Projection and patient satisfaction using the "Hamburger" nipple reconstruction technique.
Maintaining projection and achieving patient satisfaction are two key challenges in nipple reconstruction. Skin flap techniques such as CV and star flaps are currently favoured. The "Hamburger" technique was described in 2007 using stacked conchal cartilage discs within a skin flap construct, but no longer-term outcomes have been published. We evaluate both projection and patient satisfaction following nipple reconstruction using this technique. Twenty-three nipple reconstructions performed between 2007 and 2009 were reviewed. A standard pre-tattooed cylinder skin pattern was used with 3 punch biopsies of conchal cartilage harvested through a post-auricular incision. At follow up, reconstructed nipples and donor sites were examined. Nipple projection was measured bilaterally. Patients completed a short questionnaire. Mean follow up was 24 months (9-31). Mean projection was 3.3 mm (range 0-5 mm) and was well matched to the contralateral nipple. No donor site keloid scarring was observed, however cartilage defects were easily palpable in all cases. Patients were satisfied or very satisfied with overall cosmesis in 91% of cases. They were satisfied or very satisfied with projection in 57% of cases. All patients found the donor site acceptable. With the "hamburger" technique medium-term projection was maintained in most cases and was comparable to published data for other techniques with or without cartilage. Patient satisfaction was high even when projection was not well maintained. This suggests that patient satisfaction and projection are not necessarily related. Donor site morbidity was low.


Spontaneous recurrence of acute epidural hematoma: a case report.
A mildly symptomatic epidural hematoma, imaged by computed tomography (CT), appeared to resolve within 24 hours but then recurred 4 days later. The recurrent hematoma gradually resolved spontaneously and the patient became asymptomatic.


Do cinnamylideneacetophenones have antioxidant properties and a protective effect toward the oxidation of phosphatidylcholines?
Cinnamylideneacetophenones (CA) are an important group of α,β,γ,δ-diunsaturated ketones that have been widely used in a variety of synthetic transformations. Biological studies concerning these compounds are scarce and refer mainly to antiviral and antibacterial evaluations. Curcumin (CR), a natural polyphenol, is a yellow pigment extracted from the plant Curcuma longa, which is one of the major spices used in the Indian culinary. It has been reported that CR has cancer chemopreventive properties in a range of animal models of chemical carcinogenesis, along with antioxidative and anti-inflammatory properties. Inspired by the biological activity shown by CR and their structural resemblance with CA, it was considered to study the ability of the latter molecules to inhibit lipid oxidation induced by the hydroxyl radical (Fenton reaction) by electrospray ionization (ESI) mass spectrometry (MS) using phosphatidylcholine (PC) liposomes as a model of cell membrane. Compound 4, holding a methylated hydroxy group in the position R(2), and CR showed similar effects in inhibiting lipid peroxidation. In the presence of 7, the extension of oxidation was higher than the one verified in all other compounds. Other methodologies, namely DPPH radical scavenging and oxygen radical absorption capacity (ORAC) assays, were performed to complement and clarify the results attained by oxidation of PC monitored by ESI-MS and to evaluate the antioxidant profile of compounds. For both assays, compound 7 showed to be rather efficient due to its specific structure. This derivative can form a quite stable allylic radical by abstraction of a hydrogen atom which accounts for these results.


Chemical transformations of nanoscale zinc oxide in simulated sweat and its impact on the antibacterial efficacy.
Nanoscale zinc oxide (n-ZnO) is widely used in personal care products and textiles, thus, it would likely be released into human sweat. To better evaluate the potential human health risks of n-ZnO, it is essential to understand its chemical transformations in physiological solutions, such as human sweat, and the resulting changes in the n-ZnO bioavailability. Here, two types of n-ZnO, ZnO nanoparticles (ZnO-NPs) and nanorod-based ZnO nanospheres (ZnO-NSs) were synthesized and incubated in 3 types of simulated sweat with different pH values and phosphate concentrations. The content of Zn3(PO4)2 in the transformed n-ZnO was quantified by selective dissolution of Zn3(PO4)2 in 0.35 M ammonia solution where 100% and 5.5% of Zn3(PO4)2 and ZnO were dissolved, respectively. The kinetics analysis indicated that by 24-48 h the content of Zn3(PO4)2 reached the maximum, being 15-21% at pH 8.0 and 45-70% at pH 5.5 or 4.3. Interestingly, no correlation was observed between the rate constants of Zn3(PO4)2 formation and the specific surface areas of n-ZnO, implying that chemical transformations from n-ZnO to Zn3(PO4)2 in the simulated sweat might not be simply attributed to dissolution and precipitation. Using a variety of characterization techniques, we demonstrated the formation of a ZnO‒Zn3(PO4)2 core-shell structure with the shell consisting of amorphous Zn3(PO4)2 at pH 8.0 and additionally of crystalline Zn3(PO4)2 and Zn3(PO4)2•4H2O at pH 5.5 or 4.3. The phosphate-induced transformation of n-ZnO in the simulated sweat at pH 5.5 and 4.3 greatly reduced the antibacterial efficacy of n-ZnO through moderating the nanoparticle dissolution, indicating limited bioavailability of the NPs upon transformation. The results improve the understanding of the fate and hazards of n-ZnO.


Comparison of Treadmill and Cycle Ergometer Exercise During Cardiac Rehabilitation: A Meta-analysis.
To compare treadmill versus cycling-based exercise in cardiac rehabilitation (CR) on functional capacity (FC) outcomes. Databases were searched for randomized studies using single modality continuous exercise. Studies implemented a continuous cycling or treadmill protocol for patients with either coronary artery disease (CAD) or chronic heart failure (CHF). The effect of single modality exercise on FC (VO2peak) was analyzed. Differences in the effect of CR on FC was assessed between the mode subgroup (cycling vs treadmill) and disease state subgroup (CAD vs CHF) within both the cycling and treadmill groups. Data were extracted from 23 studies including 600 patients (mean age 60y, 86% men). There was a significant difference in effect size between studies that used cycling, Hedges' g=0.85 (95% confidence interval [95% CI], 0.52-1.17; k=13) and studies that used treadmill exercise, Hedges' g=0.46 (95% CI, 0.22-0.70; k=8). Within cycling studies (n=14), FC was higher among CAD patients, Hedges' g=1.03 (95% CI, 0.65-1.42; k=9) compared to those with CHF, Hedges' g=0.40 (95% CI, 0.09-0.71; k=4, P<.001). Conversely, among treadmill studies (n=9), FC was higher among CHF patients, Hedges' g=0.94 (95% CI, 0.23-1.65; k=2) compared to CAD, Hedges' g=0.33 (95% CI, 0.19-0.47; k=5; P<.01). According to identified studies, when cycling was the primary mode of exercise in CR, there was larger change in FC compared to treadmill exercise. In addition, CAD patients experienced greater gains in FC when cycling was the primary mode of exercise in CR, while CHF patients benefited more from treadmill-based exercise programs.


Efficacy of Chemical Mimicry by Aphid Predators Depends on Aphid-Learning by Ants.
Chemical mimicry is an effective strategy when signal receivers recognize and discriminate models by relying on chemical cues. Some aphid enemies mimic the cuticular chemicals of aphids through various means thus avoiding detection and attack by aphid-tending ants. However, because ants have been reported to learn the chemical signatures of aphids in order to distinguish the aphids, the efficacy of chemical mimicry is predicted to depend on the experience of the ants that had tended aphids. The present study tested this hypothesis using two predator species: larvae of the green lacewing Mallada desjardinsi, and larvae of the ladybeetle Scymnus posticalis. Lacewing larvae carry the carcasses of aphids on which they have preyed upon their backs, and these function via chemical camouflage to reduce the aggressiveness of aphid-tending ants toward the larvae. Ladybeetle larvae reportedly produce a covering of wax structures, and their chemicals appear to attenuate ant aggression. We examined whether the behavior of the ant Tetramorium tsushimae toward these predators changed depending on their aphid-tending experience. Ants moderated their aggressiveness toward both predators when they had previously tended aphids, indicating that chemical mimicry by both aphid predators is dependent on previous experience of the ants in tending aphids. Chemical mimicry by the predators of ant-tended aphids is therefore considered to exploit learning-dependent aphid recognition systems of ants.


An inward rectifier is present in presynaptic nerve terminals in the chick ciliary ganglion.
Inwardly rectifying voltage-sensitive channels have been detected in the cell bodies and axons of a number of excitable cells. The question of whether similar channels exist at axon terminals has been a matter of speculation for some time. We now report the first direct evidence for the existence of inward rectifiers in vertebrate presynaptic nerve terminals. Following impalement with intracellular electrodes, the large calyciform nerve terminals innervating chick ciliary ganglion neurons exhibit pronounced inward rectification upon hyperpolarization that increases with increasing current strength. The response is blocked by 2 mM Cs+, but is insensitive to Ba2+, tetraethylammonium and tetrodotoxin. The inward rectifier exhibits dependence on both Na+ and K+, but is unaffected by altering extracellular Ca2+. Ciliary neurons innervated by these nerve terminals display inward rectification with similar properties. We conclude that the inward rectifier present in these presynaptic nerve terminals resembles the H-current previously described in sensory ganglion neurons and the Q-current found in hippocampal pyramidal neurons. The presence of channels that are activated by hyperpolarization may serve to enhance the excitability of the calyciform nerve terminals, which are capable of relatively high frequencies (greater than 100 Hz) of discharge.


Interaction time with conspecifics induces food preference or aversion in the wild Algerian mouse.
The social transmission of a novel food preference can avoid unnecessary costs arising from tasting nonedible foods. This type of social learning has been demonstrated in laboratory rats and mice. However, among wild animals, there may be several constraints that make it less effective. Using wild Algerian mice (Mus spretus) tested in the laboratory, we demonstrate that a preference for a novel food can be transmitted between Observer and Demonstrator individuals and that it is maintained for at least 30 days. However, only half of the Observers acquired a preference for the same food as the Demonstrators, and only when the duration of oronasal investigation was above a certain threshold (≥122 s); below this threshold (<122 s), Observers acquired a preference for the alternative food offered, which was maintained for a shorter time. Sex, size, and identity of individuals did not influence the transmission of social information. The results show that different interaction times will result in animals copying or avoiding the food choices of others. This suggests that the transmission of social information among wild animals is complex and probably influenced by many factors (e.g., dominance, familiarity, and health condition), ultimately conditioning the type of interaction between individuals and its outcome. Testing wild animals and the ecological and social constraints they face is, therefore, an important step in our understanding of how effectively social information is transmitted in nature.


Patient-related characteristics associated with non-persistence with statin therapy in elderly patients following an ischemic stroke.
This study was aimed at evaluating the extent of non-persistence with statin therapy in elderly patients after an ischemic stroke and identifying patient-related characteristics that are risk factors for non-persistence. The evaluable study cohort (n = 2748) was derived from the database of the largest health insurance provider in the Slovak Republic. Patients aged ≥65 years who were initiated on statin therapy following the diagnosis of an ischemic stroke during one full year (1 January 2010 to 31 December 2010) constituted this cohort. Each patient was followed for a period of 3 years from the date of the first statin prescription. Patients with a continuous treatment gap of 6 months without statin prescription were designated as non-persistent. The Cox proportional hazard model was applied to determine patient-associated characteristics that influenced the likelihood of non-persistence. During the 3-year follow-up period, 39.7% of patients in the study cohort became non-persistent. Factors associated with decreased probability of a patient becoming non-persistent were age ≥75 years (hazard ratio (HR) 0.75), polypharmacy (concurrent use of ≥6 drugs) (HR 0.79), diabetes mellitus (HR 0.80), dementia (HR 0.81) and hypercholesterolemia (HR 0.50). On the other hand, the presence of anxiety disorders (HR 1.33) predicted an increased likelihood of a patient being non-persistent. Our findings suggest that patients aged ≥75 years or those with the presence of diabetes mellitus, dementia, hypercholesterolemia or polypharmacy were likely to be persistent with statin therapy, whereas those with anxiety disorders may need greater assistance with persistence of statin therapy. Copyright © 2016 John Wiley & Sons, Ltd.


A nitro radical anion formation from nifedipine: an electrochemical approach.
The cyclic voltammetric behaviour of nifedipine was studied. The addition of three aprotic solvents to nifedipine in an aqueous citrate buffer system was examined. Qualitatively they result in separation of the initial irreversible 4 electron reduction into two stages, the NO2/RNO2.- and RNO2.-, 4H/RNHOH, H2O couples, respectively. Particular attention was directed to the 1-electron RNO2/RNO2.- couple as measured by the cyclic voltammetric mode in mixed media. Analysis of the cyclic voltammetric response as a function of scan rate and non-aqueous solvent content yields information on the stability of the radical anion. The chemical forward reaction of the radical anion follows a second order kinetics with a stability constant of 1.1 x 10(-3) l mol-1 s-1 and a half-life time of 0.09 s for 1 mM of nifedipine in aqueous citrate buffer, pH 7.4/DMF; 50:50.


Plasma gamma-aminobutyric acid in experimental fulminant hepatic failure of rats and its diagnostic value in hepatic encephalopathy.
The plasma concentration of gamma-aminobutyric acid (GABA) was measured by radioreceptor assay in galactosamine (GalN)-induced Wistar rat model of fulminant hepatic failure (FHF). The results of sequential observations in 10 FHF rats showed that the plasma GABA concentration doubled 24 hours after GalN injection, while there was no obvious clinical evidence of hepatic encephalopathy (HE). In overt HE 48 hours after the administration of GalN, the plasma concentration of GABA reached the peak value of 9,744 +/- 1,661 pmol/ml, which was 12 times as high as that before GalN injection. The consciousness, plasma concentration of GABA and SGPT activity became normal 120 hours after GalN injection. It is suggested that determination of plasma concentration of GABA is of value in the diagnosis of HE.


Generation of DNA double-strand breaks by two independent enzymatic activities in nuclear extracts.
We have reported the existence in rat nuclear extracts of a specific cleavage activity on a DNA fragment containing the human minisatellite MsH42 region (minisatellite plus its flanking sequences). Here, we have developed a system to analyse the nature of the cleavage products from the MsH42 region generated by the nuclear extracts. Our results demonstrated the formation of DNA double-strand breaks (DSB) in the MsH42 region by two different enzymatic activities, and that their distribution along this fragment changes depending on the presence of Mg2+. In the assays with Mg2+, the DSB were located in the minisatellite and its 3'-flanking region, showing preference for G-rich stretches. Oligonucleotide mutagenesis analysis confirmed that this enzymatic activity has a strong preference for G-tracts and that the recognition site is polarized towards the 3' end. Moreover, this activity cuts GC palindromes efficiently. In contrast, in the experiments without Mg2+, most DSB were mapped within the minisatellite flanking sequences. The analysis with oligonucleotides showed that G-tracts are recognized by this endonuclease activity, but with differences in the cleavage behaviour with respect to the reactions observed with Mg2+. The existence of two separate activities (Mg2+-dependent and Mg2+-independent) for the production of DSB was confirmed by analysing the effect of EGTA, N-ethyl maleimide, ionic strength, and by preincubations of the nuclear extracts at different temperatures. The tissue distribution of both DSB-producing activities was also different. The in vitro system used in the present work may be a useful tool for studying the formation of DSB and for investigation of the mechanisms of DNA repair.


A comparison of performance assessment programs for medical practitioners in Canada, Australia, New Zealand, and the United kingdom.
To compare programs designed to assess the performance of practicing doctors in Canada, Australia, New Zealand, and the United Kingdom. Senior representatives of 11 organizations undertaking performance assessments were invited to provide a description of their programs, using a standardized written questionnaire. Collectively, the 11 organizations provide 16 performance assessment programs that operate on three levels: those that screen populations of doctors (Level 1), those that target "at risk" groups (Level 2), and those that assess individuals who may be performing poorly (Level 3). The 16 programs differ in such areas as the number of doctors enrolled, the number of assessments undertaken, the referral mechanisms, the outcomes of assessment, and in the resources provided for the task. They particularly differ in their choice of tools to assess performance. Although a uniform international approach to performance assessment may be neither feasible nor desirable, an international comparison of current practice, as provided in this report, should stimulate further debate on the development of better performance assessment processes.


A five-point change in Modified Mini-Mental State Examination was clinically meaningful in community-dwelling elderly people.
To determine what change in the Modified Mini-Mental State Examination (3MS), a validated and widely used cognitive screening tool for which meaningful change scores have not been clearly characterized, should be considered meaningful. The 3MS was administered at baseline after 5 and 10 years, as part of the population-based Canadian Study of Health and Aging. We calculated Cohen's effect sizes to estimate detectable changes in 3MS screening scores over 5 and 10 years in this large and representative study sample. A total of 3,255 older adults who were community dwelling at baseline completed the 3MS as part of a screening interview at all three interviews. Mean 3MS score was 90.4 (standard deviation [SD] 6.9) at t(1), 89.1 (SD 8.2) at 5 years, and 85.8 (SD 13.0) at 10 years. A change of just over one point, over 5 and 10 years, represented a clinically detectable change with a medium effect size (Cohen's d=0.5). Although a change of >or=1 point was clinically detectable, consideration of additional criteria for clinical meaningfulness suggested that a change of >or=5 points likely represents a clinically meaningful difference for groups, and is a reasonable choice of cutoff in studies using the 3MS to define cognitive change in individuals.


Adaptation and Validation of the Voice Handicap Index (VHI)-30 into Serbian.
To evaluate the internal consistency, test-retest reliability, and clinical validity of the Serbian version of the self-administered Voice Handicap Index (VHI)-30. Cross-sectional study. The English version of VHI-30 was translated into Serbian and then back-translated into English. The Serbian VHI-30 was administered to 91 patients divided into four groups according to voice pathology: structural, inflammatory, neurologic, and functional groups. The control group included 90 subjects with no voice problems. The internal consistency (Cronbach's alpha coefficient α), test-retest reliability (interclass correlation coefficient) of VHI-30, comparison of patient's and control's VHI-30 scores (Mann-Whitney U test; Kruskal-Wallis test), and correlation with overall severity of dysphonia (Spearman correlation coefficient, ρ) were calculated. In the patient group, we observed excellent internal consistency for the Serbian VHI-30 (α = 0.95) and good internal consistency for all VHI-30 subscales: physical (α = 0.88), functional (α = 0.88), and emotional (α = 0.88). The interclass correlation coefficient indicated strong test-retest reliability for patients (0.99) and controls (0.84). The mean scores of all 30 items in dysphonic participants were significantly higher than in controls (P < 0.001). Good correlation was obtained between the total scores of VHI-30 and patients' self-perceived overall severity of dysphonia (ρ = 0.748, P < 0.001). Within the patient group, the female participants displayed significantly higher VHI-30 scores than male participants (Mann-Whitney U test, P < 0.001). The VHI-30 scores showed strong correlation within different patient groups and controls (Spearman correlation coefficient: structural, 0.942; inflammatory, 0.756; neurologic, 0.888; functional, 0.982; controls, 0.882). The Serbian VHI-30 is a useful and valuable tool for the evaluation of patients with vocal disorders and for making subsequent clinical decisions.


Dark pigmentation and related low FMOD expression increase IL-3 and facilitateplasmacytoid dendritic cell maturation.
According to epidemiological research, skin autoimmune diseases are more prevalent among black Americans. We postulated that pigment-producing melanocytes may contribute to local immune regulation in the microenvironment. We examined murine epidermal melanocytes in vitro to determine the role of pigment production in immune responses mediated by dendritic cell (DC) activation. Our study revealed that darkly pigmented melanocytes produce more IL-3 and the pro-inflammatory cytokines, IL-6 and TNF-α, and consequently induce plasmacytoid DC (pDC) maturation. Additionally, we demonstrate that low pigment-associated fibromodulin (FMOD) interferes with cytokine secretion and subsequent pDC maturation.


Effect of a valgus brace on medial tibiofemoral joint contact force in knee osteoarthritis with varus malalignment: A within-participant cross-over randomised study with an uncontrolled observational longitudinal follow-up.
Previous investigations on valgus knee bracing have mostly used the external knee adduction moment. This is a critical limitation, as the external knee adduction moment does not account for muscle forces that contribute substantially to the medial tibiofemoral contact force (MTCF) during walking. The aims of this pilot study were to: 1) determine the effect of a valgus knee brace on MTCF; 2) determine whether the effect is more pronounced after 8 weeks of brace use; 3) assess the feasibility of an 8-week brace intervention. Participants with medial radiographic knee OA and varus malalignment were fitted with an Össur Unloader One© brace. Participants were instructed to wear the brace for 8 weeks. The MTCF was estimated via an electromyogram-assisted neuromuscular model with and without the knee brace at week 0 and week 8. Feasibility outcomes included change in symptoms, quality of life, confidence, acceptability, adherence and adverse events. Of the 30 (60% male) participants enrolled, 28 (93%) completed 8-week outcome assessments. There was a main effect of the brace (p<0.001) on peak MTCF and MTCF impulse, but no main effect for time (week 0 and week 8, p = 0.10), and no interaction between brace and time (p = 0.62). Wearing the brace during walking significantly reduced the peak MTCF (-0.05 BW 95%CI [-0.10, -0.01]) and MTCF impulse (-0.07 BW.s 95%CI [-0.09, -0.05]). Symptoms and quality of life improved by clinically relevant magnitudes over the 8-week intervention. Items relating to confidence and acceptability were rated relatively highly. Participants wore the brace on average 6 hrs per day. Seventeen participants reported 30 minor adverse events over an 8-week period. Although significant, reductions in the peak MTCF and MTCF while wearing the knee brace were small. No effect of time on MTCF was observed. Although there were numerous minor adverse events, feasibility outcomes were generally favourable. Australian and New Zealand Clinical Trials Registry (12619000622101).


Radiotherapeutic bandage for the treatment of squamous cell carcinoma of the skin.
Squamous cell carcinoma (SCC) is the second most common form of skin cancer in the United States. The efficacy of a pharmaceutically elegant radiotherapeutic bandage, previously described by us for application against SCC of the skin, was tested for the first time in vivo using a subcutaneous SCC mouse model and a therapeutically relevant radiation dose. Female athymic nude mice were injected with human Colo-16 SCC cells subcutaneously and after eight days (average tumor volume: 35±8.6mm(3)) received no treatment, or were exposed to non-radioactive or radioactive (92.5±18.5MBq) bandages for approximately 1h (n=10 per group). After treatment, tumors were measured over fifteen days, tumor volume ratios (TVRs) compared and histopathology performed. Fifteen days after treatment, the TVR of the radioactive bandage treatment group was 3.3±4.5, while TVRs of the non-radioactive bandage treatment and no treatment control groups were 33.2±14.7 and 26.9±12.6, respectively. At the time of necropsy, there was mild focal epidermal hyperplasia surrounding a small area of epidermal ulceration in the radioactive bandage group. No other examined tissue (i.e., muscle, liver, kidney, lung, spleen and heart) showed significant lesions. Our radiotherapeutic bandage exhibits promising efficacy against SCC of the skin in a mouse model. It can be individually tailored for easy application on tumor lesions of all shapes and sizes, and could complement or possibly replace surgery in the clinic.


Impact of the 2005 smoke-free policy in Italy on prevalence, cessation and intensity of smoking in the overall population and by educational group.
To estimate the immediate as well as the longer-term impact of the 2005 smoke-free law on smoking prevalence, cessation and intensity both in the overall population and separately by educational level. Interrupted time-series analyses of 11 cross-sectional nationally representative surveys. Italy, 1999-2010. Adults aged 20-64 years. For each year we computed the prevalence of current smoking, the quit ratio and the mean number of cigarettes smoked per day. All measures were standardized by age. Segmented linear regression analyses were performed for each smoking variable separately by sex. Among males, smoking prevalence decreased by 2.6% (P = 0.002) and smoking cessation increased by 3.3% (P = 0.006) shortly after the ban, but both measures tended to return to pre-ban values in the following years. This occurred among both highly and low-educated males. Among low-educated females, the ban was followed by a 1.6% decrease (P = 0.120) in smoking prevalence and a 4.5% increase in quit ratios (P < 0.001). However, these favourable trends reversed over the following years. Among highly educated females, trends in smoking prevalence and cessation were not altered by the ban. Among both males and females, long-term trends in the daily number of cigarettes, which were already declining well before the implementation of the policy, changed to a minor extent. The impact of the Italian smoke-free policy on smoking and inequalities in smoking was short-term. Smoke-free policies may not achieve the secondary effect of reducing smoking prevalence in the long term, and they may have limited effects on inequalities in smoking.


Improving public addiction treatment through performance contracting: the Delaware experiment.
In fiscal 2002, Delaware replaced traditional cost-reimbursement contracts with performance-based contracts for all outpatient addiction treatment programs. Incentives included 90% capacity utilization and active patient participation in treatment. One of the programs failed to meet requirements. Strategies adopted by successful programs included extended hours of operation, facility enhancements, salary incentives for counselors, and two evidence-based therapies (MI and CBT). Average capacity utilization from 2001 to 2006 went from 54% to 95%; and the average proportion of patients' meeting participation requirements went from 53% to 70%--with no notable changes in the patient population. We conclude that properly designed, program-based contract incentives are feasible to apply, welcomed by programs and may help set the financial conditions necessary to implement other evidence-based clinical efforts; toward the overall goal of improving addiction treatment.


Pyridyl aminothiazoles as potent inhibitors of Chk1 with slow dissociation rates.
Pyridyl aminothiazoles comprise a novel class of ATP-competitive Chk1 inhibitors with excellent inhibitory potential. Modification of the core with ethylenediamine amides provides compounds with low picomolar potency and very high residence times. Investigation of binding parameters of such compounds using X-ray crystallography and molecular dynamics simulations revealed multiple hydrogen bonds to the enzyme backbone as well as stabilization of the conserved water molecules network in the hydrophobic binding region.


Herbivorous reptiles and body mass: effects on food intake, digesta retention, digestibility and gut capacity, and a comparison with mammals.
Differences in the allometric scaling between gut capacity (with body mass, BM¹·⁰⁰) and food intake (with BM⁰·⁷⁵) should theoretically result in a scaling of digesta retention time with BM⁰·²⁵ and therefore a higher digestive efficiency in larger herbivores. This concept is an important part of the so-called 'Jarman-Bell principle' (JBP) that explains niche differentiation along a body size gradient in terms of digestive physiology. Empirical data in herbivorous mammals, however, do not confirm the scaling of retention time, or of digestive efficiency, with body mass. Here, we test these concepts in herbivorous reptiles, adding data of an experiment that measured food intake, digesta retention, digestibility and gut capacity in 23 tortoises (Testudo graeca, T. hermanni , Geochelone nigra, G. sulcata, Dipsochelys dussumieri) across a large BM range (0.5-180 kg) to a literature data collection. While dry matter gut fill scaled to BM¹·⁰⁷ and dry matter intake to BM⁰·⁷⁶, digesta mean retention time (MRT) scaled to BM⁰·¹⁷; the scaling exponent was not significantly different from zero for species > 1 kg. Food intake level was a major determinant of MRT across reptiles and mammals. In contrast to dietary fibre level, BM was not a significant contributor to dry matter digestibility in a General Linear Model. Digestibility coefficients in reptiles depended on diet nutrient composition in a similar way as described in mammals. Although food intake is generally lower and digesta retention longer in reptiles than in mammals, digestive functions scale in a similar way in both clades, indicating universal principles in herbivore digestive physiology. The reasons why the theoretically derived JBP has little empirical support remain to be investigated. Until then, the JBP should not be evoked to explain niche differentiation along a body size axis in terms of digestive physiology.


The genotoxicity of DNA intercalating drug 8-methoxy pyrimido [4',5':4,5]thieno(2,3-b)quinoline-4(3H)-one.
8-methoxypyrimido[4',5':4,5]thieno(2,3-b)quinoline-4(3H)-one (MPTQ) is known to have antitumor and cytotoxic activities on various types of tumors. This compound showed a strong clastogenic effect on bone marrow cells of Swiss albino mice treated in vivo (17.5-35 mg/kg body weight). MPTQ induced micronuclei formation (MN) at doses of 17.5, 23.3, and 35 mg/kg. Dose and time-yield effect of MPTQ was studied in the case of chromosome aberration assay. MPTQ induced a statistically significant increase in the frequency of chromosome aberrations and micronuclei induction. The drug induced significant abnormal sperms even in the sperm shape abnormality assay. Based on the data reported in the literature, we have tried to establish the relationship between the clastogenic effect observed and process of MPTQ intercalation into DNA and the formation of protein-associated DNA-strand breaks probably promoted by topoisomerase enzymes.


Experimental demonstration of error-free key distribution without an external random source or device over a 300-km optical fiber.
Based on angle rotation, we proposed an error-free key distribution scheme that does not require pre-shared information. The key consistency comes from the consistency of angular differences, and the randomness of the key comes from random initial angles and methods of key generation. The initial angle is randomly rotated in order to improve the immunity against eavesdroppers, and the scheme can resist common attacks. The error-free secure key is obtained with key post-processing techniques. The proposed scheme is validated in the physical layer by mapping angular changes to phase variations, which does not require an external random source or an additional device. Experimental results demonstrate that an error-free key can be obtained with the key generation rate of 127.12 Mbit/s over a 300-km standard single-mode fiber.


Discovery of potent IRAK-4 inhibitors as potential anti-inflammatory and anticancer agents using structure-based exploration of IRAK-4 pharmacophoric space coupled with QSAR analyses.
Interleukin-1 Receptor-Associated Kinase 4 (IRAK-4) has an important role in immunity, inflammation, and malignancy. The significant role of IRAK-4 makes it an interesting target for the discovery and development of potent small molecule inhibitors. In the current study, multiple linear regression -based QSAR analyses coupled with structure-based pharmacophoric exploration was applied to reveal the structural and physiochemical properties required for IRAK-4 inhibition. Manually built pharmacophoric models were initially validated with receiver operating characteristic curve, and best-ranked models were subsequently integrated in QSAR analysis along with other physiochemical descriptors. The pharmacophore model, selected using the statistically optimum QSAR equation, was implied as a 3D-search filter to mine the National Cancer Institute database for novel IRAK-4 inhibitors. Whereas the associated QSAR model prioritized the bioactivities of captured hits for in vitro evaluation. Experimental validation identified several potent IRAK-4 inhibitors of novel structural scaffolds. The most potent captured hit exhibited an IC50 value of 157 nM.


Measuring student satisfaction as the first assessment of the Program of Combined Studies in Medicine, an MD/PhD-like program of the Faculty of Medicine, National Autonomous University of Mexico.
The Program of Combined Studies in Medicine (PECEM, by its acronym in Spanish) is a program for simultaneous bachelor and doctorate studies (MD/PhD) that enrolls students who show academic excellence and interest in scientific research. The initial doctoral training comprises seven six-month research stays in different laboratories or clinical or computer areas with different high-quality scientific advisors who provide students with a unique experience for their scientific training. Therefore, satisfaction in this stage is decisive for students' performance and physical and psychological health. The aim of the present study was to administer a questionnaire to measure students' satisfaction with their research experience as a service-product bundle. Students answered an online questionnaire that evaluated three dimensions: perceived quality of the advisor, skills development, and infrastructure and support. Several satisfiers were also evaluated: recommendation of the advisor to peers, fulfillment of student expectations and satisfaction with the program. Correlations were calculated using Fisher's exact test. The significance was set at p < 0.05. The high quality of the advisor, skills development and guidance during the stay were satisfiers correlated to the students' recommendation of their advisors to their peers and to the fulfillment of the students' scientific expectations. Conversely, skills development and infrastructure and support were satisfiers for a good to excellent experience as a PECEM student. A lack of direct interaction with the advisor's workgroup was related to dissatisfaction. The nontangible products of the service, such as a positive interaction between the student, the advisor and the advisor's workgroup as well as support obtained during the research stay, were satisfiers. These data indicate that promoting a fruitful bond between the student and advisor is a priority to ensure the quality of our innovative MD/PhD program.


Changes in integrin expression during adipocyte differentiation.
3T3-L1 preadipocytes require cAMP for maximal differentiation. Microarray analysis reveals that the integrins alpha5 and alpha6 are coordinately regulated by cAMP. alpha5 expression is gradually diminished during adipogenesis, whereas alpha6 is increased. Overexpression of alpha5 in preadipocytes results in enhanced proliferation and attenuated differentiation. Conversely, alpha6 overexpression is without effect. The GTPase Rac is normally inhibited during differentiation. However, overexpression of integrin alpha5 increases Rac activity. Constitutively active but not dominant-negative Rac inhibits differentiation when overexpressed in preadipocytes, implying its role downstream of alpha5 integrin in maintaining preadipocytes in an undifferentiated state. Moreover, alpha6 integrin is critically involved in clustering growth-arrested preadipocytes on basement membrane Matrigel. Perturbation of such clustering enhances Rho activity and promotes growth-arrested preadipocytes to reenter the cell cycle. These findings demonstrate a role for integrin alpha6 in connecting morphogenesis with signaling processes leading to terminal differentiation.


An inexpensive, microcomputer-based system for recording movements in real time.
An inexpensive, microcomputer-based system was developed for recording movements in real time. The positions of 5 serially illuminated, infrared emitting diodes fixed on the object of interest were tracked by a remote, position-sensing photodiode. Positional information from the photodetector was digitized by an LSI 11/23+ microcomputer (sampling rate = 50/s/channel) and stored for subsequent analysis. Any microcomputer equipped to perform analog-digital conversion is compatible for use with this system. The small size of the components that are mounted on the animal allows movement to occur virtually unimpeded and makes this recording system especially suited for small animal observation.


Prevention of indocyanine green toxicity on retinal pigment epithelium with whole blood in stain-assisted macular hole surgery.
To examine whether whole blood prevents indocyanine green (ICG) toxicity on in vitro retinal pigment epithelium (RPE) and prevents RPE staining in ICG-assisted macular hole (MH) surgery. In vitro study and prospective case series. In vitro study and 20 patients who underwent ICG-assisted MH surgery (20 eyes). In the in vitro study, cultured human RPE cells were covered with balanced saline solution (BSS), heparinized whole blood, plasma, or packed red blood cells, then exposed to various concentrations of ICG. One cohort was incubated in the dark; the other cohort was exposed to light. Indocyanine green toxicity was evaluated by mitochondrial dehydrogenase assay. In the clinical study, a prospective noncomparative review of 20 consecutive patients (20 eyes) with stage 3 to stage 4 MH who underwent surgery with ICG to stain the internal limiting membrane (ILM) was performed. Indocyanine green solution (0.5 mg/ml) was used to stain the ILM after autologous whole blood covered the macular hole area. Postoperative staining of ICG on RPE was detected by an infrared-sensitive camera. Cultured human RPE cell viability, macular hole closure rate, median visual acuity preoperatively and postoperatively, postoperative ICG staining, and retinal changes. Cultured human RPE cells covered by whole blood or plasma showed no decrease of mitochondrial dehydrogenase even in 5.0 mg/ml concentration of ICG for 20 minutes with or without light exposure. Conversely, those exposed to ICG and covered with BSS demonstrated a significant decrease of mitochondrial dehydrogenase after incubation in 5, 2.5, and 1.0 mg/ml for 20 minutes in the dark and in 5 to 0.05 mg/ml with light. Clinically, no postoperative staining on RPE was detected. No atrophic RPE changes or other retinal changes were observed in the previous MH area that was covered by autologous whole blood in all 20 eyes on average follow-up of 10.6 months. The hole closed in 19 eyes (95%) on first surgery. Visual acuity improved in 17 eyes (85%) on most recent follow-up. Whole blood prevents ICG toxicity in RPE cell culture and prevents staining of RPE in surgery of MH when the ILM is stained with ICG.


An alternative method of salvaging occluded suprainguinal bypass grafts with operative angioscopy and endovascular intervention.
A study of technical feasibility was undertaken to determine whether angioscopy and parallel endovascular instrumentation could effectively evaluate and restore inflow into occluded suprainguinal grafts. Several endobronchial instruments were selected for adaptation for use in clearing occluded grafts under angioscopic guidance. These instruments were used in the treatment of 12 thrombosed grafts limbs in 10 patients who were admitted 1 to 40 days after occlusion. The occluded suprainguinal graft limbs were exposed just proximal to the femoral anastomosis. Blind retrograde balloon thrombectomy and clot extraction were performed. Graft limbs underwent angioscopy, and the presence of luminal defects were recorded. Endoluminal instruments were then inserted parallel to the angioscope, and luminal defects were corrected. After inflow was reestablished, the distal portion of the graft was thrombectomized, and any necessary distal revisions were performed. Blind retrograde thrombectomy was successful in restoring inflow deemed normal in (67%) eight of 12 graft limbs and present but diminished in two (17%) graft limbs. Balloon thrombectomy was ineffective in restoring graft flow in two (17%) graft limbs. Angioscopy revealed luminal defects in 10 (83%) graft limbs after blind retrograde thrombectomy. Only 2 (17%) graft limbs had no luminal defects after thrombectomy. Findings included pseudointimal flap in eight of 12 (67%), adherent residual thrombus in 4 (33%), and kinked graft limbs in 2 (17%) graft limbs. Endovascular instrumentation was successful in resecting all luminal disease under angioscopic guidance. There were no deaths, no episodes of graft injury or distal embolization, and only one groin hematoma. During a mean follow-up period of 6 months (2 to 13 months), there was one late reocclusion at 7 months. We conclude that angioscopically guided thrombectomy and endovascular graft revision is a useful approach to the treatment of the occluded suprainguinal graft. Enhanced luminal visualization permits refined diagnostic assessment and definitive therapy. This may prolong the benefit of suprainguinal reconstructions.


Hepatic citrate synthase suppression in the freeze-tolerant wood frog (Rana sylvatica).
The wood frog, Rana sylvatica endures whole body freezing for weeks/months while overwintering at subzero temperatures. Survival of long-term freezing requires not only cryoprotectants but also strong metabolic rate depression (MRD) and reorganization of essential processes in order to maintain a balance between ATP-producing and ATP-consuming processes. Citrate synthase (CS) (E.C. 184.108.40.206) is an important irreversible enzyme of the tricarboxylic acid (TCA) cycle and forms a crucial checkpoint for many metabolic processes. Present study investigated the regulation of CS from wood frog liver during freezing. CS was purified to homogeneity by a two-step chromatographic process. Kinetic and regulatory parameters of the enzyme were investigated and, notably, demonstrated a significant decrease in the Vmax of the purified form of CS from frozen frogs as compared to controls when assayed at both 22 °C and 5 °C. This was further supported by a decrease in the maximum activity of CS from liver of frozen frogs. Immunoblotting also showed changes in posttranslational modifications with a significant decrease in threonine phosphorylation (by 49 %) for CS from frozen frogs. Taken together, these results suggest that CS is suppressed and TCA flux is inhibited during freezing, likely to support MRD survival of harsh winters.


Towards biological applications of nanophotonic tweezers.
Optical trapping (synonymous with optical tweezers) has become a core biophysical technique widely used for interrogating fundamental biological processes on size scales ranging from the single-molecule to the cellular level. Recent advances in nanotechnology have led to the development of 'nanophotonic tweezers,' an exciting new class of 'on-chip' optical traps. Here, we describe how nanophotonic tweezers are making optical trap technology more broadly accessible and bringing unique biosensing and manipulation capabilities to biological applications of optical trapping.


A 16-year experience in performing hepatic resection in 303 patients with hepatocellular carcinoma: 1985-2000.
Hepatic resection is an accepted therapeutic modality for hepatocellular carcinoma (HCC). Over the past 2 decades, liver surgery has evolved to a refined and deliberate operation. In the present study surgical results are analyzed with an aim toward further improving the treatment of HCC. We studied 303 patients with HCC who underwent a hepatic resection at 2 university hospitals from 1985 through 2000. Living-related liver transplantation was a procedure of choice in 1 patient with early staged HCC. Fifty-five percent of the patients had associated cirrhosis. Before the operation, the liver function was mainly evaluated with the indocyanine green retention test. The mortality rate within 30 days after the operation was 1.6%. One-, 3-, 5-, 10-, and 15-year cumulative survival rates were 84%, 67%, 51%, 20%, and 11%, respectively. The tumor stage I and II groups showed superior survival rates to those of the tumor stage III and IV groups, respectively, and the difference was statistically significant. The disease-free survival curves, however, showed the rate to be 27% at 5 years and 11% at 10 years. Although the surgical results have greatly improved in the treatment of HCC, the recurrence rate is still high. In carefully screened patients with poor liver function and small HCC, liver transplantation enhances the possibility of cure.


Stem cell factor stimulates the chemotaxis, integrin upregulation, and survival of human basophils.
Little is known about the mechanisms that regulate the selective recruitment of basophils to sites of allergic inflammation. Here we examine the role of stem cell factor (SCF) in the regulation of basophil function. Human basophils were isolated from peripheral blood, and their migration was investigated in chemotaxis assays. Apoptosis was detected by means of annexin V and propidium iodide staining. The expression of cell-surface molecules was measured by means of flow cytometry. SCF amplified the chemotactic responsiveness of human peripheral blood basophils to the chemoattractants eotaxin, monocyte chemotactic protein 2 and macrophage inflammatory protein 1alpha, and C5a, without being chemotactic or chemokinetic by itself. SCF synergized with chemoattractants in causing basophil upregulation of the integrin CD11b, and this effect was inhibited by a c-kit antibody, the tyrosine kinase inhibitor imatinib mesylate (STI-571), and a phosphatidylinositol 3 kinase inhibitor but not by inhibitors of p38 mitogen-activated protein kinase or mitogen-activated protein kinase/extracellular signal-regulated kinase kinase. Basophils bound fluorescence-labeled SCF and expressed its receptor, c-kit, which was markedly upregulated in culture for 24 to 48 hours in the presence of IL-3. Moreover, SCF prolonged basophil survival in concert with IL-3 by delaying apoptosis. These effects of SCF were selective for basophils because chemotaxis and CD11b upregulation of eosinophils or neutrophils were unchanged. SCF might be an important selective modulator of basophil function through a phosphatidylinositol 3 kinase-dependent pathway.


Seizure activity and cortical spreading depression monitored by an extrinsic potential-sensitive molecular probe.
Using surface fluorescence and reflectance measurements from the exposed cerebral cortex, several potential-sensitive molecular probes, primarily oxonol V, have been evaluated as indicators of electrical activity changes developing during seizure activity in the mongolian gerbil. Intraventricular injection of bicuculline, picrotoxin, or KCl produced characteristic cyclic molecular probe fluorescence intensity decreases that could be abolished by the uncoupler CCCP or the mitochondrial electron transport inhibitor rotenone. Smaller fluorophore signals were observed when KCl was applied topically to the exposed cortex. In some cases, as the animals were recovering from anoxia induced by nitrogen inhalation, oscillations similar to those due to spreading depression were observed in both the oxonol V and pyridine nucleotide signals. In all experiments, the molecular probe signals closely followed those of the intrinsic pyridine nucleotides. The drug-induced oxonol V signal alterations have been provisionally interpreted as due at least in part to the reduction of the mitochondrial membrane potential that accompanies a state 4 to state 3 transition. Measurements at the oxonol V fluorescence excitation wavelength indicated that only small changes in the reflectance signal occurred during seizure activity suggesting minimal blood volume change contributions to the extrinsic probe signal.


Antagonism of central and peripheral anorectic effects of caerulein by L-364,718.
The reduction in food intake induced by i.p. injections of the cholecystokinin (CCK) analogue caerulein was antagonised by a low dose (0.25 mumol/kg s.c.) of the selective CCK antagonist L-364,718. To block the anorectic effect of centrally administered caerulein a dose of 25 mumol/kg of L-364,718 was required, demonstrating that central CCK receptors can be blocked effectively in the rat by choosing appropriate doses of L-364,718.


Unexpected diversity of cnidarian integrins: expression during coral gastrulation.
Adhesion mediated through the integrin family of cell surface receptors is central to early development throughout the Metazoa, playing key roles in cell-extra cellular matrix adhesion and modulation of cadherin activity during the convergence and extension movements of gastrulation. It has been suggested that Caenorhabditis elegans, which has a single beta and two alpha integrins, might reflect the ancestral integrin complement. Investigation of the integrin repertoire of anthozoan cnidarians such as the coral Acropora millepora is required to test this hypothesis and may provide insights into the original roles of these molecules. Two novel integrins were identified in Acropora. AmItgalpha1 shows features characteristic of alpha integrins lacking an I-domain, but phylogenetic analysis gives no clear indication of its likely binding specificity. AmItgbeta2 lacks consensus cysteine residues at positions 8 and 9, but is otherwise a typical beta integrin. In situ hybridization revealed that AmItgalpha1, AmItgbeta1, and AmItgbeta2 are expressed in the presumptive endoderm during gastrulation. A second anthozoan, the sea anemone Nematostella vectensis, has at least four beta integrins, two resembling AmItgbeta1 and two like AmItgbeta2, and at least three alpha integrins, based on its genomic sequence. In two respects, the cnidarian data do not fit expectations. First, the cnidarian integrin repertoire is more complex than predicted: at least two betas in Acropora, and at least three alphas and four betas in Nematostella. Second, whereas the bilaterian alphas resolve into well-supported groups corresponding to those specific for RGD-containing or laminin-type ligands, the known cnidarian alphas are distinct from these. During early development in Acropora, the expression patterns of the three known integrins parallel those of amphibian and echinoderm integrins.


Analysis of fermentation selectivity of purified galacto-oligosaccharides by in vitro human faecal fermentation.
The in vitro fermentation of several purified galacto-oligosaccharides (GOS), specifically the trisaccharides 4'-galactosyl-lactose and 6'-galactosyl-lactose and a mixture of the disaccharides 6-galactobiose and allolactose, was carried out. The bifidogenic effect of GOS at 1% (w/v) was studied in a pH-controlled batch culture fermentation system inoculated with healthy adult human faeces. Results were compared with those obtained with a commercial GOS mixture (Bimuno-GOS). Changes in bacterial populations measured through fluorescence in situ hybridization and short-chain fatty acid (SCFA) production were determined. Bifidobacteria increased after 10-h fermentation for all the GOS substrates, but the changes were only statistically significant (P<0.05) for the mixture of disaccharides and Bimuno-GOS. Acetic acid, whose formation is consistent with bifidobacteria metabolism, was the major SCFA synthesized. The acetate concentration at 10 h was similar with all the substrates (45-50 mM) and significantly higher than the observed for formic, propionic and butyric acids. All the purified GOS could be considered bifidogenic under the assayed conditions, displaying a selectivity index in the range 2.1-3.0, which was slightly lower than the determined for the commercial mixture Bimuno-GOS.


Transcription factor FOXM1 promotes hepatocellular carcinoma malignant progression through activation of the WNT pathway by binding to SETDB1.
FOXM1 is a transcription factor confirmed by studies to promote the development of hepatocellular carcinoma (HCC) and various other cancers, yet the molecular mechanism remains rather enigmatic. This study attempted to unveil the function and regulatory mechanism of FOXM1 in the progression of HCC. Bioinformatics methods first analyzed the expression of FOXM1 in HCC tissues and then screened target genes downstream of FOXM1. Possible pathways of the target gene were specified through Gene Set Enrichment Analysis (GSEA). After using qRT-PCR to measure the expression of FOXM1 and its downstream regulatory gene SETDB1 in HCC tissues, ChIP and dual-luciferase assays were employed and verified the binding relationship between FOXM1 and the promoter of SETDB1. Then the effects of the FOXM1/SETDB1/Wnt pathway on the proliferation, migration, and invasion of HCC cells were profiled by CCK-8, colony formation, wound healing, and transwell assays. WNT and EMT-related protein expression levels were detected by western blot and immunofluorescence assay, respectively. The bioinformatics prediction showed that SETDB1 was the target downstream of FOXM1, and their binding relationship was verified by ChIP and dual-luciferase assays. Cell experiments showed that FOXM1 could enhance the proliferative, migratory, and invasive abilities of HCC cells through binding to SETDB1. Rescue assay suggested that the activation of key genes of the WNT pathway and EMT-related genes were part of the regulatory mechanism that FOXM1 bound to SETDB1. This study found that FOXM1 could bind with SETDB1 and hence activate the WNT signaling pathway to promote the malignant progression of HCC. It indicated that FOXM1 could be the possible target for treating HCC.


Profiles of drug use behavior change for adolescents in treatment.
This study was designed to replicate and extend previous research on post-treatment responding by identifying trajectories of change on the basis of an empirical classification strategy and to examine predictors of those change trajectories identified. Treatment response was examined for 232 adolescents with substance use disorders who participated in one of two randomized controlled trials evaluating family and cognitive behavioral interventions in an outpatient treatment setting. Cluster analysis was used to identify, empirically, homogeneous groups of individuals who display common internally consistent patterns of change over the course of treatment.


Comparative evaluation of Duragen® and skim milk extenders to enhance ram semen quality and fertility: A promising alternative in ovine artificial insemination.
This study aimed to investigate the effectiveness of Duragen® and skimmed milk (SM) extenders on the quality parameters, bacterial load and fertilization ability of stored ram semen. A total of 50 ejaculates from Sardi rams (n = 5) aged 2.5-3 years, were collected and stored in Duragen® and SM at 15°C. The motilities and velocity parameters generated by the CASA system were then evaluated at 0, 8 and 24 h of storage. Afterward, bacterial loads of sperm extended in Duragen® and SM were determined at 0, 5 and 24 h of incubation. In addition, ewes (n = 100) aged 2 years, have been chosen in the same herd. The selected ewes were then synchronized and inseminated using semen extended in Duragen® and SM and stored for 5 h at 15°C. The results revealed that total and progressive motilities, straight velocity (VSL), straightness (SRT), lateral head displacement (ALH) and beat cross frequency (BCF) were not affected by the extender type after 24 h of storage (p > .05). However, curvilinear velocity (VCL), velocity average path (VAP), linearity (LIN) and wobble (WOB) showed higher values in Duragen® compared with SM extender after 24 h of storage (p < .05). Bacterial loads were observed mainly in sperm stored in SM at 5 h (183 UFC/mL) and at 24 h (357 UFC/mL) of incubation. However, the only case showing a bacterial load in Duragen® is when the storage time attains 24 h (199 UFC/mL). Concerning fertility, sperm diluted in both extenders resulting in high fertility rates which reaches 66% and 73% for Duragen® and SM, respectively, with no statistical difference (p > .05). In summary, Duragen® extender decreased bacterial load in stored semen and maintained high ram sperm quality and fertility. These findings suggest that Duragen® extender could be used as SM alternative in ovine artificial insemination (OAI).


Driving habits in glaucoma patients.
Glaucoma is a progressive optic neuropathy leading to loss of visual function beginning with the peripheral visual field. One large population-based study found that individuals with visual impairment reported difficulties in performing most vision-dependent daily activities, including difficulty with driving. The objective of this retrospective cohort study was to investigate the driving habits of glaucoma patients and to determine the conformance of their visual acuity and visual fields with driving regulations. The charts of 20 patients followed in the Ophthalmology Department of Foch Hospital, Suresnes, Paris, France, with open angle glaucoma (mean visual field mean deviation of the worse eye: -15.5 dB; range -1.97 to -27 dB) and still driving, were reviewed. Data collected included visual acuity, type of glaucoma, slit lamp and fundus examination, most recent standard automated perimetry, and binocular visual field test results. Each patient was asked if he or she still drove on highways, and if he or she still drove at night. The driving habits of glaucoma patients were analyzed, and visual acuity and binocular visual fields were compared to French and European legal driving criteria. Thirteen patients (65%) with glaucoma were still driving on highways, and five (25%) at night. Seven patients (35%) were below French legal minimum visual acuity or visual field criteria. Glaucoma patients appear to self-regulate their driving habits by avoiding potentially difficult driving situations. Further studies with larger sample size are necessary to determine relationships between severity of visual impairment, severity of visual field defects, and the cessation of driving.


Sex-specific increase in susceptibility to metabolic syndrome in adult offspring after prenatal ethanol exposure with post-weaning high-fat diet.
Prenatal ethanol exposure (PEE) is an established risk factor for intrauterine growth retardation. The present study was designed to determine whether PEE can increase the susceptibility of high-fat diet (HFD)-induced metabolic syndrome (MS) in adult offspring in a sex-specific manner, based on a generalized linear model analysis. Pregnant Wistar rats were administered ethanol (4 g/kg.d) from gestational day 11 until term delivery. All offspring were fed either a normal diet or a HFD after weaning and were sacrificed at postnatal week 20, and blood samples were collected. Results showed that PEE reduced serum adrenocorticotropic hormone (ACTH) and corticosterone levels but enhanced serum glucose, insulin, insulin resistant index (IRI), triglyceride and total cholesterol (TC) concentrations. Moreover, the analysis showed interactions among PEE, HFD and sex. In the PEE offspring, HFD aggravated the decrease in ACTH and corticosterone levels and further increased serum glucose, insulin, triglyceride and TC levels. The changes of serum ACTH, glucose and IRI levels in the female HFD rats were greater than those in the male HFD rats. Our findings suggest that PEE enhances the susceptibility to MS induced by HFD in a sex-specific manner, which might be primarily associated with the neuroendocrine metabolic programming by PEE.


Distal jejunal obstruction due to Cryptococcus neoformans and rifampicin-resistant Mycobacterium tuberculosis co-infection: A case report.
Jejunal obstruction secondary to Cryptococcus neoformans and rifampicin-resistant Mycobacterium tuberculosis co-infection in HIV is not previously reported. This is a case of a 30-year-old HIV-positive male with severe headaches, a positive cerebrospinal fluid cryptococcal antigen assay, and elevated intracranial pressure requiring serial lumbar punctures and opioids. He developed constipation and abdominal distension, had partial jejunectomy and histopathology revealed Cryptococcus yeasts and caseous granulomas with Mycobacterium tuberculosis (TB). Post-operatively, rifampicin-resistant TB was detected in urine.


OTX1 compensates for OTX2 requirement in regionalisation of anterior neuroectoderm.
Otx genes play a relevant role in specification, maintenance and patterning of anterior neuroectoderm. OTX1 and OTX2 proteins share extensive codogenic similarity even though in OTX1 these regions of homology are separated by stretches of amino acid insertions. From 1 to 3 somites stage onwards, Otx1 and Otx2 are largely coexpressed, but only Otx2 is expressed during gastrulation. To determine whether OTX1 and OTX2 gene products share common biochemical properties, mouse models replacing Otx1 with Otx2 and vice versa have been generated. These studies have indicated a remarkable functional equivalence between the two proteins. Nevertheless, it was still debated whether OTX1 is functionally equivalent to OTX2 in early anterior neuroectoderm. To address this issue we generated a new mouse model (hOtx1(2FL)) replacing only the coding sequence and introns of Otx2 with the human Otx1 codogenic sequence. hOtx1(2FL/2FL) and hOtx1(2FL/-) mice were viable, fertile and exhibited an apparently normal behaviour. hOtx1 mRNA was correctly transcribed under the Otx2 transcriptional control and, similarly, the hOTX1 protein was properly distributed and quantitatively very similar if not identical to that of OTX2. Patterning and regionalisation of forebrain and midbrain were unaffected as revealed by the expression of diagnostic genes which are highly sensitive to reduction of OTX proteins, such as Fgf8, Pax2 and Gbx2.


Multiple depressive episodes and plasma postdexamethasone cortisol levels.
The hypothalamic-pituitary-adrenal (HPA) axis is dysregulated in many patients with major depressive disorder (MDD). To determine whether or not a past history of depressive episodes is associated with this dysregulation, we studied the relationships among number of past depressive episodes, number of previous hospitalizations for depression, and number of years since first depressive episode and biological markers of depression (postdexamethasone plasma cortisol levels and dexamethasone suppressor/nonsuppressor status). No significant relationships were detected.


Simple and practical sandwich-type enzyme immunoassay for human oxidatively modified low density lipoprotein using antioxidized phosphatidylcholine monoclonal antibody and antihuman apolipoprotein-B antibody.
To develop a simple and practical enzyme immunoassay (EIA) for oxidatively modified low density lipoprotein (Ox-LDL) in human blood, a biological marker of atherogenesis. A sandwich EIA suitable for the measurement of human Ox-LDL was developed using the mouse monoclonal antibody FOH1a/DLH3. This antibody, specific for oxidized phosphatidylcholine, was used as the capture antibody, and a horseradish peroxidase (HRP)-labeled goat anti-human apolipoprotein-B (Apo-B) IgG was used for detection. Copper-oxidized human LDL, prepared under controlled conditions, was used as a standard and the results of the EIA were expressed in arbitrary units (U/mL). This EIA meets all the requirements for use in routine clinical assays in terms of sensitivity (detection limit: 1 U/mL), reproducibility (total CV: 2.3-7.7%), accuracy (recovery: 90.6-103.8%), simplicity and rapidity (<4 h). Clinical performance of the assay was assessed by measurement of the Ox-LDL in the plasma of normal subjects (10.8 +/- 2.8 U/mL, mean +/- SD) and patients with coronary heart disease (CHD) (19.7 +/- 10.2). The present EIA had a sensitivity of 79% and a specificity of 75% for CHD. We have developed a new assay, suitable for the measurement of Ox-LDL in human blood, which meets the requirements for routine clinical assay.


Neurogenesis in the adult dentate gyrus after cortical infarcts: effects of infarct location, N-methyl-D-aspartate receptor blockade and anti-inflammatory treatment.
Stimulation of cell proliferation and neurogenesis in the adult dentate gyrus has been observed after focal and global brain ischemia but only little is known about the underlying mechanisms. We here analyzed neurogenesis in the dentate gyrus after small cortical infarcts leaving the hippocampal formation and subcortical regions intact. Using the photothrombosis model in adult rats, focal ischemic infarcts were induced in different cortical areas (sensorimotor forelimb and hindlimb cortex) and proliferating cells were labeled at days 3-14 after infarct induction with bromodeoxyuridine. At 2, 4, and 10 weeks after ischemia, immunocytochemistry was performed with immature neuronal (doublecortin), mature neuronal (neuronal nuclei antigen) and glial (calcium-binding protein beta S100beta) markers. When compared with sham-operated controls, animals with infarcts in the forelimb as well as hindlimb cortex revealed an increase in survival of newborn progenitor cells at four and 10 weeks after the insult with predominance at the ipsilateral side. Triple immunofluorescence and confocal laser scanning microscopy revealed an increase in neurogenesis in all groups that was more pronounced 10 weeks after the infarct. Application of the N-methyl-D-aspartate (NMDA)-receptor antagonist MK-801 during lesion induction significantly enhanced neurogenesis in the dentate gyrus. An even stronger increase in newborn neurons was observed after anti-inflammatory treatment with indomethacine during the first 16 days of the experiment. The present study demonstrates that small cortical infarcts leaving subcortical structures intact increase neurogenesis in the dentate gyrus and that these processes can be stimulated by N-methyl-D-aspartate receptor blockade and anti-inflammatory treatment.


Screening for attention-deficit/hyperactivity disorder in borderline personality disorder.
A valid screening instrument is needed to detect attention-deficit/hyperactivity disorder (ADHD) in treatment-seeking borderline personality disorder (BPD) patients. We aimed to test the performance of the widely-used Adult ADHD Self-Report Scale v1.1 screener (ASRS-v1.1). 317 BPD subjects were systematically assessed for comorbid ADHD and completed the ASRS-v1.1. 79 BPD patients also completed the Wender Utah Rating Scale (WURS-25). The prevalence of adult ADHD was of 32.4%. The overall positive predictive value of the ASRS-v1.1 was of 38.5%, the negative predictive value 77.0%, the sensitivity 72.8%, and the specificity 43.9%. Combining WURS-25 and ASRS-v1.1 improved sensitivity to 81.8% and specificity to 59.6%. Cross-sectional study on treatment-seeking patients. We found a high prevalence of ADHD using structured interviews. The ASRS-v1.1 was not a sensitive screener for identifying possible ADHD cases in a BPD population, with a high number of false positives. When combined with the WURS-25, it offered improved screening.


Maternal rheumatoid arthritis and systemic lupus erythematosus and risk of cryptorchidism and hypospadias in boys: a Danish nationwide study.
RA and SLE are the most prevalent autoimmune rheumatic diseases affecting young women. Both diseases are characterized by systemic inflammation that may affect placental function and fetal development during pregnancy, and both diseases are associated with adverse pregnancy and child outcomes. We investigated the associations between maternal RA or SLE and the two genital malformations, cryptorchidism and hypospadias. In this nationwide register-based study including all male singleton live births in Denmark from 1995 to 2016, we assessed the occurrence of cryptorchidism and hypospadias according to the prenatal disease-state of the mothers. Using Cox proportional hazards models we calculated adjusted hazard ratios, accounting for varying age at diagnosis. Among 690 240 boys, 1026 had a mother with RA and 352 had a mother with SLE. We found adjusted hazard ratios of 1.72 (95% CI: 1.15; 2.57) for cryptorchidism among boys born to mothers with RA and 1.46 (95% CI: 0.69; 3.06) for boys born to mothers with SLE, compared with the general population. As the number of hypospadias cases was low, multivariate analysis was not feasible. The crude hazard ratios were 0.51 (95% CI: 0.16; 1.58) and 1.00 (95% CI: 0.25; 4.03) for RA and SLE, respectively. Boys born to mothers with RA had higher risk of cryptorchidism, compared with unexposed boys. Boys born to mothers with SLE showed a similar tendency, however with less precision of the estimate. No conclusion could be reached on the risk of hypospadias, due to the low number of events.


Immunogenicity and safety of an indigenously developed DTPw hepatitis B combination vaccine in Indian infants.
To evaluate the safety and immunogenicity of an indigenous hepatitis B, diphtheria, tetanus and B. pertussis tetravalent vaccine (Shantetra) in comparison with Tritanrix HBTM in healthy Indian infants. Multicentric, randomized, single blind intention-to-treat study with 12-18 weeks of follow up period. 5 out patient departments at tertiary care referral centers across India. 151 infants were randomized in a 2:1 ratio to recruit 101 in the Shantetra and 50 in the Tritanrix HBTM groups respectively. A total of 136 subjects completed the study. No patients were withdrawn from the study due to any adverse effects. Recruited subjects were randomized to receive three doses of either of the two DTPw-Hepatitis B combination vaccines as per the EPI schedule. Monitoring the humoral immune response (seroconversion rates) induced by each antigenic component three to six weeks after the last dose of vaccine in both the groups. Seroprotective immune response was observed in 98.9% subjects for diphtheria, tetanus and hepatitis B components in the Shantetra group as compared to 95.5% subjects in the Tritanrix HB group. Anti pertussis antibody response was seen in 89% and 91.1% in the Shantetra and Tritanrix HB groups, respectively. The commonly observed adverse events in both the groups were, pain at injection site, mild fever and transient crying. The safety and immunogenicity of indigenously developed DTPwHepatitis B combination vaccine was demonstrated in the present study.


Continent urinary diversion in gynecologic oncology.
Pelvic exenteration is a salvage procedure used primarily for recurrent gynecologic carcinoma. Up to the present time, an ileal or colon conduit has been used for urinary diversion and the patient remains incontinent of urine. This is a preliminary report of nine patients with gynecologic carcinoma in whom a continent urinary diversion procedure was performed. A segment of distal ileum, the ascending colon, and part of the transverse colon are used to create the colonic reservoir. The segment of colon is opened along the tenia and folded onto itself. The walls of the ascending and transverse colon are anastomosed to detubularize this segment of bowel and eliminate the transient high pressure of the colon. Surgical staples are used for the anastomosis. The segment of ileum is tapered and three purse-string sutures (2-O silk) are placed at the level of the ileocecal valve to achieve continence. The short segment of ileum is then exteriorized as a stoma through which the patient catheterizes. Antirefluxing, non-tunneled ureterocolonic anastomoses are performed. The anterior wall of the reservoir is closed with absorbable staples. Postoperative urodynamic studies have shown maximum capacity of 750 ml and the area of continence to be at the ileocecal valve where the purse-string sutures are placed. All patients are continent and postoperative radiographs were negative for reflux. Follow-up was 6 to 12 months. The colonic reservoir is a capacious low-pressure system and warrants further clinical trials in patients with gynecologic cancer.


The maize preligule band is subdivided into distinct domains with contrasting cellular properties prior to ligule outgrowth.
The maize ligule is an epidermis-derived structure that arises from the preligule band (PLB) at a boundary between the blade and sheath. A hinge-like auricle also develops immediately distal to the ligule and contributes to blade angle. Here, we characterize the stages of PLB and early ligule development in terms of topography, cell area, division orientation, cell wall rigidity and auxin response dynamics. Differential thickening of epidermal cells and localized periclinal divisions contributed to the formation of a ridge within the PLB, which ultimately produces the ligule fringe. Patterns in cell wall rigidity were consistent with the subdivision of the PLB into two regions along a distinct line positioned at the nascent ridge. The proximal region produces the ligule, while the distal region contributes to one epidermal face of the auricles. Although the auxin transporter PIN1 accumulated in the PLB, observed differential auxin transcriptional response did not underlie the partitioning of the PLB. Our data demonstrate that two zones with contrasting cellular properties, the preligule and preauricle, are specified within the ligular region before ligule outgrowth.


Photoinactivation of Staphylococcus aureus using protoporphyrin IX: the role of haem-regulated transporter HrtA.
Light- and photosensitiser-based antimicrobial photodynamic therapy is a very promising approach to the control of microbial infections. How the phenotypic features of a microorganism affect its response to photosensitiser-based photokilling represents an area of substantial research interest. To understand the mechanisms governing the phenomenon of a strain-dependent response to photodynamic inactivation (PDI), we analysed the possible role of the membrane-located haem transporter HrtA in Staphylococcus aureus. We used a S. aureus strains with an inactivated component of the haem-regulated transporter, HrtA, along with its wild-type counterpart to determine differences in PDI outcome and photosensitiser uptake between the studied isogenic strains. We observed that a lack of HrtA protein potentiates the phototoxic effect towards S. aureus but only when extracellular protoporphyrin IX is used. The observed effect may depend on the function of the HrtA transporter but is likely to result from changed membrane properties following the absence of the protein in the membrane. This indicates that disturbing the membrane properties is an attractive method for improving the efficacy of the photodynamic inactivation of microorganisms.


Primary pulmonary malignant meningioma.
Primary pulmonary meningiomas are relatively rare and mostly benign. To exclude pulmonary metastasis of an intracranial meningioma, imaging studies of the brain should be performed. We believe that only one primary pulmonary malignant meningioma in which a metastasis from the brain was excluded has been reported. In this report we describe a second case with malignant features.


Obesity and the risk and outcome of infection.
The interactions between obesity and infectious diseases have recently received increasing recognition as emerging data have indicated an association between obesity and poor outcome in pandemic H1N1 influenza infection. Obesity is an established risk factor for surgical-site infections, nosocomial infections, periodontitis and skin infections. Several studies indicate that acute pancreatitis is more severe in the obese. Data are controversial and limited as regards the association between obesity and the risk and outcome of community-acquired infections such as pneumonia, bacteremia and sepsis and obesity and the course of HIV infection. As the cause-effect relationship between obesity and infection remains obscure in many infectious diseases, further studies are warranted. The consequences of obesity may have substantial effects on the global burden of infectious diseases.


Impact of COVID-19 on Global Surgery: Challenges and Opportunities.
The coronavirus disease 2019 pandemic has presented a unique set of challenges to the field of global surgery. In this perspective article, the authors discuss changes to the field in a peri- and post-coronavirus disease era with anticipated opportunities and challenges for patients and providers.


Self-Expanding Transcatheter Pulmonary Valve Implant in the Right Pulmonary Artery.
Newer self-expanding transcatheter pulmonary valves (TPVs) are approved for the treatment of severe pulmonary regurgitation in patients with large right ventricular outflow tracts. We present a patient with Tetralogy of Fallot whose right ventricular outflow tract was too large for self-expanding TPV, who was treated successfully with a self-expanding TPV in the right pulmonary artery. (Level of Difficulty: Advanced.).


Distal ureteric rupture caused by blunt abdominal trauma: A rare case report.
Ureteral trauma is a rare case and generally results from severe trauma events. A 6-year-old boy came with the chief complaint open wound in the lower right abdomen after falling from the bike. Abdominal MSCT with contrast showed the free liquid in the peritoneal cavity, and Retrograde Pyelogram showed the contrast extravasation. According to the algorithm, a surgical exploration must be performed because of the contrast extravasation. In this case, there found a total rupture of right distal ureter. Debridement was performed, and Double J Stent was implanted. This patient got treatment quickly so he didn't suffer disability and death.


Stability of TSH receptor antibody concentrations and comparability of its immunoassays.
Graves' Disease (GD) is an autoimmune form of hyperthyroidism where autoantibodies are directed against the TSH-receptor (TSH-receptor antibodies; TRAb). GD is suspected if TRAb concentrations are above a pre-specified cut-off value. TRAb concentrations are measured using immunoassays. This study aimed to compare the performance of the recently implemented Alinity immunoassay to the KRYPTOR and Cobas TRAb immunoassays. Left-over serum samples in which TRAb concentrations were measured (KRYPTOR) were used. First, TRAb stability at -20 °C for four to six years and up to five freeze-thaw cycles were assessed. Second, TRAb measurements (n = 436) were repeated using the Alinity and Cobas immunoassay and results (scored as positive/negative based on cut-off value) were compared. TRAb results were stable over five years and up to five freeze-thaw cycles. When comparing immunoassays, 86.2% of the results were similar. Total discrepancy differed between the immunoassays (5.4% Cobas vs Alinity, 8.8% Alinity vs KRYPTOR, 13.3 % Cobas vs KRYPTOR). The KRYPTOR immunoassay showed more negative TRAb results than Cobas and Alinity. The Alinity immunoassay showed comparable TRAb results, even though slightly more positive results compared to the KRYPTORand slightly more negative results compared to the Cobas immunoassay were seen.


Erratum to expanded criteria for active surveillance in prostate cancer: a review of the current data.
[This corrects the article DOI: 10.21037/tau.2017.08.23.].


The mechanisms of prednisone inhibition of inflammation in Crohn's disease involve changes in intestinal permeability, mucosal TNFalpha production and nuclear factor kappa B expression.
The clinical course of Crohn's disease after the induction of remission with medical therapy is characterized by unpredictable relapse. To evaluate three surrogate markers, intestinal permeability, mucosal TNFalpha and nuclear factor (NF)-kappaB/IkappaBalpha expression, in order to determine the relationship of these parameters to clinical relapse. Thirty patients with active Crohn's disease were treated with a 10 week course of prednisone using a tapering dosing regimen. Intestinal permeability (lactulose/mannitol [L/M ratio]) was determined at baseline and at the end of prednisone tapering. TNFalpha production and the levels of expression of NF-kappaB/IkappaBalpha were measured in colonic mucosal biopsies obtained after the induction of remission. Twenty-two patients (73%) achieved remission and 50% of patients experienced a clinical relapse during the ensuing 12 months. Treatment with prednisone resulted in a significant decrease in the L/M ratio. Of the patients that relapsed, 75% had a raised L/M ratio at the time of remission compared with 20% of patients with a normal L/M ratio (P < 0.008; hazard ratio = 6.094; CI 1.55, 17.43). Mucosal TNFalpha production was greater in relapsers compared with those who remained in remission. The levels of NF-kappaB in relapsers were significantly greater and levels of cytosolic IkappaBalpha were significantly lower compared with those measured in patients who remained in remission. These findings underscore the importance of incorporating biological parameters of inflammation in determining the clinical course of Crohn's disease.


A multi-camera dataset for depth estimation in an indoor scenario.
Time-of-Flight (ToF) sensors and stereo vision systems are two of the most diffused depth acquisition devices for commercial and industrial applications. They share complementary strengths and weaknesses. For this reason, the combination of data acquired from these devices can improve the final depth estimation accuracy. This paper introduces a dataset acquired with a multi-camera system composed by a Microsoft Kinect v2 ToF sensor, an Intel RealSense R200 active stereo sensor and a Stereolabs ZED passive stereo camera system. The acquired scenes include indoor settings with different external lighting conditions. The depth ground truth has been acquired for each scene of the dataset using a line laser. The data can be used for developing fusion and denoising algorithms for depth estimation and test with different lighting conditions. A subset of the data has already been used for the experimental evaluation of the work "Stereo and ToF Data Fusion by Learning from Synthetic Data".


A novel luteinizing hormone/chorionic gonadotropin receptor mutation associated with amenorrhea, low oocyte yield, and recurrent pregnancy loss.
To study the cause for poor oocyte yield, amenorrhea, and recurrent pregnancy loss in a patient undergoing IVF. Case report. University-affiliated private IVF clinic. A 33-year-old woman with amenorrhea, recurrent ovarian cyst formation, poor oocyte yield, and repeated chemical pregnancies after IVF treatments. The hCG stimulation test and luteinizing hormone/chorionic gonadotropin receptor (LHCGR) gene sequencing. The presence of LHCGR gene mutations. The patient had a markedly abrogated androgen response to 10,000 IU of hCG. A novel heterozygous inactivating mutation in exon 1 of the LHCGR gene was detected. This mutation was superimposed on a common LHCGR polymorphism. This novel mutation may provide a potential genetic mechanism for the poor oocyte recovery in some IVF cases. It is the first example of a heterozygous inactivating mutation in the LHCGR gene.


Pilot-scale testing of natural gas pipeline monitoring based on phase-OTDR and enhanced scatter optical fiber cable.
In this paper, we present the results of lab and pilot-scale testing of a continuously enhanced backscattering, or Rayleigh enhanced fiber cable that can improve distributed acoustic sensing performance. In addition, the Rayleigh-enhanced fiber is embedded within a tight buffered cable configuration to withstand and be compatible for field applications. The sensing fiber cable exhibits a Rayleigh enhancement of 13 dB compared to standard silica single-mode fiber while maintaining low attenuation of ≤ 0.4 dB/km. We built a phase-sensitive optical time domain reflectometry system to interrogate the enhanced backscattering fiber cable both in lab and pilot-scale tests. In the laboratory experiment, we analyzed the vibration performance of the enhanced backscattering fiber cable and compared it with the standard single-mode telecom fiber. Afterward, we field validated for natural gas pipeline vibration monitoring using a 4-inch diameter steel pipeline operating at a fixed pressure level of 1000 psi, and a flow rate of 5, 10, 15, and 20 ft/s. The feasibility of gas pipeline monitoring with the proposed enhanced backscattering fiber cable shows a substantial increase in vibration sensing performance. The pilot-scale testing results demonstrated in this paper enable pipeline operators to perform accurate flow monitoring, leak detection, third-party intrusion detection, and continuous pipeline ground movement.


WSe2 Homojunction p-n Diode Formed by Photoinduced Activation of Mid-Gap Defect States in Boron Nitride.
A single nanoflake lateral p-n diode (in-plane) based on a two-dimensional material can facilitate electronic architecture miniaturization. Here, a novel lateral homojunction p-n diode of a single WSe2 nanoflake is fabricated by photoinduced doping via optical excitation of defect states in an h-BN nanoflake upon illumination. This lateral diode is fabricated using a mechanical exfoliation technique by stacking the WSe2 nanoflake partially on the h-BN and Si substrates. The carrier type in the part of the WSe2 film on the h-BN substrate is inverted and a built-in potential difference is formed, ranging from 5.0 to 4.50 eV, which is measured by Kelvin probe force microscopy. The contact potential difference across the junction of p-WSe2 and n-WSe2 is found to be ∼492 mV. The lateral diode shows an excellent rectification ratio, up to ∼3.9 × 104, with an ideality factor of ∼1.1. A typical self-biased photovoltaic behavior is observed at the p-n junction upon the illumination of incident light, that is, a positive open-circuit voltage (Voc) is generated, that is, voltage obtained (at Ids = 0 V), and also a negative short-circuit current (Isc) is generated, that is, current obtained (at Vds = 0 V). The presence of built-in potential in the proposed homojunction diode establishes Isc and Voc upon illumination, which can be implemented for a self-powered photovoltaic system in future electronics. The proposed doping technique can be effectively applied to form planar homojunction devices without a photoresist for future electronic and optoelectronic applications.


Enhancing metaproteomics--The value of models and defined environmental microbial systems.
Metaproteomics--the large-scale characterization of the entire protein complement of environmental microbiota at a given point in time--has provided new features to study complex microbial communities in order to unravel these "black boxes." New technical challenges arose that were not an issue for classical proteome analytics before that could be tackled by the application of different model systems. Here, we review different current and future model systems for metaproteome analysis. Following a short introduction to microbial communities and metaproteomics, we introduce model systems for clinical and biotechnological research questions including acid mine drainage, anaerobic digesters, and activated sludge. Model systems are useful to evaluate the challenges encountered within (but not limited to) metaproteomics, including species complexity and coverage, biomass availability, or reliable protein extraction. The implementation of model systems can be considered as a step forward to better understand microbial community responses and ecological functions of single member organisms. In the future, improvements are necessary to fully explore complex environmental systems by metaproteomics.


Effect of rectal dilation in fecal incontinence with low rectal compliance. Report of a case.
This study was undertaken to determine the effect of rectal dilation in a patient with urge-type fecal incontinence and frequent bowel movements associated with low rectal compliance and capacity. Daily rectal balloon dilation was performed for a period of four weeks. The patient regained complete fecal continence with one to two daily bowel movements. Rectal compliance, capacity, and cross-sectional area increased by 37 to 136 percent. Nine months later the patient was still without symptoms. Rectal balloon dilation may be a therapeutic alternative in selected patients.


Restriction modification (RM) tests associated to additional molecular markers for screening prevalent MRSA clones in Brazil.
In this study, we associated the restriction modification (RM) tests to the polymerase chain reaction (PCR) detection of molecular markers (SCCmec III, seh, agr II-SCCmec IV, and lukSF) for revealing the main methicillin-resistant Staphylococcus aureus (MRSA) clones circulating in Brazil. This simple and rapid approach allowed a precise classification of the MRSA analyzed when compared with pulsed-field gel electrophoresis (PFGE) data.


Gustilo type IIIC open tibia fractures with vascular repair: minimum 2-year follow-up.
Salvage or amputation for grade 3C open fracture of tibia is not well responded question universally because of surgical innovations, cultural believes, difficulties in estimate the outcome, coasts, and different results in the literature. The aim of this study was to evaluate the surgical outcomes of Gustilo grade 3C open tibia fractures with at least two years follow-up in non-military adults. Twenty-two non-military patients with a mean age of 31.1 were operated with grade 3c open fractures at tibia level in last 10 years in our clinic. We evaluated them retrospectively and asked about their daily life, pain, and if present, about the wish for secondary amputation. We also asked if they would prefer a first day amputation rather than their present status. Mean operation time after the injury was 13 h. Seven patients had nerve injury. Mean operation number was 3.5. Eight patients (%36) (all due to circulatory problem) had to have amputation. All patients treated with temporary unilateral external fixation than converted to circular external fixators when soft tissue healing was completed. Two patients were reoperated because of deformity. Four patients needed revision surgery because of non-union. At long term follow, we had osteomyelitis in one patient. Scoring systems and the ischemic time are not the only predictors of amputation. The decision of the treatment mode should be made by the patient and the care team after discussing the options and outcomes rather than relying on a scoring system.


Agreement Between the Prevalence of Nonalcoholic Fatty Liver Disease Determined by Transient Elastography and Fatty Liver Indices.
Nonalcoholic fatty liver disease (NAFLD) is a global public health problem linked to the rising prevalence of obesity and metabolic disorders.1 Accurate estimates of NAFLD in populations are challenging because the gold standard for detection is liver biopsy, an invasive procedure that precludes its use in research settings.2 NAFLD can also be detected via noninvasive imaging, such as ultrasound, magnetic resonance imaging-determined proton density fat fraction, magnetic resonance spectroscopy, and the controlled attenuation parameter derived via transient elastography (CAP-TE).2 Given the complexities of imaging in population studies, however, many estimates have been based on calculated indices, such as the Fatty Liver Index (FLI)3 and the Hepatic Steatosis Index (HSI).4 Concern has been raised that the indices underestimate the prevalence of NAFLD,5 thus downplaying the scope of the public health challenge. Ability to examine whether these concerns are substantive has been provided by a recent study of the US population. Using data from the study, it was reported that the US prevalence of CAP-TE-determined NAFLD was 47.8%.6 The current analysis used data from the same national study to examine how well the fatty liver indices corresponded to CAP-TE-determined NAFLD. Because most persons with NAFLD reportedly have elevated alanine aminotransferase (ALT) levels,7 the correspondence between elevated ALT and CAP-TE was also examined.


[Choosing wisely together with the patient].
Within the framework of the Choosing wisely initiative of the German Society for Internal Medicine, all scientific societies associated with internal medicine were requested to highlight the unnecessary or underused medical tests or procedures out of the 60 defined examples, which are of immediate relevance within the doctor-patient interaction. Each of the 12 scientific internal medicine societies compiled and substantiated 2 recommendations. This resulted in a spectrum of important recommendations covering the entire field of internal medicine. In difficult situations these recommendations should contribute to developing and supporting the dialogue with patients on an evidence-based level.


Fine mapping and candidate gene analysis of gynoecy trait in chieh-qua (Benincasa hispida Cogn. var. chieh-qua How).
Gynoecy demonstrates an earlier production of hybrids and a higher yield and improves the efficiency of hybrid seed production. Therefore, the utilization of gynoecy is beneficial for the genetic breeding of chieh-qua. However, little knowledge of gynoecious-related genes in chieh-qua has been reported until now. Here, we used an F2 population from the cross between the gynoecious line 'A36' and the monoecious line 'SX' for genetic mapping and revealed that chieh-qua gynoecy was regulated by a single recessive gene. We fine-mapped it into a 530-kb region flanked by the markers Indel-3 and KASP145 on Chr.8, which harbors eight candidate genes. One of the candidate genes, Bhi08G000345, encoding networked protein 4 (CqNET4), contained a non-synonymous SNP resulting in the amino acid substitution of isoleucine (ATA; I) to methionine (ATG; M). CqNET4 was prominently expressed in the female flower, and only three genes related to ethylene synthesis were significantly expressed between 'A36' and 'SX.' The results presented here provide support for the CqNET4 as the most likely candidate gene for chieh-qua gynoecy, which differed from the reported gynoecious genes.


Total hydroxyproline in urine of 4 to 6 year-old children--an investigation on its relationship to growth and nutrition.
We analysed over a period of 30-32 days the daily total hydroxyproline and creatinine excretine in urine from 9 healthy, normally fed 4 to 6 year-old children (2 girls, 7 boys). The average urinary hydroxyproline excretion was 45.6 mg/24 hr, with a coefficient of variation of 25.6%. Urinary hydroxyproline for individual children showed distinct differences from day to day, which were independent of urine volume. There were significant differences between the mean values for urine hydroxyproline in individual children, which were independent of age. The average creatinine in urine was 346/24 hr with a coefficient of variation of 17.7%. The hydroxyproline-index did not define the nutritional state of these normally developed children on a normal diet. Dietary hydroxyproline contributed 7.4% to the total urinary hydroxyproline in our investigation. There was a close correlation between urine hydroxyproline excretion and growth velocity in each child.


Nonlinear Conditions for Ultradifferentiability.
A remarkable theorem of Joris states that a function f is C ∞ if two relatively prime powers of f are C ∞ . Recently, Thilliez showed that an analogous theorem holds in Denjoy-Carleman classes of Roumieu type. We prove that a division property, equivalent to Joris's result, is valid in a wide variety of ultradifferentiable classes. Generally speaking, it holds in all dimensions for non-quasianalytic classes. In the quasianalytic case we have general validity in dimension one, but we also get validity in all dimensions for certain quasianalytic classes.