence on the child's level of cognitive and perceptual-motor development. Early implementation of motor-rich activities that support motor skill development in children is critical for the development of healthy levels of physical activity that carry through into adulthood. Virtual reality (VR) training may be beneficial in this regard. VR training, when grounded in an information-based theory of perceptual-motor behavior that modifies the visual information in the virtual world, can promote early development of motor skills in youth akin to more natural, real-world development as opposed to strictly formalized training. This approach can be tailored to the individual child and training scenarios can increase in complexity as the child develops. Ultimately, training in VR may help serve as a precursor to "real-world" NMT, and once the child reaches the appropriate training age can also augment more complex NMT regimens performed outside of the virtual environment.


A pressure-balanced radio-telemetry system for the measurement of intracranial pressure. A preliminary design report.
A fully implantable radio-telemetric differential intracranial pressure sensor is described with a zero-point calibration that can be confirmed repeatedly. Intracranial pressure (ICP) is measured with the device by the principle of applying a known external pressure to the scalp above the sensor and simultaneously detecting by radio-telemetry the zero-point of the sensor corresponding to a balance of pressures across it. The radio-telemetry is implemented by a resonant circuit in the sensor of which the resonant radiofrequency is detected outside the body. The sensor is passive, has built-in barametric compensation, negligible permeability of temperature drift, no calibration ambiguities, and fast dynamic response. The implanted sensor has been used successfully for short-term as well as long-term ICP monitoring. It has been implemented primarily for intermittent ICP measurements, but also adapted to continuous recording. Preliminary clinical experience with the system indicates that it is effective, safe, and simple to operate.


Thermal dynamics of few-layer-graphene seals.
Being of atomic thickness, graphene is the thinnest imaginable membrane. While graphene's basal plane is highly impermeable at the molecular level, the impermeability is, in practice, compromised by leakage pathways located at the graphene-substrate interface. Here, we provide a kinetic analysis of such interface-mediated leakage by probing gas trapped in graphene-sealed SiO2 cavities versus time and temperature using electron energy loss spectroscopy. The results show that gas leakage exhibits an Arrhenius-type temperature dependency with apparent activation energies between 0.2 and 0.7 eV. Surprisingly, the interface leak rate can be improved by several orders of magnitude by thermal processing, which alters the kinetic parameters of the temperature dependency. The present study thus provides fundamental insight into the leakage mechanism while simultaneously demonstrating thermal processing as a generic approach for tightening graphene-based-seals with applications within chemistry and biology.


Prediction of hand-wrist maturation stages based on cervical vertebrae images using artificial intelligence.
To predict the hand-wrist maturation stages based on the cervical vertebrae (CV) images, and to analyse the accuracy of the proposed algorithms. A total of 499 pairs of hand-wrist radiographs and lateral cephalograms of 455 orthodontic patients aged 6-18 years were used for developing the prediction model for hand-wrist skeletal maturation stages. The hand-wrist radiographs and the lateral cephalograms were collected from two university hospitals and a paediatric dental clinic. After identifying the 13 anatomic landmarks of the CV, the width-height ratio, width-perpendicular height ratio and concavity ratio of the CV were used as the morphometric features of the CV. Patients' chronological age and sex were also included as input data. The ground truth data were the Fishman SMI based on the hand-wrist radiographs. Three specialists determined the ground truth SMI. An ensemble machine learning methods were used to predict the Fishman SMI. Five-fold cross-validation was performed. The mean absolute error (MAE), round MAE and root mean square error (RMSE) values were used to assess the performance of the final ensemble model. The final ensemble model consisted of eight machine learning models. The MAE, round MAE and RMSE were 0.90, 0.87 and 1.20, respectively. Prediction of hand-wrist SMI based on CV images is possible using machine learning methods. Chronological age and sex increased the prediction accuracy. An automated diagnosis of the skeletal maturation may aid as a decision-supporting tool for evaluating the optimal treatment timing for growing patients.


Transcallosal Inhibition during Motor Imagery: Analysis of a Neural Mass Model.
The EEG rhythmic activities of the somato-sensory cortex reveal event-related desynchronization (ERD) or event-related synchronization (ERS) in beta band (14-30 Hz) as subjects perform certain tasks or react to specific stimuli. Data reported for imagination of movement support the hypothesis that activation of one sensorimotor area (SMA) can be accompanied by deactivation of the other. In order to improve our understanding of beta ERD/ERS generation, two neural mass models (NMM) of a cortical column taken from Wendling et al. (2002) were interconnected to simulate the transmission of information from one cortex to the other. The results show that the excitation of one cortex leads to inhibition of the other and vice versa, enforcing the Theory of Inhibition. This behavior strongly depends on the initial working point (WP) of the neural populations (between the linear and the upper saturation region of a sigmoidal function) and on how the cortical activation or deactivation can move the WP in the upper saturation region ERD or in the linear region ERS, respectively.


Effect of conventional water-bath and experimental microwave polymerization cycles on the flexural properties of denture base acrylic resins.
The effect of polymerization cycles on flexural properties of conventional (Vipi Cril(®)-VC) or microwave-processed (Vipi Wave(®)-VW) denture base acrylic resins was evaluated. Specimens (n=10) were submitted to the cycles: WB=65ºC for 1 h+1 h boiling water (VC cycle); M630/25=10 min at 270 W+5 min at 0 W+10 min at 360 W (VW cycle); M650/5=5 min at 650 W; M700/4=4 min at 700 W; and M550/3=3 min at 550 W. Specimens were submitted to a three-point bending test at 5 mm/min until fracture. Flexural strength (MPa) and elastic modulus (GPa) data were analyzed by 2-way ANOVA/Tukey HSD (α=0.05). Overall, VC showed higher values than VW. The results obtained with microwave polymerization did not differ from those obtained with water-bath for both acrylic resins. The results observed when polymerization cycles using medium power and shorter time were used did not differ from those when manufacturer's recommended microwave cycle was applied. Conventional VC might be microwave-processed without compromising its flexural properties.


Outcomes with micafungin in patients with candidaemia or invasive candidiasis due to Candida glabrata and Candida krusei.
Infection with Candida glabrata and Candida krusei represents a major challenge. We sought to describe outcomes for patients with candidaemia/invasive candidiasis (C/IC) due to these pathogens who were treated with micafungin. We pooled two randomized trials of micafungin versus comparator. We identified patients infected with either C. glabrata or C. krusei. One trial compared micafungin (100 mg/day with option for dose escalation) with liposomal amphotericin B, while the other compared micafungin (either 100 or 150 mg/day) and caspofungin (NCT00106288 and NCT00105144). Clinical cure was our primary endpoint while 28 day mortality represented a secondary endpoint. Among 1070 subjects with C/IC, 183 were infected with either C. glabrata (n = 144) or C. krusei (n = 39). One hundred and seventeen received micafungin. Clinical cure rates in those receiving micafungin were similar to those randomized to comparator [73.5% (86/117) versus 62.1% (41/66), P = not significant]. Mortality at 28 days was also similar [29.1% (34/117) with micafungin versus 34.8% (23/66) with comparator, P = not significant]. In logistic regression, treatment agent correlated with neither cure nor mortality. Factors independently linked with lower cure rates included: IC neutropenia; higher severity of illness; and medical admission. Higher severity of illness and failure to remove a central venous catheter were associated with 28 day mortality. Crude and adjusted outcomes were comparable irrespective of micafungin dose administered. Micafungin results in similar outcomes to comparators for C/IC due to C. glabrata and C. krusei. The 100 mg/day dose represents an acceptable option in this setting. Patient characteristics and catheter management appear to be more important factors affecting clinical outcomes.


Multicolor, time-gated, soft x-ray pinhole imaging of wire array and gas puff Z pinches on the Z and Saturn pulsed power generators.
A multicolor, time-gated, soft x-ray pinhole imaging instrument is fielded as part of the core diagnostic set on the 25 MA Z machine [M. E. Savage et al., in Proceedings of the Pulsed Power Plasma Sciences Conference (IEEE, New York, 2007), p. 979] for studying intense wire array and gas puff Z-pinch soft x-ray sources. Pinhole images are reflected from a planar multilayer mirror, passing 277 eV photons with <10 eV bandwidth. An adjacent pinhole camera uses filtration alone to view 1-10 keV photons simultaneously. Overlaying these data provides composite images that contain both spectral as well as spatial information, allowing for the study of radiation production in dense Z-pinch plasmas. Cu wire arrays at 20 MA on Z show the implosion of a colder cloud of material onto a hot dense core where K-shell photons are excited. A 528 eV imaging configuration has been developed on the 8 MA Saturn generator [R. B. Spielman et al., and A. I. P. Conf, Proc. 195, 3 (1989)] for imaging a bright Li-like Ar L-shell line. Ar gas puff Z pinches show an intense K-shell emission from a zippering stagnation front with L-shell emission dominating as the plasma cools.


[Basal cell adenoma of the nasal septum: a case report].
This article reports a case of an intranasal basal cell adenoma, which is an extremely rare tumor and comprises only 1 to 3% of salivary gland neoplasms. The tumor was removed by intranasal excision with the small alar rhinotomy to facilitate the access. Immunohistochemically the diagnosis of basal cell adenoma was confirmed. There was no recurrence after 24-month follow up. This location of basal cell adenoma has not yet been described in the recent literature.


The effect of coffee consumption on serum cholesterol levels.
Studies investigating the association of coffee consumption and serum cholesterol levels report conflicting results. In an attempt to resolve this controversy, we reviewed the literature to answer the question: Is there a true positive association between coffee consumption and serum cholesterol levels? A Medline database search dating back to 1965 was utilized. Key words used in the search were coffee, caffeine and cholesterol. Cholesterol was expanded to include lipoproteins and LDL-, HDL- and VLDL-cholesterol. All articles that presented cholesterol data in association with coffee consumption were examined for references missed by Medline. Recently published articles were located by a hand search through Current Contents and the latest monthly editions of Index Medicus. Three reviewers made the decision to include all publications that met the following criteria: a) reported original experimental results; b) reported total serum cholesterol levels; and c) were published in peer-reviewed journals. Two to four articles were read and analyzed each week in chronological order. Independent data extraction was performed by three reviewers, who then met as a group once a week to cross-check the analyses. A trend, representing the association between coffee consumption and serum cholesterol, was calculated for each study. The trend was based on the percent difference in cholesterol values between subjects drinking four or more cups of coffee per day in comparison to those drinking zero or less than one cup of coffee each day. In order to compare studies that reported different cup sizes and different levels of intake, weighted mean cholesterol levels were calculated. In studies discussing the data in terms of correlations, trends were established according to the r values provided by the authors. The majority of studies demonstrated a positive trend in at least one subpopulation of their subjects, indicating that serum cholesterol levels increase with increasing coffee consumption. Stronger trends were seen among subjects drinking boiled coffee than in those drinking filtered, decaffeinated or instant coffee. However, most studies were not randomized clinical trials, and results can be countered by a number of biases prevalent in the studies, indicating the need for additional well-designed investigations to resolve remaining issues.