Final Results of the Prospective Multicenter Excimer Laser-Assisted High-Flow Bypass Study on the Treatment of Giant Anterior Circulation Aneurysms.
Both conventional bypass utilizing temporary recipient vessel occlusion and the excimer laser-assisted nonocclusive anastomosis (ELANA) bypass technique are possible strategies in the treatment of giant aneurysms. These treatments have only been studied in single institutional retrospective studies. The potential advantage of the ELANA technique is the absence of temporary occlusion of major arteries, decreasing the risk of intraoperative ischemia. To investigate the risks and potential benefits of high-flow bypass surgery for giant and complex aneurysms of the anterior cerebral circulation. In addition, the effectiveness of the ELANA bypass procedure in the treatment of these aneurysms is determined. A total of 37 patients were included in 8 vascular neurosurgical centers in the United States, Canada, and Europe. A 30-d postoperative bypass follow-up was studied by using digital subtraction angiography and/or magnetic resonance angiography and computed tomography angiography to assess patency as well as by clinical monitoring in all patients. In 35 patients, an ELANA high-flow bypass was performed and the aneurysm treated. Four patients had remaining neurological deficits after 30 d caused by stroke (11.4%). These strokes were not related to the ELANA anastomosis device. This study does not prove that the ELANA technique has an advantage over conventional bypass techniques, but it appears to be an acceptable alternative to conventional transplanted high-flow bypass in this very-difficult-to-treat patient group, especially in select patients whom cannot be bypassed using conventional means in which temporary occlusion is considered to be not recommended.


Asymmetry of Posterior Condyles in Resection Plane and Axial Curvature for Total Knee Arthroplasty.
Understanding the morphology of the distal femur is essential for improving bone-implant match in total knee arthroplasty (TKA) and understanding the mechanisms behind knee kinematics. However, little is known about the asymmetry of the posterior condyles. Thus, this study aimed to thoroughly investigate asymmetries in sizes and shapes between the medial and lateral posterior condyles before and after femoral resections during TKA in osteoarthritic (OA) knees. Three-dimensional femoral models of 74 OA knees were constructed using computed tomography images. The morphologic measurements of the posterior condyle pre- and post-simulated osteotomy for TKA included the radii of the posterior condyles fitted to a circle on the sagittal and axial planes of the femoral coordinate system, the inclination angle of the articular surface and resected surface, and the width and height of the resected surface. Differences in the data were assessed using Student's t-test, and correlations were evaluated using the Pearson product-moment correlation. The radii of the medial posterior condyles fitted to the circle were, on average, 6 mm larger than those of the lateral condyles on the axial plane (p < 0.001) and 0.7 mm smaller than those of the lateral condyles on the sagittal plane (p = 0.046). The inclination angles of the medial and lateral posterior condyles on the axial plane were significantly different with both pre-simulated and post-simulated osteotomy, respectively (both p < 0.001). The resected plane of the lateral posterior condyles displaced opposite inclination directions between the distal and proximal portions. Neither heights or widths of the medial posterior condyles were significantly different from those of their lateral counterparts (both p > 0.107). This study found asymmetrical inclination of the resected surface and coronal radii between the medial and lateral posterior condyles, which may relate to the posterolateral overhang of the lateral condyle after TKA and the progression of the knee OA. These findings provides valuable morphological information and may help improve the implant designs for TKA.


Vascular plant species diversity of Mt. Etna (Sicily): endemicity, insularity and spatial patterns along the altitudinal gradient of the highest active volcano in Europe.
Altitudinal variation in vascular plant richness and endemism is crucial for the conservation of biodiversity. Territories featured by a high species richness may have a low number of endemic species, but not necessarily in a coherent pattern. The main aim of our research is to perform an in-depth survey on the distribution patterns of vascular plant species richness and endemism along the elevation gradient of Mt. Etna, the highest active volcano in Europe. We used all the available data (literature, herbarium and seed collections), plus hundreds of original (G Giusso, P Minissale, S Sciandrello, pers. obs., 2010-2020) on the occurrence of the Etna plant species. Mt. Etna (highest peak at 3,328 mt a.s.l.) was divided into 33 belts 100 m wide and the species richness of each altitudinal range was calculated as the total number of species per interval. In order to identify areas with high plant conservation priority, 29 narrow endemic species (EE) were investigated through hot spot analysis using the "Optimized Hot Spot Analysis" tool available in the ESRI ArcGIS software package. Overall against a floristic richness of about 1,055 taxa, 92 taxa are endemic, of which 29 taxa are exclusive (EE) of Mt. Etna, 27 endemic of Sicily (ES) and 35 taxa endemic of Italy (EI). Plant species richness slowly grows up to 1,000 m, then decreases with increasing altitude, while endemic richness shows an increasing percentage incidence along the altitudinal gradient (attributed to the increased isolation of higher elevation). The highest endemic richness is recorded from 2,000 up to 2,800 m a.s.l., while the highest narrow endemic richness (EE) ranges from 2,500 up to 2,800 m a.s.l. Life-form patterns clearly change along altitudinal gradient. In regard to the life-form of the endemics, the most represented are the hemicryptophytes, annual plants (therophytes) are prevailing at lower altitudes and show a decreasing trend with increasing elevation, while chamaephytes are featured by an increasing trend up to 3,100 m of altitude. Furthermore, the results of the hotspot analysis emphasize the high plant conservation priority areas localized in oro-mediterranean (1,800-2,400 m s.l.m.) and cryo-mediterranean (2,400-2,800 m) bioclimatic belts, in correspondence of the oldest substrates of the volcano. High plant speciation rate caused by increasing isolation with elevation is the most plausible explanation for the largest active volcano in Europe. The high degree of endemic species on Mt. Etna is linked to its geographical, geological and climatic isolation, all important drivers of speciation acting on the population gene flows. The hot spot map obtained represents a useful support for help environmental decision makers to identify priority areas for plant conservation.


Thromboresistance and endothelial healing in polymer-coated versus polymer-free drug-eluting stents: Implications for short-term dual anti-platelet therapy.
Short-term dual antiplatelet therapy (DAPT) is a suitable strategy after stent implantation especially in patients at high risk for bleeding. The thromboresistant characteristics and the healing profile permanent polymer stents such as the Resolute Onyx- drug-eluting stent (DES) has never been tested against the current approved stents for short-term DAPT, the polymer free (PF) biolimus-eluting stent (PF-BES) and bare metal stents (BMS) in dedicated preclinical models. An ex-vivo porcine arteriovenous shunt and in-vivo flow loop model were used to evaluate thromboresistance. The healing profile was assessed in the rabbit model at 28 days by confocal microscopy (CM), scanning electron microscopy (SEM) and histology. Onyx-DES was separately compared with Onyx-BMS in first experiment and PF-BES in second experiment. In an ex-vivo shunt model, CM and SEM showed significantly less platelet adhesion for Onyx-DES relative to Onyx-BMS and PF-BES. In a flow loop model using human blood, platelet adhesion was also significantly less in Onyx-DES as compared to PF-BES and Onyx-BMS. In the healing study, Onyx-BMS showed significantly greater healing profile relative to Onyx-DES as expected, whereas Onyx-DES showed equivalent endothelial coverage by SEM and significantly less Evan's blue uptake and comparable colocalization of p120 and vascular endothelial-cadherin when compared with PF-BES. Onyx-DES showed qualities of thomboresistance and healing which appear to be compatible with short-term DAPT. Thromboresistance was superior to PF-BES and healing was equivalent to PF-BES in this pre-clinical study. Onyx-DES might provide advantages when considering short-term DAPT especially in patients at high risk of bleeding.


Optical reprogramming of human somatic cells using ultrashort Bessel-shaped near-infrared femtosecond laser pulses.
We report a virus-free optical approach to human cell reprogramming into induced pluripotent stem cells with low-power nanoporation using ultrashort Bessel-shaped laser pulses. Picojoule near-infrared sub-20 fs laser pulses at a high 85 MHz repetition frequency are employed to generate transient nanopores in the membrane of dermal fibroblasts for the introduction of four transcription factors to induce the reprogramming process. In contrast to conventional approaches which utilize retro- or lentiviruses to deliver genes or transcription factors into the host genome, the laser method is virus-free; hence, the risk of virus-induced cancer generation limiting clinical application is avoided.


Psychological stress in adolescent and adult mice increases neuroinflammation and attenuates the response to LPS challenge.
There is ample evidence that psychological stress adversely affects many diseases. Recent evidence has shown that intense stressors can increase inflammation within the brain, a known mediator of many diseases. However, long-term outcomes of chronic psychological stressors that elicit a neuroinflammatory response remain unknown. To address this, we have modified previously described models of rat/mouse predatory stress (PS) to increase the intensity of the interaction. We postulated that these modifications would enhance the predator-prey experience and increase neuroinflammation and behavioral dysfunction in prey animals. In addition, another group of mice were subjected to a modified version of chronic unpredictable stress (CUS), an often-used model of chronic stress that utilizes a combination of stressors that include physical, psychological, chemical, and other. The CUS model has been shown to exacerbate a number of inflammatory-related diseases via an unknown mechanism. Using these two models we sought to determine: 1) whether chronic PS or CUS modulated the inflammatory response as a proposed mechanism by which behavioral deficits might be mediated, and 2) whether chronic exposure to a pure psychological stressor (PS) leads to deficits similar to those produced by a CUS model containing psychological and physical stressors. Finally, to determine whether acute PS has neuroinflammatory consequences, adult mice were examined at various time-points after PS for changes in inflammation. Adolescent mice subjected to chronic PS had increased basal expression of inflammation within the midbrain. CUS and chronic PS mice also had an impaired inflammatory response to a subsequent lipopolysaccharide challenge and PS mice displayed increased anxiety- and depressive-like behaviors following chronic stress. Finally, adult mice subjected to acute predatory stress had increased gene expression of inflammatory factors. Our results demonstrate that predatory stress, an ethologically relevant stressor, can elicit changes in neuroinflammation and behavior. The predatory stress model may be useful in elucidating mechanisms by which psychological stress modulates diseases with an inflammatory component.


Myocyte enhancer factor 2 regulates expression of medaka Oryzias latipes fast skeletal myosin heavy chain genes in a temperature-dependent manner.
We characterized the promoter activity of fast skeletal myosin heavy chain genes (MYHs) from medaka Oryzias latipes. The 5'-flanking region of approximately 6 kb in medaka MYHs, mMYH10 and mMYH30, predominantly expressed in medaka acclimated to 10 degrees C and 30 degrees C, respectively, contained various cis-elements that are supposed to bind to transcriptional regulatory factors such as MyoD and myocyte enhancer factor 2 (MEF2) family members and nuclear factor of activated T cells. To localize functional regions responsible for the mMYH expression in a temperature-dependent manner, a series of deletion and site mutation constructs prepared from the 5'-flanking regions were fused to the luciferase gene in a commercially available plasmid and directly injected into the dorsal fast muscle of medaka acclimated to 10 degrees C and 30 degrees C. The truncation of MEF2 binding site located at -966 to -957 in the 5'-flanking region of mMYH10 resulted in distinct gene expression at 10 degrees C. The activation effect by the removal of this binding site was further confirmed by the mutation construct. One of the E box sites, to which MyoD family members are supposed to bind, was located at -613 to -607 of mMYH10, and found to be responsible for the transcriptional activity. In contrast, the MEF2 binding site located at -960 to -951 of mMYH30 was involved in the activation at 30 degrees C. Thus, these transient transfection assays demonstrated that the MEF2 binding site is crucial for a temperature-dependent expression of mMYHs.


Bacteraemic urinary tract infections may mimic respiratory infections: a nested case-control study.
Daily practice suggests that respiratory signs may be observed in bacteraemic urinary infections (BUI). Our objective was to search for an association between the presence of respiratory symptoms and the bacteraemic nature of urinary tract infections (UTI). A nested case-control study was carried out based on our computerised dashboard from January 2011 to June 2015. Cases were defined as patients with a BUI due to Enterobacteriaceae species, identified in blood and urine cultures. Controls had fever and a positive urinary sample but sterile blood cultures (NBUI) and a final diagnosis of urinary infection. Patients from the BUI group were 1:1 matched to the NBUI group according to four parameters: age, gender, cardiovascular and pulmonary comorbid conditions. Subjects with cognitive impairment limiting clinical accuracy and those with healthcare-associated infections were excluded. We compared systematically recorded respiratory and urinary symptoms between groups: signs on auscultation, dyspnoea, chest pain, cough and sputum, dysuria with burning, pollakiuria, flank or costovertebral angle tenderness and ischuria. One hundred BUI were compared to 100 NBUI, both groups exhibiting a similar rate for all considered comorbid conditions. In the BUI group, 58 % showed at least one respiratory sign vs. 20 % in the NBUI group, p < 0.001, while urinary signs were less frequent: 54 % vs. 71 %, p = 0.013. In the multivariate analysis, BUI was associated with the presence of abnormal pulmonary auscultation [adjusted odds ratio (AOR), 5.91; p < 0.001] and a trend towards less urinary symptoms (AOR, 1.58; p = 0.058). Patients with BUI presented with significantly more respiratory signs, which overshadowed urinary symptoms, compared to those with non-bacteraemic UTI. Such observations impact clinical decision-making.


Serological survey of bovine brucellosis in Fulani nomadic cattle breeds (Bos indicus) of North-central Nigeria: Potential risk factors and zoonotic implications.
A cross sectional study was conducted to investigate seroprevalence and associated risk factors of bovine brucellosis in Fulani nomadic herds in the 3 agro-ecological zones of Niger State, North-central Nigeria between January and August 2013. A total of 672 cattle in 113 herds were screened for Brucella antibodies using Rose Bengal Plate Test (RBPT) and confirmed by Lateral flow Assay (LFA). Data on herd characteristics and zoonotic factors were collected using structured questionnaire administered on Fulani herd owners. Factors associated with Brucella infection were tested using Chi-square test and multivariable logistic model. The overall cattle-level seroprevalence was 1.9% (95% CI: 1.1-3.2) with highest in agro-zone C (3.2%). Herd-level seroprevalence was 9.7% (95% CI: 5.23-16.29) and highest in agro-zone C (13.5%). Sex and agro-ecological zones were significantly (P<0.006 and P<0.01, respectively) associated with Brucella abortus seropositivity. Herd composition, abortion in herd, exchange of bulls for mating, introduction of new cattle, and socio-cultural practices were significantly associated with brucellosis occurrence. Inhalation of droplets from milk of infected cows, and drinking raw milk were less likely [OR 0.27; 95% CI: 0.09-0.82 and OR 0.27; 95% CI: 0.08-0.99, respectively] not to predisposed to brucellosis in humans. Eating infected raw meat, and contact with infected placenta were more likely [OR 7.49; 95% CI: 2.06-28.32 and OR 5.74; 95% CI: 1.78-18.47, respectively] to be risks for the disease in humans. These results highlighted the important risk factors for bovine brucellosis in Fulani herds. Thus, brucellosis control programs which take these factors into consideration will be beneficial.


Multiple abiotic stress tolerance in Vigna mungo is altered by overexpression of ALDRXV4 gene via reactive carbonyl detoxification.
Vigna mungo (blackgram) is an important leguminous pulse crop, which is grown for its protein rich edible seeds. Drought and salinity are the major abiotic stresses which adversely affect the growth and productivity of crop plants including blackgram. The ALDRXV4 belongs to the aldo-keto reductase superfamily of enzymes that catalyze the reduction of carbonyl metabolites in the cells and plays an important role in the osmoprotection and detoxification of the reactive carbonyl species. In the present study, we developed transgenic plants of V. mungo using Agrobacterium mediated transformation. The transgene integration was confirmed by Southern blot analysis whereas the expression was confirmed by RT-PCR, Western blot and enzyme activity. The T1 generation transgenic plants displayed improved tolerance to various environmental stresses, including drought, salt, methyl viologen and H2O2 induced oxidative stress. The increased aldose reductase activity, higher sorbitol content and less accumulation of the toxic metabolite, methylglyoxal in the transgenic lines under non-stress and stress (drought and salinity) conditions resulted in increased protection through maintenance of better photosynthetic efficiency, higher relative water content and less photooxidative damage. The accumulation of reactive oxygen species was remarkably decreased in the transgenic lines as compared with the wild type plants. This study of engineering multiple stress tolerance in blackgram, is the first report to date and this strategy for trait improvement is proposed to provide a novel germplasm for blackgram production on marginal lands.


Identification and discrimination of sweep formants.
Earlier identification experiments with sweep tones are repeated with rising and falling single formant (band) sweeps, with durations ranging from 15 to 40 msec and sweep rates from 0 to 40 oct/sec. Steady-state portions of 100-msec duration are then added to the sweeps. The general conclusions are that the tendency to perceive level and slightly rising tones as falling, which was such a prominent feature of the earlier results, disappears as the stimuli become more complex, and that sweep discrimination seems to be a function of the difference between the initial and the final frequency of a sweep.


Role of disease status and type D personality in outcomes in patients with peripheral arterial disease.
Patients with peripheral arterial disease (PAD) often experience diminishing quality of life (QOL) in many domains of their lives. However, factors associated with impaired QOL and perceived stress in these patients are not completely understood. The relative effects of disease status and type D ("distressed") personality (tendencies to experience negative emotions and be socially inhibited) on these patient-based outcomes were examined. It has been argued that type D personality might depend on disease status; therefore, its effect was examined in a combined sample of 150 patients with PAD and 150 healthy controls. The Type D Scale-14, World Health Organization Quality of Life Assessment Instrument-100, and Perceived Stress Scale-10 Item assessed type D personality, QOL, and perceived stress, respectively. PAD severity (mild, moderate, or severe) was not associated with QOL or perceived stress. However, patients with PAD reported decreased QOL (p < 0.05) compared with healthy controls. Type D patients reported significantly poorer QOL than non-type D patients across PAD and healthy subgroups (p < 0.0001). After controlling for disease status (presence or absence of PAD), type D personality remained associated with increased risk for impaired QOL (odds ratio [OR] 7.35, 95% confidence interval [CI] 3.39 to 15.96, p < 0.0001) and perceived stress (OR 6.45, 95% CI 3.42 to 12.18, p < 0.0001). Hence, type D personality was associated with impaired QOL beyond the impairment already related to PAD and with increased stress in this high-risk population. In conclusion, type D personality is not merely a function of PAD but seems to represent a different determinant of patient-based outcomes.


Evaluation of the educational quality and reliability of YouTube videos addressing eyelid ptosis surgery.
To evaluate the educational content, quality, and reliability of YouTube videos addressing anterior approach ptosis surgery. A search on YouTube using the term "ptosis surgery" was performed between March 20 and March 26 2021. The quality, reliability, and accuracy of the contents of 38 videos meeting the inclusion criteria were evaluated by two independent ophthalmologists using the DISCERN questionnaire and the Journal of the American Medical Association (JAMA) benchmark criteria. The Global Quality Score (GQS) and a surgical scoring system were used to assess the educational value of the content. The mean DISCERN score was 32.8 ± 10, and the mean JAMA score was 1.3 ± 0.5, indicating poor quality; the mean global quality score was 3.1 ± 1.1, indicating moderate quality; and the mean surgical score was 7.5 ± 2.7, indicating moderate to good quality. The surgical, DISCERN, and GQS scores of the videos uploaded by physicians were significantly higher than those of the videos uploaded by private clinics (p = .015, p= .049, and p= .01, respectively). There was a significant positive correlation between the surgical, DISCERN, JAMA, and GQS scores (p< .001). A significant positive correlation was found between video duration and surgical score (p= .013), DISCERN score (p ˂0.001), and GQS score (p ˂0.001). Videos with known sources, uploaded by physicians, and supported by audio narration may be useful in obtaining educational information. However, the available videos are not a reliable source of educational information about ptosis surgery.


Effects of intestinal trefoil, factor on colonic mucosa in experimental colitis of rats.
In order to investigate the protective effects of intestinal trefoil factor (ITF) on colonic mucosa in experimental colitis of rats, ITF was detected by RT-PCR and immunohistochemistry at different time points. Three days after colitis induction, rats were treated with either 0.9% saline solution or rhITF. Pathological changes and the expression of iNOS mRNA, NO, MDA and SOD were measured respectively. It was found that ITF was mainly located in goblet cells, significantly higher in model group than in normal group (P<0.05). rhITF could increase the iNOS mRNA expression and NO contents, and there was statistically significant difference between rhITF group and model group (P<0.05). rhITF also caused an increase of MDA and a decrease of SOD, but there was no significant difference between two groups. These results indicated that ITF has apparent therapeutic effects in ulcerative colitis, which may be associated with iNOS and NO.


Psychoneuroimmunology and cancer: a decade of discovery, paradigm shifts, and methodological innovations.
This article introduces the supplement Advances in Cancer and Brain, Behavior, and Immunity and outlines important discoveries, paradigm shifts, and methodological innovations that have emerged in the past decade to advance mechanistic and translational understanding of biobehavioral influences on tumor biology, cancer treatment-related sequelae, and cancer outcomes. We offer a heuristic framework for research on biobehavioral pathways in cancer. The shifting survivorship landscape is highlighted, and we propose that the changing demographics suggest prudent adoption of a life course perspective of cancer and cancer survivorship. We note opportunities for psychoneuroimmunology (PNI) research to ameliorate the long-term, unintended consequences of aggressive curative intent and call attention to the critical role of reciprocal translational pathways between animal and human studies. Lastly, we briefly summarize the articles included in this compilation and offer our perspectives on future research directions.


The mutagenic activity of chlorpromazine.
The mutagenic activity of chlorpromazine hydrochloride based on the Ames plate incorporation test and the modified fluctuation test in the presence and absence of liver microsomal enzyme (S9 fraction) and NADPH was determined. The results indicated that chlorpromazine required activation for mutagenic activity for the reversion of some of the tester bacterial strains from tryptophan and histidine dependence to independence respectively. The positive response of Escherichia coli WP2 trp, uvrA, E. coli WP2 trp (pKM101 and pAQ1) and Salmonella typhimurium his TA102 indicated that chlorpromazine mediates base-pair substitution and frame-shift mutagenesis.


Thioredoxin reductase is a key factor in the oxidative stress response of Lactobacillus plantarum WCFS1.
Thioredoxin (TRX) is a powerful disulfide oxido-reductase that catalyzes a wide spectrum of redox reactions in the cell. The aim of this study is to elucidate the role of the TRX system in the oxidative stress response in Lactobacillus plantarum WCFS1. We have identified the trxB1-encoded thioredoxin reductase (TR) as a key enzyme in the oxidative stress response of Lactobacillus plantarum WCFS1.Overexpression of the trxB1 gene resulted in a 3-fold higher TR activity in comparison to the wild-type strain. Subsequently, higher TR activity was associated with an increased resistance towards oxidative stress. We further determined the global transcriptional response to hydrogen peroxide stress in the trxB1-overexpression and wild-type strains grown in continuous cultures. Hydrogen peroxide stress and overproduction of TR collectively resulted in the up-regulation of 267 genes. Additionally, gene expression profiling showed significant differential expression of 27 genes in the trxB1-overexpression strain. Over expression of trxB1 was found to activate genes associated with DNA repair and stress mechanisms as well as genes associated with the activity of biosynthetic pathways for purine and sulfur-containing amino acids. A total of 16 genes showed a response to both TR overproduction and hydrogen peroxide stress. These genes are involved in the purine metabolism, energy metabolism (gapB) as well as in stress-response (groEL, npr2), and manganese transport (mntH2). Based on our findings we propose that overproduction of the trxB1-encoded TR in L. plantarum improves tolerance towards oxidative stress. This response coincides with simultaneous induction of a group of 16 transcripts of genes. Within this group of genes, most are associated with oxidative stress response. The obtained crossover between datasets may explain the phenotype of the trxB1-overexpression strain, which appears to be prepared for encountering oxidative stress. This latter property can be used for engineering robustness towards oxidative stress in industrial strains of L. plantarum.


Comparison of N-acetylcysteine and fenoldopam for preventing contrast-induced nephropathy (CAFCIN).
N-acetylcysteine and fenoldopam are commonly prescribed for prevention of contrast mediated nephropathy, however, comparative superiority of either agent is unknown. In a prospective, randomized, parallel-group trial, adult cardiac catheterization patients at the university and veterans' hospitals with pre-existing stable renal insufficiency were randomized to N-acetylcysteine 600 mg orally twice daily for 4 doses or fenoldopam 0.1 mcg/kg/min intravenously for a minimum of 8 h. All patients received intravenous hydration with normal saline (5% dextrose in normal saline for diabetics on insulin). Randomization was stratified for diabetes. The primary endpoint was mean change in Scr at 72 h. Secondary endpoint was the incidence of contrast-induced nephropathy (25% increase above baseline Scr or absolute increase of 0.5 mg/dL). Study termination occurred after ninety-five patients (mean age 68+/-10 years, female 25%, diabetic 42%, mean baseline Scr 1.5+/-0.4 mg/dL) were randomized, with 84 completing follow-up (44 N-acetylcysteine, 40 fenoldopam). Overall, there were no significant differences in mean change in Scr at 72 h (N-acetylcysteine 0.20+/-0.72 vs. fenoldopam 0.08+/-0.48 mg/dL, p=0.4) or incidence of contrast-induced nephropathy (N-acetylcysteine 5 vs fenoldopam 8, p=0.4). No differences were detected in subgroup analyses for diabetes, baseline Scr >1.7 or 2.0 mg/dL, gender, age >70 years, or contrast volume >150 mL. Results were similar after multivariate adjustment for diabetes, contrast volume, heart failure and gender. Our randomized comparison failed to demonstrate a significant difference in the abilities of N-acetylcysteine and fenoldopam to prevent the decline in renal function or the incidence of contrast-induced nephropathy during cardiac catheterization.


Subjective stress reactivity in psoriasis - a cross sectional study of associated psychological traits.
Stress or psychological distress is often described as a causative or maintaining factor in psoriasis. Psychological traits may influence the appraisal, interpretation and coping ability regarding stressful situations. Detailed investigations of psychological traits in relation to stress reactivity in psoriasis are rare. The aim of this study was to examine whether patients with psoriasis who report an association between psychological distress and exacerbation, "stress reactors" (SRs), differ psychologically from those with no stress reactivity "non-stress reactors" (NSRs). This cross-sectional study was conducted among 101 consecutively recruited outpatients with plaque psoriasis. A psychosocial interview was performed including questions concerning stress reactivity in relation to onset and exacerbation. Three validated self-rating scales were used: Spielberger State-Trait Anxiety Inventory (STAI, Form-Y), Beck Depression Inventory (BDI-II) and Swedish Universities Scales of Personality (SSP). Independent samples t-tests, Chi-square tests and one-way ANOVA analyses were used for group comparisons when appropriate. A logistic regression model was designed with SR as the dependent variable. Sixty-four patients (63%) reported a subjective association between disease exacerbation and stress (SRs). Patients defined as SRs reported significantly higher mean scores regarding state and trait anxiety, depression, and also five SSP scale personality traits, i.e. somatic trait anxiety, psychic trait anxiety, stress susceptibility, lack of assertiveness and mistrust, compared with NSRs. In multivariate analysis, SSP-stress susceptibility was the strongest explanatory variable for SR, i.e. OR (95% CI)=1.13 (1.02 - 1.24), p=0.018. According to our results, patients who perceive stress as a causal factor in their psoriasis might have a more vulnerable psychological constitution. This finding suggests important opportunities for clinicians to identify patients who may benefit from additional psychological exploration and support.


Cr(VI) photocatalytic reduction: effects of simultaneous organics oxidation and of gold nanoparticles photodeposition on TiO2.
Commercial TiO(2) samples with different phase composition and surface area were tested as photocatalysts in the photoinduced reduction of Cr(VI) in aqueous suspensions at pH 3.7 under UV-visible light irradiation. This reaction was also coupled with the simultaneous photocatalytic oxidation of the pollutant azo dye Acid Orange 8 (AO8) and of formic acid, acting as hole scavengers. The co-presence of oxidizable and reducible species ensured better separation of photogenerated charge carriers, resulting in a higher rate of both organics' oxidation and Cr(VI) reduction, especially in the case of high surface area anatase TiO(2), having the strongest affinity for Cr(VI) and AO8, as demonstrated by competitive adsorption tests. The effects on Cr(VI) photocatalytic reduction of gold nanoparticles photodeposited on TiO(2) and of the Au loading were also investigated, aiming at ascertaining if this noble metal plays a role in the electron transfer processes involved in Cr(VI) reduction.


Depletion of T lymphocyte population in pneumococcal infection.
T lymphocyte population in absolute numbers and percentage is decreased during the course of pneumococcal infection in Nigerians and may explain, to some extent, the frequent complication of herpes labialis.


Psychological disturbances in asylum seekers held in long term detention: a participant-observer account.
The process of applying for refugee status in Australia is complex, lengthy and often poorly understood by asylum seekers. The psychological reaction patterns of detainees whose claims for asylum are unsuccessful are characterised by stages of increasing depression, punctuated by periods of protest, as feelings of injustice overwhelm them. These reactions have a marked secondary impact on their children in detention. The prolonged detention of asylum seekers appears to cause serious psychological harm. Even if many of those who spend long periods of time are not deemed to have proven their refugee claims, this administrative decision should not be grounds for inflicting grave ongoing psychological injury on the applicants.


Co-construction of health technology assessment recommendations with patients: An example with cardiac defibrillator replacement.
The National Institute of Excellence in Health and Social Services (INESSS), which functions as the Québec health technology assessment (HTA) agency, tested a new way to engage patients along with health-care professionals in the co-construction of recommendations regarding implantable cardioverter-defibrillator replacement. The objective of this article was to describe the process of co-construction of recommendations and to propose methods of building best practices for patient involvement (PI) in HTA. Throughout the process, documents were collected and participant observations were made. Individual interviews were conducted with patients, health-care professionals and the INESSS scientific team, from January to March 2018. Three committees were established: an expert patient committee to reflect on patient experience literature; an expert health professional committee to reflect on medical literature; and a co-construction committee through which both patients and health-care professionals contributed to develop the recommendations. The expert patients validated and contextualized a literature review produced by the scientific team. This allowed the scientists to consider aspects related to the patient experience and to integrate the feedback from patients into HTA recommendations. The most important factor contributing to a positive PI experience was the structured methodology for selecting patient participants, and a key factor that inhibited the process was a lack of training in PI on the part of the scientific team. This experience demonstrates that it is possible to co-construct recommendations, even for technically complex HTA subjects, through a more democratic process than usual which led to more patient-focused guidance.


The impact of treating parental anxiety on children's mental health: An empty systematic review.
Children of anxious parents are at heightened risk of developing an anxiety disorder of their own, but promising research indicates that targeting parenting behaviours can reduce the risk of intergenerational transmission of anxiety. Given there is extensive evidence for the efficacy of treatments for adult anxiety, the current review sought to identify whether interventions solely addressing parental symptoms had any effect on the mental health and wellbeing of their children. Randomised Controlled Trials of psychological interventions targeting adults with a probable anxiety disorder and which included a child mental health or wellbeing outcome were eligible for inclusion. Scopus, Web of Science, PubMed, PsychINFO, and PsychArticles were searched, and 2137 articles were systematically reviewed. However, no articles were identified that met the review criteria. Research into interventions targeting adult anxiety is failing to consider the potential benefit treatment may have on dependent children. This is a missed opportunity to evaluate a potential means of support for children who are known to be at risk of anxiety. Evaluation of psychological interventions for adult anxiety should consider including both adult and child mental health outcomes to determine potential preventative effects.


Primary brain tumour presenting as spontaneous intracerebral haemorrhage.
In an autopsy series of 430 spontaneous intracerebral haematomas 44 cases, or 10.2 percent, were caused by a proved neoplasm, including 21 anaplastic gliomas, 17 metastases, 2 oligodendrogliomas, 2 malignant lymphomas, and one meningioma. These instances of massive bleeding into brain tumour represented 2.4 percent of about 1,800 primary and secondary cerebral neoplasms proved by necropsy. In only four of the patients with primary brain tumours (two glioblastomas, one oligodendroglioma invading the leptomeninges, and one primary malignant lymphoma), three of them with a history of arterial hypertension, were the presenting symptoms these of a spontaneous intracerebral haemorrhage, and the tumour itself was not diagnosed until surgery or necropsy. One patient with acute haemorrhage into a glioblastoma of the basal ganglia showed a rapidly lethal course, while the others demonstrated one or more episodes before the onset of the acute fatal illness and a prolonged period from the time of the bleed until death. The clinical features and the pathogenesis of spontaneous haemorrhage into cerebral neoplasms are briefly reviewed.


Construction of carrier state viruses with partial genomes of the segmented dsRNA bacteriophages.
The cystoviridae are bacteriophages with genomes of three segments of dsRNA enclosed within a polyhedral capsid. Two members of this family, Phi6 and Phi8, have been shown to form carrier states in which the virus replicates as a stable episome in the host bacterium while expressing reporter genes such as kanamycin resistance or lacalpha. The carrier state does not require the activity of all the genes necessary for phage production. It is possible to generate carrier states by infecting cells with virus or by electroporating nonreplicating plasmids containing cDNA copies of the viral genomes into the host cells. We have found that carrier states in both Phi6 and Phi8 can be formed at high frequency with all three genomic segments or with only the large and small segments. The large genomic segment codes for the proteins that constitute the inner core of the virus, which is the structure responsible for the packaging and replication of the genome. In Phi6, a carrier state can be formed with the large and middle segment if mutations occur in the gene for the major structural protein of the inner core. In Phi8, carrier state formation requires the activity of genes 8 and 12 of segment S.


Blood lead and cadmium levels in occupationally exposed workers and their effect on markers of DNA damage and repair.
Occupational exposure to heavy metals like lead and cadmium causes a wide range of biological effects and may elevate the risk of genetic damage. Heavy metal toxicity is now becoming a significant public health problem. There are many discrepancies in the results of the studies on the genotoxicity of heavy metals. Therefore, the study aimed to estimate lead, cadmium, and 8-OHdG levels (8-hydroxy-2-deoxyguanosine) and expression of DNA repair gene OGG1 (8-oxoguanine DNA glycosylase 1) in occupationally heavy metal exposed workers. The study comprised 100 workers, occupationally exposed to lead and cadmium from different factories and 100 controls without history of metal exposure. The lead and cadmium mean ± SD were 5.69 ± 12.07 µg/dL and 3.44 ± 1.33 µg/L in the cases and 1.27 ± 1.10 µg/dL and 1.07 ± 0.67 µg/L in the controls. The 8-OHdG concentration was significantly higher in the cases than the controls. Cadmium showed a significant positive correlation with 8-OHdG in the cases. The expression of OGG1 was significantly down-regulated in the cases compared to the controls. Lead levels did not show any significant correlation with OGG1, whereas cadmium level had a significant positive correlation with OGG1 in the cases. To conclude, the exposure to heavy metals is associated with increased oxidative DNA damage and impaired expression of the DNA repair gene, OGG1.


Industrial-scale application of the plunger flow electro-oxidation reactor in wastewater depth treatment.
Effluents after biochemical treatment contain pollutants that are mostly non-degradable. Based upon previous pilot-scale test results, an industrial-scale electro-oxidation device was built to decompose these refractory materials in the effluent from a park wastewater treatment plant. The electro-oxidation device comprised a ditch-shaped plunger flow electrolysis cell, with mesh-plate Ti/PbO2 electrodes as the anode and the same size mesh-plate Ti as the cathode. Wastewater flowed vertically through electrodes; the effective volume of the cell was 2.8 m(3), and the surface-to-volume ratio was 17.14 m(2) m(-3). The optimal current density was 100 A m(-2), and a suitable flow velocity was 14.0 m h(-1). The removal efficiencies for chemical oxygen demand and color in the effluent were over 60.0 and 84.0 %, respectively. In addition, the electro-oxidation system offered a good disinfection capability. The specific energy consumption for this industrial-scale device was 43.5 kWh kg COD(-1), with a current efficiency of 32.8 %, which was superior to the pilot-scale one. To meet the requirements for emission or reuse, the operation cost was $0.44 per ton of effluent at an average price for electricity of $0.11 kWh(-1).


Familial adult onset of Krabbe's disease resembling hereditary spastic paraplegia with normal neuroimaging.
Krabbe's disease (globoid cell leucodystrophy) is a disorder involving the white matter of the peripheral and central nervous systems. Mutations in the gene for the lysosomal enzyme galactocerebrosidase (GALC) result in low enzymatic activity and decreased ability to degrade galactolipids found in myelin. The disease is classically of infantile onset, but adult onset cases have been reported. Magnetic resonance imaging (MRI) of the brain shows characteristic abnormalities. A unique family with Krabbe's disease is described, with proven GALC deficiency but normal MRI. A neurological phenotype is present in heterozygotes and the family shows the extent of homozygotic phenotypic diversity that can be seen in this disorder.


Inhibitors of sterol biosynthesis. Synthesis and activities of ring C oxygenated sterols.
The chemical syntheses of a number of C27 ring C oxygenated sterols have been pursued to permit evaluation of their activity in the inhibition of sterol biosynthesis in cultured mammalian cells. Thus, 5 alpha-cholest-7-ene-3 beta, 11 alpha-diol, 3 alpha-hydroxy-5 alpha-cholest-9(11)-en-12-one, and the previously unreported 11 alpha-hydroxy-5 alpha-cholest-7-en-3-one, 5 alpha-cholest-9(11)-ene-3,12-dione, and 3 beta-hydroxy-5 alpha-cholest-9 (11)-en-12-one have been synthesized. The effects of these compounds on the synthesis of digitonin-precipitable sterols from labeled acetate in mouse L cells and on the levels of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity in the same cells have been investigated and compared with previously published data on other ring C oxygenated sterols. 5 alpha-Cholest-7-ene-3 beta, 11 alpha-diol was shown to be the most potent inhibitor of sterol synthesis.


Allergens TRP a swITCH to Initiate Type 2 Immunity.
Allergens induce type-2 immunity, but unresolved questions remain about initiation of this response. In this issue, Perner et al. propose that cutaneous activation of TRPV1+ sensory neurons by protease allergens stimulates release of substance P to induce migration of Th2-skewing CD301b+ DC to draining lymph nodes.


The arrival of millets to the Atlantic coast of northern Iberia.
Despite being one of the most important crops in the recent prehistory of Eurasia, the arrival and exploitation of millets in the westernmost part of Europe are still largely underexplored. Here and for the first time, we report multipronged biomolecular evidence of millet consumption along the Atlantic façade of northern Iberia through a combination of radiocarbon dating, stable isotopes, and dental calculus analyses on the human individuals found in the burial site of El Espinoso cave (Asturias, Spain). The high-resolution chronological framework established for individuals placed the burials between 1235 and 1099 cal. BC. The discovery of high δ13C values on their bone collagen and the identification of polyhedral starch grains within their dental plaque underline the relevance of C4 plants in their diet and highlights the timing of the systematic consumption of millets in the Late Bronze Age. Our data support previous regional archaeobotanical evidence and establish a more precise chronology of the dispersal of millets into northern Iberia during the Bronze Age, becoming an essential crop until the arrival of maize from America after AD 1492. This study emphasizes the importance of multidisciplinary methods to ascertain the origin and development of agricultural practices during recent prehistory.


Growth and manipulation of a human T-cell leukemia virus type 2 full-length molecular clone.
In retrovirus research, the generation of an infectious molecular clone is a landmark event, opening up new avenues of research using the cloned virus. A full-length proviral plasmid clone of the human T-cell leukemia virus (HTLV) makes possible reproducible viral genetic studies. However, the growth of full-length infectious HTLV proviral plasmid clones in bacteria, their manipulation using molecular techniques, and further characterization of replication capacity and other biological properties are not trivial. This chapter describes successful methods used for the preparation and manipulation of the full-length HTLV-2 proviral plasmid clone pH6neo. The plasmid-borne full-length clone of HTLV-2 permits the study of the interactions and contributions of viral proteins in viral replication and cellular transformation in vitro and in animal models in vivo. These types of studies have provided and will continue to provide critical insight into understanding the virus-host interactions and ultimately the contribution of viral genes and elements to the pathogenesis of HTLV.


Cerebral A1 adenosine receptor availability in female and male participants and its relationship to sleep.
The neuromodulator adenosine and its receptors are mediators of sleep-wake regulation which is known to differ between sexes. We, therefore, investigated sex differences in A1 adenosine receptor (A1AR) availability in healthy human subjects under well-rested conditions using [18F]CPFPX and positron emission tomography (PET). [18F]CPFPX PET scans were acquired in 50 healthy human participants (20 females; mean age ± SD 28.0 ± 5.3 years). Mean binding potential (BPND; Logan's reference tissue model with cerebellum as reference region) and volume of distribution (VT) values were calculated in 12 and 15 grey matter brain regions, respectively. [18F]CPFPX BPND was higher in females compared to males in all investigated brain regions (p < 0.025). The largest differences were found in the pallidum and anterior cingulate cortex, where mean BPND values were higher by 29% in females than in males. In females, sleep efficiency correlated positively and sleep latency negatively with BPND in most brain regions. VT values did not differ between sexes. Sleep efficiency correlated positively with VT in most brain regions in female participants. In conclusion, our analysis gives a first indication for potential sex differences in A1AR availability even under well-rested conditions. A1AR availability as measured by [18F]CPFPX BPND is higher in females compared to males. Considering the involvement of adenosine in sleep-wake control, this finding might partially explain the known sex differences in sleep efficiency and sleep latency.


Integrated approach to the understanding of the degradation of an urban river: local perceptions, environmental parameters and geoprocessing.
The use of interdisciplinary approaches such as the proposed report provides a broad understanding of the relationship between people and the environment, revealing reliable aspects not previously considered in the study of this relationship. This study compiled evidence on the environmental degradation of an urbanized river over the past few decades, providing a diagnosis of the consequences of this process for the river, its ichthyofauna, and the local human population. The study was focused on the Beira Rio community on the Capibaribe River in the municipality of São Lourenço da Mata, Pernambuco, Brazil. Data were collected using geoprocessing and ethnobiological approaches, as well as environmental parameters. This research was conducted with the most experienced long-term residents in the local community, through interviews and participatory methodologies to recovering information about the river environment, its ichthyofauna and its environmental services for the last decades. According to the GIS analysis, the study area was subject to an accelerated process of urbanization, with the total urban area increasing from 73 565, 98 m(2) in 1974 to 383 363, 6 m(2) in 2005. The informants perceived the urban growth, especially in the late twentieth century, being this period recognized as the phase of greatest negative changes in the river environment. The perceived decline of fish stocks was indicated by the community as one of the effects of river degradation. According to the interviews, the deterioration of the river affected the ecosystem services and the relationship of the adjacent human community with this ecosystem. The environmental data indicated that the river is suffering eutrophization and has fecal coliform concentrations 160 times higher than the maximum level permitted by Brazilian legislation. The interdisciplinary approach used in this research allowed the understanding of the degradation process of an urban river and some negative effects through the integration of environmental data, GIS and the local knowledge, revealing the complementarity of obtained data and the effectiveness of implementation of this approach.


Monitoring of clinical and laboratory data in two cases of imported Lassa fever.
During 2000, four cases of fatal Lassa fever were imported from Africa to Europe. In two patients, consecutive serum samples were available for monitoring of virus load and cytokine levels in addition to standard laboratory data. Both patients had non-specific early clinical symptoms including high fever. Patient 1 developed multi-organ failure and died of hemorrhagic shock on day 15 of illness, while patient 2 died of respiratory failure due to aspiration without hemorrhage on day 16. Ribavirin was administered to both patients beginning only on day 11. High serum aspartate aminotransferase and lactate dehydrogenase (LDH) levels were remarkable in both patients. Patient 1 had an initial virus load of 10(6) S RNA copies/ml as measured by real-time RT-PCR. Viremia increased steadily and reached a plateau of approximately 10(8)-10(9) copies/ml 4 days before death, while IFN-gamma and TNF-alpha rose to extremely high levels only shortly before death. In contrast, in patient 2 the virus load decreased from 10(7) to 10(6) copies/ml during the late stage of illness which was paralleled by a decrease in the IFN-gamma and TNF-alpha levels. The IL-10 level increased when specific IgM and IgG appeared. These data suggest that a high virus load and high levels of pro-inflammatory cytokines in the late stage of Lassa fever play an important role in the pathogenesis of hemorrhage, multi-organ failure, and shock in Lassa fever.


Calcium dependence of the apparent rate of force generation in single striated muscle myofibrils activated by rapid solution changes.
Single myofibrils or small groups of myofibrils were isolated from different types of striated muscle: rabbit psoas, frog tibialis anterior, frog atrial and ventricular muscle. The Ca2+ concentration of the solution perfusing the myofibrils was changed within few milliseconds by translating the interface between two flowing streams of solution across the preparations. In all types of myofibrils tested, the time course of force rise in response to maximal activation (pCa 4.75) was approximately monoexponential and nearly superimposable on that observed after a release-restretch protocol applied to the myofibril at the plateau of maximal contractions. This suggests that the kinetics of force development following rapid myofibril activation essentially reflects the kinetics of interaction between contractile proteins. The half time of force rise in response to maximal activation varied among different myofibril types; it was shortest in frog tibialis anterior myofibrils and longest in frog ventricular myofibrils. In all types of myofibril preparations tested the half time of force rise increased with decreasing Ca2+ levels in the activating solution. The finding provides support for a kinetic mechanism of force regulation by Ca2+ in all types of striated muscle. The extent of this Ca2+ effect, however, varied among the different myofibril preparations tested; at 15 degrees C for instance, it was smaller in frog tibialis anterior myofibrils than in the other preparations.


Essential fatty acid metabolism in cultured astroblasts.
The fetal calf serum on which two astroblast cell lines were grown was shown to be deficient in essential fatty acids. The fatty acid profiles of lipids of these two cell lines showed very low amounts of polyunsaturated fatty acids. In order to know if this low level of unsaturation was due to the lack of essential fatty acids in serum, or to a lack of desaturase activities in the cells, we have investigated the modifications of the cell lipid fatty acid patterns when serum was enriched in essential fatty acids. Linoleic acid was incorporated in rather high amounts in the cell lipids, while linolenic acid was very poorly incorporated. These two essential fatty acids were converted into polyunsaturated fatty acids only when they were added alone to the serum. Both cell clones exhibited a lack in the delta 4 desaturase activity. No morphological changes of the cells occured after nine days of culture with modified serum.


Prevalence of interatrial block in a general population of elderly people.
Interatrial block (IAB: P wave > or = 110 ms) is highly prevalent in people > or =65 years old living in a community. We investigated 720 consecutive people age > or =65 years old, from the general population, with the intention of evaluating the prevalence of IAB in their electrocardiogram. After excluding 42 people with atrial fibrillation and atrial flutter (5%) or having a permanent pacemaker (0,83%), we evaluated the electrocardiograms of the remaining 678 people with sinus rhythm. We identified 400 (59%) persons with IAB with a similar distribution between men (58.5%) and women (59.4%). IAB was also identified in 347 from a total of 570 hypertensive people (60,9%) and only in 53 out of 108 (49.1%) nonhypertensive people (P = 0.015). The surprisingly large prevalence of the IAB in the general older population emphasizes the importance of the early recognition of this abnormality from the surface 12-lead electrocardiogram.


Flexible free-standing antibacterial nanoporous Ag ribbon.
The biomedical field has the potential to significantly benefit from the use of flexible free-standing Ag nanostructures due to their outstanding mechanical and antibacterial properties. However, the intricate process of synthesizing these nanostructures, as well as the potential toxicity of nanostructured Ag, pose significant challenges. This study used a facile etching method to synthesize the free-standing nanoporous Ag (NP-Ag) ribbons with a homogeneous and bicontinuous three-dimensional ligament structure. The free-standing NP-Ag ribbons demonstrated stable mechanical performance and excellent flexibility when subjected to various deformation states on artificial fingers. Additionally, the NP-Ag ribbons exhibited remarkable antibacterial capacity with rates of 99.81 ± 0.14% against Escherichia coli, 96.11 ± 1.49% against Staphylococcus aureus, and 95.37 ± 1.24% against methicillin-resistant Staphylococcus aureus. The antibacterial mechanism of NP-Ag is attributed to the rapid release of Ag ions (Ag+) in 24 h, causing damage to the bacterial membrane. Moreover, the in vivo results demonstrate that the NP-Ag ribbons provide rapid antibacterial efficacy and are biosafe due to the long-term stable Ag+ release of NP-Ag. The development of these free-standing flexible NP-Ag ribbons offers a new avenue for wearable antibacterial applications.


A genetic screen reveals Foxa3 and TNFR1 as key regulators of liver repopulation.
The fundamental question of which genes are most important in controlling liver regeneration remains unanswered. We employed a parallel screen to test the impact of 43 selected genes on liver repopulation in the Fah(-/-) mouse model of hereditary tyrosinemia. We discovered that the transcription factor Foxa3 was a strong promoter of liver regeneration, while tumor necrosis factor receptor 1 (TNFR1) was the most significant suppressor of repopulation among all of the genes tested. Our approach enabled the identification of these factors as important regulators of liver repopulation and potential drug targets for the promotion of liver repopulation.


Regulation of the human PDZK1 expression by peroxisome proliferator-activated receptor alpha.
Although PDZK1 is a well-known adaptor protein, the mechanisms for its role in transcriptional regulation are largely unknown. The peroxisome proliferator-activated receptor alpha (PPARalpha) is a ligand-activated transcription factor that plays an important role in the regulation of lipid homeostasis. Previously, we established a tetracycline-regulated human cell line that can be induced to express PPARalpha and identified candidate target genes, one of which was PDZK1. In this study, we cloned and characterized the promoter region of the human pdzk1 gene and determined the PPAR response element. Finally, we demonstrate that endogenous PPARalpha regulates PDZK1 expression.


Effect of Cyclooxygenase(COX)-1 and COX-2 inhibition on furosemide-induced renal responses and isoform immunolocalization in the healthy cat kidney.
The role of cyclooxygenase(COX)-1 and COX-2 in the saluretic and renin-angiotensin responses to loop diuretics in the cat is unknown. We propose in vivo characterisation of isoform roles in a furosemide model by administering non-steroidal anti-inflammatory drugs (NSAIDs) with differing selectivity profiles: robenacoxib (COX-2 selective) and ketoprofen (COX-1 selective). In this four period crossover study, we compared the effect of four treatments: placebo, robenacoxib once or twice daily and ketoprofen once daily concomitantly with furosemide in seven healthy cats. For each period, urine and blood samples were collected at baseline and within 48 h of treatment starting. Plasma renin activity (PRA), plasma and urinary aldosterone concentrations, glomerular filtration rate (GFR) and 24 h urinary volumes, electrolytes and eicosanoids (PGE2, 6-keto-PGF1α, TxB2), renal injury biomarker excretions [N-acetyl-beta-D-glucosaminidase (NAG) and Gamma-Glutamyltransferase] were measured. Urine volume (24 h) and urinary sodium, chloride and calcium excretions increased from baseline with all treatments. Plasma creatinine increased with all treatments except placebo, whereas GFR was significantly decreased from baseline only with ketoprofen. PRA increased significantly with placebo and once daily robenacoxib and the increase was significantly higher with placebo compared to ketoprofen (10.5 ± 4.4 vs 4.9 ± 5.0 ng ml(-1) h(-1)). Urinary aldosterone excretion increased with all treatments but this increase was inhibited by 75 % with ketoprofen and 65 % with once daily robenacoxib compared to placebo. Urinary PGE2 excretion decreased with all treatments and excretion was significantly lower with ketoprofen compared to placebo. Urinary TxB2 excretion was significantly increased from baseline only with placebo. NAG increased from baseline with all treatments. Immunohistochemistry on post-mortem renal specimens, obtained from a different group of cats that died naturally of non-renal causes, suggested constitutive COX-1 and COX-2 co-localization in many renal structures including the macula densa (MD). These data suggest that both COX-1 and COX-2 could generate the signal from the MD to the renin secreting cells in cats exposed to furosemide. Co-localization of COX isoenzymes in MD cells supports the functional data reported here.


Dissociated motor development--developmental patterns, clinical characteristics, causal factors and outcome, with special reference to late walking children.
Dissociated motor development, defined as marked gross motor delay without any abnormal neurological signs and contrasting to a normal fine motor-adaptive performance, was studied prospectively in a consecutive in a consecutive series of 78 children, 48 girls and 30 boys, aged 7-23 months at first examination. When 17 months of age, 10 of them had become normalized, and in further three a disability explaining their gross motor delay had been diagnosed. At an average age of 4.2 years, the remaining 65 late walkers were, regardless of cause and developmental and neurological findings at final follow-up, characterized by a number of deviating clinical features as muscular hypotonia (71%), shuffling (51%) and dissociated or late pattern of learning to sit (79%). In 30 out of 65 late walkers (46%) a defined clinical condition of probable pathogenetic implication was found. In 35 out of 65 late walkers (54%), no explaining clinical condition was found. They have been designed to be idiopathic late walkers. Except for muscular hypotonia, present in 77%, conventional neurology was normal in this group. Minor neurological signs such as a positive Foerster sign, defect balance reactions in standing, or asymmetry in prewalking locomotion were, however, occasionally and temporarily observed. Girls were overrepresented among idiopathic late walkers, 69% compared to 43% among the symptomatic late walkers. Complete normalization was more common in the idiopathic group (66%) than in the symptomatic group (27%). Early differentiation between the late walkers who were normalized and those who developed mild mental retardation or neurological handicaps was difficult but not quite impossible. Heredity for shuffling, a non-revealing pre- and perinatal history, a developmental pattern of late learning to sit, and shuffling favoured a normal outcome. Creepers with a dissociated pattern of learning to sit and crawlers with muscular hypotonia were found to have an increased risk for later handicap.


Tissue metal concentrations in two crayfish species cohabiting a tennessee cave stream.
Concentrations of Cd, Cr, Cu, Fe, Mg, Mn, Pb, Zn, Ca and K were examined in tissues of the troglobitic (obligatory cave-dwelling) crayfish Orconectes australis australis and troglophilic (facultative cave-dwelling) species Cambarus tenebrosus. These two species cohabit a stream in Merrybranch Cave, located in rural White Co., Tennessee. Tissue concentrations of essential metals did not exhibit any trends between species. In contrast, Cd and Pb concentrations were found to be significantly greater in O. a. australis for almost all of the tissues analyzed. The higher Cd and Pb concentrations in O. a. australis are thought to be due to the increased longevity of this troglobitic species. Because of the toxicity of Cd and Pb, chronic exposure to relatively low concentrations of these metals could cause changes in mortality, fecundity or behavior in aquatic organisms possessing long life spans. The bioaccumulation of metals from low level, non-point sources is discussed in relation to life history strategies.


Securing the Airway in a Patient with Massive neck Swelling, Emergency Tracheostomy: A Technical Note.
To describe the technical aspects of emergency tracheostomy in a case of extensive neck swelling with a challenging airway. We report a case of difficult tracheostomy in a patient with a huge neck swelling causing obscured anatomical landmarks in significant stridor. A literature review was performed to identify similar cases or techniques. Emergency tracheostomy was successfully executed with the help of clinical acumen, imaging findings and intra-operative ultrasound usage. We describe a safe and effective technique of emergency tracheostomy in patients with huge neck swelling and obscured anatomical landmarks. Collaboration of surgeon with the anaesthesia service is of paramount importance in dealing with challenging airways.


Molecular Chaperone Receptors: An Update.
Extracellular heat shock proteins (HSP) play important roles in cell signaling and immunity. Many of these effects are mediated by surface receptors expressed on a wide range of cell types, including immune cells. We have investigated the nature of such proteins by cloning candidate receptors into cells (CHO-K1) with the rare property of being null for HSP binding. Using this approach, we have discovered that mammalian and eukaryotic Hsp70 binds avidly to at least three classes of receptor including: (1) c-type lectin receptors (CLR), (2) scavenger receptors (SR) and (3) lectins. However, the structural nature of the receptor-ligand interactions is not currently clear. Hsp70 can bind to LOX-1 (a member of both the CLR and SR), with the c-type lectin binding domain (CTLD), to the SR family members SREC-I and FEEL-1/CLEVER-1/STABILIN-1, which by contrast have arrays of EGF-like repeats in their extracellular domains as well. In this chapter, we will discuss: (1) methods for the discovery of HSP receptors, (2) approaches to the study of individual receptors in cells that contain multiple such receptors and (3) methods for investigating HSP receptor function in vivo.


Persistent regional variation in treatment of hypertension.
To assess regional variation within England in the proportion of people with survey-defined hypertension who were on treatment, and hypothesize if this was due to chance or confounding. Data from three annual, cross-sectional health examination surveys, the Health Survey for England. Nationally representative random samples of the free-living general population were visited by an interviewer and a nurse. Blood pressure was measured with an automated monitor using a standardized protocol (2005: n = 5321, 2006: n = 10,213, 2007: n = 4848). Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, and/or taking prescribed medication to lower blood pressure. In London, a higher proportion of participants with survey-defined hypertension were on anti-hypertensive medication in each separate year's sample compared with the rest of England [2005-2007 average: 61% men, 66% women in London; 43% men, 55% women in England (P for London vs rest of England <0.001 for each sex)]. Regression analysis showed that this regional effect [odds ratio (OR) 1.47 95% confidence interval (CI) 1.94-2.47, P = 0.031] was no longer significant after adjustment for demographic and socio-economic factors (OR 1.37, 95% CI 0.94-1.98, P = 0.101), but was strengthened (OR 1.69, 95% CI 1.09-2.60, P = 0.018) by including longstanding illness, diabetes, cardiovascular disease and health behaviours in the model. The proportion of hypertensive patients on anti-hypertensive medication was consistently above the national average in London, and this was associated with personal characteristics. Comorbidities increased the effect, even after adjustment for personal characteristics. This result may be due to greater population mobility in London, with more people having new patient health checks. Understanding this variation could enhance treatment nationally and internationally.


Lack of tolerance or withdrawal effects in mice after chronic administration of the non-sedating anxiolytic, CGS 9896.
CGS 9896, a non-sedating anxiolytic, was compared to diazepam with respect to the development of tolerance and withdrawal. Both compounds were administered daily to mice at various doses (3, 10 or 30 mg/kg) for periods of up to 4 weeks. Measures of sedation/muscle relaxation, motor activity and anticonvulsant effects were then assessed. When administered acutely, CGS 9896 increased motor activity, had no effect on traction reflex, and elevated the threshold for PTZ-induced convulsions. After chronic administration of CGS 9896, no changes in these parameters were observed compared to the effects seen after acute treatment. Acute administration of diazepam reduced motor activity, impaired traction reflex and increased PTZ-induced convulsion threshold. Tolerance developed to the effects of diazepam in all three measures. Following a four week dosing period with 30 mg/kg of either CGS 9896 or diazepam, the drugs were withdrawn and similar behavioral measures obtained at various withdrawal intervals up to 15 days. In separate groups of mice, precipitated withdrawal was also assessed by the administration of the benzodiazepine agonist, CGS 8216. No effects were observed after any period of withdrawal from CGS 9896. By contrast, withdrawal from diazepam resulted in significant alterations of motor activity and convulsion threshold. These results indicate that CGS 9896 is likely to be free of undesirable tolerance and withdrawal effects typically associated with the benzodiazepines.


SB8: A Bevacizumab Biosimilar.
SB8 is a biosimilar of the monoclonal anti-VEGF antibody bevacizumab and is approved in the EU for use in the same types of cancer as bevacizumab. SB8 has similar physicochemical and pharmacodynamic properties to those of reference bevacizumab and pharmacokinetic equivalence was shown in healthy volunteers and patients with non-small cell lung cancer (NSCLC). SB8 demonstrated equivalent clinical efficacy to reference bevacizumab in patients with metastatic or recurrent nonsquamous NSCLC, with similar tolerability, safety and immunogenicity profiles.


A retrospective cohort study of pulmonary function, radiographic measures, and quality of life in children with congenital scoliosis: an evaluation of patient outcomes after early spinal fusion.
Retrospective cohort study. The purpose of this study is to evaluate pulmonary function and quality of life (QOL) in children treated with early spinal fusion for progressive congenital scoliosis. The relationships between radiographic measures, pulmonary function tests (PFT), and QOL were examined. METHODS.: Twenty-one patients with congenital scoliosis treated with early spinal fusion were evaluated using radiographs, PFT, and the Child Health Questionnaire (CHQ) at 12.6 +/- 3.5 years. They were 6.9 +/- 2.3 years postdefinitive fusion, which occurred at 4.9 +/- 3.1 year of age. The cohort was also divided in two groups, "thoracic fusion" (apex above the thoracolumbar T-L junction) and "nonthoracic fusion" (below T-L junction). Forced vital capacity, forced expiratory volume (FEV1), vital capacity (P < 0.0001), and total lung capacity (P = 0.017) were significantly lower compared with healthy children. CHQ scores were significantly lower than in healthy children in physical function (P = 0.036), general health (P = 0.007), physical summary (P = 0.026), and parental impact/emotional (P = 0.01). Correlation analysis showed that the degrees of thoracic curves were negatively correlated with FEV1 (P < 0.05), family activities, role/social physical (P < 0.05), and physical summary (P < 0.01). The degree of kyphosis was negatively correlated with Self-Esteem (P < 0.01). Patients who had thoracic fusions had shorter spinal height (P = 0.049), lower forced vital capacity (P = 0.004), FEV (P = 0.012), vital capacity (P = 0.031), and reported more pain (P = 0.033) than nonthoracic fused. Compared with healthy peers, congenital scoliosis patients treated with early spinal fusion have worse PFT and QOL scores at 6.9 years follow up. Patients with thoracic fusions had shorter spines, worse pulmonary function, and more pain than nonthoracic fused. The results may support alternatives to early spinal fusion such as growing rods, epiphysiodesis, and distraction thoracoplasty. Current efforts are underway to compare outcomes of this study to those of other treatments.


Electrophysiologic profile of dronedarone on the ventricular level: beneficial effect on postrepolarization refractoriness in the presence of rapid phase 3 repolarization.
Dronedarone (D) is developed to maintain sinus rhythm in patients suffering from atrial fibrillation. The aim of the present study was to investigate, whether dronedarone also has an antiarrhythmic potential in the ventricle and to elucidate the mechanisms for its low proarrhythmic potential in an experimental whole heart model. Thirty-five rabbits underwent chronic treatment with D (n = 15; 50 mg · kg(-1) · d(-1)) and amiodarone (A; n = 20; 50 mg · kg(-1) · d(-1)). Hearts were perfused on a Langendorff apparatus. Results were compared with hearts acutely treated with sotalol (S; 50-100 μM; n = 14). A 12-lead electrocardiogram and up to 8 ventricular epi- and endocardial monophasic action potentials showed a significant prolongation of QT interval (D: +24 milliseconds, A: +28 milliseconds, S: +35 milliseconds (50 μM), +56 milliseconds (100 μM); P < 0.02) compared with baseline. In contrast to D and A, S led to a significant increase in dispersion of repolarization and exhibited reverse use dependence. D, A, and S increased refractory period, resulting in a significant increase in postrepolarization refractoriness (effective refractory period minus action potential duration; D = +12 milliseconds; A = +14 milliseconds; S = +25 milliseconds; P < 0.05). S led to a triangular action potential configuration, whereas D and A caused a fast phase 3 prolongation. After lowering of potassium concentration, 50% of S-treated hearts showed torsade de pointes, in contrast to an absence of torsade de pointes in D and A. Prolongation of myocardial repolarization and postrepolarization refractoriness by D may act antiarrhythmic. A fast phase 3 repolarization in the absence of both increased dispersion of repolarization and reverse use dependence prevents proarrhythmia.


Intermittent pneumatic compression pump settings for the optimum reduction of oedema.
This study investigated the reduction in lower limb oedema achieved when different combinations of intermittent pneumatic compression (IPC) pump settings were used. Twenty-seven individuals aged between 22 and 96 years, with ankle oedema of venous origin, were randomised to either a treatment or control group. Treatment was delivered via a Flowpac pump (Huntleigh Healthcare Ltd, Luton, UK) possessing variable controls. The control group were 'treated' by elevating both lower limbs. The average difference in limb volumes was compared, for each combination of pump setting, to changes in limb volume in the control group. These comparisons revealed that the highest mean reduction in limb volumes was recorded for a pressure of 40 mmHg (p = 0.02), 10 second deflation time (p = 0.0002) and 15 second inflation time (p = 0.0096). Other significant results were obtained by the 30 mmHg pressure (p = 0.017), 35 second deflation time (p = 0.018), and 5 and 45 second inflation times (p = 0.012, 0.013 respectively). For many setting combinations no significant differences were observed between the limb oedema seen in the control and experimental groups. The results should be interpreted with caution because of the large number of tests performed. In addition adverse effects were observed in six out of nine subjects at 70 mmHg pressure and this pressure was discontinued. One subject suffered cramp at 60 mmHg pressure. Lower pressures together with shorter inflation and deflation times appear to be more efficient than higher pressures and long inflation/deflation times. In addition the lack of significant reduction in oedema at pressures above 40 mmHg suggests that the higher pressures cause a tourniquet effect.


Repair of the thoracic aorta by transaortic stent grafting (open stenting).
The late results of direct open stent grafting of the aortic arch for aortic arch repair have not been reported previously. Between September 1997 and December 2000 19 patients underwent open stent grafting with carotid artery bypass for thoracic arteriosclerotic aneurysms (TAA) of the distal aortic arch. In addition, 21 patients underwent open stent grafting with total aortic arch replacement for Stanford type A acute aortic dissection and 7 patients underwent stenting with carotid bypass for Stanford type B chronic aortic dissection. The early mortality rate was 11% for TAA, 10% for type A dissection, and 0% for type B dissection. Whereas none of the TAA or type A dissection required a second operation on the thoracic aorta, 1 TAA patient died 6 months postoperatively after sudden aortic rupture and 1 type B patient required descending aortic replacement because of ulceration caused by the stent graft at 11 months postoperatively. On follow-up computed tomography scan, in TAA patients, true aneurysms excluded by the stent graft showed early thrombosis, but the absorption of thrombosed aneurysms started from 1 to 6 months postoperatively and gradually progressed. In patients with type B chronic dissection, the false lumen showed early thrombosis and the true lumen was dilated at the central portion of the graft, which might increase turbulent flow by interaction with the stent. In patients with type A acute dissection, the false lumen showed both early thrombosis and early absorption. Early and late results of open stenting are acceptable and follow-up computed tomography scan may be able to predict late results of open stenting.


Key gravity-sensitive signaling pathways drive T cell activation.
Returning astronauts have experienced altered immune function and increased vulnerability to infection during spaceflights dating back to Apollo and Skylab. Lack of immune response in microgravity occurs at the cellular level. We analyzed differential gene expression to find gravity-dependent genes and pathways. We found inhibited induction of 91 genes in the simulated freefall environment of the random positioning machine. Altered induction of 10 genes regulated by key signaling pathways was verified using real-time RT-PCR. We discovered that impaired induction of early genes regulated primarily by transcription factors NF-kappaB, CREB, ELK, AP-1, and STAT after crosslinking the T-cell receptor contributes to T-cell dysfunction in altered gravity environments. We have previously shown that PKA and PKC are key early regulators in T-cell activation. Since the majority of the genes were regulated by NF-kappaB, CREB, and AP-1, we studied the pathways that regulated these transcription factors. We found that the PKA pathway was down-regulated in vg. In contrast, PI3-K, PKC, and its upstream regulator pLAT were not significantly down-regulated by vectorless gravity. Since NF-kappaB, AP-1, and CREB are all regulated by PKA and are transcription factors predicted by microarray analysis to be involved in the altered gene expression in vectorless gravity, the data suggest that PKA is a key player in the loss of T-cell activation in altered gravity.


Simulating birth to investigate clinician-applied loads on newborns.
This report describes the design, development and testing of a force-measuring birth stimulator. Designed to mimic the feel of an obstetric emergency, the simulator is named shoulder dystocia birth model (SDBM). The SDBM consists of a simply supported overhung beam, instrumented with two strain gauges and one commercially-available sensor, all of which are embedded in a maternal manikin that rests on a height-adjustable scissors jack. Rigidly affixed to the free end of the beam, a model of a newborn head protrudes from the manikin to allow physicians to simulate the loads they exert when delivering a newborn. A microcomputer-based data acquisition system monitors, analyses and processes the output from the gauges and the sensor in real time. The system measures axial force and vertical force to within 2% accuracy and the end-moment to within 5% accuracy. Testing with 15 University of Maryland clinicians simulating routine, difficult and SD deliveries reveals average peak force magnitudes of 68 N, 118 N and 172 N and average peak moment magnitudes of 138 N. cm, 384 N.cm and 621 N.cm, respectively. The standard deviations for these average peak values are large indicating wide variation in perceived loads required to deliver. Confirming clinical observation, average peak forces for some difficult and many shoulder dystocia deliveries exceed the force necessary to induce clavicle fracture at birth.


Studying the Early Stages of Protein Aggregation Using Replica Exchange Molecular Dynamics Simulations.
The simulation of protein aggregation poses several computational challenges due to the disparate time and lengths scales that are involved. This chapter focuses on the use of atomistically detailed simulations to probe the initial steps of aggregation, with an emphasis on the Tau peptide as a model system, run under a replica exchange molecular dynamics protocol.


Gall mite (Eriophyes laevis) infestation and leaf removal affect growth of leaf area in black alder (Alnus glutinosa) short shoots.
We measured the effects ofEriophyes laevis mite galls on the relative growth of short shoot leaf area ofAlnus glutinosa. A portion of leaves was artificially removed from a set of short shoots with both high and low gall density to cause local stress conditions. Nontreated high and low gall density short shoots were used as controls. The results show that the relative growth of leaf area measured for short shoots is negatively affected by high gall density. Artificial leaf removal, on the other hand, had positive effects on leaf area growth. Interestingly, the growth of leaf area did not differ for high gall density short shoots with leaf removal and noninfested short shoots with no leaf removal. This result may be caused by the combined, opposite effects of leaf removal and gall infestation.


Carbon Supported Engineering NiCo₂O₄ Hybrid Nanofibers with Enhanced Electrocatalytic Activity for Oxygen Reduction Reaction.
The design of cheap and efficient oxygen reduction reaction (ORR) electrocatalysts is of a significant importance in sustainable and renewable energy technologies. Therefore, ORR catalysts with superb electrocatalytic activity and durability are becoming a necessity but still remain challenging. Herein, we report C/NiCo₂O₄ nanocomposite fibers fabricated by a straightforward electrospinning technique followed by a simple sintering process as a promising ORR electrocatalyst in alkaline condition. The mixed-valence oxide can offer numerous accessible active sites. In addition, the as-obtained C/NiCo₂O₄ hybrid reveals significantly remarkable electrocatalytic performance with a highly positive onset potential of 0.65 V, which is only 50 mV lower than that of commercially available Pt/C catalysts. The analyses indicate that C/NiCo₂O₄ catalyst can catalyze O₂-molecules via direct four electron pathway in a similar behavior as commercial Pt/C catalysts dose. Compared to single NiCo₂O₄ and carbon free NiCo₂O₄, the C/NiCo₂O₄ hybrid displays higher ORR current and more positive half-wave potential. The incorporated carbon matrices are beneficial for fast electron transfer and can significantly impose an outstanding contribution to the electrocatalytic activity. Results indicate that the synthetic strategy hold a potential as efficient route to fabricate highly active nanostructures for practical use in energy technologies.


Seasonal patterns of acid fluctuations and resource storage in the arborescent cactus Opuntia excelsa in relation to light availability and size.
We investigated relationships between light availability, diel acid fluctuation, and resource storage in the arborescent cactus Opuntia excelsa growing in western Mexico. We compared canopy and understory individuals from a deciduous forest as well as open-grown plants of the same approximate size as those in the understory. During the wet season light availability and daily fluctuations in titratable acidity (an index of carbon uptake) were lower in the understory than in unshaded habitats. In the dry season all plants had reduced levels of acid fluctuation, with the smallest individuals, regardless of habitat, showing the greatest reduction. These data suggest that light availability in the forest understory constrains carbon assimilation during the wet season, but that a factor associated with plant size, possibly water status, limits carbon gain during the dry season. Plants in all habitats remained physiologically active for at least five months into the dry season. We suggest that this was possible due to the maintenance of constant concentrations of water and nitrogen in the photosynthetically active chlorenchyma. Parenchyma in terminal cladodes showed a different seasonal pattern of resource storage; water content and nitrogen concentration were reduced from the wet to the dry season in the parenchyma. Using the parenchyma to supply photosynthetic tissues during times of reduced resource availability allows O. excelsa to assimilate carbon during times of the year when most other trees in the forest are leafless.


Rapid epidemiologic characterization of cytomegalovirus strains from pediatric bone marrow transplant patients.
DNA amplification by the polymerase chain reaction (PCR) of human cytomegalovirus (CMV) nucleotide sequences recently has been reported for differentiation of CMV strains. Retrospective study. Evaluate the strain patterns of 15 CMV-positive buffy coat specimens from five pediatric bone marrow transplant patients. Pediatric bone marrow transplant unit. We perform PCR using primers corresponding to two distinct regions of the CMV genome, the major immediate-early (MIE) region and the a-sequence region, with subsequent restriction enzyme analysis of the amplified products. Restriction enzyme analysis with Hae III and Hinf I of products amplified with nested PCR for the MIE region revealed distinguishable digestion patterns between patients but similar patterns for samples from each patient. All were distinct from the CMV Towne laboratory control strain. In contrast to these results, amplification of specimens with a-sequence primers, followed by restriction enzyme analysis, did not allow differentiation between all patients. Our results indicate that nested amplification directly from buffy coat specimens using primers for the CMV MIE gene allows rapid CMV strain characterization that is useful for laboratory quality control and epidemiological studies. Distinct CMV strains were found in each patient, suggesting horizontal transmission was not responsible for acquisition of CMV infection in these patients.


Acquired Non-malignant Cervical Trachea-Esophageal Fistula: A Case Series.
Acquired non-malignant trachea-esophageal fistula (TEF) of cervical oesophagus is rare. Surgical closure of fistula is the standard treatment of choice. Our experience in management of such cases is presented. Five cases of acquired cervical TEF of varying etiology were retrospectively analysed. Two patients had history of migrated endoluminal stent. All the patients were treated by trans-cervical repair with muscle interposition. Tracheal Stenosis in two patients was managed concurrently. Successful repair was achieved in four cases. One patient with chronic obstructive pulmonary disease and active leprosy has residual fistula. Of the two patients with tracheal stenosis correction one was decannulated 6 month later and second has stent in situ. Post-operative vocal cord palsy occurred in one patient. Transcervical repair with muscle interposition is treatment of choice in cases of acquired nonmalignant cervical tracheoesophageal fistulas. Endoluminal stents have high tendency to migrate and are not recommended.


The Advent of the Internet of Things in Airfield Lightning Systems: Paving the Way from a Legacy Environment to an Open World.
This paper discusses the design and prototype implementation of a software solution facilitating the interaction of third-party developers with a legacy monitoring and control system in the airfield environment. By following the Internet of Things (IoT) approach and adopting open standards and paradigms such as REpresentational State Transfer (REST) and Advanced Message Queuing Protocol (AMQP) for message dispatching, the work aims at paving the way towards a more open world in the airfield industrial sector. The paper also presents performance results achieved by extending legacy components to support IoT standards. Quantitative results not only demonstrate the feasibility of the proposed solution, but also its suitability in terms of prompt message dispatching and increased fault tolerance.


Prevalence of psoriatic arthritis in Chinese population with psoriasis: A multicenter study conducted by experienced rheumatologists.
Reports on the prevalence of psoriatic arthritis (PsA) among Chinese patients with psoriasis are very limited. This study, conducted by rheumatologists, estimated the prevalence of PsA in a large number of Chinese patients with psoriasis. Consecutive patients with a confirmed diagnosis of psoriasis attending nine dermatology clinics in five hospitals were recruited. All psoriasis patients were asked to complete a questionnaire comprising 16 questions to identify possible cases of PsA. All patients with one or more positive answers to the questionnaire were evaluated by two experienced rheumatologists. A total of 2434 psoriasis patients, including 1561 males and 873 females, were enrolled. Both the questionnaire and rheumatologists' examinations were completed in the dermatology clinics. The results identified 252 patients with PsA, comprising 168 males and 84 females. The overall prevalence of PsA among psoriasis patients was 10.4% (95% confidence interval [95% CI], 9.1%-11.7%). By sex, the prevalence was 10.8% (95% CI, 9.2%-12.5%) for males and 9.6% (95% CI, 7.7%-11.9%) for females and there was no significant sex difference in the prevalence of PsA (P = 0.38). Of the 252 PsA patients, 125 (49.6%, 95% CI, 41.3%-59.1%) were newly diagnosed by rheumatologists. Consequently, the prevalence of undiagnosed PsA among psoriasis patients was 5.2% (95% CI, 4.4%-6.2%). The prevalence of PsA in the Chinese population with psoriasis is about 10.4%, which is almost double that of previous reports in the Chinese population, but lower than that in Caucasians.


Conversion to Gastric Bypass After Either Failed Gastric Band or Failed Sleeve Gastrectomy.
Roux-en-Y gastric bypass (RYGB) is still considered the gold standard in bariatric surgery. Before, adjustable gastric banding (AGB) was regarded as an alternative; nowadays, sleeve gastrectomy (SG) is a more favorable alternative. In case of unsatisfactory results, RYGB is often performed as a secondary procedure. Conversion of an AGB is associated with a high risk of complications; the hypothesis was that this would be less after conversion of an SG. All patients undergoing conversion to RYGB after AGB or SG between 2005 and 2012 were included for retrospective analysis. Patient characteristics, operative details, postoperative complications, the relief of complaints, weight loss, reasons for failure, and evolution of known comorbidities up to 2 years were analyzed. A total of 178 patients were included (79.8 % female): AGB 110 (61.8 %) versus SG 68 (38.2 %). Main reasons for conversion were weight regain/insufficient weight loss (48.4 %) or dysphagia/reflux complaints (39.9 %). Surgical complications were found in 19 patients (AGB 13 vs SG 6; p = 0.530). Infectious complications occurred in 13 patients (AGB 11 vs SG 2; p = 0.135). Total body weight loss was equal between groups after 2 years (AGB 31.6 ± 11.0 % vs SG 31.6 ± 12.0 %; p = 0.998). Similar results were found in a subgroup analysis on patients undergoing conversion for additional weight loss (AGB 31.7 ± 11.7 % vs SG 27.0 ± 13.1 %; p = 0.173). Conversion to RYGB after failed AGB or SG showed comparable short-term results in terms of postoperative complications and weight loss.


Artificial Intelligence and Big Data Science in Neurocritical Care.
In recent years, the volume of digitalized web-based information utilizing modern computer-based technology for data storage, processing, and analysis has grown rapidly. Humans can process a limited number of variables at any given time. Thus, the deluge of clinically useful information in the intensive care unit environment remains untapped. Innovations in machine learning technology with the development of deep neural networks and efficient, cost-effective data archival systems have provided the infrastructure to apply artificial intelligence on big data for determination of clinical events and outcomes. Here, we introduce a few computer-based technologies that have been tested across these domains.


A new lithophilous species of Gesneriaceae, Petrocodonrubrostriatus, from the karst area of South Yunnan, China.
A new lithophytic species of Gesneriaceae, Petrocodonrubrostriatus K.Tan, X.Q.Song & M.X.Ren, sp. nov. from Lvchun County, South Yunnan, China, is described and illustrated here. It closest resembles P.mollifolius (W.T.Wang) A.Weber & Mich.Möller, but the new species is differentiated from it by red to brownish-red stripes in the yellow corolla throat and 4.5 mm long bract lobes, a ca. 10 mm long style, and staminodes inserted at 2.5-3 mm from the corolla base. The species is preliminarily assessed as 'Critically Endangered' (CR) according to IUCN criteria, since currently only one single locality is known with a few subpopulations on a fragmented limestone cliff, with fewer than 300 individuals.


Long-term stability of hydrocarbons in NIST gas standard reference material (SRM) 1800.
A gas standard reference material (SRM) containing fifteen hydrocarbons in nitrogen at a nominal 5 nmol mol(-1) was issued in 1993. The certification period for SRM 1800 was assigned as 2 years, because of limited stability data. Over a period of 10 years reanalysis of the lot standard (a sample chosen from the SRM lot to which all other lot samples are compared), SRM samples remaining in stock for sale, and SRMs returned to the National Institute of Standards and Technology (NIST) for recertification, were compared with primary standards to assess the stability of the hydrocarbons. New primary standards were periodically introduced into the original primary standard suite to assess the stability and consistency of the primary standards. Over this ten-year period 11 SRM 1800 samples were reanalyzed, resulting in 210 amount-of-substance fraction (concentration) determinations performed for quality-assurance purposes. Of these measurements 209 (99.5%) agreed within the original 95% confidence interval of the +/-4% expanded uncertainty, demonstrating the stability of the standards. There was also agreement to within +/-2% of the original concentration for 204 (97%) of the measurements. This is well within the original +/-4% expanded uncertainty assigned to the hydrocarbon concentrations at the approximate 95% confidence interval demonstrating stability. These results will enable the expiry date to be increased for future restock issues of SRM 1800.


Erratum: "New contrast agents for photoacoustic imaging and theranostics: Recent 5-year overview on phthalocyanine/naphthalocyanine-based nanoparticles" [APL Bioeng. 5, 031510 (2021)].
[This corrects the article DOI: 10.1063/5.0047660.].