Changes in tissue free amino acid contents, branchial Na+/K+ -ATPase activity and bimodal breathing pattern in the freshwater climbing perch, Anabas testudineus (Bloch), during seawater acclimation.
This study aimed to examine effects of short- or long-term acclimation to brackish water or seawater on the climbing perch, Anabas testudineus, which is an aquatic air-breathing teleost living typically in freshwater. A. testudineus exhibits hypoosmotic and hypoinoic osmoregulation; the plasma osmolality, [Na+] and [Cl-] of fish acclimated to seawater were consistently lower than those of the external medium. However, during short-term (1 day) exposure to brackish water (15 per thousand) or seawater (30 per thousand), these three parameters increased significantly. There were also significant increases in tissue ammonia and urea contents, contents of certain free amino acids (FAAs) in the muscle, and rates of ammonia and urea excretion in the experimental fish. The accumulated FAAs might have a transient role in cell volume regulation. In addition, these results indicate that increases in protein degradation and amino acid catabolism had occurred, possibly providing energy for the osmoregulatory acclimation of the gills in fish exposed to salinity stress. Indeed, there was a significant increase in the branchial Na+/K+ -ATPase activity in fish exposed to seawater for a prolonged period (7 days), and the plasma osmolality, [Na+] and [Cl-] and the tissue FAA contents of these fish returned to control levels. More importantly, there was a significant increase in the dependence on water-breathing in fish acclimated to seawater for 7 days. This suggests for the first time that A. testudineus could alter its bimodal breathing pattern to facilitate the functioning of branchial Na+/K+ -ATPase for osmoregulatory purposes.


A data-driven quality-score system for rating drug products and its implications for the health care industry.
The quality of drug products in the United States has been a matter of growing concern. Buyers and payers of pharmaceuticals have limited insight into measures of drug-product quality. Therefore, a quality-score system driven by data collection is proposed to differentiate between the qualities of drug products produced by different manufacturers. The quality scores derived using this proposed system would be based upon public regulatory data and independently-derived chemical data. A workflow for integrating the system into procurement decisions within health care organizations is also suggested. The implementation of such a quality-score system would benefit health care organizations by including the consideration of the quality of products while also considering price as a part of the drug procurement process. Such a system would also benefit the U.S. health care industry by bringing accountability and transparency into the drug supply chain and incentivizing manufacturers to place an increased emphasis on the quality and safety of their drug products.


Virtual reality for behavioral health workforce development in the era of COVID-19.
The coronavirus 2019 disease (COVID-19) pandemic emerged at a time of substantial investment in the United States substance use service infrastructure. A key component of this fiscal investment was funding for training and technical assistance (TA) from the Substance Abuse and Mental Health Services Administration (SAMHSA) to newly configured Technology Transfer Centers (TTCs), including the Addiction TTCs (ATTC Network), Prevention TTCs (PTTC Network), and the Mental Health TTCs (MHTTC Network). SAMHSA charges TTCs with building the capacity of the behavioral health workforce to provide evidence-based interventions via locally and culturally responsive training and TA. This commentary describes how, in the wake of the COVID-19 pandemic, TTCs rapidly adapted to ensure that the behavioral health workforce had continuous access to remote training and technical assistance. TTCs use a conceptual framework that differentiates among three types of technical assistance: basic, targeted, and intensive. We define each of these types of TA and provide case examples to describe novel strategies that the TTCs used to shift an entire continuum of capacity building activities to remote platforms. Examples of innovations include online listening sessions, virtual process walkthroughs, and remote "live" supervision. Ongoing evaluation is needed to determine whether virtual TA delivery is as effective as face-to-face delivery or whether a mix of virtual and face-to-face delivery is optimal. The TTCs will need to carefully balance the benefits and challenges associated with rapid virtualization of TA services to design the ideal hybrid delivery model following the pandemic.


Mutational analysis of a human immunodeficiency virus type 1 Tat protein transduction domain which is required for delivery of an exogenous protein into mammalian cells.
The human immunodeficiency virus type 1 (HIV-1) Tat protein transduction domain (PTD), which contains a high proportion of arginine and lysine residues, is responsible for highly efficient protein transduction through the plasma membrane. To identify the role of the PTD sequence motif in transduction, various deletions and substitutions were introduced into the PTD. Tat-green fluorescent protein (GFP) fusion proteins, containing various lengths of the Tat PTD, were expressed and the extent of their transduction into mammalian cells was analysed by Western blot analysis and fluorescence microscopy. Deletion analysis of PTD mapped to a nine amino acid motif (residues 49-57: RKKRRQRRR) sufficient for transduction. Further deletion of this Tat basic domain either at the N terminus or at the C terminus significantly decreased transduction efficiency. The transduction efficiencies of GFPs fused to nine consecutive lysine (9Lys-GFP) or arginine (9Arg-GFP) residues were similar to that of Tat(49-57)-GFP. The transduced proteins localized to both the nucleus and the cytosol, as assessed by confocal microscopy and Western blot analysis of subcellular fractions from transduced cells. Thus, the availability of recombinant GFP fusion proteins facilitates the simple and specific identification of protein transduction mediated by these peptide sequences. The modified PTD sequences designed in this study may provide useful tools necessary for delivering therapeutic proteins/peptides into cells.


Does completing a dental anxiety questionnaire increase anxiety? A randomised controlled trial with adults in general dental practice.
The assessment of dental anxiety can be achieved by using brief multi-item scales. To test the null hypothesis that completing the Modified Dental Anxiety Scale had no immediate influence on patient state anxiety. Speilberger State Anxiety Inventory-6 item Short Form. Randomised controlled trial. Patients (n = 1,028) attending 18 dental practices in Northern Ireland were invited to participate. Twenty-four patients refused (response rate 98%) providing 1,004 patients (mean age = 41 years, range = 16 to 90 years; 65% female) for analysis. Patients who completed the dental anxiety scale were found to have a virtually identical state anxiety score: mean (SD) = 11.36 (4.33) compared to those who completed the state anxiety assessment only: mean (SD) = 11.01 (4.35). The mean (CI95%) difference was 0.35 (0.89 to -0.18), t = 1.29, df1002, p = 0.2. The completion of a brief dental anxiety questionnaire before seeing the dentist has a non significant effect on state anxiety.


Lesion Heterogeneity on High-Field Susceptibility MRI Is Associated with Multiple Sclerosis Severity.
Susceptibility MR imaging contrast variations reflect alterations in brain iron and myelin content, making this imaging tool relevant to studies of multiple sclerosis lesion heterogeneity. In this study, we aimed to characterize the relationship of high-field, susceptibility contrasts in multiple sclerosis lesions to clinical outcomes. Twenty-four subjects with multiple sclerosis underwent 7T MR imaging of the brain, disability examinations, and a fatigue inventory. The inverse of T2* relaxation time (R2*), frequency, and relative susceptibility (from quantitative susceptibility mapping) were analyzed in 306 white matter lesions. Most lesions were hypointense on R2* (88% without a rim, 5% with). Lesions that were hyperintense on quantitative susceptibility mapping were more frequent in relapsing-remitting than in progressive multiple sclerosis (54% versus 35%, P = .018). Hyperintense lesion rims on quantitative susceptibility maps were more common in progressive multiple sclerosis and patients with higher levels of disability and fatigue. Mean lesion R2* was inversely related to disability and fatigue and significantly reduced in progressive multiple sclerosis. Relative susceptibility was lower in lesions in progressive multiple sclerosis (median, -0.018 ppm; range, -0.070 to 0.022) than in relapsing-remitting MS (median, -0.010 ppm; range, -0.062 to 0.052; P = .003). A progressive clinical phenotype and greater disability and fatigue were associated with lower R2* and relative susceptibility values (suggestive of low iron due to oligodendrocyte loss) and rimmed lesions (suggestive of chronic inflammation) in this multiple sclerosis cohort. Lesion heterogeneity on susceptibility MR imaging may help explain disability in multiple sclerosis and provide a window into the processes of demyelination, oligodendrocyte loss, and chronic lesion inflammation.


Tritium isotope effect in high-pressure liquid chromatography of vitamin D metabolites.
A significant chromatographic isotope effect is reported for 1,25-dihydroxyvitamin D3 in a wide variety of HPLC separation systems. The effect is also observed for 24,25-dihydroxyvitamin D3. Retention times differ from less than 1% up to 4% depending on the separation system and the degree and position of tritium substitution. Such an effect must be corrected for whenever both labeled and unlabeled vitamin D metabolites are used in HPLC cochromatography or assay recovery studies.


Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women.
Radiotherapy (RT) might lead to atherosclerotic plaque buildup and coronary artery stenosis of breast cancer (BC) survivors, and coronary artery calcium (CAC) might be a sign of preclinical atherosclerosis. This study explores possible determinants affecting the acceleration of CAC burden in BC patients after adjuvant RT. Female BC patients receiving adjuvant RT from 2002 to 2010 were included. All patients received noncontrast computed tomography (NCCT) of thorax before and after adjuvant RT. Their CAC burden was compared with healthy controls from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. The progression of the CAC burden was manifested by the increment of CAC percentiles (%CACinc). Ninety-four patients, including both left- and right-side BC, were enrolled in this study. From undergoing the first to second NCCT, the %CACinc in BC patients significantly increased rather than non-BC women. In addition, the %CACinc was significantly higher in left-side than right-side BC patients (p < 0.05), and significant differences in most heart outcomes were found between the two groups. Besides, the lower the mean right coronary artery (RCA) dose, the lower the risks of CAC percentiles increase ≥ 50% after adjusting the disease's laterality. A significantly higher accelerated CAC burden in BC patients than non-BC women represents that BC could affect accelerated CAC. A higher risk of accelerated CAC burden was found in left-side than right-side BC patients after adjuvant RT. A decrease of the mean RCA dose could reduce more than 50% of the risk of accelerated CAC burden in BC patients.


Monoclonal antibodies directed against human Ia antigens detect an evolutionary conserved epitope on guinea pig Ia antigens with unique functional properties.
Three murine monoclonal antihuman Ia antibodies were found to cross react with guinea pig Ia antigens. Sequential immunoprecipitation studies demonstrated that these antibodies recognized a subset of guinea pig Ia antigens. In competition binding studies, the antihuman Ia antibodies competed with each other, but not with a number of murine monoclonals raised directly to guinea pig Ia antigens. When the antihuman Ia monoclonals were tested for their ability to inhibit the proliferative response of primed guinea pig T cells to antigen-pulsed macrophages, they completely inhibited the response of strain 2 T cells to the complex antigen ovalbumin while having no effect on the response to the copolymer L-glutamic acid, L-lysine. In contrast, the monoclonals raised against guinea pig Ia had much less dramatic effects on the response of uncloned T cells to these antigens. These results suggest that the cross-reactive monoclonals may recognize an evolutionary conserved epitope on Ia that has a regulatory function in T-cell activation.


Extra-amniotic prostaglandin induction of labour supplemented with intravenous oxytocin following fetal death in utero.
A five year retrospective study (1984-1989) was undertaken on 24 consecutive patients with fetal death to ascertain the efficacy, side effects and complications associated with a combination of extra-amniotic prostaglandin E and intravenous oxytocin to induce labour. Six patients with primigravidae and eighteen multigravidae with inductions carried out at gestations ranging from 16 to 37 weeks (mean 26 weeks and 3 days). The estimated time from fetal death to induction ranged from 1 day to 3 weeks (mean 8 days). Induction was successful in all cases with a mean induction to delivery time of 9 hours and 30 minutes. The mean dose of prostaglandin required was 0.914 gms and of oxotocin 12.78 I.U.s. Minor side effects were experienced by 16% of patients though none were serious. This series confirms the combination of extra-amniotic prostaglandin and intravenous oxytocin as an effective means of inducing labour where fetal death has occurred.


Left gastric artery arising from the superior mesenteric artery--case reports.
Two case reports of a left gastric artery replaced to the SMA are presented. Normal left gastric anatomy and development are described, and the importance of such anomalies is discussed.


The covalent structure of calf skin type III collagen. II. The amino acid sequence of the cyanogen bromide peptide alpha 1(III)CB1,8,10,2(Positions 223--402).
The cyanogen bromide peptide alpha 1-(III)CB1,8,10,2 is 180 amino acid residues in length and occupies position 223 to 402 along the alpha 1(III) chain. In order to elucidate its amino acid sequence, alpha 1(III)CB1,8,10,2 was fragmented with hydroxylamine, protease from Staphylococcus aureus V8 and trypsin. Peptides necessary for sequence analysis with the automated Edman degradation were separated using molecular and ion exchange chromatography. Edman degradation of the hydroxylamine-derived fragments resulted in the elucidation of 80% of the entire sequence. The rest was completely established by sequence analysis of some protease V8 and trypsin-derived peptides.


Postnatal weaning to different diets leads to different reproductive phenotypes in female offspring following perinatal exposure to high levels of dietary advanced glycation end products.
To examine, following perinatal exposure to a diet high in advanced glycation end products (AGEs), whether the use of standard AGE-free mouse chow during the postweaning period alters metabolism and reproduction differently than exposure to a diet low in AGEs. Experimental animal study. University-based research laboratory. Female CD1 mice. Seven-week-old mice were placed on a diet either low or high in AGEs perinatally, before mating and then during pregnancy and lactation. All offspring were weaned onto an AGE-free normal chow. Growth curve, liver and abdominal fat weight, insulin and glucose tolerance tests, vaginal opening, estrous cyclicity, and serum levels of antimüllerian hormone, leptin, and adiponectin were assessed. Ovarian histologic examination for follicular count and gene expression was also performed. Compared with the mice exposed to a diet low in AGEs, the mice exposed to a diet high in AGEs showed lower body weight in pups, lower liver weight, delayed vaginal opening, higher serum antimüllerian hormone levels, lower primordial and secondary follicle pools, and higher ovarian Fshr messenger RNA levels. Following weaning, perinatal AGEs can target puberty onset and folliculogenesis differently to standard mouse chow.


Endogenous Aspergillus versicolor endophthalmitis in an immuno-competent HIV-positive patient.
A 25-year-old white, HIV-positive, immuno-competent man was referred to us because of a progressive blurred vision in his right eye. Clinical characteristics were suggestive for an unilateral fungal endophthalmitis, and thereby fluconazole firstly, followed by conventional amphotericin B were intravenously administered, without any significant improvement. Thus, a pars plana vitrectomy was performed. Aspergillus versicolor was isolated from the cultures of the vitreous sample and intravenous liposomal amphotericin B was administered. An increase of visual acuity together with a reduction of vitreous inflammation occurred. This case of ours represents the first report describing an endogenous endophthalmitis induced by Aspergillus versicolor.


Systematic profiling of the bacterial phosphoproteome reveals bacterium-specific features of phosphorylation.
Protein phosphorylation is a crucial posttranslational modification for regulating cellular processes in bacteria; however, it has not been extensively studied because of technical difficulties in the enrichment of phosphopeptides. We devised an enrichment protocol that enabled the identification of >1000 phosphopeptides from a single bacterial sample. We discovered three high-confidence serine and threonine phosphorylation motifs, as well as 29 other motifs at various levels of confidence, from three distinct bacterial phosphoproteomes. We found that the proline-directed and basophilic phosphorylation motifs that are commonly enriched in eukaryotes were not observed in bacteria. Unlike eukaryotes, bacteria had a low occurrence of both phosphorylation and acetylation in N-terminal phosphopeptides. Because infection of host cells by bacterial pathogens is often accompanied by kinase-mediated phosphorylation events, the differences in phosphorylation preferences between bacteria and eukaryotes revealed by this study could be useful in identifying bacterial-specific targets for future therapies.


Telemedicine for the pediatric preoperative assessment during the COVID-19 pandemic: Evaluating patient and provider satisfaction.
The COVID-19 pandemic has presented unprecedented challenges in delivering healthcare to surgical patients. To avoid delays in patient care while still minimizing COVID-19 infection risk to patients and providers, anesthesiology preoperative clinics were presented with the opportunity to implement telemedicine to assess patients' risks prior to surgery. This study explores patient and provider satisfaction with video-based telemedicine preoperative clinic visits during the COVID-19 pandemic via a patient and provider satisfaction survey. A vast majority (>93%) of patients expressed overall satisfaction with telemedicine visits. Similarly, >85% of providers agreed with the benefits of and expressed overall satisfaction with the preoperative telemedicine visits. Overall, patient and provider study participants had positive feedback in response to anesthesia preoperative telemedicine visits. Future studies could assess the preference of telemedicine to in-person visits once the fears of COVID-19 spread have been mitigated, as well as an assessment of outcomes comparing telemedicine and in-person visits.


[Resistine--a new hormone secreted by adipose tissue (adipose tissue in insulin resistance)].
Obesity is an important risk factor for the development of insulin resistance and type 2 diabetes. The molecular mechanism linking obesity to insulin resistance is, however, unclear. Recently, a new circulating hormone resistine, which is expressed in adipose tissue, has been identified. Resistine has been shown to antagonize insulin action. Resistine levels are increased in diet-induced obesity as well as in genetic models of obesity and insulin resistance. Furthermore, resistine gene expression is markedly downregulated by treatment with anti-diabetic drugs called thiazolidinediones, that improve target-tissue sensitivity to insulin. It has been found that in human abdominal adipose tissue, which is thought to be a main risk factor for insulin resistance, amount of resistine mRNA is higher than in other fat depots. Resistine, therefore, may play a role in the pathogenesis of obesity-related insulin resistance.


Chloroquine inhibits HIV-1 replication in human peripheral blood lymphocytes.
Chloroquine has inhibitory effects on human immunodeficiency deficiency virus (HIV)-1 replication in human lymphocytes with an ED50 of 15 microM, which approximates the chloroquine plasma concentration generated in the acute treatment of malaria. Chloroquine has a parallel inhibitory effect on DNA replication in human lymphocytes, although the inhibitory effect on DNA replication is not as pronounced as is the drug inhibition of HIV-1 replication in the cells.


The renal response to exogenous parathyroid hormone in treated pseudohypoparathyroidism.
Resistance to the renal actions of parathyroid hormone (PTH) in pseudohypoparathyroidism (PsH) may be improved after treatment with vitamin D or its metabolites, but reports conflict. We have examined the renal response to infusion of 35 micrograms of 1-38 PTH in patients with PsH type I (n = 8) and PsH type II (n = 1) during treatment and related this to prevailing endogenous serum PTH and calcium levels. Nine patients with postsurgical or idiopathic hypoparathyroidism (HP) served as controls. The urinary cAMP increase (delta cAMP) was lower (p < 0.001) in the PsH type I (175 +/- 6.4 nmol/l glomerular filtrate) than in the HP group (3251 +/- 515 nmol/l glomerular filtrate). delta cAMP in the PsH type I subjects was dependent on endogenous PTH concentrations (r = -0.76; p = 0.046) and serum calcium (r = 0.74; p = 0.037). Phosphaturic responses (expressed as % decrease in TmPO4/glomerular filtration rate) were lower (p = 0.013) in the PsH type I (28.8 +/- 3.75) compared with those of the HP patients (43 +/- 3.48). The phosphaturic responses in the PsH type I patients were strongly dependent on endogenous PTH (r = 0.94; p < 0.001) and serum calcium levels (r = 0.94; p < 0.001) so that the responses of subjects with normal or low PTH levels were no different (p = 0.16) from the HP group. Renal handling of calcium and sodium in response to exogenous PTH was identical in patients with PsH (types I and II) and HP. Renal tubular reabsorption during a calcium infusion was normal in all patients with PsH. These results emphasise the importance of the modulatory effects due to associated biochemical abnormalities in PsH on the responses to exogenous PTH. They also confirm that renal handling of calcium and sodium is probably normal in treated PsH.


Assaying Spontaneous Network Activity and Cellular Viability Using Multi-Well Microelectrode Arrays.
Microelectrode array (MEA) technology is a neurophysiological method that allows for the measurement of spontaneous or evoked neural activity to determine chemical effects thereon. Following assessment of compound effects on multiple endpoints that evaluate network function, a cell viability endpoint in the same well is determined using a multiplexed approach. Recently, it has become possible to measure electrical impedance of cells attached to the electrodes, where greater impedance indicates greater number of cells attached. This would allow rapid and repeated assessments of cell health as the neural network develops in longer exposure assays without impacting cell health. Typically, the lactate dehydrogenase (LDH) assay for cytotoxity and CellTiter-Blue® (CTB) assay for cell viability are only performed at the end of the chemical exposure period because these assays involve lysing of the cells. Procedures describing the multiplexed methods in acute and network formation screening are included in this chapter.


A single centre 20-year retrospective cohort study: Percutaneous endoscopic colostomy.
Percutaneous endoscopic colostomy (PEC) represents an important intervention in specific patients. Limited data currently exist. We present the largest recorded study of patients undergoing PEC. Retrospective analysis of consultant logbooks highlighted all patients from 1997 to 2020. Two independent reviewers assessed records. Parameters measured were age, sex, indication, number of sites, complications, mortality and survival. Three subgroups were identified: recurrent sigmoid volvulus (RSV), pseudo-obstruction and neurogenic. ANOVA, chi-squared and Fischer's exact tests were utilized; Kaplan-Meier curves estimated survival and the log-rank test was applied. A p value of <0.05 was considered statistically significant. Ninety-six PEC insertions were done on 91 patients (five reinsertions). There were 66 men (69%) and the mean age was 73.1 years (interquartile range 23). The indications were RSV n = 72, pseudo-obstruction n = 13, neurogenic n = 11. The 30-day complication rate was overall n = 27 (28%), RSV n = 23, pseudo-obstruction n = 4. Nine patients leaked (9.9%) (eight RSV, one pseudo-obstruction), of whom five died. 90-day mortality was 14.6% (14 patients), 18.5% (13/72) for RSV, 7.7% (1/13) for pseudo-obstruction. Overall recurrence following PEC was 10.4%. The median follow-up was 25 months (interquartile range 4.6-62.2 months). At 3, 5 and 10 years survival was 46%, 34% and 26% for RSV, 70%, 55% and 15% for pseudo-obstruction and 91%, 91% and 81% for neurogenic respectively. Recurrent sigmoid volvulus and pseudo-obstruction patients undergoing PEC compared to neurogenic patients have poorer outcomes with higher complication rates and shorter life expectancy. We advocate that high volume specialist units undertake PEC. The significant associated risks of PEC require careful consideration when determining patient suitability. Utilizing risk stratification scores may help guide shared decision making between patients, relatives and clinicians.


Purification of granulocyte neutral protease from human blood and rheumatoid synovial fluid.
The neutral protease activity of human synovial fluid cells, like that of peripheral blood leucocytes, is located in a granule fraction. It can be solubilised by various agents but only 1 M neutral salts do so without inactivation. Salt-solubilised neutral protease has been purified (300 X) from synovial fluid cells; like preparations obtained in the same way (600 X purified) from peripheral blood leucocytes, it has a broad pH profile of activity (pH 7--10.5) and in this, as well as in substrate specificity and sensitivity to activators and inhibitors, it behaves as a serine-histidine type protease similar to elastase (EC 126.96.36.199). The product showed two major components on polyacrylamide gel electrophoresis. Collagenase or chymotrypsin-like activity were not detected.


Haemodynamic changes during neck pressure and suction in seated and supine positions.
We sought to quantify the contribution of cardiac output (Q) and total vascular conductance (TVC) to carotid baroreflex-mediated changes in mean arterial pressure (MAP) in the upright seated and supine positions. Acute changes in carotid sinus transmural pressure were evoked using brief 5 s pulses of neck pressure and neck suction (NP/NS) via a simplified paired neck chamber that was developed to enable beat-to-beat measurements of stroke volume using pulse-doppler ultrasound. Percentage contributions of Q and TVC were achieved by calculating the predicted change in MAP during carotid baroreflex stimulation if only the individual changes in Q or TVC occurred and all other parameters remained at control values. All NP and NS stimuli from +40 to -80 Torr (+5.33 to -10.67 kPa) induced significant changes in Q and TVC in both the upright seated and supine positions (P < 0.001). Cardiopulmonary baroreceptor loading with the supine position appeared to cause a greater reliance on carotid baroreflex-mediated changes in Q. Nevertheless, in both the seated and supine positions the changes in MAP were primarily mediated by alterations in TVC (percentage contribution of TVC at the time-of-peak MAP, seated 95 +/- 13, supine 76 +/- 17 %). These data indicate that alterations in vasomotor activity are the primary means by which the carotid baroreflex regulates blood pressure during acute changes in carotid sinus transmural pressure.


Traumatic left ventricular papillary muscle rupture: the role of transesophageal echocardiography in diagnosis and surgical management.
We report a case of left ventricular posteromedial papillary muscle rupture caused by blunt chest trauma. Transesophageal echocardiography was used to establish the diagnosis and to assist with surgical repair of the mitral valve apparatus. Echocardiographic findings of the acutely ruptured papillary muscle are reviewed.


Management of quintuplet pregnancy by selective embryocide.
Selective embryocide was performed as a two-stage procedure in a patient with a quintuplet pregnancy in the first trimester. No complications occurred, and the patient was delivered of healthy twins at term. This procedure may be offered to selected patients with pregnancies with greater than five embryos.


Knowledge, attitudes and practice of confidentiality of patients' health records among health care professionals at Federal Medical Centre, Bida.
The quality of information shared with health care professionals depends on their ability to keep it confidential especially in this information technology age when unguided access is imminent. In view ofthis, the study described knowledge, attitude and practice of confidentiality of patients' health records amongst health care professionals at Federal Medical Centre Bida, Nigeria. A semi-structured self-administered.questionnaire on the subject was administered to 313 health professionals chosen by stratified random sampling in the hospital. Majority (161, 66.8%) of the participants were less than ten years in practice. Virtually, all (232, 96.3%) have heard about confidentiality mostly from schools (134, 55.6%), on-the-job (61, 25.3%) and from multiple sources (18, 7.5%). On responsibility for confidentiality; only 35 (14.5%) knew it is the responsibility of every health professional, while the majority; 117 (48.5%) felt it was exclusively meant for health information management professionals. Responses to issues on confidentiality range from 58.1% (revelation of documented next of kin to relatives of dead patients by staff) to 94.2% (employing the service of untrained interpreter). Very few (28, 11.6%) argued that confidentiality and privacy are not synonymous. Recommendations given to improve the practice of confidentiality include among others, observance of good health records practice by all professionals/stakeholders, continuing sensitisation of all staffandsanction against erring staff. Although, most professionals were aware of confidentiality, there appears a gap of in-depth knowledge and lack of awareness of respective responsibility towards it. However, they will do better if given the enabling environment and continuing education on the subject.


Effects of diet and exercise on adipocytokine levels in patients with moderate to severe chronic kidney disease.
Obesity is a pro-inflammatory risk factor for progression of CKD and cardiovascular disease. We hypothesized that implementation of caloric restriction and endurance exercise would improve adipocytokine profiles in patients with moderate to severe CKD. We enrolled patients with moderate to severe CKD through a multi-center pilot randomized trial of diet and exercise in a 4-arm design (dietary restriction of 10%-15% reduction in caloric intake, exercise three times/week, combined diet and exercise, and control) (NCT01150851). Adipocytokines (adiponectin and leptin) were measured at the beginning and end of the study period as secondary outcomes. Treatment effect was analyzed in a multivariable model adjusted for baseline outcome values, age, gender, site and diabetes. A total of 122 participants were consented, 111 were randomized (42% female, 25% diabetic, and 91% hypertensive), 104 started intervention and 92 completed the study (Figure 1). Plasma adiponectin levels increased significantly in response to diet by 23% (95% CI: 0.2%, 49.8%, p = 0.048) among participants randomized to the caloric restriction and usual activity arm but not to exercise, whereas circulating leptin did not change by either treatment. Our data suggest that dietary caloric restriction increases plasma adiponectin levels in stage 3-4 CKD patients, with limited effect on leptin levels. These findings suggest the potential for improving the metabolic milieu of CKD with moderate calorie restriction.


Isolation and characterization of a new Mycobacterium austroafricanum strain, IFP 2015, growing on MTBE.
A new Mycobacterium austroafricanum strain, IFP 2015, growing on methyl tert-butyl ether (MTBE) as a sole carbon source was isolated from an MTBE-degrading microcosm inoculated with drain water of an MTBE-supplemented gasoline storage tank. M. austroafricanum IFP 2015 was able to grow on tert-butyl formate, tert-butyl alcohol (TBA) and alpha-hydroxyisobutyrate. 2-Methyl-1,2-propanediol was identified as the TBA oxidation product in M. austroafricanum IFP 2015 and in the previously isolated M. austroafricanum IFP 2012. M. austroafricanum IFP 2015 also degraded ethyl tert-butyl ether more rapidly than M. austroafricanum IFP 2012. Specific primers designed to monitor the presence of M. austroafricanum strains could be used as molecular tools to detect similar strains in MTBE-contaminated environment.


Effect of confinement potential shape on the electronic, thermodynamic, magnetic and transport properties of a GaAs quantum dot at finite temperature.
The effect of the shape of the confinement potential on the electronic, thermodynamic, magnetic and transport properties of a GaAs quantum dot is studied using the power-exponential potential model with steepness parameter p. The average energy, heat capacity, magnetic susceptibility and persistent current are calculated using the canonical ensemble approach at low temperature. It is shown that for soft confinement, the average energy depends strongly on p while it is almost independent of p for hard confinement. The heat capacity is found to be independent of the shape and depth of the confinement potential at low temperatures and for the magnetic field considered. It is shown that the system undergoes a paramagnetic-diamagnetic transition at a critical value of the magnetic field. It is furthermore shown that for low values of the potential depth, the system is always diamagnetic irrespective of the shape of the potential if the magnetic field exceeds a certain value. For a range of the magnetic field, there exists a window of p values in which a re-entrant behavior into the diamagnetic phase can occur. Finally, it is shown that the persistent current in the present quantum dot is diamagnetic in nature and its magnitude increases with the depth of the dot potential but is independent of p for the parameters considered.


Genomic and Epigenetic Changes Drive Aberrant Skeletal Muscle Differentiation in Rhabdomyosarcoma.
Rhabdomyosarcoma (RMS), the most common soft-tissue sarcoma in children and adolescents, represents an aberrant form of skeletal muscle differentiation. Both skeletal muscle development, as well as regeneration of adult skeletal muscle are governed by members of the myogenic family of regulatory transcription factors (MRFs), which are deployed in a highly controlled, multi-step, bidirectional process. Many aspects of this complex process are deregulated in RMS and contribute to tumorigenesis. Interconnected loops of super-enhancers, called core regulatory circuitries (CRCs), define aberrant muscle differentiation in RMS cells. The transcriptional regulation of MRF expression/activity takes a central role in the CRCs active in skeletal muscle and RMS. In PAX3::FOXO1 fusion-positive (PF+) RMS, CRCs maintain expression of the disease-driving fusion oncogene. Recent single-cell studies have revealed hierarchically organized subsets of cells within the RMS cell pool, which recapitulate developmental myogenesis and appear to drive malignancy. There is a large interest in exploiting the causes of aberrant muscle development in RMS to allow for terminal differentiation as a therapeutic strategy, for example, by interrupting MEK/ERK signaling or by interfering with the epigenetic machinery controlling CRCs. In this review, we provide an overview of the genetic and epigenetic framework of abnormal muscle differentiation in RMS, as it provides insights into fundamental mechanisms of RMS malignancy, its remarkable phenotypic diversity and, ultimately, opportunities for therapeutic intervention.


Determination of glycosylated hemoglobin by affinity electrophoresis on agarose gel.
We describe a method for electrophoretic determination of glycosylated hemoglobin (GHb) on agarose gel membrane. Clear separation of GHb from non-GHb is achieved after 30 min electrophoresis at 60 V using a sodium citrate buffer solution (34 mmol/l, pH 6.5) containing 0.6 g/l dextran sulfate. The results obtained by this method correlate well with those by agar gel electrophoresis (r = 0.98) and column chromatography (r = 0.96). However, unlike column chromatographic methods, GHb values obtained on agarose gel are not affected by fluctuations in ambient temperature (18-28 degrees C), changes in pH (6.2-6.6) and ionic strength of buffer solution (26-40 mmol/l), or variant hemoglobin S and C. Also, electrophoresis on agarose gel membrane eliminates the lengthy preparative steps required for cellulose acetate electrophoresis. We conclude that agarose gel electrophoresis is a simple method for quantitative determination of GHb.


How to Solve the Underestimated Problem of Overestimated Sodium Results in the Hypoproteinemic Patient.
The availability of a fast and reliable sodium result is a prerequisite for the appropriate correction of a patient's fluid balance. Blood gas analyzers and core laboratory chemistry analyzers measure electrolytes via different ion-selective electrode methodology, that is, direct and indirect ion-selective electrodes, respectively. Sodium concentrations obtained via both methods are not always concordant. A comparison of results between both methods was performed, and the impact of the total protein concentration on the sodium concentration was investigated. Furthermore, we sought to develop an adjustment equation to correct between both ion-selective electrode methods. A model was developed using a pilot study cohort (n = 290) and a retrospective patient cohort (n = 690), which was validated using a prospective patient cohort (4,006 samples). ICU and emergency department at Ghent University Hospital. Patient selection was based on the concurrent availability of routine blood gas Na⁺(direct) as well as core laboratory Na⁺(indirect) results. In the pilot study, left-over blood gas syringes were collected for further laboratory analysis. There was a significant negative linear correlation between Na⁺(indirect) and Na⁺(direct) relative to changes in total protein concentration (Pearson r = -0.69; p < 0.0001). In our setting, for each change of 10 g/L in total protein concentration, a deviation of ~1.3 mmol/L is observed with the Na⁺(indirect) result. Validity of our adjustment equation protein-corrected Na⁺(indirect) = Na⁺(indirect) - 10.53 + (0.1316 × total protein) was demonstrated on a prospective patient cohort. As Na⁺(direct) measurements on a blood gas analyzer are not influenced by the total protein concentration in the sample, they should be preferentially used in patients with abnormal protein concentrations. However, as blood gas analyzers are not available at all clinical wards, the implementation of a protein-corrected sodium result might provide an acceptable alternative.


[Relationship between blood zinc level and EEG changes under the influence of hyperpnea in normal subjects].
The red blood cell and serum zinc levels have been determined by atomic absorption spectrophotometry on 27 human subjects in apparent good state of health, tested monthly for five months successively. The subjects who present a decreased frequency of the E.E.G. pattern during hyperventilation, also show a diminished red blood cell Zn level, by comparison with the other subjects. This phenomenon suggests a possible relationship between red blood cell zinc concentration and E.E.G. signs of cortical hyperexcitability. These findings are discussed in the light of the recent literature.


A patient with worsening mobility: a diagnostic challenge.
Worsening mobility and "off legs" are common reasons to seek a medical opinion. A 62-year-old gentleman, previously fit and healthy, was referred to a district general hospital in the UK with worsening mobility. The initial clinical features were suggestive of Miller Fisher syndrome (MFS). Initial investigations were unremarkable apart from mild hypokalemia. Despite correction of the hypokalemia and immunoglobulin infusion, the patient's condition deteriorated. The presence of hypokalemia raised the possibility of underlying malignancy with ectopic ACTH secretion. A CT of the chest/abdomen showed a mediastinal mass. A post-mortem examination revealed a metastatic anaplastic pancreatic carcinoma. To the best of our knowledge, this is the first report in which MFS has occurred in association with pancreatic carcinoma. This case highlights that malignancy should be considered as a possibility in patients presenting with MFS and/or worsening mobility.


Outcomes after anti-thymocyte globulin vs Basiliximab induction before deceased donor kidney transplants.
Deceased donor kidney transplants represent an important source of renal replacement for the 100 000 patients initiating hemodialysis annually. We compared the association of induction therapy, anti-thymocyte globulin [rabbit] (rATG) or basiliximab, with posttransplant rejection, graft and patient survival. Using the United Network for Organ Sharing (UNOS) database, we identified patients that received deceased donor kidney transplants. The outcomes analyzed were 6- month rejection, 1-year rejection, patient survival and graft survival. Multivariate logistic regression models were constructed to understand the association of induction therapy and rejection. Cox-proportional hazards models were constructed to ascertain the association of choice of induction therapy with both patient and graft survival. Of 45 339 patients, 33 906 patients received rATG induction therapy and 11 433 patients received basiliximab induction therapy. The rATG group were younger (53.44 years vs 55.28 years, P < 0.001), more frequently female (58.74% male vs 66.08%, P < 0.001) and more frequently Black (34.78% vs 25.66%, p < 0.001) compared with patients in the basiliximab group. Rejection was more likely with basiliximab compared with rATG at 6 months(OR = 1.64, P < 0.001; 7.81% Basiliximab vs 5.23% rATG)and at 12 months (OR = 1.56, P < 0.001; 8.81% Basiliximab vs 6.31% rATG). Basiliximab induction therapy was associated with worse patient survival, (HR = 1.05, P = 0.017). Basiliximab induction therapy was associated with worse graft survival, (HR = 1.03, P = 0.037). The analysis of the national experience demonstrated favorable rejection, patient survival, and graft survival with rATG usage. Further prospective data are necessary to provide treatment recommendations.


Role of the gut microbiota in nutrient competition and protection against intestinal pathogen colonization.
The human gut microbiota can restrict the growth of pathogens to prevent them from colonizing the intestine ('colonization resistance'). However, antibiotic treatment can kill members of the gut microbiota ('gut commensals') and reduce competition for nutrients, making these nutrients available to support the growth of pathogens. This disturbance can lead to the growth and expansion of pathogens within the intestine (including antibiotic-resistant pathogens), where these pathogens can exploit the absence of competitors and the nutrient-enriched gut environment. In this review, we discuss nutrient competition between the gut microbiota and pathogens. We also provide an overview of how nutrient competition can be harnessed to support the design of next-generation microbiome therapeutics to restrict the growth of pathogens and prevent the development of invasive infections.


S100 calcium-binding protein A9 from tumor-associated macrophage enhances cancer stem cell-like properties of hepatocellular carcinoma.
Tumor-associated macrophages (TAMs) are crucial components of the tumor microenvironment. They play vital roles in hepatocellular carcinoma (HCC) progression. However, the interactions between TAMs and HCC cells have not been fully characterized. In this study, TAMs were induced using human monocytic cell line THP-1 cells in vitro to investigate their functions in HCC progression. S100 calcium-binding protein A9 (S100A9), an inflammatory microenvironment-related secreted protein, was identified to be significantly upregulated in TAMs. S100A9 expression in tumor tissues was associated with poor survival of HCC patients. It could enhance the stem cell-like properties of HepG2 and MHCC-97H cells by activating nuclear factor-kappa B signaling pathway through advanced glycosylation end product-specific receptor in a Ca2+ -dependent manner. Furthermore, we found that, after treatment with S100A9, HepG2 and MHCC-97H cells recruited more macrophages via chemokine (CC motif) ligand 2, which suggests a positive feedback between TAMs and HCC cells. Taken together, our findings reveal that TAMs could upregulate secreted protein S100A9 and enhance the stem cell-like properties of HCC cells and provide a potential therapeutic target for combating HCC.


The role of murine cell surface galactosyltransferase in trophoblast: laminin interactions in vitro.
Implantation of the mouse embryo involves the invasion of the secondary trophoblast giant cells of the ectoplacental cone (EPC) into the uterine decidua. The mechanisms of this event are poorly understood. The putative substrate molecules found in the decidua which could support trophoblast invasion include laminin, fibronectin, and collagen type IV. EPCs dissected from Day 7.5 embryos were cultured on all three matrices. Galactosyltransferase (GalTase) was localized by immunolabeling on trophoblast cell surfaces when grown on laminin but not the other matrices. Perturbations of the enzyme:substrate complex with alpha-lactalbumin, uridine diphosphogalactose, anti-GalTase, and pregalactosylation of the matrix did not affect rates of EPC attachment. However, decreased rates of migration or altered morphologies of spreading cells were observed. Laminin, and not fibronectin or collagen type IV, could be galactosylated with both exogenous GalTase or EPC outgrowths. Digests of galactosylated laminin produced a glycoconjugate substrate with a molecular weight of less than 10K. The results suggest that invasive secondary trophoblast cells possess a GalTase-mediated migration system that is functional on laminin.


The Prognostic Performance of Rotational Thromboelastometry for Excessive Bleeding and Increased Transfusion Requirements in Hip Fracture Surgeries.
Hip fracture surgeries are associated with considerable blood loss, while the perioperative coagulopathy is associated with the bleeding risk of these patients. We aimed to evaluate the ability of rotational thromboelastometry (ROTEM) to detect patients at high risk for excessive bleeding and increased transfusion requirements. We conducted a prospective observational study of 221 patients who underwent hip fracture surgeries. ROTEM analysis was performed preoperatively and immediately postoperatively. Blood loss parameters including blood loss volume, number of transfused red blood cell (RBC) units, and drop in hemoglobin levels were recorded. ROTEM parameters were compared between patients with and without excessive bleeding, and between patients with and without increased transfusion requirements (i.e., ≥2 RBC units). The postoperative FIBTEM MCF value ≤15 mm had 66.6% (95% confidence interval [CI]: 59.7-74.1%) sensitivity and 92.0% (95% CI: 80.7-97.7%) specificity to prognose excessive bleeding, and preoperative FIBTEM MCF value ≤15 mm had 80.4% (95% CI: 73.5-86.2%) sensitivity and 91.2% (95% CI: 80.7-97.0%) specificity to prognose increased transfusion requirements. Preoperative FIBTEM MCF ≤11 mm and postoperative FIBTEM MCF ≤15 mm were associated with considerably increased risks of excessive bleeding (odds ratio [OR]: 44.8, 95% CI: 16.5-121.3, p < 0.001; and OR: 23.0, 95% CI: 7.8-67.0, p < 0.001, respectively). ROTEM parameters demonstrated high prognostic accuracy for excessive bleeding and increased transfusion requirements. This can enable implementation of blood sparing strategies in high-risk patients, while blood banks could be better prepared to ensure adequate blood supply.


'Let's fix the chemical imbalance first, and then we can work on the problems second': an exploration of ethical implications of prescribing an SSRI for 'depression'.
The creation of pharmacotherapies, such as Selective Serotonin Reuptake Inhibitors (SSRIs), for the treatment of depression was hailed as a great breakthrough in mental health care. However, since that time, serious questions have arisen as to their safety and the way they are prescribed without full information being provided to patients about a range of important issues, including the possible aetiologies of depression, and the efficacy and potential side-effects of medication. These issues have been especially important in the care and treatment of young people, as there is evidence that SSRIs may be implicated in increased suicidal behaviour. In this article, we examine the experiences of five individuals who were prescribed an SSRI in their late teens or early twenties, and discuss some of the ethical issues that arise from their accounts.


Microwave-assisted drying of pharmaceutical granules and its impact on drug stability.
The advent of microwave technology has intensified the search for pharmaceuticals amenable to microwave processing. This study investigated the influences of powder load, diluent particle size and amount of granulating liquid employed on the microwave-assisted drying and stability of acetylsalicylic acid (ASA)-loaded granules in a single pot high shear processor. Powder load affected the profiles, rate and extent of drying. Drying was more dependent on the size and structural properties of granules rather than their surface areas as heat was generated volumetrically. Increased granule size brought about by increasing the size of diluent particles and amount of granulating liquid resulted in higher drying rates. Drug stability was negatively correlated to the drying time of granules.


Radical cystectomy in presence of fused "cake" kidney.
Radical cystectomy is the optimal treatment for patients with invasive bladder cancer. The presence of a fused pelvic kidney is an uncommon congenital abnormality and when found in a patient with bladder cancer may alter the operative procedure. Herein we report on a patient presenting with invasive bladder cancer and a pelvic "cake" kidney.


The effect of radiation dose and chemotherapy on overall survival in 237 patients with Stage III non-small-cell lung cancer.
To study the effects of radiation dose, chemotherapy, and their interaction in patients with unresectable or medically inoperable Stage III non-small-cell lung cancer (NSCLC). A total of 237 consecutive Stage III NSCLC patients were evaluated. Median follow-up was 69.0 months. Patients were treated with radiation therapy (RT) alone (n = 106), sequential chemoradiation (n = 69), or concurrent chemoradiation (n = 62). The primary endpoint was overall survival (OS). Radiation dose ranged from 30 to 102.9 Gy (median 60 Gy), corresponding to a bioequivalent dose (BED) of 39 to 124.5 Gy (median 72 Gy). The median OS of the entire cohort was 12.6 months, and 2- and 5-year survival rates were 22.4% and 10.0%, respectively. Multivariable Cox regression model demonstrated that Karnofsky performance status (p = 0.020), weight loss < 5% (p = 0.017), chemotherapy (yes vs. no), sequence of chemoradiation (sequential vs. concurrent; p < 0.001), and BED (p < 0.001) were significant predictors of OS. For patients treated with RT alone, sequential chemoradiation, and concurrent chemoradiation, median survival was 7.4, 14.9, and 15.8 months, and 5-year OS was 3.3%, 7.5%, and 19.4%, respectively (p < 0.001). The effect of higher radiation doses on survival was independent of whether chemotherapy was given. Radiation dose and use of chemotherapy are independent predictors of OS in Stage III NSCLC, and concurrent chemoradiation is associated with the best survival. There is no interaction between RT dose and chemotherapy.


Emergent endovascular stent grafting for perforated acute type B dissections and ruptured thoracic aortic aneurysms.
The purpose of our study was to demonstrate the effectiveness of endovascular stent grafts in the treatment of acutely ruptured thoracic aortic aneurysms and type B dissections as an alternative to the conventional surgical approach in an emergency setting. From January 2001 to October 2001, we deployed 11 emergent endovascular stent grafts into the thoracic aorta. We treated seven ruptured aortic aneurysms and four acutely perforated type B dissections. Aortic rupture was confirmed preoperatively by spiral computed tomography. In all cases, hemothorax was present. The average interval from onset of symptoms to treatment was 28.5 hours. We used nine Talent and two Excluder stent grafts. Deployment of the stent grafts was successful in nine cases. There were two cases of access failure due to small caliber of iliac arteries, and 1 of these patients died shortly after the procedure was abandoned, At 12 months of follow-up, there were no cases of paraplegia, stent migration, or endoleaks. There was, however, one temporary renal failure, and 2 patients required mechanical ventilation for more than 48 hours. Our experiences with emergency endovascular stent grafting show that the procedure is technically feasible, with less morbidity and mortality than conventional open surgery, in high-risk patients.


Longer Photoperiods with the Same Daily Light Integral Increase Daily Electron Transport through Photosystem II in Lettuce.
Controlled environment crop production recommendations often use the daily light integral (DLI) to quantify the light requirements of specific crops. Sole-source electric lighting, used in plant factories, and supplemental electric lighting, used in greenhouses, may be required to attain a specific DLI. Electric lighting is wasteful if not provided in a way that promotes efficient photochemistry. The quantum yield of photosystem II (ΦPSII), the fraction of absorbed light used for photochemistry, decreases with increasing photosynthetic photon flux density (PPFD). Thus, we hypothesized that the daily photochemical integral (DPI), the total electron transport through photosystem II (PSII) integrated over 24 h, would increase if the same DLI was provided at a lower PPFD over a longer photoperiod. To test this, ΦPSII and the electron transport rate (ETR) of lettuce (Lactuca sativa 'Green Towers') were measured in a growth chamber at DLIs of 15 and 20 mol m-2 d-1 over photoperiods ranging from 7 to 22 h. This resulted in PPFDs of 189 to 794 μmol m-2 s-1. The ΦPSII decreased from 0.67 to 0.28 and ETR increased from 55 to 99 μmol m-2 s-1 as PPFD increased from 189 to 794 μmol m-2 s-1. The DPI increased linearly as the photoperiod increased, but the magnitude of this response depended on DLI. With a 7-h photoperiod, the DPI was ≈2.7 mol m-2 d-1, regardless of DLI. However, with a 22-h photoperiod, the DPI was 4.54 mol m-2 d-1 with a DLI of 15 mol m-2 d-1 and 5.78 mol m-2 d-1 with a DLI of 20 mol m-2 d-1. Our hypothesis that DPI can be increased by providing the same DLI over longer photoperiods was confirmed.


Assessment of the effects of soil PAH accumulation by a battery of ecotoxicological tests.
Surface soils were collected at remote, urban and industrial sites in the Southern of Italy in order to evaluate PAH concentrations and assess the toxic effects by a battery of ecotoxicological tests. The tests were performed on whole soils and on both organic and aqueous extracts. Further goal of this study was to integrate the results coming from each test and matrix in a synthetic toxicity index. The highest summation sigmaPAH concentrations were measured at the industrial soil, although this one did not show an high ecotoxicological risk. Among the performed tests, the phytotoxicity tests showed the highest sensitivity. For whole soil, the worst case always has been represented by test through bacteria. Our results could represent the first step toward the selection of a proper battery to characterize the soil ecotoxicological risk.


Analytical and clinical validation of a new point-of-care testing system for determination of D-Dimer in human blood.
D-Dimer testing is used for exclusion of deep venous thrombosis (DVT). AQT90 FLEX D-Dimer (AQT D-Dimer) is a novel time-resolved fluorescence based point-of-care test for quantification of D-Dimer in whole blood or plasma. Presently we have determined the analytical and clinical performance of AQT D-Dimer and compared it with four routine D-Dimer assays. The within-run CV of AQT D-Dimer was 3.8-7.2% and the between-run CV was 5.7- 9.7%. Excellent agreement was found between the D-Dimer concentrations recorded in citrate-, heparin- and EDTA stabilised blood. The plasma concentration of D-Dimer was determined with AQT D-Dimer, AxSYM, Biopool Auto-Dimer, STA-Liatest and Vidas New in 170 consecutive patients suspected for DVT. Phlebograms were positive in 64 patients (22 distal, 42 proximal). ROC-curves (ROC), the negative and positive predictive values (NPV, PPV), the sensitivity and specificity of the tests were compared. The area under ROC was comparable for all tests. NPV for all DVT was 87-88%, the sensitivity was 88-92% and the PPV was 45-55%. For proximal DVT the NPV and sensitivity were 100% for all tests, whereas the PPV was 37-48%. For distal DVT we obtained a NPV of 87-88%. The sensitivity was 64-77%, the PPV was 19-24% whereas a specificity of 32-58% was observed. The AQT D-Dimer demonstrates excellent analytical and diagnostic performance. The test is rapidly performed and the measuring range of the assay is wide. The NPV, PPV, specificity, sensitivity and AUC of AQT D-Dimer for both proximal and distal DVT are comparable to routine D-Dimer assays.


Who am I? Key influences on the formation of academic identity within a faculty development program.
Professional identity encompasses how individuals understand themselves, interpret experiences, present themselves, wish to be perceived, and are recognized by the broader professional community. For health professional and health science educators, their 'academic' professional identity is situated within their academic community and plays an integral role in their well being and productivity. This study aims to explore factors that contribute to the formation and growth of academic identity (AI) within the context of a longitudinal faculty development program. Using a qualitative case study approach, data from three cohorts of a 2-year faculty development program were explored and analyzed for emerging issues and themes related to AI. Factors salient to the formation of AI were grouped into three major domains: personal (cognitive and emotional factors unique to each individual); relational (connections and interactions with others); and contextual (the program itself and external work environments). Faculty development initiatives not only aim to develop knowledge, skills, and attitudes, but also contribute to the formation of academic identities in a number of different ways. Facilitating the growth of AI has the potential to increase faculty motivation, satisfaction, and productivity. Faculty developers need to be mindful of factors within the personal, relational, and contextual domains when considering issues of program design and implementation.


[Abscess of the cervical soft tissues and the mediastinum resulting from an infected jaw cyst].
A woman is described in whom an infected radicular cyst of the mandible resulted in a cervical phlegmon with abscess formation and spreading into the superior mediastinum.


Annexin A6 controls neuronal membrane dynamics throughout chick cranial sensory gangliogenesis.
Cranial sensory ganglia are components of the peripheral nervous system that possess a significant somatosensory role and include neurons within the trigeminal and epibranchial nerve bundles. Although it is well established that these ganglia arise from interactions between neural crest and neurogenic placode cells, the molecular basis of ganglia assembly is still poorly understood. Members of the Annexin protein superfamily play key roles in sensory nervous system development throughout metazoans. Annexin A6 is expressed in chick trigeminal and epibranchial placode cell-derived neuroblasts and neurons, but its function in cranial ganglia formation has not been elucidated. To this end, we interrogated the role of Annexin A6 using gene perturbation studies in the chick embryo. Our data reveal that placode cell-derived neuroblasts with reduced Annexin A6 levels ingress and migrate normally to the ganglionic anlage, where neural crest cell corridors correctly form around them. Strikingly, while Annexin A6-depleted placode cell-derived neurons still express mature neuronal markers, they fail to form two long processes, which are considered morphological features of mature neurons, and no longer innervate their designated targets due to the absence of this bipolar morphology. Moreover, overexpression of Annexin A6 causes some placode cell-derived neurons to form extra protrusions alongside these bipolar processes. These data demonstrate that the molecular program associated with neuronal maturation is distinct from that orchestrating changes in neuronal morphology, and, importantly, reveal Annexin A6 to be a key membrane scaffolding protein during sensory neuron membrane biogenesis. Collectively, our results provide novel insight into mechanisms underscoring morphological changes within placode cell-derived neurons that are essential for cranial gangliogenesis.


Are Staphylococcus aureus Carrier Types Evidence of Population Heterogeneity?
Asymptomatic colonization by Staphylococcus aureus is a precursor for infection, so identifying the mode and source of transmission which leads to colonization could help in targeting interventions. Longitudinal studies have shown that some people are persistently colonized for years, while others seem to carry S. aureus for weeks or less, and conventional wisdom attributes this disparity to an underlying risk factor in the persistently colonized. We analyze published data with mathematical models of acquisition and carriage to compare this hypothesis with alternatives. The null model assumed a homogeneous population and still produced highly variable colonization durations (mean = 101.7 weeks; 5th percentile, 5.2 weeks; 95th percentile, 304.7 weeks). Simulations showed that this inherent variability, combined with censoring in longitudinal cohort studies, is sufficient to produce the appearance of "persistent carriers," "intermittent carriers," and "noncarriers" in data. Our estimates for colonization duration exhibited sensitivity to the assumption that false-positive test results can occur despite being rare, but our model-based approach simultaneously estimates specificity and sensitivity along with epidemiologic parameters. Our results show it is plausible that S. aureus colonizes people indiscriminately, and improved understanding of the types of exposures which result in colonization is essential.


Video Tutorials Increase Precision in Minimally Invasive Surgery Training - a Prospective Randomised Trial and Follow-up Study.
Simulation-based practice has become increasingly important in minimally invasive surgery (MIS) training. Nevertheless, personnel resources for demonstration and mentoring simulation-based practice are limited. Video tutorials could be a useful tool to overcome this dilemma. However, the effect of video tutorials on MIS training and improvement of MIS skills is unclear. A prospective randomised trial (n = 24 MIS novices) was conducted. A video-trainer with three different tasks (#1 - 3) was used for standardised goal-directed MIS training. The subjects were randomised to two groups with standard instructional videos (group A, n = 12) versus comprehensive video tutorials for each training task watched at specific times of repetition (group B, n = 12). Performance was analysed using the MISTELS score. At the beginning and following the curriculum, an MIS cholecystectomy (CHE) was performed on a porcine organ model and analysed using the GOALS score. After 18 weeks, participants performed 10 repetitions of tasks #1 - 3 for follow-up analysis. More participants completed tasks #1 and #2 in group B (83.3 and 75%) than in group A (66.7 and 50%, ns). For task #2, there was a significant improvement in precision in group B (p < 0.001). For the entire cohort, the GOALS-Scores were 12.9 before and 18.9 after the curriculum (p < 0.001), with no significant difference between groups. Upon follow-up, 84.2% (task#1), 26.3% (task#2) and 100% (task#3) of MIS novices were able to reach the defined goals (A vs. B ns). There was a trend for a better MISTELS score in group B upon follow-up. Standardised comprehensive video tutorials watched frequently throughout practice can significantly improve precision in MIC training. This aspect should be incorporated in MIS training.


Flexure and residual astigmatism with Paraperm O2 and Boston II lenses on toric corneas.
It has been shown previously that thin polymethyl methacrylate (PMMA), cellulose acetate butyrate (CAB), and Polycon I contact lenses flex on toric corneas. We investigated the flexure and induced residual astigmatism of two gas permeable contact lens materials, Paraperm O2 and Boston II, and compared the results with those of other materials. Six subjects (12 eyes) with corneal toricities ranging from 1.75 to 3.25 D wore five Paraperm O2 lenses and five Boston II lenses with center thicknesses ranging from 0.10 to 0.20 mm. Flexure and induced residual astigmatism were measured on all corneas wearing all lenses in a double-masked fashion. All lenses studied showed flexure and induced residual astigmatism, which increased as center thickness decreased. For both lens types, lenses thinner than 0.15 mm flexed significantly more than thicker lenses. This critical center thickness should be considered when fitting these lens types on toric corneas.


Morphological and biochemical effects of lonidamine on cultured Sertoli cells.
Lonidamine, an antispermatogenic compound derivative of indazole-3-carboxylic acid, administered to rat Sertoli cells induced morphological changes of the cells which rapidly shrinked forming cytoplasmic projections. Some biochemical parameters of Sertoli cells measured after drug administration were their aromatizing ability, protein synthesis, and ribonucleic acid synthesis. The amount of estradiol produced by treated cells was significantly lower than the amount produced by control cells, whereas protein and ribonucleic acid synthesis were not affected by the drug. Our results demonstrate the change of a specific metabolic parameter of Sertoli cells induced by this antispermatogenic compound.


Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death.
Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark. To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010. Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. Somatic morbidity and cause of death. Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male). Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality.


Osteoporosis in the lower extremities in chronic spinal cord injury.
Cross-sectional study. To investigate the effect of chronic motor complete spinal cord injury (SCI) and sex on bone densitometry parameters of the hip, femoral neck, tibial epiphysis, and diaphysis and on long bone fractures. SCI rehabilitation center. Women and men with long-term (≥7 years) motor complete SCI were compared with able-bodied women and men. Dual-energy X-ray absorptiometry was used to assess bone densitometry parameters at the hip and femoral neck, whereas peripheral quantitative computed tomography was used for the tibial epiphysis and diaphysis. The data of 18 women and 25 men with SCI with a mean age of 54.7 ± 12.4 and 53.5 ± 8.6 years, respectively, were analyzed. As reference groups, 74 able-bodied women and 46 men with a mean age of 51.0 ± 13.1 and 50.9 ± 11.2 years were evaluated. Most bone densitometry values were significantly (p ≤ 0.033) lower in the SCI compared with the reference groups, including total bone mineral density at the distal tibial epiphysis (-58.0% in SCI women and -53.6% in SCI men). Fracture rates per 100 patient-years were 3.17 and 2.66 in women and men with SCI compared with 0.85 and 0.21 in able-bodied women and men, respectively. Compared with able-bodied women and men, individuals with chronic motor complete SCI showed considerably lower bone densitometry values and a higher historical fracture rate. These findings support the need for preventative and therapeutic strategies against bone loss in individuals with SCI.


Is there a role of creativity in the relationship between working memory consolidation and long-term memory?
While holding items in working memory has been shown to improve delayed long-term recall, the mechanisms underlying this relationship remain unclear. One potential mechanism is working memory consolidation, which may facilitate the formation of novel associations between items during learning and lead to improved memory search at delayed retrieval. Forming novel associations via consolidation may share mechanisms with creative ability. The present research aims to explore how an individual's creativity relates to the relationship between working memory consolidation and long-term memory. In Experiment 1, participants completed a stimulus identification task that manipulated the need for consolidation followed by a surprise delayed recognition task and measures of objective and self-reported creativity. While creativity scores were correlated with general performance on memory tasks, this effect was not related to working memory consolidation. In Experiment 2, participants were induced into either a creative or a non-creative state prior to completing the stimulus identification and delayed recognition tasks. Performance on these tasks was not significantly different between the groups and was again unrelated to working memory consolidation. The results of these two experiments suggest that creativity is not related to the mechanism underlying the effect of working memory consolidation on delayed recognition.


Effect of praziquantel on adult Echinostoma paraensei worms in experimentally infected mice.
Echinostomiasis is a food-borne intestinal, snail-mediated parasitosis caused principally by ingestion of snails infected with digenean trematodes of the Echinostoma genus. The treatment and control of trematodiasis is usually done by administration of praziquantel (PZQ). In this study, we evaluated the effect on Echinostoma paraensei of different doses of praziquantel through analysis of morphological parameters using light microscopy, scanning electron microscopy, and confocal scanning laser microscopy along with parasitological data. We used 30 female mice aged 4 weeks. Each animal was given 40 metacercarie of E. paraensei by gavage. The animals were divided into five groups, each group containing six animals, where one group was utilized as untreated control. Two weeks after infection, the mice were given praziquantel by gavage at total dosages of 12.5, 25, 50 or 100 mg/kg by body weight. Two days after treatment, the mice were euthanized in a CO(2) chamber for recovery of helminths in the small intestine. The doses of 50 and 100 mg/kg of praziquantel eliminated all the worms. There were significant differences (p<0.05) between all the treated groups when compared to the control group. The body morphology showed contraction with vacuolization of the parenchyma, and the spine of the peristomic collar was not evident by light microscopy. The scanning electron microscopy revealed that the other doses caused retraction of spines of the peristomic collar and also the tegument spines at the body edge, as well as the development of vesicles and peeling; all these alterations were more evident at the dose of 25 mg/kg. In turn, the confocal scanning laser microscopy revealed vacuolization and disorganization of spines and vitelline glands. E. paraensei responds differently to experimental treatment with praziquantel according to the doses utilized causing morphological alteration and even worm elimination.


Thorotrast kinetics and radiation dose: results from studies in thorotrast patients and from animal experiments.
As a presupposition for estimating the mean tissue dose from intravascularly injected Thorotrast results of investigations on tissue distribution and steady state activity ratios of 232Th and daughters in Thorotrast patients were compiled and are presented as "best estimates". Special emphasis has been given to the non-uniformity of Thorotrast distribution on the organ and cellular level on the basis of results from animal experiments. Moreover, the variation widths of the mean tissue doses were calculated from the individual standard errors of the mean Thorotrast tissue distribution and activity ratios. According to the results of Thorotrast tissue distribution analyses about 97% of intravascularly injected colloidal ThO2 are retained by the organs of the reticulo-endothelial-system (RES) of the average Thorotrast patient (liver: 59%; spleen: 29%; bone marrow: 9%). Only 0.7 and 0.1% are distributed within the lungs and the kidneys, respectively. The fractional retention of 232Th in the marrow-free skeleton proved to be 2% on the average. Considering in addition the results on the steady state activity ratios between 232Th and its daughters and self-absorption of alpha-energy in Thorotrast agglomerates the mean annual tissue doses to the liver, spleen, red bone marrow, lungs (respiratory zone), and cells on bone surface, e.g., from 30 ml intravascularly injected Thorotrast are about 30 (10-70), 80 (30-200), 10 (4-27), 4.5 (1.8-11.3), and 15 (6-38) rad. The variation widths of the mean tissue doses given in brackets are based upon an average individual standard error of the mean Thorotrast tissue distribution and activity ratios of 150%. The data on mean tissue doses, however, do not include variations of the dose due to macroscopic inhomogeneities of Thorotrast distribution on the organ level, which in the liver may go up to a factor of 50. Contrary to the mean tissue dose the local annual dose, i.e., the dose to cells adjacent to the surface of 0.1-50 micron Thorotrast aggregates is between 40 and 40,000 rad.


Evolutionary relationships between the t and H-2 haplotypes in the house mouse.
Thirty-three mouse strains carrying t haplotypes were typed with a large battery of monoclonal and polyclonal antibodies specific for class I and class II antigens controlled by the H-2 complex. Among these t haplotypes were representatives of the six complementation groups defined previously and of eight new groups defined by us recently. The typing resulted in the identification of the H-2 haplotypes of these strains and of their alleles at K, D, A, and E loci. Nineteen of the 33 strains proved to carry a mutation that prevents the expression of the E molecule on the cell surface. All H-2 haplotypes of the t strains are related in terms of sharing certain antigenic determinants, most of which have not, as yet, been found in inbred strains or in wild mice that do not carry t haplotypes. According to the degree of serological relatedness, the haplotypes can be arranged into a pedigree presumably reflecting the evolutionary history of the t chromosomes. The ancestral t chromosome from which the 33 chromosomes derive was presumably present in the mouse population before the divergence of the Mus musculus and Mus domesticus species. The E0 mutation, too, is apparently ancient because it occurs in different branches of the evolutionary tree.


c-Jun N-terminal kinase activation in dorsal root ganglion contributes to pain hypersensitivity.
Inflammatory pain, characterized by a decrease in the nociceptive threshold, arises through the actions of inflammatory mediators. Mitogen-activated protein kinase cascades participate in peripheral nociceptive sensitization. We examined the involvement of c-Jun N-terminal kinase (JNK) in the dorsal root ganglion (DRG) in the early phase of inflammation-induced hyperalgesia. An intra-plantar (i.pl.) injection of complete Freund's adjuvant induced the activation of JNK in DRG neurons within 30 min. Pre-treatment as well as post-treatment of rats with a JNK inhibitor, SP600125, significantly attenuated thermal hyperalgesia, as assessed by paw-withdrawal latency, and the upregulation of c-fos immunoreactivity in dorsal horn neurons. An i.pl. injection of nerve growth factor (NGF) also induced the phosphorylation of JNK as well as thermal hyperalgesia, and SP600125 improved hyperalgesia. Inhibitor experiments suggest that JNK and extracellular signal-regulated protein kinase act on primary nociceptive neurons synergistically. These findings demonstrate that JNK is a therapeutic target for treating inflammation-induced pain hypersensitivity.


Insulin, glucose and glycated hemoglobin in Alzheimer's and vascular dementia with and without superimposed Type II diabetes mellitus condition.
Increased concentrations of insulin, glucose and glycohemoglobin are associated with Type II diabetes mellitus (DM) and recognized as characteristic markers of the disease; in Alzheimer's (AD), Vascular dementia (VaD), and both dementia's with superimposed diabetes (AD + DM, VaD + DM) the knowledge is scarce. The sample (n = 122; males = 60; mean age = 73 +/- 7) comprised DM, AD, VaD, AD + DM, and VaD + DM patients, and healthy controls (C). The ANOVA's yielded significant differences between groups: Insulin p = 3.7 x 10(-3); Glucose p < 10(-12); Glycohemoglobin p = 9.2x10(-4). Comparisons between groups (DM vs. C, AD + DM vs. AD, VaD + DM vs. VaD, and demented DM vs. non-demented DM) resulted significant for all variables (Bonferroni's statistic, alpha = 0.05). Diabetic and diabetic demented patients presented significant increases largely different from controls (0.01 < p < 0.001), unlike the non-significant changes in their non-diabetic counterparts; linear relationships were found across all groups. The correlation's insulin/glucose and insulin/glycohemoglobin change to positive within demented groups, indicating a different performance of insulin in demented and non-demented subjects.


Efficacy of prostatic fossa biopsy in detecting local recurrence after radical prostatectomy.
To evaluate retrospectively the efficacy of prostatic fossa biopsy in detecting local recurrence of prostate cancer in men with biochemical failure after radical prostatectomy. Between January 1997 and December 2002, 100 men without prior adjuvant therapy after radical prostatectomy underwent transrectal ultrasound (TRUS)-guided biopsy of the prostatic fossa. The TRUS findings, digital rectal examination (DRE) findings, serum total prostate-specific antigen (PSA) level at TRUS, PSA velocity, and pathologic stage and Gleason score of the radical prostatectomy specimen were correlated with the biopsy results. Overall, 29 (29%) of the 100 men who underwent biopsy had documented local recurrence. The sensitivity and specificity of DRE to detect biopsy-proven local recurrence was 72.4% and 64.8%, respectively. The corresponding values for TRUS were 86.2% and 53.5%. None of the men with a serum PSA concentration of less than 0.5 ng/mL at biopsy who had normal results for both TRUS and DRE had a biopsy-proven local recurrence. By stepwise multivariate logistic regression analysis, abnormal TRUS findings and serum PSA concentration at biopsy were independent predictors for positive fossa biopsy results. The combination of TRUS and serum PSA concentration was the best predictive model for a positive fossa biopsy result. Prostatic fossa biopsy should be avoided in patients with both or either normal DRE or TRUS findings when the PSA level is less than 0.5 ng/mL.


PCR method for detection and identification of Lactobacillus casei/paracasei bacteriophages in dairy products.
Bacteriophage infections of starter lactic acid bacteria (LAB) pose a serious risk to the dairy industry. Nowadays, the expanding use of valuable Lactobacillus strains as probiotic starters determines an increase in the frequency of specific bacteriophage infections in dairy plants. This work describes a simple and rapid Polymerase Chain Reaction (PCR) method that detects and identifies bacteriophages infecting Lactobacillus casei/paracasei, the main bacterial species used as probiotic. Based on a highly conserved region of the NTP-binding genes belonging to the replication module of L. casei phages phiA2 and phiAT3 (the only two whose genomes are completely sequenced), a pair of primers was designed to generate a specific fragment. Furthermore, this PCR detection method proved to be a useful tool for monitoring and identifying L. casei/paracasei phages in industrial samples since specific PCR signals were obtained from phage contaminated milk (detection limit: 10(4) PFU/mL milk) and other commercial samples (fermented milks and cheese whey) that include L. casei/paracasei as probiotic starter (detection limit: 10(6) PFU/mL fermented milk). Since this method can detect the above phages in industrial samples and can be easily incorporated into dairy industry routines, it might be readily used to earmark contaminated milk for use in processes that do not involve susceptible starter organisms, or processes which involve phage-deactivating conditions.


Risk of death or life-threatening injury for women with children not sired by the abuser.
Women who are abused by their male intimate partners incur many costs, ranging in severity from fleeting physical pain to death. Previous research has linked the presence of children sired by a woman's previous partner to increased risk of woman abuse and to increased risk of femicide. The current research extends this work by securing data from samples of 111 unabused women, 111 less severely abused women, 128 more severely abused women, and 26 victims of intimate partner femicide from the Chicago Women's Health Risk Study to document an ordinal trend in the risk of experiencing more severe forms of violence for women who have children in the household sired by a previous partner. The discussion addresses two potential explanations for this trend and highlights directions for future research.


Stressful splicing.
A novel study in a recent issue of Molecular Cell (Shi and Manley, 2007) provides insight into a complex signaling pathway that controls the phosphorylation status of an SR-related protein that functions as a splicing repressor following heat shock-dependent dephosphorylation.


Mercury in breast milk from women in the Federal District, Brazil and dietary risk assessment for breastfed infants.
Mercury is a toxic metal, ubiquitous in nature; it is excreted in breast milk from exposed mothers and may affect infant neuro-development. In this study, 224 breast milk samples provided by eight human milk banks in the Federal District of Brazil were analyzed for total mercury (THg), of which 183 were also analyzed for methyl mercury (MeHg), the most relevant form of this metal for the breastfed infants. Samples were acid digested in a microwave oven and THg determined by atomic fluorescence spectrometry (LOQ of 0.76μg/L). Samples were lyophilized, ethylated and MeHg determined in a MERX automated system (LOQ of 0.10μg/L). Inorganic mercury (IHg) levels were estimated from the THg and MeHg determined in the samples. Most of the samples were collected 1-2 months postpartum, with 38% during the first month. Over 80% of the samples had THg values above the LOQ, reaching a maximum of 8.40μg/L, with a mean of 2.56μg/L. On average, MeHg accounted for 11.8% of THg, with a maximum of 97.4%. Weekly intakes were estimated individually, considering the baby's age and body weight at the time of milk collection. Mean weekly intake for MeHg was 0.16±0.22μg/kg bw, which represented 10% of the PTWI; in only one case, the intake exceeded 100% of the PTWI (1.90μg/kg bw, 119% of PTWI). Mean intake for IHg was 2.1±1.5μg/kg bw, corresponding to 53% PTWI. These results indicate no health concern for the breastfed babies, a conclusion that can be extended to the consumers of breast milk donated to the milk banks, primarily immature and low weight babies.


Clinicopathological investigation on caseous lymphadenitis in local breed sheep in Algeria.
This study was carried out of 4,419 animals raised in an extensive system on local breed sheep of the Tiaret region during 2 years (2010-2011) to determine some clinical and pathological aspects associated to caseous lymphadenitis (CL). Clinical examination revealed a prevalence rate of 5.7 %. CL prevalence rate was significantly higher in females (6 %) than in males (4.8 %). The most affected superficial lymph nodes were mandibular lymph nodes (46.1 %). Gross examination of 1,679 carcasses of sheep at the abattoir revealed the presence of abscesses on 250 carcasses (14.9 %). Out of 105 cases showing lesions of CL, Corynebacterium pseudotuberculosis (53.6 %) was isolated as mixed infection with Staphylococcus aureus (43 %) and Escherechia coli (17.9 %). CL prevalence was significantly higher in adult than in young sheep and in female than in male ones. Visceral form of CL was associated to "thin ewe syndrome" responsible for significant economic losses in Algeria.


Determination of radium isotopes in environmental samples by gamma spectrometry, liquid scintillation counting and alpha spectrometry: a review of analytical methodology.
Radium (Ra) isotopes are important from the viewpoints of radiation protection and environmental protection. Their high toxicity has stimulated the continuing interest in methodology research for determination of Ra isotopes in various media. In this paper, the three most routinely used analytical techniques for Ra isotope determination in biological and environmental samples, i.e. low-background γ-spectrometry, liquid scintillation counting and α-spectrometry, were reviewed, with emphasis on new methodological developments in sample preparation, preconcentration, separation, purification, source preparation and measurement techniques. The accuracy, selectivity, traceability, applicability and minimum detectable activity (MDA) of the three techniques were discussed. It was concluded that the MDA (0.1mBqL(-1)) of the α-spectrometry technique coupled with chemical separation is about two orders of magnitude lower than that of low-background HPGe γ-spectrometry and LSC techniques. Therefore, when maximum sensitivity is required, the α-spectrometry technique remains the first choice.


Random perturbations of spiking activity in a pair of coupled neurons.
We examine the effects of stochastic input currents on the firing behaviour of two coupled Type 1 or Type 2 neurons. In Hodgkin-Huxley model neurons with standard parameters, which are Type 2, in the bistable regime, synaptic transmission can initiate oscillatory joint spiking, but white noise can terminate it. In Type 1 cells (models), typified by a quadratic integrate and fire model, synaptic coupling can cause oscillatory behaviour in excitatory cells, but Gaussian white noise can again terminate it. We locally determine an approximate basin of attraction, [see text] of the periodic orbit and explain the firing behaviour in terms of the effects of noise on the probability of escape of trajectories from [see text].


Cognitive status is a determinant of health resource utilization among individuals with a history of falls: a 12-month prospective cohort study.
Falls are a costly public health problem worldwide. The literature is devoid of prospective data that identifies factors among fallers that significantly drive health care resource utilization. We found that cognitive function--specifically, executive functions--and cognitive status are significant determinants of health resource utilization among older fallers. Although falls are costly, there are no prospective data examining factors among fallers that drive health care resource utilization. We identified key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with a history of falls. Specifically, with the increasing recognition that cognitive impairment is associated with increased falls risk, we investigated cognition as a potential driver of health resource utilization. This 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 319) included participants with a history of at least one fall in the previous 12 months. Based on their cognitive status, participants were divided into two groups: (1) no mild cognitive impairment (MCI) and (2) MCI. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, global cognition, executive functions, and cognitive status (MCI versus no MCI) were examined. Age, sex, comorbidities, depression status, and activities of daily living were included regardless of statistical significance. Global cognition, comorbidities, working memory, and cognitive status (MCI versus no MCI ascertained using the Montreal Cognitive Assessment (MoCA)) were significant determinants of total HRU at 6 months. The number of medical comorbidities and global cognition were significant determinants of total HRU at 12 months. MCI status was a determinant of HRU at 6 months among older adults with a history of falls. As such, efforts to minimize health care resource use related to falls, it is important to tailor future interventions to be effective for people with MCI who fall. ClinicalTrials.gov Identifier: NCT01022866.


Influence of parameter estimation on integrated backscatter: a model study.
This paper studies the influence of parameter estimation on integrated backscatter using a computer model. The study is specifically aimed at applications to the heart muscle; however, the validity of the conclusions drawn from this work should be confirmed by in vivo tests.


Medical care delivery at the Inaugural Youth Olympic Games Singapore 2010.
Mass gatherings such as the Youth Olympic Games require medical services for large populations with special needs specific to elite competitive youth athletes. The location of the Games in a heavily populated city with dispersed competition venues provides unique challenges. To describe the planning and delivery of medical services and to provide data for future planning. Singapore. One large multipurpose clinic was set up in the Games Village as well as medical posts at competitive venues for 26 sports for onsite coverage. PERIOD OF COVERAGE: 10 August 2010 to 28 August 2010. Participants A total of 1,337 medical encounters ranging from athletes to officials and volunteers who received medical care from a spectrum of medical professionals. measures Number of cases attended to at the Games Village medical centres and the medical posts at the competition venues, utilisation of medical services, and the pattern of these injuries and referral patterns to hospitals. Medical encounters for non-athletes represented 40.9% of the total medical encounters. The rate of heat illnesses was low for athletes at 1.7% (N = 13). The total hospitalisation rate was low at 1.7% (n = 23). Utilisation of onsite pharmacy and physiotherapy services were high at 45.2% (n = 887) and 37.8% (n = 743), respectively, of the encounters for all support services. The dispersed nature of the Games venues provided challenges to the organisation of medical cover for the participants. Organisers in future Games can make use of the data to plan for future Games of a similar nature.


In-vitro translation of mitochondrial mRNAs by yeast mitochondrial ribosomes is hampered by the lack of start-codon recognition.
In an attempt to reconstitute an homologous in-vitro translation system for yeast mitochondrial mRNAs, we have isolated ribosomes, supernatant factors, and tRNAs from mitochondria of Saccharomyces carlsbergensis. While poly(U) is translated faithfully in this system, no translation of in-vitro synthesised cytochrome c oxidase subunit II (COX2) mRNA could be detected. Formation of formylmethionyl-puromycin on mitochondrial ribosomes is stimulated by ApUpG, but not by COX2 mRNA, although mitochondrial small ribosomal subunits bind to this mRNA in vitro, even without added tRNA and initiation factors. We conclude, therefore, that the inability to faithfully translate mitochondrial mRNAs in vitro may be the result of an inability of mitochondrial ribosomes to recognize the initiation codon.


Clinical Liver Disease Progression Among Hepatitis C-Infected Drug Users With CD4 Cell Count Less Than 200 Cells/mm(3) Is More Pronounced Among Women Than Men.
Background. Hepatitis C virus (HCV) infection is a leading cause of liver-related morbidity and mortality in the United States, and injection drug users are at particularly high risk. Methods. This prospective observational cohort study assessed the rate of, and risk factors for, clinical liver disease progression in a cohort of HCV monoinfected and human immunodeficiency virus (HIV)/HCV coinfected drug users using unadjusted and multivariate Cox proportional hazards regression analyses. Results. Of 564 subjects including 421 (75%) with HIV/HCV coinfection and 143 with HCV monoinfection, 55 (10%) had clinical liver disease progression during follow-up with a rate of 25.3 events per 1000 person-years. In unadjusted analysis, there was an interaction between sex and HIV status. In sex-stratified multivariate analysis, HIV/HCV-coinfected women with CD4 <200 cells/mm(3) had 9.99 times the risk of liver disease progression as HCV-monoinfected women (confidence interval [CI], 1.84-54.31; P = .008), and white women had a trend towards increased risk of liver disease progression compared with non-white women (hazard ratio, 2.84; CI, .93-8.68; P = .07). Human immunodeficiency virus/HCV-coinfected men with CD4 <200 cells/mm(3) had 2.86 times the risk of liver disease progression as HCV-monoinfected men (CI, 1.23-6.65; P = .01). Conclusions. Hepatitis C virus-monoinfected and HIV/HCV-coinfected drug users had high rates of clinical liver disease progression. In those with HIV infection, liver disease progression was associated with advanced immune suppression. This effect was strikingly more pronounced in women than in men.


Molecular mechanisms and treatment of bone metastasis.
The metastasis of cancer cells to bone alters bone architecture and mineral homeostasis. As described by the 'seed and soil' hypothesis, bone represents a fertile ground for cancer cells to flourish. A 'vicious cycle' of reciprocal bone-cancer cellular signals occurs with osteolytic (bone-resorbing) metastases, and a similar mechanism likely modulates osteoblastic (bone-forming) metastatic lesions as well. The development of targeted therapies either to block initial cancer cell chemotaxis, invasion and adhesion or to break the 'vicious cycle' is dependent on a more complete understanding of bone metastases. Although bisphosphonates delay progression of skeletal metastases, it is clear that more-effective therapies are needed. Cancer-associated bone morbidity remains a major public health problem, and to improve therapy and prevention it is important to understand the pathophysiology of the effects of cancer on bone. This review details scientific advances in this area.