Rising population of survivors of oral squamous cell cancer in the United States.
The incidence of oropharyngeal cancer (OPC) and a subset of oral cavity cancer (OCC) is increasing in the United States. To the authors' knowledge, the presumed growing prevalence of survivors of OPC and OCC has not been investigated to date. Retrospective analysis of Surveillance, Epidemiology, and End Results data (1975-2012) estimated changes in incidence, 5-year cause-specific survival, and prevalence for OPC and OCC. Changes in incidence, cause-specific survival and prevalence were estimated by linear regression and expressed as the percentage change (B). Differences in incidence trends over time were determined by joinpoint analysis. The incidence of OPC increased by 62.6% from 1975 through 2012. Notable increases in OPC incidence were observed among men, white individuals, and those of younger ages. The 5-year survival for OPC increased significantly for all sexes, races, and individuals aged >30 years, with white individuals and males experiencing the largest increase in survival. By contrast, the incidence of OCC declined by 22.3% during the same time period. OCC incidence decreased across all groups but increased among individuals aged 30 to 39 years. Significant increases in survival were observed for OCC, except for those who were female, black, and aged <40 years. The prevalence of survivors of OPC increased from 2000 to 2012 (B, 115.1 per 100,000 individuals per year; P<.0001), whereas the prevalence of survivors of OCC significantly decreased (B, -15.8 per 100,000 individuals per year; P<.0001). The prevalence of survivors of OPC is increasing, whereas the prevalence of survivors of OCC is declining. These data portend significant implications for long-term care planning for survivors of OPC and OCC. Cancer 2016;122:1380-1387. © 2016 American Cancer Society.


Quantitative Detection of Anti-SARS-CoV-2 Antibodies Using Indirect ELISA.
Real-time reverse transcription-polymerase chain reaction is the gold standard for the diagnosis of COVID-19, but it is necessary to utilize other tests to determine the burden of the disease and the spread of the outbreak such as IgG-, IgM-, and IgA-based antibody detection using enzyme-linked immunosorbent assay (ELISA). We developed an indirect ELISA assay to quantitatively measure the amount of COVID-19 IgG, IgM, and IgA antibodies present in patient serum, dried blood, and plasma. The population cutoff values for positivity were determined by receiver operating characteristic curves to be 1.23 U/mL, 23.09 U/mL, and 6.36 U/mL for IgG, IgM, and IgA, respectively. After albumin subtraction, the specificity remained >98% and the sensitivity was 95.72%, 83.47%, and 82.60%, respectively, for IgG, IgM, and IgA antibodies to the combined spike subunit 1 receptor binding domain and N proteins in serum. Plasma and dried blood spot specimens were also validated on this assay. This assay may be used for determining the seroprevalence of SARS-CoV-2 in a population exposed to the virus or in vaccinated individuals.


Neoliberal Misfits: Reconceptualizing Debility in the Critical Medical Humanities.
In recent years, the concept of debility has gained a lot of attention. In critical theory and in the critical medical humanities, the concept has come to refer specifically to the general ill-health of ordinary lives under neoliberal capitalism; as such, it has triggered a surge of interest in large-scale affective assemblages that incapacitate multitudes of bodies. This article proposes neoliberal misfit as a conceptual tool to remedy the dissolution of subjectivity in these discussions. Pushing back against Jasbir Puar specifically, it argues that processes of debilitation produce a particular type of subject formation often ignored in this body of work. The article does so by distinguishing this subject formation in three contemporary illness narratives that dramatize encounters between ill bodies and accelerating rhythms, competitive atmospheres, and mobile attachments, respectively. Ultimately, the aim is to help the critical medical humanities capture how neoliberal environments affect the self-perception of people suffering from ill-health.


Investigating Molecular Exciton Polaritons Using Ab Initio Cavity Quantum Electrodynamics.
Coupling molecules to the quantized radiation field inside an optical cavity creates a set of new photon-matter hybrid states called polariton states. We combine electronic structure theory with quantum electrodynamics (QED) to investigate molecular polaritons using ab initio simulations. This framework joins unperturbed electronic adiabatic states with the Fock state basis to compute the eigenstates of the QED Hamiltonian. The key feature of this "parametrized QED" approach is that it provides the exact molecule-cavity interactions, limited by only approximations made in the electronic structure. Using time-dependent density functional theory, we demonstrated comparable accuracy with QED coupled cluster benchmark results for predicting potential energy surfaces in the ground and excited states and showed selected applications to light-harvesting and light-emitting materials. We anticipate that this framework will provide a set of general and powerful tools that enable direct ab initio simulation of exciton polaritons in molecule-cavity hybrid systems.


New devices for scalp reduction. Intraoperative and prolonged scalp extension.
Scalp reduction for male pattern and other extensive, permanent crown-vertex alopecias has been a beneficial, adjuvant procedure in hair replacement surgery and has been augmented by unsightly and sometimes painful intraoperative and chronic scalp expansion techniques. Ten patients underwent scalp reduction for male pattern baldness utilizing intraoperative Sure-Closure, a skin-stretching device. Ten patients had Frechet Extenders placed under the scalp during their scalp reductions with subsequent removal 28 days later followed immediately by second reduction procedures. The skin-stretching device, Sure-Closure, allowed the excision of 20%-30% more alopecic scalp during scalp reduction than what would have been possible with scalp reduction alone. The Frechet Extender when combined with a lazy S excision pattern for scalp reduction procedures generated between 25% and 50% more excision of alopecic scalp than with scalp reduction alone. Scalp reduction procedures can be more effectively performed with minimal complications and fewer reductions required per patient using either intraoperative scalp extension with the Sure-Closure device or chronic scalp extension with the Frechet Extender.


A complete rule set for designing symmetry combination materials from protein molecules.
Diverse efforts in protein engineering are beginning to produce novel kinds of symmetric self-assembling architectures, from protein cages to extended two-dimensional (2D) and three-dimensional (3D) crystalline arrays. Partial theoretical frameworks for creating symmetric protein materials have been introduced, but no complete system has been articulated. Only a minute fraction of the possible design space has been explored experimentally, in part because that space has not yet been described in theory. Here, in the form of a multiplication table, we lay out a complete rule set for materials that can be created by combining two chiral oligomeric components (e.g., proteins) in precise configurations. A unified system is described for parameterizing and searching the construction space for all such symmetry-combination materials (SCMs). In total, 124 distinct types of SCMs are identified, and then proven by computational construction. Mathematical properties, such as minimal ring or circuit size, are established for each case, enabling strategic predictions about potentially favorable design targets. The study lays out the theoretical landscape and detailed computational prescriptions for a rapidly growing area of protein-based nanotechnology, with numerous underlying connections to mathematical networks and chemical materials such as metal organic frameworks.


Urolithiasis in adult spina bifida patients: study in 260 patients and discussion of the literature.
To describe incidence and risk factors of urinary tract stones in adult spina bifida (SB) patients. Although spina bifida patients have an allegedly higher risk of urinary tract stones, only two small non-English case series are available and do not provide adequate epidemiological data and analyses on risk factors. A total of 260 adult SB patients followed in our centre for 10 years were retrospectively analysed for stone disease. Both a univariate analysis (Fisher's exact, two-sided Student's t test) and a binary logistic regression analysis were performed to identify independent risk factors for stone disease. Of the 260 patients, 24 (9.2 %) were identified with a history of urolithiasis. Fourteen patients (5.4 %) had bladder stones in 26 episodes. Sixteen patients (6.2 %) had upper urinary tract stones: 14 kidney stones and two ureteral stones. Lifetime incidence of both bladder stones and upper tract stones was 2.25 per 1,000 patient-years. Recurrent urinary tract infections (OR 4.34, p = 0.013) and incorporation of bowel tissue into a continent reservoir (including enterocystoplasty) (OR 4.80, p = 0.012) were independent risk factors for bladder stone disease in a multivariate model. An indwelling catheter was an independent predictor for upper tract stones (OR 5.89, p = 0.02). Urolithiasis, especially in the bladder, is a frequent finding in patients with SB. Bladder stones occur about 10 times more often in SB patients than in the population. In patients without risk factors, frequent ultrasound of the urinary tract is not necessary for the sole detection of stones.


Report on IL-10 gene polymorphism at position -819 for major depression and schizophrenia in Korean population.
The present study was carried out to examine the relationship of interleukin (IL)-10 gene polymorphism at position -819 for major depression and schizophrenia in the Korean population. DNA was extracted from 92 Korean patients with major depression, 141 Korean patients with schizophrenia, and 146 ethnically matched controls. DNA was amplified by a polymerase chain reaction-based method and digested by MaeIII, and the restriction fragment length polymorphism of two alleles, IL-10*C and IL-10*T, were assessed. There were no significant differences in genotype frequencies of IL-10*T/T, IL-10*T/C, and IL-10*C/C as well as allelic frequencies of IL-10*T and IL-10*C between patients with major depression and controls in the Korean population. Comparison of genotype and allelic frequencies of IL-10 gene between patients with schizophrenia and controls were also not significant. The present study suggests that IL-10 gene polymorphism at position -819 does not confer susceptibility to major depression and schizophrenia, at least in the Korean population. Further systematic studies including various clinical variables would be required.


Evaluation of satisfaction in an extracurricular enrichment program for high-intellectual ability participants.
The objective of this study was to evaluate the satisfaction of an extracurricular enrichment program of the cognitive and personal management of participants with high intellectual ability. At the first time point, the sample consisted of n= 38 participants, and n= 20 parents; n= 48 participants at the second time point; and n= 60 participants at the third time point. The Satisfaction Questionnaire (CSA in Spanish), both for students (CSA-S) and for parents (CSA-P), was constructed. The CSA-S scores showed adequate psychometric properties. Exploratory factor analysis yielded a unidimensional structure. Cronbach's alpha ranged between 85 and .86. Test-retest reliability was 0.45 (p<.05). The generalizability coefficient was .98. A high percentage of the sample was satisfied with the program, perceived improvements in cognitive and emotional management, motivation and interest in learning, and in the frequency and quality of their interpersonal relationships. The evaluation of educational programs is necessary in order to determine the efficacy and the effects of their implementation on the participants' personal and intellectual management.


Th1 effector T cells selectively orchestrate cardiac fibrosis in nonischemic heart failure.
Despite emerging data indicating a role for T cells in profibrotic cardiac repair and healing after ischemia, little is known about whether T cells directly impact cardiac fibroblasts (CFBs) to promote cardiac fibrosis (CF) in nonischemic heart failure (HF). Recently, we reported increased T cell infiltration in the fibrotic myocardium of nonischemic HF patients, as well as the protection from CF and HF in TCR-α-/- mice. Here, we report that T cells activated in such a context are mainly IFN-γ+, adhere to CFB, and induce their transition into myofibroblasts. Th1 effector cells selectively drive CF both in vitro and in vivo, whereas adoptive transfer of Th1 cells, opposite to activated IFN-γ-/- Th cells, partially reconstituted CF and HF in TCR-α-/- recipient mice. Mechanistically, Th1 cells use integrin α4 to adhere to and induce TGF-β in CFB in an IFN-γ-dependent manner. Our findings identify a previously unrecognized role for Th1 cells as integrators of perivascular CF and cardiac dysfunction in nonischemic HF.


Upgrading liquor-making wastewater into medium chain fatty acid: Insights into co-electron donors, key microflora, and energy harvest.
Ethanol and lactate are considered suitable electron donors (EDs) for chain elongation (CE); however, their respective shortcomings still limit the substrate conversion ratio and medium chain fatty acid (MCFA) production. To address this limitation, different EDs and electron acceptors (EAs) were combined to compare their CE performances, and to investigate whether the combination of ethanol and lactate could further enhance the MCFA production based on the complementary characteristics of ethanol and lactate. The results verified, for the first time, ethanol and lactate as the co-EDs formed a cooperative relationship to largely promote the conversion of substrates into MCFA. The co-EDs of ethanol and lactate stimulated the transformation of dispersive lactate-carbon flux from the competing acrylate pathway into n-heptylate. Additionally, the coexisting by-products (H2 and CO2) from ethanol and lactate also contributed to the supererogatory MCFA generation. The key microbial taxa that distinguished the co-EDs from their single action were the preponderant species from class Negativicutes and family Ruminococcaceae. In addition, the co-EAs of acetate, n-butyrate, and n-caproate also promoted MCFA generation. Low concentration of n-caproate could be directly elongated into n-caprylate, while n-caproate concentration exceeding the toxic limit was unsuitable as an EA. This research provided a guide for substrate selection and collocation for CE technology. Chinese liquor-making wastewater (CLMW) was subsequently used as a substrate for MCFA production since it contains abundant lactate, ethanol, and short-chain fatty acids. In this study, a MCFA selectivity of 80.34 ± 5.26%, a slightly higher selectivity which is in the range of previously reported ones, was obtained. This study paves a way for the sustainable development of Chinese liquor industry by recycling the high-output CLMW into MCFA.


Robotic versus laparoscopic approach for minimally invasive lateral pelvic lymph node dissection of advanced lower rectal cancer: a retrospective study comparing short-term outcomes.
The importance of lateral pelvic lymph node dissection (LLND) for advanced low rectal cancer is gradually being recognized in Europe and the USA, where some patients were affected by uncontrolled lateral pelvic lymph node (LLNs) metastasis, even after total mesorectal excision (TME) with neoadjuvant chemoradiotherapy (CRT). The purpose of this study was thus to compare robotic LLND (R-LLND) with laparoscopic (L-LLND) to clarify the safety and advantages of R-LLND. Sixty patients were included in this single-institution retrospective study between January 2013 and July 2022. We compared the short-term outcomes of 27 patients who underwent R-LLND and 33 patients who underwent L-LLND. En bloc LLND was performed in significantly more patients in the R-LLND than in the L-LLND group (48.1% vs. 15.2%; p = 0.006). The numbers of LLNs on the distal side of the internal iliac region (LN 263D) harvested were significantly higher in the R-LLND than in the L-LLND group (2 [0-9] vs. 1 [0-6]; p = 0.023). The total operative time was significantly longer in the R-LLND than in the L-LLND group (587 [460-876] vs. 544 [398-859]; p = 0.003); however, the LLND time was not significantly different between groups (p = 0.718). Postoperative complications were not significantly different between the two groups. The present study clarified the safety and technical feasibility of R-LLND with respect to L-LLND. Our findings suggest that the robotic approach offers a key advantage, allowing significantly more LLNs to be harvested from the distal side of the internal iliac region (LN 263D). Prospective clinical trials examining the oncological superiority of R-LLND are thus necessary in the near future.


FGF21-FGFR1 controls mitochondrial homeostasis in cardiomyocytes by modulating the degradation of OPA1.
Fibroblast growth factor 21 (FGF21) is a pleiotropic hormone secreted primarily by the liver and is considered a major regulator of energy homeostasis. Recent research has revealed that FGF21 could play an important role in cardiac pathological remodeling effects and prevention of cardiomyopathy; however, the underlying mechanism remains largely unknown. This study aimed to determine the mechanism underlying the cardioprotective effects of FGF21. We engineered FGF21 knock out mice and subsequently elucidated the effects of FGF21 and its downstream mediators using western blotting, qRT-PCR, and mitochondrial morphological and functional analyses. FGF21 knockout mice showed cardiac dysfunction, accompanied by a decline in global longitudinal strain (GLS) and ejection fraction (EF), independent of metabolic disorders. Mitochondrial quality, quantity, and function were abnormal, accompanied by decreased levels of optic atrophy-1 (OPA1) in FGF21 KO mice. In contrast to FGF21 knockout, cardiac-specific overexpression of FGF21 alleviated the cardiac dysfunction caused by FGF21 deficiency. In an in vitro study, FGF21 siRNA deteriorated mitochondrial dynamics and impaired function induced by cobalt chloride (CoCl2). Both recombinant FGF21 and adenovirus-mediated FGF21 overexpression could alleviate CoCl2-induced mitochondrial impairment by restoring mitochondrial dynamics. FGF21 was essential for maintaining mitochondrial dynamics and function of the cardiomyocytes. As a regulator of cardiomyocyte mitochondrial homeostasis under oxidative stress, FGF21 could be an important new target for therapeutic options for patients with heart failure.


Angiotensinogen M235T polymorphism is associated with coronary artery disease severity.
Previous reports relating coronary artery disease and functional variants of the renin-angiotensin system have been contradictory in establishing the role of these polymorphisms in coronary artery disease (CAD) development. The aim of the present study is to determine if there is an association between the M235T variant of the angiotensinogen gene and severity of coronary artery disease in patients with clinically suspected disease undergoing cineangiogram. The angiotensinogen M235T variant was analyzed in 871 consecutive patients with clinically suspected coronary artery disease submitted to coronary angiography study. Three different angiographic scores were used to determine severity of the disease analyzing 20 coronary segments. All patients were evaluated considering classical risk factors for coronary artery disease throughout a medical oriented questionnaire, anthropometric measures, and blood glucose and lipid profile determination. Presence of the 235T allele was associated with higher angiographic extension scores in univariate analysis (p < 0.05). The 235T allele was also associated with an increased risk of presenting 3-vessel disease (p < 0.05). In addition, the T allele was significantly associated with higher Gensini's scores both in univariate (p = 0.05) and multivariate analyses (p < 0.05). Finally, a 1.86 fold increase in the risk of multivessel disease (95% CI: 1.174-2.947) was associated with the TT genotype independently of other cardiovascular risk factors associated with disease extension. The data hereby provide further support for the association between angiotensinogen M235T polymorphism and CAD severity independently of other cardiovascular risk factors.


Seasonal variations in egg passage of Fasciola hepatica in dairy cows in Quebec.
Seasonal changes in Fasciola hepatica egg passage were documented in 17 dairy herds in Portneuf County, Quebec (Canada). Egg passage was low or absent in spring and summer but rose in autumn to reach a peak in winter, then subsequently returned to low levels. This study suggests that there are two periods of transmission to the bovine host during the grazing season: a minor period in the spring, due to overwintered snails, and a major period in August and September due to snails that acquired the infection in May or June.


Anti-glycine receptor antibody-positive progressive encephalomyelitis with rigidity and myoclonus initially presenting with one-sided stiff face: A case report.
Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a subtype of stiff-person syndrome, a rare cerebrospinal disease that causes brainstem symptoms, myoclonus, muscle rigidity, and hyperekplexia. A 71-year-old man experienced left-sided stiff face, and was subsequently admitted to our hospital because of the appearance of left-dominant lower limb myoclonus. Muscle rigidity followed 3 days later. Magnetic resonance imaging revealed no abnormality. An electrophysiological examination showed a toughness of the antagonistic muscle following evocation of the Achilles tendon reflex, and a tonic phenomenon affecting the left facial muscles during the blink reflex. The patient's serum was positive for anti-glycine receptor (anti-GlyR) antibody, suggesting PERM. The patient was administered steroids, immunoglobulin therapy, and immunosuppressive drugs. He gradually improved after these therapies and became able to walk using a walker. We conclude that this was a rare case of anti-GlyR antibody-positive PERM with unilateral brainstem symptoms, myoclonus, and muscle rigidity.


MAN1B1 is associated with poor prognosis and modulates proliferation and apoptosis in bladder cancer.
Bladder cancer (BC) has been regarded as the most common malignancy of the urinary system worldwide. With lack of investigations for molecular pathogenesis underlying that develop BC, the therapeutic efficacy of several therapeutic approaches existing is still unsatisfactory. Here, our study aimed to explore the potentially biological function of MAN1B1 on BC. In this study, MAN1B1 expression level in BC tissues and normal tissues was analyzed based on The Cancer Genome Atlas (TCGA) data and correlation between its expression and prognosis was determined using Kaplan-Meier analysis. Knockout of MAN1B1 was performed using silencing RNA and the efficacy of MAN1B1 knockout was identified using quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis. The BC cells proliferation was assessed by Cell Counting Kit-8 (CCK8) assay, and then the cells apoptosis was detected by Annexin V-fluorescein isothiocyanate (Annexin V-FITC)/propidium iodide (PI) staining and flow cytometry following MAN1B1 knocked down by small interfering RNA. Protein kinase B (AKT) signaling was evaluated by detecting related markers, namely AKT, p-AKT, 4E-BP-1 and Bax using western blot assay. As a result, the MAN1B1 expression was higher in BC tissues than those in normal tissues, besides, its overexpression was associated with poor prognosis. Moreover, MAN1B1 reduction by silencing RNA approach resulted in BC cells proliferation suppression and BC cells apoptosis promotion. Finally, AKT signaling activity was inhibited by MAN1B1 silencing. Taken together, these results unraveled that MAN1B1 may act on an oncogenic action in BC, which improved the likelihood of MAN1B1 taking on a promising prognostic biomarker and a potential target for treating BC.


Impact evaluation of the Urban Health Initiative in urban Uttar Pradesh, India.
The Urban Health Initiative (UHI) was initiated in 2009 with the goal of increasing family planning (FP) use among the poor in urban areas of Uttar Pradesh, India. The Measurement, Learning & Evaluation project (MLE) was tasked with rigorous impact evaluation of the UHI. This paper presents the impact evaluation findings of the UHI program. The MLE design includes a longitudinal sample of women and health facilities with baseline (2010) and endline (2014) data collection in six cities in Uttar Pradesh, India. At baseline, samples representative of women in each city were selected with oversampling of the poor. Eighty-four percent of women interviewed at baseline were reinterviewed 4 years later at endline. The longitudinal data support a within/fixed-effects approach to identification of program impact on changes in modern FP use. Impact evaluation results show significant effects of exposure to both demand and supply side program activities. In particular, women exposed to brochures (marginal effect: 6.96, p<.001), billboards/posters/wall hangings (marginal effect: 2.09, p<.05), and FP on the television (marginal effect: 2.46, p<.001) were significantly more likely to be using a modern method at endline. In addition, we found borderline significance for being exposed to a community health worker (marginal effect: 1.66, p<.10) and living close to an improved public and private supply environment where UHI undertook activities (marginal effects and p values: 2.48, p<.05 and 1.56, p<.10, respectively). UHI program activities were designed to complement the Government of India's strategies aimed at ensuring access to and provision of FP to urban poor populations. The effective demand- and supply-side strategies of the UHI program are therefore likely to be sustainable and scalable to other urban areas in India. Findings from this study are important for designing sustainable and scalable FP strategies for urban India where increases in FP use will be relevant for meeting international FP targets.


Solid-phase synthesis and biological evaluation of a uridinyl branched peptide urea library.
A 1000-member uridinyl branched peptide library was synthesized on PS-DES support using IRORI technology. High-throughput screening of this library for anti-tuberculosis activity identified several members with a MIC(90) value of 12.5 microg/mL.


Expression of ADRB2 in children with neuroblastoma and its influence on prognosis.
Neuroblastoma (NB), originating from sympathetic spinal tissue, is a serious threat to the life of children. Especially in the high-risk group, an overall five-year survival rate less than 50% indicates an extremely poor clinical outcome. Here, the expression the of β-2 adrenergic (ADRB2) receptor gene in tumor tissues of children with NB was detected and the correlation between its expression and clinical characteristics and prognosis was analyzed. Forty-five tumor tissue samples and forty-eight paraffin sections of NB were obtained from Children's Hospital of Chongqing Medical University from 2015 to 2021. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was utilized to detect the expression of ADRB2 at the mRNA level and immunohistochemistry (IHC) at the protein level. For the RT-qPCR, the analysis showed that the expression of ADRB2 in the high-risk group was significantly lower (P = 0.0003); in addition, there were also statistically significant differences in Shimada classification (P = 0.0025) and N-MYC amplification (P = 0.0011). Survival prognosis analysis showed that the prognosis was better with high ADRB2 expression (P = 0.0125), and the ROC curve showed that ADRB2 has a certain accuracy in predicting prognosis (AUC = 0.707, CI: 0.530-0.884). Moreover, the expression of ADRB2, N-MYC amplification and bone marrow metastasis were the factors that independently affected prognosis, and at the protein level, the results showed that the differential expression of ADRB2 was conspicuous in risk (P = 0.0041), Shimada classification (P = 0.0220) and N-MYC amplification (P = 0.0166). In addition, Kaplan-Meier curves showed that the prognosis in the group with high expression of ADRB2 was better (P = 0.0287), and the ROC curve showed that the score of ADRB2 had poor accuracy in predicting prognosis (AUC = 0.662, CI: 0.505-0.820). ADRB2 is a protective potential biomarker and is expected to become a new prognostic biomolecular marker of NB.


Determination of herbicides by solid phase extraction gas chromatography-mass spectrometry in drinking waters.
A solid phase extraction (SPE) method has been optimized for the gas chromatography-mass spectrometry (GC-MS) simultaneous determination of herbicides belonging to the following different families: carbamate (molinate), atrazines (atrazine, propazine, simazine, ametryne, cyanazine, terbutylazine, deethylterbutylazine, deethylatrazine), dinitroaniline (trifluralin, pendimethalin), chloroacetamide (alachlor, metolachlor). Different solid substrates have been compared (C18, cyano, styrene-divinylbenzene, phenyl, graphitic carbon). The type of conditioning and elution solvent, its volume, and the sample flow rate have been considered as variables affecting the recovery yields of the herbicides. The optimized experimental conditions are C18 phase conditioned with 3 mL acetone, loaded with 1L water sample at 5 mL min(-1), and eluted with 3 mL acetone. Good recoveries (included between 79% and 99%) and R.S.D. (included between 2% and 12%) have been obtained for all analytes, except for deethylatrazine whose recovery was 46+/-7%. The recovery of deethylatrazine increases up to 94+/-17% if a non-porous graphitic carbon is coupled to the C18 phase, keeping the other parameters constant as optimized. The optimized method has been successfully checked for the identification and quantitation of the selected herbicides in raw and drinking water samples, with quantitation limits as low as 0.01 microg L(-1), fully in agreement with the current legislation. The method is easily routinable. After development, the method is currently routinely applied for the analysis of herbicides in waters and, up today, more than one thousand samples have been analysed at the "Laboratorio della Società Metropolitana Acque di Torino" (Laboratory of the Municipal Waterworks of Turin) in charge of the control of drinking water quality in Torino.


Polymorphisms of the WRN gene and DNA damage of peripheral lymphocytes in age-related cataract in a Han Chinese population.
Werner syndrome is caused by mutations in the DNA repair Werner helicase (WRN) gene and characterized by accelerated aging including cataracts. Age-related cataract (ARC) cases (N = 504) and controls (N = 244) were recruited from a population-based study to evaluate the association of single-nucleotide polymorphisms (SNPs) of WRN and another DNA repair gene (human 8-oxoguanine DNA N-glycosylase 1) with ARC. Among the five SNPs tested, only WRN rs1346044 was found to be significantly associated between cases and controls before multiple-testing adjustment. The minor C allele of rs1346044 was associated with ARC with an odds ratio (OR) of 0.66, suggesting a protective role of the C allele for developing ARC. The stratification analysis on the subtypes of ARC showed that rs1346044 was significantly associated with cortical cataract, but not with nuclear, posterior subcapsular, and mixed types after multiple-testing adjustment (OR = 0.51, p< 0.01). The genetic model analysis showed that the results fit the dominant model (OR = 0.44, p < 0.001). The comet assay used to assess the extent of DNA damage in peripheral lymphocytes of ARC cases found that the DNA damage in lymphocytes from patients with CC genotype was significantly less than that in patients with TT genotype. We concluded that the C allele of rs1346044, a non-synonymous SNP resulting in the conversion of Cys to Arg at amino acid position 1367 of WRN, alters susceptibility to ARC, especially the cortical type of the disease, in the Han Chinese. The underlying mechanism of its protective role might be related to the improved DNA repair function.


Transbrachial endoclamping of the graft for descending aortic aneurysm after the elephant trunk procedure.
Patients who have undergone the elephant trunk procedure because of aortic dissection may subsequently present with a descending aortic aneurysm. We describe the technique of "endograft aortic control by inflating a compliant aortic occlusion balloon," in which a balloon is placed in the proximal descending aortic graft without cross-clamping to avert problems of hemorrhage at the second stage of the elephant trunk procedure.


Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Fixation for Degenerative Lumbar Disease.
To evaluate the clinical effect of the minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation using a tubular retractor in the management of degenerative lumbar disease. A retrospective analysis was conducted to analyze the clinical outcome of 58 degenerative lumbar disease patients who were treated with minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation during December 2012 to January 2015. The spine was unilaterally approached through a 3.0-cm skin incision centered on the disc space, located 2.5 cm lateral to the midline, and the multifidus muscles and longissimus dorsi were stripped off. After transforaminal lumbar interbody fusion and posterolateral fusion the unilateral pedicle screw fixation was performed. The visual analogue scale (VAS) for back and leg pain, the Oswestry disability index (ODI), and the MacNab score were applied to evaluate clinical effects. The operation time, peri-operative bleeding, postoperative time in bed, hospitalization costs, and the change in the intervertebral height were analyzed. Radiological fusion based on the Bridwell grading system was also assessed at the last follow-up. The quality of life of the patients before and after the operation was assessed using the short form-36 scale (SF-36). Fifty-eight operations were successfully performed, and no nerve root injury or dural tear occurred. The average operation time was 138 ± 33 min, intraoperative blood loss was 126 ± 50 mL, the duration from surgery to getting out of bed was 46 ± 8 h, and hospitalization cost was 1.6 ± 0.2 ten thousand yuan. All of the 58 patients were followed up for 7-31 months, with an average of 14.6 months. The postoperative VAS scores and ODI score were significantly improved compared with preoperative data (P < 0.05). The evaluation of the MacNab score was excellent in 41 patients, good in 15, and fair in 2, suggesting an effective rate of 96.6%. The intervertebral height had reduced 0.2 ± 1.2 mm by the last follow-up, and there were 55 Grade I and II cases based on the Bridwell evaluation criterion. The fusion rate was 94.8%, and no screw breakage and loosening occurred. The scores of physical pain, general health, social, and emotional functioning were significantly increased at the last follow-up. Minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation provide a new choice for degenerative lumbar disease, and the short-term clinical outcome is satisfactory.


Stabilized red soil-an efficient liner system for landfills containing hazardous materials.
In recent decades, disposal of hazardous material has become a challenging task especially in case of landfills where leaching out of waste is possible. In such cases, an efficient and economical liner system using locally available material is very essential. In this paper, an attempt has been made to study the suitability of red soil stabilized using lime and Prosopis juliflora fibers as liner material for landfills. Prosopis is a woody weed available abundantly in tropical and subtropical regions of the world. The fibers were used at 0.0%, 0.25%, 0.50%, 0.75%, and 1.0% by weight of the soil and the amount of lime used was kept constant as 4%. Tests results revealed decrease in plasticity index, increase in UCC strength, ductile behavior, decrease in consolidation settlement, reduction in permeability and shrinkage, and increase in CBR resistance in soils treated with both lime and Prosopis fibers. SEM images of stabilized soil revealed adherence of hydrated products of lime on the fiber surface, which facilitate efficient stress transfer between the soil and fibers. A single composite liner system was modeled using Visual MODFLOW by replacing the compacted clay layer with the stabilized red soil below the HDPE liner and the model was simulated. The simulation result showed that the performance of liner system with stabilized red soil is good and could prevent the aquifer from contamination. From the study, it can be concluded that stabilized red soil possesses the geotechnical properties required for an efficient liner system.


Satellite associations of human acrocentric chromosomes identified by trypsin treatment at metaphase.
In the present work 2526 metaphase plates were prepared from 28 normal adult individuals (12 male and 16 female) and then treated with the trypsin method in order to recognize the acrocentric chromosomes involved in the satellite associations. From our data it can be inferred that while the pattern of association of D--D, D--G and G--G groups seems to be random, there exists some preferential association, particularly between the pairs 13--14, 13--13, 13--21 and 21--21. This non-random participation of the acrocentric chromosomes could fit with the new concepts of interphase/metaphase organization of the chromatin fibre.


Home monitoring of daily living activities and prediction of agitation risk in a cohort of people living with dementia.
People living with dementia (PLWD) have an increased susceptibility to developing adverse physical and psychological events. Internet of Things (IoT) technologies provides new ways to remotely monitor patients within the comfort of their homes, particularly important for the timely delivery of appropriate healthcare. Presented here is data collated as part of the on-going UK Dementia Research Institute's Care Research and Technology Centre cohort and Technology Integrated Health Management (TIHM) study. There are two main aims to this work: first, to investigate the effect of the COVID-19 quarantine on the performance of daily living activities of PLWD, on which there is currently little research; and second, to create a simple classification model capable of effectively predicting agitation risk in PLWD, allowing for the generation of alerts with actionable information by which to prevent such outcomes. A within-subject, date-matched study was conducted on daily living activity data using the first COVID-19 quarantine as a natural experiment. Supervised machine learning approaches were then applied to combined physiological and environmental data to create two simple classification models: a single marker model trained using ambient temperature as a feature, and a multi-marker model using ambient temperature, body temperature, movement, and entropy as features. There are 102 PLWD total included in the dataset, with all patients having an established diagnosis of dementia, but with ranging types and severity. The COVID-19 study was carried out on a sub-group of 21 patient households. In 2020, PLWD had a significant increase in daily household activity (p = 1.40e-08), one-way repeated measures ANOVA). Moreover, there was a significant interaction between the pandemic quarantine and patient gender on night-time bed-occupancy duration (p = 3.00e-02, two-way mixed-effect ANOVA). On evaluating the models using 10-fold cross validation, both the single and multi-marker model were shown to balance precision and recall well, having F1-scores of 0.80 and 0.66, respectively. Remote monitoring technologies provide a continuous and reliable way of monitoring patient day-to-day wellbeing. The application of statistical analyses and machine learning algorithms to combined physiological and environmental data has huge potential to positively impact the delivery of healthcare for PLWD.


A Case Report of Neonatal Supraventricular Tachycardia Resolved with Single-Syringe Adenosine.
Supraventricular tachycardia (SVT) is a condition requiring emergency care in neonates. We describe a successfully treated case of neonatal SVT in a four-week-old neonate using the novel adenosine administration method. This technique is potentially easier to facilitate and does not require equipment such as a stopcock. Adenosine 0.2 milligrams per kilogram was drawn up into a syringe containing 0.9% sodium chloride to a total volume of 3 milliliters. Once administered, the patient had near-immediate return to normal sinus rhythm without sequelae. This case demonstrates that the single-syringe method appears potentially safe and effective in neonates.


Synergistic teratogenic effect produced in mice by whole cell pertussis vaccine.
Pertussis whole cell bacterial vaccine was injected in mice during early pregnancy to disclose any teratogenic effect on the brain of the fetuses. Cytochalasin D by itself induced exencephaly in a dose dependent way in fetal mice. When pregnant mice received a single injection of pertussis vaccine on day 8 of gestation and a subteratogenic dose of cytochalasin D on days 8, 9 and 10 of gestation a synergistic teratogenic action of pertussis vaccine and cytochalasin D in mice was observed. When autopsy was performed after a further 9 to 10 days a significant number of brain malformations was found. In order to analyse which component in the vaccine might be responsible for the co-teratogenic effect, purified pertussis components, pertussis toxin and filamentous haemagglutinin were used in combination with cytochalasin D, but no malformations occurred. The same results were obtained by using diphtheria-tetanus-polio (DiTePol) vaccine and acellular pertussis component vaccine, whereas the use of whole cell typhoid vaccine resulted in a high rate of fetuses with exencephalies. Experiments with purified Bordetella pertussis and Escherichia coli lipopolysaccharides indicated that lipopolysaccharides in whole cell pertussis vaccine as well as in typhoid vaccine were the factors causing teratogenicity in fetal mice.


A new approach to preventing relapse in opiate addicts: a psychometric evaluation.
The present study investigated psychological aspects after different methods of withdrawal treatments in opiate addicts had been conducted. Two pharmacological strategies based on delivering an opioid agonist or antagonist were used for withdrawal in opiate addicts. After detoxification, the antagonist was delivered by a pellet implanted subcutaneously. Four days after the beginning of the treatment several psychological variables such as craving, anxiety, depression, and mood were assessed and compared with data from actively consuming opiate addicts and healthy controls. In addition, 6 and 12 weeks later the relapse rates were assessed. Compared with addicts detoxified and treated with Levomethadone as well as actively heroin consuming addicts, subjects treated with Naltrexone demonstrated significantly higher positive psychological outcome concerning all assessed variables and significantly lower relapse rates. Naltrexone implants prove prevention of relapse during the most vulnerable period after detoxification. Compared with Levomethadone withdrawal, they lead to a significantly better psychological condition in patients.


Comparison of native and microwave irradiated DNA.
Chemical changes induced in the testicular DNA of irradiated Swiss male mice are described. Parameters quantified were hyperchromocity and melting temperature. The data supports the possibility that microwave causes strand separation.


Exploration of key ferroptosis-related genes and immune infiltration in Crohn's disease using bioinformatics.
Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) that manifests mainly as chronic inflammation in different parts of the gastrointestinal tract, and its incidence has come to be increasing in recent years. Ferroptosis, a novel type of programmed cell death, it seems the role of ferroptosis-related biomarkers in CD has not been mentioned. Thus, the role of ferroptosis in CD and its relationship with immune infiltration were explored in this study. The CD dataset was downloaded from the Gene Expression Omnibus database. The validated ferroptosis genes (FRGs) were retrieved from the public FerrDb database. The gene expression matrix of the CD dataset was analyzed with the "limma" package in R language to obtain differentially expressed genes (DEGs) between diseased and healthy samples. Then, intersecting genes between DEGs and FRGs were identified as differentially expressed ferroptosis-associated genes (DE-FRGs). Protein-protein interaction (PPI) network analysis and visualization were carried out with STRING and Cytoscape, and key CD ferroptosis-related genes (CD-FRGs) were identified along with their Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways using the clusterProfiler package. Immune cell infiltration was analyzed with CIBERSORT. The correlation between key CD-FRGs and immune-infiltrated cells in CD was studied by Spearman's correlation method. A total of 37 DE-FRGs and 6 key CD-FRGs (CAV1, CD44, HIF1A, IFNG, TIMP1 and TLR4) were identified. GO and KEGG functional analysis indicated these genes enrichment in programmed cell death and apoptotic process, HIF-1 signaling pathway and IBD. Infiltration matrix analysis of immune cells showed abundant T cells CD4 memory activated, M1 macrophages, M2 macrophages, Mast cells activated and Neutrophils in CD intestinal tissues. The 6 key CD-FRGs were correlated with immune-infiltrated cells in CD based on correlation analysis. Taken together, immune cells with abnormal infiltration can be implicated in CD due to ferroptosis. This study identified 6 key CD-FRGs that may be key biomarkers of ferroptosis in CD; they include CAV1, CD44, HIF1A, IFNG, TIMP1 and TLR4. These findings suggest that the immune response is critical in CD caused by ferroptosis through the interaction between key CD-FRGs and immune infiltrating cells.


Two novel HLA-DQ2.5-restricted gluten T cell epitopes in the DQ2.5-glia-γ4 epitope family.
Celiac disease is a chronic inflammatory condition of the small intestine caused by aberrant adaptive immune response to gluten protein from wheat and related cereal plants. Over 90% of celiac disease patients carry the HLA-DQ2.5 allotype and HLA-DQ2.5 presents gluten peptides to gluten-reactive CD4+ T cells in celiac disease patients. A large number of HLA-DQ2.5-restricted gluten T cell epitopes have been identified over the years. These epitopes are in general proline-rich and contain at least one glutamic acid residue that is generated from glutamine in the native gluten protein by deamidation. The deamidation is mediated by the enzyme transglutaminase 2 (TG2). It has been shown that the same T cell could recognize several different HLA-DQ2.5-restricted gluten T cell epitopes due to sequence similarities. In this paper, we demonstrate that three T cell clones derived from duodenal biopsies of different celiac disease patients are able to respond to at least five different gluten T cell epitopes within the DQ2.5-glia-γ4 epitope family, including two novel epitopes.


Thromboxane synthase activity and platelet function after furegrelate administration in man.
Furegrelate sodium (U-63,557A), a pyridine-derivative thromboxane synthase inhibitor, was administered orally in single doses of 200 to 1600 mg to normal male subjects. Furegrelate produced a dose-related inhibition of thromboxane synthesis for 8-12 hours when measured either ex vivo from platelet-rich plasma (PRP) or in vivo from urine. In general, the extent of thromboxane synthesis inhibition was greater in PRP than in urine. Furegrelate significantly inhibited platelet aggregation, but the effect was variable and measurements of thromboxane synthase did not predict the impact on platelet aggregation. Bleeding times and coagulation parameters were not altered significantly. Furegrelate was well absorbed orally with Tmax = 1 hr and t1/2 = 3.5 to 5 hrs. There was no marked metabolism; elimination was primarily by renal excretion of parent compound. Thus, furegrelate is an effective inhibitor of thromboxane synthase in man with a relatively long biologic and circulating half-life.


Dynamic shimming in the cervical spinal cord for multi-echo gradient-echo imaging at 3 T.
Obtaining high quality images of the spinal cord with MRI is difficult, partly due to the fact that the spinal cord is surrounded by a number of structures that have differing magnetic susceptibility. This causes inhomogeneities in the magnetic field, which in turn lead to image artifacts. In order to address this issue, linear compensation gradients can be employed. The latter can be generated using an MRI scanner's first order gradient coils and adjusted on a per-slice basis, in order to correct for through-plane ("z") magnetic field gradients. This approach is referred to as z-shimming. The aim of this study is two-fold. The first aim was to replicate aspects of a previous study wherein z-shimming was found to improve image quality in T2*-weighted echo-planar imaging. Our second aim was to improve upon the z-shimming approach by including in-plane compensation gradients and adjusting the compensation gradients during the image acquisition process so that they take into account respiration-induced magnetic field variations. We refer to this novel approach as realtime dynamic shimming. Measurements performed in a group of 12 healthy volunteers at 3 T show improved signal homogeneity along the spinal cord when using z-shimming. Signal homogeneity may be further improved by including realtime compensation for respiration-induced field gradients and by also doing this for gradients along the in-plane axes.


[Medial versus lateral plating in distal tibial fractures: a prospective study of 40 fractures].
Tibial plafond fractures are one of the most challenging injuries in orthopaedic surgery. Their results could be improved by following the new guidelines for the management, and modern plating techniques. The results and complication rate between anteromedial and anterolateral approach for open reduction and internal fixation of these fractures were compared. A study was conducted on 40 patients treated by open reduction an internal fixation between 2007 and 2008. The surgical approach was selected by the surgeon in charge, depending on fracture pattern and skin situation. Patients were evaluated clinically and radiographically by an independent orthopaedic surgeon, not involved in the surgical procedure, using clinical (American Orthopaedic Foot and Ankle Society score) and radiological criteria at a minimum of two years. The appearance of complications after both approaches was recorded. Forty patients were included. The mean age was 53 years, with 24 males and 16 females. Seventeen of the injuries were of high energy, and there were 8 open fractures (3 of type i, 4 type ii and one type iii), and 12 of the closed injuries were grade ii or iii in the Tscherne classification. Six patients (15%) had associated injuries. At final follow-up there were 33 (82%) excellent or good results. No statistical differences were found between either surgical approach regarding time to bone union, rate of delayed union and infection rate. Three plates of the anteromedial group and none of the anterolateral group needed to be removed. Open reduction and internal fixation of distal tibia fractures produced reliable results, with no statistical differences found between anteromedial and anterolateral surgical approaches. Clinical and radiological results and complication rate were mainly related to the fracture type.


Low serum copper and zinc concentrations in North Indian children with overweight and obesity
There are limited data on the alterations of serum copper and zinc, which have been proposed to have associations among children with obesity. A total of 173 children were enrolled and grouped into overweight/obese (n = 69) and non-obese (n = 104) according to CDC 2000 growth charts. Serum and whole blood zinc and copper concentrations were measured by validated ICP-MS method, and copper/zinc ratios were calculated and correlated to various anthropometric parameters. Mean BMI in obese (24.78 ±3.93) was significantly higher as compared to non-obese (16.44 ±2.34; p < 0.0001, 95% CI: 15.9873-16.8998) children. Mean serum copper levels in obese children (1099.80 ±478.67 µg/l) were significantly lower than for non-obese children (2063.77 ±1006.81 µg/l; p = 0.0001, 95% CI: 1867.9755-2259.5755). Similarly, the mean serum zinc levels in obese children (851.53 ±406.33 µg/l) were also significantly lower as compared to non-obese children (1528.72 ±796.82 µg/l; p = 0.0001, 95% CI: 1373.76-1683.6879). Mean whole blood copper levels were significantly lower in obese (929.56 ±200.15 µg/l) as compared to non-obese (1393.22 ±861.92 µg/l; p = 0.0001, 95% CI: 1225.6023-1560.8481) children. Similarly, the mean whole blood zinc levels in obese (4384.11 ±881.87 µg/l) were also significantly lower as compared to non-obese (5380.14 ±2236.77 µg/l; p = 0.001, 95% CI: 4945.1491-5815.1416) children. The serum and whole blood concentrations of zinc and copper were found to be significantly lower in children with exogenous obesity as compared to controls. Additional investigations are recommended to see the underlying aspect of these elements in the development of obesity along with their co-morbidities.


Effect of sodium succinate on gas exchange in rats with barbiturate-induced coma.
Injection of sodium succinate in doses of 5 or 10 mmol/kg (but not 1 mmol/kg) intensified oxygen consumption in rats with sodium thiopental-induced coma. Injection of SDH inhibitor (sodium malonate) inhibited gas exchange and abolished the effect of sodium succinate. The effect of succinate on rat survival was positive, while that of malonate was negative, but manifested only as a trend. The critical role of succinate oxidation in preventing lethal complications of barbiturate-induced coma is proved.


Preparation, characterization and luminescent properties of lanthanide complexes with a new aryl amide bridging ligand.
A new aryl amide type bridging ligand 1,4-bis{[(2'-benzylaminoformyl)phenoxyl]ethoxyl}benzene (L) and its complexes with lanthanide ions (Ln=Pr, Nd, Sm, Eu, Gd, Tb, Dy, Er) were synthesized and characterized by elemental analysis, infrared spectra and electronic spectra. At the same time, the luminescent properties of the Sm, Eu, Tb and Dy complexes in solid state and the Tb complex in solvents were also investigated. At room temperature, these four complexes exhibited characteristic luminescence emissions of the central metal ions under UV light excitation and could be significant in the field of supramolecular photonic devices.


Genetic diversity and phylogenetic analysis of two Tunisian bivalves (Mactridae) Mactra corallina (Linnaeus, 1758) and Eastonia rugosa (Helbling, 1799) based on COI gene sequences.
A partial sequence of mitochondrial cytochrome c oxidase subunit I (COI) was used as a genetic marker for a genetic diversity and phylogenetic analysis (DNA barcoding) of two Mactridae species, Mactra corallina and Eastonia rugosa, collected from the Tunisian coast. These Mactridae species could be distinguished by DNA barcoding techniques and they will be considered as monophyletic clades with the Neighbor-Joining (NJ) tree. The genetic structure detected that E. rugosa presents three haplotypes with a high frequency of HER1 (0.89). However, M. corralina shared 14 haplotypes. The haplotypic diversity (H) was equal to 0.205 and 0.954, respectively, for E. rugosa and M. corallina. While the nucleotide diversity (π) was higher for M. corallina (π=0.0818), the mismatch distribution showed a unimodal curve for E. rugosa (a recent sudden demographic expansion) and a multimodal distribution for M. corallina (size stability).


Immunodeficiency-Associated Epstein-Barr Virus-Positive B-cell Lymphoproliferative Disorders: A Review and New Paradigm.
Sources of immune deficiency and dysregulation (IDD) are being increasingly recognized and defined, as are IDD-related B-cell lymphoproliferative lesions and lymphomas occurring in these patients. In this review, basic biology of Epstein-Barr virus (EBV) as it relates to classification of EBV-positive B-cell lymphoproliferative disorders (LPDs) is reviewed. Also discussed is the new paradigm of classification of IDD-related LPDs adopted by the fifth edition World Health Organization classification. IDD-related EBV-positive B-cell hyperplasias, LPDs, and lymphomas are discussed with particular attention to unifying and unique features that assist with recognition of these IDD-related lesions and their classification scheme.


Identification of putative Arabidopsis DEMETER target genes by GeneChip analysis.
The Arabidopsis DEMETER (DME) DNA glycosylase is required for the maternal allele expression of imprinted Polycomb group (MEDEA and FIS2) and transcription factor (FWA) genes in the endosperm. Expression of DME in the central cell, not in pollen or stamen, establishes gene imprinting by hypomethylating maternal alleles. However, little is known about other genes regulated by DME. To identify putative DME target genes, we generated CaMV:DME plants which ectopically express DME in pollen and stamens. Comparison of mRNA profiles revealed 94 genes induced by ectopic DME expression in both stamen and pollen. Gene ontology analysis identified three molecular functions enriched in the DME-inducible RNA list: DNA or RNA binding, kinase activity, and transcription factor activity. Semi-quantitative RT-PCR verified the candidate genes identified by GeneChip analysis. The putative target genes identified in this study will provide insights into the regulatory mechanism of DME DNA glycosylase and the functions of DNA demethylation.


Feasibility study of defecation studied with a wireless Fecobionics probe in normal subjects.
Several technologies have been developed for assessing anorectal function including the act of defecation. We used a new prototype of the Fecobionics technology, a multi-sensor simulated feces, to visualize defecatory patterns and introduced new metrics for anorectal physiology assessment in normal subjects. Fourteen subjects with normal fecal incontinence and constipation questionnaire scores were studied. The 10-cm-long Fecobionics device provided measurements of axial pressures, orientation, bending, and shape. The Fecobionics bag was distended to the urge-to-defecate level inside rectum where after the subjects were asked to evacuate. Physiological evacuation parameters were assessed. Special attention was paid to the Fecobionics rectoanal pressure gradient (F-RAPG) during evacuation. Anorectal manometry (ARM) and balloon expulsion test (BET) were done as references. The user interface displayed the fine coordination between pressures, orientation, bending angle, and shape. The pressures showed that Fecobionics was expelled in 11.5 s (quartiles 7.5 and 18.8s), which was shorter than the subjectively reported expulsion time of the BET balloon. Six subjects did not expel the BET balloon within 2 min. The F-RAPG was 101 (79-131) cmH2 O, whereas the ARM-RAPG was -28 (-5 to -47) cmH2 0 (p < 0.001). There was no association between the two RAPGs (r2 = 0.19). Fecobionics showed paradoxical contractions in one subject (7%) compared to 12 subjects with ARM (86%). Fecobionics obtained novel physiological data. Defecatory patterns and data are reported and can be used to guide larger-scale studies in normal subjects and patients with defecatory disorders. In accordance with other studies, this Fecobionics study questions the value of the ARM-RAPG.


Apolipoprotein D predicts adverse outcome in women >or=70 years with operable breast cancer.
Apolipoprotein D (ApoD) is a lipocalin involved in various cellular processes, including cytoprotection. We retrospectively evaluated its prognostic impact in 272 women (median age 63 (range 21-89) years, with operable breast cancer (Stage I or IIa) treated according to national guidelines, stratified by age and menopausal status, with a median long-term follow-up of 12 years. ApoD, estrogen receptor-alpha (ERalpha), and progesterone receptor (PR) positivity were determined by quantitative immunohistochemistry in tissue microarrays taken from the invasive front of the tumors and in whole tumor sections. ApoD was expressed in 50% of the tumors. Diffuse nuclear and cytoplasmic (ApoD(CN)), but not granular cytoplasmic ApoD expression in the invasive front was a detrimental factor for elderly patients over 70 years of age, (n = 83), but not for younger and pre-menopausal patients. ApoD(CN )expression correlated with lymph node metastases (P = 0.04). Moreover, a correlation between ApoD(CN )localization and age over 70 years was observed (P = 0.03). In the elderly, ApoD(CN) positive tumors had both a significantly shorter relapse-free survival (all locations) (P = 0.02) and a decreased breast cancer-specific survival (P < 0.0001). Moreover, the prognostic importance of ApoD was dose dependent (P = 0.002) Multivariate analysis confirmed the prognostic value of ApoD(CN). When the elderly patients were stratified by nodal status, ApoD showed prognostic importance only in the node positive patients (n = 30) (HR = 9.6; 95% CI = 2.3-40.4). The potential relevance of ApoD in this increasingly frequent group of breast cancer patients should be further explored.


Reversal of diabetic retinopathy in two patients following the use of physiologic insulin Resensitization.
We followed two patients with diabetic retinopathy over the course of their treatment with physiologic Insulin resensitization. Both patients showed improvement of their diabetic retinopathy, after treatment.


Duct carcinoma in situ: 227 cases without microinvasion.
From 1979 to 1990, 227 patients with intraductal carcinomas (DCIS) without microinvasion were selectively treated; the least favourable (large lesions with involved biopsy margins) with mastectomy, the most favourable (small lesions with clear margins) with breast preservation. The preservation group was further subdivided into those who received radiation therapy (excision and radiation) and those who did not (excision alone). In the mastectomy group, there were 98 patients (43%) with an average lesional size of 3.3 cm; 41% had multifocal lesions, 15% had multicentric lesions. There has been one local invasive recurrence and no deaths. The 7-year actuarial disease-free survival is 98% with mastectomy. In the excision and radiation group, there were 103 patients (45%) with an average lesional size of 1.4 cm. 10 patients have had local recurrences (5 invasive and 5 noninvasive) one of whom has died. The 7-year actuarial disease-free survival is 84%, a statistically significant difference when excision and radiation is compared with mastectomy (P = 0.038). In the excision alone group, there were 26 patients (11%) with an average lesional size of 1.0 cm. There have been two local recurrences (8%), one of which was invasive and no deaths. The 7-year actuarial disease-free survival is 67%, but only 3 patients have been followed for more than 4 years. A total of 163 axillary node dissections were done; all were negative. Since DCIS without microinvasion rarely metastasizes to axillary lymph nodes, routine dissection should not be performed. Patients in this series with intraductal carcinoma treated with excision and radiation recurred locally at a statistically higher rate than those treated with mastectomy, in spite of the fact that those chosen for excision and radiation had clinically more favourable lesions. 6 of 12 (50%) local recurrences in conservatively treated patients were invasive. There was, however, no significant difference in overall survival in any subgroup regardless of treatment.


Cellular State Transformations Using Deep Learning for Precision Medicine Applications.
We introduce the Transcriptome State Perturbation Generator (TSPG) as a novel deep-learning method to identify changes in genomic expression that occur between tissue states using generative adversarial networks. TSPG learns the transcriptome perturbations from RNA-sequencing data required to shift from a source to a target class. We apply TSPG as an effective method of detecting biologically relevant alternate expression patterns between normal and tumor human tissue samples. We demonstrate that the application of TSPG to expression data obtained from a biopsy sample of a patient's kidney cancer can identify patient-specific differentially expressed genes between their individual tumor sample and a target class of healthy kidney gene expression. By utilizing TSPG in a precision medicine application in which the patient sample is not replicated (i.e., n = 1 ), we present a novel technique of determining significant transcriptional aberrations that can be used to help identify potential targeted therapies.


The aetiology of diarrhoea in pigs weaned at two days of age.
When pigs are weaned at two days of age large numbers of Excherichia coli appear in the anterior gut and the incidence of diarrhoea rises. The two phenomena do not appear to be directly related because the strains of E coli isolated are not serotypes previously found to be associated with neonatal pig scouring. Representative strains of the non-enteropathogenic serotypes did not produce enterotoxin and did not adhere to small intestine brush borders. Moreover when antibiotics were fed to eliminate E coli from the gut, the pigs still scoured. Rotavirus was detected in the gut contents and gut epithelium of scouring pigs and a bacteria-free filtrate of gut contents produced diarrhoea when administered to germ-free pigs. It is suggested that rotavirus may be one of the causes of the scouring seen shortly after weaning pigs at two days of age.


The epidemiology of all-cause and rotavirus acute gastroenteritis and the characteristics of rotavirus circulating strains before and after rotavirus vaccine introduction in Yemen: analysis of hospital-based surveillance data.
Rotavirus (RV) vaccine was added to Yemen's childhood vaccination schedule in late 2012. We evaluated the effect of vaccination on the epidemiology of acute gastroenteritis (AGE) and the characteristics of circulating RV strains. Surveillance data was obtained at two sentinel hospitals from 5,691 children with acute gastroenteritis (AGE) who were under 5 years of age. Data collected before (2007-2011) and after (2013-2014) RV vaccine introduction were retrospectively analyzed. Treatment outcome, presence of severe dehydration, and the proportion of all-cause AGE due to RV-antigen positive AGE were calculated for each period and compared. Binominal generalized linear models were used to calculate adjusted odds ratios (ORs) and 95 % confidence intervals (CIs). We also compared severe RVAGE and severe dehydration proportions in hospitalized children with severe AGE and characterized RV circulating strains in available specimens from the two periods. Before RV vaccination, mean RVAGE prevalence peaked in October (58.8 %), November (69.5 %), and December (56.4 %). In 2013-2014, the variation became less defined, with only a few RVAGE cases. The average annual prevalence of severe RVAGE needing hospitalization was 42.9 % in 2007-2011, decreased to 21.1 % in 2013, and to 18.5 % in 2014, representing declines of 50.8 % (95 % CI: 36.4-65.0) and 56.9 % (95 % CI: 42.1-70.5). The proportion of children <12 months of age with all-cause AGE decreased significantly after introduction of RV vaccination (58.7 % vs. 62.3 %; p = 0.042), severe dehydration decreased by 50 % (14.7 % vs. 21.7 %; OR = 0.501, p < 0.0001), and RVAGE proportion decreased by 48 % (19.9 % vs. 41.6 %; OR = 0.52, p < 0.0001). The proportion of severe RVAGE in hospitalized patients decreased by 67 % (20.1 % vs. 43.5 %; OR = 0.33, p < 0.0001), and severe dehydration decreased by 58 % (17.2 % vs. 33.1 %; OR = 0.42, p < 0.0001). Non-RV AGE prevalence significantly increased, with ORs of 2.8-3.1 in favor of non-RV AGE in 2013-2014. Analysis of 128 available stool specimens revealed that circulation of the G1 genotype did not change following vaccination (33.3 % vs. 41.3 %; p = 0.366). G2 significantly decreased in 2013-2014 (4.2 % vs. 42.5 % p = 0.0001), and G9 increased (29.2 % vs. 6.3 %; p = 0.001). G1P[8] and G2P[4] remained prevalent, and G9P[8] and G9P[4], which were not detected in the pre-vaccine period appeared in 2013-2014. G and [P] mixed genotypes became more prevalent in 2013-2014. It is not known if this predominance is related to the vaccine introduction or attributable to normal genotype fluctuations. Rotarix substantially reduced the prevalence of RVAGE, with a 67 % reduction of severe RVAGE hospitalizations, and over 50 % reduction of diarrhea with severe dehydration. Circulation of RV G and [P] mix strains was significantly increased in 2013-2014 and needs continuous monitoring.


Bacterial cellulose-based magnetic nanocomposites: A review.
Bacterial cellulose (BC) is a natural polymer that has unique and interesting structural, physical and chemical properties. These characteristics make it very attractive as a starting point for several novel developments in innovative research. However, the pristine BC lacks certain properties, in particular, magnetic property, which can be imparted to BC by incorporation of several types of magnetic nanoparticles. Magnetic nanocomposites based on BC exhibit additional magnetic functionality on top of the excellent properties of pristine BC, which make them promising materials with potential uses in various medical and environmental applications, as well as in advanced electronic devices. This review has compiled information about all classes of BC magnetic nanocomposites fabricated by various synthesis approaches and an overview of applications as well as improved features of these materials. A summary of the key developments of BC magnetic nanocomposites and emphasis on novel advances in this field is presented.


Complex Genetics of Behavior: BXDs in the Automated Home-Cage.
This chapter describes a use case for the genetic dissection and automated analysis of complex behavioral traits using the genetically diverse panel of BXD mouse recombinant inbred strains. Strains of the BXD resource differ widely in terms of gene and protein expression in the brain, as well as in their behavioral repertoire. A large mouse resource opens the possibility for gene finding studies underlying distinct behavioral phenotypes, however, such a resource poses a challenge in behavioral phenotyping. To address the specifics of large-scale screening we describe how to investigate: (1) how to assess mouse behavior systematically in addressing a large genetic cohort, (2) how to dissect automation-derived longitudinal mouse behavior into quantitative parameters, and (3) how to map these quantitative traits to the genome, deriving loci underlying aspects of behavior.


Treating coronary artery disease in patients with a history of cerebrovascular disease.
Patients with coronary artery disease and a history of stroke account for as many as one in eight of all patients with coronary artery disease, and they are at higher risk of ischaemic events than patients with 'lone' coronary artery disease. It is therefore tempting to increase the potency of antithrombotic treatment in this patient subset. However, these patients are also at greater risk of intracranial haemorrhage. In recent trials of new antithrombotic agents in acute coronary syndromes, patients with a history of cerebrovascular disease derived no clinical benefit from (and were even harmed by) the potent novel antithrombotic agents, with an increased risk of intracranial haemorrhage. However, this risk did not appear to be uniform: it was higher in patients with a history of stroke than in those with a history of transient ischaemic attack, and appeared to be largely confined to the first year after stroke/transient ischaemic attack. Specific strategies to optimize the benefit/risk ratio of antithrombotic agents in this relatively common patient group should be developed and evaluated.


Identification of heat stress-responsive genes in heat-adapted thermal Agrostis scabra by suppression subtractive hybridization.
To gain insights into molecular mechanisms of grass tolerance to heat stress, we constructed a suppression subtractive cDNA library to identify heat-responsive genes for a C(3) grass species, thermal Agrostis scabra adapted to heat stress in geothermal areas in Yellowstone National Park. Plants were exposed to 20 degrees C (control) or 35 degrees C for 12d. The SSH analysis was performed with control samples as the driver and heat-stressed samples as the tester. Differentially expressed cDNA fragments were cloned to screen the heat up-regulated library. The SSH analysis identified 120 non-redundant putative heat-responsive cDNAs out of 1180 clones. Genes with homology to known proteins were categorized into six functional groups, with the largest group of genes involved in stress/defense, followed by the group of genes related to protein metabolism. Immunoblot analysis confirmed increases in transcripts of selected genes under heat stress. Transcripts of seven and eight genes were strongly enhanced or induced in shoots and roots, respectively, while two genes were only induced in roots under heat stress. The heat up-regulated genes in thermal A. scabra adapted to long-term heat stress are potential candidate genes for engineering stress-tolerant grasses and for revealing molecular mechanisms of grass adaptation to heat stress.


Site selectivity switch in Lewis acid catalysis. Mechanism and kinetic simulation of skeletal rearrangement of cyclobutene-fused homoquinones.
[reactions: see text] We investigated the site selectivity switch in BF3-catalyzed dual skeletal rearrangements of cyclobutene-fused diarylhomobenzoquinones by changing the stoichiometric amount of acid concentration. From the lower to the higher equivalency of BF3 x Et2O, the branching product ratios (path A/path B) obeyed nonlinear sigmoid curves against the equivalency of BF3 x Et2O. The observed selectivity profiles were simulated to elucidate factors that govern thermodynamic aspects (binding affinity K of each carbonyl function with acid) and kinetic aspects (rate constants k for the cyclobutene-ring cleavage).


Assessment of sagittal plane segmental motion in the lumbar spine. A comparison between distortion-compensated and stereophotogrammetric roentgen analysis.
Sagittal plane translatory and rotatory motion was measured in 15 lumbar motion segments of 8 patients by distortion-compensated and stereophotogrammetric Roentgen analysis. To compare measurement precision of the new distortion-compensated Roentgen analysis protocol with that of the established Roentgen stereophotogrammetric technique under realistic clinical conditions. Roentgen stereophotogrammetric analysis constitutes the most precise method available to assess segmental motion. Because of the invasive nature of the procedure, however, there is interest in alternative, noninvasive protocols suitable for studying larger patient cohorts. In 8 patients, segmental motion of 15 lumbar segments that had undergone previous spinal surgery was assessed from stereo views by using Roentgen stereophotogrammetric analysis. Sagittal plane segmental motion was assessed by distortion-compensated Roentgen analysis. Sagittal plane translatory and rotatory motion data obtained by both methods were compared. With respect to Roentgen stereophotogrammetric analysis, sagittal plane rotation was determined by distortion-compensated Roentgen analysis with an error (standard deviation) of 1.4 degrees and a mean difference of less than 0.05 degree. Sagittal plane translation was determined by distortion-compensated Roentgen analysis, with an error of 1.25 mm and a mean difference 0.5 mm. Measurement precision of distortion-compensated Roentgen analysis is slightly inferior to that of Roentgen stereophotogrammetric analysis but substantially higher than that of conventional protocols assessing lumbar segmental motion. If measurement precision is considered adequate and if a noninvasive technique is indicated, distortion-compensated Roentgen analysis can be used to provide reliable motion data required for epidemiologic and clinical studies.


Comparison of IVP and CT findings in patients with suspected severe renal injury.
Excretory urography (IVP) is the primary diagnostic tool for renal injury but has been indeterminate in diagnosing severe renal injuries in most cases. Computed tomography (CT) provides precise anatomic detail of renal injuries. The IVP and CT findings were compared in 22 patients with suspected severe renal injuries suggested by clinical examination and initial screening IVP. CT provided determinate diagnoses in all the cases of severe renal injury, while the IVP diagnoses were indeterminate in 82 per cent of these cases. Although clarification is needed on the accuracy of CT in diagnosing renal vascular injury, the CT diagnoses were accurate in all other types of severe renal injury (as well as minor renal injuries).


Changing the science education paradigm: from teaching facts to engaging the intellect: Science Education Colloquia Series, Spring 2011.
Dr. Jo Handelsman, Howard Hughes Medical Institute Professor in the Department of Molecular, Cellular and Developmental Biology at Yale University, is a long-time devotee of scientific teaching, receiving this year's Presidential Award for Science Mentoring. She gave a seminar entitled "What is Scientific Teaching? The Changing Landscape of Science Education" as a part of the Scientific Education Colloquia Series in spring 2011. After dissecting what is wrong with the status quo of American scientific education, several ideological and practical changes are proposed, including active learning, regular assessment, diversity, and mentorship.


Effect of vitamin D on clinical and biochemical parameters in polycystic ovary syndrome women: A meta-analysis.
Using a meta-analysis framework, we investigated the association between the serum level of vitamin D and the risk of polycystic ovary syndrome (PCOS) and further examined the therapeutic effect of vitamin D on the clinical features of PCOS. Multiple databases were searched to retrieve studies. We chose clinical studies that investigated the relation between the serum level of vitamin D and the risk of PCOS or the therapeutic effect of vitamin D on PCOS. The search results were screened according to strict inclusion and exclusion criteria to select high-quality studies for inclusion. Statistical analyses were carried out using stata 12.0. Seventeen studies were eligible in this meta-analysis. The levels of 25-hydroxyvitamin D and the quantitative insulin-sensitivity check index in the PCOS group were remarkably lower than in the controls, whereas the homeostasis model assessment of insulin resistance in the PCOS group was markedly higher than in the controls. No statistically significant difference was observed in serum parathyroid hormone levels between the two groups. The 25-hydroxyvitamin D levels were significantly elevated after PCOS patients received vitamin D3 treatment, but serum parathyroid hormone concentration, homeostasis model assessment of insulin resistance and quantitative insulin-sensitivity check index did not show any significant changes, indicating a lack of therapeutic response. Our results suggest that the serum level of vitamin D is associated with the risk of PCOS, but the therapeutic effect of vitamin D on PCOS remains to be further explored.


CHMP2A regulates tumor sensitivity to natural killer cell-mediated cytotoxicity.
Natural killer (NK) cells are known to mediate killing of various cancer types, but tumor cells can develop resistance mechanisms to escape NK cell-mediated killing. Here, we use a "two cell type" whole genome CRISPR-Cas9 screening system to discover key regulators of tumor sensitivity and resistance to NK cell-mediated cytotoxicity in human glioblastoma stem cells (GSC). We identify CHMP2A as a regulator of GSC resistance to NK cell-mediated cytotoxicity and we confirm these findings in a head and neck squamous cells carcinoma (HNSCC) model. We show that deletion of CHMP2A activates NF-κB in tumor cells to mediate increased chemokine secretion that promotes NK cell migration towards tumor cells. In the HNSCC model we demonstrate that CHMP2A mediates tumor resistance to NK cells via secretion of extracellular vesicles (EVs) that express MICA/B and TRAIL. These secreted ligands induce apoptosis of NK cells to inhibit their antitumor activity. To confirm these in vitro studies, we demonstrate that deletion of CHMP2A in CAL27 HNSCC cells leads to increased NK cell-mediated killing in a xenograft immunodeficient mouse model. These findings illustrate a mechanism of tumor immune escape through EVs secretion and identify inhibition of CHMP2A and related targets as opportunities to improve NK cell-mediated immunotherapy.


Seasonal patterns of canopy development and carbon gain in nineteen warm desert shrub species.
Canopy development and photosynthetic rate were measured at monthly intervals over a period of one year in 19 shrub and subshrub species of the Mojave and upper Sonoran Deserts. Thirteen of these species realized a substantial fraction of their total net carbon assimilation via twig photosynthesis. The twig contribution to whole plant yearly carbon gain reached a maximum of 83% in species such as Thamnosma montana, Salizaria mexicana, and Baccharis brachyphylla. This large contribution by twigs was due to both low levels of leaf production and the greater longevity of twig tissues. In some other species, however, leaf and twig organs had similar lifespans. During the year of this study (which had an unusually warm, mild winter), no species showed a pattern of winter deciduousness. The reduction in total photosynthetic area between maximal spring canopy development and mid August summer dormancy ranged from 32 to 94%. Some herbaceous perennial species died back to the ground, but none of the woody shrubs were totally without green canopy area at any time of the year. No species studied were capable of high rates of photosynthesis at low plant water potentials in July and August, but, in those species which maintained a substantial canopy area through the drought period, previously stressed tissues showed substantial recovery after fall rains. Photosynthetic rate was significantly correlated with both plant water potential and tissue nitrogen content over the entire year, but only weakly so. This is due in part to the winter months when plant water potentials and tissue nitrogen contents were high, but photosynthetic rates were often low.


Management of main bile duct injuries that occur during laparoscopic cholecystectomy.
The introduction of laparoscopic cholecystectomy in surgical practice resulted with an increased incidence of bile duct injuries and required new classification systems. This article presents six cases of major bile duct injuries that occurred in our first 1,000 laparoscopic cholecystectomies. Four female and two male patients (ages, 36-71 years) were detected to have major bile duct injuries. Laparoscopic dissection was difficult because of acute inflammation in four patients and fibrosis in two patients. These six cases were between laparoscopic cholecystectomies 26 and 377 performed by the operating surgeons. Three of the patients had type E2 injury according to the Strasberg classification: one detected intraoperatively and the other two postoperatively. All were treated with Roux-en-Y hepaticojejunostomy. The other three patients had type D injuries: two realized intraoperatively and one postoperatively. Two of these injuries were repaired primarily over a T-tube. The remaining patient, whose injury was realized intraoperatively, underwent nasobiliary drainage postoperatively. Only one patient had a complication associated with a trocar injury to the liver parenchima during the first operation. A hepatic abscess and external biliary fistula developed, which were treated conservatively. At this writing, all the patients are well and without problems after 2.5 to 6 years of follow-up evaluation. Difficulties in laparoscopic dissection because of severe inflammation or fibrosis resulted in injuries to our patients. We can underscore the fact that experience may not always protect from complications, and that conversion to laparotomy might have prevented some of these injuries. Patients with a minor injury and a controlled leak can be treated by a combination of surgical and endoscopic or radiologic techniques. The treatment plan must be individualized for every patient, depending on the injury type, presentation, and condition of the patient.


Effects of priming injections of MDMA and cocaine on reinstatement of MDMA- and cocaine-seeking in rats.
Exposure to self-administered drugs is sufficient to produce drug-seeking in animal models. In many cases priming injections of drugs that share discriminative stimulus properties with the self-administered drug also can lead to drug-seeking, suggesting that exposure might precipitate relapse. The present investigation examined the ability of MDMA or cocaine priming injections to reinstate extinguished drug-seeking in rats. Priming injections of cocaine (0-20.0 mg/kg) and MDMA (0.0-10.0 mg/kg) reinstated extinguished drug-taking for both the cocaine- and MDMA-trained rats. In a separate group of cocaine-trained rats that received repeated exposure to 10.0 mg/kg MDMA, the initial exposure to MDMA (10.0 mg/kg, i.p.) failed to reinstate extinguished responding but MDMA became an effective prime for reinstatement of extinguished cocaine-taking behavior with repeated exposure. Effects of MDMA in MDMA-trained rats was greater than the effect in cocaine-trained rats suggesting that extensive experience with MDMA self-administration might have sensitized rats to this effect. These findings show that extinguished MDMA self-administration, like self-administration of other drugs of abuse, can be reinstated by exposure to psychostimulants thereby precipitating relapse.


Surgical robotics beyond enhanced dexterity instrumentation: a survey of machine learning techniques and their role in intelligent and autonomous surgical actions.
Advances in technology and computing play an increasingly important role in the evolution of modern surgical techniques and paradigms. This article reviews the current role of machine learning (ML) techniques in the context of surgery with a focus on surgical robotics (SR). Also, we provide a perspective on the future possibilities for enhancing the effectiveness of procedures by integrating ML in the operating room. The review is focused on ML techniques directly applied to surgery, surgical robotics, surgical training and assessment. The widespread use of ML methods in diagnosis and medical image computing is beyond the scope of the review. Searches were performed on PubMed and IEEE Explore using combinations of keywords: ML, surgery, robotics, surgical and medical robotics, skill learning, skill analysis and learning to perceive. Studies making use of ML methods in the context of surgery are increasingly being reported. In particular, there is an increasing interest in using ML for developing tools to understand and model surgical skill and competence or to extract surgical workflow. Many researchers begin to integrate this understanding into the control of recent surgical robots and devices. ML is an expanding field. It is popular as it allows efficient processing of vast amounts of data for interpreting and real-time decision making. Already widely used in imaging and diagnosis, it is believed that ML will also play an important role in surgery and interventional treatments. In particular, ML could become a game changer into the conception of cognitive surgical robots. Such robots endowed with cognitive skills would assist the surgical team also on a cognitive level, such as possibly lowering the mental load of the team. For example, ML could help extracting surgical skill, learned through demonstration by human experts, and could transfer this to robotic skills. Such intelligent surgical assistance would significantly surpass the state of the art in surgical robotics. Current devices possess no intelligence whatsoever and are merely advanced and expensive instruments.


High flow velocity across a complicated atrial septal defect: Doppler findings and hemodynamic correlations.
An unusually high atrial shunt flow velocity pattern was recorded in a patient whose atrial septal defect was created iatrogenically during a transatrial septal approach to aortic valvuloplasty. The flow velocity pattern measured by Doppler echocardiography was predictive of the high transatrial pressure gradient noted later at catheterization.


Wound-induced changes in the palatability of Betula pubescens and B. pendula.
Leaves of Betula were damaged artificially in April, June and August 1982. Palatability of damaged and adjacent undamaged leaves was assessed against controls in bioassays using the polyphagous Lepidoptera Spodoptera littoralis and Orgyia antiqua. Assessments were carried out at intervals from six hours to five months following each damage date. Palatability (relative proportions of leaves consumed) was significantly lower than controls in damaged and adjacent leaves after six hours and remained detectable for up to two months but this was less clear in the June-damaged samples and undetectable in the August group. Adjacent leaves were significantly affected whether distal or proximal to the damaged leaves. Marked and significant changes occurred in levels of soluble tannins in the damaged and adjacent leaves but the relationship between crude tannin levels and changed palatability was not simple cause and effect. No significant effects of damage on aphid (Euceraphis punctipennis) reproduction could be detected among birches in a growth room experiment in which half the trees were artificially damaged and half were controls. The results are discussed in the light of earlier work on induced defence in birch and five areas of significant new information represented by the results in this paper are identified.


Argon laser lesions of the rabbit iris: quantitative aspects.
The destructive effect of nonperforating argon laser coagulations in the brown irides of rabbits was studied with quantitative histological methods. Power, spot size, and exposure time were systematically varied. The lateral and axial extensions of the crater and the denaturation of the adjacent tissue were studied. The main conclusions are: (1) the extent of tissue damage is significantly correlated with power and spot size, though the correlation is not proportional; (2) the lateral extension of the tissue reaction is far more pronounced than the axial extension; (3) increase in exposure time is effective up to 0.2 s, though a further increase up to 0.5 s does not enhance the tissue reaction. It is discussed that for conventionally switched lasers the main determinant for the final extension of the lesion is the density and distribution of the pigment granules within the iris. The radial distribution of the protrusions of the melanocytes in brown irides of the rabbits used in this study favors the lateralization of the tissue reaction. The nonlinearity of the tissue reaction and exposure time might be due to the fact that after initial damage in early phases of irradiation (e.g., up to 50 or 100 ms, the absorbed laser energy is dissipated in already destroyed tissue. Some practical aspects for iridectomy are discussed.


Implementing Health Policy Initiatives: An Effective Breastfeeding Teaching Strategy for Prelicensure Nursing Students.
Exclusive breastfeeding for 6 months is recommended by all health professional organizations. However, women cite lack of support from health professionals as a barrier to breastfeeding. Foundational nursing education does not prepare students (future nurses) to support breastfeeding women. Therefore, an evidence-based breastfeeding curriculum "toolkit" supporting health policy was developed and implemented. The study was performed to determine the effectiveness of the toolkit education compared with standard education in an associate degree nursing program. A pretest-posttest survey design with intervention and comparison groups was used. Students (N = 102) completed pre- and posttests. A 15-item survey derived from Marzalik's (2004) instrument was used to measure nursing student knowledge about breastfeeding. The mean number of pretest questions correct were statistically the same for the control and intervention groups. Both groups showed growth in their posttest scores, however the intervention group scored significantly higher on the posttest (intervention mean = 12.34, control mean = 10.73, t value (100 df) = -4.12, p < .0001). The toolkit provides a curriculum that demonstrated enhanced student learning about breastfeeding. Use of a reliable intervention like this breastfeeding toolkit is essential in the development of nurses who can provide effective breastfeeding support.


Detection of individual fluorescently labeled reovirions in living cells.
Reovirus serotype 1 (Lang) can be conjugated with rhodamine B or fluorescein isothiocyanate in a way that preserves viral infectivity. We have used epifluorescence microscopy to detect individual virions bound to the surface of cells and to follow in real time the early stages of reovirus infection in living cells. Following uptake of the virus into endocytic vesicles, the movement of these vesicles can be observed readily. The vesicle movement is inhibited by nocodazole or colchicine, consistent with previous findings that the movement of intracellular vesicles is often microtubule-based.


An assessment of the reliability and validity of the Chinese version of the Reporting of Clinical Adverse Events Scale for nursing interns: A cross-cultural adaptation of scales and online investigation.
The Reporting of Clinical Adverse Events Scale is a tool for evaluating the attitudes of medical staff toward reporting adverse events in clinical practice. This study aimed to assess the reliability and validity of the Reporting of Clinical Adverse Events Scale translated into Chinese used with trainee nurses in mainland China. The Chinese version of the Reporting of Clinical Adverse Events Scale was developed following guidelines for the cross-cultural adaptation of self-reporting measures. The reliability and validity of the Chinese version of the Reporting of Clinical Adverse Events Scale was tested on 773 nursing interns by online investigation. Confirmatory factor analysis was performed on 350 questionnaires completed by the participants while exploratory factor analysis was performed on 423 questionnaires to test the structural validity of the scale. There were 23 items included in the Chinese version of the Reporting of Clinical Adverse Events Scale. The Cronbach's α-coefficient for the internal consistency of the total score was found to be 0.84 with a test-retest reliability value of 0.82, indicating a high level of reliability. Five common factors were extracted. The structural validity on the Kaiser-Meyer-Olkin test was 0.87 and the contribution rate of cumulative variance was 58.51%. The content validity values ranged between 0.86 and 1.00. The Chinese version of the Reporting of Clinical Adverse Events Scale is a valid and reliable tool for evaluating nursing interns' attitudes toward reporting clinical adverse events in China. This validation of the Chinese version of the scale also extends the use of the scale to a different population. Nursing interns are responsible for a relatively high incidence of adverse events and their attitude to reporting these is crucial to patient safety. The Chinese version of the Reporting of Clinical Adverse Events Scale will be helpful for evaluating the reporting attitude of nursing interns.


Simultaneous folate intake may prevent adverse effect of valproic acid on neurulating nervous system.
The aim of this study is to elucidate the preventive effect of folic acid (FA) on teratogenic effects of valporic acid (VA) in early stage chick embryos on neural tube development. One hundred and fifty specific pathogen-free (SPF) chick eggs were used to investigate the neurulation in five groups. Group A was the control group. Group B was injected 0.02 ml of saline (0.9% NaCl) and was used for sham group. VA (0.72 mg) in 0.02 ml saline was injected in Group C, and 0.342 mcg of FA in 0.02 ml NaCl were administered to the embryos in Group D. VA (0.72 mg) + 0.342 mcg of FA in 0.02 ml saline were administered simultaneously to the eggs in Group E. At the end of 72 h, all embryos were extracted from eggs and were fixed, and for histological analyses hematoxylin and eosine was used, for detection of apoptotic cells terminal deoxyribonucleotide transferase-mediated dUTP-X nick end labeling (TUNEL) was used and for distribution of P53, bcl-2 and caspase-3, caspase-6, caspase-8 and caspase-9 immunoperoxidase techniques were used. While there were no neural tube defects in the embryos of groups A, B and D, eight embryos died in group C and there were 12 embryos with retarded embryological development. In contrast to that, no death was observed in group E, but only eight embryos were detected with maldevelopmental delay stage. These results suggested that VA may induce apoptotic mechanisms but not through the p53 pathway. In addition, FA effectively prevents the teratogenic influence of VA on chick embryo at neurulation stages by stopping cascade of apoptosis before caspase 3 expression.